International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2010
Case ReportsAtypical locations of retropharyngeal abscess: beware of the normal lateral soft tissue neck X-ray.
Retropharyngeal abscesses (RPA) are uncommon but potentially lethal deep neck space infections, over 95% of which occur in children under six years of age. Without a high index of suspicion, early recognition and prompt intervention, catastrophic consequences can ensue, and mortality can be as high as 60% if jugular vein thrombosis or mediastinitis occurs. ⋯ While we recognise the role of lateral neck X-rays in retropharyngeal and other upper airway pathologies, we present three case series in which lateral neck X-rays were normal and diagnosis was made only after CT scanning. These three cases were unusual as the abscesses were located high in the naso-pharynx making them impossible to detect on the lateral soft tissue neck X-rays and this underscores the need for high index of suspicion and prompt CT or MRI scanning, in any child with symptoms or signs suggestive of a possible retropharyngeal abscess.
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Int. J. Pediatr. Otorhinolaryngol. · Nov 2010
Management and outcome of pediatric skull base fractures.
The management of skull base fractures in the pediatric age group continues to be a major challenge even for experienced multidisciplinary teams. This retrospective study was undertaken at a tertiary care academic hospital to evaluate the management and outcome of pediatric skull base fractures. ⋯ We conclude that skull base fracture is a rare injury in childhood. Mortality is uncommon, but this trauma is commonly associated with intracranial injury. Early neurological deficits are caused by traumatic brain injury and were observed in one-third of the patients. However, only less than one-sixth suffered from permanent neurological or neuropsychiatric disorders.
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Int. J. Pediatr. Otorhinolaryngol. · Nov 2010
Mandibular fractures in a group of Brazilian subjects under 18 years of age: A epidemiological analysis.
This study showed a retrospective analysis of the etiology, incidence and treatment of maxillofacial injuries in a pediatric and adolescent population of the State of Sao Paulo. ⋯ The incidence of trauma and mandible fractures in pediatric and adolescent patients was high in the area of study. Bicycle accidents and falls being the main etiological factors. The group of adolescents was most affected. The conservative and surgical treatment was used almost in the same proportion.
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Int. J. Pediatr. Otorhinolaryngol. · Nov 2010
Obstructive sleep disorders in Prader-Willi syndrome: The role of surgery and growth hormone.
To review the effectiveness and safety of surgical intervention for obstructive sleep apnea in Prader-Willi syndrome. ⋯ Our series, and other small case series, have demonstrated that complete resolution of sleep apnea in PWS patients is difficult to obtain with upper airway surgery alone. It is suggested that children with PWS being considered for growth hormone therapy undergo assessment for OSA by polysomnography. Patients identified with OSA should be referred for management by tonsillectomy and/or continuous positive airway pressure (CPAP) and then reassessed for residual airway obstruction prior to instituting hormonal therapy.
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Int. J. Pediatr. Otorhinolaryngol. · Oct 2010
ReviewInterventions in health care professionals to improve treatment in children with upper respiratory tract infections.
To analyse which strategies are used to promote evidence based interventions in the management of children with upper respiratory tract infections (URTIs) in daily practice. To assess the effectiveness of these interventions, and when more are effective--which works best. And to analyse the costs associated with these interventions. ⋯ Multifaceted and computer strategies appear to be most effective to put evidence into practice in the area of URTIs in children.