International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · May 2001
Evoked otoacoustic emissions--an approach for monitoring cisplatin induced ototoxicity in children.
Cisplatin chemotherapy is associated with an increased risk of ototoxic changes. The incidence of hearing loss after the 1st cisplatin-infusion session is only scarcely mentioned in the international literature. With increasing survival rates, prevention and/or early detection of ototoxicity are important for providing management options. The predictive value of pure-tone audiometry in early detection of ototoxicity has been questioned, particularly in the higher frequencies. Otoacoustic emissions appear to be more sensitive to cochlear insult than the conventional pure-tone audiometry. The aims of our study was (a) to define the extent of hearing damage in children after the 1st cisplatin-infusion session (50 mg/m(2)); and (b) to compare the efficacy of otoacoustic emissions (transient evoked otoacoustic emissions, distortion-product otoacoustic emissions) with that of pure-tone audiometry as methods of audiological monitoring. ⋯ A significant high-frequency hearing loss is identified in children even after one low-dose cisplatin-infusion session. As ototoxicity screening tools DP-grams were extremely sensitive and superior to pure-tone audiometry and/or transient evoked otoacoustic emissions. Their use is recommended for regular monitoring of cochlear function, aiming in prevention of permanent damage. Some suggestions for reducing the potential for cisplatin ototoxicity (chemoprotective agents, gene therapy, inhibition of apoptosis) are also discussed.
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Int. J. Pediatr. Otorhinolaryngol. · May 2001
Preoperative and postoperative cardiac and clinical findings of patients with adenotonsillar hypertrophy.
Our aim was to determine if there was any detectable clinical and cardiac changes in hypertrophied adenotonsillary disease with obstructive sleep apnea syndrome and to demonstrate the curative effect of adenotonsillectomy on these patients. ⋯ This study illustrated that adenotonsillary disease with obstructive sleep apnea symptoms leaded to right and/or left ventricular enlargement, hypertrophy when compared with control subjects, which were recovered postoperatively.
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Int. J. Pediatr. Otorhinolaryngol. · Apr 2001
Prospective study of morbidity after tonsillectomy in children.
Post-operative morbidity was prospectively studied in 384 children after tonsillectomy or adenotonsillectomy, using visual analogue scores to record symptom levels, and questionnaires to monitor satisfaction scores from the children and their families. Assessments were performed between the 7th and 14th day post-operatively. Two hundred children were assessed before the introduction of a pre-admission programme which consisted of an instructional videotape session in the ward and an advice booklet. ⋯ Following these changes in practice a further 184 children were assessed. The provision of relatively simple measures in the programme increased parental satisfaction rates (P<0.05) and reduced GP contact rates (35--17%, P<0.05) post-operatively. The actual levels of morbidity were unchanged despite the provision of analgesia.
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A retrospective chart review of children who had airway foreign body removed via direct laryngoscopy and bronchoscopy (DLB) from 1987-1997 was conducted in Children's Hospital, Boston. Patient characteristics noted included age, sex, and clinical presentation. Pre-operative radiographic findings, reason for delay in evaluation, DLB findings, length of procedure, reason for repeat DLB, and types of foreign body etc. were recorded. ⋯ Long-standing airway foreign bodies are associated with considerable morbidity, and early diagnosis remains the key to successful and uncomplicated management of foreign body aspiration. Education aimed at increasing diagnostic acumen of the physicians and heightening of public awareness are the most important steps needed to reduce the morbidity and mortality. Parents should be instructed to abstain from feeding nuts and seeds to young children and to keep small, potentially ingestible objects out of their reach.
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Int. J. Pediatr. Otorhinolaryngol. · Oct 2000
Comparative StudySmell and taste in children with simple obesity.
In 30 children, aged 10-16 years and suffering from simple obesity, significantly lowered odour detection thresholds were noted. The thresholds were lower than the average for a given age group in around 20% of obese children in cases of odours stimulating olfactory nerve and in around 57% in cases of substances stimulating olfactory and trigeminal nerves. ⋯ In 77% cases also the electrogustometric thresholds were found below the normal range values when anode was used as the stimulating electrode. The detected alterations may be linked to metabolic disturbances, which accompany simple obesity.