title: Nasopharyngeal fiberendoscopy in children: a survey of current Italian pediatric otolaryngological practices.
abstract: BACKGROUND
  Nasopharyngeal fiberendoscopy (NFE) is the gold standard diagnostic procedure for adenoidal disease, but there is no consensus concerning the optimal technical approach. The aim of this study was to investigate the attitudes of Italian otolaryngologists towards diagnostic NFE in children, and the most widely used methods.
  
  
  METHODS
  Nine hundred randomly selected members of the two largest Italian otolaryngological scientific societies were e-mailed an anonymous web-based questionnaire containing 29 multiple-choice items regarding their opinions about, and use of NFE in children.
  
  
  RESULTS
  Questionnaires were returned by 764 clinicians (84.9 %). About 75 % declared they used NFE, but 35 % said they preferred alternative diagnostic methods. Most of the respondents considered NFE safe, but more than 80 % judged it to be poorly or only fairly well tolerated. Almost all declared that they generally use flexible, small-diameter instruments, with the patient seated on a chair or a parent's lap; 65 % use gentle restraining methods. Fewer than 50 % reported using a standardised hypertrophy grading system.
  
  
  CONCLUSIONS
  Italian otolaryngologists have a generally positive attitude towards using NFE in children. However, some have reservations, and there was no unanimous agreement concerning how it should be done. Given the medical advantages of NFE, it is essential to clarify the many still controversial aspects of the procedure by means of comparative studies and educational programmes.
authors.affiliation: Otolaryngology Unit, Department of Clinical Sciences and Community Health, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy. sara.torretta@gmail.com.
authors.forename: Sara
authors.initials: S
authors.lastname: Torretta
authors.affiliation: Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. paola.marchisio@unimi.it.
authors.forename: Paola
authors.initials: P
authors.lastname: Marchisio
authors.affiliation: Academic Oncologic Department, Otolaryngology Service, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy. giovanni.succo@unito.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Succo
authors.affiliation: Otolaryngology Unit, Department of Clinical Sciences and Community Health, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy. pasquale.capaccio@unimi.it.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Capaccio
authors.affiliation: Otolaryngology Unit, Department of Clinical Sciences and Community Health, University of Milan, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122, Milan, Italy. lorenzo.pignataro@unim.it.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Pignataro
mesh_terms: D003430:Cross-Sectional Studies; D004724:Endoscopy / Q000379:methods*; D005336:Fiber Optic Technology; D006801:Humans; D007558:Italy; D010036:Otolaryngology; D010372:Pediatrics / Q000379:methods*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012955:Societies, Medical; D011795:Surveys and Questionnaires