International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Sep 2015
Comparative StudyPostoperative nonsteroidal anti-inflammatory drugs and risk of bleeding in pediatric intracapsular tonsillectomy.
In light of current FDA guidelines on opioid use in children, we sought to determine the risk of post-tonsillectomy hemorrhage (PTH) in children who received ibuprofen with acetaminophen versus those who received narcotic with acetaminophen for postoperative pain control. ⋯ Use of ibuprofen after intracapsular tonsillectomy in children is associated with statistically significant increase in PTH requiring return to the operating room, as well as an increase in overall rates of both primary and secondary PTH. Ibuprofen provides pain control that is at least equivalent to narcotic and is not associated with respiratory depression. Further study of ibuprofen use in the post-tonsillectomy patient is warranted.
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Int. J. Pediatr. Otorhinolaryngol. · Sep 2015
ReviewThe uncomfortable reality … We simply do not know if general anesthesia negatively impacts the neurocognitive development of our small children.
Annually in the United States more than one million children under the age of 5 years are exposed to anesthetics for therapeutic and diagnostic procedures. Pre-clinical data in animal models has consistently shown that anesthetic exposure to the developing brain results in long-term cognitive deficits. Current clinical data addressing the safety of these pharmaceutical agents on the developing human brain is limited. ⋯ Until then, there is little data that absolutely reassures clinicians and parents that the pharmaceutical agents used are indeed safe for our children. The uncomfortable reality is that despite the fact that there are more than one million children younger than 5 years old who receive general anesthesia in the United States annually, and thousands more who are deeply sedated for imaging and diagnostic studies or as a necessary adjunct to care in the intensive care unit, there is little data that assures clinicians and parents that the pharmaceutical agents used are indeed safe for the developing brain. That said, there are no convincing human data to suggest that they are not.
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Int. J. Pediatr. Otorhinolaryngol. · Sep 2015
Randomized Controlled Trial Comparative StudyA comparison of two myringoplasty techniques in Nepalese children: a prospective randomized trial.
In children, the success of myringoplastywith temporalis fascia is lower compared to adults and cartilage as an alternative graft material has shown higher success rate. ⋯ In our study of pediatric myringoplasty, the morphological and functional outcomes in both cartilage palisades and temporalis fascia groups were comparable.
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Int. J. Pediatr. Otorhinolaryngol. · Sep 2015
Case ReportsEndoscopic endonasal transclival approach to a pontine cavernous malformation: case report.
Cavernous malformations of the brainstem are difficult to manage because of their location in eloquent tissue and their high propensity for symptomatic bleeding. Traditional neurosurgical approaches are often associated with significant morbidities. Here we present the case of a 15 year-old male patient with an acute onset of severe cephalalgia associated with neurological signs (right cranial nerve VI, VII and VIII palsies). ⋯ The lesion was removed by way of an endoscopic endonasal transclival approach. Post-operative neurological examination showed a dramatic improvement in cranial nerves function. The patient remains stable two years after surgery.
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Int. J. Pediatr. Otorhinolaryngol. · Sep 2015
Case ReportsAirway obstruction after lingual frenulectomy in two infants with Pierre-Robin Sequence.
Pierre-Robin Sequence (PRS) is defined as the triad of micrognathia, glossoptosis, and cleft palate and affects approximately 1/8500 births. Airway obstruction is common in infants with PRS and results from glossoptosis leading to pharyngeal obstruction. ⋯ This report discusses two cases of significant airway decompensation after lingual frenulectomy requiring surgical intervention in infants with PRS. We suggest that lingual frenulectomy be contraindicated in infants with PRS or suspected PRS due to the possible increased risk of airway obstruction.