International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Oct 2018
Predictive factors associated with spontaneous passage of coins: A ten-year analysis of paediatric coin ingestion in Australia.
Coins are the commonest foreign body ingested in paediatric populations. Although most ingested coins are either spontaneously passed or retrieved with medical intervention without serious consequence, there is potential for serious morbidity and mortality related to paediatric coin ingestion. We performed a 10-year retrospective review of Australian denomination coin ingestion at a tertiary paediatric hospital in Sydney, Australia. We attempted to determine whether a relationship exists between coin size, patient age, coin ingestion and spontaneous passage. ⋯ Coin size, coin weight and age of the child appear to be predictors for both likelihood of ingestion and spontaneous passage in paediatric coin ingestion cases. A child with minimal symptoms, witnessed ingestion and radiographic identification of the coin in the lower oesophagus or more distal can often be safety observed for up to 24 h in anticipation of spontaneous passage.
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Int. J. Pediatr. Otorhinolaryngol. · Oct 2018
Subglottic hemangioma: Understanding the association with facial segmental hemangioma in a beard distribution.
A subglottic hemangioma (SGH) is a benign tumor of infancy that can cause severe obstruction of the airway. Infantile hemangiomas, in general, are the most common head and neck tumor in children, affecting 4-5% of the pediatric population. This retrospective cohort study characterizes subglottic infantile hemangiomas at a single vascular anomaly center over a 5-year period (2013-2017) during the era of propranolol treatment. ⋯ Subglottic hemangiomas are a rare presentation of infantile hemangiomas but with significant morbidity. While the classic teaching that a segmental beard distribution hemangioma raises concern for a subglottic hemangioma, this cohort indicates subglottic hemangiomas occur in a NBD presentation (1.3%), and demonstrated only an approximate 10% incidence rate with a beard distribution. But more importantly, this study raises the question that beard distribution in setting of PHACES syndrome may herald a more recalcitrant and complicated natural history for a subglottic hemangioma. This is of significant concern as risk for CVA in setting of PHACES is highest with use of steroid treatment. None of our patients had high risk extra or intra cranial vascular arterial anomalies and no CVA were noted.
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Int. J. Pediatr. Otorhinolaryngol. · Oct 2018
3-Dimensional printed haptic simulation model to teach incomplete cleft palate surgery in an international setting.
Cleft palate is one of the most common congenital anomalies, yet surgical repair remains challenging and can lead to significant complications in the hands of inexperienced surgeons. There is a great need for the development of a simulation model that will allow surgeons worldwide to learn and practice the intricate skills needed for cleft palate surgery. ⋯ The use of 3D printed haptic simulation models for teaching and learning cleft palate repair techniques could enhance skill acquisition and possibly improve surgical outcomes. In outreach settings, it could help achieve local, sustainable comprehensive care for cleft palate patients.
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Int. J. Pediatr. Otorhinolaryngol. · Oct 2018
Vallecular cyst in the pediatric population: Evaluation and management.
To review the presentation of pediatric vallecular cysts and outline an approach for evaluation and management. ⋯ Vallecular cysts can cause feeding difficulties due to upper airway obstruction and pressure at the laryngeal inlet. Diagnostic work-up for vallecular cysts should include a detailed medical history, complete head and neck examination including endoscopic examination, and appropriate imaging, as each of these components complements the histopathologic findings. Our findings indicate that performing marsupialization is associated with low rate of recurrence or complication.
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Int. J. Pediatr. Otorhinolaryngol. · Sep 2018
Case ReportsTranscanal incision and drainage of a parapharyngeal abscess in a pediatric patient: A novel technique.
The disease of parapharyngeal abscess is well known to the otolaryngologist and is commonly managed via transoral, transcervical, or combined incision and drainage. We report a novel approach to an abscess that was drained through the external auditory canal (EAC). An otherwise healthy 2-year-old female presented with a 4-day history of fevers, decreased oral intake, neck stiffness, and voice changes. ⋯ Successful incision and drainage was performed via transcanal approach. She received intravenous antibiotics and steroids post-operatively and surgical packing was removed. She was discharged home on post-operative day 5 afebrile and tolerating a regular diet and continued to do well at most recent outpatient follow-up.