International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Oct 2017
Review Case ReportsPediatric primary Sjögren syndrome presenting with bilateral ranulas: A case report and systematic review of the literature.
Primary Sjögren syndrome is uncommon in children, and the standard clinical criteria used in diagnosis of adult Sjögren syndrome will miss many children with the disease. Floor of mouth ranulas have not been described in Sjögren syndrome. ⋯ This is the first report of a child presenting with floor of mouth ranulas in association with Sjögren syndrome. While recurrent parotitis is the most common presentation in children, other salivary gland and extra-salivary manifestations may be seen, and the clinician must maintain a high index of suspicion for underlying Sjögren syndrome.
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Int. J. Pediatr. Otorhinolaryngol. · Oct 2017
Implementation of a perioperative surgical home protocol for pediatric patients presenting for adenoidectomy.
The perioperative surgical home (PSH) is a patient-centered model designed to improve health, streamline the delivery of health care, and reduce the cost of care. Following the national introduction of PSH in 2014 by the ASA, adult hospitals have reported success with this model, with studies validating the benefits of PSH including reducing length of stay, lowering costs, and improving patient satisfaction. ⋯ We present our experience and success in developing a PPSH for patients, ranging in age from 16 to 35 months of age, undergoing adenoidectomy either alone or with tympanostomy tube insertion by protocolizing care, collaborating among care providers, and educating families. With this process in place, a significant percentage of these patients who were previously admitted were discharged home the same day of surgery.
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Int. J. Pediatr. Otorhinolaryngol. · Oct 2017
Case ReportsThe implications of pneumomediastinum and subcutaneous emphysema for the paediatric otolaryngologist.
Three patients presented within a 6-month period with pneumomediastinum. The underlying cause in each was distinct. One case occurred due to blunt laryngeal trauma and required urgent surgical intervention due to a decompensating airway. ⋯ Pneumomediastinum may be spontaneous or secondary to an underlying cause. Children should be managed using a multidisciplinary approach. Investigation and management should be influenced by clinical stability and invasive procedures should only be considered in patients who exhibit respiratory distress.
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Int. J. Pediatr. Otorhinolaryngol. · Oct 2017
Adherence to Swedish guidelines for pain treatment in relation to pediatric tonsil surgery: A survey of the multidisciplinary team.
Pain management in children after tonsil surgery is essential, and optimal pain treatment has been discussed for many years. Data from the National Tonsil Register in Sweden (NTRS) and a national mapping have demonstrated the need for national pain treatment guidelines for pediatric tonsil surgery. As a result, Swedish national guidelines, together with updated patient information on the website tonsilloperation.se, were developed and implemented in 2013. ⋯ The respondents' opinions of and the ENT departments adherence to the Swedish national guidelines were considered to be good. The national implementation process in Sweden has impacted the manner in which ENT departments treat pain after tonsil surgery.