bluuebunny/crossref_metadata_2025_split huggingface dataset:
Awareness of Otitis Media with Effusion among Children Store Consumers
Authors: Rashid Mamun , Chan John 
Published: September 2011

ObjectiveA recent awareness campaign by Deafness Research UK involving distributing 120,000 leaflets to 6,000 general practitioners’ offices resulted in 42% of responders to the subsequent survey seeking further consultation. There is no equivalent data available for consumer awareness. We present a survey of awareness of this condition among children‐store consumers.MethodSurvey of parent shoppers at Mothercare, Adams, and the children’s clothing section at Debenhams in Manchester, UK.ResultsA total of 68 consumers took part. A total of 66% (45/68) were aware of glue ear. A total of 43% (29/68) were aware of grommets as a treatment for OME, but only 6% (4/68) were aware of conservative measures. A total of 97% (66/68) felt more information would be useful. A total of 44% (21/68) indicated that they would seek further consultation.ConclusionA total of 66% of children‐store consumers were aware of OME, but only 43% were aware of treatment options, and most thought surgery was the only option. Despite previous campaigns to increase awareness of OME, there is still need for wider awareness for this common treatable condition among the public at large.
Bilateral Infant Mastoiditis: An Unusual Clinical Entity
Authors: Goldsztein Hernan , Dobrosky Christine , Eisenman David J. , Pereira Kevin D. 
Published: September 2011

ObjectiveDescribe the clinical presentation and management of bilateral mastoiditis in infants.MethodRetrospective chart review of patients under the age of one presenting with clinical evidence of bilateral mastoiditis.ResultsTwo infants fulfilling inclusion criteria were identified. Both had clinical and radiologic evidence of bilateral mastoiditis with unilateral coalescent mastoiditis and an ipsilateral subperiosteal abscess. The patients required surgical intervention, including incision and drainage of the subperiosteal abscess and bilateral myringotomies with or without pressure equalizing tubes. Streptococcus pneumoniae was cultured from both patients. One patient also grew MRSA. Significant comorbidities were identified including neutropenia, history of recent meningitis, and prematurity.ConclusionAcute mastoiditis pursues an aggressive course in infants and can be bilateral. Streptococcus pneumoniae tends to be the most common offending organism. Bilateral disease should prompt investigation for significant co‐morbidities, including immune deficiencies.
Cephalometric Evaluation of Facial Pattern and Hyoid Bone Position in Children with OSAS
Authors: Valera Fabiana , Vieira Bruno B. , Itikawa Carla Enoki , Almeida Leila , Tamashiro Edwin , Anselmo‐Lima Wilma T. , Sander Heidi H. 
Published: September 2011

ObjectiveThe relation between craniofacial changes and OSAS in nonsyndromic children is not well established. The objective of the present study was to assess the development of face and hyoid bone in children with OSAS through lateral cephalometries.MethodTwenty nasal breathing children aged 7 to 10 years were compared with 20 matched in age children polysomnographically diagnosed as OSAS patients. All children underwent otorhinolaryngological evaluation and cephalometries.ResultsChildren with OSAS presented an increase in total and inferior anterior heights of the face when compared to nasal breathers. In addition, children with OSAS presented a significantly more anterior and inferior position of the hyoid bone than nasal breathers. No significant differences in superior anterior or posterior heights of the face were observed between groups.ConclusionThe results suggest that there are evident and early changes in facial growth and development among children with OSAS, characterized by increased total and inferior anterior heights of the face, as well as a more anterior and inferior position of the hyoid bone.
Cochlear Implant Outcomes in Children with Aplasia/Hypoplasia of the Cochleovestibular Nerve
Authors: Musso Mary Frances , Baker Dian , Emery Claudia , Lin Jerry W. 
Published: September 2011

ObjectiveCochlear implant (CI) candidates undergo a preoperative workup including radiologic, audiologic, and neurologic testing to determine if they are candidates for implantation. A percentage of these patients are found to have aplasia/hypoplasia of the cochleovestibular nerve (CVN). Past literature has debated if this population of children benefit from CI.MethodRetrospective review evaluating 17 children with radiographically diagnosed aplasia/hypoplasia of CVN. Eight of these children underwent cochlear implantation during the period from 2002 to 2009. The remaining 9 children were treated nonsurgically with hearing aids. Medical records, audiologic testing, imaging studies, and speech and language evaluations were reviewed.ResultsMeaningful Auditory Integration Scale (MAIS) scores were available for 6 out of 8 CI patients. The average MAIS score pre‐CI was 6.16. The average scores post‐CI were 46.6, 72.8, 70.25, and 75. Auditory Preschool Language Scale (PLS‐4) pre‐CI was 4.75, and post‐CI score was 23. The pre‐ and post‐CI Expressive PLS‐4 scores improved from 11.25 to 23.5. Phonetic inventory scores were 3.7 for vowel sounds and 3.17 for consonant sounds. Scores post‐CI were 10.8 for vowel sounds and 12.5 for consonants. Linear regression analysis revealed a significantly faster acquisition of consonant sounds with the CI group.ConclusionChildren with CVN aplasia/hypoplasia who received a CI had improved audiologic and speech and language assessments post‐CI. The CI group averaged higher scores in vowel and consonant sound production, which was statistically significant. Long term follow‐up is needed to further evaluate outcomes of CI with CVN aplasia/hypoplasia.
Factors Affecting Blood Loss during Pediatric Tonsillectomy
Authors: Park Seok‐Won , Han Min‐Seok , Cho Chang‐Gun , Kwon Seong‐Keun , Song Jae‐Jun 
Published: September 2011

Objective1) Know the factors that can affect the amount of blood loss or the change of the hemoglobin or hematocrit level after adenotonsillectomy in children. 2) Find any quantitative correlations between factors and bleeding parameters.MethodFrom 172 child patients receiving adenotonsillectomy, CBC was measured before and after surgery, and then hemoglobin and hematocrit loss percent was calculated respectively. We selected some factors that can affect operative bleeding parameters. Data were analyzed to find any correlation between the factors and bleeding parameters.ResultsData were statistically analyzed with two‐tailed Spearman’s rho correlation test and multiple linear regression. Patient body weight factor correlated significantly with hemoglobin (P =. 018) or hematocrit loss percent (P =. 036), but not with estimated bleeding amount. Regression equation was [Hemoglobin loss percent = 7.172 ‐ 0.096x (body weight)(P =. 015)] and [hematocrit loss percent = 6.267 ‐ 0.086x (body weight) (P =. 029)]. Other factors such as surgery‐indicated main symptom, technique, application of adenoid packing, subjective bleeding, and adhesion severity did not correlate with any operative bleeding parameters.ConclusionWe can estimate the usual reduction amount of the postoperative hemoglobin (hematocrit) level in children receiving adenotonsillectomy. Amount of reduction of hemoglobin (hematocrit) is larger when the child’s body weight is lower, though the absolute bleeding amount is not affected by body weight. The surgeon should be more careful when performing adenotonsillectomy on a lower weight child.
Immediate versus Interval Tonsillectomy for Peritonsillar Abscess
Authors: Matijasec Jackie , Perry Alvin , Cecola Patrick , Kluka Evelyn A. , Simon Lawrence M. , Hagmann Michael A. 
Published: September 2011

Objective1) Compare operative time and intraoperative blood loss in patients receiving either Quinsy or interval tonsillectomy for peritonsillar abscess. 2) Compare postoperative bleeding and readmission rates for patients receiving either Quinsy or interval tonsillectomy for peritonsillar abscess.MethodStudy design: Retrospective review. Setting: Academic tertiary pediatric hospital. Patients: Children treated between 2007 and 2011 for peritonsillar abscess. Patients were identified by searching the hospital database for all children treated for the ICD‐9 code 475 (peritonsillar abscess). Children who never received a tonsillectomy (CPT codes 42820/42821/42825/42826) were excluded.ResultsA total of 49 children received tonsillectomy for peritonsillar abscess from 2007 to 2011. Of these, 37 received a Quinsy tonsillectomy, and 12 received antibiotics with or without incision and drainage, followed by tonsillectomy a minimum of 2 weeks later. Total hospital days in treatment course was 2.2 days for the Quinsy tonsillectomy group and 2.3 days for the interval tonsillectomy group. Estimated blood loss was less than 20 milliliters for both groups. Operative time was 38 minutes for Quinsy tonsillectomy and 39 minutes for interval tonsillectomy. There were no posttonsillectomy hemorrhages. One patient in the interval tonsillectomy group required readmission for dehydration.ConclusionThere were no significant differences in total hospital days, blood loss, operative time, or postoperative complications between Quinsy tonsillectomy and interval tonsillectomy in the treatment of pediatric peritonsillar abscess.
Kawasaki Disease Presenting as Retropharyngeal Cellulitis
Authors: Kurihara Risa , Yamazaki Hiroshi , Fujiwara Keizo , Kanazawa Yuji , Kikuchi Masahiro , Kikuchi Shogo , Naito Yasushi 
Published: September 2011

ObjectiveKawasaki disease (KD), which occurs in infants and children, is an acute multisystemic vasculitis of unknown etiology. Several reports mentioned retropharyngeal cellulitis as a rare manifestation of KD. The purpose of this study is to investigate the population and characteristics of KD manifested by retropharyngeal soft tissue swelling.MethodA retrospective review of 213 patients (mean age of 2 years, age range of 7 months to 10 years) diagnosed as KD between 2005 and 2010.ResultsEnhanced computed tomography showed an abnormal low density area without ring enhancement in the retropharyngeal space in 9 cases (4.2%). All of them had fever and cervical lymphadenopathy as the first symptom. Though cervical lymphadenopathy is one of the 6 diagnostic features of KD (fever, skin rash, cervical lymphadenopathy, conjunctivitis, fissuring of lips, and strawberry tongue), the occurrence is reported to be the lowest (about 50%). They were treated by a pediatrician as suppurative lymphadenitis in 6 cases and as retropharyngeal cellulitis in 3 cases, and they were finally diagnosed as KD owing to ineffectiveness of antibiotics or emergence of the other symptoms.ConclusionA low density area on computed tomography in the retropharyngeal space was identified in 4.2% of KD. Early diagnosis is essential in KD because coronary artery lesions emerge in 50% of patients without treatment. If a young child has fever, cervical lymphadenopathy and swelling of the retropharyngeal space, KD should be within differential diagnoses.
Laser Epiglottopexy: Flexible versus Line‐of‐Sight Technique
Authors: Janus Jeffrey R. , Cofer Shelagh A. , Chinnadurai Sivakumar 
Published: September 2011

ObjectiveDetermine outcomes in children with epiglottic laryngomalacia treated with laser (CO2, LISA) epiglottopexy by both flexible (photonic band gap technology) and traditional direct line‐of‐sight techniques. These procedures are used as a monotherapy for the treatment of obstructive sleep apnea resulting from epiglottic retroflexion or sagittal collapse.MethodSingle center, retrospective review of patients with epiglottic laryngomalacia treated with laser epiglottopexy from 2005 to 2010. Outcomes measured include sex, age, gestational age, primary obstructive sleep apnea presentation, type of dynamic epiglottic collapse, polysomnogram information, medical comorbidities, and resolution of symptoms after surgery.ResultsFive cases were reviewed; 80% male, 20% female. The average age at treatment was 9.4 years. All patients had underlying medical comorbidities (Turner Syndrome, Bardet‐Biedl, etc). Various initial presentations include (can be more than one): 80% sleep disturbance, 80% apneic episodes, 20% cyanosis, and 20% snoring. A total of 80% had epiglottic retroflexion as the primary anatomic dilemma, with only one having sagittal collapse. Average AHI was 23.8. All received laser epiglottopexy (3 flexible laser, 2 line‐of‐sight). All but one received concomitant tacking sutures. Average operative time was 150 min. Average hospital stay was 5.2 days. All had symptom resolution at 135 days of average follow‐up.ConclusionLaser epiglottopexy, using either flexible technology or line‐of‐sight method, can be done safely, efficiently, and effectively as monotherapy for obstructive sleep apnea caused by epiglottic collapse. Advances in this technology and in these techniques may prove helpful not only in this specific problem, but for the treatment of laryngomalacia in general.
Late Onset Laryngomalacia in Neurologically Normal Children
Authors: Tanweer Faiz , Bateman Neil D. 
Published: September 2011

ObjectiveLaryngomalacia in neurologically normal children over the age of 2 is uncommon. The purpose of our study was to determine the mode of presentation and mechanisms of obstruction. We retrospectively reviewed our hospital database to identify late onset laryngomalacia (LOM) patients who had confirmed endoscopic diagnosis of laryngomalacia.MethodWe retrospectively reviewed our hospital database to identify patients who had confirmed endoscopic diagnosis of laryngomalacia. Patients symptoms, age at diagnosis, co‐morbidities, medical and surgical intervention, and short‐term outcome (symptoms within 3 months) were recorded. Patients were excluded if they were symptomatic before 2 years of age or there were congenital anomalies involving upper aerodigestive tract.ResultsWe identified 5 cases after searching our patient database over the past 5 years (from May 2005 to Jun 2010). Two patients presented with poor exercise tolerance at the ages of 13 and 14 years, while 2 younger patients (3 and 4 years) presented with obstructive sleep apnea (OSA) not relieved with adenotonsillectomy. All patients responded well to the surgery combined with antireflux therapy.ConclusionLOM presents with a variety of symptoms rather than the typical inspiratory stridor well recognized of infantile laryngomalacia. Our patients more commonly present as OSA or exercise induced inspiratory stridor. The mechanisms of late presentation appear to be unclear.
Management for Epistaxis in Children with Bleeding Disorders
Authors: Kibort Jonathan , Nelson Stephen , Sidman James D. , Grischkan Jonathan M. , Tibesar Robert J. , Lander Timothy 
Published: September 2011

ObjectiveMedical management of epistaxis is the traditional standard of care in treating children with bleeding disorders. Our objective is to review our experience with physical intervention as a method of epistaxis management and to evaluate its safety and efficacy as an appropriate treatment for pediatric patients with an identified coagulopathy.MethodChildren with a known coagulopathy and who were treated for epistaxis were identified, and a retrospective chart review was performed. Medical records from 2000 to 2011 were reviewed and abstracted. The number of episodes, method of management used, type of coagulopathy, complications, and success rates for controlling the hemorrhage were recorded.ResultsThirty‐five children with a total of 102 encounters for epistaxis met the study criteria. Sixty‐nine procedures (approximately 67.6%) did not require further surgical intervention during the intervention success period (21‐28 days after the initial procedure). Physical intervention was successful 57% of the time (21 out of 37 procedures) in patients with Glanzmann thrombasthenia. In children with von Willebrand disease, physical intervention prevented recurrent epistaxis 75% of the time (21 out of 28 successful procedures). For patients with acquired coagulopathies due to chemotherapy treatment for hematogenous malignancies, physical intervention proved successful in 76% of procedures (13 of 17).ConclusionMedical management is the traditional treatment for epistaxis in children with known coagulopathies. In treating children with known coagulopathies where medical management is unsuccessful, physical intervention is a safe, effective, and minimally invasive treatment that may decrease the frequency of recurrences for epistaxis in children with coagulopathy.
Pediatric Small Vessel AVMs Mistaken for Hemangioma
Authors: Chun Robert H. , North Paula E. , Jakubowski Luke A. 
Published: September 2011

ObjectiveA majority of vascular anomalies in children are infantile hemangiomas (IH). However, some children with an atypical growth pattern can be suggestive of an AVM. This case series discusses the clinical presentation, diagnosis, radiology, pathology, and treatment of small vessel AVMs at a multidisciplinary vascular anomalies center.MethodRetrospective case series of three patients. Chart review was obtained with IRB approval.ResultsThree patients presented with increasing head and neck masses at 12 months to 2.5 years. All patients had magnetic resonance imaging indicating likely infantile hemangioma. All patients underwent surgical excision, one requiring preoperative embolization. All pathology specimens were GLUT 1 negative and were diagnosed as small vessel arteriovenous malformations. Serial clinical photographs, imaging studies, and pathology will be presented.ConclusionMany pediatric vascular anomalies appear to be an IH, but atypical growth patterns should raise clinical suspicion of an AVM. Diagnostic error leads to inadequate treatment, disease progression, and increased morbidity. This series highlights the importance of clinical suspicion and a multidisciplinary team approach toward pediatric vascular anomalies.
Outcomes and Predictive Factors of Furlow Palatoplasty
Authors: Jacobs Britni , Muckala Jennifer , Sowder Derrick , Wooten Christopher , Goudy Steven L. , Zheng Wei 
Published: September 2011

Objective1) Describe patients with submucous cleft palates (SMCP) and velopharyngeal insufficiency (VPI) treated with furlow palatoplasty who later required subsequent surgery due to persistent VPI. 2) Identify risk factors predictive of revision surgery in SMCP patients in order to develop a clinical algorithm to apriori determine the most efficacious primary surgery based on preoperative evaluation.MethodA retrospective review of 14 patients with SMCP undergoing furlow palatoplasty to correct VPI. Data reviewed included need for secondary surgery, syndrome diagnosis, velopharyngeal closure, and preoperative speech evaluations.ResultsA series of 14 patients having furlow palatoplasty between ages 3 and 16 (average age of 4.9 years) was identified. Three of these patients (21.4 %) required secondary correction of VPI via superiorly based pharyngeal flap an average of 2.3 years following the initial operation. There was no association between age at primary surgery or syndromic diagnosis and persistent VPI. Predictors of persistent VPI after palatoplasty were poor preoperative speech (P <. 03) and nasometry scores (P <. 09). Pattern of velopharyngeal closure was not predictive of further surgery, however an association between larger velopharyngeal gap and need for revision surgery was found.ConclusionPreoperative speech and nasal endoscopic assessment of patients with SMCP and VPI is predictive of patients who require palatoplasty alone or may benefit from primary velopharyngeal surgery.
Pediatric Maxillary Sinus Growth Curve
Authors: Thakkar Nirav , Schroeder James W. 
Published: September 2011

ObjectiveDescribe the growth pattern of the maxillary sinus in the pediatric population. This includes identifying growth spurts and comparing growth by side and gender. This data is intended to assist a surgeon recommending or delaying surgical treatment and to help with surgical planning.MethodCT scans performed in patients under 18 years at a Children’s hospital from January 2006 through June 2009 were reviewed. Scans with sinus disease affecting the normal sinus anatomy were excluded. The height, width, and depth of the right and left maxillary sinuses were measured to characterize its growth pattern.ResultsThe overall growth rate of each sinus from birth to age18 years is 1.98 mm3 per year. The growth from ages 1 to 7 years is 1.4 mm3 per year, 7 to 9 years is 3.1 mm3 per year, 9 to 12 years is 0.4 mm3 per year, 12 to 15 years is 4.8 mm3 per year, and 15 to 18 years is 1.5 mm3 per year. The predominant dimension contributing to growth during each growth spurt, ages 7 to 9 years and 12 to 15 years are height and depth respectively. The rate is 0.15 mm per year and 1.9 mm per year respectively.ConclusionComparison of gender and side demonstrated no significant difference in height, width, or depth at each age. The maxillary sinus gradually grows from ages 1 to 7, 9 and 12 and 15 onward. Two growth spurts were identified from ages 7 and 9 and 12 and 15.
Pediatric Myringoplasty
Authors: Takahashi Emiko , Mishiro Yasuo , Sakagami Masafumi 
Published: September 2011

ObjectiveInvestigate “the true success rate” of myringoplasty for pediatric patients.MethodThis was a retrospective analysis of 72 myringoplasites performed at Hyogo College of Medicine between 2000 and 2009. Success was defined as an intact tympanic membrane (no perforation, no adhesion, no retraction, and no effusion) and preservation of hearing at 1 year after surgery.ResultsThe graft success rate was 85%, similar to adult patients. However, the defined success rate was only 54%. There were 8 cases with graft failure, 3 cases with retraction pocket, 3 cases with OME, 3 cases with pearl formation, 2 cases with adhesion of tympanic membrane, and 2 cases with postoperative abscess needing re‐operation. The success rate was 70% in patients with normal contralateral ear and 37% in patients with diseased contralateral ear (eg, CMO, OME, cholesteatoma, and atelectasis). There was a significant difference concerning the state of the contra‐lateral ear.ConclusionThe true success rate of a pediatric myringoplasty seemed to be lower than commonly expected and quoted to parents. The results are similar to other reports using a similar definition of success. We should especially pay attention to myringoplasty for patients with diseased contra‐lateral ears.
A Study into the Benefits of Bilateral Packing for Epistaxis
Authors: Hollis Sophie , Titoria Puneet 
Published: September 2011

ObjectiveTheoretically there is a safety benefit in using bilateral nasal packs in managing epistaxis. Our study aims to show an additional benefit in this practice: the reduction to the deformity caused across the nasal septum with bilateral packing, therefore creating a safer and more pleasant patient experience.MethodWe created a simple nasal model to illustrate the nasal septal cartilage as a structure that is anchored inferiorly, superiorly, and posteriorly, but with a free anterior edge. Using 7.5 cm Arthrocare RapidRhino packs and a manometer, we measured the septal deflection created using different pack pressures, unilaterally and bilaterally.ResultsBy measuring the anterior deflection of the cartilage analogue (3 mm wide silicone sheeting) at 3 different fixed points along the anterior edge, we were able to demonstrate significantly less septal deflection when using bilateral packing with the same pressures, compared with unilateral packing. The dynamic nature of the model meant that the maximum deflection points varied between repetitions of the study, yet less septal deflection was seen with bilateral packing, particularly with higher inflation pressures, regardless of the starting deformity.ConclusionOur simple model shows that the nasal septal deformity with bilateral packing is reduced, compared with unilateral packing. We theorize that the reduced deformity shown with bilateral packing will make for greater patient comfort. We have commissioned a model with pressure sensors across the nasal septum to analyze this theory.