The Journal of otolaryngology
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The necessity of early identification of hearing loss has long been urged by otolaryngologists, pediatricians, audiologists, and others working with the deaf. Yet there have been difficulties in implementing accurate and cost-effective newborn hearing screening programs. This article reviews some of the history of infant screening programs, discusses various areas of research related to stimulus and response parameters, and outlines a screening program, designed to fit new recommended procedures, currently under way in Halifax.
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Acute infectious respiratory distress in children has known different modalities of treatment during these past few years, but controversy remains between tracheostomy and naso-tracheal intubation as ways to cope with the problem. This study, which was undertaken at St. ⋯ These results entitle us to think that naso-tracheal intubation is the treatment which should be used. This study also reviews different incidence in regards to age, sex, and seasonal prevalence between croup and epiglottitis and also compares the duration of hospital care between the two modalities.
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Acute epiglottitis is a pediatric airway emergency. No deaths occurred in 61 cases treated by elective tracheostomy at The Montreal Children's Hospital between 1966 and 1974. Seven patients (11.5%) showed evidence of aspiration pneumonia prior to tracheostomy and seven others developed pulmonary atelectasis in the first 24 hours following tracheostomy but only 9.8% of the total had a complication which continued in evidence 24 hours following surgery. ⋯ Of these patients, 32 (52.4%) were seen between a year and seven-and-a-half years later. Twenty were completely asymptomatic with a small, neat scar. Twelve patients had experienced some upper respiratory problem or minor problems related to the tracheostomy incision.
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The criteria for screening infants' hearing in the newborn nursery are reviewed. The problems encountered are discussed and a screening program outlined. Over 12,000 newborn infants were screened for hearing over a five year period and a total of eight were confirmed deaf - an incidence of one in 1,500 live births.
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The development and increasing use of flexible fiberoptic bronchoscopy has added immeasurably to the potential of diagnostic and therapeutic bronchoscopy. However, neither the flexible nor rigid (open tube) bronchoscope should be regarded as the "primary instrument", but the use of one or the other in the individual case should depend on relative indications. ⋯ In any case, the need for facility in management of airway obstruction, indirect and direct laryngoscopy, and proper administration of topical anesthetics to the larynx and tracheobronchial tree should be recognized. Indications, instrumentarium and technique, special applications, contraindications and complications of flexible bronchoscopy are reviewed.