Ethosuximide induced macroglossia and oropharyngeal edema.

xloma.fota.13 shared this article with you from Inoreader Ethosuximide induced macroglossia and oropharyngeal edema. Via International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Related Articles Ethosuximide induced macroglossia and oropharyngeal edema. Int J Pediatr Otorhinolaryngol. 2020 Nov 15;:110498 Authors: Shang H, Glaun M, Ongkasuwan J Abstract Acute macroglossia and laryngeal edema are rare adverse side effects that can cause life-threatening airway obstruction. We report a case of acute macroglossia that began after initiation of ethosuximide in a 15-year-old female with severe medically refractory epilepsy. Macroglossia worsened over the next two weeks of ethosuximide administration, preventing extubation. Macroglossia and laryngeal edema improved upon ethosuximide wean, and completely resolved after discontinuation. The patient was extubated successfully, with precautionary nasal trumpet placement and dexamethasone administration prior to extubation. In medically complex patients on multiple pharmacologic agents, anti-epileptic drugs should be suspected as a possible cause of acute macroglossia. PMID: 33218689 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Effects of allergic rhinitis on the progression and recovery of acute otitis media in a mouse model.

xloma.fota.13 shared this article with you from Inoreader Effects of allergic rhinitis on the progression and recovery of acute otitis media in a mouse model. Via International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Related Articles Effects of allergic rhinitis on the progression and recovery of acute otitis media in a mouse model. Int J Pediatr Otorhinolaryngol. 2020 Nov 13;:110497 Authors: Cho CG, Kim HB, Kim CK, Kim BH, Lim YS, Park SW, Park JH Abstract OBJECTIVES: The objective of this study was to evaluate the effects of allergic rhinitis (AR) on the development, progression, and recovery of acute otitis media (OM) in an animal model and investigate the secondary effects of bacterial infection. METHODS: BALB/c mice were divided into four groups: AR + OM, AR, OM, and control groups. AR + OM and AR groups were sensitized with ovalbumin (OVA) and alum and then challenged intranasally with OVA. Phosphate-buffered saline (PBS) was administered to the OM and control groups the same number of times. After AR induction, OM was induced by surgical inoculation of non-typeable Haemophilus influenza (NTHi) into the middle ear (ME) cavity of the mice in the AR + OM and OM groups. PBS was injected into the bulla in the AR and control groups. Each group was subdivided into sets of six mice, one for each of the four time points (0, 2, 7, and 10 days post-bacterial inoculation), at which point the mice were euthanized and ME and nasal cavity mucosa were obtained and evaluated. The occurrence of OM and the ME mucosa thickness were evaluated and compared among the four groups. Tissue expression of interleukin (IL)-1β, IL-6, and tumor necrosis factor-α ( TNF-α) in infected ME mucosa was assessed by immunohistochemical staining. We also investigated IgE, IL-4, and IL-5 in the nasal mucosa. RESULTS: Most of the ears showed OM on post-inoculation day 2 in both AR + OM and OM groups. In the AR + OM group, 58.3% of ears still had OM on post-inoculation day 10, while only 16.7% of the OM group had OM. The ME mucosa of all groups increased, and the AR + OM group exhibited the thickest mucosa. The OM group showed peak thickness on post-inoculation day 2 and then decreased, whereas the ME mucosa thickness of the AR + OM group continued to increase to day 7. In the OM group, the expression of IL-1β, IL-6, and TNF-α in the ME also increased significantly, peaking on post-inoculation day 2, and then gradually decreased. In the AR + OM group, the expression of these proteins increased until day 7 and then decreased. The IgE and Th2 response (IL-4 and IL-5) cytokines were expressed at higher levels in the AR + OM and AR groups than in the OM and control groups. CONCLUSION: The inflammatory reaction to NTHi was more intense and lasted longer in the allergic group, which indicates that AR affects the progression and subsequent recovery of acute bacterial OM. PMID: 33218690 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A case series of dermoids in the middle ear.

xloma.fota.13 shared this article with you from Inoreader A case series of dermoids in the middle ear. Via International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Related Articles A case series of dermoids in the middle ear. Int J Pediatr Otorhinolaryngol. 2020 Nov 04;:110472 Authors: Chen S, Huang Y, Li Y Abstract OBJECTIVE: Dermoid is a rare disease located in the head and neck and only sporadic cases were previously reported. Surgery with different operational paths is the best solution to the disease. We aimed to analyze the clinical characteristics and outcomes of surgical approach for treating dermoid originated from the middle ear and Eustachian tube. METHODS: In this retrospective case series, four cases of dermoids of the middle ear and Eustachian tube, treated by endoscopic-assisted surgical approach were reviewed and analyzed. RESULTS: Patients' ages ranged from 7 months to 16 years. All cases involved the middle ear, eustachian tube, and the parapharyngeal space. Postoperative follow-up ranged from 6 months to 11 years. No facial nerve paralysis was observed during or after surgeries. Treatment was efficient in the four cases, with no residual symptoms during post-operative follow-up. CONCLUSIONS: Dermoid of the middle ear involving the eustachian tube usually appears in children of early age. Surgical resection with assistance of endoscope has satisfying outcome for these cases. PMID: 33221033 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Perception of speech stress in children with hearing impairment.

xloma.fota.13 shared this article with you from Inoreader Perception of speech stress in children with hearing impairment. Via International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Related Articles Perception of speech stress in children with hearing impairment. Int J Pediatr Otorhinolaryngol. 2020 Nov 12;:110495 Authors: Konadath S, Raveendran R, Yeshoda K Abstract PURPOSE: The study aimed to test effect of training on the perception of speech stress in children with severe to profound hearing impairment. The first objective was to compare the speech stress perception scores of children with hearing impairment and language age-matched children with normal hearing sensitivity after short term prosody training and the second objective was to correlate between the speech stress perception scores and the language age of the children with hearing impairment. METHOD: Thirty children with normal hearing (CWNH) in the age range of 3-7 years and thirty children with hearing impairment (CWHI) who had a language age of 3-7 years participated in the study. The authors formulated 24 concrete Malayalam sentences and their picture cognate pairs (stressed and unstressed) for each sentence. The stressed and unstressed version for each sentence was audio recorded separately.The study was carried out in two phases; phase 1 included the training on acoustic cues of speech stress followed by testing in phase 2. Both the phases were attended by all the participants. RESULTS: There was a significant difference between the CWNH and CWHI wherein, children with hearing impairment had lower speech stress perception scores. However, improvements in speech stress perception were observed in children with hearing impairment after the training phase. Also, a positive correlation between the language age and the perception of speech stress scores in CWHI was found indicating that as the language age increased there was an increase in the speech stress perception scores. CONCLUSION: The pre and post training speech stress perception scores were significantly different, with higher scores on the post-training test, indicating that the short term speech stress training for the children with hearing impairment was beneficial. The positive strong correlation between stress perception scores and language age shows that, prosody perception and language learning facilitate each other. Thereby, the conventional speech-language and auditory training should expand and include prosody training from an early age for children with hearing impairment. PMID: 33221034 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The influence of tonsillectomy on allergic diseases in pediatric patients.

xloma.fota.13 shared this article with you from Inoreader The influence of tonsillectomy on allergic diseases in pediatric patients. Via International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Related Articles The influence of tonsillectomy on allergic diseases in pediatric patients. Int J Pediatr Otorhinolaryngol. 2020 Nov 17;:110503 Authors: Funakoshi U, Yonekura S, Iinuma T, Arimoto Y, Nakano A, Yamaide A, Tomiita M, Hoshioka A, Sakurai D, Okamoto Y Abstract BACKGROUND: The influence of tonsillectomy on allergic airway diseases is not well known. OBJECTIVES: In the present study, the influence of tonsillectomy on perennial allergic rhinitis (PAR) and bronchial asthma (BA) among pediatric subjects was prospectively investigated. METHODS: The tonsillectomy (surgery group) and the age-matched non-surgical subjects (control group) were examined and followed prospectively. In addition, immunological analysis was conducted. RESULTS: After in vitro allergen stimulation, the production of a small number of allergen-specific Th2 cells was induced in the tonsillar cells, even in sensitized subjects. Flow cytometry analysis detected more effector regulatory T cells (Tregs) in the tonsils than in peripheral blood. Clinically, after surgery, the PAR and BA symptoms improved in the surgery group but not in the control group. The total IgE in the surgery group was significantly lower than in the control group; after surgery, IgE levels slightly increased but remained lower. The postoperative Dermatophagoides farina (Der f)-specific IgE level increased in the sensitized subjects but not in the non-sensitized subjects. CONCLUSION: Tonsillectomy did not improve the underlying mechanisms of the allergy, however the decreased risk of infection and upper airway obstruction could lead to improved symptoms of allergic airway diseases. PMID: 33223275 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Characteristics of the wideband absorbance of acoustic energy in children (3-7 years old) with otitis media with effusion.

xloma.fota.13 shared this article with you from Inoreader Characteristics of the wideband absorbance of acoustic energy in children (3-7 years old) with otitis media with effusion. Via International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Related Articles Characteristics of the wideband absorbance of acoustic energy in children (3-7 years old) with otitis media with effusion. Int J Pediatr Otorhinolaryngol. 2020 Nov 16;:110496 Authors: Liang J, Xiao L, Sun XY, Zou B Abstract OBJECTIVE: This study aimed to investigate the characteristics of the wideband absorbance (WBA) of acoustic energy in children (3-7 years old) with otitis media with effusion (OME) under environmental ear-canal air pressure and tympanometric peak pressure and to determine the diagnostic value of the acoustic energy absorption rate (AR) in OME at different frequencies. METHODS: A total of 178 children aged 3-7 years were enrolled in the study between April and October 2018. They were separated into two groups: those with middle ear effusion were placed in the OME group (n = 80; 136 ears), while those without OME (n = 98; 182 ears) were placed in the control group. A WBA test was performed on the children in both groups under environmental ear-canal pressure and tympanometric peak pressure to analyze the changing characteristics of the AR value within the 0.226-8 kHz range. RESULTS: Under ambient ear-canal air pressure, the AR of the OME group in each frequency band was significantly lower than that of the control group (P < 0.01). Under tympanometric peak pressure, the AR of the OME group in most frequencies was also significantly lower than those of the control group (P < 0.01) except in the 2-2.5 kHz range. The area under the receiver operating characteristic curve (AUROC) was highest at 0.47-1.03 kHz: 0.96 and 0.94 at ambient ear-canal pressure and tympanometric peak pressure, respectively. Of the single frequency points, those at 0.65, 0.67, 0.69, 0.71, and 0.73 kHz had a higher AUROC value (0.96-0.97) under both ambient ear-canal air pressure and tympanometric peak pressure. The difference in the AUROC values of the two pressure conditions was not statistically significant (P < 0.01). CONCLUSION: Overall, WBA is an effective method of diagnosing OME in children. The frequency band with the most predictive value of AR for OME is 0.47-1.03 kHz. Middle ear effusion can be quickly identified by observing AR values in this frequency range, which provides a diagnostic basis for OME. PMID: 33229030 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical practice guidelines on newborn hearing screening: A systematic quality appraisal using the AGREE II instrument.

xloma.fota.13 shared this article with you from Inoreader Clinical practice guidelines on newborn hearing screening: A systematic quality appraisal using the AGREE II instrument. Via International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Related Articles Clinical practice guidelines on newborn hearing screening: A systematic quality appraisal using the AGREE II instrument. Int J Pediatr Otorhinolaryngol. 2020 Nov 17;:110504 Authors: Chorath K, Garza L, Tarriela A, Luu N, Rajasekaran K, Moreira A Abstract INTRODUCTION: Several guidelines and consensus statements have been produced and disseminated for the detection and management of newborn hearing loss. However, to date, the quality and methodologic rigor of these screening and management protocols have not been appraised. OBJECTIVE: To identify and evaluate existing guidelines and consensus statements for the detection and management of neonatal hearing loss. METHODS: A comprehensive search of EMBASE, MEDLINE/PubMed, SCOPUS and grey literature sources was conducted until August 2020. The quality of these guidelines was assessed by four independent reviewers using the Appraisal of Guidelines for Research and Evaluation, 2nd edition (AGREE II). Domain scores were considered satisfactory quality if they scored >60%, and intraclass correlation coefficients (ICC) were calculated to assess agreement among the appraisers. RESULTS: Twelve guidelines were assessed for critical evaluation. Only two guidelines were classified as 'high quality', and the remaining were 'average' or 'low quality'. The 'Scope and Purpose' domain achieved the highest mean score (91.3% ± 5.8%), and lowest was 'Rigor of Development' (35.8% ± 19.1%). ICC analysis showed good to very good agreement across all domains (0.63-0.95). CONCLUSION: These findings highlight the variability in methodologic quality of guidelines and consensus statement for the detection and management of neonatal hearing loss. These results may help to improve the reporting of future guidelines and guide the selection and use of these guidelines in clinical practice. PMID: 33229031 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Monopolar tonsillotomy versus cold dissection tonsillectomy in children: Prospective study on postoperative recovery.

xloma.fota.13 shared this article with you from Inoreader Monopolar tonsillotomy versus cold dissection tonsillectomy in children: Prospective study on postoperative recovery. Via International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Related Articles Monopolar tonsillotomy versus cold dissection tonsillectomy in children: Prospective study on postoperative recovery. Int J Pediatr Otorhinolaryngol. 2020 Nov 19;:110513 Authors: Sakki AJ, Mäkinen LK, Kanerva M, Nokso-Koivisto J Abstract OBJECTIVES: To compare postoperative self-reported recovery results with monopolar tonsillotomy and cold dissection tonsillectomy in children. To evaluate the feasibility of the monopolar technique in tonsillotomy. METHODS: Children <12 years undergoing tonsillotomy or tonsillectomy between April 2018 and March 2020 who (with a caregiver) were willing to participate in a two-week follow-up formed the study group. They filled in a questionnaire about pain-related outcomes, return to normal activities, weight changes, complications, and length of home care. RESULTS: Altogether 166 patients were recruited; 103 (62%) returned the questionnaire. The first pain-free day with tonsillotomy was day 5 and with tonsillectomy day 11. After tonsillotomy, patients returned to normal activities faster, e.g. they were able to eat normally 6.5 days earlier than tonsillectomy patients. During the first postoperative week weight dropped after tonsillectomy, but not after tonsillotomy. The length of home care was 6 days with tonsillotomy and 10 days with tonsillectomy. The incidence of postoperative hemorrhage (including minor bleedings at home) was 14% after tonsillotomy and 32% after tonsillectomy. Hemorrhages needing interventions were 0% with tonsillotomy and 2% with tonsillectomy. CONCLUSION: Children operated on with monopolar tonsillotomy recovered faster and had less postoperative hemorrhage than those undergoing tonsillectomy. They were able to return earlier to daycare/school and their caregivers back to work. Recovery results with monopolar tonsillotomy were equal to other tonsillotomy techniques reported in the literature, hence the monopolar technique can be considered an alternative method to perform tonsillotomy. PMID: 33234329 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endotracheal metallic stent removal: A novel ABC (airway balloon collapse) technique.

xloma.fota.13 shared this article with you from Inoreader Endotracheal metallic stent removal: A novel ABC (airway balloon collapse) technique. Via International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Related Articles Endotracheal metallic stent removal: A novel ABC (airway balloon collapse) technique. Int J Pediatr Otorhinolaryngol. 2020 Nov 10;:110490 Authors: Cofer SA, Badaoui JN, Boesch RP, Balakrishnan K Abstract To illustrate a previously unreported method of tracheal stent removal that appears to cause less mucosal injury we present a case of a 9-year-old Down syndrome patient with a history of tracheoesophageal fistula, brought to our attention after recurrent bouts of exacerbating cough and tracheo-bronchitis. Endoscopic examination under general anesthesia noted the presence of severe tracheomalacia with inspiratory collapse, and a 10-mm balloon expandable metallic stent (BEMS) was deployed and symptomatic improvement was noted. The initial stent was then removed to consider a definitive procedure using the typical grasping fashion with an alligator forceps and expected mucosal excoriation was noted. Due to symptom recurrence, the patient underwent placement of a second BEMS stent. Initial improvement was noted followed by recurrent episodes of respiratory distress due to granulation tissue formation and stent compression and a decision to remove the stent was made. A new method of stent removal deemed ABC (airway balloon collapse) method was utilized where an expandable airway balloon is placed outside the stent between the stent and tracheal wall and then inflated to collapse the stent, facilitating easy removal. PMID: 33229032 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Swedish hearing in noise test for children, HINT-C.

xloma.fota.13 shared this article with you from Inoreader The Swedish hearing in noise test for children, HINT-C. Via International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Related Articles The Swedish hearing in noise test for children, HINT-C. Int J Pediatr Otorhinolaryngol. 2020 Nov 19;:110509 Authors: Hjertman H, Hällgren M, Mäki-Torkko E, Stenfelt S Abstract OBJECTIVE: The aim of this study was to develop and evaluate a Swedish version of the Hearing In Noise Test for Children (HINT-C). DESIGN: In the first part, the Swedish HINT lists for adults was evaluated by children at three signal to noise ratios (SNRs), -4, -1 and +2 dB. Lists including sentences not reaching 50% recognition at +2 dB SNR were excluded and the rest constituted the HINT-C. In the second part, HINT-C was evaluated in children and adults using an adaptive procedure to determine the SNR for 50% correctly repeated sentences. Study Sample In the first part, 112 children aged 6-11 years participated while another 28 children and 9 adults participated in the second part. RESULTS: Eight out of 24 tested adult HINT lists did not reach the inclusion criteria. The remaining 16 lists formed the Swedish HINT-C which was evaluated in children 6-11 years old. A regression analysis showed that the predicted SNR threshold (dB) was 0.495-0.365*age (years + months/12) and the children reached the mean adult score at an age of 10.5 years. CONCLUSIONS: A Swedish version of HINT-C was developed and evaluated in children six years and older. PMID: 33234330 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Novel variants in EDNRB gene in waardenburg syndrome type II and SOX10 gene in PCWH syndrome.

xloma.fota.13 shared this article with you from Inoreader Novel variants in EDNRB gene in waardenburg syndrome type II and SOX10 gene in PCWH syndrome. Via International journal of pediatric otorhinolaryngology,http://goo.gl/4YdRhz Related Articles Novel variants in EDNRB gene in waardenburg syndrome type II and SOX10 gene in PCWH syndrome. Int J Pediatr Otorhinolaryngol. 2020 Nov 13;:110499 Authors: Varga L, Danis D, Drsata J, Masindova I, Skopkova M, Slobodova Z, Chrobok V, Profant M, Gasperikova D Abstract Waardenburg syndrome (WS) is a clinically and genetically heterogeneous group of inherited disorders manifesting with sensorineural hearing loss and pigmentary anomalies. Here we present two Caucasian families with novel variants in EDNRB and SOX10 representing both sides of phenotype spectrum in WS. The c.521G>A variant in EDNRB identified in Family 1 leads to disruption of the cysteine disulfide bridge between extracellular segments of endothelin receptor type B and causes relatively mild phenotype of WS type II with low penetrance. The novel nonsense variant c.900C>A in SOX10 detected in Family 2 leads to PCWH syndrome and was found to be lethal. PMID: 33234331 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.