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Biomedical subjects

K Riding

Publications and source records attributed to K Riding.

9 recordsLinked to original sources
PubMed1992

Subglottic hemangioma: a practical approach.

A specific entity known as a subglottic hemangioma may present in a six to 12-week-old baby with gradual onset of a two-way stridor. A cough may be present. The voice and feeding may be normal, until severe airway obstruction occurs. A barium swallow with fluoroscopy should be performed by a radiologist or technician experienced with babies to rule out other lesions such as a vascular ring. Direct examination is then performed using a 3.0 mm Storz-Hopkins bronchoscope under general anesthetic as a method of choice. Other methods are discussed. Ideal treatment is probably best undertaken in a large center, using a carbon dioxide laser through a subglottiscope again under general anesthesia with the child breathing spontaneously. Airway support may be necessary at any stage. Alternative treatments are discussed.

Glottis↗
PubMed1991

Orbital complications of ethmoiditis: B.C. Children's Hospital experience, 1982-89.

Orbital complications of ethmoiditis primarily affect children. Infection proceeds through contiguous spread to the orbit. We undertook a retrospective analysis of all children admitted to British Columbia Children's Hospital in Vancouver with a diagnosis of periorbital and orbital cellulitis due to ethmoiditis between 1982 and 1989. The majority of children presented with periorbital cellulitis, which resolved with aggressive parenteral antibiotic therapy. Five children (17%) progressed to subperiosteal abscess formation as documented by CT scan and required external ethmoidectomy as a drainage procedure. We conclude that early hospitalization and aggressive parenteral antibiotics are effective in resolving periorbital cellulitis. Surgical drainage is indicated when subperiosteal abscess is documented by CT scan. In our series, there were no cases of permanent visual deficit resulting from complications of ethmoiditis.

Anti-Bacterial Agents↗
PubMed1991

Daycare tonsillectomy and/or adenoidectomy at the British Columbia Children's Hospital.

The fact that tonsillectomy (T), or tonsillectomy with adenoidectomy (T & A) or adenoidectomy (A) can be performed safely in selected children on a daycare or outpatient basis is well proven. This article illustrates the approach that the British Columbia Children's Hospital (B.C.C.H.) took to confirm that the procedures were safe locally. A pilot project was started in June of 1984 to perform daycare adenoidectomies only, using two full-time pediatric otolaryngologists. When this proved successful, other otolaryngologists were encouraged to use the program. In June of 1988, a second pilot project was started for daycare tonsillectomies (or tonsillectomy and adenoidectomy). Criteria were established for patient selection, preparation, anesthesia, post-anesthetic recovery (PAR), Daycare Unit (DCU) nursing, and discharge. Follow-up information was obtained. Daycare tonsillectomy with or without adenoidectomy and daycare adenoidectomy are now routine procedures at B.C.C.H.

Adenoidectomy↗
PubMed1987

Comparative efficacies of erythromycin-sulfisoxazole and cefaclor in acute otitis media: a double blind randomized trial.

A prospective double blind trial compared the fixed combination of erythromycin-sulfisoxazole (E/S) with cefaclor in the treatment of acute otitis media. One hundred nineteen children in six centers across Canada were studied. Diagnostic tympanocentesis of 134 ears yielded 135 bacterial isolates: Streptococcus pneumoniae (42%); Haemophilus influenzae (21%); Branhamella catarrhalis (10%); Streptococcus pyogenes (5%); and other bacteria (22%). Seventy-seven percent of strains of B. catarrhalis and 14% of strains of H. influenzae were beta-lactamase producers. E/S exhibited greater in vitro activity against H. influenzae and B. catarrhalis. Twenty-three patients had bacteriologically sterile middle ear fluid. The overall clinical outcome at Days 10 and 31 was identical in both treatment groups. Otoscopic findings improved more rapidly in the E/S group than in the cefaclor group at 10 and 31 days (P less than or equal to 0.04). In cases where pre-treatment middle ear fluid was negative on routine bacterial culture, complete cure at 10 days was observed in 75% of patients treated with E/S but only in 14% of those treated with cefaclor (P = 0.02). Side effects were infrequent and comparable between the test drugs. E/S is at least as effective as cefaclor in the management of acute otitis media and may be superior, particularly for cases not yielding bacteria on routine culture.

Acute Disease↗
PubMed1986

Cancer of the nasopharynx in British Columbia.

The Chinese population in British Columbia has been increasing in recent years due to the migration of the Chinese from Southern China, which has tripled during the last decade. From 1939 to 1980, 296 cases of nasopharyngeal carcinoma (NPC) were seen at the Cancer Control Agency of British Columbia (CCABC). Of these, 167 (56%) were Chinese and 119 (40%) were Caucasians. The incidence of cancer of the nasopharynx in the Chinese born in China was 115 times greater than Caucasians before 1970 and 107 times greater in the 1970s. The incidence of NPC in the Caucasian population remained unchanged as did that of the North American-born Chinese (six times greater than that of the Caucasians) for the last 2 decades. The overall survival for all cases was 39% at 5 years and 28% at 10 years. The survival of cases was better in patients treated after 1970 (48% at 5 years and 36% at 10 years) than in patients treated before 1970 (34% at 5 years and 20% at 10 years). The survival was 50% at 5 years for all N0 cases but it was only 27% in patients with nodal metastasis. The survival of NPC was related essentially to initial staging, type and dose of irradiation, and pre-irradiation biopsy of neck metastasis. The survival was not significantly related to birth place, race, or histological grade.

Adult↗
PubMed1986

Subglottic hemangiomas in infants.

Subglottic hemangioma, a lesion absent at birth and developing in the first few months of life, may present as an acute airway obstruction. Definitive diagnosis may be delayed or confused with other conditions. Recent experience with infants presenting with subglottic hemangioma lead to the proposal of delayed laser surgical intervention until age nine months, at which time natural involution begins. Five cases are reviewed to illustrate this contention.

Female↗
PubMed1986

Stridor due to cricoarytenoid arthritis in pauciarticular onset juvenile rheumatoid arthritis.

A 2-year-old girl developed severe inspiratory and expiratory stridor 2 months after onset of pauciarticular juvenile rheumatoid arthritis (JRA). Direct laryngoscopy demonstrated that both vocal cords were immobile and approximated to each other in the midline secondary to arthritis of the cricoarytenoid joints. High dose corticosteroid therapy resulted in clinical and laryngoscopic improvement and tracheostomy was avoided. Cricoarytenoid arthritis can be a life threatening complication in JRA. Early institution of corticosteroids appears to be the treatment of choice.

Arthritis, Juvenile↗
PubMed1977

Management of nasopharyngeal angiofibroma.

Successful surgical treatment of nasopharyngeal angiofibroma requires complete pre-operative evaluation and careful choice of a suitable surgical approach. Experience with 12 patients presenting with this tumor demonstrates the value of polytomography and angiography in evaluation. The use of pre-operative estrogens and temporary vessel ligation has decreased blood loss. The surgical approach is modified depending upon tumor location. A tumor confined to the nasopharynx is removed by a transpalatal approach. Extension into the sinuses or orbit necessitates a sublabial incision or lateral rhinotomy. Pterygo-maxillary tumor may be exposed by extension of the sublabial incision posterior to the maxillary tuberosity. This allows one to push the tumor back into the nasopharynx. Intracranial extension is removed by a combined otolaryngologic-neurosurgical approach.

Adolescent↗