International journal of pediatric otorhinolaryngology
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Int. J. Pediatr. Otorhinolaryngol. · Feb 2011
Case ReportsCongenital cricopharyngeal achalasia in a 4.5-year-old managed by cervical myotomy: a case report.
Congenital cricopharyngeal achalasia (CCA) is a rare disorder in children characterized by inappropriate contraction of the cricopharyngeus muscle, resulting in the inability to relax the upper esophageal sphincter during deglutition. We report the diagnostic process and management of a relatively older patient who underwent cricopharyngeal myotomy at the age of 4.5 years. ⋯ Our patient is one of the oldest children reported to have undergone myotomy, recovered quickly, and had no difficulty swallowing at any time following surgery. We suggest transcervical cricopharyngeal myotomy as the preferred treatment due to its lasting effects and repeated success in relieving dysphagia in young patients with CCA.
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Int. J. Pediatr. Otorhinolaryngol. · Jan 2011
Randomized Controlled Trial Comparative StudyTopical bupivacaine compared to lidocaine with epinephrine for post-tonsillectomy pain relief in children: a randomized controlled study.
To compare the topical administration of bupivacaine hydrochloride, lidocaine hydrochloride with epinephrine and saline in alleviating post tonsillectomy pain. ⋯ Topical administration of bupivacaine hydrochloride proved to provide more efficient pain control than both saline and lidocaine without any drug related complication.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2010
Case ReportsAtypical locations of retropharyngeal abscess: beware of the normal lateral soft tissue neck X-ray.
Retropharyngeal abscesses (RPA) are uncommon but potentially lethal deep neck space infections, over 95% of which occur in children under six years of age. Without a high index of suspicion, early recognition and prompt intervention, catastrophic consequences can ensue, and mortality can be as high as 60% if jugular vein thrombosis or mediastinitis occurs. ⋯ While we recognise the role of lateral neck X-rays in retropharyngeal and other upper airway pathologies, we present three case series in which lateral neck X-rays were normal and diagnosis was made only after CT scanning. These three cases were unusual as the abscesses were located high in the naso-pharynx making them impossible to detect on the lateral soft tissue neck X-rays and this underscores the need for high index of suspicion and prompt CT or MRI scanning, in any child with symptoms or signs suggestive of a possible retropharyngeal abscess.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2010
Endoscopic anterior cricoid split and balloon dilation in pediatric subglottic stenosis.
To analyze the outcome of a new endoscopic approach for the treatment of pediatric subglottic stenosis. ⋯ EACS is a safe and efficient technique to treat pediatric subglottic stenosis, regardless of their grade and length, provided to associate it with postoperative laryngeal stenting and regular endoscopic follow-up with possible additional balloon dilations. In our teams, it has become the first line treatment for most grades II to IV SGS. Its indications can be extended to congenital stenosis with cartilaginous involvement and to long-lasting acquired stenosis with firm fibrosis.
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Int. J. Pediatr. Otorhinolaryngol. · Dec 2010
Randomized Controlled Trial Comparative StudyEfficacy of manual jet ventilation using Manujet III for bronchoscopic airway foreign body removal in children.
To evaluate the efficacy of a manual jet ventilation device for bronchoscopic removal of foreign bodies in children. ⋯ This study confirmed the safety and efficacy of performing manual jet ventilation with Manujet III in foreign body removal by rigid bronchoscopy in children.