Triple scope
A triple scope is similar to a DLB, but more comprehensive because it allows two additional specialists to assess other parts of the digestive tract and airway.
“It begins with an ENT conducting a DLB, the gold standard for diagnosing a laryngeal cleft.”
Next, a pulmonologist uses a flexible scope to view the lower airway/lungs and collect biopsies, if needed. In addition, the doctor may perform a lavage (rinsing with a saline solution) of the lower airway to look for signs of aspiration and other issues.
“By itself, a flexible bronchoscopy is not considered a reliable method to diagnose or exclude a laryngeal cleft.”
Finally, a gastroenterologist uses a flexible scope to view the esophagus, stomach, and small intestine. The doctor is able to check for other anatomical abnormalities, such as a tracheoesophageal fistula. Biopsies of the digestive tract may also be taken to detect the presence of reflux and other conditions. Sometimes only an esophagoscopy is performed to assess the esophagus alone.
Triple Scope
Location: Operating room
Advantages:
Able to fully view and probe the potential cleft area, upper and lower airway, and part of the digestive tract.
Able to assess a cleft depth/type.
Other airway abnormalities may be seen and diagnosed.
Able to diagnose more conditions than a DLB.
Patient is asleep so there is no discomfort during the procedure.
Generally well tolerated by the patient.
Disadvantages:
Must be performed in the operating room using general anesthesia.
After the procedure, swelling/discomfort may occur and sometimes requires an overnight hospital stay for breathing observation.
A sore throat lasting a day or two is common.
Other risks exist and other complications may occur.