Video Laryngoscope Assistance in Button Battery Retrieval.

Foreign body ingestion remains a common cause of pediatric emergency surgery with button battery ingestion of particular concern. Newer, higher power lithium batteries can cause catastrophic damage of the gastrointestinal tract through erosion of mucosa into surrounding structures. Prompt diagnosis and treatment are paramount. We present a case of an 11-month-old with a button battery lodged in the proximal esophagus. The extraction was difficult and only made possible with the assistance of a video laryngoscope. We make the case for more routine usage of video laryngoscopy for removal of foreign bodies in the upper esophagus.

Retinal ganglion cell function in recovered optic neuritis: Faster is not better.

OBJECTIVE: To assess residual retinal ganglion cell (RGC) function in patients with recovered optic neuritis (ON) and multiple sclerosis (MS). METHODS: Age-matched controls (C, n = 32) and MS patients (n = 17) with history of ON in one eye but normal visual acuity and color vision were tested with steady-state Pattern Electroretinogram (PERG). Light Emitting Diodes (LED)-generated bar gratings, robust signal averaging and Fourier analysis were used to assess response amplitude and latency. RESULTS: PERG amplitude was similar for C, ON and fellow eyes (FE) (P = 0.4), but PERG latency was shortened in ON by 3.2 ms (P = 0.002) and in FE by 2.0 ms (P = 0.02) and was correlated (P < 0.01) with both Retinal Nerve Fiber Layer (RNFL) and Ganglion Cell Inner Plexiform Layer (GCIPL) thicknesses. PERG latency shortening could be simulated in control subjects (n = 8) by dioptrically blurring the edges of gratings (high spatial frequencies), which reduced activity of parvocellular RGCs with smaller/slower axons. The blurred PERG latency was shorter than baseline by 2.9 ms (P = 0.01). CONCLUSIONS: PERG latency is shortened in both eyes of MS patients with recovered unilateral ON, suggesting relative dysfunction of RGCs with slower axons and sparing of RGCs with faster axons. SIGNIFICANCE: Assessment of PERG latency in MS and ON may help identifying and monitoring RGC dysfunction. PERG latency shortening in FE suggests primary retinopathy in MS.