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At least 523 records · Page 29Linked to original sources
PubMed1998

Relationship between tympanic membrane perforations and retained ventilation tubes.

OBJECTIVES: To determine the effects of prolonged ventilation tube retention on tympanic membrane healing and the efficacy of patching procedures used concomitantly at the time of tube removal. DESIGN: Retrospective chart review. SETTING: Tertiary referral academic institution. PATIENTS: Seventy-six patients aged 12 years and younger, with a total of 99 ears identified from January 1989 to December 1994. All patients underwent ventilation tube removal for prolonged tube retention or infection unresponsive to medical management. A minimum of 6 months of follow-up was required for inclusion. INTERVENTION: Ventilation tube removal under general anesthesia, with or without concomitant patching. OUTCOME MEASURES: All medical charts were reviewed for age, sex, indications for tube removal, tube retention time, type of patch used (if any), type of tube, outcome after removal, other medical problems, and previous surgical history. RESULTS: The perforation rate was significantly higher in children with tubes retained beyond 36 months (P=.02). History of previous adenoidectomy predicted poor outcome, with a rate of 47% vs 17% in patients with no such history (P=.002). Patching did not improve healing. No other patient factors significantly influenced the perforation rate. CONCLUSIONS: Ventilation tube retention longer than 36 months resulted in an increased perforation rate after surgical removal. Paper patching at the time of tube removal does not improve healing. Prospective studies are needed to confirm these findings and to determine the efficacy of other patching techniques.

Child↗
PubMed1999

Idiopathic thrombocytopenic purpura presenting as postmyringotomy hemorrhage.

Acute idiopathic thrombocytopenic purpura has an annual incidence of about 4 per 100000 children and usually presents after a viral illness with new-onset petechiae, easy bruisability, and, occasionally, mucosal bleeding. It usually follows an uneventful course en route to a spontaneous recovery. We describe a patient with chronic otitis media who developed idiopathic thrombocytopenic purpura as a postmyringotomy complication.

Child, Preschool↗
PubMed2002

Otolaryngologic surgery in children with von Willebrand disease.

OBJECTIVE: To assess the efficacy, safety, and complications of otolaryngologic surgery in children with von Willebrand disease (vWD) undergoing surgery. DESIGN: A prospective, controlled study of 41 children with vWD who underwent surgery between June 1, 1999, and January 31, 2001. SETTING: A tertiary care, university-based children's hospital. INTERVENTIONS: All children had a preoperative diagnosis of vWD. The patients were treated with either a protocol that includes the use of desmopressin acetate and tranexamic acid (37 children) or factor VIII concentrate in children with a positive history of seizures (4 children). MAIN OUTCOME MEASURES: Immediate and delayed postoperative bleeding, hyponatremia, seizures, and urine output. RESULTS: Two adenotonsillectomy patients (5%) had an immediate postoperative hemorrhage. Delayed postoperative bleeding was not detected in our patients. Severe hyponatremia occurred in 2 patients (1 of them with clinical manifestations). CONCLUSIONS: Our management of children with vWD was efficacious in otolaryngologic surgery. One child had important adverse effects with the use of desmopressin (seizure). Thus, the use of desmopressin should be weighed and closely monitored.

Adenoidectomy↗
PubMed2002

Quality-of-life outcomes after surgical intervention for otitis media.

OBJECTIVE: To assess the change in disease-specific quality of life in children with recurrent acute otitis media and/or chronic otitis media with effusion treated with surgical intervention. DESIGN: Prospective questionnaire-based outcome study. SETTING: An academic pediatric otolaryngology practice. PARTICIPANTS: Consecutive series of 123 children referred for surgical treatment of recurrent acute otitis media and/or chronic otitis media with effusion. INTERVENTION AND METHODS: Surgery included bilateral myringotomy and tympanostomy tube placement either alone or with adenoidectomy. An otitis media disease-specific questionnaire was administered before and after surgical intervention. MAIN OUTCOME MEASURES: Comparison of the mean percentage change in total ear symptom score between presurgery and postsurgery scores at 1 and 6 months after surgery. RESULTS: The mean percentage change in total ear symptom score was a 74.5% improvement (P<.001) at the 1-month follow-up and a 59.8% improvement (P<.001) at the 6-month follow-up. Parental worry related to the child's ear problems was also significantly decreased, with a mean otitis media disease-specific questionnaire score of 3.43 (P<.001) at 1 month and 2.64 (P<.001) at 6 months after surgery. When caregivers were asked if they would have their child undergo tympanostomy tube placement if they had to make the decision again, 91% and 84% responded yes at the 1- and 6-month follow-up, respectively. CONCLUSIONS: The disease-specific quality of life of children with recurrent acute otitis media and/or chronic otitis media with effusion with appropriate surgical indications significantly improved after surgical intervention. The amount of parental worry concerning their children's ear problems also significantly improved following surgery, and most caregivers would opt again for tube placement.

Acute Disease↗