Accuracy and safety of tracheoscopy for infants in a tertiary care clinic.
OBJECTIVE
To assess the diagnostic accuracy and safety of office-based tracheoscopy when combined with flexible fiberoptic laryngoscopy (FFLT). Flexible laryngoscopy on infants is routinely performed by otolaryngologists in the clinic. The addition of tracheoscopy may improve overall airway assessment but is rarely performed due to the suspected risk of airway compromise.


METHODS
A 6-year retrospective medical record review.


METHODS
Tertiary care hospital.


METHODS
Thirty-one infants younger than 1 year with complete data from preoperative FFLT and microlaryngoscopy and bronchoscopy (MLB) were examined.


METHODS
Results from 241 MLB procedures were reviewed.


RESULTS
Laryngomalacia (LM) and tracheomalacia (TM) were identified more often by FFLT than by MLB. In particular, the detection rate for LM and TM by MLB, as seen preoperatively by FFLT, was 79% and 61%, respectively. Compared with FFLT, MLB accurately diagnosed the severity of LM and TM only 55% and 65%, respectively, of the time. Fiberoptic laryngoscopy revealed synchronous airway lesions in 62% of infants with LM, while MLB discovered synchronous airway lesions in 54%. Static airway lesions were more frequently diagnosed with MLB. No respiratory events occurred during FFLT.


CONCLUSIONS
In an appropriate patient, FFLT is a safe and effective diagnostic tool for common infant tracheal and laryngeal abnormalities. Detection and characterization of dynamic airway lesions is better achieved by FFLT than by MLB.
Hartzell
Larry D
LD
University of Arkansas for Medical Sciences, Department of Otolaryngology, 4301 W Markham, Slot 543, Little Rock, AR 72205, USA. ldhartzell@uams.edu
Richter
Gresham T
GT
Glade
Robert S
RS
Bower
Charles M
CM
D001999:Bronchoscopy; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007818:Laryngeal Diseases / Q000175:diagnosis*; D007828:Laryngoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D012189:Retrospective Studies; D012449:Safety; D014132:Trachea / Q000002:abnormalities*; D014133:Tracheal Diseases / Q000175:diagnosis*