International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · May 2012
ReviewManagement of foreign bodies in the airway and oesophagus.
Ingestion and/or aspiration of foreign bodies (FB) are avoidable incidents. Children between 1 and 3 years are common victims for many reasons: exploration of the environment through the mouth, lack of molars which decreases their ability to properly chew food, lack of cognitive capacity to distinguish between edible and inedible objects, and tendency to distraction and to perform other activities, like playing, whilst eating. Most FBs are expelled spontaneously, but a significant percentage impacts the upper aerodigestive tract. Approximately 80% of children's choking episodes are evaluated by pediatricians. The symptoms of aspiration or ingestion of FBs can simulate different paediatric diseases such as asthma, croup or pneumonia, delaying the correct diagnosis. ⋯ Ingestion and or aspiration of FB in children are multifactorial in their aetiology, in their broad spectrum of different resolutions for the same FB and in the response of each patient to the treatment. Prevention remains the best treatment, implying an increased education of parents on age-appropriate foods and household items, and strict industry standards regarding the dimensions of toy parts and their secure containers.
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Int. J. Pediatr. Otorhinolaryngol. · May 2012
Randomized Controlled Trial Comparative StudyComparison of pre-emptive tonsillar lodge infiltration with ropivacaine versus intravenous tramadol in pediatric tonsillectomies: a randomized placebo-controlled study.
To investigate the placebo controlled effect of pre-emptive local infiltration of ropivacaine and intravenous tramadol in postoperative pain and nausea-vomiting in pediatric tonsillectomy cases. ⋯ This study showed that peritonsillar ropivacaine infiltration might produce an effective postoperative analgesia probably due to a preventing effect on sensitization of the pain pathways.
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Report 2 cases of coat hanger floor of mouth injuries in children. We describe 2 cases of children who presented with coat hanger impalement injuries of the floor of mouth and their management. Removal under anesthesia is safe with a period of observation postoperatively. ⋯ Plain film radiographs may be useful to determine the depth of injury and trajectory of the foreign body. Careful removal under anesthesia is safe. Little if any floor of mouth edema was encountered postoperatively, but close observation for potential critical floor of mouth hematoma or edema should be considered.
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Int. J. Pediatr. Otorhinolaryngol. · May 2012
Case ReportsA fatal presentation of dermatomyositis with facial swelling.
Juvenile dermatomyositis (JDM) is the most common inflammatory autoimmune myopathy in children. Most common presentations consist of heliotrophic rash and/or gottron's papules in addition to proximal muscle weakness. A typical presentations have been reported. ⋯ He had elevated transaminases but no detectable muscle weakness. A muscle biopsy was consistent with juvenile dermatomyositis. This case highlights the need to consider dermatomyositis in cases of facial swelling and the use of aggressive immunosuppressive therapies due to its associated vasculopathies.
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Int. J. Pediatr. Otorhinolaryngol. · May 2012
Case ReportsTongue entrapment in aluminum water bottle: discussion of removal and airway management.
Tongue entrapment in a bottle neck is rare, with few cases reported in the literature. Reported here is the case of a child who presented to the Emergency Department with her tongue entrapped in an aluminum bottle. ⋯ These include sedated mechanical removal of the strangulating object and transnasal fiberoptic intubation. We review published cases and the options for removal of an entrapped tongue from a bottle neck, and we discuss the importance of airway management.