Procedures Used to Evaluate the Airway and Respiratory Function
Robert B. Beecher, MS, CCC/SLP
Speech/Language Pathologist
PO Box 26264
Milwaukee WI 53226-0264
The procedures listed are some of the procedures available to pediatric otolaryngologists (ENT) and pulmonologists. They are the more common procedures (with a few exceptions) that are used. The procedures are selected by the physicians based upon their clinical evaluation and assessment to provide the information necessary to make a definitive diagnosis.
Lateral Head/Neck X-Ray - provides lateral view of the structures of the upper airway.
Sinus X-Ray - general look at the sinuses of the head.
CT Sinuses - definitive assessment of sinuses.
Flexible Nasopharyngoscopy - a flexible fiberoptic scope is used to evaluate the upper airway.
1. General study - assess structures and functions.
2. Fiberoptic Endoscopic Evaluation of Swallowing (FEES) - assess structures and functions at rest, during phonation, and during swallowing.
3. Fiberoptic Endoscopic Evaluation of Swallowing/Sensory Testing - assess structures and functions at rest, during phonation, during swallowing and to assess sensitivity of the structures near the supraglottic space.
Rigid Laryngoscopy - a rigid scope used to provide microlaryngoscopy for definitive tissue diagnosis.
Chest X-Ray - general assessment of the lungs to diagnose respiratory disease.
Chest CT - a definitive assessment of chest disease.
Barium Esophgram - assess for esophageal motility, tracheoesophageal fistulas, gastroesophageal relfux, and abnormal vessels compressing the esophagus and/or airways.
Flexible Bronchoscopy - a flexible fiberoptic scope used to evaluate the larynx, trachea, bronchi, bronchioles, and alveoli.
Rigid Bronchoscopy - a rigid scope used to provide definitive tissue diagnosis of the trachea and bronchi.
Pulse Oximetry (Oxygen Sat) - measures oxygen saturation of arterial blood.
Pulmonary Function Studies - assess by measuring:
1. pulmonary perfusion - the blood flow through the pulmonary vessels.
2. pulmonary diffusion - the exchange of oxygen and carbon dioxide between the alveoli and capillaries.
3. pulmonary ventilation - the air exchange between the atmosphere and the lung tissue.
Pulmonary function studies are typically categorized as:
1. lung volumes and capacities - the amount of air inhaled and exhaled.
2. airway flow rates - the rate at which air moves through the pulmonary (lung) airways.
3. gas exchange tests - the rate of gas movement between the alveoli and the capillaries.
Spirometry - a spirometer is used to assess lung capacity by measuring the volume of inhaled and exhaled air.
Resources
Behrman, R., & Kliegman, R. Essentials of pediatrics. Philadelphia: W.B. Saunders, 1990.
Moisio, M., & Moisio, E. Understanding laboratory and diagnostic tests. Albany, NY: Delmar, 1998.
Myer, C., Cotton, R., & Shott, S. The pediatric airway: An interdisciplinary approach. Philadelphia: Lippincott, 1995.
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