Endoscopy in the assessment of children with nasal obstruction

Nasal obstruction is common in children, and is often attributed to adenoid enlargement. This prospective study was performed to determine whether rou tine nasal endoscopy is of value for children undergoing surgery for nasal obstruction. Forty-eight children aged two to nine years undergoing adenoid ectomy, and six normal controls, were examined under general anaesthesia wi th a 4 mm rigid endoscope. A video of the endoscopy was subsequently assess ed independently by an observer blinded to the original findings and the pr esence of nasal symptoms. The endoscopist and independent assessor were in agreement regarding 86 per cent of the findings. Three quarters of the children had abnormalities on endoscopy in addition to enlarged adenoids, and in 23 per cent these were p otentially of major clinical significance (unsuspected foreign body, gross septal deviation, gross hypertrophy of the turbinates). Endoscopy produced no post-operative complications and was possible in children as young as tw o years of age, without decongestants. Nasal endoscopy is a safe, objective and useful means of identifying potent ially significant abnormalities in children with nasal obstruction.