International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Feb 2017
The impact of ethnicity on cochlear implantation in Norwegian children.
To explore the impact of parental ethnicity on cochlear implantation in children in Norway with regard to incidence rates of cochlear implants (CIs), comorbidies, age at onset of profound deafness (AOD), age at first implantation, uni- or bilateral CI, and speech recognition. ⋯ The incidence of CI was significantly higher in children with a non-Nordic vs. a Nordic ethnicity, reflecting a higher incidence of profound deafness. Children born in Norway have equal access to CIs regardless of their ethnicity, but despite being born and receiving care in Norway, prelingually deaf children with non-Nordic parents are at risk of receiving CI later than Nordic children. Moreover, prelingually deaf children who arrive in Norway at an older age may be at risk for a worse prognosis after receiving a CI due to lack of auditory stimulation in early childhood, which is critical for language development and late implantation; this is a serious issue with regard to deafness among refugees.
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Int. J. Pediatr. Otorhinolaryngol. · Feb 2017
Risk factors for cerebrospinal fluid leak in pediatric patients undergoing endoscopic endonasal skull base surgery.
To determine the risk factors associated with cerebrospinal fluid (CSF) leak following endoscopic endonasal surgery (EES) for pediatric skull base lesions. ⋯ Pediatric patients with an intra-operative CSF leak during EES of the skull base have a high rate of post-operative CSF leaks. Clival chordomas appear to be a particularly high-risk group. The use of vascularized flaps and perioperative lumbar drains did not statistically decrease the rate of post-operative CSF leak.
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Int. J. Pediatr. Otorhinolaryngol. · Jan 2017
Surgical scheduling categorization system (SSCS): A novel classification system to improve coordination and scheduling of operative cases in a tertiary pediatric medical system.
To describe a surgical categorization system to create a universal nomenclature, delineating patient complexity as a first step toward developing a true risk stratification system. ⋯ This surgical categorization system streamlines surgical scheduling in a tertiary pediatric hospital system, particularly with respect to the designation of cases as ambulatory surgery center or main operating room appropriate. The case mix complexity is also readily apparent, enhancing recognition of the coordination and attention required for the perioperative management of high complexity patients. The SSCS helps convey concerns not addressed by ASA physical status alone.
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Int. J. Pediatr. Otorhinolaryngol. · Jan 2017
Risk of failure of adenotonsillectomy for obstructive sleep apnea in obese pediatric patients.
Pediatric obesity is a leading risk factor for obstructive sleep apnea (OSA), a condition commonly treated with adenotonsillectomy (T&A). It has been hypothesized that obesity increases a child's risk of failing T&A for OSA, however this relationship has not yet been quantified. The primary objective of this study was to investigate the relationship between obesity as measured by perioperative Body Mass Index (BMI) and persistent OSA following T&A as measured by polysomnography (PSG). ⋯ Our study established an inverse linear relationship between perioperative BMI z-score and improvement in total AHI with essentially no improvement in patients with BMI z-scores >3. Further studies are required to further elucidate this relationship and investigate the role of additional procedures in the initial management of OSA in obese children.
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Int. J. Pediatr. Otorhinolaryngol. · Jan 2017
Randomized Controlled Trial Comparative StudyThe effect of IV dexamethasone versus local anesthetic infiltration technique in postoperative nausea and vomiting after tonsillectomy in children: A randomized double-blind clinical trial.
Local anesthetic infiltration and corticosteroids had shown effectiveness in reducing post tonsillectomy nausea, vomiting and pain. ⋯ Local anesthetic infiltration in addition to NSAIDS and paracetamol could serve as a multimodal analgesia and decrease PONV.