ABSTRACT
Median clefts of the lower lip and mandible are very rare congenital anomalies. We report a female infant born to nonconsanguineous parents with unilateral microphthalmia and complete median clefting of the lower lip and mandible. This uncommon constellation of congenital malformations has never been reported in a liveborn infant.
Subject(s)
Lip/abnormalities , Mandible/abnormalities , Microphthalmos/complications , Aortic Valve/abnormalities , Female , Humans , Infant, Newborn , Lip/surgery , Mandible/surgery , Microphthalmos/surgery , Optic Nerve/abnormalities , Orbital Implants , Plastic Surgery Procedures , TwinsABSTRACT
OBJECTIVE: To evaluate the impact of vocal cord dysfunction on feeding in children after cardiovascular surgery. STUDY DESIGN: Of the 2255 children who had cardiovascular surgery between January 2000 to January 2006, 38 (1.7%) had postoperative vocal cord dysfunction confirmed at laryngoscopy. The following data were obtained retrospectively: type of surgery, laryngoscopic examination results, swallowing studies, upper gastrointestinal (UGI) studies, and feeding route: oral, nasogastric tube (NG), and gastrostomy. RESULTS: Surgeries included aortic arch reconstruction (n = 20), patent ductus arteriosus ligation (n = 8), arterial switch (n = 3), cervical cannulation for extracorporeal membrane oxygenation (n = 2), and others (n = 5). A swallowing study confirmed dysfunction in 27 of 29 patients. Gastrostomy was placed in 18/38 patients. At discharge, 18 patients were fed by gastrostomy, 13 orally, 3 by NG, and 4 by combination oral/NG. At a median follow-up of 12 months, 20 were fed orally, 1 by NG, 7 by gastrostomy, 7 by combination gastrostomy/orally, 1 was lost to follow-up, 2 died. CONCLUSION: Vocal cord dysfunction after pediatric cardiovascular surgery is associated with significant feeding problems and may require prolonged gastrostomy feeding. These findings support aggressive surveillance for vocal cord dysfunction, especially in patients undergoing aortic arch surgery.
Subject(s)
Cardiac Surgical Procedures/adverse effects , Feeding Methods , Vascular Surgical Procedures/adverse effects , Vocal Cord Paralysis/etiology , Aorta, Thoracic/surgery , Child, Preschool , Extracorporeal Membrane Oxygenation , Gastrostomy , Humans , Infant , Infant, Newborn , Intubation, Gastrointestinal , Laryngoscopy , Retrospective Studies , TracheostomyABSTRACT
With the growing prevalence of methamphetamine use and production in home laboratories, children are at risk for injuries resulting from living in a drug-endangered environment. Although the ingestion of household cleaners is usually accidental and not a result of illicit drug use or production, medical providers must be aware of the chemicals associated with methamphetamine and illicit drug production to identify patients harmed in this environment. We present the first reported cases of children harmed by ingesting caustic substances used in the production of methamphetamine in the home.
