prospective, observational, epidemiological evaluation of the aetiology and antimicrobial susceptibility of acute otitis media in Saudi children younger than 5 years of age

Information regarding acute otitis media [AOM] aetiology is important for developing effective vaccines. Here, bacterial aetiology and antimicrobial susceptibility of AOM were determined in young Saudi children. Children aged 3-60 months with a new episode of AOM, who had not received antibiotics or had received antibiotics for 48-72 h but remained symptomatic, were enrolled in this prospective, observational, epidemiological study in Riyadh. Middle ear fluid [MEF] samples were collected by tympanocentesis or from spontaneous otorrhea, and tested for the presence of Streptococcus pneumoniae, Haemophilus influenzae, Streptococcus pyogenes and Moraxella catarrhalis. Antimicrobial susceptibility of the identified pathogens was assessed using E-tests. Between June 2009 and May 2011, 66 children were enrolled. S. pneumonia was detected in 6 episodes and non-typeable H. influenza [NTHi] in 8 episodes. Moreover, Staphylococcus aureus, which is an uncommon cause of AOM, was detected in 17 episodes. Pneumococcal serotypes were 7F [n = 2], 23F [n = 2], 19F [n = 1] and 15F [n = 1]. Susceptibility to cefotaxime was observed in all pneumococcal and H. influenza isolates, to cefuroxime in 4/6 pneumococcal and 8/8 H. influenza isolates, and to penicillin in 5/6 pneumococcal isolates. S. pneumonia and NTHi were major bacterial contributors for AOM in Saudi children

Poland-Mobius syndrome in an infant girl

Mobius syndrome is a rare condition of unclear origin, characterized by a unilateral or bilateral congenital facial weakness with impairment of ocular abduction, which is frequently associated with limb anomalies. Poland described a condition in which there was unilateral absence of pectoralis major muscle and ipsilateral syndactyly. The combination of Poland-Mobius syndrome is rare, with an estimated prevalence 1:500000. We describe a case of Poland-Mobius syndrome in association with congenital bilateral vocal fold immobility. To our knowledge, this is the first report of such an association between Poland-Mobius syndrome and congenital bilateral vocal fold immobility

Surgical emergencies in pediatric otolaryngology

To obtain baseline data on the most common surgical emergencies in pediatric otolaryngology in Saudi Arabia. This report is a retrospective study of all children presenting to the pediatric otolaryngology emergency service at King Abdulaziz University Hospital in Riyadh, Kingdom of Saudi Arabia. Between January 2001 to January 2006 data were carefully collected and then analyzed for patients requiring emergent surgical intervention by the pediatric otolaryngology service. A total of 15,850 children presented to our pediatric otolaryngology emergency service. Surgical intervention was indicated in 183 children [1.2%].The larynx/head and neck was the most common site involved. Foreign body related emergencies were the most common presentation requiring surgical interventions [42%]. The aero-digestive tract was the most common site for foreign body retrieval [54%].Pediatric patients have always constituted a significant portion of the general otolaryngology service. Most pediatric otolaryngology emergencies are relatively benign. Aero-digestive tract foreign bodies are the most common indication for surgical intervention in pediatric otolaryngology

Characteristics of antrochoanal polyps in the pediatric age group

To evaluate and compare the clinical and the pathological characteristics of antrochoanal polyps [ACPS] in adults and children. Medical records of 35 patients [19 children, 16 adults] operated upon for ACPS between 1995 and 2005 at an academic tertiary center were reviewed retrospectively. Demographic characteristics, clinical presentation, surgical management, histological findings and recurrence rate were compared. Of the 35 patients, 19 [54%] were children [mean age, 12.6 years] and 16 [46%] were adults [mean age, 31.4 years]. Nasal obstruction was the most common presenting symptom in both groups. The incidence of snoring and/or obstructive sleep apnea was statistically significant, more common among the pediatric age group as compared to the adult group [P =.001]. Epistaxis was also found to be more common among the pediatric age group [P =.027], while sinusitis was noted to be significantly more common among the adult group [P =.019].Transnasal endoscopic removal of ACPS was performed in 12 [63.1%] children and 11 [68.7%] adults. A combined open/endoscopic approach was required in 36.9% of children and 31.3% of adults. On histologic examination, allergic ACPS [the mucosal surface is respiratory epithelium, no mucus glands, abundant eosinophils] was more common than inflammatory ACPS [the mucosal surface is respiratory epithelium, no mucus glands, abundant neutrophils] in children [2.8:1] as compared to adults [0.8:1] [P =.045]. All of our patients were followed with endoscopic examination for a period ranging from 9 to 42 months [mean, 24 months]. Recurrence of ACPS was identified in 2 children and 1 adult. Antrochoanal polyps are a rare clinical entity. Children have unique clinical and pathological features as compared to adults. Endoscopic excision is safe and effective in the pediatric age group and has the capability to ensure complete removal and lower recurrence rate