[Flexible fiberoptic bronchoscopy in pediatrics--an analysis of 420 examinations].
Over a 4-year period we performed 420 endoscopic investigations in 262 patients (aged 1 day-26 yrs) under sedation and local anesthesia, using several different flexible instruments; repeat procedures were performed in 58 children. The most common indications for diagnostic endoscopy were tracheostomy evaluation (27.1%), non-specific chest x-ray changes (13.8%), stridor (12.4%), atelectasis (7.9%), and the sampling of airway secretions or cells by bronchoalveolar lavage (5.5%); indications for 17 therapeutic endoscopies (4%) included the removal of airway secretions and mucus plugs, and aid in difficult intubations. Bronchomalacia (46X), tracheomalacia (41X), obstructing granulation tissue (36X), and laryngomalacia (35X) were the most common diagnoses; in addition, subglottic stenosis was found in 13, a subglottic hemangioma in 5, vocal cord paralysis in 5 and an endobronchial foreign body in 5 children. Findings were normal in 39 (9.3%) cases. A relevant diagnosis was established on 73.7% of all investigations. The diagnostic yield was highest in patients with stridor, persistent wheezing, atelectasis, non-specific chest x-ray changes, and in patients with a tracheostomy. The success rate of therapeutic procedures was 70.6%. Minor complications occurred in altogether 4.3% of cases; all were completely and rapidly reversible. Flexible fiberoptic bronchoscopy is a safe and valuable diagnostic and therapeutic tool for the management of infants and children with respiratory problems.
Eber
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Klinische Abteilung für Pulmonologie und Allergologie, Universitäts-Kinderklinik, Graz.
Zach
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D000293:Adolescent; D000328:Adult; D000402:Airway Obstruction / Q000209:etiology* / Q000628:therapy; D020680:Bronchoscopes; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004867:Equipment Design; D005260:Female; D005336:Fiber Optic Technology / Q000295:instrumentation*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012135:Respiratory Sounds / Q000209:etiology*; D012140:Respiratory Tract Diseases / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D012142:Respiratory Tract Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D014139:Tracheostomy / Q000295:instrumentation
Flexible fiberoptische Bronchoskopie in der Pädiatrie--Eine Analyse von 420 Untersuchungen.