Large cervicothoracic thymic cyst causing prominent airway deviation in a 3-day-old neonate.

Cervicothoracic mass in the pediatric population is uncommon and has a broad differential diagnosis. Frequently, masses in the cervical region present with airway compromise, particularly in younger patients. We present a case of an extremely large cervicothoracic mass causing airway obstruction in a 3-day-old, otherwise healthy male infant. Following awake intubation for airway protection, a 4.5 cm x 2.5 cm x 1.5 cm thymic cyst was removed. This case illustrates the wide differential diagnosis of cervicothoracic masses and shows the difficulty of preoperative diagnosis, especially in the case of thymic cysts with extension into the cervical space.

Attitudes of children with dysphonia.

SUMMARY: Because voice disorders in childhood may have a negative impact on communicative effectiveness, social development, and self-esteem, the objective was to determine the impact of voice disorders on lives of children from the perspective of chronically dysphonic children and their parents. This study consisted of focused interviews with chronically dysphonic children and their caregivers. Focused interviews were conducted with 10 children in each of the following age groups: Toddler (2-4 years old), Young Child (5-7 years old), School-Aged Child (8-12 years old), and Adolescent (13-18 years old). Interview questions were formulated to elicit attitudes in the following conceptual domains: emotional, social/functional, and physical. Interviews were transcribed and subjected to systematic qualitative analyses that identified common themes within each age group for each conceptual domain. For Toddlers, interviews relied heavily on parents and the biggest concerns were found in the physical and functional domains. Young Children expressed that their biggest issues related to voice were physical ("run out of air," "sometimes voice does not work"). Ninety percent of Young Children were repeatedly asked to use a quieter voice. Emotional factors and physical factors were prominent in the interviews of School-Aged Children and Adolescents. Children and Adolescents often felt that their dysphonic voice received undue attention and also limited their participation in important events. Anger, sadness, and frustration were also expressed. Chronic dysphonia negatively affects the lives of children. This work will serve as the basis for development of a valid, reliable, and age-appropriate measure of voice-related quality of life in children.