The diagnostic role of triple endoscopy in pediatric patients with chronic cough
| Autor: | Gillian R. Diercks, Anna Cook, Christopher J. Hartnick, Marina Hartnick, M. Shannon Fracchia, Stephen Hardy, Cheryl Hersh |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Adolescent Biopsy Specialty Bronchoalveolar Lavage Endoscopy Gastrointestinal Otolaryngology Young Adult 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Internal medicine Bronchoscopy Pulmonary Medicine medicine Humans Medical diagnosis Child 030223 otorhinolaryngology Eosinophilic esophagitis Retrospective Studies medicine.diagnostic_test business.industry Gastroenterology Infant General Medicine medicine.disease Endoscopy Chronic cough Pulmonology Cough Otorhinolaryngology Tracheomalacia Child Preschool Chronic Disease Pediatrics Perinatology and Child Health Female medicine.symptom business |
| Zdroj: | International Journal of Pediatric Otorhinolaryngology. 116:58-61 |
| ISSN: | 0165-5876 |
| DOI: | 10.1016/j.ijporl.2018.10.017 |
| Popis: | Objective/hypothesis Multi-disciplinary aero-digestive centers provide high quality health care through improved outcomes and treatment costs over separate sub specialty clinics. These outcomes are often the result of a common investigative tool known as triple endoscopy: a rigid bronchoscopy performed by an otolaryngologist, flexible bronchoscopy and lavage obtained by a pulmonologist, and an endoscopy with guided biopsies performed by a gastroenterologist. Combining such procedures into one 'triple endoscopy' allows for diagnoses which otherwise might have been missed with just one procedure. The goal of our study was to describe the efficacy of the triple endoscopy procedure in diagnosing recalcitrant aero-digestive conditions, specifically chronic cough. Study design: Retrospective chart review Methods Multiple charts from children who underwent the triple endoscopy for chronic cough were retrospectively reviewed from 2005 and 2017. Complete data from the triple procedure was gathered on 243 patients, including findings by sub specialty (otolaryngology, pulmonology, and gastroenterology). Results Of the 243 patients with complete data who underwent triple endoscopy, 203 (83.5%) children had at least one positive finding. Of these children, 101 (41.5%) had one specialty specific diagnosis, and 102 (42%) had multiple cross specialty diagnoses. When describing the diagnoses, 63 children had gastro esophageal reflux (GER), 14 had eosinophilic esophagitis (EoE), 118 had tracheomalacia, 54 had laryngeal clefts, and 102 children had positive bronchoalveolar lavages. Outcome data was available on 226 patients (93%), of these patients, 188 patients had a diagnosis from the triple scope. Of those patients with a diagnosis and outcome data, 144 (76.6%) children had an improved outcome as a result of a treatment plan targeting that diagnosis, while 16 of the 37 patients without a diagnosis improved. This difference was significant by chi square analysis (p Conclusion The triple scope procedure is a useful investigative tool for patients with recalcitrant aero-digestive complaints like chronic cough. In particular, triple scope can yield more than one specialty specific diagnosis, normally missed by one procedure. The triple scope also leads to improved parental satisfaction by improved cost and healthcare outcomes. |
| Databáze: | OpenAIRE |
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