International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Feb 1987
Historical ArticleThe head-pad in art and medicine: a forgotten nasal protector.
From the beginning of the 16th century the use of the padded cap to prevent injuries of the middle-face and skull in infants during their period of learning to walk is documented in art and medicine. Especially the painters of the Dutch and Flemish schools left beautiful paintings and drawings showing children with head-pads. Till the end of the 18th century the use of the head-pad was widely spread over Europe. In the 19th century the educational concepts of Rousseau and Kant probably induced a rejection and an abolition of this useful protective cap, which has been rediscovered during the past 20 years.
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Int. J. Pediatr. Otorhinolaryngol. · Feb 1986
Prevention of subglottic stenosis in neonatal ventilation.
Mechanical ventilation of the newborn is now widely used in neonatal intensive care. The oro-tracheal route of intubation is simpler, but for long-term ventilation has been considered unstable. A method of fixation of oro-tracheal tubes is described which overcomes this instability. ⋯ Of the 287 survivors, 44 developed a degree of post-extubation stridor. No surviving infant developed clinical evidence of subglottic stenosis and in almost 200 postmortem examinations laryngeal narrowing was not identified. The method of oro-tracheal fixation described is stable and may reduce the incidence of subglottic stenosis.
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Acute airway obstruction secondary to supraglottic inflammation is a regional manifestation of epiglottitis in children. Pneumonia, meningitis, cervical adenitis and septic shock are systemic manifestations which can complicate the course of acute epiglottitis. Prompt airway control and institution of appropriate high dose i.v. antibiotics are both important to continue to decrease the morbidity and mortality associated with the regional and systemic manifestations of acute epiglottitis in children.
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During a 22-month period, 5 children, 6-13 months of age, presented with an acute obstructive upper airway infection which resembled both croup and epiglottitis. All 5 failed to respond to standard treatment for croup, including aerosolized racemic epinephrine. In all patients, direct laryngoscopy revealed minimal or no change in the epiglottis and aryepiglottic folds but severe subglottic swelling and copious purulent tracheal secretions. ⋯ Influenzae and frequent tracheal suctioning. Hospitalization varied from one to 3 weeks. We reported findings in these patients because: the initial diagnosis was unclear due to confusion caused by clinical features common to both croup and epiglottitis and bacterial tracheitis requires a prompt accurate diagnosis and aggressive antibiotic and airway management in order to prevent unnecessary morbidity and mortality.
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Int. J. Pediatr. Otorhinolaryngol. · Aug 1985
Case ReportsLymphangioma of the larynx as a cause of progressive dyspnea.
The following is a case report of a lymphangioma of the larynx in a 16-year-old girl with Down's Syndrome. The clinical record of the girl, the diagnosis of the tumour and its surgical treatment as well as the postoperative course and the follow-up results are described.