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1.
Front Public Health ; 12: 1337395, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38454985

RESUMO

Background: Online medical education often faces challenges related to communication and comprehension barriers, particularly when the instructional language differs from the healthcare providers' and caregivers' native languages. Our study addresses these challenges within pediatric healthcare by employing generative language models to produce a linguistically tailored, multilingual curriculum that covers the topics of team training, surgical procedures, perioperative care, patient journeys, and educational resources for healthcare providers and caregivers. Methods: An interdisciplinary group formulated a video curriculum in English, addressing the nuanced challenges of pediatric healthcare. Subsequently, it was translated into Spanish, primarily emphasizing Latin American demographics, utilizing OpenAI's GPT-4. Videos were enriched with synthetic voice profiles of native speakers to uphold the consistency of the narrative. Results: We created a collection of 45 multilingual video modules, each ranging from 3 to 8 min in length and covering essential topics such as teamwork, how to improve interpersonal communication, "How I Do It" surgical procedures, as well as focused topics in anesthesia, intensive care unit care, ward nursing, and transitions from hospital to home. Through AI-driven translation, this comprehensive collection ensures global accessibility and offers healthcare professionals and caregivers a linguistically inclusive resource for elevating standards of pediatric care worldwide. Conclusion: This development of multilingual educational content marks a progressive step toward global standardization of pediatric care. By utilizing advanced language models for translation, we ensure that the curriculum is inclusive and accessible. This initiative aligns well with the World Health Organization's Digital Health Guidelines, advocating for digitally enabled healthcare education.


Assuntos
Multilinguismo , Humanos , Criança , Atenção à Saúde , Barreiras de Comunicação , Currículo , Inteligência Artificial
2.
Front Pediatr ; 11: 1090713, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37181422

RESUMO

Pediatric invasive fungal rhinosinusitis (PIFR) is a rapidly progressive, potentially fatal disease. Previous medical literature demonstrates that its early diagnosis significantly reduces the risk of mortality in these patients. This study aims to present an updated clinical algorithm for optimized diagnosis and management of PIFR. A comprehensive review was conducted with only original, full-text articles published in English and Spanish from Cochrane Library, Pub-Med/MEDLINE, Embase, Scopus, and Google Scholar between January 2010 and June 2022. Relevant information was extracted and then integrated to develop a clinical algorithm for a proper diagnosis and management of PIFR.

3.
Iran J Otorhinolaryngol ; 31(104): 177-180, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31223598

RESUMO

INTRODUCTION: Hamartomas is a neoplasms composed of mature tissue elements from the affected site with disproportion between their components. Although lingual hamartomas are traditionally infrequent in the head and neck, a significant number of case reports with this disorder in infancy are arising from the literature. CASE REPORT: We present a remarkable case of a vallecular hamartoma in a 5-month-old infant. Moreover, the value of histopathological diagnosis was highlighted regarding the differentiation between hamartomas and other benign/reactive lesions. CONCLUSION: Surgical excision is regarded as the treatment of choice for vallecular hamartomas; in addition, no recurrence has been reported after complete resection.

4.
Otol Neurotol ; 40(5): 645-650, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31083092

RESUMO

OBJECTIVE: To evaluate the effectiveness of the chemically assisted dissection with sodium 2-mercaptoethanesulfonate (MESNA), in the reduction of residual and recurrent cholesteatoma after mastoidectomy in children with chronic cholesteatomatous otitis media (CCOM). STUDY DESIGN: Retrospective case-control study. SETTING: Tertiary referral center. POPULATION: One hundred forty mastoidectomies performed in patients under 18 years of age for the treatment of CCOM. INTERVENTIONS: Chemically assisted dissection (CAD) with MESNA compared with surgical dissection without MESNA. MAIN OUTCOME MEASURES: Recidivism of cholesteatoma (recurrence and residual disease), variations in the average of bone conduction threshold after treatment, and complications. RESULTS: Recidivism of cholesteatoma was significantly lower when CAD with MESNA was used (p < 0.0001). No difference was found in the mean variation of the average of bone conduction thresholds between the groups, confirming its safety profile regarding auditory function. Meatoplasty stenosis after surgery was more prevalent within CAD with MESNA group (p: 0.049). CONCLUSION: Recurrent and residual cholesteatoma remains a problem, especially in children and despite surgical techniques such as canal wall down mastoidectomy and endoscopic ear surgery. CAD with MESNA can be safe and effective to reduce recurrence rates. Multicenter and prospective studies with larger number of patients are needed to validate these findings. The higher rate of meatoplasty stenosis after CAD with MESNA merits additional clinical research to confirm these findings, as well as in vitro studies evaluating the effect of the drug on the activity of fibroblasts and other growth factors that may be involved.


Assuntos
Colesteatoma da Orelha Média/tratamento farmacológico , Colesteatoma da Orelha Média/cirurgia , Mastoidectomia/métodos , Mesna/uso terapêutico , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Colesteatoma da Orelha Média/etiologia , Dissecação/métodos , Feminino , Humanos , Masculino , Otite Média/complicações , Otite Média/cirurgia , Recidiva , Estudos Retrospectivos , Resultado do Tratamento
5.
Bol. méd. Hosp. Infant. Méx ; 76(2): 87-94, mar.-abr. 2019. tab
Artigo em Espanhol | LILACS | ID: biblio-1055272

RESUMO

Resumen Introducción: Los niños con trisomía 21 enfrentan una amplia gama de problemas en la región de la cabeza y el cuello, por lo cual es importante reconocer las manifestaciones otorrinolaringológicas que presentan, así como su apropiado manejo. Métodos: Estudio de serie de casos retrospectivo de pacientes pediátricos con trisomía 21. De cada caso se analizó el espectro de manifestaciones otorrinolaringológicas, el manejo establecido y los resultados. Resultados: Se incluyeron 171 niños. La edad media de la primera valoración por otorrinolaringología en la institución fue de 7.2 ± 4.2 años. Las manifestaciones otológicas más frecuentes fueron la estenosis del conducto auditivo externo y la disfunción de la trompa de Eustaquio. Más de la mitad de los pacientes (63 %) presentaron hipoacusia, principalmente de tipo conductivo bilateral, y hasta el 75 % de los pacientes con afectación otológica requirieron algún procedimiento quirúrgico. Las manifestaciones rinológicas más comunes fueron la rinosinusitis crónica y la rinitis alérgica. La apnea obstructiva del sueño estuvo presente en el 30% de los pacientes. El tratamiento principal fue la amigdalectomía, seguida del tratamiento con dispositivos de presión positiva de la vía aérea. Menos del 5 % de los pacientes presentaron un compromiso laríngeo. Conclusiones: Los pacientes pediátricos con trisomía 21 deben ser remitidos sistemáticamente a una evaluación otorrinolaringológica periódica, debido a la alta incidencia de manifestaciones en esta región. Se deben ofrecer tratamientos oportunos para mejorar su salud y calidad de vida.


Abstract Introduction: Children with trisomy 21 face a wide range of conditions in the head and neck region, for which it is important that physicians are aware and have a strong understanding of the ear, nose, and throat (ENT) disorders, and their management as well. Methods: Retrospective case series of pediatric patients with trisomy 21. The spectrum of otolaryngological manifestations, their management, and outcomes of each case were analysed. Results: One hundred and seventeen pediatric patients were included. The mean age was 7.2 ± 4.2 years. More than half of the patients (63 %) had hearing loss (HL). The most frequent presentation was conductive HL, predominating the mild and bilateral type. The most common otological manifestations found were external ear canal stenosis and Eustachian tube dysfunction. Up to 75 % of the patients with otologic involvement required some surgical procedure. The most common rhinological manifestations were chronic rhinosinusitis and allergic rhinitis. Obstructive sleep apnea (OSA) was present in 30% of all patients, which main treatment was tonsillectomy, followed by continuous positive and biphasic positive airway pressure treatments. Less than 5 % of the patients presented a laryngeal compromise. Conclusions: Pediatric patients with trisomy 21 systematically should be referred to periodic ENT assessment due to the high incidence of manifestations in this region. Timely treatments should be offered in order to improve the health and the quality of life of the patient.


Assuntos
Humanos , Cromossomos Humanos Par 7/genética , Deleção Cromossômica , Hibridização in Situ Fluorescente , Neoplasias Hematológicas/genética , Cariotipagem/métodos , Transtornos Mieloproliferativos/genética , Prognóstico , Síndromes Mielodisplásicas/diagnóstico , Síndromes Mielodisplásicas/genética , Leucemia Mieloide Aguda/diagnóstico , Leucemia Mieloide Aguda/genética , Estudos de Coortes , Neoplasias Hematológicas/diagnóstico , Neoplasias Hematológicas/patologia , Frequência do Gene , Transtornos Mieloproliferativos/diagnóstico , Transtornos Mieloproliferativos/patologia
6.
Bol Med Hosp Infant Mex ; 76(2): 87-94, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30907388

RESUMO

Introduction: Children with trisomy 21 face a wide range of conditions in the head and neck region, for which it is important that physicians are aware and have a strong understanding of the ear, nose, and throat (ENT) disorders, and their management as well. Methods: Retrospective case series of pediatric patients with trisomy 21. The spectrum of otolaryngological manifestations, their management, and outcomes of each case were analysed. Results: One hundred and seventeen pediatric patients were included. The mean age was 7.2 ± 4.2 years. More than half of the patients (63%) had hearing loss (HL). The most frequent presentation was conductive HL, predominating the mild and bilateral type. The most common otological manifestations found were external ear canal stenosis and Eustachian tube dysfunction. Up to 75% of the patients with otologic involvement required some surgical procedure. The most common rhinological manifestations were chronic rhinosinusitis and allergic rhinitis. Obstructive sleep apnea (OSA) was present in 30% of all patients, which main treatment was tonsillectomy, followed by continuous positive and biphasic positive airway pressure treatments. Less than 5% of the patients presented a laryngeal compromise. Conclusions: Pediatric patients with trisomy 21 systematically should be referred to periodic ENT assessment due to the high incidence of manifestations in this region. Timely treatments should be offered in order to improve the health and the quality of life of the patient.


Introducción: Los niños con trisomía 21 enfrentan una amplia gama de problemas en la región de la cabeza y el cuello, por lo cual es importante reconocer las manifestaciones otorrinolaringológicas que presentan, así como su apropiado manejo. Métodos: Estudio de serie de casos retrospectivo de pacientes pediátricos con trisomía 21. De cada caso se analizó el espectro de manifestaciones otorrinolaringológicas, el manejo establecido y los resultados. Resultados: Se incluyeron 171 niños. La edad media de la primera valoración por otorrinolaringología en la institución fue de 7.2 ± 4.2 años. Las manifestaciones otológicas más frecuentes fueron la estenosis del conducto auditivo externo y la disfunción de la trompa de Eustaquio. Más de la mitad de los pacientes (63%) presentaron hipoacusia, principalmente de tipo conductivo bilateral, y hasta el 75% de los pacientes con afectación otológica requirieron algún procedimiento quirúrgico. Las manifestaciones rinológicas más comunes fueron la rinosinusitis crónica y la rinitis alérgica. La apnea obstructiva del sueño estuvo presente en el 30% de los pacientes. El tratamiento principal fue la amigdalectomía, seguida del tratamiento con dispositivos de presión positiva de la vía aérea. Menos del 5% de los pacientes presentaron un compromiso laríngeo. Conclusiones: Los pacientes pediátricos con trisomía 21 deben ser remitidos sistemáticamente a una evaluación otorrinolaringológica periódica, debido a la alta incidencia de manifestaciones en esta región. Se deben ofrecer tratamientos oportunos para mejorar su salud y calidad de vida.


Assuntos
Síndrome de Down/complicações , Otorrinolaringopatias/epidemiologia , Qualidade de Vida , Adolescente , Criança , Pré-Escolar , Feminino , Perda Auditiva/epidemiologia , Perda Auditiva/etiologia , Humanos , Lactente , Masculino , México , Otorrinolaringopatias/etiologia , Otorrinolaringopatias/terapia , Estudos Retrospectivos
7.
Int J Pediatr Otorhinolaryngol ; 119: 131-135, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30708179

RESUMO

INTRODUCTION: Laryngomalacia is the most common congenital laryngeal anomaly. Because of supraglottic prolapse, laryngomalacia may be associated with obstructive sleep apnea (OSA) and sleep disturbances. The effects of OSA and sleep disorders in children include failure to thrive, cognitive and behavioral disturbances, cardiovascular compromise, and an association with sudden infant death syndrome. OBJECTIVE: To evaluate the presence of OSA and sleep disturbances in children with severe laryngomalacia through complete nocturnal polysomnography, as well as to establish the effects of supraglottoplasty in each of the polysomnographic parameters. RESULTS: Nine infants with severe laryngomalacia were included, all with a complete polysomnographic study prior to and after supraglottoplasty. The average age was 5.5 months. All patients presented an Apnea-Hypopnea Index (AHI) within the range of severe OSA. After supraglottoplasty, a significant reduction in AHI was found, from 34.87 ±â€¯20.34 to 9.44 ±â€¯5.28 after surgery (p: 0.022). Additionally, sleep efficiency had a significant increase, from 21.4% to 56.29% of total sleep time (p: 0.0013). All patients presented a significant decrease in obstructive apnea episodes (p < 0.0001), as well as in hypopnea episodes (p: 0.0154). The mean and minimum peripheral oxygen saturation (SpO2) had a significant increase after supraglottoplasty from 88.2% to 94.09% (p: 0.0002), and from 81.01% to 89.33% (p < 0.0001), respectively. CONCLUSION: Polysomnography (PSG) may provide better surgical sustenance in infants with severe laryngomalacia and OSA, as well as, serving as a monitoring tool of success. However, the surgical decision should not be reduced to polysomnographic results, and a good history and examination remain as the fundamental criteria.


Assuntos
Laringomalácia/complicações , Laringoplastia/métodos , Laringe/fisiopatologia , Polissonografia/métodos , Apneia Obstrutiva do Sono/etiologia , Estudos de Casos e Controles , Criança , Feminino , Humanos , Lactente , Laringomalácia/cirurgia , Laringe/cirurgia , Masculino , Projetos Piloto , Estudos Prospectivos , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/cirurgia , Resultado do Tratamento
8.
Bol. méd. Hosp. Infant. Méx ; 75(6): 377-382, nov.-dic. 2018. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1011486

RESUMO

Resumen: Introducción: Los hemangiomas de la vía aérea son neoplasias congénitas de baja incidencia. Su presentación clínica consiste en una obstrucción de la vía aérea superior con disnea progresiva y estridor, ocasionando una obstrucción grave, aguda y grave de la vía aérea. Los hemangiomas infantiles tienen una incidencia al nacimiento del 2%, incrementándose al 9% a los 12 meses de vida. Casi el 60% de los hemangiomas infantiles afectan la región de la cabeza y el cuello. Sin embargo, la localización en la vía aérea superior no es tan frecuente y solo se informa en el 1.8% de los pacientes con hemangiomas cutáneos. El tratamiento tradicional de los hemangiomas laríngeos ha sido la administración de corticoides sistémicos por periodos largos, la cirugía endolaríngea con láser de CO2, la cirugía abierta, la traqueostomía y, recientemente, el propranolol oral. Casos clínicos: Se presentan cinco casos de hemangiomas subglóticos tratados con propranolol sistémico y la evaluación del tiempo de respuesta terapéutica, definido como el control satisfactorio de los síntomas obstructivos y aseguramiento de la vía aérea. En estos casos, el propranolol mostró ser una opción efectiva y segura para el tratamiento de hemangiomas laríngeos, con un tiempo de respuesta terapéutica de 48 a 72 horas. Conclusiones: El tratamiento con propranolol oral se ha convertido en los últimos años en la primera opción terapéutica debido a su alta eficacia y su buen perfil de seguridad.


Abstract: Background: Airway hemangiomas are congenital neoplasms of low incidence. Its clinical presentation consists of obstruction of the upper airway with progressive dyspnea and stridor and the life of the patient at risk. Infantile hemangiomas have an incidence at birth of 2%, increasing to 9% at 12 months of life. Almost 60% of childhood hemangiomas affect the head and neck region. However, localization in the upper airway is not as frequent and it is only reported in 1.8% of patients with cutaneous hemangiomas. The traditional treatment of laryngeal hemangiomas has been the administration of systemic corticosteroids for long periods, endolaryngeal surgery with CO2 laser, open surgery, tracheostomy or, recently, oral propranolol. Case report: Five cases of subglottic hemangioma treated with systemic propranolol are presented. The therapeutic time of response with the satisfactory control of obstructive symptoms and assurance of the airway was evaluated. In these cases, propranolol was shown to be an effective and safe option for the treatment of laryngeal hemangiomas with a therapeutic response time of 48 to 72 hours. Conclusions: In recent years, the treatment with oral propranolol has become the first therapeutic option due to its high efficacy and safety profile.


Assuntos
Feminino , Humanos , Lactente , Masculino , Propranolol/uso terapêutico , Neoplasias Laríngeas/tratamento farmacológico , Hemangioma/tratamento farmacológico , Antineoplásicos/uso terapêutico , Propranolol/administração & dosagem , Fatores de Tempo , Neoplasias Laríngeas/complicações , Administração Oral , Resultado do Tratamento , Hemangioma/complicações , Antineoplásicos/administração & dosagem
9.
Bol Med Hosp Infant Mex ; 75(6): 377-382, 2018.
Artigo em Espanhol | MEDLINE | ID: mdl-30407450

RESUMO

Background: Airway hemangiomas are congenital neoplasms of low incidence. Its clinical presentation consists of obstruction of the upper airway with progressive dyspnea and stridor and the life of the patient at risk. Infantile hemangiomas have an incidence at birth of 2%, increasing to 9% at 12 months of life. Almost 60% of childhood hemangiomas affect the head and neck region. However, localization in the upper airway is not as frequent and it is only reported in 1.8% of patients with cutaneous hemangiomas. The traditional treatment of laryngeal hemangiomas has been the administration of systemic corticosteroids for long periods, endolaryngeal surgery with CO2 laser, open surgery, tracheostomy or, recently, oral propranolol. Case report: Five cases of subglottic hemangioma treated with systemic propranolol are presented. The therapeutic time of response with the satisfactory control of obstructive symptoms and assurance of the airway was evaluated. In these cases, propranolol was shown to be an effective and safe option for the treatment of laryngeal hemangiomas with a therapeutic response time of 48 to 72 hours. Conclusions: In recent years, the treatment with oral propranolol has become the first therapeutic option due to its high efficacy and safety profile.


Introducción: Los hemangiomas de la vía aérea son neoplasias congénitas de baja incidencia. Su presentación clínica consiste en una obstrucción de la vía aérea superior con disnea progresiva y estridor, ocasionando una obstrucción grave, aguda y grave de la vía aérea. Los hemangiomas infantiles tienen una incidencia al nacimiento del 2%, incrementándose al 9% a los 12 meses de vida. Casi el 60% de los hemangiomas infantiles afectan la región de la cabeza y el cuello. Sin embargo, la localización en la vía aérea superior no es tan frecuente y solo se informa en el 1.8% de los pacientes con hemangiomas cutáneos. El tratamiento tradicional de los hemangiomas laríngeos ha sido la administración de corticoides sistémicos por periodos largos, la cirugía endolaríngea con láser de CO2, la cirugía abierta, la traqueostomía y, recientemente, el propranolol oral. Casos clínicos: Se presentan cinco casos de hemangiomas subglóticos tratados con propranolol sistémico y la evaluación del tiempo de respuesta terapéutica, definido como el control satisfactorio de los síntomas obstructivos y aseguramiento de la vía aérea. En estos casos, el propranolol mostró ser una opción efectiva y segura para el tratamiento de hemangiomas laríngeos, con un tiempo de respuesta terapéutica de 48 a 72 horas. Conclusiones: El tratamiento con propranolol oral se ha convertido en los últimos años en la primera opción terapéutica debido a su alta eficacia y su buen perfil de seguridad.


Assuntos
Antineoplásicos/uso terapêutico , Hemangioma/tratamento farmacológico , Neoplasias Laríngeas/tratamento farmacológico , Propranolol/uso terapêutico , Administração Oral , Antineoplásicos/administração & dosagem , Feminino , Hemangioma/complicações , Humanos , Lactente , Neoplasias Laríngeas/complicações , Masculino , Propranolol/administração & dosagem , Fatores de Tempo , Resultado do Tratamento
10.
Rev. otorrinolaringol. cir. cabeza cuello ; 78(3): 318-325, set. 2018. tab, ilus
Artigo em Espanhol | LILACS | ID: biblio-978820

RESUMO

RESUMEN Las indicaciones de traqueostomía en niños han cambiado considerablemente en los últimos años, así como el perfil epidemiológico de los pacientes y la morbimortalidad de este procedimiento. Las complicaciones de este procedimiento pueden ser clasificadas en intraoperatorias, inmediatas y tardías. La mortalidad global en pacientes pediátricos llevados a traqueostomía oscila entre el 13% y 19%. Sin embargo, menos del 5% es directamente atribuible a la cirugía. La presente revisión abarcará las complicaciones más frecuentes asociadas a traqueostomía pediátrica con recomendaciones en su prevención y manejo.


ABSTRACT Indications of tracheostomy in children have changed considerably in recent years, as well as the epidemiological profile of patients, and morbidity and mortality related to this procedure. Complications of pediatric tracheostomy can be classified into intraoperative, immediate and late. Overall mortality in pediatric patients with tracheostomy ranges from 13% to 19%. However, less than 5% is directly attributable to tracheostomy. This review will cover the most frequent complications associated with pediatric tracheostomy with recommendations for its prevention and management.


Assuntos
Humanos , Masculino , Feminino , Complicações Pós-Operatórias/epidemiologia , Traqueostomia/mortalidade , Traqueostomia/efeitos adversos , Mortalidade Hospitalar , Complicações Intraoperatórias/epidemiologia
11.
Int J Pediatr Otorhinolaryngol ; 108: 63-66, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29605367

RESUMO

BACKGROUND: Juvenile recurrent respiratory papillomatosis (JRRP) is generally aggressive and with a high recurrence rate. Currently, there is no definite curative treatment for JRRP. Therefore, a greater understanding of the aspects that influence the severity and prognosis of the disease is required. OBJECTIVE: The aim of this study was to establish the clinical and socioeconomic characteristics of pediatric patients with JRRP and its relationship with the severity of the disease in a tertiary care pediatric hospital. RESULTS: A strong relationship was observed between the severity of the disease and the age at the time of diagnosis, and having a tracheostomy. A moderate association was found between the severity of the disease and the age at the time of the study, the area of origin and the recurrence rate. None of the socioeconomic statuses had a correlation with the severity of the JRRP. CONCLUSIONS: JRRP is associated with multiple surgeries due to the recurrence and aggressiveness of the disease. The socioeconomic status does not seem to influence the severity of the disease, whereas younger patients and users of tracheostomy should receive a more strict follow-up given the increased risk of severe disease.


Assuntos
Infecções por Papillomavirus/epidemiologia , Infecções Respiratórias/epidemiologia , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Hospitais Pediátricos , Humanos , Laringoscopia/estatística & dados numéricos , Masculino , Infecções por Papillomavirus/terapia , Prognóstico , Recidiva , Infecções Respiratórias/terapia , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Classe Social , Atenção Terciária à Saúde , Traqueostomia/estatística & dados numéricos
12.
J Stomatol Oral Maxillofac Surg ; 119(1): 16-18, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29030281

RESUMO

INTRODUCTION: Temporomandibular joint internal derangement is a common disorder, which usually resolves with conservative management. However, 5% of patients require surgery and although many techniques have been described, a gold standard surgical procedure has not yet been established. OBJECTIVES: The aim of this study was to compare the clinical outcome of disc repositioning plus temporal eminectomy versus disc repositioning alone, for the treatment of temporomandibular joint internal derangement. METHODOLOGY: Matched case-control retrospective pilot study. Records of patients diagnosed with temporomandibular joint internal derangement from January 2010 to December 2015 were studied. Eleven patients treated with disc repositioning plus temporal eminectomy for the case group and 11 patients treated with disc repositioning alone for the age- and gender-matched control group. RESULTS: No difference was found in terms of pain, noise or blockage with the maximum oral opening between the groups at the first or sixth month after surgery. However, there were differences in movement restriction at the first and sixth month after surgery, in favor of the temporal eminectomy group. These differences were statistically significant only at the sixth month after surgery (P: 0.03). CONCLUSIONS: Our results suggest that disc repositioning plus temporal eminectomy could be a short-term benefit in terms of mobility and oral opening. However, larger samples and prospective trials will be necessary to corroborate the current findings.


Assuntos
Luxações Articulares , Disco da Articulação Temporomandibular , Humanos , Projetos Piloto , Estudos Prospectivos , Estudos Retrospectivos , Resultado do Tratamento
13.
Int J Pediatr Otorhinolaryngol ; 95: 29-33, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28576528

RESUMO

Extracranial internal carotid artery (ICA) pseudoaneurysms are uncommon in the pediatric population and are usually secondary to direct trauma to the vessel. Treatment options include surgery (ligation), anticoagulation therapy and endovascular treatment. Endovascular covered stents have shown good results in adult populations, resulting in occlusion of the aneurysm and preservation of the artery without significant complications. However, there have been only limited reports in the literature reporting endovascular carotid stent placement in the pediatric population. We report a case of a 9-year-old boy patient, who developed a cervical ICA pseudoaneurysm after a parapharyngeal tumor resection. He was successfully treated by primary endovascular covered stent placement. During a follow-up of 6 months the patient has been asymptomatic, without any adverse event. Additionally, a literature review is done.


Assuntos
Falso Aneurisma/etiologia , Lesões das Artérias Carótidas/etiologia , Artéria Carótida Interna/cirurgia , Procedimentos Endovasculares/métodos , Falso Aneurisma/cirurgia , Lesões das Artérias Carótidas/cirurgia , Criança , Humanos , Doença Iatrogênica , Masculino , Stents/efeitos adversos
14.
Int J Pediatr Otorhinolaryngol ; 90: 138-149, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27729121

RESUMO

INTRODUCTION: Pain is a disease by itself and it's a public health concern of major implication in children, not just because of the emotional component of the child and his family, but also due to the potential morbidity and mortality involving it. A proper assessment of pain it's a challenge in the pediatric population, due to their lack of understanding and verbalization of hurt. Additionally, a satisfactory treatment of pediatric pain can be arduous due to a lack of clinical knowledge, insufficient pediatric research, and the fear to opioid side effects and addiction. OBJECTIVES: The aim of this review is to address the current definitions of pain, its physiological mechanisms and the consequences of its inadequate management, as well as, to guide the clinicians in the assessment and management of pain in the pediatric population at otolaryngology services. METHODOLOGY: Narrative review by selective MeSH search terms: Children, Pediatrics, Otolaryngology, Pain measurement, Pain Management, Analgesics and Analgesia, from databases: MEDLINE/PubMed, Cochrane, ISI, Current Contents, Scielo and LILACS, between January 2000 and May 2016. RESULTS: 129 articles were reviewed according to the requirements of the objectives. Pain measurement is a challenge in children as there are no physical signs that constitute an absolute or specific indicator of pain, and its diagnosis must rely on physiological, behavioral and self-report methods. Regarding treatment, a suitable alternative are the non-pharmacological cognitive/behavioral therapies helped by pharmacological therapies tailored to the severity of pain and the child's age. We provide evidence-based recommendations on pain treatment, including non-opioid analgesics, opioid analgesics and adjuvant medicines to improve the management of pain in children in otolaryngology services. CONCLUSIONS: We present a global review about assessment and management of pain in pediatric otolaryngology, which leads to future specific reviews on each topic. Research gaps on pain assessment and pharmacological interventions in neonates, infants and children are very wide and it should be promoted ethical and safe research on pain control in this population.


Assuntos
Analgésicos/uso terapêutico , Otolaringologia , Manejo da Dor , Medição da Dor , Dor Pós-Operatória/terapia , Dor/tratamento farmacológico , Pediatria , Analgésicos não Narcóticos/uso terapêutico , Analgésicos Opioides/uso terapêutico , Criança , Pré-Escolar , Terapia Cognitivo-Comportamental , Humanos , Lactente , Recém-Nascido , Ventilação da Orelha Média , Tonsilectomia
15.
Repert. med. cir ; 24(4): 294-297, 2015. Il.
Artigo em Inglês, Espanhol | LILACS, COLNAL | ID: lil-795730

RESUMO

Los mucoceles del seno esfenoidal representan de 1 a 2% de todos los de los senos paranasales. Se han reportado 140 casos de los cuales 95% ocurrieron en adultos, siendo un paciente de 11 años el más joven informado. El objetivo es presentar nuestra experiencia en una paciente de siete años de edad con un mucocele del seno esfenoidal. Los signos y síntomas consistieron en cefalea y rinorrea purulenta escasa. El diagnóstico se realizó mediante TAC y RMN de senos paranasales, así como por los hallazgos histopatológicos. El tratamiento consistió en abordaje endoscópico. El diagnóstico precoz es importante para evitar déficit neurológico permanente o alteraciones visuales y nerviosas por vecindad. Se analizó la etiología, manifestaciones y tratamiento de los mucoceles esfenoidales y se revisa la literatura médica disponible...


Sphenoid sinus mucoceles represent only 1 to 2% of all paranasal mucoceles. Only 140 cases have been reported so far, 95% in adults and an 11-year-old child is the youngest patient reported. Our objective is to describe our experience in a 7-year-old girl with a sphenoid sinus mucocele. Signs and symptoms consisted of headache and mild purulent rhinorrhea. Paranasal sinus CT and MR imaging, as well, as the histopathologic findings allowed the diagnosis. Patient was treated by endoscopic approach. Because of close proximity with vital structures early diagnosis is essential to prevent permanent neurologic deficit, such as, visual or nerve impairment. Etiology, manifestations and treatment of sphenoid sinus mucoceles and relevant medical literature were reviewed...


Assuntos
Humanos , Feminino , Criança , Mucocele , Seio Esfenoidal , Seios Paranasais , Conchas Nasais
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