International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Mar 1993
Impalement injuries of the palate in children: review of 131 cases.
Impalement injuries of the soft palate and oropharynx are common injuries especially in children. Devastating neurologic sequelae secondary to thrombus propagation in the internal carotid artery are rare but well-documented complications of these innocuous appearing injuries. Neurologic sequelae have been reported anywhere from 3 to 60 hours after the injury. ⋯ Based on this review, the majority of soft plate and oropharyngeal impalement injuries can be managed on an outpatient basis. Parental counseling, similar to instructions given in instances of mild head trauma, as well as close follow up in the office are felt to be a more reasonable and as well as a safe treatment plan. A suggested instruction form is presented.
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A retrospective analysis of 94 cases of childhood myiasis admitted over a 6-year period is presented. Children formed 37.9% of all cases of myiasis. More than 50% of the children were less than 5 years of age and most (96.8%) belonged to a rural background. ⋯ In nasal myiasis epistaxis (100%), foul smell (100%) passage of worms (90.9%) and pain (72.72%) were the prime presenting symptoms. All patients were treated with chloroform and turpentine oil in the ratio 1:4 which was followed by manual removal of the maggots and were made maggot-free in 2-3 days. No complications were seen.
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Int. J. Pediatr. Otorhinolaryngol. · Nov 1992
Otolaryngology and infectious disease team approach for outpatient management of serious pediatric infections requiring parenteral antibiotic therapy.
Children with community-acquired serious otolaryngologic infections are conventionally hospitalized for parenteral antibiotic therapy. However, effective and safe outpatient therapy is desirable since it is less traumatic and less costly. During a 24-month period outpatient parenteral antibiotic therapy, usually once daily i.m. ceftriaxone, was evaluated in 41 children with serious otolaryngologic infections (acute mastoiditis, complicated otitis media, severe external otitis and severe sinusitis with orbital or periorbital involvement). ⋯ One case of sinusitis-orbital cellulitis relapsed during therapy. Most patients and parents returned to normal life activities within 72 h from starting outpatient therapy. Our data suggest that many children with serious otolaryngologic infections can be managed successfully and safely as outpatients by a combined team of otolaryngology and infectious disease specialists.
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Int. J. Pediatr. Otorhinolaryngol. · Jul 1992
Case ReportsUrgent adenotonsillectomy for upper airway obstruction.
Adenotonsillar hypertrophy has been documented to cause chronic upper airway obstruction resulting in cardiopulmonary sequelae in children. It has been less recognized that long-term adenotonsillar hypertrophy may additionally cause acute, life-threatening airway obstruction. ⋯ Observations of cyanosis, cor pulmonale, and use of accessory respiratory muscles were carefully recorded. This study illustrates that life-threatening upper airway obstruction may be due to chronic adenotonsillar enlargement and require treatment by urgent adenotonsillectomy.
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Int. J. Pediatr. Otorhinolaryngol. · Jan 1992
Masseter spasm and malignant hyperthermia: a retrospective review of a hospital-based pediatric otolaryngology practice.
It has been claimed that the combination of halothane and succinylcholine, commonly used for anesthetic induction during short pediatric otolaryngologic procedures, is associated with a 1% incidence of masseter spasm (MS) which may be an early sign of malignant hyperthermia (MH). An 18-month retrospective chart review of all patients undergoing general anesthesia at the Children's Hospital of Pittsburgh (n = 14, 112) was conducted to assess the incidence of MS and its management. ⋯ In the otolaryngology service, the incidence of developing MS was 2 of 206 (1%) in children who were anesthetized with halothane and received succinylcholine, patients were identified in the MH high-risk group, and none developed MH. The findings affirmed the risks of using this combination of anesthetic and neuromuscular blocking agents during induction and the need for establishing management guidelines.