International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · May 2007
A national audit of paediatric service provision in otolaryngology in England and Wales.
Otolaryngology is the surgical speciality with the highest paediatric workload, accounting for 29% of the total. Children are not miniature adults and require specially trained staff, equipment, facilities and an environment appropriate to their needs. Documents from the Department of Health and the Royal Colleges of Surgeons and Anaesthetists have been published outlining national standards and recommendations for paediatric surgical service provision. We undertook an audit to assess the current state of paediatric services in ENT in England and Wales and how they conform to these guidelines. ⋯ This audit reveals that we are not meeting the guidelines in nearly 50% of the targeted areas. Paediatric care should be "child centred" and if we are not able to provide this specialised care then paediatric surgical services could be forced into centralisation.
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Int. J. Pediatr. Otorhinolaryngol. · Apr 2007
The nasopharyngeal prong airway: an effective post-operative adjunct after adenotonsillectomy for obstructive sleep apnoea in children.
Obstructive sleep apnoea is a common childhood disorder. Adenotonsillar enlargement is most commonly implicated, with adenotonsillectomy representing an effective treatment in the majority of cases. Such children may develop respiratory compromise post-operatively, sometimes necessitating admission to the intensive care unit. We describe insertion of a nasopharyngeal "prong" airway and evaluate its benefits after adenotonsillectomy for obstructive sleep apnoea and milder forms of sleep-disordered breathing. ⋯ Use of a nasopharyngeal prong significantly improves the post-operative course of selected children who are at high risk of respiratory compromise after adenotonsillectomy. This largely avoids the need for medical intervention and intensive care admission.
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Int. J. Pediatr. Otorhinolaryngol. · Mar 2007
Evaluation of the Parental Perspective instrument for pediatric cochlear implantation to arrive at a short version.
Evaluation of the well-known and widely used Parental Perspectives questionnaire (PP) by means of statistical analysis and exploring the possibility to develop a short version, as the instrument is often regarded as being rather lengthy with 74 questions. ⋯ The Parental Perspectives instrument (PP) is an important tool to assess the impact of cochlear implantation of a child for the quality of life for the family and the child itself. This statistical investigation showed a possible option for development of a short form usable in prospective follow-up studies.
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Int. J. Pediatr. Otorhinolaryngol. · Mar 2007
The management of general and disease specific ENT problems in children with Epidermolysis Bullosa--a retrospective case note review.
Epidermolysis Bullosa encompasses a group of inherited disorders characterized by excessive susceptibility of the skin and mucosa to separate from underlying tissues following mechanical trauma. Information in the literature and guidance on the management of Ear, Nose and Throat problems in such children is scarce. The aim of this study is to report the experience of an Ear, Nose and Throat department in a tertiary paediatric hospital linked to a national Epidermolysis Bullosa unit, describing how children have presented and the care that has been given including a theatre protocol aimed at reducing shearing forces. ⋯ Optimal management depends on the support of a multidisciplinary team, including otolaryngologists, pediatricians, dermatologists, anaesthetists, and specialist nurses. Adherence to a protocol for theatre management can help avoid intraoperative complications.
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Int. J. Pediatr. Otorhinolaryngol. · Feb 2007
Choking on pins, needles and a blowdart: aspiration of sharp, metallic foreign bodies secondary to careless behavior in seven adolescents.
To review the demographics, pathophysiology and management of aspiration of sharp, metallic foreign bodies; to review prevention strategies. ⋯ Aspiration of a sharp, metallic foreign body is a serious injury which is best treated by rigid bronchoscopy. These injuries potentially could be prevented through education.