International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Mar 1996
Review Case ReportsNager acrofacial dysostosis: management of a difficult airway.
Nager acrofacial dysostosis, first described by Nager and deReynier in 1948, is a rare syndrome characterized by mandibulofacial dysostosis with associated radial defects. The facial features include downward slanting palpebral fissures, absent eyelashes in the medial third of the lower lids, mandibular and malar hypoplasia, dysplastic ears with conductive deafness, and variable degrees of palatal clefting. Upper limb malformation is a constant feature of Nager syndrome and ranges from thumb hypoplasia to absence of the radial ray. ⋯ The craniofacial anomalies and associated trismus make emergent airway intubation challenging. We present a case of Nager syndrome with life threatening airway obstruction unresponsive to conservative management. This case and a review of the literature emphasize the importance of early tracheotomy for these patients.
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Int. J. Pediatr. Otorhinolaryngol. · Aug 1995
Review Case ReportsLigation of the common carotid artery for the management of a mycotic pseudoaneurysm of an extracranial internal carotid artery. A case report and review of the literature.
Although vascular involvement by deep neck space infections occurs very rarely today with the widespread use of antibiotics, they often pose a significant challenge to the modern otolaryngologist, who most likely will have had no previous experience with either the diagnosis or treatment of these potentially life-threatening infections. We describe the case of a young female presenting with fevers, dysphagia, and blood-tinged sputum, who was diagnosed by contrast-enhanced computerized tomography, to possess a mycotic pseudoaneurysm of her right extracranial internal carotid artery, for which ligation of her common carotid artery was required. We also discuss both the clinical findings which should lead one to suspect that a neck infection may be involving the extracranial carotid arteries, and the English literature, on the morbidity and mortality of ligating a common carotid artery.
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Int. J. Pediatr. Otorhinolaryngol. · Mar 1995
Randomized Controlled Trial Clinical TrialThe effect of post-operative diet on recovery in the first twelve hours after tonsillectomy and adenoidectomy.
The effect of post-operative diet selection on the recovery rate of 100 children ages 3-17 years undergoing tonsillectomy and adenoidectomy (T & A) was studied. In the first 12 h after T & A children were allowed either a 'restricted' diet of only soft foods and liquids or a 'non-restricted' diet of foods preselected and usually eaten by the child. Parental evaluation of the child's general well being, pain level and nausea were evaluated. ⋯ Children in the 'non-restricted' group were able to eat foods more often associated with their regular diet. No child from either group experienced any immediate or delayed complications. Implications for children and their families undergoing T & A are discussed.
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Int. J. Pediatr. Otorhinolaryngol. · Jan 1995
Home application of EMLA cream prior to venipuncture. Is it feasible in pediatric ENT day care surgery?
EMLA (Eutectic Mixture of Local Anaesthetics) cream is an emulsion made from lidocaine and prilocaine. The cream is well known among parents in Scandinavia, and it has become most popular in preventing pain during venipuncture in children. To be fully effective the cream must be applied at least 60 min before the painful stimulus, which is a major drawback in outpatient practice. ⋯ Twenty-three children were excluded from the study due to failure in registration or they were called in to fill vacancies. One hundred and eighty out of 205 children had EMLA cream applied. Home application of EMLA cream reduced the waiting time at the ENT outpatient clinic by at least 60 min, and the study showed that home application of EMLA cream is safe, easy to perform and a well-tolerated procedure.