Consensus recommendations on the evaluation and treatment of laryngotracheal anomalies in infants and young children / 临床耳鼻咽喉头颈外科杂志

Infants with laryngotracheal anomalies are clinically manifested as stridor or noisy breathing, choking, hoarseness, feeding difficulties, and cyanotic spells, followed by developmental and growth retardation and other health issues; in severe cases, patients may present with severe dyspnea, which is associated with high mortality. A timely diagnosis as well as appropriate strategy for laryngotracheal anomalies is still challenging for pediatric otolaryngologists. This consensus statement, evolved from expert opinion by the members of the Pediatric Otorhinolaryngology Professional Committee of the Pediatrician Branch of the Chinese Medical Doctor Association, provides comprehensive recommendations and standardized guidance for otolaryngologists who manage infants and young children with laryngotracheal anomalies in evaluation and treatment based on symptomatology, physical and laboratory examinations.

Repercusiones de la roncopatía y respiración bucal en el crecimiento facial / Impact of snoring and mouth breathing on facial growth

Los trastornos respiratorios obstructivos del sueño corresponden a un amplio espectro de patologías que incluyen a los roncadores primarios, el síndrome de resistencia de vía aérea superior y al síndrome de apnea obstructiva del sueño (SAOS). Dentro de sus manifestaciones clínicas se encuentra la roncopatía y la respiración bucal, las cuales generan alteraciones en el crecimiento craneofacial del niño pudiendo ser la causa de un SAOS residual. El objetivo de esta revisión es analizar las alteraciones del crecimiento craneofacial en niños generadas por la roncopatía y respiración bucal.

Obstructive sleep breathing disorders correspond to a broad spectrum of diseases that include primary snorers, upper airway resistance syndrome and obstructive sleep apnea syndrome (OSAS). Its clinical manifestations include snoring and mouth breathing, which generates alterations in the craniofacial growth of the child that may be the cause of a residual OSAS. The objective of this review is to analyze the alterations of craniofacial growth generated by snoring and mouth breathing in children.

Pattern of causes and management of permanent loss of voice studied at a tertiary care hospital

To determine the frequency of causes of hoarseness leading to permanent loss of voice and discuss their management. This descriptive study was carried out at the department of ENT, Head and Neck Surgery, Lady Reading Hospital Peshawar from January 2009 to December 2011. All these patients were evaluated in terms of detailed history, thorough examination and relevant investigations. Biopsy from laryngeal mass was taken in case of tumours. Total laryngectomy was performed in patients with advanced laryngeal tumours provided with preoperative counseling regarding postoperative handicaps. The patients with laryngeal narrowing due to trauma were subjected to laryngeal stenting. The data was analyzed using SPSS 15. Out of 16 patients 10 were male and 6 were female with male: female ratio of 1.6:1. The ages ranged from 09-75 years with mean age of 43.68 +/- S.D 18.65 years. Majority of patients [68.75%] had low socioeconomic status. Main presentation of these patients was hoarseness [100%]. The commonest cause of change of voice was laryngeal carcinoma [n-6, 37.5%], followed by blast injury [25%].Endolaryngeal stenting was the commonest [43.75%] procedure performed for traumatic laryngeal stenosis followed by total laryngectomy. Most of the patients gained good esophageal speech. It is concluded that beside laryngeal cancer, trauma to the larynx is a common cause of permanent loss of voice resulting due to increased incidence of violence in our set up. Esophageal speech can be easily and successfully instituted in laryngectomized patients among other voice rehabilitative options

Rosai-dorfman disease of the larynx. a case report with molecular genetic analysis for immunoglobulin and t-cell receptor genes rearrangement

Sinus histiocytosis with massive lymphadenopathy [SHML], or Rosai-Dorfman disease [RDD], is rare histiocytic disorder originally described in 1969 as a benign Clinicopathoiogic entity characterized by massive bilateral cervical lymphadenopathy and fever. The indolent clinical course of RDD suggests a reactive disorder rather than a neopiastic process. We present a 21 year- old woman with RDD of the larynx with a recurrence of the disease after 13 months. To determine whether the lymphoplasmacytic components in these lesions clonal or polyclonal we performed a molecular testing using PCR and southern blot analyses to examine Immunoglobulin [JH] and T-cell receptor genes [TCR] genes rearrangement. The analysis showed polyclonal pattern [germline] for JH and TCR. Surface marker analysis by flow cytometry and immunohistochernistry revealed a mixed population of T and B cells with no evidence of light or heavy chain restriction. This indicates that the lymphoplasmacytic proliferation in RDD is reactive and consistent with the indolent behavior