Upper airway abnormalities detected in children using flexible bronchoscopy.
OBJECTIVE
Rapid anatomical evaluation is essential to establish the severity of cases with upper respiratory obstruction and to define the degree of respiratory distress. Detailed airway endoscopy is required in most patients, not only for diagnosis, but also to treat the condition. In this study, as two of the largest paediatric pulmonology centres in Turkey, we reviewed the data of our bronchoscopy patients, and aimed to document the upper airway abnormalities that we detected during these procedures.


METHODS
A retrospective analysis was made of the records of 1076 paediatric cases with pulmonary/airway disease who had undergone flexible bronchoscopy between 2007 and 2011.


RESULTS
Upper airway malacia disorders were the most common (79.6%, n=259) bronchoscopic findings detected in the patients. The other most common pathologies were laryngeal edema (12.9%, n=42), external tracheal compression (12.3%, n=40), subglottic stenosis (4.0%, n=13), tracheal stenosis (2.8%, n=9), and vocal cord paralysis/irregularity (2.8%, n=9). The mean duration of symptoms was shortest in patients with vocal cord paralysis, and longest in patients with tracheal nodules (p<0.001).


CONCLUSIONS
Paediatricians should keep in mind the possibility of malacia disorders and other congenital and acquired upper airway abnormalities in children with chronic respiratory problems. Diagnosis of underlying diseases, as soon as possible, permits the withdrawal of antibiotics or antiasthmatic drugs often used unnecessarily for long periods to treat these children.
Department of Pediatric Pulmonology, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Investigation Hospital, Istanbul, Turkey. midyatlev@yahoo.com
Levent
L
Midyat
Erkan
E
Çakır
Arif
A
Kut
D000367:Age Factors; D000402:Airway Obstruction / Q000209:etiology* / Q000473:pathology* / Q000628:therapy; D001999:Bronchoscopy; D002648:Child; D005260:Female; D006801:Humans; D055092:Laryngomalacia / Q000150:complications / Q000473:pathology* / Q000628:therapy; D007829:Laryngostenosis / Q000150:complications / Q000473:pathology* / Q000628:therapy; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014135:Tracheal Stenosis / Q000150:complications / Q000473:pathology / Q000628:therapy; D055089:Tracheobronchomalacia / Q000150:complications / Q000473:pathology* / Q000628:therapy; D014421:Turkey