Pain Perception of Children Undergoing Flexible Laryngoscopy/Nasendoscopy for Investigation of Voice Disorders

Imogen Hay

The flexible laryngoscope/nasendoscope is regarded as the optimum instrument for examination of laryngeal functioning in the paediatric population. Anecdotal reports suggest, however, that flexible laryngoscopy/nasendoscopy can be distressing and uncomfortable for children. Because examination of vocal function with a flexible endoscope is an interactive process, requiring the cooperation of the examinee, pain and discomfort behaviours exhibited can interfere with the success of the examination. However, no studies have been conducted focusing on the perception and level of pain experienced by children undergoing flexible laryngoscopy/nasendoscopy. The present study measured the degree of procedural pain experienced by children and adolescents undergoing examination of the nasopharynx and larynx with the flexible laryngoscope at the Laryngology/Nasendoscopy Clinics at the Royal Children’s Hospital in Melbourne. Twenty three children and adolescents (aged 4 to 18 years) and their parents participated in this study. Self- and parent-reports of the child’s pain perception on the Wong-Baker Faces Pain Rating Scale, plus observer ratings of pain behaviours as adapted from the Child-Adult Medical Procedure Interaction Scale and the Procedure Behaviour Check List, revealed the procedure to be perceived, on average, as moderately painful for the population studied. No significant correlations were found between pain and the variables of gender, previous experience of flexible laryngoscopy, or experience of other distressing medical procedures. A low negative correlation was found between age and self-reported pain perception. These findings indicate the need for development of appropriate methods of pain management in children and adolescents undergoing flexible laryngoscopy/nasendoscopy.

Imogen Hay and Jennifer Oates
Schoolof HumanCommunication Sciences,
La Trobe University
Alessandra Giannini
Department of Speech Pathology,
Royal Children’s Hospital
Robert Berkowitz and Brian Rotenberg
Department of Otolaryngology,
Royal Children’s Hospital