International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Sep 2015
ReviewThe uncomfortable reality … We simply do not know if general anesthesia negatively impacts the neurocognitive development of our small children.
Annually in the United States more than one million children under the age of 5 years are exposed to anesthetics for therapeutic and diagnostic procedures. Pre-clinical data in animal models has consistently shown that anesthetic exposure to the developing brain results in long-term cognitive deficits. Current clinical data addressing the safety of these pharmaceutical agents on the developing human brain is limited. ⋯ Until then, there is little data that absolutely reassures clinicians and parents that the pharmaceutical agents used are indeed safe for our children. The uncomfortable reality is that despite the fact that there are more than one million children younger than 5 years old who receive general anesthesia in the United States annually, and thousands more who are deeply sedated for imaging and diagnostic studies or as a necessary adjunct to care in the intensive care unit, there is little data that assures clinicians and parents that the pharmaceutical agents used are indeed safe for the developing brain. That said, there are no convincing human data to suggest that they are not.
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Int. J. Pediatr. Otorhinolaryngol. · Aug 2015
Korean hand therapy for tonsillectomy pain in children.
Severe throat pain can result from tonsillectomy and last up to 10 days in children. Codeine has recently been banned by the FDA in light of a recently recognized risk of death in these patients. Acupuncture has previously been associated with decreased pain in children after tonsillectomy. However, about 1 in 5 patients will refuse traditional acupuncture because of fear of needles. We explored Korean Hand Therapy (KHT), an acupuncture technique which does not involve needles, to see if this would also be associated with pain relief and be more widely accepted by children. ⋯ The data tentatively suggest KHT is associated with decreases in perceived pain after tonsillectomy and is widely accepted by children. These data - combined with the cost effectiveness, safety and ease of administering KHT - suggest that further studies exploring the effectiveness of KHT for pain relief after tonsillectomy are merited.
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Int. J. Pediatr. Otorhinolaryngol. · Aug 2015
Comparative StudyRigid or flexible laryngoscope: The preference of children.
The aim of this study was to evaluate the effects of flexible and rigid endoscopes using a visual analog scale and reveal which one is better tolerated by children. ⋯ In this study, most of the children (80%) preferred rigid laryngoscopy rather than flexible fiberoptic laryngoscopy. Pain and irritation were the most prominent findings for patients who were reluctant to be examined by FFL. Rigid laryngoscopy can be recommended rather than FFN for evaluation of children with vocal fold pathologies.
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Int. J. Pediatr. Otorhinolaryngol. · Jul 2015
Clinical TrialA new approach for cerumenolytic treatment in children: In vivo and in vitro study.
To demonstrate the effects of various cerumenolytic solutions in vivo and in vitro and to measure the change in pain following treatment. ⋯ In our study, the best cerumenolytic solutions were identified to be glycerine 10cc+3% hydrogen peroxide 10cc+10% sodium bicarbonate 10cc+distilled water 10cc. Especially the use of this mixture ease in terms of pain for the patient and in terms of time and comfort for the physician during the removal procedure.
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Int. J. Pediatr. Otorhinolaryngol. · Jul 2015
Comparative StudyComparative outcomes of severe obstructive sleep apnea in pediatric patients with Trisomy 21.
To analyze the outcomes of severe obstructive sleep apnea (OSA) in pediatric patients with Trisomy 21 compared with non-syndromic patients. ⋯ A majority of Trisomy 21 patients with severe OSA had residual symptoms following surgical intervention. There is also an increased risk of post-operative airway intervention and increased length of hospital stay in these patients.