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Utility of sleep nasendoscopy versus microlaryngotracheobronchoscopy in the diagnosis of paediatric upper airway obstruction

Published online by Cambridge University Press:  29 March 2021

G Khong ,
S Sood ,
H Jones ,
S Sharma  and
S De
G Khong
Affiliation:
Department of ENT – Head and Neck Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
S Sood
Affiliation:
Department of ENT – Head and Neck Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
H Jones
Affiliation:
Department of ENT – Head and Neck Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
S Sharma
Affiliation:
Department of ENT – Head and Neck Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
S De*
Affiliation:
Department of ENT – Head and Neck Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom
*
Author for correspondence: Ms Sujata De, Department of ENT – Head and Neck Surgery, Alder Hey Children's NHS Foundation Trust, LiverpoolL12 2AP, UK E-mail: su.de@alderhey.nhs.uk
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Abstract

Objective

To describe the utility of sleep nasendoscopy in determining the level of upper airway obstruction compared to microlaryngotracheobronchoscopy.

Methods

A retrospective observational study was conducted at a tertiary level paediatric hospital. Patients clinically diagnosed with upper airway obstruction warranting surgical intervention (i.e. with obstructive sleep apnoea or laryngomalacia) were included. These patients underwent sleep nasendoscopy in the anaesthetic room; microlaryngotracheobronchoscopy was subsequently performed and findings were compared.

Results

Twenty-seven patients were included in the study. Sleep nasendoscopy was able to induce stridor or stertor, and to detect obstruction at the level of palate and pharynx, including tongue base collapse, that was not observed with microlaryngotracheobronchoscopy. Only 47 per cent of patients who had prolapse or indrawing of arytenoids on sleep nasendoscopy had similar findings on microlaryngotracheobronchoscopy. However, microlaryngotracheobronchoscopy was better in diagnosing shortened aryepiglottic folds.

Conclusion

This study demonstrates the utility of sleep nasendoscopy in determining the level and severity of obstruction by mimicking physiological sleep dynamics of the upper airway.

Keywords

LaryngomalaciaRetrospective StudiesObstructive Sleep ApneaAirway ObstructionLaryngoscopes
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 4 , April 2021 , pp. 367 - 369
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Ms S De takes responsibility for the integrity of the content of the paper

Presented orally at the British Association for Paediatric Otolaryngology Annual Meeting, 20 September 2019, Edinburgh, Scotland, UK

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