Direct Flexible Fiberoptic Nasopharyngolaryngoscopy
At Dr. Mete İnançlı’s office we believe parents and guardians can contribute to success of this noninvasive test. Please read the following information to learn about the test and how can you help.
Facts about flexible fiberoptic nasopharyngolaryngoscopy
- Flexible endoscope is a quick, effective way for ENT doctor to get a look at your child’s airway, including nose, the throat and the voice box.
- Older children (over 8 years old) can handle the flexible endoscopy, but it can be difficult for very young children (under 5 years) to cooperate with the test. If your child seems not to cooperate with the test a special computer application is recommended for the child to play for 3 days prior to the test. This application will help the child to personalize the test and obey the orders during the test.
- Doctor might ask for flexible endoscopy if your child has;
- Problems swallowing, hoarseness or reflux(Laryngopharyngeal reflux, Gastroeasophageal reflux)
- Noisy and difficult breathing (stridor) not related to tonsils of asthma
- Inhaled a foreign object or swallowed a caustic liquid
- Had a surgery or planned a surgery to the nose and/or throat(adenotonsillectomy)
- A tumor suspicion in his or her airway
- A neck breathing tube, also called tracheostomy to check the size and the position.
- In a flexible endoscopy, the ENT doctor uses a thin tube with fiberoptic system allows examining the child’s airway, including the larynx and the nasal passages.
- The ENT doctor might use a topical anesthetic- a medication applied directly inside the nose to numb it- and/or a decongestant to reduce swellin in the nasal passages for this test.
- The test takes about 15 minutes.
What is flexible fiberoptic nasopharyngolaryngoscopy?
Flexible laryngoscopy enables the doctor to get an immediate look at your child’s throat and nasal passages. Flexible tracheoscopy through a pre-existing tracheostomy tube enables the doctor to get an immediate look at your child’s windpipe.
The flexible laryngoscopy often can be done without any medication at all, but sometimes a topical anesthetic and/or a decongestant may be used. The topical anesthetic is applied directly to the nose to numb it. The decongestant helps open up swollen (stuffy) nasal passages. Because the anesthetic and/or the decongestant are the only medications that might be needed, the flexible laryngoscopy can be done right in the doctor’s office during your child’s ENT appointment.
The doctor will be looking for inflammation (swelling), infection, foreign objects or other abnormal conditions in order to determine the best treatment for your child.
The flexible laryngoscope or “scope” consists of an eyepiece and a fiber-optic light enclosed in a thin, flexible tube. The scope looks like a strand of black spaghetti or like an elephant trunk with a tiny light on the end of it. The scope is inserted through the nose, and can be moved around to help the doctor see all areas of a child’s nasal passages and throat.
Laryngoscopy is a safe way for doctors to examine these internal body parts; however, there are some risks involved. Although rare, these risks include possible swelling in the voice box requiring special treatment and overnight observation; voice box injury; or infection, requiring surgical drainage and antibiotics. A nosebleed is also possible from the passing of the scope. Your child’s doctor will discuss these risks with you prior to your child’s test.
Because flexible laryngoscopy may trigger your child’s gagging reflex, your child should not have the test done on a full stomach.
For all children: In the 2 hours before your scheduled arrival time, give only clear liquids. Clear liquids include water, Pedialyte®, Kool-Aid® and apple juice.
Do not give your child any medication containing aspirin or ibuprofen for the 10 days before the test.
Do not give your child any natural supplements or homeopathic therapy for the 10 days before the test.
Make sure you have non-aspirin children’s pain reliever (Tylenol® or acetaminophen), and a thermometer at home for after the test.
Buy juices, clear soups, and soft, bland foods like bread, rice and oatmeal to have at home after the test.
A Parent’s/Guardian’s Role During the Test
The most important role of a parent or guardian is to help your child stay calm and relaxed before the test. The best way to help your child stay calm is for you to stay calm.
You may stay with your child and hold his or her hand for reassurance during the test.
Your child may bring along a “comfort” item, such as a stuffed animal or “blankie,” to hold during the test.
The doctor might give a medication to dry up any swollen lining in your child’s nose and throat, and may suction the nasal cavities with a thin, flexible suction catheter. Depending on your child’s age, a topical anesthetic might be sprayed in your child’s nose to numb it.
When your child’s anterior (front) nasal cavities are numb, the doctor will put the thin, flexible scope into your child’s nose and thread it down the throat.
The doctor also might swab or spray a medication inside your child’s nose that dilates the nasal passages to provide a better view of the airway.
The doctor will thoroughly examine your child’s nasal passages, throat and voice box.
Your child might gag for a moment as the scope is passed down his or her throat.
Special instruments may be used to remove foreign objects or to take tissue samples (biopsies).
After the test, the doctor will discuss the results with you and, together, you will plan for the best interests of your child. The plan may include additional tests, X-rays(usually radiation is avoided in our diagnostic skills but in some cases like a suspicious tumoral mass), surgery, hospitalization, office visits, medication, a special diet or consultations with other specialists.
After the Test
Your child may resume normal activities after the test. After a flexible laryngoscopy, you might notice some of the following signs. These symptoms are normal:
Your child might have a sore throat and some hoarseness and or a cough for a few days. Sucking on Popsicles® or gargling with warm, mildly salty water might help.
Your child might have some mild throat pain. You may give your child Tylenol® or acetaminophen, as directed for your child’s age. DO NOT give aspirin, Advil®, Motrin®, Aleve®, or ibuprofen.
Warning Signs After Flexible Laryngoscopy
Although most children have no problems after the flexible laryngoscopy, you should immediately call your child’s ENT doctor, pediatrician or Children’s Hospital test nurse if your child has any of these symptoms:
- Large amounts of blood, or bleeding for 24 hours
- Fever higher than 38˚ C
- Severe pain
- Severe nausea or vomiting, or can’t keep clear liquids down
- Breathing trouble
- Rashes anywhere on his or her body
If your child has any special needs or health issues you feel the doctor needs to know about, please call Dr Mete İnançlı’s Office before the test and ask to speak with doctor directly. It is important to notify us in advance about any special needs your child might have.
Assoc. Prof. Dr. Mete İnançlı
10 Hasan Arseven Sok, Akay Plaza, Floor:1, Flat:1, Ortakoy, Nicosia
(Opposite the Dr. Burhan Nalbantoğlu State Hospital in Nicosia)