Arch Otolaryngol
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Randomized Controlled Trial Clinical Trial
Postoperative behavioral changes in children after adenoidectomy.
Pain is a common complaint after adenoidectomy. Behavioral changes after adenoidectomy in children have been reported, and it has been concluded that postoperative pain significantly affects the occurrence of behavioral changes. Behavioral changes, when a proactive pain treatment has been used, have not been systematically studied. ⋯ Day-case adenoidectomy with proactive pain treatment seems to result in a negligible incidence of behavioral troubles in children.
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To determine whether the pathogenesis of lower airway colonization and infection was endogenous (via the oropharynx) or exogenous (via the endotracheal tube or tracheotomy) during the 2 modes of ventilation in the same subset of children requiring long-term ventilation. ⋯ Surveillance samples allow the distinction between primary endogenous ("imported" bacteria) from secondary endogenous and exogenous ("nosocomial" microorganisms) colonization and infection. This classification permits the development of preventive strategies to control both endogenous and exogenous pathways.
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To determine the incidence of perioperative anesthesia complications during bilateral myringotomy with tympanostomy tube placement (BMTT). ⋯ Anesthesia administered for placement of tympanostomy tubes by physicians who specialize in the care of children in a tertiary care children's hospital is safe. The most significant predictor of a minor anesthetic event during BMTT is the presence of a preexisting medical condition or concurrent acute illness.
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Clinical Trial
Head and neck muscle spasm after radiotherapy: management with botulinum toxin A injection.
To introduce the concept of neck muscle pain and spasm after radiotherapy and its treatment with botulinum toxin A. ⋯ A subset of patients with irradiation-induced cervical muscle spasm benefit from treatment with botulinum toxin A injections. Further study is needed to more clearly define the entity and treatment.
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To determine the relationship between child behavior and quality of life before and after tonsillectomy and adenoidectomy by means of a standardized assessment of child behavior, the Child Behavior Checklist (CBCL), and a validated quality-of-life survey of pediatric obstructive sleep apnea, the OSA-18. ⋯ Behavioral and emotional difficulties are found in children with sleep-disordered breathing before treatment and improve after intervention. Scores on a standardized measure of assessment of behavior demonstrate significant correlation with scores on a validated quality-of-life instrument.