International journal of pediatric otorhinolaryngology
-
Int. J. Pediatr. Otorhinolaryngol. · Sep 1996
Comparative StudyPost-tonsillectomy hemorrhage: an assessment of risk factors.
Hemorrhage is the most frequent complication of tonsillectomy and is responsible for the majority of post-tonsillectomy fatalities. The incidence of this hemorrhage has been reported to be as high as 20% [6]. Despite continued efforts to reduce this problem, it remains a persistent risk. ⋯ Intraoperative blood loss that exceeded 50 cm3 was also a significant risk factor for post-tonsillectomy hemorrhage. It is concluded that older age, a history of chronic tonsillitis, excessive intraoperative blood loss and elevated postoperative mean arterial pressure are significant risk factors for post-tonsillectomy hemorrhage. An awareness of these risk factors can help identify patients with potential to bleed postoperatively.
-
Int. J. Pediatr. Otorhinolaryngol. · Jul 1996
Randomized Controlled Trial Comparative Study Clinical TrialOndansetron decreases postoperative vomiting in pediatric patients undergoing tonsillectomy and adenoidectomy.
One of the most frequently performed pediatric surgical procedures is tonsillectomy and adenoidectomy. Nausea and vomiting and the inability to tolerate oral fluids lead to unplanned hospitalizations. Despite treatment with metoclopramide and droperidol, nausea and vomiting continue to be high after this procedure. ⋯ Both ondansetron and droperidol are effective in decreasing emesis when given before surgical incision in pediatric patients undergoing tonsillectomy and adenoidectomy. Ondansetron's antiemetic effect persists for up to 24 h following surgery with significant reductions in emesis. Ondansetron's effectiveness in eliminating vomiting without sedation or other side effects suggests that it should be considered as part of the standard management in pediatric patients undergoing tonsillectomy and adenoidectomy.
-
Int. J. Pediatr. Otorhinolaryngol. · May 1996
Case ReportsPediatric cervical esophageal perforation secondary to abusive blunt thoracic trauma.
Cervical esophageal perforation secondary to blunt trauma is extremely rare. A case of an 8-week-old infant that sustained a cervical esophageal perforation from abusive acceleration/deceleration blunt trauma is presented. ⋯ Diagnosis and management are discussed. The pediatrician, emergency department, nursing staff and otolaryngologist should have strong suspicions of abuse when esophageal perforation is identified in an infant.
-
Int. J. Pediatr. Otorhinolaryngol. · Mar 1996
Randomized Controlled Trial Clinical TrialTopical lidocaine for postoperative analgesia following myringotomy and tube placement.
One of the most frequently performed surgical procedures in pediatrics is myringotomy and tube placement. Analgesia is often difficult to achieve and children may be uncontrollable, distressing both parents and nursing staff. We designed this investigation to determine if topical lidocaine instilled in the ear canal after myringotomy and tube placement could improve postoperative analgesia. ⋯ No reports or complaints of vertigo or tinnitus were noted in any patient. The application of 4% lidocaine in antibiotic drops significantly improves postoperative analgesia in patients undergoing myringotomy and tube insertion under general anesthesia. Utilizing this technique should help improve analgesia, specifically in the early postoperative period, and decrease the presence of stress following surgery.
-
Int. J. Pediatr. Otorhinolaryngol. · Mar 1996
Review Case ReportsNager acrofacial dysostosis: management of a difficult airway.
Nager acrofacial dysostosis, first described by Nager and deReynier in 1948, is a rare syndrome characterized by mandibulofacial dysostosis with associated radial defects. The facial features include downward slanting palpebral fissures, absent eyelashes in the medial third of the lower lids, mandibular and malar hypoplasia, dysplastic ears with conductive deafness, and variable degrees of palatal clefting. Upper limb malformation is a constant feature of Nager syndrome and ranges from thumb hypoplasia to absence of the radial ray. ⋯ The craniofacial anomalies and associated trismus make emergent airway intubation challenging. We present a case of Nager syndrome with life threatening airway obstruction unresponsive to conservative management. This case and a review of the literature emphasize the importance of early tracheotomy for these patients.