International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Jun 2012
Comparative StudySimilarities and differences in aspirated tracheobronchial foreign bodies in patients under the age of 3 years.
To investigate the clinical pathological features of aspirated tracheobronchial foreign body (FB) cases in children under the age of 3 years and to improve the level of diagnosis and treatment. ⋯ FBAs of animal-derived FBs (especially animal bones) are very common in infants in southern China. Children between the ages of 1 and 2 years are most likely to suffer from FBA. FBA in children under the age of 3 years carries significant hazards, including morbidity and mortality. Asphyxia and/or cardiopulmonary arrest is prone to occur shortly after FBA in infants, but these events can occur days later in older children after FBA because of delays in the diagnosis and/or treatment of this condition.
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Int. J. Pediatr. Otorhinolaryngol. · Jun 2012
Comparative StudyEffect of adenotonsillectomy on the use of respiratory medication.
Recurrent tonsillitis and upper respiratory tract obstruction due to adenotonsillar hypertrophy are the most common indications for (adeno)tonsillectomy ((A)TE). Symptoms of upper respiratory tract infection and obstruction can, however, be attributed to lower airway pathology and thus treated with respiratory medication - this is non-antimicrobial medication used for lower respiratory diseases like bronchitis, bronchiolitis, asthma and episodic wheezing. The aim of this study is to investigate the effect of the current (A)TE practice in Belgium on the use of respiratory medication in subjects aged 0-15. ⋯ Compared with the year before surgery, the median use of respiratory medication in subjects aged 0-15 drastically reduces in the year after (A)TE. A possible reason for this reduction is that children with upper airway obstruction and infections are often wrongly diagnosed as having lower airway problems.
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Int. J. Pediatr. Otorhinolaryngol. · May 2012
ReviewManagement of foreign bodies in the airway and oesophagus.
Ingestion and/or aspiration of foreign bodies (FB) are avoidable incidents. Children between 1 and 3 years are common victims for many reasons: exploration of the environment through the mouth, lack of molars which decreases their ability to properly chew food, lack of cognitive capacity to distinguish between edible and inedible objects, and tendency to distraction and to perform other activities, like playing, whilst eating. Most FBs are expelled spontaneously, but a significant percentage impacts the upper aerodigestive tract. Approximately 80% of children's choking episodes are evaluated by pediatricians. The symptoms of aspiration or ingestion of FBs can simulate different paediatric diseases such as asthma, croup or pneumonia, delaying the correct diagnosis. ⋯ Ingestion and or aspiration of FB in children are multifactorial in their aetiology, in their broad spectrum of different resolutions for the same FB and in the response of each patient to the treatment. Prevention remains the best treatment, implying an increased education of parents on age-appropriate foods and household items, and strict industry standards regarding the dimensions of toy parts and their secure containers.
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Int. J. Pediatr. Otorhinolaryngol. · May 2012
Case ReportsA fatal presentation of dermatomyositis with facial swelling.
Juvenile dermatomyositis (JDM) is the most common inflammatory autoimmune myopathy in children. Most common presentations consist of heliotrophic rash and/or gottron's papules in addition to proximal muscle weakness. A typical presentations have been reported. ⋯ He had elevated transaminases but no detectable muscle weakness. A muscle biopsy was consistent with juvenile dermatomyositis. This case highlights the need to consider dermatomyositis in cases of facial swelling and the use of aggressive immunosuppressive therapies due to its associated vasculopathies.
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Report 2 cases of coat hanger floor of mouth injuries in children. We describe 2 cases of children who presented with coat hanger impalement injuries of the floor of mouth and their management. Removal under anesthesia is safe with a period of observation postoperatively. ⋯ Plain film radiographs may be useful to determine the depth of injury and trajectory of the foreign body. Careful removal under anesthesia is safe. Little if any floor of mouth edema was encountered postoperatively, but close observation for potential critical floor of mouth hematoma or edema should be considered.