Characteristics of obstructive sleep apnea in children with allergic rhinitis / 中国小儿急救医学

Objective:To analyze the characteristics of sleep disordered breathing (SDB) in children with allergic rhinitis (AR), and improve the diagnosis and treatment at AR combined with obstructive sleep apnea (OSA).Methods:The clinical data of 120 patients with AR and OSA (AR and OSA group) admitted to the respiratory department at Shenzhen Children′s Hospital from May 2019 to December 2020 were retrospectively analyzed.A total of 120 children diagnosed with OSA and excluded AR during the same period were selected as control group.The SDB day and night symptoms, sleep structure characteristics and sleep breathing events were compared between two groups.Results:The average course of disease in children with AR and OSA was significantly longer than that in control group ( P=0.030). The main manifestations of children in AR and OSA group were mouth breathing (100.0%), snoring (99.2%), nasal obstruction (88.5%), and restless sleep (68.0%). There was no significant difference in sleep structure between two groups ( P>0.05), but the sleep efficiency of AR and OSA group was significantly lower than that of control group ( P=0.028). The respiratory events apnea hypopnea index, obstructive apnea index, obstructive apnea hypopnea index, hypopnea index and oxygen desaturation index of each sleep period in AR and OSA group were significantly higher than those in control group ( P<0.05). Among the children in AR and OSA group, moderate and severe OSA were the main manifestations, and the difference between two groups was statistically significant ( P<0.001). Conclusion:The combination of AR delayed the course of OSA in children.The main characteristics of sleep disordered breathing in children with AR are mouth opening, restless sleep, snoring and nasal obstruction.The sleep efficiency is decreased.Obstructive hypopnea and apnea are the most common respiratory events, and oxygen deficiency often occurs in rapid eye movement phase.Children with AR are more likely to have moderate or severe obstructive sleep apnea.

Pediatric laryngeal clefts: an experience in the diagnosis and management of 13 cases / 中华耳鼻咽喉头颈外科杂志

Objective@#To investigate the diagnosis and management of laryngeal cleft.@*Method@#The clinical data of 13 cases of laryngeal cleft treated between 2007 and 2015 was analyzed retrospectively.@*Results@#The children with laryngeal cleft were classified according to the classification of Benjamin-Inglis, as type Ⅰ(11 cases), typeⅡ(1 case) and type Ⅲ(1 case). All patients were confirmed by microlaryngobronchoscopy under general anaesthetic. Eleven typeⅠ and 1 type Ⅱ clefts were managed conservatively, with which all type Ⅰ patients were successfully managed, while the type Ⅱ patient was resolved by surgical endoscopy. The type Ⅲ patient was treated by open repair but the results was poor.@*Conclusions@#Patients who suffered with choking on feeding or recurrent aspiration pneumonia, especially coexisted with other congenital malformation, needed detailed evaluation for laryngeal cleft, although which was a rare congenital abnormality. Electronic laryngoscope could be the first step to screen the cleft, while microlaryngobronchoscopy is the gold standard for diagnosis of laryngeal cleft. The majority of children with lower type clefts can be managed conservatively. Surgical endoscopy has high success rate when strictly following the indication. Type Ⅲ and Ⅳ clefts have high mortality for usually combining with severe complications and abnormalities.

Olfactory function in children with adenoid hypertrophy who underwent adenotonsillectomy during pre- and post-operative period / 中华耳鼻咽喉头颈外科杂志

Objective@#To assess the olfactory function in children with adenoid hypertrophy and investigate the changes of both olfactory function and appetite in children with adenoid hypertrophy before and after adenoidectomy.@*Methods@#Forty-four children with adenoid hypertrophy admitted for adenoidectomy, aged 7-12 years, mean age (10.0±2.0) years were tested by Sniffin′ Sticks test and visual analog scale(VAS) of the children′s appetite preoperatively between March and August 2015.In a appointment 6 months after operation, all of them returned and were tested again. The control group consisted of 40 healthy children, aged 7-12 years, mean age (11.2±0.8) years.SPSS 13.0 software was used for statistical analysis@*Results@#The olfactory function of the study group TDI scores (32.4±3.5) preoperatively were significantly lower in comparison with the results of the control group TDI scores (37.3±2.8)(t=7.057, P<0.001). Significant improvement of olfaction TDI scores (36.8±1.9) was observed in the follow-up appointment(t=13.573, P<0.001). The VAS of the children′s appetite during post-adenoidectomy was higher compared to pre-adenoidectomy(t=16.765, P<0.001). There was a strong correlation between the increase in appetite of children and the change of TDI score (r=0.59, P<0.01).@*Conclusions@#Children with adenoid hypertrophy have a reduced ability of both olfactory function and appetite. Surgery had a greater impact on olfaction and appetite.

Causes and management of pediatric spontaneous tonsillar haemorrhage / 中华耳鼻咽喉头颈外科杂志

Objective@#To analyze the causes and management plan of pediatric spontaneous tonsillar haemorrhage(STH).@*Methods@#According to the criteria of STH difined by Griffies, patients with STH from December 2013 to January 2016 were included in this retrospective study.@*Results@#A total of 11 patients were reviewed. The etiological diagnosis included 3 pediatric Epstein-Barr virus associated infectious mononucleosis(EBV-IM), 3 suspected pediatric EBV-IM to 3 acute suppurative tonsillitis, 1 acute viral tonsillitis and 1 hemophilia A. The management strategies included antiviral, antibacteria, transfusion, surgical examination followed with bipolar coagulation hemostasis under general anesthesia. No patient treated with tosillectomy.@*Conclusions@#STH is now a rare condition, the causes of which in child are more or less different from adult.This emergency can be treated in time if a detailed management plan for pediatric STH is formulated.

Management of nasal orbital cellulitis in children / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the clinical characteristics, diagnostic and treatment principle of orbital cellulitis in children, and to improve the experience of antibiotic treatment in orbital cellulites.</p><p><b>METHODS</b>Twenty children were admitted to Shenzhen Children's Hospital with the diagnosis of nasal orbital cellulitis between January 2009 and December 2013. The children were severe enough to warrant hospital admission. There were 13(65%) males and 7 (35%) females. The median age was 3.5 years (2 months to 7.2 years). The relationship between the serum C-reactive protein (CRP), white blood cell count and the hospitalization days were analyzed. The children were divided into 2 groups: Cefoperazone Sodium and Sulbactam Sodium for injection group and other antibiotic treatment group, the difference was compared. Statistical calculation was performed using SPSS 13.0 software.</p><p><b>RESULTS</b>The serum CRP [(29.8 ± 22.0) mg/L] at the time of admission had a positive correlation with the time of hospitalization[ (6.3 ± 4.1) d, r = 0.46, P < 0.05]. The time of CRP decreased to normal range after admission [(3.4 ± 1.8) d] were apparently related to the hospitalization time (r = 0.81, P < 0.01). The hospital days whose CRP could be decreased to normal within 3 days [n = 12, (4.3 ± 1.7) d] were significantly shorter than that in the others [n = 8, (9.1 ± 5.0) d, t = 2.61, P < 0.05]. The hospitalization of 12 cases with Cefoperazone Sodium and Sulbactam Sodium for injection [(4.3 ± 1.9) d] was shorter than that in other 8 cases with other drugs [(9.3 ± 4.7) d, t = 2.83, P < 0.05]. Bacterial pathogens were only identified in 4 children, including 3 cases of methicillin-resistant staphylococcus aureus (MRSA), 1 case of streptococcus anginosus. Only 1 case in 20 cases with positive blood culture for Staphylococcus aureus, consistented with the pus culture.</p><p><b>CONCLUSIONS</b>If early treatment at the first three days is valid, the course of nasal orbital cellulitis will be shorter and the orbital abscess can be prevented. Cefoperazone sulbactam and Sulbactam Sodium for injection is effective in treating pediatric orbital cellulitis.</p>

A preliminary observe of the different age children with unilateral hearing loss / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the effect on children with unilateral hearing loss (UHL).@*METHOD@#One hundred and one children with unilateral hearing loss were included in this study from October 2008 to December 2009 in Shenzhen Children's Hospital, 95 of them were investigated on speech recognition abilities, learning abilities et al by telephone interviews.@*RESULT@#The intelligence quotient (IQ) including full-scale intelligence quotient, verbal intelligence quotient and performance intelligence quotient were significantly lower in the severe and profound unilateral hearing loss group when compared with school children with bilateral normal hearing (P 0.05).@*CONCLUSION@#IQ, speech recognition abilities and learning abilities were affected during unilateral hearing loss children, but proper, early intervention can compensate the deleterious effects of UHL.

Clinical analysis on 368 children cases with tracheobronchial foreign body / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the clinical pathological features of children tracheobronchial foreign bodies and to improve diagnosis and treatment.@*METHOD@#A retrospective study 368 children cases with tracheobronchial foreign bodies in our hospital. Each patient was analyzed for age, sex, nature,complication and location of the foreign body, results of bronchoscopic removal and presence of foreign bodies in the airways. Among this cases, three of them coughed out the foreign body before operation; two of them failed to be operated for serious complication, others were conducted by rigid bronchoscopy and bronchoscopic removal with general anaesthesia.@*RESULT@#Three children of 368 coughed out the foreign body before operation; 4 children of them were dead for the long heartbeat respiratory arrest and deep coma; 2 children of them suffered form hypoxic ischemic encephalopathy and epilepsy; others were successfully taken out by operation.@*CONCLUSION@#For the diagnosis of children cases with tracheobronchial foreign bodies, it is very important to collect the detailed history of foreign body inhalation, physical examination and careful analysis on the findings from chest radiographs or CT scan.

DNA character of the cholesteatoma DNA character of the cholesteatoma / 临床耳鼻咽喉头颈外科杂志

Objective:To compare the DNA character with in cholesteatoma tissues with that in normal skin.Method:DNA content within 25 cholesteatoma tissues and 10 normal postauricular skin was measured with flow cytometry.Result:The content of cholesteatoma tissues and postauricular skin specimens are a normal euploid.The cell number during S phase of cholesteatoma(10.9±2.32)% was higher than that in normal skin(7.31±2.82)%.Conclusion:Although the cholesteatoma has a very high proliferating character,the result suggest it isn′t a malignant tumor.

Expression of Proliferating Cell Nuclear Antigen and B-cell Lymphoma/Leukemia-2 Gene in Cholesteatoma and Its Clinical Implication / 华中科技大学学报(医学版)

The expression of proliferating cell nuclear antigen (PCNA) and B-cell lymphoma/leukemia-2 gene (Bcl-2) was detected in 25 cases of cholesteatoma tissues and 10 cases of normal skin by using immunohistochemical technique. The results showed that the PCNA index of cholesteatoma tissues was higher than that of normal skin, but Bcl-2 was not expressed in cholesteatoma tissues and normal skin. The PCNA index was correlated with the aggressiveness of cholesteatoma. It was suggested that PCNA could be considered to be a prognostic marker and an indicator of aggressive behavior in cholesteatoma. Although the cholesteatoma had a very high proliferating character, it wasn't a malignant tumor.