ABSTRACT
Use of a fiberoptic endoscope to visualize the vault of the inferior turbinate during lacrimal duct probing and irrigation revealed a high incidence of false passages. This was confirmed on dacryocystofluoroscopy. The creation of false passages as documented by us can help explain clinical probing failure in apparently successful probings in which "metal on metal" is felt in the nose.
Subject(s)
Lacrimal Apparatus/anatomy & histology , Lacrimal Duct Obstruction/therapy , Nasolacrimal Duct/anatomy & histology , Endoscopy , Humans , Infant , Nasolacrimal Duct/diagnostic imaging , Radiography , Therapeutic IrrigationSubject(s)
Tonsillectomy/methods , Cryosurgery , Electrocoagulation , Hemostasis , Humans , Tonsillectomy/instrumentationSubject(s)
Endoscopy/methods , Maxillary Sinus , Nasopharynx , Child , Endoscopes , Humans , Intubation , Maxillary Sinus/embryology , Nasopharynx/embryologyABSTRACT
A 2 1/2-year-old child was found to have subglottic stenosis with no obvious etiology. He initially responded well to dilatation, injection of triamcinolone and intermittent stenting of the airway, but four months later developed a marked, unyielding subglottic stenosis requiring tracheostomy. He had a gradual good response to dilatations and injections with triamcinolone and acquired a good subglottic lumen. However, he developed a recurrence following an episode of croup. Systemic steroids were added to the regimen leading to gradual resolution of the stenosis and successful decannulation. The embryogenesis of subglottic stenosis and the correlation with the known anatomy and histology are discussed. Subglottic stenosis may be congenital, traumatic, inflammatory, neoplastic or neurogenic. An additional group of patients has no obvious etiology and are classified as idiopathic. Treatment consists of various combinations of stents, systemic and intralesional steroids, dilatations and various operative procedures in the more refractory cases.
Subject(s)
Laryngostenosis/etiology , Airway Obstruction/etiology , Bronchoscopy , Child, Preschool , Dilatation , Humans , Laryngostenosis/pathology , Laryngostenosis/therapy , Larynx/pathology , Male , Recurrence , TracheotomySubject(s)
Birth Injuries , Joint Dislocations , Nasal Septum/injuries , Adolescent , Adult , Birth Injuries/diagnosis , Birth Injuries/etiology , Birth Injuries/therapy , Birth Weight , Facial Injuries/diagnosis , Facial Injuries/therapy , Female , Humans , Infant, Newborn , Joint Dislocations/diagnosis , Joint Dislocations/etiology , Joint Dislocations/therapy , Labor Presentation , Labor Stage, Second , Male , Maternal Age , Nose Deformities, Acquired/etiology , Otolaryngology/instrumentation , Parity , Pregnancy , Pregnancy ComplicationsABSTRACT
Sinus disease in children is usually ethmoidal in location. Acute illness is common and responds well to antibiotics. Sometimes the infection causes ipsilateral orbital cellulitis or rarely an orbital abscess. Systemic administration of antibiotics is usually effective in bringing about resolution. Surgery is not often needed. Acute maxillary sinus disease occurs more often in the older child in the second decade of life. It is manifested by pain in the cheek and teeth, nasal obstruction, and discharge. Treatment with antibiotics is usually effective. For chronic illness, irrigations in most cases bring about resolution. However, occasionally Caldwell-Luc surgery may be necessary.
Subject(s)
Endoscopy , Paranasal Sinus Diseases , Abscess/diagnosis , Cellulitis/diagnosis , Child , Child, Preschool , Endoscopes , Endoscopy/methods , Ethmoid Sinus , Humans , Intubation , Maxillary Sinus , Orbit , Paranasal Sinus Diseases/diagnosis , Sinusitis/diagnosis , Therapeutic Irrigation/methodsABSTRACT
We attempted to study the nasal mucosa of children (both normal and diseased) under light microscopy followed by both scanning and transmission electron microscopy. Combined methods of microscopy are valuable tools in establishing the diagnosis and lead to a better understanding of disease and its management. For this reason we found it necessary to study the ultrastructural details of the cells of the nasal mucosa. Through scanning electron microscopy we studied the functional aspects and the nature of the surface of these cells. Ultrastructural details of these cells were studied with the aid of transmission electron microscopy.
