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Use of Rigid and Flexible Bronchoscopy Among Pediatric Otolaryngologists
Seth Cohen, MPH, MD;
Harold Pine, MD;
Amelia Drake, MD
Arch Otolaryngol Head Neck Surg. 2001;127:505-509.
Objective To explore how rigid and flexible bronchoscopy are used in pediatric
otolaryngologic practice.
Design Survey.
Participants Members of the American Society of Pediatric Otolaryngology who practice
in the United States and Canada and were listed in the membership directory
were eligible. Of the 206 members, 24 practicing outside the United States
or Canada and 11 without an e-mail address or a fax machine were excluded.
Hence, a questionnaire was e-mailed or faxed to 171 pediatric otolaryngologists.
Main Outcome Measures Questions concerned the practice setting, type and number of bronchoscopies,
indications, complications, and medicolegal cases.
Results Responses were received from 120 subjects (70.2%), with 3 retired and
2 practicing only otology, leaving 115 respondents who completed at least
some of the questionnaire. Rigid and flexible bronchoscopy were performed
by 72.7% (56/77) of those in academic settings and by 71.1% (27/38) of those
in group or solo practices. In the last 12 months, approximately 10 454
total bronchoscopies were performed, with 2052 flexible and 9117 rigid bronchoscopies.
Stridor, suspected foreign body inhalation, and laryngomalacia were the most
common indications for bronchoscopy. Of the 83 respondents practicing rigid
and flexible bronchoscopy, 25 (30.1%) used both instruments to manage complex
or repeated foreign bodies, 25 (30.1%) used both to manage patients with cystic
fibrosis, and 15 (18.1%) used both to manage simple foreign bodies. Complications
were reported by 15.7% of the respondents, the most common being arrhythmia.
Familiarity with a case resulting in medicolegal action was reported by 32.2%
of the respondents.
Conclusions Rigid and flexible bronchoscopy have multiple uses in pediatric otolaryngologic
practice. Also, flexible bronchoscopy appears to be emerging as a more frequently
used diagnostic and therapeutic tool.
From the Division of Otolaryngology, University of North Carolina School
of Medicine, Chapel Hill. Dr Cohen is now with the Department of Otolaryngology,
Vanderbilt School of Mediicine, Nashville, Tenn.
Corresponding author: Seth Cohen, MPH, MD, 5025 Hillsboro Rd, Apt
7D, Nashville, TN 37215 (e-mail: seth.cohen{at}mcmail.vanderbilt.edu).
Reprints: Amelia Drake, MD, Division of Otolaryngology, University of North
Carolina School of Medicine, 610 Burnette-Womack, Campus Box 7070, Chapel
Hill, NC 27599-7070 (e-mail: drakeaf{at}med.unc.edu).
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