ABSTRACT
OBJECTIVE: To evaluate whether the addition of BCS (balloon catheter sinuplasty) would improve the treatment outcome in children with chronic rhinosinusitis (CRS) compared to FESS (functional endoscopic sinus surgery). STUDY DESIGN: Two-group, retrospective cohort with blinded chart review comparison. SETTING: Children's Hospital of Michigan, Detroit, MI. SUBJECTS AND METHODS: Chart review of 15 pediatric patients who underwent BCS with ethmoidectomy and 16 who underwent FESS from 2008 to 2011 for treatment of CRS in a tertiary care, university affiliated, pediatric institution. Pre-operative CT-scans as well as pre and post-operative sinus symptoms and medications were compared. Post-surgical outcome was examined using chi square analysis. RESULTS: Mean age of children at the time of the procedure was 9.3 (SD=4.19; range=3-17). Both groups had similar pre-surgical Lund-Mackay CT CRS scores (FESS: mean=9.33 and t=0.67; balloon: mean=10.58, t=0.68, and p=0.51). Analyses identified significant post-treatment reductions in overall symptoms and needed interventions in both treatment groups. Side-by-side post-operative comparison of patients who underwent balloon sinuplasty to FESS demonstrated statistically significant post-operative difference between the two groups in antibiotic requirement, sinus congestion and headaches. Though not statistically significant, 62.5% of FESS patients and 80.0% of BCS patients (χ(2)=1.15) reported improvement in their overall sinus symptoms post-operatively. CONCLUSION: Both BCS and FESS are suitable treatments for CRS in children. Both treatments significantly reduced CRS complaints post-operatively and had similar overall results. BCS patients required significantly fewer antibiotics post-operatively for CRS related disease when compared to FESS. Larger prospective studies with long-term data are needed to further evaluate.
Subject(s)
Endoscopy/methods , Ethmoid Bone/surgery , Ethmoid Sinus/surgery , Sinusitis/surgery , Adolescent , Catheterization , Child , Child, Preschool , Female , Humans , Male , Retrospective Studies , Treatment OutcomeABSTRACT
Acquired tracheoesophageal fistula (TEF) is a life-threatening disorder of the airway that requires early diagnosis and treatment. The case of an infant who had delayed development of a TEF following endoscopic removal of a disc battery lodged in the midesophagus is reported. A repeat bronchoscopy, performed for respiratory distress 4 days later, showed a large defect in the posterior wall of the distal trachea, including the carina. A Foley catheter was used for airway management in the repair of the acquired TEF.
Subject(s)
Airway Management/methods , Foreign Bodies/complications , Tracheoesophageal Fistula/etiology , Bronchoscopy/methods , Catheterization/methods , Esophagoscopy/methods , Esophagus/pathology , Humans , Infant , Male , Time Factors , Tracheoesophageal Fistula/surgerySubject(s)
Glottis/physiopathology , Heart Defects, Congenital/complications , Heart Defects, Congenital/surgery , Laryngostenosis/therapy , Postoperative Complications/therapy , Bronchoscopes , Bronchoscopy/methods , Child, Preschool , Fatal Outcome , Female , Granuloma/complications , Granuloma/diagnosis , Granuloma/surgery , Humans , Infant , Intubation, Intratracheal/adverse effects , Intubation, Intratracheal/methods , Laryngoscopy/methods , Laryngostenosis/diagnosis , Male , Postoperative Complications/diagnosis , Pyelonephritis/complications , Severity of Illness IndexABSTRACT
Juvenile-onset recurrent respiratory papillomatosis is primarily a disease of children and adolescents. Although most patients experience spontaneous regression at a later age, some patients continue to be affected throughout their lives. We report the case of a 35-year-old woman with a 33-year history of juvenile-onset recurrent respiratory papillomatosis who developed pulmonary dissemination with malignant transformation. Malignant transformation is the most feared sequela of pulmonary dissemination, and it should be addressed aggressively. If treated promptly, the patient can enjoy prolonged survival. Computed tomography is superior to plain radiography for detecting and evaluating the extent of disease.
