Use of rigid and flexible bronchoscopy among pediatric otolaryngologists

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 fared 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 per- formed 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 10454 total bronchoscopies were performed, with 2052 flexible and 9117 rigid bronchoscopies. Strider, suspected foreign body inhalation, and layvngomalacia 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.