International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Feb 2015
Post tonsillectomy hemorrhage: who needs intervention?
Post-tonsillectomy hemorrhage (PTH) remains a significant complication. There are no guidelines for Pediatric Emergency Department (PED) disposition of children with secondary PTH. ⋯ Majority of children with secondary PTH were admitted and nearly 3/5th of them required an intervention. Our data suggests that healthy children <6 years with a confirmed normal oropharyngeal exam are less likely to require an intervention and may be candidates for safe discharge from the ED provided reliability of return for recurrence can be assured.
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Int. J. Pediatr. Otorhinolaryngol. · Feb 2015
Apoptosis in chronic tonsillitis and tonsillar hypertrophy.
Chronic tonsillitis is the persistent inflammation of the tonsillar tissue that occurs due to recurrent, acute or subclinical infection. The recurrent and chronic inflammation of palatine tonsils sometimes results in hypertrophy. Apoptosis provides an important balance between lymphocytes in tonsillar lymphoid tissue. The aim of this study is to investigate the apoptosis in tonsillar diseases. ⋯ In the light of these findings, it was concluded that apoptosis played a role in the tonsillar hypertrophy and atrophy. Apoptosis functioned to balance lymphocyte proliferation in tonsil tissue. The association of apoptosis with tonsillar hypertrophy seemed to be age-dependent.
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Int. J. Pediatr. Otorhinolaryngol. · Feb 2015
Case ReportsForeign body resulting in chronic otomastoiditis and facial palsy.
We present a case of a foreign body in the ear of 5-year-old girl child. She presented with features of chronic suppurative otitis media with facial nerve palsy. On exploration exuberant granulation was found in attic and middle ear. ⋯ Bony facial canal was dehiscent in the tympanic segment. She had recovery of facial nerve function. The case is being reported to increase awareness among otolaryngologist and to consider foreign body as a differential diagnosis in cases of complicated CSOM; especially in children.
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Int. J. Pediatr. Otorhinolaryngol. · Jan 2015
Observational StudyChanges in intracuff pressure of a cuffed endotracheal tube during prolonged surgical procedures.
With the introduction of redesigned cuffed endotracheal tubes (ETTs), there has been an increasing trend toward their use in pediatric patients. Despite improvements in design, an unintended and prolonged hyperinflation of the cuff can compromise tracheal mucosal perfusion. The current study prospectively monitors changes in intracuff pressure continuously in pediatric patients undergoing prolonged surgical procedures. ⋯ We noted significant variations in the intracuff pressure during prolonged surgical procedures. These unintended changes, both increases and decreases, may impact the perioperative course of patients. Our study suggests the need for continuously monitoring intracuff pressure if a cuffed ETT is used in children for prolonged surgical procedures.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2014
Airway laser procedures in children and the American Society of Anesthesiologists' Practice Advisory: a survey among pediatric anesthesiologists.
Recognizing the risk of fire during laser procedures involving the airway, the American Society of Anesthesiologists (ASA) developed recommendations designed to promote safe practice and reduce burn injuries. The aim of this study was to identify how reported anesthetic management of airway laser endoscopies in pediatric patients aligns with the ASA Practice Advisory (ASA-PA). ⋯ Our results indicate that, in general, pediatric anesthesiologists do not adhere to the ASA-PA in several important aspects. Possible explanations might be knowledge deficiencies about the Practice Advisory or a perceived limited clinical applicability in the pediatric setting. Regardless, airway fires during laser airway surgeries in this population do occur, emphasizing the need for safe practice standards for both anesthesiologists and surgeons.