Because accurate diagnosis is essential to planning treatment, we may perform or order additional tests during your child’s visit to establish or confirm a suspected condition. We may do any of the following procedures during your child's office visit and evaluation.
In this study, the physician gently places a small, thin, flexible endoscope with a camera down through the nose to view your child’s upper airway anatomy above the vocal cords. This procedure takes only a few minutes and family members can also see the exam on a video monitor while it is being done. It can provide valuable information regarding the anatomy, the movement and the condition of the upper airway structures. The procedure is painless and does not require any sedation.
This video-recorded study is sometimes done to evaluate the safety and effectiveness of a child’s swallow. The physician gently places a small, thin flexible endoscope with a camera down through the nose to view the back of the throat. While the study is being recorded, a speech language pathologist carefully feeds the child small amounts of certain liquids or foods that have green food coloring added (so that it is easy to see on the video monitor as the child swallows). This study is sometimes used instead of a modified barium swallow study, which must be done in Radiology.
This video recorded study is sometimes done to evaluate the motion of a child’s vocal cords, for certain concerns regarding the strength, pitch and quality of a child’s voice. A small, thin, flexible endoscope with a camera is gently inserted through the nose to the area in the back of the throat above the vocal cords. The child is directed to say or speak certain sounds or words, which should make the vocal cords perform specific movements. This procedure takes only a few minutes and family members can also see the exam on a video monitor while it is being recorded. The procedure is painless and does not require any sedation.
This study is done to evaluate the strength, range, pitch and quality of a child’s voice. It is particularly useful for developmentally appropriate children over the age of 3 years who have a history of vocal cord paralysis, airway reconstruction, or tracheostomy that have problems with their voice. It is performed with a physician and specially trained speech language pathologist. The child repeats specific phrases and sounds when prompted into a microphone that is attached to specialized equipment. The results can help guide a child’s speech therapy plan or surgical management.
For children with a tracheostomy, this is a test of a child’s ability to use a speaking valve safely. The test must be arranged in advance of the visit so that the correct speaking valve can be provided by the child’s home medical supply company to the family beforehand. The valve must be tested on the child with a special pressure gauge by our speech language pathologist and respiratory therapist, with the physician, to make sure that the child’s medical condition is not compromised. Specific directions for use would be given at the time of the visit based on the results.
For children with a tracheostomy, this is a test of their ability to breathe completely through their nose and mouth, once it has been determined that their airway is of proper size and they are healthy. A special cap is used to block the tracheostomy tube while their breathing effort is carefully monitored by the physician, respiratory therapist, and nurse practitioner or physician’s assistant. If successful in the office, specific instructions for cap use are provided. Tracheostomy capping is an important step in making sure a child is medically ready to have the tracheostomy tube removed.
For a child with a tracheostomy tube, this procedure allows the physician to assess the lower airway and look at the way the trach tube rests within it. A small, thin flexible endoscope with a camera is inserted into the child’s lower airway through the tracheostomy tube. This procedure takes less than a minute and family members can also see the exam on a video monitor while it is being done. It can provide valuable information about regarding fit and size of the child’s current trach tube and the condition of the lower airway below the tube.
The physician may occasionally need to use a large microscope to remove ear wax or ear drainage to thoroughly examine your child’s ears, if there are hearing or other ear concerns.
The physician may request an evaluation by an audiologist if there are hearing concerns, based on your child’s history and physical exam. Our Audiology team is located next to us in the Center for Childhood Communication Disorders.
Other diagnostic tests that may be ordered include: