Extraction of a Foreign Body From the Middle Ear Following a Complicated Hearing Aid Fitting: A Case Report.

Ear molding is a safe way to evaluate the ear for hearing aid fitting. A very rare complication of ear molding is the entry of a foreign body into the middle ear. We report the case of a three-year-old boy who had a perforated left tympanic membrane and bilateral sensorineural hearing loss that required the use of hearing aids. During the ear molding procedure, the molding material was unintentionally introduced into his middle ear cavity, necessitating immediate surgery to remove it. Such patients with tympanic membrane perforation must be handled cautiously while an aural impression is taken via ear molding to prevent introducing a foreign body into the middle ear.

The Incidence and Risk Factors of Cisplatin and Carboplatin Ototoxicity in Pediatric Oncology Patients at Tertiary Oncology Center.

Pediatric cancers are relatively rare diseases when considering all types of cancer. Platinum-based chemotherapeutic agents are potent agents against a variety of pediatric malignancies. An important adverse effect of platinum-based agents is the occurrence of hearing loss. This hearing loss can pose a challenge to detect especially if the child is in his early of life. It will also significantly affect the child development of social, pedagogical, and personal dimensions. It is integral to identify incidence of platinum-based ototoxicity and risk factors that increase the likelihood of developing hearing loss in cancer children. We performed a retrospective chart review of 123 pediatric patients who had completed cisplatin and carboplatin therapy for a variety of malignancies. Patients were diagnosed at Princess Nourah Oncology Centre between January 2011 and December 2016, were less than 14 years old at diagnosis. Audiograms were scored using the International Society of Pediatric Oncology (SIOP) Boston Scale (0-4), a validated grading system for cisplatin-related hearing loss. Ototoxicity was reported in 16 patients out of 123 with a rate of 13%. The incidence of ototoxicity was highest in CNS tumors such as medulloblastoma (37.5%) and optic glioma (25%). Males were at greater risk for developing hearing loss than females. Cumulative cisplatin dose and addition radiation therapy were also identified as risk factors for development of ototoxicity (P = 0.008). Nature and location of cancer, gender, cumulative dose, and addition of radiation therapy are important clinical biomarkers of cisplatin ototoxicity.

Clinical practice guidelines: Approach to cough in children: The official statement endorsed by the Saudi Pediatric Pulmonology Association (SPPA).

Cough is the most common presenting symptom in primary care settings. Cough can impact a child's activity level and ability to sleep, play or attend school and is often a source of parental anxiety. Cough in children differs from that in adults in terms of presentation, etiology and management. The majority of cough attacks in children are related to previous upper respiratory tract infections and have a self-limited nature. Cough management strategies should focus on characterizing the cough by means of clinical assessment to identify and address its underlying etiology accurately. Clinical algorithms based on acute/chronic presentation and specific/non-specific causes of cough have been developed to provide guidance for clinical practice. The application of children-specific guidelines for the management of cough can lead to earlier cough resolution and improved parental quality of life. This paper presents the clinical statement of the Saudi Pediatric Pulmonology Association (SPPA) in relation to the management of cough in children.