Pierre Robin sequence: review of diagnostic and treatment challenges.

Pierre Robin sequence is not a rare condition and paediatric specialists caring for respiratory related issues are likely to encounter cases in their practice. There have been a few recent reviews on the topic, mostly focusing on the surgical interventions performed for cases with severe airway obstruction. In the present review, we will highlight the different challenges that remain today in the global evaluation of infants afflicted with this condition through a thorough review of the medical literature, giving the clinician a full scope of the disease and of the various management options. The need for an improved objective evaluation of airway obstruction and for a better classification will be emphasized. We are therefore proposing a novel classification scheme that will better account for respiratory and feeding difficulties in these infants. Finally, many knowledge gaps persist regarding this condition, underlining the necessity for further research both in the genetic field and regarding the outcome of therapy.

Hemorrhagic Hairy Polyp Causing Velopharyngeal Dysfunction in a Newborn.

Velopharyngeal dysfunction (VPD) can be secondary to anatomic, neurologic, or functional maldevelopment in the pediatric population. We present a case of transient VPD after the removal of a voluminous oropharyngeal hairy polyp in a newborn with an intact palate. This report sensitizes physicians, speech-language pathologists, and occupational therapists not only to the repercussions of oropharyngeal congenital masses, such as hairy polyps, on the feeding mechanisms of a newborn but also to the possibility of conservative management.

Use of an endoscopic urology basket to remove bronchial foreign body in the pediatric population.

Foreign body (FB) aspiration is a common problem in the pediatric population. Rigid bronchoscopy is considered the treatment of choice for removal of tracheobronchial FB. This is a report of two cases of tracheobronchial foreign body aspiration that were managed using an endoscopic urology basket through a flexible bronchoscope. This report's main purpose is to inform physicians on the benefit of flexible bronchoscopy and of the potential use of the endoscopic urology basket for tracheobronchial FB retrieval. We hope that the flexible bronchoscopy and the endoscopic basket will become a standard tool in FB retrieval kits for pediatric otolaryngologists who deal with this issue on a routine basis.

The use of dexamethasone to reduce pain after tonsillectomy in adults: a double-blind prospective randomized trial.

OBJECTIVES/HYPOTHESIS: To determine the effectiveness of dexamethasone to reduce pain after tonsillectomy in adults by at least 13 mm on the visual analogue scale. The secondary objective was to reduce the use of narcotics by at least 20%. STUDY DESIGN: This multicentric study is a prospective double-blind randomized controlled trial. METHODS: A total of 102 patients were enrolled and received a 4-day trial either of dexamethasone in decreasing doses or placebo. The patients were asked to note the level of pain on the visual analogue scale daily for 7 days. They also had to record their consumption of analgesic and any eventual side effects. RESULTS: There were no statistically or clinically significant differences between the two groups for the level of pain noted on the visual analogue scale for the first 4 and 7 days. There were no statistical differences for the consumption of hydromorphone between the two groups. CONCLUSION: We cannot recommend the use of dexamethasone on a routine basis following tonsillectomy in adults for the reduction of pain or narcotics consumption.