International journal of pediatric otorhinolaryngology
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The role of the pediatric laryngologist has changed. He now manages a greater range of clinical problems in the upper airways. ⋯ It is a precise procedure utilizing a range of modern miniaturized instruments. Major technological improvements include quartz iodine and xenon light sources, flexible light carrying leads, fiberoptic rod lighting, special purpose laryngoscopes, rigid telescopes, versatile techniques of anesthesia, microlaryngeal surgery, laser surgery and reliable photographic documentation.
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Int. J. Pediatr. Otorhinolaryngol. · Oct 1987
Case ReportsNasal obstruction in the neonate secondary to nasolacrimal duct cysts.
The neonate is an obligate nasal breather and any form of nasal obstruction causes respiratory distress during feeding and sleeping. We report two patients with unusual causes of respiratory distress secondary to nasolacrimal duct cysts. ⋯ Removal of the nasal wall of the cyst resolves the obstruction and the dacryocystitis. The nasolacrimal duct cyst is an unusual, but readily treated, cause of neonatal respiratory distress.
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Int. J. Pediatr. Otorhinolaryngol. · Oct 1987
An assessment of preoperative coagulation screening for tonsillectomy and adenoidectomy.
Preoperative coagulation studies are commonly employed in order to try to identify the 2-4% of all patients undergoing tonsillectomy/adenoidectomy surgery who experience hemorrhagic complications. In an atmosphere of increasing cost consciousness, evaluation of the efficacy of screening tests is warranted. The records of 994 out of 1050 patients consecutively scheduled for tonsillectomy, adenoidectomy or T&A over a 2.5-year period were retrospectively reviewed in order to determine the usefulness of partial thromboplastin (PTT) and prothrombin time (PT) screening in predicting surgical and postsurgical bleeding. ⋯ The purpose of any screening test is to identify disease early enough for therapeutic intervention to be effective. Although preoperative PT/PTT will occasionally identify an unsuspected von Willebrand's or other coagulopathy, the prevalence of bleeding disorders in patients with negative history and examination is low enough that PT/PTT has essentially a zero predictive value for surgical bleeding. Screening PT/PTT should therefore be reserved for patients with known or suspected coagulopathies.