Your child will have a laryngoscopy (LAYR inn GOSS koh pee) and bronchoscopy (bron KOSS koh pee). This is a way to see the voice box (larynx) and windpipe (trachea and bronchi) through a rigid lighted telescope. This allows the doctor to look closely at your child’s airways. During this test, the doctor may be able to give some treatments or take small bits of tissue (samples).
There are many reasons why your doctor may need to look at your child's voice box or windpipe. It is usually done to find out what is wrong when there is concern about the airways narrowing or collapsing. Sometimes this is done to take out an object, get a biopsy (tissue sample), or to open (dilate) the airway. Pictures or video may also be taken to record what the doctor finds.
This procedure is done in the operating room, with general anesthesia (sleeping medicine). We will let you know when the procedure is over and your child is in the Post Anesthesia Care Unit (PACU) or Recovery Room. Your child will return to his or her room after waking up in the PACU.
Before the Test – Food and Drink
- Your child may have CLEAR LIQUIDS up to 2 hours before surgery. After that, he may have nothing else to drink. Clear liquids are those you can see through that have no pulp or food bits in them. Examples of clear liquids are water, apple juice, white grape juice and Pedialyte®.
- Your child may have breast milk up to 4 hours and formula up to 6 hours before surgery and water or Pedialyte® up to 2 hours before surgery. All other liquids, semi-liquids and solid foods MUST BE STOPPED 8 hours before surgery.
- Gum, cough drops and hard candy are not allowed. If your child has been chewing gum, surgery will be delayed 2 hours from the time the gum is spit out. If the gum has been swallowed, surgery will be delayed 6 hours from the time it was swallowed.
During the Test
The test may last only 20 to 30 minutes, but can take much longer depending on what is planned. Your child’s surgeon will give you an idea of how much time is expected, but that could change during the test.
Your child’s surgeon will talk to you about the procedure and findings after it is completed. You will usually be shown pictures from the test as well.
After the Test
When your child is fully awake and not nauseated or vomiting, he may have small amounts of clear liquids such as water, apple juice, or popsicles. Your child should drink plenty of liquids for 24 hours after the test (Picture 1). The doctor will decide when your child may start eating solid foods.
- Your child may be more sleepy or tired than usual.
- Your child's voice may be hoarse and he may have a sore throat. The nurse may give your child acetaminophen (Tylenol®) for the discomfort. Read the next section for more information about this medicine.
- A slight fever is normal. Encourage your child to drink plenty of liquids to help lower or prevent a fever.
Pain Medicine After the Test
- Your child's doctor may recommend acetaminophen. Tylenol®, Feverall®, and Tempra® are some of the brand names of this medicine.
- Follow the instructions on the label to find the correct number of tablets or amount of liquid to give your child.
- If your child has severe pain that does not go away with acetaminophen, call your child’s doctor. Do not give extra medicine.
- Read the label each time before you give your child this medicine.
- Stay with your child until he or she has swallowed the dose of medicine.
- Give the exact amount of medicine as ordered by your doctor.
- If the medicine is a liquid, use a pediatric measuring device (Picture 2, available at pharmacies) to measure the exact dose.
- Do not measure liquid medicines in kitchen spoons.
- Do not give more than 5 doses of acetaminophen in a 24-hour period unless ordered by your child’s doctor.
- If your child or someone else takes too much of this medicine, first call the Central Ohio Poison Center at 1-800-222-1222 (TDD 614-228-2272). They will tell you what to do.
- Side effects are rare. If your child does have nausea or vomiting, skin rash or bruises, stop giving this medicine and call your child’s doctor.
- Store all medicine out of the reach of children.
- Your child’s doctor may prescribe more pain medicine or antibiotics. Please use these as directed.
The surgeon may decide that it is safe for your child to go home right after the test. The surgeon may decide that your child needs to stay for a while at the hospital afterwards. The surgeon will talk with you about your child’s activity level and when he or she can to return to school.
When to Call the Doctor
After your child goes home from the hospital, watch for any of the following problems:
- Trouble breathing, noisy breathing, or pauses in breathing.
- Sudden change from his or her normal way of breathing.
- Color change of the skin, especially if the lips, face, or hands look blue.
- Tiredness (lethargy).
- Fever that lasts longer than 24 hours after the test.
- Fever above 101 degrees Fahrenheit (taken under the tongue).
- Bleeding from the mouth.
- Nausea (upset stomach) or vomiting that goes on for more than 24 hours after the test (or for more than 12 hours if your child is under one year of age).
- Hoarseness that gets worse after a day or two.
- Coughing up blood.
If you notice any of these problems, call your child's doctor at (614) __________________.
If you cannot reach your child's doctor, call the ENT Clinic at (614) __________________.
The ENT Clinic is open Monday through Friday (8:00 a.m. to 4:30 p.m.).
If needed, call the Nationwide Children's Hospital Emergency Department at (614) 722-2500.
HH-III-84, Rev 6/93, 9/07, 2/15 Copyright 1993, Nationwide Children's Hospital