The use of nasofibrolaryngoscopy during respiratory assessment in children

Abstract

Airway obstruction is a serious and common problem in pediatric practice. The airways' gold standard assessment occurs through nasofibrolaryngoscopy, a fast, low-cost endoscopic examination that suggests the diagnosis and allows for early treatment. We aim to evaluate the main characteristics of children undergoing nasofibrolaryngoscopy to characterize their profile, the indications for the examination, and the most common laryngeal and tracheal abnormalities. This retrospective study was conducted by analyzing medical records of children who underwent nasofibrolaryngoscopy between 2015 and 2017 in a reference hospital in otorhinolaryngology. The sample consisted of patients who had a tracheoscopy or nasofibrolaryngoscopy code in the hospital's database. Three hundred nineteen medical records were reviewed using the data collection instrument, and 90 were excluded. The variables analyzed were age, sex, previous diseases, indication for the exam, birth weight, current weight, diagnosis and laryngeal/tracheal findings. We evaluated 224 children with an average age of 40.8 months. The malacias were among the main findings during the examination (laryngomalacia and/or pharyngomalacia), with 27.3%. Patients who presented stridor as the main indication, representing 30.8% of the sample, were evaluated separately, which is the main indication for performing nasofibrolaryngoscopy. The patients' mean age was 11.4 months, and the most common finding (57.9%) was the malacias (laryngomalacia and/or pharyngomalacia). Most patients who underwent nasofibrolaryngoscopy had laryngeal or tracheal alterations, showing the importance of knowing their profile to be diagnosed and treated as soon as possible.