International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Jan 2010
Enzymatic study of tonsil tissue alkaline and acid phosphatase in children with recurrent tonsillitis and tonsil hypertrophy.
Indications for tonsillectomy in recurrent tonsillitis are defined according to the number of episodes of acute bacterial infections in a year. However, little is known about the tonsil immune competence status in patients presenting with recurrent tonsillitis with either hypertrophied or atrophied tonsils, or in patients presenting with obstructive sleep apnoea. In this study we examined the tonsil immune status in children with 3-5 acute recurrent infections a year and in children with obstructive sleep apnoea by comparing the activity of tonsil and adenoid tissue nonspecific alkaline and acid phosphatase. ⋯ Similar acid phosphatase activity in all three groups implies that all three groups have preserved antigen presenting cell activity. In patients with hypertrophied tonsils similar tissue nonspecific alkaline phosphatase activity suggests preserved B cell tonsil immune activity, regardless of the pathology. Patients with atrophied tonsils had significantly lower alkaline phosphatase activity, indicating relative tonsil B cell immune deficiency. Thus, different immunological status in patients presenting with hypertrophied vs. atrophied tonsils could point to a different underlying pathophysiologic mechanism of the disease.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2009
Review Case ReportsComplete traumatic laryngotracheal disruption--a case report and review.
Blunt neck trauma is an infrequent cause of injury in the pediatric population; however, significant injury is possible even with minor trauma to the neck. The authors present the previously unreported case of a combined laryngotracheal and esophageal disruption as well as a severe laryngeal crush injury in a pediatric patient following a blunt, clothesline neck injury. Immediate management of laryngotracheal or esophageal separation is frequently discussed, but little information exists concerning long-term treatment and management of total laryngotracheal disruption and crush injuries in pediatric patients. A review of the literature is presented to address these concerns.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2009
Randomized Controlled Trial Comparative StudyL-epinephrine and dexamethasone in postextubation airway obstruction: a prospective, randomized, double-blind placebo-controlled study.
This prospective randomized double-blind placebo-controlled study paired trial groups to investigate the effect of intravenous dexamethasone and nebulized L-epinephrine on the clinical development of postextubation laryngeal edema. ⋯ Dexamethasone and l-epinephrine did not reduce the clinical progression of airway obstruction due to laryngeal edema in the early postextubation period.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2009
ReviewIdiopathic benign paroxysmal vertigo in children, a migraine precursor.
Vertigo and dizziness are common conditions in the adult population that can be rarely seen during childhood; only a few articles describing vertigo in children can be found in literature. Although many causes of vertigo in adulthood occur also in childhood, their frequency may be different. A typical example is benign paroxysmal positional vertigo, the most common peripheral vestibular disorder in adults, which occurs quite uncommonly in children. ⋯ At present, BPV is defined as a migraine's equivalent, a precursor of migraine or a periodic syndrome of childhood. The International Headache Society also studied this form of vertigo and included the Benign Paroxysmal Vertigo in section 1.3.3. of the International Classification of Headaches (ICHD-2). The present review analyzes recent patho-physiological and clinical evidences regarding idiopathic BPV in children.