International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Nov 2015
Review Case ReportsParadoxical vocal cord movement during sleep - A unique case with review of literature.
Paradoxical vocal cord movement (PVCM) refers to paradoxical adduction of the true vocal cords during inspiration resulting in variable upper airway obstruction. The condition often presents with shortness of breath, wheeze or stridor, mimicking bronchial asthma. ⋯ PVCM occurring only during sleep has rarely been reported in patients with CNS disease. We present a case of PVCM occurring only during sleep in a 14-year-old boy without any CNS disease, who was initially misdiagnosed as bronchial asthma.
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Int. J. Pediatr. Otorhinolaryngol. · Nov 2015
Predictors of complications following adenotonsillectomy in children with severe obstructive sleep apnea.
To identify pre-operative risk factors predicting complications following adenotonsillectomy in children with severe OSA. ⋯ Preoperative polysomnography yields significant independent predictors of post-op complications in children with OSA. While AHI is a significant independent predictor, minimum O2 saturation on preop PSG appeared the strongest predictor when <80%. Patients with these risk factors, especially low O2 on PSG, warrant overnight observation with continuous pulse oximetry.
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Int. J. Pediatr. Otorhinolaryngol. · Nov 2015
Cost effective use of audiograms after pediatric temporal bone fractures.
To identify the relationship of pediatric temporal fractures to the incidence and type of hearing loss present. To analyze the timing and utility of audiometric testing in children with temporal bone fractures. ⋯ Patients with otic capsule violating fractures or those with ossicular disruption are at higher risk for persistent hearing loss. Cost-saving may be accrued by selecting only those patients at high risk for persistent hearing loss for audiometric testing after temporal bone fractures.
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Int. J. Pediatr. Otorhinolaryngol. · Nov 2015
Otolaryngologic surgery in children with trisomy 18 and 13.
Trisomy 18 and 13 are the most common autosomal trisomy disorders after Down syndrome. Given the high mortality rate (5-10% one-year survival), trisomy 18 and 13 were historically characterized as uniformly lethal and palliation was the predominant management approach. Management strategy has shifted with recognition that through medical and surgical intervention, children with trisomy 18 and 13 can achieve developmental milestones, live meaningful lives, and exhibit long-term survival. Otolaryngologic surgery in children with trisomy 18 and 13 has not been described. The objective of this article is to describe the role of the otolaryngologist in the management of children with trisomy 18 and 13. ⋯ Seventeen percent of procedures performed in children with trisomy 18 and 13 were otolaryngologic, highlighting the significant role of the otolaryngologist in the treatment of these patients. Surgical intervention may be considered as part of a balanced approach to patient care.
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Int. J. Pediatr. Otorhinolaryngol. · Oct 2015
Postoperative complications in obese children undergoing adenotonsillectomy.
The incidence of obesity in the pediatric population is increasing. To date, data are limited regarding safety of adenotonsillectomy in this patient population. The purpose of this study is to assess perioperative outcomes of adenotonsillectomy in the obese pediatric patient. ⋯ Performing adenotonsillectomy on the obese pediatric patient is safe. When performing adenotonsillectomy on this patient population, one must be aware that respiratory events are the most common type of complication and risk of respiratory complications is higher in males, patients of low socioeconomic status, and patients with comorbid asthma, regardless of race or insurance status.