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.