[Flexible rhinopharyngolaryngoscopy in the evaluation of patients with allergic and upper respiratory airway disorders].

Flexible rhinofaringolaryngoscopy is a valuable diagnostic tool in our daily practice, adding up to 60% of additional information in the diagnosis and clinical approach in neonates, children and adults with pathology of the upper respiratory tract and allergic diseases. We present a practical method for office use, and review our experience with 423 patients in whom the exam was performed. 49% had an abnormal nasal mucosa and middle meatus, site related to ethmoidal and maxillary sinus drainage. In 23 patients we found abnormal turbinates, either clefting, polypoidal changes, degeneration or concha bullosa; most of these findings were not appreciated after routine speculum examination. 7% of our patients had mucosal changes in the area related to the olfactory epithelium, edema and inflammation related to taste and smell disorders. 56 patients had inflammation and hypertrophy in adenoids, 50% of these with some degree of auditory canal obstruction (Eustaquian orifice). In the inferior pharynx and larynx, 58 patients had abnormalities, inflammation in glotic area (8%) due to speech dysfunction. They required speech therapy 4% (14 patients) with abnormal vocal cords, polyps (5), paralysis (4). 2 patients with carcinoma, were referred for biopsy and specific treatment. After gaining sufficient expertise rhinofaringolaryngoscopy is a useful and safe procedure which enhances the diagnostic ability of the practicing allergist/immunologist to evaluate complains referable to the upper airways.