International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Apr 2018
Superiorly-based turnover skin flap: Pediatric tracheocutaneous fistula closure.
To present a novel superiorly-based turnover skin flap for the primary repair of pediatric tracheocutaneous fistula closure, and to determine the efficacy and safety of this tracheocutaneous fistula turnover flap primary closure technique. ⋯ The turnover technique presented is simple, straightforward, reliable, safe, and effective with excellent cosmetic results.
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Int. J. Pediatr. Otorhinolaryngol. · Apr 2018
Volume relationships between cricoid and main stem bronchi in children using three-dimensional computed tomography imaging.
There are limited data to guide the selection of the appropriate sized endobronchial tube for main stem intubation to provide one-lung ventilation in children. The relationship between the cricoid and the main bronchi (right and left) has been previously evaluated using two-dimensional computed tomography (CT) imaging and video-bronchoscopic images. The present study defines the three-dimensional, CT-derived volume-based relationships between the right main-stem bronchus (RMB), left main-stem bronchus (LMB), and the cricoid ring. ⋯ The relationship (ratio) between the volumes of the cricoid and main stem bronchi remains constant by age. The cricoid dimensions can be used to predict the main stem bronchi dimensions.
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Int. J. Pediatr. Otorhinolaryngol. · Apr 2018
Review Case ReportsRisk factors for laryngeal trauma and granuloma formation in pediatric intubations.
Intubation has been associated with laryngeal injury that often resolves spontaneously without complication. We present a case of a child intubated for less than 48 hours, who presented with dysphonia and intermittent dyspnea two months after intubation due to epiglottic and vocal process granulomas. This is unusual in that multiple granulomas were found in the posterior glottis and supraglottis after short-term intubation. Our objective was to determine if there are risk factors for developing persistent post-intubation sequelae, including the delayed presentation and unusual location of post-intubation granulomas in our case. ⋯ Trauma to the larynx during intubation should be avoided to minimize post-intubation injury in pediatric patients, by using appropriate intubation protocols, endotracheal tube size, and adequate sedation.
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Int. J. Pediatr. Otorhinolaryngol. · Apr 2018
Respiratory events after adenotonsillectomy requiring escalated admission status in children with obstructive sleep apnea.
To characterize postoperative respiratory complications following adenotonsillectomy (AT) in children with obstructive sleep apnea (OSA) and to identify variables associated with pediatric intensive care unit (PICU) admission. ⋯ Pediatric patients requiring post-AT PICU care have more risk factors for respiratory compromise. Total PACU time and total PACU time requiring supplemental oxygen may indicate patient risk for postoperative respiratory complications and need for intensive care. Future work includes prospective determination of appropriate post-AT PICU admission.
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Int. J. Pediatr. Otorhinolaryngol. · Apr 2018
Diagnosis and treatment of paradoxical vocal fold motion in infants.
Paradoxical vocal fold motion (PVFM) is a disorder often misdiagnosed in children presenting with shortness of breath and stridor. In infants, little is known about the clinical course and best approach for treatment of PVFM. This retrospective study assesses the approach to treatment and outcomes for infants with PVFM. ⋯ PVFM can be challenging to diagnose in the infant population. PVFM resolves uneventfully with reflux treatment, however, it is unknown whether reflux treatment is essential or if PVFM would spontaneously resolve. The rarity of infantile PVFM mandates formal evaluation and monitoring by a pediatric otolaryngologist.