International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Feb 2009
Postoperative airway events of individuals with CHARGE syndrome.
CHARGE syndrome is a heterogeneous genetic disorder comprising multiple congenital anomalies. Major clinical diagnostic criteria include ocular coloboma, choanal atresia/stenosis, characteristic ear abnormalities, and cranial nerve abnormalities. CHARGE syndrome is caused by a mutation in the gene CHD7 located on chromosome 8. Patients with CHARGE syndrome require multiple anesthetics for surgical and otorhinolaryngology procedures. This study describes the postoperative anesthetic related airway events (i.e. re-intubations for apneas and desaturations, airway obstruction due to excessive secretions) of nine individuals with CHARGE syndrome. ⋯ Individuals with CHARGE syndrome face a significant risk of postoperative airway events with anesthesia, and this is exacerbated by the high number of surgeries they require. Surgeons and anesthesiologists should be aware of potential for postoperative airway events in individuals with CHARGE syndrome and plan accordingly.
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Int. J. Pediatr. Otorhinolaryngol. · Feb 2009
Orientation and position of head posture, scapula and thoracic spine in mouth-breathing children.
Mouth-breathing is a common clinical condition among school-age children and some studies have correlated this condition with quality of life and postural alterations. Therefore, the objective of this study was to investigate the orientation and position of the scapula, thoracic spine and head posture among mouth-breathing (MB) children and nasal-breathing (NB) children. ⋯ MB children increased scapular superior position in comparison to NB children due probably to the position of forward head, leading to an alteration in the positioning of the mandible. The absence of significantly difference in posture pattern between groups in the present study could attributed to height-weight development in this age, as the posture of children changes in order to adapt to new body proportions, regardless of health status. The results observed in this study demonstrate the importance of using reliable measurements in the postural assessment of MB and NB children helping physical therapists to focus their strategies during rehabilitation in more specific conditions.
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Int. J. Pediatr. Otorhinolaryngol. · Jan 2009
Obesity and risk of peri-operative complications in children presenting for adenotonsillectomy.
Adenotonsillectomy (T&A) is a very common surgical procedure in children. With the rising prevalence of childhood overweight and obesity, our goal was to describe the prevalence of overweight/obesity in children presenting for T&A in our institution. We also sought to compare the frequency of peri-operative complications and the likelihood of being admitted following T&A between overweight/obese and normal weight children. ⋯ Overweight and obese children presenting for T&A have a higher incidence of peri-operative complications and are more likely to be admitted and stay for longer than their healthy weight peers.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2008
Preoperative continuous positive airway pressure compliance in children with obstructive sleep apnea syndrome: assessed by a simplified approach.
The frequency of diagnoses of obstructive sleep apnea syndrome (OSAS) in children is increasing and more and more adenotonsillectomies (A&T) are being performed on severely ill children who have a higher perioperatory risk. The objective of the present study was to describe preoperative compliance in the use of continuous positive airway pressure (CPAP) in children with OSAS, when this treatment was prescribed as a means of preventing complications. ⋯ The mean preoperative use of CPAP equipment by children with severe OSAS was 4.5+/-2.6h. Seventy-three percent of subjects used the equipment for >/=3h.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2008
Retropharyngeal and parapharyngeal abscesses or phlegmons in children. Is there an association with adenotonsillectomy?
Retropharyngeal and parapharyngeal abscesses or phlegmons are relatively uncommon. Since the tonsils and adenoids are part of the lymphoid tissues of the nasopharynx and oral cavity, one may hypothesize that their removal would lead to an increased susceptibility to pharyngeal infections. ⋯ In conclusion, the development of a retropharyngeal or parapharyngeal abscess or phlegmon is strongly associated with a history of adenotonsillectomy.