title: Alternative agents to prevent fogging in head and neck endoscopy.
abstract: BACKGROUND
  The essential factor for diagnosis and treatment of diseases in head and neck endoscopy is the visibility of the image. An anti-fogging agent can reduce this problem by minimizing surface tension to prevent the condensation of water in the form of small droplets on a surface. There is no report on the use of hibiscrub(®) or baby shampoo to reduce fogging in the literature. The objective of this study was to compare the efficacy between commercial anti-fogging agent, hibiscrub(®) and baby shampoo to reduce fogging for the use in head and neck endoscopy.
  
  
  METHODS
  The study was conducted at the Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University in August 2010. Commercial anti-fogging agent, baby shampoo and hibiscrub(®) were applied on rigid endoscope lens before putting them into a mist generator. The images were taken at baseline, 15 seconds, 30 seconds and 1 minute. The images' identifiers were removed before they were sent to two evaluators. A visual analogue scale (VAS) was used to rate the image quality from 0 to 10.
  
  
  RESULTS
  The difference in mean VAS score between anti-fogging agent, baby shampoo and hibiscrub(®) versus no agent were 5.46, 4.45 and 2.1 respectively. The commercial anti-fogging agent and baby shampoo had most protective benefit and performed significantly better than no agent (P = 0.05).
  
  
  CONCLUSIONS
  Baby shampoo is an effective agent to prevent fogging during head and neck endoscopy and compares favourably with commercial anti-fogging agent.
authors.affiliation: Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand .
authors.forename: Patorn
authors.initials: P
authors.lastname: Piromchai
authors.forename: Pornthep
authors.initials: P
authors.lastname: Kasemsiri
authors.forename: Sanguansak
authors.initials: S
authors.lastname: Thanaviratananich
keywords: endoscopy; fogging; shampoo