RESUMO
OBJECTIVE: To review Children's Hospital and Regional Medical Center experience with pediatric airway foreign bodies, and examine the incidence and treatment of laryngeal foreign bodies. To determine if plastic laryngeal foreign bodies present differently than other laryngeal foreign bodies. METHODS: A retrospective review of all cases of children (1874 patients) undergoing direct laryngoscopy and/or bronchoscopy from 1st January 1997 to 9th September 2003 at a tertiary care children's hospital. Patients with endoscopically documented laryngeal foreign bodies were identified and the medical record reviewed in more detail. Patient age, gender, foreign body location, foreign body type, duration of foreign body presence, radiographic findings, endoscopic findings and treatment complications were recorded. RESULTS: One hundred and five aspirated foreign bodies were identified. The nine laryngeal foreign bodies included five clear plastic radiolucent items, two radiolucent food items, and two sharp radioopaque pins. Time to diagnosis and treatment was on average 11.6 days with 17.6 days for thin/plastic foreign bodies and 1.6 days for metal/food foreign bodies. CONCLUSION: Laryngeal foreign bodies represent a small portion of all pediatric airway foreign bodies. Difficulty in identifying laryngeal foreign bodies, especially thin, plastic radiolucent foreign bodies can delay treatment. Thin plastic foreign bodies can present without radiographic findings, can be difficult to image during endoscopy and can be particularly difficult to diagnose. A history of choking and vocal changes is associated with laryngeal foreign bodies. Laryngeal foreign bodies should be in the differential diagnosis of all children presenting with atypical upper respiratory complaints especially if a history suggestive of witnessed aspiration and dysphonia can be obtained.
Assuntos
Corpos Estranhos/diagnóstico , Laringe , Plásticos , Obstrução das Vias Respiratórias/etiologia , Brônquios , Broncoscopia , Pré-Escolar , Feminino , Humanos , Lactente , Inalação , Laringoscopia , Masculino , Estudos Retrospectivos , Traqueia , Distúrbios da Voz/etiologiaAssuntos
Otite Média/complicações , Otite Média/terapia , Criança , Pré-Escolar , Humanos , Lactente , Otite Média/fisiopatologiaRESUMO
La otitis media en Latinoamérica es a causa más importante de deterioro de la audición en la población infantil, originando además repercusiones en el lenguaje y aprendizaje. Sus complicaciones infecciosas intra y extratemporales son además padecimientos que ponen en peligro la vida del paciente. Todo esto puede ser prevenido de manera simple y económica. El programa educacional y de investigación sobre la otitis media en Latinoamérica es un proyecto internacional multidisciplinario, diseñado para mejorar su diagnóstico y tratamiento; más de 200 profesionistas al cuidado de la salud han participado en los seminarios piloto presentados en Brasil, Costa Rica y México. Los cursos teórico-prácticos con apoyo audiovisual destacan el papel de la otoscopia neumática y se concluye que este programa de educación médica continua contribuye significativamente a la atención primaria y mejora el nivel de la salud infantil