International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2015
Case ReportsThe "multiport airway adapter" in flexible bronchoscopy for peripheral bronchial foreign bodies in children.
Many children require emergency foreign body removal by bronchoscopy. Although a flexible bronchoscope is frequently used for removal of a bronchial foreign body in children, this procedure is difficult in children with a narrow tracheal lumen, even using a thin flexible bronchoscope. ⋯ The thicker forceps etc. were passed alongside the flexible bronchoscope through the adaptor. These findings suggest that this multiport airway adaptor will be useful as an advanced tool for foreign body removal in pediatric patients.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2015
Oral morphine for pain management in paediatric patients after tonsillectomy and adenotonsillectomy.
The withdrawal of codeine for use in children following tonsillectomy enforced a change in our practice of providing regular paracetamol and ibuprofen, with codeine for breakthrough pain relief. Our objectives were to; examine the effectiveness of paracetamol and ibuprofen; examine the effectiveness of the addition of rescue (PRN) morphine to regular paracetamol and ibuprofen. ⋯ This service evaluation found that postoperative morphine on an as-required basis, in addition to regular paracetamol and ibuprofen, did not significantly alter initial pain profile, worst pain scores or rate of health service contact when compared to regular paracetamol and ibuprofen alone. The majority of children in this study felt additional analgesia required. Children in the morphine groups experienced significantly less pharmacological intervention when contacting the GP after surgery.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2015
Reliable acoustic measurements in children between 5;0 and 9;11 years: Gender, age, height and weight effects on fundamental frequency, jitter and shimmer in phonations without and with controlled voice SPL.
Current pediatric voice assessment guidelines include instrumental measurements of fundamental frequency (F0) and the perturbation indices jitter and shimmer. In children below 10 years, gender, age, height and weight effects on these parameters have been inconsistently characterized. Recent research in healthy children showed, that differences in habitual speaking voice intensity (voice SPL) under the usual assessment procedure significantly affect jitter and shimmer. These effects were reduced in phonations with controlled voice SPL >80dBA. Reliable measurement methods and description of physiologic influencing factors are essential to identify pathologic voices. ⋯ Neither without nor with controlled voice SPL there were systematic gender, age, height or weight effects on voice F0, jitter and shimmer. Gender related F0 discrepancies were equalized in phonations with >80dBA. In children below 10 years gender related acoustic voice differences may be mainly linked to behavior, which should be considered in future works regarding physiologic voice development.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2015
Ex vivo ovine model for pediatric flexible endoscopy training.
Medical students and residents in training have limited opportunities to develop pediatric endoscopy skills and would benefit from a realistic simulation model. We sought to develop such a model for flexible endoscopy using fresh head and neck tissue from young sheep. ⋯ Despite variations in proportion and structure, the experience of passing a flexible nasopharyngoscope through a sheep's airway is remarkably similar to pediatric endoscopy. The nasal anatomy is elongated, but very much like a child's in terms of anatomy, color and texture. The tactile feedback is nearly identical. Annoying secretions and their associated "whiteout" phenomena nicely simulate these challenges in pediatric endoscopy. When performing transnasal intubation, navigating to the larynx and advancing an endotracheal tube under guidance have the look and feel of the pediatric procedure. Issues of cost, availability, risk of zoonotic infection, and ethics are discussed.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2015
Symptoms associated with button batteries injuries in children: An epidemiological review.
To provide an epidemiological framework of symptoms related to Foreign Body (FB) injuries due to Button Battery (BB). ⋯ These findings provide new insight in clinical presentation of BB injuries: the identification of unique patterns of symptoms related to BB injuries is useful to perform an early diagnosis (and to guarantee a prompt medical reaction), also when the injury is un-witnessed.