[Functional nasopharyngeal fiberoptic endoscopy for pre-therapeutic diagnosis of sleep apnea syndrome in infants. A case report].

We report a 2-year-old infant with severe obstructive sleep apnoea. The symptoms had deteriorated for several months, and indicated complete obstruction shortly after the child fell asleep, with reduction of the oxygen saturation to under 30%. Since the obstruction could only be interrupted by waking the child, a tracheostomy was proposed. Endoscopy under general anaesthesia revealed no pathological findings. The stenosis could only be seen using transnasal fibre-optic endoscopy when the obstruction occurred during sleep: the oropharyngeal wall collapsed at the level of the velopharyngeal sphincter. A tube passed through the nose and through the collapsing section of the pharynx to the entrance of the larynx prevented the apnoea. The parents were taught to introduce and fix the tube. After an observation period of 1 year the larynx had stabilized spontaneously, and the tube has to be introduced only rarely.