The Journal of otolaryngology
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Laryngomalacia is the most common congenital laryngeal anomaly. Usually the symptoms are mild, do not interfere with growth and development and resolve spontaneously. Occasionally it results in failure to thrive, apnea and cardiopulmonary disease. ⋯ Their pre-operative symptoms resolved after surgery. The cases, indications and complications reported in the literature are discussed. We conclude that in certain severe cases of laryngomalacia, epiglottoplasty is a useful and safe tool.
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Foreign bodies in the nose are commonly encountered in ORL practice. Miniature button battery impaction in the nose has rarely been reported. Seven such cases have been encountered, each suffering complications directly attributable to the button battery. ⋯ The site of maximal damage corresponded with the negative pole of the battery in every case. The possible explanation for this and mechanisms of cellular injury are proposed. This paper underlines the potential hazards of button batteries as foreign bodies in the nose and emphasizes the need for rapid removal and long-term follow-up of these patients.
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Five cases of presbycusis are presented. Analysis included audiological tests, cochlear hair cell and ganglion cell counts, assessment of degree of strial atrophy, and ventral cochlear nucleus neuron counts. One case showed a reduction in cochlear nucleus neuron counts without significant cochlear changes, indicating that this pattern of pathological changes is a possible cause of high tone sensorineural deafness.
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This is a retrospective study of 500 cases of hospitalized patients with the diagnosis of croup (laryngotrachitis), admitted between January 1986 and August 1988, at the Montreal Children's Hospital. The patient's age, sex, clinical history, physical examination, number of admissions, season of admission, method of diagnosis, treatment and management were reviewed. Two per cent of these patients were diagnosed as bacterial croup. ⋯ Of all the viral croup patients, less than one-third were severe enough to require an intensive care setting for their management. In these patients, 6% required endotracheal intubation, and on endoscopy, a significant number of these patients had an endoscopic airway abnormality in addition to croup (subglottic edema). According to our findings, we suggest diagnostic micro-laryngoscopy and bronchoscopy be performed on certain groups of croup patients because of their higher yield of airway abnormality on endoscopy.
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Subcutaneous emphysema of the head, neck and mediastinum occurs with a variety of disease processes. Most cases involve the passive escape of air from the aerodigestive tract into subcutaneous tissues. The many causes include head and neck surgical procedures, tracheal and esophageal trauma, intraoral trauma, foreign bodies and neoplasms of the aerodigestive tract, and pulmonary barotrauma from mechanical ventilation or in patients with pulmonary disorders. ⋯ The patient required airway observation and high-dose antibiotic therapy. Early recognition of this unique problem is essential in preventing such life-threatening complications as airway obstruction, mediastinitis, deep neck infection, and cardiac failure. Diagnostic and therapeutic recommendations are included.