Conscious sedation in pediatric speech endoscopy.
OBJECTIVE
Speech nasoendoscopy is one of the gold standards for evaluating velopharyngeal insufficiency. The vast majority of pediatric patients are able to tolerate this procedure within the clinic under local anesthetic. However, a select group of pediatric patients is unable to cooperate with the examination. Conscious sedation is commonly used in pediatrics to aid in patient tolerance and cooperating with selected procedures. Conscious sedation has never been reported in the literature for use in speech endoscopy. The purpose of this study is to describe a technique for performing sedated speech endoscopy and to review our experience with sedated speech endoscopy in a selected group of patients who were unable to cooperate with examination under local anesthesia alone.


METHODS
A retrospective chart review was performed of pediatric patients between the ages of 2 and 15 who underwent conscious sedation for the speech nasoendoscopy. All examinations were performed at a tertiary care pediatric hospital. Sedation agent, tolerance of procedure, success of procedure, and complications associated with the procedure were recorded.


RESULTS
Fifty-seven sedated speech endoscopies were evaluated. Adequate examinations were obtained in 93% of patients overall and 100% of the patients evaluated while sedated with nitrous oxide. Complication rates and post-endoscopy speech management are reported.


CONCLUSIONS
Sedated speech endoscopy is a promising modality for evaluating velopharyngeal insufficiency in the pediatric population that may not otherwise be able to cooperate with examination in the clinic.
Heman-Ackah
Selena E
SE
Department of Otolaryngology, University of Minnesota, Children's Hospitals and Clinics of Minnesota, United States.
Sidman
James
J
Lui
Meixia
M
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016292:Procedural Sedation / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009609:Nitrous Oxide / Q000494:pharmacology; D009666:Nose; D012189:Retrospective Studies; D018570:Risk Assessment; D017751:Safety Management; D013064:Speech Disorders / Q000175:diagnosis* / Q000209:etiology; D014681:Velopharyngeal Insufficiency / Q000150:complications / Q000175:diagnosis*
D009609:Nitrous Oxide