Bhat N, De R, Zeiton H
West Midlands Rotation in Otolaryngology, Edgebaston, Birmingham, United Kingdom.
Rev Laryngol Otol Rhinol (Bord). 2000;121(1):31-5.
To review all paediatric endoscopies performed in a tertiary referral unit over a three-year period.
Retrospective analysis of case-notes of all paediatric endoscopies performed between May 1993 and June 1996.
333 paediatric airway endoscopies were performed on 146 children, of which 52% were GP referrals and the remainder secondary referrals. 70% were diagnostic endoscopies, 30% therapeutic procedures, with the commonest indication being stridor and respiratory distress (82%). Routine chest radiographs, lateral neck X-rays, and barium swallows were unhelpful in the management of the commoner upper-airway conditions. The commonest findings were laryngomalacia (44%) and subglottic stenosis (22%) and 17% of all cases had multiple airway abnormalities. Tracheotomy was performed on 18.4%, laryngotracheoplasty on 7.5%, and laryngotracheal reconstruction on 2.5%. There were no major complications in this series.
All children with airway symptoms should have a thorough rigid-endoscopic evaluation of their upper and lower airways. Radiology has a limited role in the diagnosis of the more common airway pathologies. These patients need to be assessed and managed in regional centres.
回顾一家三级转诊单位在三年期间进行的所有儿科内镜检查。
对1993年5月至1996年6月期间进行的所有儿科内镜检查病例记录进行回顾性分析。
对146名儿童进行了333次儿科气道内镜检查，其中52%是由全科医生转诊，其余为二级转诊。70%为诊断性内镜检查，30%为治疗性操作，最常见的指征是喘鸣和呼吸窘迫（82%）。常规胸部X光片、颈部侧位X光片和吞钡检查对较常见的上气道疾病的处理并无帮助。最常见的发现是喉软化（44%）和声门下狭窄（22%），所有病例中有17%存在多种气道异常。18.4%的患儿进行了气管切开术，7.5%进行了喉气管成形术，2.5%进行了喉气管重建术。该系列中无重大并发症。
所有有气道症状的儿童都应接受对上、下气道的全面硬质内镜评估。放射学在较常见气道疾病的诊断中作用有限。这些患者需要在区域中心进行评估和管理。
