International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Jul 2013
Tracheostomy in mucopolysaccharidosis type II (Hunter's Syndrome).
Patients with mucopolysaccharidosis type II (MPS II) may develop progressive multi-level upper airway obstruction. Despite the unique challenges presented by these complex patients, tracheostomy remains an important intervention to safeguard the airway when other interventions have failed or when the airway obstruction involves multiple sites. Airway involvement is largely responsible for the significant anaesthetic risk seen in MPS II. We reviewed our tertiary unit's experience of tracheostomies in patients with MPS II. ⋯ 2c.
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Int. J. Pediatr. Otorhinolaryngol. · Jul 2013
Subglottic stenosis and socio-economic deprivation: a 6-year review of the Scottish National Service for Paediatric Complex Airway Reconstruction.
Subglottic stenosis is the third most common cause of stridor in children, and severe cases may need surgical reconstruction. Babies born to parents in high-deprivation areas are at increased risk of prematurity and low birth weight. This may require intensive care admission with prolonged intubation, hence, putting them at increased risk of subglottic stenosis. We aimed to review cases of subglottic stenosis requiring surgical intervention in the Scottish population and its association with socio-economic deprivation. ⋯ Our data is the first attempt to review the incidence of subglottic stenosis in the Scottish population and its association with deprivation. Perhaps surprisingly, we found no association.
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Int. J. Pediatr. Otorhinolaryngol. · Jul 2013
Cuffed endotracheal tubes in infants and children: a technique to continuously measure the intracuff pressure.
Various devices have been used to measure the intracuff pressure (CP) of an endotracheal tube at the time of inflation; however, no device has found widespread acceptance for the continuous monitoring of CP. We devised a simple method to continuously measure the CP using an invasive pressure monitoring setup (IPMS), which is used routinely in the operating room to monitor arterial or central venous pressures. The accuracy of the device was compared to those obtained from a commercially available and clinically used manometer (MM). ⋯ A standard IPMS can be used to continuously monitor intracuff pressure with the use of a cETT. Although various techniques can be used safely to avoid hyperinflation of the cuff, they provide only an instantaneous measure of the CP. The current technique allows for continuous monitoring of CP during prolonged cases or in other clinical scenarios when such monitoring is required.
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Int. J. Pediatr. Otorhinolaryngol. · Jun 2013
ReviewAuditory risk of hyperbilirubinemia in term newborns: a systematic review.
High levels of unconjugated bilirubin have been associated with neuronal damage. The auditory brain nuclei and the inferior colliculi are often the first part of the brainstem to be involved, often leading to hearing abnormalities. A systematic review of clinical studies was conducted to evaluate the effect of hyperbilirubinemia on hearing in term newborns, to show the relationship between hearing function and bilirubin levels as well as the effect of treatment. ⋯ Hyperbilirubinemia resulted in abnormal hearing assessment in up to 83.3% of term newborns. Greater hearing abnormalities were observed with rising serum bilirubin levels. Treatment of hyperbilirubinemia led to a considerable decrease in the incidence of hearing loss.
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Int. J. Pediatr. Otorhinolaryngol. · Jun 2013
ReviewThe quality and accuracy of internet information on the subject of ear tubes.
The World Wide Web is a commonly used source of health information for patients. The objective of this study is to assess the quality and accuracy of information on the internet regarding ear tubes and their insertion. ⋯ Overall, internet information regarding ear tubes is of mixed quality and the readability is generally low. Certain topics such as the number of patients that require repeat ear tube insertion and advice on bathing and showering with ear tubes were poorly described.