© Borgis - New Medicine 3/1999, s. 22-23
Grażyna Eberhardt, Danuta Chojnacka-Wądołowska
Application of videolaryngoscopy in laryngopathy diagnostics in children, based on phoniatric clinic, at practice the Children´s Memorial Health Institute
Audiology, Phoniatrics and Laryngology Institute of the Children´s Memorial Health Institute
Director: Barbara Bułat, M.D.
The study illustrates the usefulness of videolaryngoscopic examination in laryngopathy diagnostics, as well as the advantages of applying this method in children based on our own experience. It also describes some cases where videolaryngoscopic examinations enabled to make a proper diagnosis, a decision on the most appropriate treatment, evaluation of treatment progress, or the extent of improvement in the patient´s health.
The aim of this paper is to present our experience in applying videolaryngoscopy in laryngopathy diagnostics in children, and to present several cases where patients have been diagnosed with significant aberrations in larynx images. Laryngoscopic examination in children is difficult and time-consuming.
Kornut and Venet, examining a group of 50 children aged 5 to 14, could evaluate the larynx during the first examination in only 16 cases. Videolaryngoscopy proved helpful by providing much more information, enabling diagnosis and treatment.
The advantages of videolaryngoscopy are generally known. In our practice the following features are most useful:
Receiving the image on a monitor - this enables evaluation of an image by a number of people at the same time and a joint diagnosis.
Playing the image in slow motion - the examination of a child is often made very quickly and deviations are spotted only after playing the tape repeatedly.
The image of the larynx recorded on a cassette can be consulted at other medical centres without the need to move the patient.
An 8-year-old boy, referred for chronic hoarseness, intensifying up to aphonia.
Laryngoscopy showed the centre of the left vocal fold to be swollen, bright red, glossy, and the fold surface uneven. Stroboscopic examination revealed asymmetrical vibration of vocal folds, amplitude reduction, with border shift on left side slightly marked. Diagnosed as haemorrhaging into the vocal fold. After treatment, the effusion was absorbed.
An 11-year-old boy, treated for hyperfunctional disphonia and vocal nodules. Examination revealed a triangular sharp shape, on the right vocal fold lesion, protruding from under the vocal fold, and of the same colour as the fold, projecting into the lumen of the glottis. Preliminary diagnosis: hyperkeratosis, resembling a cutaneous horn. The child was being prepared for surgical removal of the lesion but, before the operation, the lesion grew smaller and soon disappeared.
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