International journal of pediatric otorhinolaryngology
-
Int. J. Pediatr. Otorhinolaryngol. · Mar 2013
Comparative StudyEtiologies of pediatric craniofacial injuries: a comparison of injuries involving all-terrain vehicles and golf carts.
To determine incidence and etiologies of craniofacial injuries in the pediatric population through comparison of injuries caused by all-terrain vehicles and golf cart trauma. ⋯ ATVs and golf carts are often exempt from the safety features and regulations required of motor vehicles, and ATV and golf cart accidents represent a significant portion of pediatric traumas. This study found that ATV and golf cart accidents contribute significantly to craniofacial trauma requiring hospitalization, with resultant morbidity and mortality. Further investigation of these injuries and their prevention in the pediatric population is needed before efforts to promote effective safety regulations for such vehicles in the future can be addressed.
-
Int. J. Pediatr. Otorhinolaryngol. · Mar 2013
Combination of symptoms and oxygen desaturation index in predicting childhood obstructive sleep apnea.
To develop a screening process of obstructive sleep apnea in children based on a combination of symptoms and oxygen desaturation index (ODI). ⋯ Observable apnea during sleep was an independent positive predictive factor for OSA in children. A child with observable apnea during sleep should be referred to a special sleep laboratory for PSG diagnosis. When the total score is 3 or 4 based on a combination of symptoms and ODI, OSA can be diagnosed and the child should be referred to a sleep pediatrician for appropriate intervention. When the total score is 0 or 1, the child can be considered normal but should be monitored. When the total score is 2, the result cannot be determined and the child should be referred to a special sleep laboratory for PSG diagnosis. Thus, a screening process is developed based on a combination of symptoms and ODI.
-
Int. J. Pediatr. Otorhinolaryngol. · Feb 2013
Reversal of pulmonary hypertension in children after adenoidectomy or adenotonsillectomy.
Adenotonsillar hypertrophy is a common condition in pediatric patients with upper respiratory airways complaints, and pulmonary arterial hypertension (PAH) may be one complication of that condition. ⋯ In children with pulmonary hypertension associated to adenotonsillar hypertrophy, the adenotonsillectomy decreased PAP to normal values in all patients.
-
Int. J. Pediatr. Otorhinolaryngol. · Feb 2013
ReviewFuture of pediatric tonsillectomy and perioperative outcomes.
Although commonly performed, pediatric tonsillectomy is not necessarily a low risk procedure due to potentially life threatening perioperative complications. There is paucity of literature on lethal anesthesia and surgical complications of tonsillectomy. In this article, we have reviewed both minor and serious complications following tonsillectomy. Hemorrhage, burn injuries, respiratory complications, postoperative nausea and vomiting, and pain management are discussed. We have highlighted our practice of pain management at Cincinnati Children's Hospital after tonsillectomy recent warning about codeine by the FDA on children undergoing tonsillectomy. We describe post-tonsillectomy outcomes including postanesthesia care unit stay, post discharge maladaptive behavioral outcomes and finally effective ways to identify children at risk for anesthesia and a few preventive strategies. ⋯ Tonsillectomy in children carries a high risk of perioperative complications and malpractice claims. Though postoperative bleeding is the most common complication associated with malpractice claims, anoxia related to anesthesia and opioids had the greatest overall risk from a monetary standpoint.
-
Int. J. Pediatr. Otorhinolaryngol. · Feb 2013
Randomized Controlled TrialRole of topical antibiotic prophylaxis in prevention of bacterial translocation into upper trachea in nasally intubated patients undergoing tonsillectomies.
The human oropharynx and nasopharynx are home of different bacteria and fungi. The initial sterile endotracheal tube (ETT) transfers mechanically the bacteria from the nasopharynx and oropharynx to the sterile tracheobronchial tree. We investigated the efficacy of Neomycin-Bacitracin combination spray in the prevention of this bacterial translocation through its application over and inside the lumen of the endotracheal tubes preoperatively. ⋯ Bacterial translocation by endotracheal intubation to the tracheobronchial tree could be prevented by local antibiotic spray application to outer and inner walls of the endotracheal tubes.