Pre-operative Evaluation and Optimization of Children Undergoing Airway Surgery

Optimal outcomes in pediatric airway surgery hinge upon meticulous preoperative evaluation and multidisciplinary collaboration. This review emphasizes the critical role of a comprehensive preoperative assessment in children requiring surgical intervention for airway pathology. Key components include awake transnasal fiberoptic laryngoscopy (TNFL) and flexible bronchoscopy under general anesthesia to assess dynamic airway function and identify concurrent pathologies like gastroesophageal reflux and eosinophilic esophagitis. Rigid laryngotracheobronchoscopy (LTB) further refines anatomical evaluation, crucial for surgical planning and outcome prediction using established classifications like the Myer-Cotton and ELS scoring systems. Integration of esophagogastroduodenoscopy with bronchoalveolar lavage during triple endoscopy reduces procedural risks and informs treatment strategies for conditions such as MRSA colonization and chronic lung disease. Moreover, comprehensive swallowing evaluations aid in mitigating postoperative complications related to dysphagia and aspiration. This structured approach ensures tailored management strategies, optimizing surgical success and postoperative quality of life in pediatric airway surgery.