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Table 3 Otolaryngologists’ methods of carrying out nasopharyngeal fiberendoscopy (NFE) in children

From: Nasopharyngeal fiberendoscopy in children: a survey of current Italian pediatric otolaryngological practices

Parameter

Possible answers

No. of otolaryngologists

Percent

Recommended type of endoscope

   
 

Flexible

720

94.3

 

Rigid

44

5.7

Recommended endoscope diameter

   
 

About 2 mm

312

40.9

 

About 3 mm

369

48.3

 

About 4 mm

83

10.8

Recommended sterilisation

   
 

Disposable sheaths

574

75.2

 

Disposable towels

140

18.3

 

Antiseptic solutions

50

6.5

Use of endoscope connected to a video recorder/monitor set

   
 

Yes

588

76.9

 

No

176

23.1

Method of removing nasal secretions before NFE

   
 

None

184

24.1

 

Urging child to blow his/her nose

211

27.6

 

Helping child to blow his/her nose

117

15.3

 

Nasal saline irrigation

44

5.7

 

Aspiration

208

27.3

Recommended position for NFE

   
 

Seated (alone or on parent’s lap)

714

93.5

 

Lying on back

50

6.5

Need for restraint

   
 

Never

221

28.9

 

Only younger children

495

64.8

 

Always

48

6.3

Recommended method of restraint

   
 

Holding head gently

67/543

12.4

 

Sitting on a parent’s lapa

443/543

81.6

 

Lying on back wrapped in a sheet

33/543

6.0

Restrainers

   
 

Only parents

202/543

37.3

 

Health workers, if parents unable to cooperate

341/543

62.7

Local pre-medication

   
 

None

244

32.0

 

Vasoconstrictors

231

30.2

 

Anesthetic

169

22.1

 

Lubricating ointment

120

15.7

Frequency of bilateral NFE

   
 

Never

20

2.7

 

Sometimes

403

52.7

 

Always

341

44.6

First anatomical landmark assessed

   
 

Adenoids and nasopharynx

562

73.7

 

Ostiomeatal complex

200

26.3

Frequency of evaluation of anatomical structures other than adenoids during NFE

   
 

Never

10

1.3

 

Sometimes

348

45.5

 

Always

406

53.2

How adenoidal hypertrophy is graded

   
 

Percentage of choanal obstruction

252

33.0

 

Percentage of choanal obstruction and patency of Eustachian tube orifice

417

54.5

 

Adenoidal hypertrophy: yes/no

7

1.0

 

Choanal obstruction: yes/no

88

11.5

Standardised classification for grading adenoidal hypertrophy

   
 

None

400

52.4

 

Cassano’s classification [5]

275

36.0

 

Parikh’s classification [9]

65

8.5

 

Other

24

3.1

  1. awith legs held between the thighs of the parent, who holds the child’s wrists over the abdomen with one hand and the child’s head against his or her chest with the other