International journal of pediatric otorhinolaryngology
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We report the case of a 6-month-old child who developed acute pulmonary edema because of laryngeal spasm during orthopedic manipulations for congenital hip dysplasia. Laryngospasm was probably secondary to an unsuspected light level of anesthesia, maintained via face mask. No other predisposing factors, such as enlarged adenoid tonsils, laryngitis, epiglottitis, mechanical stimulation of the larynx or aspiration of foreign material were identified. ⋯ This type of pulmonary edema is caused by marked elevated negative intra-airway pressure, massive sympathetic discharge causing a blood shift from the systemic to the pulmonary circulation, and accentuation of physiological ventricular interdependence during forceful inspiratory effort against a closed glottis. As usual in such cases, pulmonary edema and laryngospasm resolved spontaneously without specific treatment, and extubation was carried out uneventfully two hours later. The child suffered no sequelae.
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Int. J. Pediatr. Otorhinolaryngol. · Aug 1990
Review Case ReportsJuvenile myasthenia gravis: an unusual presentation.
Myasthenia gravis is a disease characterized by muscular weakness and fatigability which afflicts 2-10 patients per 100,000 with 20% of cases presenting in childhood. Muscles innervated by cranial nerves are frequently involved with ptosis and diplopia being the most frequent presenting complaints. We review the literature and report a case of a 20-month-old infant presenting with inspiratory stridor and cyanosis, resembling foreign body aspiration.
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Int. J. Pediatr. Otorhinolaryngol. · Mar 1990
Case ReportsEmbedded earrings: a complication of the ear-piercing gun.
Ear-piercing techniques include needles, safety pins, sharpened studs, and self-piercing kits. Complications from ear piercing are well documented and may involve local infection, sepsis, keloid scar formation, sarcoid granulomas, cyst formation, bifid ear lobe deformity, and organizing hematoma. ⋯ The embedded earring complication may result from improper aseptic technique, insufficient training of personnel at ear-piercing centers, or piercing the ears of young. To diminish the risk of embedded earrings we recommend aseptic technique, proper training, limiting ear piercing to the lobe, frequent cleansing of the lobe, and removal of the earring if signs of infection develop.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 1989
Lateral cricoid cuts as an adjunctive measure to enlarge the stenotic subglottic airway: an anatomic study.
The technique of laryngotracheoplasty, with an anterior approach, with or without a posterior cut, and with or without anterior or posterior cartilage grafts, has been described previously. On occasion, a severely stenotic subglottis or aberrant shape to the cricoid cartilage makes division of the lateral aspects of the cricoid cartilage desirable. ⋯ The distance was very close in the fetal larynx (measuring 1.5 mm in the 23rd week of gestational age), with an increase in dimension in the infant and child, increasing to a distance of over 1 cm in the mature adult. The clinical significance of this relationship to proposed cuts of the lateral cricoid in different age groups is discussed.
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During the period January 1982 to December 1985 nasal resistance (NR) was measured by computer-assisted 'head-out' plethysmography in 986 patients aged 4-18 years referred to the Airflow Laboratory at the Hospital for Sick Children, Toronto. Nasal resistance was found to decline with increasing age, and it was elevated in the presence of mucosal swelling, adenoid enlargement and other significant nasal pathology. Studies of variance on the equipment used indicated that in the assessment of NR results of the head-out volume displacement plethysmographic method of active posterior rhinometry were highly reproducible.