International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Feb 2006
Prognosis of airway obstruction and feeding difficulty in the Robin sequence.
To evaluate the course and prognosis of airway obstruction and feeding difficulty in the Pierre Robin sequence (PRS). ⋯ Diagnostic subgroups based on the presence of additional anomalies help families and physicians in understanding the severity and duration of feeding and airway difficulty in PRS. Two-thirds of PRS patients who fail positional therapy may ultimately require a surgical airway procedure. Feeding difficulty can be present in the absence of clinically significant airway obstruction. Families and physicians should be encouraged that by 3 years of age, most patients were successfully taking an oral diet without airway obstruction.
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Int. J. Pediatr. Otorhinolaryngol. · Jan 2006
Closure of persistent tracheocutaneous fistula following "starplasty" tracheostomy in children.
The "starplasty" technique of pediatric tracheostomy was introduced in 1990 as an alternative pediatric tracheostomy technique associated with several advantages. The only apparent drawback of this technique is the higher incidence of persistent tracheocutaneous fistula following decannulation. Several methods have been proposed for closure of persistent tracheocutaneous fistula in children, including fistulectomy with primary closure and fistulectomy with healing by secondary intent. Some authors advocate placement of a drain at the time of primary closure. We present our experience with closure of persistent tracheocutaneous fistula following starplasty in children over the past 15 years. ⋯ "Starplasty" is a safe, reliable pediatric tracheostomy technique that has been shown to decrease the incidence of perioperative morbidity and mortality. The only drawback appears to be a high incidence of postoperative tracheocutaneous fistula. Our method of persistent tracheocutaneous fistula closure following starplasty is safe and effective, with no major complications and no incidence of postoperative airway narrowing.
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To evaluate the evolution of indications for tracheostomy in children. ⋯ Evolving indication has been ventilator dependence. Upper airway obstruction as an indication has diminished in frequency, especially with the concomitant progress of endoscopic techniques.
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Int. J. Pediatr. Otorhinolaryngol. · Jan 2006
Randomized Controlled TrialThe effect of preoperative dexamethasone on early oral intake, vomiting and pain after tonsillectomy.
Postoperative morbidity in patients undergoing tonsillectomy with or without adenoidectomy includes inadequate oral intake, pain, nausea, vomiting and bleeding. The purpose of this study is to evaluate the effect of preoperative 0.5 mg/kg i.v. dexamethasone on postoperative early oral intake, pain, vomiting in patients undergoing adenotonsillectomy while performing standard anesthesia technique and sharp dissection tonsillectomy. ⋯ Preoperative dexamethasone use significantly reduces early posttonsillectomy pain, improves oral intake and facilitates meeting the discharge criteria while using standard anesthesia technique and sharp dissection tonsillectomy without any significant side effects.
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Int. J. Pediatr. Otorhinolaryngol. · Jan 2006
Review Case ReportsManagement of parapharyngeal minor salivary neoplasms in children: a case report and review.
Parapharyngeal neoplasms are rare entities in children. Benign minor salivary gland neoplasms of the parapharyngeal space have been described in the adult literature, but there is little guidance in the pediatric literature. We present the case of an adolescent male with a primary minor salivary gland pleomorphic adenoma presenting as an enlarging, asymptomatic parapharyngeal mass. We discuss the clinical presentation, radiologic findings, differential diagnosis and our surgical management with a summary of the current literature on the topic.