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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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