Arch Otolaryngol
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To assess polysomnogram (PSG) results and global and disease-specific quality of life (QOL) in children with obstructive sleep apnea (OSA), before and after adenotonsillectomy, and to assess the association between PSG findings and QOL. ⋯ Children with OSA and sleep-disordered breathing have significantly worse QOL than healthy children. However, the association between PSG findings and QOL was only moderate. Children with OSA treated with adenotonsillectomy demonstrated large improvements in disease-specific and global QOL as well as PSG parameters.
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To determine the incidence and character of clinically significant laryngotracheal anomalies in pediatric patients undergoing surgical repair of congenital cardiac defects at a tertiary care center. ⋯ Pediatric patients with congenital cardiac disease are predisposed to laryngeal anomalies owing to (1) frequent intubation, (2) prolonged ventilatory support, and (3) recurrent laryngeal nerve injury. In our patients, subglottic stenosis was the most common laryngeal abnormality. When recognized early, in the eschar phase, most of these cases can be managed with sequential endoscopic debridement, which is conceptually similar to debridement that is performed after functional endoscopic sinus surgery. Established stenosis requires more vigorous intervention, the invasive degree of which depends on the length and circumference of the narrowing. Unilateral vocal paralysis tends to be a self-limited problem, while an elegant solution to bilateral paralysis remains elusive.
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Comparative Study
A parallel group analysis of tonsillectomy using the harmonic scalpel vs electrocautery.
To evaluate efficiency and postoperative morbidity in tonsillectomy using the harmonic scalpel (HS) vs conventional electrocautery (EC). ⋯ Recent prospective studies indicate that the HS provides advantages over conventional EC with respect to postoperative pain and return to normal activity. This study shows that HS tonsillectomy was as efficient as the conventional EC method. In addition, there was evidence that the rate of postoperative bleeding was significantly reduced by using the HS vs conventional EC.