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.