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Airway surgery in children

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https://www.readbyqxmd.com/read/28427542/recurrent-respiratory-papillomatosis-a-state-of-the-art-review
#1
REVIEW
Helena Ribeiro Fortes, Felipe Mussi von Ranke, Dante Luiz Escuissato, Cesar Augusto Araujo Neto, Gláucia Zanetti, Bruno Hochhegger, Carolina Althoff Souza, Edson Marchiori
Recurrent respiratory papillomatosis (RRP) is a benign disease of the upper aero-digestive tract caused by human papillomavirus (HPV) infection, which affects children and young adults. The aim of this review is to describe the main etiological, epidemiological, clinical, diagnostic, and treatment aspects of RRP. Most infections in children occur at birth, during passage through the birth canals of contaminated mothers. In adults, HPV is transmitted sexually. Papillomas usually appear as exophytic nodules, primarily in the larynx, but occasionally involving the nasopharynx, tracheobronchial tree, and pulmonary parenchyma...
May 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28405043/anaesthetic-management-of-a-child-with-stone-man-syndrome-look-before-you-leap
#2
Geeta Kamal, Anju Gupta, Sapna Batla, Nishkarsh Gupta
Stone Man syndrome or fibrodysplasia ossificans progressiva (FOP) is an extremely rare (1 in 2 million) genetic disorder characterised by ectopic ossification of the skeletal and connective tissues leading to progressive fusion of axial and appendicular skeleton. Surgery and anaesthesia-induced trauma can lead to disease flare-up if due precautions are not taken and disable the patient further. However, rarity of the disease may lead to its common misdiagnosis and anaesthesiologist may be caught unaware. There is relative paucity of literature regarding anaesthetic management of children with FOP...
March 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28399908/using-cone-beam-ct-to-assess-the-upper-airway-after-surgery-in-children-with-sleep-disordered-breathing-symptoms-and-maxillary-mandibular-disproportions-a-clinical-pilot
#3
Noura A Alsufyani, Michelle L Noga, Manisha Witmans, Irene Cheng, Hamdy El-Hakim, Paul W Major
BACKGROUND: The surgical excision of anatomic obstructions such as adenoids, palatine or lingual tonsils are commonly performed in children with sleep disordered breathing (SDB). Imaging studies measuring airway changes post-surgery in the SDB pediatric population are scarce, rarely addresses the nasal cavity, and are based on global measures (e.g. volume) that do not represent the complexity of the upper airway anatomy. The purpose of this pilot is to test the feasibility in using cone beam CT (CBCT) to analyze the nasal and pharyngeal airway space post-surgery using meaningful methods of analyses, and correlating imaging findings with clinical outcomes in children with SDB symptoms and maxillary-mandibular disproportion...
April 11, 2017: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28393433/nasal-high-flow-oxygen-delivery-in-children-with-abnormal-airways
#4
Susan Humphreys, Derek Rosen, Tessa Housden, Julia Taylor, Andreas Schibler
BACKGROUND: Transnasal Humidified Rapid-Insufflation Ventilatory Exchange has been shown to safely prolong the safe apnea time in well children post induction of anesthesia and is rapidly becoming a new standard for apneic oxygenation in adults. The same oxygenation technique is described as nasal high flow and can be used in infants and children at risk of apnea during anesthesia. AIM: We investigated the use of nasal high flow oxygen delivery during anesthesia in children with abnormal airways requiring tubeless airway assessment or surgery...
April 10, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28387106/-when-an-encircling-aortic-arch-anomaly-hides-behind-respiratory-and-digestive-symptoms-in-children
#5
M Solowianiuk, C Soulatges, N Farhat, J Holzki, M-C Seghaye
Aortic arch anomalies are relatively frequent and account for 15 to 20 % of all congenital cardiovascular malformations. They can be discovered in case of symptoms of airway or esophageal compression such as dysphagia, chronic cough, stridor, wheezing and recurrent respiratory infections. We report the cases of two children with encircling aortic arch anomaly. The 3-year-old boy had complained of chronic respiratory symptoms such as laryngitis and asthma since the age of 4 months. The 20-month-old boy presented with inter-mittent stridor, dysphagia and frequent vomiting...
November 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28379334/impact-of-adenotonsillectomy-on-the-dentofacial-development-of-obstructed-children-a-systematic-review-and-meta-analysis
#6
Bibi E Becking, Jop P Verweij, Sonja M Kalf-Scholte, Cees Valkenburg, Eric W P Bakker, J P Richard van Merkesteyn
Background: Dentofacial deformities frequently require orthodontic treatment. Understanding of preventable risk factors is essential for reducing treatment need. Upper airway obstruction (for example due to hypertrophic adenoids and/or tonsils) has been hypothesized to be a risk factor. Objectives: This systematic review aimed to reflect the contemporary evidence on the risk of obstruction by hypertrophic adenoids and/or tonsils, by assessing the dentofacial changes after adeno- and/or tonsillectomy...
April 3, 2017: European Journal of Orthodontics
https://www.readbyqxmd.com/read/28372992/the-effects-of-clinical-factors-on-airway-outcomes-of-mandibular-distraction-osteogenesis-in-children-with-pierre-robin-sequence
#7
REVIEW
X C Ren, Z W Gao, Y F Li, Y Liu, B Ye, S S Zhu
Mandibular distraction osteogenesis (MDO) is an effective treatment for tongue-based airway obstruction in children with severe Pierre Robin sequence. An investigation was performed to determine whether certain clinical factors influence the airway outcomes of MDO. A literature search of several databases was performed to identify studies providing individual patient data. Data extracted from the studies included patient sex, age at distraction, disease type, experience of any previous surgery on the airway, length of distraction, pre- and postoperative blood oxygen saturation nadir, and osteotomy design...
March 31, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28369014/a-comparative-analysis-of-rhbmp-2-dbm-vs-icbg-for-secondary-alveolar-bone-grafts-in-patients-with-cleft-lip-and-palate-review-of-501-cases
#8
Jeffrey A Hammoudeh, Artur Fahradyan, Daniel D Gould, Fan Liang, Thomas Imahiyerobo, Leo Urbinelli, JoAnna T Nguyen, William Magee, Stephen Yen, Mark M Urata
BACKGROUND: Alveolar cleft reconstruction using iliac crest bone graft(ICBG) is considered standard of care for children with complete cleft lip and palate at the time of mixed dentition. Harvesting bone may result in donor site morbidity, additional operating time and length of hospitalization. Recombinant human bone morphogenetic protein(rhBMP)-2 with a demineralized bone matrix(DBM) was used as an alternative bone source for alveolar cleft reconstruction. We investigate the outcomes of rhBMP-2/DBM versus ICBG for alveolar cleft reconstruction by reviewing postoperative surgical complications and cleft closure...
March 31, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28366715/twenty-years-of-anesthetic-and-perioperative-management-of-patients-with-tetralogy-of-fallot-with-absent-pulmonary-valve
#9
John D Jochman, Douglas B Atkinson, Luis G Quinonez, Morgan L Brown
OBJECTIVE: Review the authors' institutional experience of the induction and perioperative airway management of children with tetralogy of Fallot with an absent pulmonary valve. DESIGN: Retrospective chart review. SETTING: Large academic children's hospital. PARTICIPANTS: Patients with the diagnosis of tetralogy of Fallot with absent pulmonary valve undergoing primary cardiac repair over a 20-year period. INTERVENTIONS: None...
February 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28338364/indications-risk-of-lower-airway-infection-and-complications-to-pediatric-tracheotomy-report-from-a-tertiary-referral-center
#10
Christian Grønhøj, Birgitte Charabi, Christian von Buchwald, Thomas Hjuler
BACKGROUND: Although pediatric tracheotomy is potentially life-saving, the procedure is associated with high risk of complications, and indications have changed the last decade. We report indications, complications, and lower airway infections (LAIs) to pediatric tracheotomy performed at a tertiary referral center. METHODS: We identified all children (<18 years) who underwent tracheotomy at our institution during 2008-2015. A review of hospital records was performed to extract data on indication of the procedure, complications, and information on pre- and postoperative LAI...
March 24, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28337533/incidence-of-second-surgery-following-pediatric-adenotonsillar-surgery-a-population-based-cohort-study
#11
Ola Sunnergren, Erik Odhagen, Joacim Stalfors
The aim of the study is to evaluate the incidence and risk factors of a second surgery of the adenoids or tonsils for hypertrophy in children who have already undergone surgery for the same condition. This is a retrospective study (2004-2013) based on data from the National patient registry in Sweden. A total of 41,401 children underwent a first surgery of the adenoids or tonsils during the studied period. The most commonly performed (first) surgical procedure was adenoidectomy followed by adenotonsillotomy, adenotonsillectomy, tonsillotomy, and tonsillectomy...
March 23, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28291127/an-update-on-the-perioperative-management-of-children-with-upper-respiratory-tract-infections
#12
Adrian Regli, Karin Becke, Britta S von Ungern-Sternberg
PURPOSE OF REVIEW: This review summarizes the current evidence for the management of children with recent upper respiratory tract infections (URTIs). Furthermore, the review includes management guidelines for children with URTIs. RECENT FINDINGS: Good history and clinical examination is sufficient in most children presenting with URTI. Testing for immune markers or preoperative nitric oxide measurement does not add any additional value. Preoperative bronchodilator administration, intravenous induction with propofol, and noninvasive airway management all reduce the occurrence of respiratory adverse events...
March 11, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28289832/indirect-costs-related-to-caregivers-absence-from-work-after-paediatric-tonsil-surgery
#13
Gunnhildur Gudnadottir, G Ragnarson Tennvall, J Stalfors, J Hellgren
Tonsillotomy has gradually replaced tonsillectomy as the surgical method of choice in children with upper airway obstruction during sleep, because of less postoperative pain and a shorter recovery time. The aim of this study was to examine the costs related to caregivers' absenteeism from work after tonsillectomy (TE) and tonsillotomy (TT). All tonsillectomies and tonsillotomies in Sweden due to upper airway obstruction during 1 year, reported to the National Tonsil Surgery Register in children aged 1-11 were included, n = 4534...
March 14, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28267299/predicting-the-effect-of-treatment-in-paediatric-osa-by-clinical-examination-and-functional-respiratory-imaging
#14
Monique Slaats, Wim Vos, Cedric Van Holsbeke, Jan De Backer, Dieter Loterman, Wilfried De Backer, An Boudewyns, Stijn Verhulst
OBJECTIVE: The aim of this study was to investigate whether functional respiratory imaging (FRI) or clinical examination could predict treatment outcome for obstructive sleep apnea (OSA) in normal-weight, non-syndromic children. METHODS: Normal weight children diagnosed with OSA by polysomnography were prospectively included. All children got a thorough evaluation and an ultra-low dose computed tomography scan of the upper airway (UA). A 3-D reconstruction was built combined with computational fluid dynamics for FRI...
March 7, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28259381/fast-track-pediatric-thoracic-surgery-toward-day-case-surgery
#15
Pauline Clermidi, Myriam Bellon, Alia Skhiri, Olivier Jaby, Christine Vitoux, Michel Peuchmaur, Arnaud Bonnard
PURPOSE: Thoracoscopic lung resection for congenital pulmonary airway malformation (CPAM) is a safe technique for children. Our purpose was to evaluate the feasibility of a fast-track protocol in such cases. METHODS: From September 2007 to May 2016, 101 patients underwent a thoracoscopic pulmonary resection of which 83 for CPAM (lobectomy, wedge resection or sequestrectomy). We retrospectively reviewed the characteristics of surgical procedure, postoperative management and complications through three time periods (September 2007-December 2009: n=14, January 2010-March 2013: n=30, April 2013-May 2016: n=39) corresponding to management protocols modifications introducing fast-track pathways...
February 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28249684/short-lasting-pediatric-laparoscopic-surgery-are-muscle-relaxants-necessary-endotracheal-intubation-vs-laryngeal-mask-airway
#16
Serkan Tulgar, Ibrahim Boga, Basri Cakiroglu, David Terence Thomas
PURPOSE: Technical advances have led to lower insufflation pressures and shorter anesthesia times for children undergoing laparoscopic procedures. In this study we compared the use of endotracheal tube (ETT) and laryngeal mask airway (LMA) with or without muscle relaxant (MR) in children undergoing laparoscopic repair for inguinal hernia. METHODS: Children undergoing laparoscopic inguinal hernia repair were randomized into four groups which underwent procedure with either ETT+MR (group 1), ETT without MR (group 2), LMA with subparalytic dose of MR (group 3) or LMA without MR (group 4)...
February 20, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28239978/sleep-disordered-breathing-and-its-management-in-children-with-achondroplasia
#17
Rossana Tenconi, Sonia Khirani, Alessandro Amaddeo, Caroline Michot, Geneviève Baujat, Vincent Couloigner, Livio De Sanctis, Syril James, Michel Zerah, Valérie Cormier-Daire, Brigitte Fauroux
Sleep-disordered breathing is a common feature in children with achondroplasia. The aim of our study was to review the poly(somno)graphic (P(S)G) findings and consequent treatments in children with achondroplasia followed in the national reference center for skeletal dysplasia. A retrospective review of the clinical charts and P(S)G of 43 consecutive children (mean age 3.9 ± 3.5 years) with achondroplasia seen over a period of 2 years was performed. Twenty four (59%) children had obstructive sleep apnea (OSA)...
February 27, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28229031/characterization-of-sleep-architecture-in-down-syndrome-patients-pre-and-post-airway-surgery
#18
Mark Mims, Prasad John Thottam, Dennis Kitsko, Amber Shaffer, Sukgi Choi
OBJECTIVES: To define obstructive sleep architecture patterns in Down syndrome (DS) children as well as changes to sleep architecture patterns postoperatively. STUDY DESIGN: The study was a retrospective review. METHODS: Forty-five pediatric DS patients who underwent airway surgery between 2003 and 2014 at a tertiary children's hospital for obstructive sleep apnea (OSA) were investigated. Postoperative changes in respiratory parameters and sleep architecture (SA) were assessed and compared to general pediatric normative data using paired t-tests and Wilcoxon signed-rank test...
January 17, 2017: Curēus
https://www.readbyqxmd.com/read/28224634/pepsin-as-a-biomarker-for-laryngopharyngeal-reflux-in-children-with-laryngomalacia
#19
Kendra Luebke, Tina L Samuels, Thomas H Chelius, Cecille G Sulman, Michael E McCormick, Joseph E Kerschner, Nikki Johnston, Robert H Chun
OBJECTIVES/HYPOTHESIS: Laryngomalacia is a common cause of newborn stridor. Laryngopharyngeal reflux (LPR) has been associated with laryngomalacia. Although pepsin, a component of LPR, has been associated with inflammatory diseases of the aerodigestive tract, its presence in the airways of laryngomalacia patients is unknown. STUDY DESIGN: Prospective case-control study comparing patients under age 3 years with laryngomalacia to children without laryngomalacia. METHODS: Children less than 3 years old undergoing supraglottoplasty for laryngomalacia or surgery unrelated to the airway, without a history of laryngomalacia, reflux, or respiratory disease, were offered enrollment...
February 22, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28222678/tracheal-extubation-in-deeply-anesthetized-pediatric-patients-after-tonsillectomy-a-comparison-of-high-concentration-sevoflurane-alone-and-low-concentration-sevoflurane-in-combination-with-dexmedetomidine-pre-medication
#20
Meiqin Di, Yuan Han, Zhuqing Yang, Huacheng Liu, Xuefei Ye, Hongyan Lai, Jun Li, Wangning ShangGuan, Qingquan Lian
BACKGROUND: Dexmedetomidine can facilitate a smooth extubation process and reduce the requirement of sevoflurane and emergence agitation when administrated perioperatively. We aimed to observe the extubation process and the recovery characteristics in pediatric patients undergoing tonsillectomy while anesthetized with either high-concentration sevoflurane alone or low-concentration sevoflurane combined with pre-medication of single dose of intravenous dexmedetomidine. METHODS: Seventy-five patients (ASA I or II, aged 3-7 years) undergoing tonsillectomy were randomized into three equal groups: to receive intravenous saline (Group D0), dexmedetomidine 1 μg/kg (Group D1), or dexmedetomidine 2 μg/kg (Group D2) approximately 10 min before anesthesia...
February 21, 2017: BMC Anesthesiology
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