International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Oct 1998
Case ReportsMeningitis as a complication of tonsillectomy.
Adenotonsillar surgery remains among the most commonly-performed pediatric surgical procedures. The complication rate of tonsillectomy is generally considered to be in a range of 1-5%. Bacterial meningitis following adenotonsillectomy is a rarely reported complication. ⋯ The successful management of meningitis depends on early clinical suspicion and diagnosis, with prompt medical treatment using high-dose, broad-spectrum antibiotics that adequately cross the blood-brain barrier. We present a case of meningitis complicating a tonsillectomy procedure, in a 7-year-old girl. The diagnosis and treatment of this rare complication is illustrated, and the possible etiology is discussed.
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Int. J. Pediatr. Otorhinolaryngol. · Oct 1998
Case ReportsThe silent epidural abscess as a complication of acute otitis media in children.
Acute otitis media with complications is a persistent problem in the modern antibiotic era with a relatively high mortality rate. Acute mastoiditis is a serious complication of acute otitis media with potentially grave consequences and the epidural abscess constitutes the commonest of all intracranial complications, arising from middle ear infections. We report two cases of children with acute mastoiditis without evidence of intracranial complication or subperiosteal abscess, in whom the early evaluation with computed tomography (CT) disclosed an unsuspected epidural abscess. Therefore, we stress the use of CT as a rule of thumb for every child with acute mastoiditis.
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Int. J. Pediatr. Otorhinolaryngol. · Jun 1998
Case ReportsSpontaneous passage of coins lodged in the upper esophagus.
Coin ingestion with subsequent esophageal coin impaction is common in children. Although spontaneous passage to the stomach of coins at the gastroesophageal sphincter is fairly common, spontaneous passage of coins from the upper or mid-esophagus has only rarely been reported. ⋯ These cases suggest that spontaneous passage of proximal esophageal coins does, in fact, occur in some children. A second set of radiographs, therefore, may identify these children, and prevent unnecessary invasive removal procedures.
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Foreign bodies of the hard palate are rare occurrences with only 11 reported cases in the literature. These patients can present to the Otolaryngologist in a variety of ways and often with confusing histories. We present seven cases of foreign bodies adherent to the hard palate. ⋯ The most common object removed was a nut shell. In six of the seven cases the foreign body could be removed in the ambulatory clinic without the need for sedation or anesthesia. The clinical presentation, incidence and management is reported and discussed with reference to the literature.
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Int. J. Pediatr. Otorhinolaryngol. · Feb 1998
Comparative StudyThe immediate effects of local trauma on the shape of the cricoid cartilage.
Injury-induced abnormal development of the cricoid ring has been demonstrated in previous growth studies. In this study we focused on the immediate effects of various types of lesions to the cricoid, eliminating the influence of inserting muscles. In isolated, vital cricoids (cricoid explants) the anterior arch was split, creating a small gap between the cut ends. ⋯ On the contrary, injuring the external surface of the cricoid cartilage prior to anterior cricoid split, leads to an overlap of the cut edges, and a narrowing of the ring. These injury-specific changes in shape of the cricoid ring are ascribed to the release of interlocked stresses, present in the cartilage. It is suggested that the demonstrated methods to change the shape of the cricoid ring in a predictable way, are relevant for the treatment of patients with cricoid malformation.