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https://www.readbyqxmd.com/read/28915135/otolaryngologic-management-of-down-syndrome-patients-what-is-new
#1
Ethan C Bassett, Mary F Musso
PURPOSE OF REVIEW: The management of children with Down syndrome as it pertains to the otolaryngologist continues to evolve. Obstructive sleep apnea (OSA) has dominated the recent literature, but other topics including hearing loss, swallowing, and perioperative considerations are also reported. RECENT FINDINGS: The prevalence of OSA in children with Down syndrome ranges from 57 to 73% in certain cohorts, and, whereas adentonsillectomy can decrease Apnea-Hypopnea Index, up to 80% may have persistent OSA...
September 14, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28895429/effectiveness-of-adenotonsillectomy-and-risk-of-velopharyngeal-insufficiency-in-children-with-prader-willi-syndrome
#2
Reema Padia, Harlan Muntz, Kathleen Pfeffer, Jeremy Meier
OBJECTIVES: (1) Review effectiveness of adenotonsillectomy (T&A) for obstructive sleep apnea (OSA) in children with Prader-Willi syndrome (PW). (2) Examine the incidence of velopharyngeal insufficiency (VPI) after T&A in this population. (3) Compare outcomes of T&A in PW and Trisomy 21 (T21) patients. METHODS: Outcomes after T&A in a PW cohort were retrospectively reviewed and compared to those in patients with T21. RESULTS: The study cohort included 22 PW patients...
September 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28895149/efficacy-of-dexmedetomidine-for-perioperative-morbidities-in-pediatric-tonsillectomy-a-metaanalysis
#3
REVIEW
Hye Kyung Cho, Ho Young Yoon, Ho Jun Jin, Se Hwan Hwang
OBJECTIVES: This study aimed to assess the effects of perioperative dexmedetomidine as an adjuvant to tonsillectomy compared with opioid or sham in children. DATA SOURCE: Five databases (PubMed, SCOPUS, Embase, Web of Science, and Cochrane Central Register of Controlled Trials) were searched from inception of article collections to April 2017. REVIEW METHODS: Prospective, randomized controlled studies that compared outcomes between children who underwent tonsillectomy plus dexmedetomidine administration (intervention) and children who underwent tonsillectomy with placebo or opioid (control) were systemically and independently reviewed by two researchers...
September 12, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28873028/randomized-prospective-evaluation-of-intraoperative-intravenous-acetaminophen-in-pediatric-adenotonsillectomy
#4
Christopher A Roberts, Shivani Shah-Becker, Ashley O'Connell Ferster, Aaron Baker, Lauren E Stahl, Khaled Sedeek, Michele M Carr
Objective To establish the safety and efficacy of single-dose intraoperative intravenous (IV) acetaminophen in postoperative pain management following adenotonsillectomy in addition to a standardized regimen of oral pain medication. Study Design Randomized, controlled prospective clinical trial. Setting Single academic medical center. Subjects and Methods Patients between the ages of 3 and 17 years scheduled for tonsillectomy or adenotonsillectomy by a single surgeon between December 2014 and November 2016 were recruited...
September 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28871845/accuracy-of-parental-perception-of-nighttime-breathing-in-children-with-down-syndrome
#5
Norman R Friedman, Amanda G Ruiz, Dexiang Gao, David G Ingram
Objective In 2011, the American Academy of Pediatrics published a guideline for children with Down syndrome (DS), recommending a polysomnogram (PSG) by age 4 years regardless of symptoms. Their rationale was based on 2 publications with small cohorts, where at least 50% of the children had no obstructive sleep apnea (OSA) symptoms but their PSG results were abnormal. The American Academy of Otolaryngology-Head and Neck Surgery Foundation published a clinical practice guideline recommending PSG prior to adenotonsillectomy for these children...
September 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28857996/effect-of-suturation-plus-surgicel-application-on-post-tonsillectomy-bleeding-and-pain
#6
Hasan Cetiner, Ilker Cavusoglu, Sertac Duzer, Oner Sakallioglu, Nihat Susaman, Yavuz Sultan Selim Yildirim
OBJECTIVE: The aim of this study was to evaluate the effect of suturation (tonsillary fossa closure) plus Surgicel application on postoperative bleeding and pain after tonsillectomies performed using a classical dissection method. STUDY DESIGN: A prospective, randomized, double-blind, clinical trial was performed on 760 patients undergoing tonsillectomy or adenotonsillectomy during a 5-year period. METHODS: After excluding patients with hemorrhagic disorder, chronic disease, and peritonsillar abscess, both tonsils were removed via classic dissection technique (cold knife or blunt dissection) and then electrocauterized for hemostasis...
August 28, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28857989/albuminuria-in-pediatric-patients-with-adenotonsillar-hypertrophy
#7
Ozlem Unsal, Gulpembe Bozkurt, Meltem Esen Akpinar, Egehan Salepci, Gokce Aktas Oguz, Berna Uslu Coskun
The relationship between intermittent nocturnal hypoxia and albuminuria in pediatric patients with adenotonsillar hypertrophy was evaluated in this prospective study. Fifty children with grade 3 to 4 adenotonsillar hypertrophy scheduled for adenoidectomy and/or adenotonsillectomy were selected for study group. Fifteen patients with adenotonsillar grade 1 to 2 or adenotonsillectomized subjects in a similar range of sex, age, and body mass index scheduled for other surgeries were selected for control group. All children were monitored using finger pulse oximeter during the night before surgery...
August 28, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28846176/the-role-of-ultrasound-in-appropriate-endotracheal-tube-size-selection-in-pediatric-patients
#8
Demet Altun, Mukadder Orhan-Sungur, Achmet Ali, Tülay Özkan-Seyhan, Nükhet Sivrikoz, Emre Çamcı
BACKGROUND: The aim of this prospective study was to investigate the success of ultrasound in pediatric patients in determining the appropriate sized cuffed endotracheal tube and to compare the results with conventional height-based (Broselow) tape and age-based formula tube size. METHODS: One hundred and fifty-two children of 1-10 years of age, who received general anesthesia for adenotonsillectomy were enrolled to the study. In all participants, the transverse diameter of the subglottis was measured with ultrasound during apnea...
August 28, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28838318/anesthetic-management-during-adenotonsillectomy-for-twins-with-congenital-insensitivity-to-pain-with-anhidrosis-two-case-reports
#9
Cong Wang, Xianwei Zhang, Shanna Guo, Jiaoli Sun, Ningbo Li
BACKGROUND: Congenital insensitivity to pain with anhidrosis is a rare autosomal recessive disorder characterized by hyperpyrexia, anhidrosis, pain insensitivity, self-inflicted injuries, and intellectual disability. The anesthetic management of these patients is challenging owing to the high risk of perioperative complications resulting from their autonomic dysfunction, such as hyperthermia, hypotension, and bradycardia, which result from autonomic nervous system dysfunction. CASE PRESENTATION: Two 3-year-old Han Chinese identical male twins (weighing 13...
August 25, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28833606/dna-methylation-profiles-between-airway-epithelium-and-proxy-tissues-in-children
#10
Rossa Brugha, Robert Lowe, A John Henderson, John W Holloway, Vardhman Rakyan, Eva Wozniak, Nadiya Mahmud, Kay Seymour, Jonathan Grigg, Seif O Shaheen
AIM: Epidemiological studies of deoxyribonucleic acid (DNA) methylation in airway disease have largely been conducted using blood or buccal samples. However, given tissue specificity of DNA methylation, these surrogate tissues may not allow reliable inferences about methylation in the lung. We sought to compare the pattern of DNA methylation in blood, buccal and nasal epithelial cells to that in airway epithelial cells from children. METHODS: Samples of blood, and buccal, nasal and airway epithelium were obtained from six children undergoing elective anaesthesia for adenotonsillectomy...
August 18, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28833232/persistent-respiratory-effort-after-adenotonsillectomy-in-children-with-sleep-disordered-breathing
#11
Jean-Benoît Martinot, N Nam Le-Dong, Stéphane Denison, Hervé Jean-Pierre Guénard, Jean-Christian Borel, Philip E Silkoff, Jean-Louis Pepin, David Gozal
OBJECTIVES: Adenotonsillectomy (AT) markedly improves but does not necessarily normalize polysomnographic findings in children with adenotonsillar hypertrophy and related sleep-disordered breathing (SDB). Adenotonsillectomy efficacy should be evaluated by follow-up polysomnography (PSG), but this method may underestimate persistent respiratory effort (RE). Mandibular movement (MMas) monitoring is an innovative measurement that readily identifies RE during upper airway obstruction. We hypothesized that MMas indices would decrease in parallel of PSG indices and that children with persistent RE more reliably could be identified with MMas...
August 22, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28828761/coblation-versus-other-surgical-techniques-for-tonsillectomy
#12
REVIEW
Melissa Pynnonen, Jennifer V Brinkmeier, Marc C Thorne, Lee Yee Chong, Martin J Burton
BACKGROUND: Tonsillectomy is a very common operation and is performed using various surgical methods. Coblation is a popular method because it purportedly causes less pain than other surgical methods. However, the superiority of coblation is unproven. OBJECTIVES: To compare the effects of coblation tonsillectomy for chronic tonsillitis or tonsillar hypertrophy with other surgical techniques, both hot and cold, on intraoperative morbidity, postoperative morbidity and procedural cost...
August 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28802392/utilization-and-trends-in-surgical-instrument-use-in-pediatric-adenotonsillectomy
#13
David L Walner, Christopher Mularczyk, Auddie Sweis
OBJECTIVE: Examine trends in surgical instrument usage for pediatric adenotonsillectomy. METHODS: An online survey asking questions about current and previous surgical instrument use was created by the authors and distributed to 517 members of the American Society of Pediatric Otolaryngology in October 2015. The survey was designed to assess trends in the use of surgical instruments in pediatric adenotonsillectomy by comparing the results of our 2015 survey to data from a previously published 2005 study...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28802388/adenotonsillectomy-outcomes-in-children-with-sleep-apnea-and-narcolepsy
#14
Sneh Biyani, Tina D Cunningham, Cristina M Baldassari
OBJECTIVE: To identify improvements in daytime sleepiness following adenotonsillectomy in children with non-severe obstructive sleep apnea and narcolepsy. STUDY DESIGN: Case series with chart review over 15 years. SETTING: Tertiary Children's Hospital. SUBJECTS AND METHODS: Children between 6 and 17 years of age with narcolepsy that underwent adenotonsillectomy for non-severe obstructive sleep apnea (OSA) were included...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28802358/guillotine-vs-classic-dissection-adenotonsillectomy-what-s-the-ideal-technique-for-children-in-tanzania
#15
Desderius C Chussi, Sophie W Poelman, Niels Van Heerbeek
OBJECTIVES: Adenotonsillectomy (ATE) is one of the most performed surgeries in children. Extensive research on which operation technique is the best in terms of minimal pain and complications, operative time and duration of hospital stay is being done mostly in highly resourced developing countries. In developing countries a need for cost effective and time saving operation techniques is essential due to the low-resource setting. This study aims to investigate whether the Guillotine Sluder operation techniques is ideal in a limited resource developing country setting...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28802352/assessment-of-weight-gain-following-adenotonsillectomy-in-children-with-down-syndrome
#16
Christopher F D'Esposito, Zachary Farhood, Andrew B Baker, Shaun A Nguyen, Angela C LaRosa, Chitra Lal, David R White
INTRODUCTION: Adenotonsillectomy (T&A) has been associated with postoperative weight gain in children. The purpose of this study is to determine whether a similar association exists in children with Down syndrome (DS). METHODS: The medical records of 311 DS patients were reviewed. Subjects were classified into either a control group or surgical group based on whether they had undergone adenotonsillectomy (T&A). Subjects were excluded if they only had one recorded BMI...
September 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28790543/haemorrhage-rates-after-two-commonly-used-tonsillectomy-methods-a-multicenter-study
#17
Faris Brkic, Majda Mujic, Sekib Umihanic, Nermin Hrncic, Amna Goga, Ermin Goretic
INTRODUCTION: Tonsillectomy is a frequently used, low-risk surgical procedure. The post-tonsillectomy haemorrhage occurs rarely, but is a life-threatening complication. Some studies show that the surgical technique affects the haemorrhage rate. AIMS: To analyse the post-tonsillectomy haemorrhage rate, and to determine whether the effect of the surgical technique on the haemorrhage rate exists. METHODS: We retrospectively reviewed data of all patients who underwent a tonsillectomy in three regional ENT departments in Bosnia and Herzegovina (Tuzla, Zenica and Bihac) between January 1(st) 2015 and October 31(st) 2016...
April 2017: Medical Archives
https://www.readbyqxmd.com/read/28782193/resident-responses-to-after-hours-otolaryngology-patient-phone-calls-an-overlooked-aspect-of-residency-training
#18
Ashton E Lehmann, Elliott D Kozin, Rosh K V Sethi, Kevin Wong, Brian M Lin, Stacey T Gray, Michael J Cunningham
OBJECTIVES/HYPOTHESIS: Otolaryngology residents are often responsible for triaging after-hours patient calls. However, residents receive little training on this topic. Data are limited on the clinical content, reporting, and management of otolaryngology patient calls. This study aimed to characterize the patient concerns residents handle by phone and their subsequent management and reporting. STUDY DESIGN: Retrospective review. METHODS: Five hundred consecutive after-hours patient calls in a tertiary pediatric hospital were reviewed...
August 7, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28759260/nocturnal-oximetry-based-evaluation-of-habitually-snoring-children
#19
Roberto Hornero, Leila Kheirandish-Gozal, Gonzalo C Gutiérrez-Tobal, Mona F Philby, María Luz Alonso-Álvarez, Daniel Álvarez, Ehab A Dayyat, Zhifei Xu, Yu-Shu Huang, Maximiliano Tamae Kakazu, Albert M Li, Annelies Van Eyck, Pablo E Brockmann, Zarmina Ehsan, Narong Simakajornboon, Athanasios G Kaditis, Fernando Vaquerizo-Villar, Andrea Crespo Sedano, Oscar Sans Capdevila, Magnus von Lukowicz, Joaquín Terán-Santos, Félix Del Campo, Christian F Poets, Rosario Ferreira, Katalina Bertran, Yamei Zhang, John Schuen, Stijn Verhulst, David Gozal
BACKGROUND: The vast majority of children around the world undergoing adenotonsillectomy for obstructive sleep apnea-hypopnea syndrome (OSA) are not objectively diagnosed with nocturnal polysomnography (NPSG) due to access availability and cost issues. Automated analysis of nocturnal oximetry (nSpO2), which is readily and globally available, could potentially provide a reliable and convenient diagnostic approach for pediatric OSA. METHODS: De-identified nSpO2 recordings from a total of 4,191 children originating from 13 pediatric sleep laboratories around the world were prospectively evaluated after developing and validating an automated neural network algorithm using an initial set of single-channel nSpO2 recordings from 589 patients referred for suspected OSA...
July 31, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28758381/the-impact-of-allergic-rhinitis-on-symptom-improvement-in-pediatric-patients-after-adenotonsillectomy
#20
Dong-Jun Lee, Young-Jun Chung, Yeon-Jun Yang, Ji-Hun Mo
Objectives: It is well known that allergic rhinitis (AR) has positive association with adenotonsillectomy. However, the impact of AR on symptom improvement after adenotonsillectomy is not well documented. Hence, we aimed to evaluate the effect of AR on the symptom improvement after adenotonsillectomy between AR and nonallergic patients. Methods: A retrospective analysis was performed on 250 pediatric patients younger than 10 years old who received adenotonsillectomy from June 2009 to June 2014 in a tertiary referral hospital...
August 1, 2017: Clinical and Experimental Otorhinolaryngology
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