[Optic fiber endoscopy in childhood with facial mask]

Flexible fibroscopy is the method of choice in the diagnosis of upper airway (UA) pathologies. Some Authors believe that it should be carried out under local anaesthesia even in children less than one year of age. In this article, the Authors report on their experience with general anaesthesia, using an airway mask that simultaneously allows the flexible endoscope to be inserted and the patient to be ventilated. The study was carried out in the period 2000-2001 in 32 subjects, 18 males and 14 females between 2 and 12 months of age who presented different degrees of stridor and dyspnoea. 18 patients were affected by laryngomalacia, 6 presented bilateral paralysis of the vocal cords, 3 had a paralysis of the left vocal cord, 3 were suffering from congenital anomalies of the epiglottis and 2 had normal larynx from the point of view of morphology and motility. The method described is easy to perform and allows the subglottid area to be carefully evaluated, prolonging, if necessary, procedure time without risking hypoventilation-induced hypoxemia; carrying out the examination on a sedated patient furthermore reduces the likelihood of complications. The Authors therefore recommend that in all infants under one year of age, endoscopy of the upper airways be effected under general anaesthesia with an airway mask, reserving the execution of the same procedure under local anaesthesia to cases involving older children.