Pediatric clinics of North America
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Training in the management of pediatric airway cases has been limited by the number of cases and by the involved risks to the child. Simulation is an alternative and accessible means to practice that complex psychomotor task in a safe and reproducible environment. A high-fidelity baby mannequin provides an acceptable airway anatomic resemblance combined with measurable respiratory and cardiovascular parameters, allowing practice to be interactive and challenging. The availability of simulation laboratories within hospitals and the development of pathology-inspired accessories for the mannequins will determine the rate of adherence of ENT departments to this evolving field of simulation-based education.
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Adenotonsillectomy (AT) is one of the most common pediatric surgical procedures performed in the United States; more than 530,000 are performed annually in children younger than 15 years of age. AT was traditionally performed for recurrent tonsillitis and its sequelae but in recent times, sleep-disordered breathing/obstructive sleep apnea in children has emerged as the primary indication for surgical removal of adenoids and tonsils. The new guidelines used by clinicians to identify children who are appropriate candidates for AT address indications based primarily on obstructive and infectious causes.
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Pediatric obstructive sleep apnea syndrome (OSAS) is a common health problem diagnosed and managed by various medical specialists, including family practice physicians, pediatricians, pulmonologists, and general and pediatric otolaryngologists. If left untreated, the sequelae can be severe. Over the last decade, significant advancements have been made in the evidence-based management of pediatric OSAS. This article focuses on the current understanding of this disease, its management, and related clinical practice guidelines.
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The placement of myringotomy tubes remains an effective treatment of recurrent acute otitis media and chronic otitis media with effusion. Infants and young children are prone to these entities because of their immature anatomy and immunology. ⋯ The procedure continues to be one of the most common outpatient pediatric procedures. Close vigilance and identification of potential complications is of utmost importance in the ongoing management of the child with middle ear disease.