Materials & Methods:
This is a single center retrospective observational study conducted in Amrut Medical foundation, Panvel, Maharashtra. All children less than 5 years old with clinical complains of stridor admitted in our hospital were enrolled in the study. FB was done in children in all these patients having stridor with or without other respiratory findings like wheezing, respiratory distress and cyanosis. Demographic characteristics, symptoms, physical examination on presentation, FB findings, presence of associated co-morbidities were obtained from the patients’ medical records. All these findings were assembled in a tabular format and the data was analyzed.
FB was performed by the same pulmonologist with a flexible bronchoscope (Pentax videoscope 3.5 with working port 1.2mm). The procedure was explained to the parents of the selected children and consent was taken. Before every procedure, both the nasal cavities were examined and the wider nostril was selected for introduction of FB. 2% Lignocaine jelly was used as a topical anesthetic agent which was introduced in the nasal cavity before the procedure. The child was given intravenous sedation with IV Propofol or IV Midazolam before initiation of the procedure. All emergency drugs and equipments were kept bedside. The child was continuously monitored for heart rate, respiratory rate, pulse oximetry and non-invasive blood pressure during the procedure. Continuous Oxygen was delivered via nasal cannula in order to keep SpO2above 92%.
FB was performed through trans-nasal approach while the patient was breathing spontaneously and under conscious sedation with the above-mentioned drugs. The anatomy of nose, nasopharynx and larynx were noted. Active movement of the vocal cords were observed. After completing the evaluation of the vocal cord movement, injection 2% lignocaine was flushed through the port of FB over the vocal cords as local anesthesia. Gradually the decreased movement of vocal cord was observed and then the scope was negotiated into the trachea to observer the abnormalities of trachea-bronchial tree.