Why do children require airway evaluations?

Children may require a telescopic examination of the voice box (larynx) and windpipe for a variety of reasons.  The three main reasons are:

Breathing problems

  • Noisy and/or difficult breathing (stridor) in a child
  • Children unable to breathe on their own, requiring a breathing tube and ventilator
  • Objects accidentally lodged in the airway (airway foreign body)
  • Recurrent croup

Voice problems

  • Voice concerns such as hoarseness

Swallowing difficulties

  • Difficulty swallowing certain consistencies of food
  • Difficulty swallowing liquids

What is a microlaryngoscopy and how is it done?

Examination of the voice box can be done with a flexible scope passed through the nose. This examination can be done in the office.

If a rigid scope is used, the examination is done either in the office or in the operating room. This type of scope is passed through the mouth.

While office evaluations are good for evaluating most forms of hoarseness, a rigid examination allows a better, more magnified view of most vocal cord abnormalities and what might be required to treat the problem.  Treatment of vocal cord growths, swallowing problems, or voice box masses is best evaluated by a rigid scope examination.

Flexible voice box examination (laryngoscopy) is done in the office with topical anesthesia.  The examination is usually done with the child sitting upright. The examination takes  less than 5 minutes to complete.  Risks for this type of procedure are minimal, with the most common risk being a nosebleed.

Rigid laryngoscopy is done in the operating room with the child asleep with a mask placed on the face.  A tooth guard is placed across the upper teeth and a metal scope is passed through the mouth down to view the voice box.  Microscopes and telescopes are used to thoroughly examine the voice box (larynx), upper windpipe (trachea), and upper esophagus.  Abnormalities identified during the examination may also be treated through the scope during the same procedure.

What is a bronchoscopy and how is it done?

Most often done with a rigid scope in conjunction with microlaryngoscopy, bronchoscopy is a more detailed examination of the windpipe and its first series of branches into the right and left lungs.  It also allows certain problems to be treated when identified, such as removal of a foreign body from the windpipe.

A rigid bronchoscope is a metal breathing tube passed through the mouth with the child asleep.  Oxygen and anesthetic gas is passed through the scope, while a bright light and telescope contained in the center of the scope are used to thoroughly examine the windpipe and its main branches.

Flexible bronchoscopy is also sometimes used to evaluate the windpipe in children who are not good candidates for the rigid scope, or who have had a tracheotomy (breathing tube in the neck).

For more information or to schedule an appointment, call 404-255-2033.