a) Endoscopic surgery includes panendoscopy, laryngoscopy, microlaryngoscopy (laryngoscopy aided by an operating microscope), esophagoscopy, and bronchoscopy. All of these procedures can be performed by using a rigid or flexible endoscope. If the rigid laryngoscope is used, the laryngoscope may be suspended from an arching support anchored to the patient’s abdomen or chest or from a Mayo stand over the patient.

b) One of the most common endoscopic procedures performed is endoscopic sinus surgery. Endoscopic sinus surgery is often associated with multiple and seasonal allergies leading to polyps. Patients undergoing surgery are often also being evaluated for such pathology responsible for hoarseness, stridor, or hemoptysis. Other possible reasons for endoscopic examination include foreign body aspiration, papillomas, trauma, tracheal stenosis, obstructing tumors, and vocal cord dysfunction. Several complications can arise with endoscopic surgery; eye trauma, epistaxis, laryngospasm, bronchospasm, and excessive plasma levels of local anesthesia and epinephrine have been reported.

a) Preoperatively, the patient should be examined for any signs of airway obstruction and proper measures taken to ensure safe and controlled airway management. Knowledge of the location and size of a mass is important, and discussion with the surgeon about chest radiography, magnetic resonance imaging (MRI), and computed tomography (CT) scan results can be invaluable.

b) Light sedation is suggested for premedication because older children and adults may experience respiratory depression and worsening of airway obstruction. The airway must be protected from aspiration of gastric contents, especially during prolonged airway manipulation and deeper sedation.