International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Aug 2007
Randomized Controlled TrialThe effect of dexamethasone on postoperative vomiting and oral intake after adenotonsillectomy.
Vomiting is one of the most important postoperative complications of adenotonsillectomy. This study was designed to determine the effectiveness of preoperative intravenous dexamethasone on postoperative emesis. ⋯ A single dose of dexamethasone significantly decreased the incidence of postoperative vomiting in early and late recovery phase and shortened the time to first oral intake and the duration of IV therapy.
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Int. J. Pediatr. Otorhinolaryngol. · Aug 2007
Comparative StudyFlexible fiberoptic laryngoscopy in children: effect of sitting versus supine position.
Currently no standard exists as to the exact technique of flexible fiberoptic laryngoscopy (FFL) for children. Our objective was to determine the effects of examination in the sitting versus supine position on upper airway findings during FFL in children using a standardized technique and a grading system. In this prospective study, each child acted as his or her own control. ⋯ We conclude that although sitting versus supine position statistically significantly affects upper airway findings during FFL in children, examination in either position is usually acceptable. Examination in both positions may detect small differences in approximately one third of children, but we believe this would usually not alter management. Investigators are encouraged to adopt standardized techniques for FFL and grading systems that will allow meaningful comparisons between patients, techniques, and centers.
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Int. J. Pediatr. Otorhinolaryngol. · Jul 2007
Multicenter Study Historical ArticleSpeech and language development in a population of Swedish hearing-impaired pre-school children, a cross-sectional study.
There is little information on speech and language development in pre-school children with mild, moderate or severe hearing impairment. The primary aim of the study is to establish a reference material for clinical use covering various aspects of speech and language functions and to relate test values to pure tone audiograms and parents' judgement of their children's hearing and language abilities. ⋯ Reference values for expected speech and language development are presented that cover nearly 60% of the studied population. The effect of the peripheral hearing impairment is compensated for in many children with hearing impairment up to 60 dB HL. Above that degree of impairment, language delay is more pronounced, probably due to a loss of acuity. The importance of central cognitive functions, speech reading and signing for compensation of peripheral limitations is pointed out.
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Int. J. Pediatr. Otorhinolaryngol. · Jul 2007
Multicenter StudyThe clinical relevance of the submucosal cricoid cleft.
Although fairly uncommon and sometimes difficult to diagnose, laryngeal clefts have been well-defined in the literature. The submucosal cleft variant has been described anatomically, but not clinically. We describe a series of patients with a submucosal cricoid cleft variant and its clinical relevance. ⋯ Because of the subtle nature of its clinical presentation, submucosal cricoid cleft can be a challenging diagnostic entity, and the results of surgical reconstruction may be compromised if the cleft is undiagnosed.
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Int. J. Pediatr. Otorhinolaryngol. · Jun 2007
Randomized Controlled Trial Comparative StudyThe use of ketamine or ketamine-midazolam for adenotonsillectomy.
Ketamine's role in clinical anaesthesia is developing as a result of the evolving concepts of its mechanism of action and the advantages of its alternative routes of administration. In this study, we aimed to investigate the frequency and severity of adverse effects, specifically emergence phenomena and vomiting, when ketamine with or without midazolam used as a sole anaesthetic. ⋯ As a sole anaesthetic ketamine with or without midazolam provided a calm and safe anaesthesia for paediatric patients in short term procedures. In addition, it must be noted that, a better postoperative early period was achieved by ketamine with midazolam.