International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · May 2013
Discharge after tonsillectomy in pediatric sleep apnea patients.
Outpatient tonsillectomy has gained favor in recent years, however patients with obstructive sleep apnea/hypopnea syndrome have been excluded from outpatient surgery criteria. It is the practice of the senior author to discharge patients after tonsillectomy with a respiratory disturbance or apnea hypopnea index of 5 or less. The purpose of this study is to examine the respiratory complication rate based on respiratory disturbance or apnea hypopnea index, and co-morbidities in order to determine which pediatric patients with obstructive sleep apnea/hypopnea syndrome can be safely discharged after tonsillectomy. ⋯ Our data suggest there is a correlation between higher respiratory disturbance or apnea hypopnea index and post operative complications. Patients with an RDI of <5.0, and minimal co-morbidities can be safely discharged home following tonsillectomy for OSAHS. Complications related to sleep apnea were not seen in patients with RDI <11.0, suggesting that patients with an RDI between 5 and 10, who are not obese and have no significant comorbidities may also be sent home after surgery.
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Int. J. Pediatr. Otorhinolaryngol. · May 2013
The dysphonic videolaryngoscopy with stroboscopy paradox and challenge of acquired subglottic stenosis after laryngotracheal reconstruction.
There's no greater challenge in pediatric laryngology than diagnosis and treatment of chronic dysphonia following laryngotracheal reconstruction of acquired subglottic stenosis. Videolaryngoscopy with stroboscopy provides incomparable diagnostic information to fiberoptic endoscopy. Unfortunately, this pediatric subpopulation which would benefit the most from videolaryngoscopy with stroboscopy infrequently does. We present the unique videolaryngostroboscopic patterns with their diagnostic and treatment implications in this complex population. ⋯ Videolaryngoscopy with stroboscopy results in patterns that are not only unique to patients after airway reconstruction for subglottic stenosis but are also critical for both surgical and non-surgical treatment of chronic dysphonia in these children.
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Int. J. Pediatr. Otorhinolaryngol. · May 2013
Variations in pre-operative management of adolescents undergoing elective surgery.
To understand whether preoperative care of adolescent patients differs according to two different pediatric subspecialties with respect to patient pregnancy status, drug use, and patient assent. To understand how preoperative care of adolescent patients varies with length of practice and practice setting. ⋯ ASPO and APSA members differ in their preoperative management of adolescent patients. Newer physicians and those with fewer adolescent patients also differ from physicians with more extensive experience with adolescents.
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Int. J. Pediatr. Otorhinolaryngol. · May 2013
Proper size of endotracheal tube for cleft lip and palate patients and intubation outcomes.
The aim of the current study was to identify the proper size of endotracheal tube for intubation of cleft lip and palate patients and intubation outcomes in these patients. ⋯ Findings proved that considering subglottic stenosis incidence in these children, it is reasonable to determine the tube size for nonsyndromic cleft lip and palate patients by applying the currently available standards for normal children.
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Int. J. Pediatr. Otorhinolaryngol. · May 2013
Patterns of Internet and smartphone use by parents of children attending a pediatric otolaryngology service.
To assess Internet use and the influence of smartphones on health-information seeking by parents and carers of children with ENT conditions. ⋯ Whilst online sources must increasingly be considered in the dialogue with parents, it is clear that parents still rate the clinical team as most important for information gathering. Clinician-provided websites and smartphone applications may be the key to ensuring the provision of quality information into the future.