International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2001
Randomized Controlled Trial Comparative Study Clinical TrialPaediatric coblation tonsillectomy.
Tonsillectomy has been described using a number of techniques. Recently Coblation Technology has been used to remove tonsils with anecdotal evidence of a reduction in post-operative morbidity. In this study we aim to see if there is any difference in post-operative pain, tonsillar fossae healing and return to a normal diet performing tonsillectomy, using tissue coblation compared with standard bipolar dissection. ⋯ This new technique using tissue coblation for tonsil removal offers significant advantages in the post-operative period, with rapid return to a normal diet and a drastic reduction in analgesic requirements following the surgery.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2001
Clinical TrialThe need for routine pre-operative coagulation screening tests (prothrombin time PT/partial thromboplastin time PTT) for healthy children undergoing elective tonsillectomy and/or adenoidectomy.
In some medical centers, the routine pre-operative evaluation of healthy children undergoing elective tonsillectomy and/or adenoidectomy (T and A) includes coagulation screening tests (PT, prothrombin Time; PTT, partial thromboplastin time; and INR, international normalized ratio). In this retrospective study, we determined whether there is a positive correlation between prolonged PT/PTT/INR tests in healthy children, with no prior medical history of coagulation problems, and bleeding during surgery and/or bleeding in the month following surgery. We reviewed the records of 416 elective T and A surgeries performed at the Soroka University Medical Center in Beer-Sheva, Israel, over the course of 1999. ⋯ Two (3.3%) of the 61 with prolonged PTT values experienced light bleeding during the 1st month subsequent to surgery. We therefore concluded that pre-operative coagulation screening tests provide low sensitivity and low bleeding predictive value. As such, routine coagulation tests before T &A are not indicated unless a medical history of bleeding tendency is suspected.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2001
Case Reports Clinical TrialUse of digital subtraction fluoroscopy to diagnose radiolucent aspirated foreign bodies in infants and children.
Most tracheobronchial foreign bodies in children are radiolucent, and accurate diagnosis of such foreign bodies is not always easy. This can result in delay of diagnosis or misdiagnosis of foreign body aspiration. We report the usefulness and pitfalls of use of digital subtraction fluoroscopy (DSF) to diagnose radiolucent aspirated foreign bodies in infants. ⋯ DSF was very sensitive in the diagnosis of foreign body aspiration and stenotic changes in the bronchial lumen. However, its diagnostic specificity for aspirated foreign body itself was not high (17%). Therefore, when abnormalities are found on DSF, we recommend to perform flexible bronchofiberscopy initially under general anesthesia via a tracheal tube. When a foreign body is verified, rigid ventilation bronchoscopy is successively performed to retrieve the foreign body.
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Int. J. Pediatr. Otorhinolaryngol. · Nov 2001
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of cortisporin and ciprofloxacin otic drops as prophylaxis against post-tympanostomy otorrhea.
Myringotomy and tube insertion, a common pediatric surgical procedure, is frequently complicated by purulent otorrhea. Many otolaryngologists routinely use topical antibiotics as prophylaxis against post-tympanostomy otorrhea. The aminoglycosides (neomycin sulfate, tobramycin and gentamicin) contained in commonly used topical antibiotics as well as components of the solutions have been shown to be ototoxic in animal studies. ⋯ The difference in rate of otorrhea was not statistically significant (P=0.372, 95% confidence interval equals -6-16%). Our data suggest that topical Cortisporin offers no benefit over Ciprofloxacin for post-operative otorrhea prophylaxis. Therefore we recommend topical quinolone prophylaxis, which should eliminate concerns about ototoxicity, without sacrificing efficacy.
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Int. J. Pediatr. Otorhinolaryngol. · Nov 2001
Review Case ReportsBezold's abscess in children: case report and review of the literature.
The introduction of antibiotics in the treatment of suppurative otitis media has significantly decreased the incidence of complications. Reports of Bezold's abscess secondary to this disorder are rare, particularly in infants and young children, in whom mastoid bone pneumatization is not yet complete. We present a case of Bezold's abscess occurring in a child aged 18 months. The literature is reviewed and methods to accurately diagnose this complication are emphasized.