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Two children with late-onset congenital central hypoventilation syndrome were reported, one of whom was male and had no abnormal manifestations after birth, respiratory failure occurs at the age of 1 year and 6 months. After being hospitalized, he was treated with oxygen inhalation and non-invasive ventilation, but carbon dioxide retention could not be corrected. After one month of tracheal intubation, he was failure to wean from ventilator, so tracheostomy was performed. He needs a ventilator to help breath while sleeping, and can breath autonomously during the day without ventilator. The other case was a female, with no abnormalities after birth. At the age of 11 months, she developed respiratory failure. During sleep, the child needs non-invasive assisted ventilation through a nasal mask, and during the day, she breathed autonomously.Two patients were followed up forever 2 years and their growth and development were normal.
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Humans , Child , Male , Female , Infant , Sleep Apnea, Central/therapy , Respiration, Artificial , Hypoventilation/congenital , OxygenABSTRACT
Summary@#The French Society of ENT and Head Neck Surgery（SFORL）present the guidelines on the roles of the various treatment options in childhood obstructive sleep apnea in May 2018，this paper is the interpretation of the guidelines.
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The French Society of ENT and Head Neck Surgery（SFORL）present the guidelines on the roles of the various treatment options in childhood obstructive sleep apnea in May 2018，this paper is the interpretation of the guidelines.
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OBJECTIVE To investigate the value of rigid bronchoscope combined with fiber bronchoscope application in children with airway obstruction.METHODS Retrospective analysis of 176 cases children with airway obstruction from January 1, 2006 to January1, 2016, all patients were diagnosised and treated in our hospital. RESULTS All children were acceptted rigid bronchoscopy combined with fiber bronchoscope under general anesthesia, then received the different thrapy according to the different causes. 104 patients with airway foreign body were all obtained satisfactory effect, 2 cases of children with bronchial foreign body(cap) inspection, failed to remove and contact thoracic surgery doctors to remove the foreign body by thoracotomy. 10 plastic bronchitis patients improved after treatment or cured. 7 cases of bronchial tuberculosis were cured after treatment. 4 patients with airway tumor after minimally invasive surgery, obtained good effect, 2 cases were turned to the other cancer hospital. 2 cases of patients with tracheal stenosis, the symptom is reduced after expansion. Bronchial granulation, tracheomalacia, bronchial softening, bronchial atresia patients improved after treatment. This group of all patients with pneumonia were cured after symptomatic treatment.CONCLUSION Rigid bronchoscopy and fiber bronchoscope are both useful for diagnosis and treatment of children with airway obstruction, both have its advantages and disadvantages, combined application can improve the accuracy of disease diagnosis and timely intervention on the patients.
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OBJECTIVE This study was conducted to analyze the underlying bacterial pathogens of the tonsils and adenoids in children with sleep-disordered breathing(SDB).METHODS The core tissue from the tonsils and/or adenoids of 163 SDB children was cultured aerobically. Of the 163 cases, 120 children underwent adenoidectomy and tonsillectomy simultaneously(A+T), 39 children underwent adenoidectomy(A) and 4 tonsillectom(T) only. 124 children who underwent tonsillectomy were subdivided into two groups based on history(with or without a history of recurrent tonsillitis). 71 children with the history were enrolled in the 'recurrent tonsillitis group' and 53 children without the history were enrolled in 'non- recurrent tonsillitis group'.RESULTS Of the total 120 cases who underwent A+T, 114(95.00%) cases had same distribution of bacteria detected in both sides in the same patient. Besides this, 17 cases in whom mixed organisms were identified in both sites shared common pathogen. No significant difference in the detection rates of staphylococcus aureus and haemophilus influenzae were found when we compared seasons(Tonsil:χ2=8.538,P=0.201; Adenoid:χ2=5.427, P=0.490). No significant difference in the type and detection rate of essential bacteria was found when we compared between recurrent tonsillitis group and 'non-recurrent tonsillitis group' (χ2=3.028,P=0.387).CONCLUSION The bacterial isolates from the tonsils and adenoids are virtually identical in type and detection rate in the same SDB patient. The bacterial distribution of the tonsillar and adenoidal core is unaffected by the seasonal variation and history of recurrent tonsillitis.
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OBJECTIVE@#To explore the characteristics of post-operative pain following coblation tonsillectomy and/or adenoidectomy in children with sleep-disordered breathing (SDB) and explore the correlation between the first day post-operative pain scores and age and operating time.@*METHOD@#1) A total of 113 SDB children scheduled to undergo coblation tonsillectomy and/or adenoidectomy were recruited. 113 children were divided into two groups according to the method of operation, children who underwent coblation tonsillectomy and adenoidectomy were enrolled in study group one and children who underwent coblation adenoidectomy only were in study group two. Be sides, children of study group one with a history of chronic tonsillitis were in chronic tonsillitis group, children without a history of chronic tonsillitis were in non-chronic tonsillitis group. 2) The parents scored pain in their children on a VAS (anchored by "no pain" at 0 and "worst pain" at 10) in the morning, before using any analgesics and having breakfast, over the first 3 and the seventh post-operative days. 3) Post-operative pain scores were compared between both the study group one and two and chronic tonsillitis group and non-chronic tonsillitis group. Futhermore, the correlation between the first day post-operative pain scores and age and operating time were also analysed.@*RESULT@#1) The difference of post-operative pain scores over the first 3 and the seventh post-operative days were significant between the study group one and group two (P0.05). 3) The first day post-operative pain scores was correlated with age (r=0.273, P<0.01) and operating time (r=0.423, P<0.01).@*CONCLUSION@#The first day post-operative pain scores was correlated with age and operating time. Children with a history of chronic tonsillitis were more painful than children without the history.
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Child , Child, Preschool , Female , Humans , Male , Adenoidectomy , Methods , Hypothermia, Induced , Pain Measurement , Pain, Postoperative , Sleep Apnea Syndromes , General Surgery , Tonsillectomy , MethodsABSTRACT
Objectives To observe the clinical efficacy of combined treatment with montelukast and intranasal steroid for chronic adenoid hypertrophy in children. Methods 47 children with chronic adenoid hypertrophy were selected and ran-domly divided into drug combination group (n=23) treated with montelukast combined with intranasal steroids for two months and control group (n=24) treated with intranasal steroids only for two months. Clinical efficacy was compared between two groups by clinical score and the result of fibronasopharyngoscopy. Results The clinical scores were 0 (0, 1.0) and 0(0, 0) at 2 weeks and 2 months after treatment in combination group, and 1.0 (1.0, 1.0) and 0 (0, 1.0) in control group. There were sig-nificant differences between two groups (Z=2.404, P<0.05;Z=2.069, P<0.05). Conclusions The clinical efficacy of combined treatment with Montelukast and intranasal steroid is better than that of treatment with intranasal steroid only in children with chronic adenoid hypertrophy.
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OBJECTIVE@#To compare low temperature coblation assisted tonsillectomy with conventional dissection tonsillectomy intra-operation and after-operation.@*METHOD@#Ninety-two pedia-patients were randomly divided into coblation-assisted tonsillectomy group and the control group. Arthrocine EVac 70 T&A Wand was used for coblation-assisted tonsillectomy, and the energy set was 7. Conventional dissection tonsillectomy was operated in control group. The operating time,bleeding,tonsillar fossae healing and return to normal diet and activities, intraoperative complications were recorded separately. Postoperative pain of the pedia-patients was recorded daily using Wong Baker FACES pain scale for 10 days of after-operation.@*RESULT@#Coblation assisted group had a shorter operative time than the control group (10.2 min vs. 36.5 min, P<0.001). The average amount of intraoperative bleeding of Coblation assisted group was (6.83+/-3.36) ml, while the control group was (30.07+/-7.04) ml. Pedia-patients of Coblation group had a better pain score on 1, 2, 3 days after operation than in control group, and there was no statistically significant difference on 4 to 10 days between the two groups. Coblation group ones returned to normal diet earlier than the control group, but both group required similar time returned to normal activities. There was one patient in control group,who required suturing to stop bleeding for active oropharyngeal bleeding on the 6th day after operation.@*CONCLUSION@#Comparing with traditional dissection, Coblation assisted tonsillectomy is easy to perform with less intraoperative bleeding, shorter operation time, earlier return to normal diet, less pain on 1st to 3rd day postoperatively.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Cold Temperature , Cryosurgery , Methods , Dissection , Methods , Tonsillectomy , Methods , Tonsillitis , General Surgery , Treatment OutcomeABSTRACT
Objective:To compare low temperature coblation assisted tonsillectomy with conventional dissec-tion tonsillectomy intraoperation and afteroperation. Method:Ninty-two pedia-patients were randomly divided into coblation-assisted tonsillectomy group and the control group. Arthrocare EVac 70 T&.A Wand was used for cobla-tion-assisted tonsillectomy, and the energy set was 7. Conventional dissection tonsillectomy was operated in control group. The operating time,bleeding,tonsillar fossae healing and return to normal diet and activities, intraoperative complications were recorded seperately. Postoperative pain of the pedia-patients was recorded daily using Wong Baker FACES pain scale for 10 days of afteroperation. Result: Coblation assisted group had a shorter operative time than the control group (10. 2min vs. 36. 5min, P<0. 001). The average amount of intraoperative bleeding of Coblation assisted group was(6. 83±3. 36) ml, while the control group was(30. 07±7. 04)ml. Pedia-patients of Coblation group had a better pain score on 1, 2, 3 days after operation than in control group, and there was no statistically significant difference on 4 to 10 days between the two groups. Coblation group ones returned to normal diet earlier than the control group, but both group required similar time returned to normal activities. There was one patient in control group, who required suturing to stop bleeding for active oropharyngeal bleeding on the 6th day after operation. Conclusion: Comparing with traditional dissection, Coblation assisted tonsillectomy is easy to perform with less intraoperative bleeding,shorter operation time,earlier return to normal diet, less pain on 1st to 3th day postoperatively.