Outcome of kinesio taping in drooling children: A systematic review.

INTRODUCTION: Drooling is a troublesome condition, especially in children with neuromuscular and intellectual disability. Over the past decade, novel interventions have been trialled to alleviate drooling in the affected children. Kinesio tape (KT) application has shown promising results in controlling drooling in children. We reviewed the literature to determine the outcome of KT application in drooling children. METHODS: A literature search was conducted from January 1, 1990 to March 2024 by searching several databases over a 1-month period (April 2024) according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The primary outcome was defined as the success of the intervention determined by the improvement or resolution of symptoms, and the secondary outcome was determined by adjunct or repeated procedures and the presence of complications. RESULTS: Overall, 172 children from 10 studies were identified. All studies included are retrospective studies (Level III). This review included 172 children, with a mean age of 8.2 years (Male: 58.7 %). All included children had underlying comorbidities (100 %), with neurological disorders (77 %) being the most prevalent. KT application was performed predominantly over the orbicularis oris in 6 studies, 118 children[68.6 %], suprahyoid region in 3 studies, 45 children (26.2 %) and multiregion over the head and neck in 1 study of children (5.2 %). Drooling was assessed subjectively in all 100 % of children with objective measurement performed in 3 studies. KT was the only intervention in 40.7 % of the included children, whereas KT was performed in combination with oromotor therapy in 48 children, speech therapy in 44 children, and manipulation therapy in 10 children. All included children (100 %) reported improvement in drooling. No studies reported adverse reactions to KT application. CONCLUSIONS: KT application is a safe, effective alternative for drooling children. The effect of KT, however, may be temporary. The quality of the evidence is inadequate to recommend widespread use of the intervention until a better-quality study has been completed. Future randomised controlled studies with a large sample size are warranted to determine the efficacy of this intervention among children.

Familial congenital laryngotracheal stenosis: A systematic review.

BACKGROUND: Congenital laryngotracheal stenosis (CLS) is a rare cause of stridor among newborns. Evidence has shown that several family members can be affected by CLS. Knowledge of the pathophysiology of familial congenital laryngotracheal stenosis (FCLS) will enable more effective therapeutic strategies. OBJECTIVE: To determine the clinical course and outcome of familial congenital laryngotracheal stenosis (FCLS). METHODS: A literature search was conducted over a period of one month (September 2023) by searching several databases to identify studies published from inception to 31st August 2023. RESULTS: Of 256 papers identified, five articles met the inclusion criteria. A total of 17 patients with slight female predominance (59 %) were identified. Familial congenital tracheal stenosis was reported in female twins (100 %). A variety of clinical presentations were listed. An endoscopic airway study was performed on all patients. 64.8 % of the included children were managed surgically. Genetic studies performed on 41 % of children could not locate genetic abnormalities. CONCLUSION: Consanguinity, twin births, and female gender could be predisposing factors for FCLS, although the quality of evidence is low due to the rarity of the condition.

Juvenile recurrent parotitis: Review and proposed management algorithm.

INTRODUCTION: Despite being the second most common salivary disease in childhood, the aetiology and appropriate management of juvenile recurrent parotitis (JRP) remains uncertain. Consequently patients may be misdiagnosed, or even undergo indeterminate or potentially invasive procedures without benefit. This article reviews the current understanding of the epidemiology and pathophysiology of JRP, and to appraise the management options available. METHODS AND RESULTS: Medline and Google Scholar databases were searched and peer reviewed journal articles assessed. The epidemiology of JRP remains uncertain, and the clinical presentation of JRP can vary widely in frequency and severity. Diagnosis is still largely based on clinical signs and symptoms including parotid swelling, pain and fever. Investigation typically focuses on the exclusion of other diseases and immunodeficiencies, however there are noted typical radiological findings on both ultrasound and magnetic resonance imaging. The ideal management of this condition still remains unclear, however symptoms typically resolve by puberty. Treatment focuses on minimally invasive procedures such as sialography and sialendoscopy to reduce the frequency and severity of acute episodes. CONCLUSIONS: Acute episodes of JRP can occur up to 30 times per year and have a significant impact on the quality of life of an affected child. Consequently a management algorithm is proposed based on the exclusion of other pathology. There is increasing evidence for non-ablative, minimally invasive approaches such as sialography and sialendoscopy to reduce the impact of this disease.

Cost of Stem Cell-Based Tissue-Engineered Airway Transplants in the United Kingdom: Case Series.

Stem cell-based tissue-engineered tracheas are at an early stage in their product development cycle. Tens of patients have been treated worldwide in predominantly compassionate use settings, demonstrating significant promise. This potentially life-saving treatment is complex, and the cost and its implications for such treatments are yet to be fully understood. The costs are compounded by varying strategies for graft preparation and transplant, resulting in differing clinical and laboratory costs from different research groups. In this study, we present a detailed breakdown of the clinical and manufacturing costs for three of the United Kingdom (UK) patients treated with such transplants. All three patients were treated under Compassionate Use legislation, within the UK National Health Service (NHS) hospital setting. The total costs for the three UK patients treated ranged from $174,420 to $740,500. All three patients were in a state of poor health at time of treatment and had a number of complexities in addition to the restricted airway. This is the first time a cost analysis has been made for a tissue-engineered organ and provides a benchmark for future studies, as well as comparative data for use in reimbursement considerations.