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Does tonsillar hypertrophy contribute to speech disorders in children? 扁桃体肥大会导致儿童语言障碍吗?
Q4 Medicine Pub Date : 2018-12-01 DOI: 10.25121/newmed.2018.22.4.129
Iwona Łapińska, L. Zawadzka-Głos
Introduction. Hypertrophy of the pharyngeal and/or palatine tonsils as well as otitis media with effusion are the most prevalent childhood diseases leading to the referral of children to the ENT specialist. Adenoidectomy is the most commonly performed surgical procedure among paediatric patients. The main indications to adenoidectomy include sleep apnoea, frequent infections of the upper respiratory tract, and otitis media with effusion (OME). OME is defined as the presence of fluid in the middle ear without coexisting symptoms of ear infection. Aim. The aims of the study were to perform a clinical analysis of patients undergoing surgery on tonsils, and to evaluate the effect of tonsillar hypertrophy on speech disorders. Material and methods. The prospective study involved a group of 92 patients subjected to surgical procedures including adenoidectomy, adenotonsillotomy and adenotonsillectomy. Results. The study was carried out in a group of 92 patients aged 4.5-18 years who underwent tonsil surgery in two of Poland’s specialist medical centres. A total of 63 patients treated in the Warsaw centre, and 29 patients receiving treatment in the Elbląg centre, were included. The vast majority of the study group comprised children aged 5 to 9 years. Hearing impairment and the need to turn up the volume of the TV before the procedure were reported by 42 (45.7%) of the respondents. A total of 37 (40.2%) patients reported having to ask about the same thing several times. Among the patients who presented with hearing problems, 28 (30.4%) reported speech disorders, and 4 (4.3%) had slurred speech. Conclusions. Correct and early diagnosis and appropriate treatment of OME in children is necessary. An improvement of hearing in children contributes to an improvement in pronunciation.
介绍。咽部和/或腭扁桃体肥大以及中耳炎伴积液是最常见的儿童疾病,导致儿童转介到耳鼻喉专科。腺样体切除术是儿科患者中最常用的外科手术。腺样体切除术的主要适应症包括睡眠呼吸暂停、频繁上呼吸道感染和中耳炎伴积液(OME)。OME的定义是中耳有积液,但不伴有耳部感染的症状。的目标。本研究的目的是对接受扁桃体手术的患者进行临床分析,并评估扁桃体肥大对语言障碍的影响。材料和方法。这项前瞻性研究涉及92名接受手术治疗的患者,包括腺样体切除术、腺扁桃体切除术和腺扁桃体切除术。结果。这项研究是在92名年龄在4.5-18岁之间的患者中进行的,他们在波兰的两家专科医疗中心接受了扁桃体手术。共有63名患者在华沙中心接受治疗,29名患者在Elbląg中心接受治疗。绝大多数的研究对象是5到9岁的儿童。42名(45.7%)受访者表示有听力障碍,并在手术前需要把电视音量调大。共有37名(40.2%)患者报告不得不多次询问同一件事。在出现听力问题的患者中,28例(30.4%)报告语言障碍,4例(4.3%)报告言语不清。结论。儿童OME的正确早期诊断和适当治疗是必要的。儿童听力的改善有助于发音的改善。
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引用次数: 0
Retroauricular region involvement during otitis externa caused by P. aeruginosa 铜绿假单胞菌引起的外耳炎累及耳后区
Q4 Medicine Pub Date : 2018-09-01 DOI: 10.25121/newmed.2018.22.3.79
A. Wasilewska, L. Zawadzka-Głos
Introduction. Diffuse otitis externa is one of the causes of ear pain, especially in school-age children. Risk factors for the disease include skin damage during cleaning audito ry canal, moisture exposure, anatomical factors, and dermatological comorbidities. Aim. The aim of the study was to present clinical picture, differential diagnosis and method of treatment of diffuse otitis externa based on cases of patients hospitalized in the Department of Pediatric Otolaryngology of the Medical University of Warsaw. Material and Methods. A retrospective analysis of the clinical presentation and diagnostic tests of 12 cases of children with diffuse otitis externa hospitalized in the Department of Pediatric Otolaryngology of the Medical University of Warsaw from 1st March 2017 to 1st March 2018 was conducted. Results. The most common etiological factor of diffuse otitis externa was Pseudomonas aeruginosa. Over half of the patients presented an involvement of retroauricular region during otitis externa. All the patients were treated with local and intravenous antibiotics. Conclusions. Atypical course associated with the spread of inflammation to the retroauricular region may lead to an erroneous diagnosis of otitis externa as a complication of otitis media. Treatment is difficult due to severe pain and resistance of P. aeruginosa to most antibiotics.
介绍弥漫性外耳道炎是引起耳朵疼痛的原因之一,尤其是学龄儿童。该疾病的风险因素包括清洁耳道过程中的皮肤损伤、水分暴露、解剖因素和皮肤病合并症。目标本研究的目的是根据华沙医科大学儿童耳鼻咽喉科住院患者的病例,介绍弥漫性外耳道炎的临床表现、鉴别诊断和治疗方法。材料和方法。对2017年3月1日至2018年3月31日在华沙医科大学儿科耳鼻咽喉科住院的12例弥漫性外耳道炎儿童的临床表现和诊断测试进行了回顾性分析。后果弥漫性外耳道炎最常见的病因是铜绿假单胞菌。超过一半的患者在外耳道炎期间表现为耳后区受累。所有患者均接受局部和静脉注射抗生素治疗。结论。与炎症扩散到耳后区域相关的非典型病程可能导致外耳道炎作为中耳炎并发症的错误诊断。由于严重的疼痛和铜绿假单胞菌对大多数抗生素的耐药性,治疗是困难的。
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引用次数: 0
Ocular compications in ethmoiditis in children treated in a reference laryngological academic center 在一个参考喉学术中心治疗儿童筛炎的眼部并发症
Q4 Medicine Pub Date : 2018-09-01 DOI: 10.25121/newmed.2018.22.3.87
Iryna Drohobycka, L. Zawadzka-Głos
Introduction. One of the most commonly diagnosed upper respiratory diseases is sinusitis. A particular form of sinusitis in children is ethmoiditis. Due to the location of ethmoidal cells, their inflammation is associated with higher risk of complications compared with inflammation of other sinuses. Aim. The aim of the study was to assess the prevalence, severity and management of ocular complications of ethmoiditis in the retrospective material of the reference laryngological academic center. Material and Methods. The retrospective analysis included 41 patients with ocular complications of ethmoid sinusitis who were hospitalized in the Department of Pediatric Otolaryngology in the years 2012–2017. The analysis included the severity of complications on Chandler’s scale, management and results of culture of the material obtained during surgery. Results. The study included 25 boys (60%) and 16 girls (40%) aged from 3 months to 16 years. Mean age of the patients was 5.34 years (SD = 3.98). According to Chandler’s scale, retroseptal complications were diagnosed in 12 patients (29.27%), and anteroseptal complications – in 29 patients (70.73%). Surgical treatment was performed in 12 patients (29.27%), 8 of whom (66.7%) underwent external ethmoidectomy with orbital drainage, and 4 of whom (33.3%) underwent functional endoscopic sinus surgery (FESS). Consistent findings of CT scan with lesions found during surgical intervention were found in 10 patients (83.3%). Fifteen different pathogens were isolated from the material collected during the procedures. In more than half of the patients (53.3%), the pathogen was a staphylococcus. Al the patients with retroseptal ocular complications underwent combination therapy consisting of surgical management and two intravenous antibiotics targeted for the etiological factor. The most frequently used antibiotics included 3rd generation cephalosporins and clindamycin. Conclusions. In children with ethmoiditis treated in a reference laryngological academic center, anteroseptal complications occurred twice as often as retroseptal complications. Most cases did not require surgical intervention.
介绍。最常见的上呼吸道疾病之一是鼻窦炎。儿童鼻窦炎的一种特殊形式是筛炎。由于筛窦细胞的位置,其炎症与其他鼻窦炎症相比,并发症的风险更高。的目标。本研究的目的是评估筛炎眼部并发症的患病率、严重程度和处理,回顾参考喉学术中心的资料。材料和方法。回顾性分析2012-2017年在儿科耳鼻喉科住院的41例筛窦炎眼部并发症患者。分析包括并发症的严重程度、处理和术中获得的材料的培养结果。结果。该研究包括25名男孩(60%)和16名女孩(40%),年龄从3个月到16岁。患者平均年龄5.34岁(SD = 3.98)。根据钱德勒量表,12例(29.27%)患者诊断为间隔后并发症,29例(70.73%)患者诊断为间隔前并发症。手术治疗12例(29.27%),其中8例(66.7%)行筛外切除术联合眶内引流,4例(33.3%)行功能性内镜鼻窦手术(FESS)。10例(83.3%)患者的CT扫描结果与手术干预时发现的病变一致。从过程中收集的材料中分离出15种不同的病原体。半数以上(53.3%)患者的病原菌为葡萄球菌。所有发生隔后眼并发症的患者均接受手术治疗和针对病因的两种静脉注射抗生素的联合治疗。最常用的抗生素包括第三代头孢菌素和克林霉素。结论。在参考喉学术中心治疗的筛炎患儿中,室间隔前并发症的发生率是室间隔后并发症的两倍。大多数病例不需要手术干预。
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引用次数: 0
Nasal septum perforation – new treatment methods 鼻中隔穿孔-新的治疗方法
Q4 Medicine Pub Date : 2018-09-01 DOI: 10.25121/newmed.2018.22.3.95
M. Michalik, Adrianna Podbielska-Kubera, A. Dmowska-Koroblewska
Perforation is a defect of nasal septum manifested by the disruption of mucosa in the cartillaginous or bone part of nasal septum or in both of the parts at the same time.As a result, disruption of air transport through the nose and impaired nasal physiology occur. Crusting, epistaxis, and wheezing arise. Perforations are classified according to their size, type, and localization. There are many causes for nasal septum perforation: trauma, surgery, tumors, coexistence of inflammatory, infectious, degenerative, and autoimmune diseases, and cocaine abuse. The assessment of a patient with nasal septum perforation includes detailed medical history, physical examination, diagnostic and laboratory tests. Treating the underlying disease is of primary importance. The second step involves closing the perforation. Perforations can be treated conservatively (pharmacologically) or surgically. The choice of approach depends on the etiology, size, and location of the perforation. Surgical approach is the most effective. Surgical closure of nasal septal perforation is a difficult procedure associated with many complications. All surgical approaches are based on two main principles: creating mucosal, mucoperichondrial, and/or mucoperiosteal flaps or transplant. Prosthetic treatment is another solution. Literature data shows that highest success rate is achieved after surgical procedures with the use of mucosal flaps and temporal fascia transplants, as well as acellular human dermal allografts.
穿孔是鼻中隔的一种缺损,表现为鼻中隔软骨部分或骨部分或两者同时出现粘膜破坏。结果,通过鼻子的空气运输中断和鼻腔生理机能受损。出现结痂、鼻出血和喘息。穿孔根据其大小、类型和位置进行分类。造成鼻中隔穿孔的原因有很多:外伤、手术、肿瘤、炎症、感染性、退行性和自身免疫性疾病并存,以及滥用可卡因。对鼻中隔穿孔患者的评估包括详细的病史、体格检查、诊断和实验室检查。治疗潜在疾病是最重要的。第二步是闭合穿孔。穿孔可以保守治疗(药理学)或手术治疗。入路的选择取决于病因、大小和穿孔的位置。手术是最有效的方法。鼻中隔穿孔的手术封闭是一项困难的手术,有许多并发症。所有的手术入路都基于两个主要原则:制造粘膜、黏液骨膜和/或黏液骨膜瓣或移植。假肢治疗是另一种解决方案。文献资料显示,使用粘膜瓣和颞筋膜移植以及脱细胞人类真皮同种异体移植手术后,成功率最高。
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引用次数: 1
Seasonality in the incidence of deep neck space infections in children hospitalized in the Department of Pediatric Otolaryngology of the Medical University of Warsaw 华沙医科大学儿童耳鼻咽喉科住院儿童深颈间隙感染发生率的季节性
Q4 Medicine Pub Date : 2018-06-01 DOI: 10.25121/newmed.2018.22.2.35
Karolina Raczkowska-Łabuda, Anna Gorzelnik, Jolanta Jadczyszyn, Monika Jabłońska-Jesionowska, L. Zawadzka-Głos
Introduction. Parapharyngeal abscesses are invariably a diagnostic and therapeutic challenge for pediatric otolaryngologists. The lack of consistency in the Polish nomenclature in relation to the English terms additionally complicates the problem. The wide spectrum of signs and symptoms, as well as an extremely heterogenous clinical presentation of the disease, also delay the implementation of appropriate treatment. Aim. The aim of the study was to analyze selected epidemiological and clinical characteristics of the parapharyngeal abscesses in children, such as the seasonality in the incidence, diagnostic difficulties, and available treatment methods. Material and Methods. A retrospective analysis was conducted on data obtained from medical histories of patients treated for deep neck space infections in the years 2013–2018 in the Department of Pediatric Otolaryngology of the Medical University of Warsaw. The study analyzed the age and sex of the children, as well as diagnostic methods and bacterial culture tests of the abscess. Particular attention was drawn to the seasonality in the incidence of the parapharyngeal abscesses in children. A statistical analysis was performed and seasonality index for the data was calculated, and a simulation of the prognosis of the occurrence of the factor for a moving average with a reference period of 2 months was performed. Next, the thesis on the discrete uniform data distribution was adopted, and Monte Carlo method was used for testing of the hypothesis. The significance level was α = 1%. The probability of 9 cases in one month was calculated based on the binomial distribution. Results. In the years 2013–2018, 23 children with parapharyngeal and retropharyngeal abscesses were admitted to the Department, 9 of which were admitted in December. In the analyzed group, a slight advantage in the number of boys was observed, with the male to female ratio being M:F = 1.3:1. Mean age of the patients was 3 years and 5 months. All the children had undergone an upper respiratory tract infection before being diagnosed with a deep neck space infection. All the patients had enlarged neck lymph nodes. The seasonality index for December was over 3 times higher than for March and accounted 4.696. The hypothesis on the discrete uniform data distribution was adopted (H0). The significance level was α = 1%. Based on monomial distribution, the probability of the occurrence of 9 cases in one month was calculated and amounted P(9) = 0.000141. Hence, the rejection of H0 occurs with an error of 0.17% < 1%. Conclusions. In Poland, the admission of a child diagnosed with a retropharyngeal or parapharyngeal abscess is most likely in late autumn – in November and December. Purulent deep neck space infections in children are a complication of upper respiratory tract infections. Deep neck space infections are difficult to diagnose due to the lack of pathognomonic signs and symptoms. The conservative treatment is an alternative to the surgica
介绍。咽旁脓肿始终是儿科耳鼻喉科医生的诊断和治疗挑战。波兰语的命名法与英语术语缺乏一致性,这使问题更加复杂。广泛的体征和症状,以及疾病的极其异质的临床表现,也延误了适当治疗的实施。的目标。本研究的目的是分析儿童咽旁脓肿的流行病学和临床特征,如发病率的季节性、诊断难点和可用的治疗方法。材料和方法。回顾性分析华沙医科大学儿科耳鼻喉科2013-2018年深颈间隙感染患者的病史数据。本研究分析了患儿的年龄和性别,以及脓肿的诊断方法和细菌培养试验。特别注意的是提请季节性的发病率咽旁脓肿在儿童。对数据进行统计分析,计算季节性指数,并以参考期为2个月的移动平均线模拟因子发生的预后。其次,采用离散均匀数据分布的论文,采用蒙特卡罗方法对假设进行检验。显著性水平为α = 1%。根据二项分布计算1个月内出现9例的概率。结果。2013-2018年,该科共收治咽旁及咽后脓肿患儿23例,其中9例于12月入院。在分析组中,男生在数量上略有优势,男女比例为M:F = 1.3:1。患者平均年龄3岁5个月。所有的孩子在被诊断为深颈间隙感染之前都经历了上呼吸道感染。所有患者均有颈部淋巴结肿大。12月份的季节性指数为4.696,是3月份的3倍多。采用离散均匀数据分布假设(H0)。显著性水平为α = 1%。根据单项分布计算1个月内发生9例的概率,P(9) = 0.000141。因此,H0被拒绝的误差为0.17% < 1%。结论。在波兰,诊断为咽后脓肿或咽旁脓肿的儿童最可能在深秋——11月和12月入院。儿童化脓性深颈间隙感染是上呼吸道感染的并发症。深颈间隙感染由于缺乏典型的症状和体征而难以诊断。对于病情稳定的小脓肿患者,在炎症标志物水平恢复正常及患者一般情况改善的情况下,保守治疗可替代手术引流。
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引用次数: 0
Diode laser-assisted uvulopalatoplasty using palisade technique 用栅栏技术进行二极管激光辅助悬雍垂腭成形术
Q4 Medicine Pub Date : 2018-06-01 DOI: 10.25121/newmed.2018.22.2.46
M. Michalik, Adrianna Podbielska-Kubera, A. Dmowska-Koroblewska
Introduction. The patency of the lower part of the upper respiratory tract depends on the muscle tone of pharynx, soft palate and tongue muscles. The consequence of the lowered tone of these muscles is recurrent total or partial narrowing of the airways. In this case, the turbulent airflow causes soft tissue vibration, which is heard as snoring. Material and Methods. The study included 34 patients: 27 men and 7 women. Carbon dioxide diode laser-assisted uvulopalatoplasty was employed. The diode laser with a wavelength of 810 mm, power of 5 W, and pulse length of 4 seconds was used. Before the procedure, all the patients underwent laryngological assessment. Medical history of the patients was also collected. In addition, the patients completed 2 questionnaires: a sleep disorder screening questionnaire and Ephworth Sleepiness Scale. Moreover, a 3D CT scan and acoustic rhinometry were performed. All the tests were repeated 3 months after the procedure. Results. The procedure was performed in 34 patients. Complete clinical response was observed in 21 cases, and a partial response was seen in 13 cases. There were no patients in the study group who had not experienced at least a partial improvement of symptoms. None of the patients reported any complications. Conclusions. Good clinical outcome was obtained in all the patients after obtaining palatal stiffening, which contributed to the resolution of symptoms. The advantages of diode laser-assisted uvulopalatoplasty using palisade technique include the safety of the procedure, minimal invasiveness, short healing time, and a low risk of complications. The procedure is performed on an out-patient basis under local anesthesia.
介绍上呼吸道下部的通畅程度取决于咽部、软腭和舌头肌肉的肌肉张力。这些肌肉张力降低的结果是反复出现气道的完全或部分狭窄。在这种情况下,湍流会引起软组织振动,这被称为打鼾。材料和方法。该研究包括34名患者:27名男性和7名女性。采用二氧化碳二极管激光辅助悬雍垂腭成形术。使用波长为810mm、功率为5W、脉冲长度为4秒的二极管激光器。手术前,所有患者均接受了喉科评估。还收集了患者的病史。此外,患者还完成了2份问卷:睡眠障碍筛查问卷和Ephworth失眠量表。此外,还进行了3D CT扫描和声学鼻测量。所有测试在手术后3个月重复进行。后果对34名患者进行了手术。21例观察到完全临床反应,13例观察到部分反应。研究组中没有任何患者的症状没有至少部分改善。没有患者报告任何并发症。结论。所有患者在腭部僵硬后都获得了良好的临床结果,这有助于症状的解决。使用栅栏技术的二极管激光辅助悬雍垂腭成形术的优点包括手术安全、微创、愈合时间短和并发症风险低。该手术是在门诊的基础上在局部麻醉下进行的。
{"title":"Diode laser-assisted uvulopalatoplasty using palisade technique","authors":"M. Michalik, Adrianna Podbielska-Kubera, A. Dmowska-Koroblewska","doi":"10.25121/newmed.2018.22.2.46","DOIUrl":"https://doi.org/10.25121/newmed.2018.22.2.46","url":null,"abstract":"Introduction. The patency of the lower part of the upper respiratory tract depends on the muscle tone of pharynx, soft palate and tongue muscles. The consequence of the lowered tone of these muscles is recurrent total or partial narrowing of the airways. In this case, the turbulent airflow causes soft tissue vibration, which is heard as snoring. Material and Methods. The study included 34 patients: 27 men and 7 women. Carbon dioxide diode laser-assisted uvulopalatoplasty was employed. The diode laser with a wavelength of 810 mm, power of 5 W, and pulse length of 4 seconds was used. Before the procedure, all the patients underwent laryngological assessment. Medical history of the patients was also collected. In addition, the patients completed 2 questionnaires: a sleep disorder screening questionnaire and Ephworth Sleepiness Scale. Moreover, a 3D CT scan and acoustic rhinometry were performed. All the tests were repeated 3 months after the procedure. Results. The procedure was performed in 34 patients. Complete clinical response was observed in 21 cases, and a partial response was seen in 13 cases. There were no patients in the study group who had not experienced at least a partial improvement of symptoms. None of the patients reported any complications. Conclusions. Good clinical outcome was obtained in all the patients after obtaining palatal stiffening, which contributed to the resolution of symptoms. The advantages of diode laser-assisted uvulopalatoplasty using palisade technique include the safety of the procedure, minimal invasiveness, short healing time, and a low risk of complications. The procedure is performed on an out-patient basis under local anesthesia.","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47420328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Periorbital complications as a result of rhinosinusitis in a pediatric patient. Case report. 儿童鼻窦炎引起的眶周并发症。病例报告。
Q4 Medicine Pub Date : 2018-05-21 DOI: 10.25121/newmed.2018.22.2.65
Piotr Kwast, Maja Waszak, J. Rafałowska, L. Zawadzka-Głos
Introduction. Acute rhinosinusitis is a very common disease in children, however, its complications occur much less frequently. The most common complication of rhinosinusitis is periorbital cellulitis, and its manifestations include subperiosteal abscess of the orbit. Case report. We present a case of a 3-year-old boy with a preexisting bilateral exophtalmia, who was treated twice for periorbital cellulitis in the course of acute rhinosinusitis. During the first episode, an orbital abscess occurred and was subsequently treated with external ethmoidectomy. The second episode was treated conservatively. In computed tomography, a potential dehiscence of lamina papyracea was identified as the reason for recurrent periorbital complications. The patient underwent planned adenoidectomy and endoscopic sinus surgery. He currently remains under the care of the Department. No recurrence of complicated rhinosinusitis have been diagnosed. Conclusions. Periorbital complications, which are considered an emergency in otorhinolaryngology, should be immediately treated in hospital conditions. Dehiscence of lamina papyracea may predispose to periorbital complications in children with acute rhinosinusitis. Special caution should be exercised when diagnosing patients with preexisting exophtalmia reporting with orbital complications of rhinosinusitis.
介绍急性鼻窦炎是一种非常常见的儿童疾病,但其并发症发生的频率要低得多。鼻窦炎最常见的并发症是眶周蜂窝组织炎,其表现包括眶骨膜下脓肿。病例报告。我们报告了一个3岁男孩的病例,他之前患有双侧鼻外膜炎,在急性鼻窦炎的过程中接受了两次眶周蜂窝组织炎的治疗。在第一次发作期间,发生了眼眶脓肿,随后进行了筛外切除术。第二次发作采用保守治疗。在计算机断层扫描中,潜在的丘疹板裂开被确定为复发性眶周并发症的原因。患者接受了计划中的腺样体切除术和鼻内镜鼻窦手术。他目前仍由该部照料。尚未诊断出并发鼻窦炎复发。结论。眶周并发症在耳鼻喉科被视为紧急情况,应立即在医院进行治疗。患急性鼻窦炎的儿童,丘疹板脱落可能容易引起眶周并发症。在诊断报告有鼻窦炎眼眶并发症的先前存在的外耳道外炎患者时,应特别小心。
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引用次数: 0
Drug-induced sleep endoscopy in assessing airway patency – own experiences 药物诱导睡眠内窥镜评估气道通畅性的经验
Q4 Medicine Pub Date : 2017-11-30 DOI: 10.25121/NEWMED.2017.21.4.115
A. Dmowska-Koroblewska, M. Michalik, Adrianna Podbielska-Kubera, Włodzimierz Jakub Siemianowski
Introduction. Obstructive sleep apnea is a disorder of breathing during sleep. Lack of clinical improvement after previously performed laryngological procedures is an indication for endoscopic examination during drug – induced sleep. Drug-induced sleep endoscopy (DISE) provides important information about functional upper airways patency. Material and methods. The study was performed in patients in whom other treatment methods had not been effective. DISE was performed in these patients. Continuous intravenous propofol infusion was given as general anesthetic to ensure the safety of the procedure. Results. From 2007 to 2017, 2897 procedures for snoring and sleep apnea were performed at the MML Medical Center. At this time, 176 DISE examinations were performed. Causative treatment methods were determined by the means of questionnaire, CBCT, laryngological examination, and DISE examination. Subjective improvement of apnea symptoms was achieved in 80% of patients. In 70% of cases, snoring decreased. The rest of the patients are required to look for systemic causes of cardiological, neurological gastrological, or endocrine origin. Conclusions. In our patients, the use of the DISE examination enabled to precisely determine the location of the vibration and of the collapse of the respiratory tract. DISE enables to effectively diagnose the cause of sleep disorders when other methods, such as cone beam computed tomography (CBCT) or cephalometry are not sufficient. Keywords
介绍。阻塞性睡眠呼吸暂停是一种睡眠期间的呼吸障碍。在先前的喉科手术后缺乏临床改善是在药物诱导睡眠期间内窥镜检查的指征。药物诱导睡眠内窥镜(DISE)提供了关于功能性上呼吸道通畅的重要信息。材料和方法。该研究是在其他治疗方法无效的患者中进行的。在这些患者中进行了DISE。持续静脉输注异丙酚作为全身麻醉,以确保手术的安全性。结果。从2007年到2017年,在MML医疗中心进行了2897例打鼾和睡眠呼吸暂停手术。此时,进行了176例DISE检查。通过问卷调查、CBCT、喉科检查、DISE检查确定病因治疗方法。80%的患者主观呼吸暂停症状得到改善。在70%的病例中,打鼾减少了。其余的患者需要寻找心脏、神经、胃肠或内分泌的全身性原因。结论。在我们的患者中,使用DISE检查能够精确地确定振动和呼吸道塌陷的位置。当其他方法,如锥束计算机断层扫描(CBCT)或头测术不充分时,疾病诊断能够有效地诊断睡眠障碍的原因。关键字
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引用次数: 0
Parotitis in children hospitalized in the Department of Pediatric Otolaryngology of the Medical University of Warsaw in the years 2010-2017 2010-2017年华沙医科大学儿科耳鼻喉科住院儿童的腮腺炎
Q4 Medicine Pub Date : 2017-11-23 DOI: 10.25121/newmed.2017.21.4.99
Monika Jabłońska-Jesionowska, Małgorzata Dębska-Rutkowska, Piotr Kwast, L. Zawadzka-Głos
Introduction. Parotitis can be divided into chronic and acute parotitis. Acute parotitis is caused by a viral or bacterial infection. Chronic parotitis includes chronic recurrent parotitis, parotitis due to sialolithiasis, parotitis related to angiomas, as well as parotitis as a symptom of autoimmune diseases. Aim. The aim of the study was to analyze the inflammatory changes in parotid salivary glands in children. Material and Methods. Between 2010 and 2017, 30 children were hospitalized in the Department of Pediatric Otolaryngology of the Medical University of Warsaw due to the swelling and pain of a parotid gland . Age, gender, etiology of the disease, location, laboratory findings, and comorbidities were assessed. Results. The cause of hospitalization was swelling and pain of a parotid salivary gland. The age of children ranged from 1 month to 15 years of age (mean age was 4.2 years). In 11 children, bilateral parotitis was diagnosed, in 19 children, the lesions were unilateral. In 7 children, acute parotitis was diagnosed. In these patients, elevated inflammatory markers, enlarged lymph nodes, or an abscess of the gland in the ultrasonographic examination was observed. In 20 children, chronic recurrent parotitis was diagnosed. In these patients, no elevated inflammatory markers were observed during exacerbations. In ultrasound, hypoechogenic foci were observed. Eleven children were diagnosed with autoimmune diseases. Three children were diagnosed with lymphangioma or hemangioma. None of the patients suffered from sialolithiasis nor pneumoparotitis. Conclusions. Parotitis that have its onset between 3 and 4 years of age may be recurrent parotitis. The diagnosis of chronic recurrent parotitis is based on clinical symptoms, ultrasound signs, and lack of elevated inflammatory markers. Bilateral chronic recurrent parotitis is related to an increased risk of autoimmunological diseases; chronic parotitis precedes their onset. Children with bilateral chronic recurrent parotitis require further testing for autoimmune diseases. Keywords
介绍腮腺炎可分为慢性腮腺炎和急性腮腺炎。急性腮腺炎是由病毒或细菌感染引起的。慢性腮腺炎包括慢性复发性腮腺炎、唾液结石引起的腮腺炎、与血管瘤有关的腮腺炎,以及作为自身免疫性疾病症状的腮腺炎。目标本研究的目的是分析儿童腮腺的炎症变化。材料和方法。2010年至2017年间,华沙医科大学儿童耳鼻喉科有30名儿童因腮腺肿胀和疼痛住院。评估了年龄、性别、疾病病因、地点、实验室检查结果和合并症。后果住院的原因是腮腺肿胀和疼痛。儿童年龄从1个月到15岁不等(平均年龄4.2岁)。11名儿童被诊断为双侧腮腺炎,19名儿童的病变为单侧。7名儿童被诊断为急性腮腺炎。在这些患者中,在超声检查中观察到炎症标志物升高、淋巴结肿大或腺体脓肿。20名儿童被诊断为慢性复发性腮腺炎。在这些患者中,在病情恶化期间没有观察到炎症标志物升高。在超声检查中,观察到低回声病灶。11名儿童被诊断患有自身免疫性疾病。三名儿童被诊断为淋巴管瘤或血管瘤。没有一名患者患有唾液结石或腮腺炎。结论。发病年龄在3至4岁之间的腮腺炎可能是复发性腮腺炎。慢性复发性腮腺炎的诊断是基于临床症状、超声体征和缺乏升高的炎症标志物。双侧慢性复发性腮腺炎与自身免疫性疾病风险增加有关;慢性腮腺炎发病前。患有双侧慢性复发性腮腺炎的儿童需要进一步检测自身免疫性疾病。关键词
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引用次数: 1
Diagnostic difficulties in salivary gland tumors in children 儿童唾液腺肿瘤的诊断困难
Q4 Medicine Pub Date : 2017-11-20 DOI: 10.25121/newmed.2017.21.4.108
Małgorzata Dębska-Rutkowska, Piotr Kwast, Monika Jabłońska-Jesionowska, L. Zawadzka-Głos
Introduction. Tumors of major salivary glands, due to their low incidence and the wide spectrum of possible diagnoses, are a challenge for physicians. Imaging studies are the key elements of the diagnostic process, although their results often do not provide a definitive diagnosis. Aim. The aim of the study was to assess the usefulness of additional tests in the diagnosis of tumors of major salivary glands in children. Material and Methods. A retrospective analysis of medical data of children with tumors of parotid or submandibular salivary gland hospitalized in the Department of Pediatric Otolaryngology of Medical University of Warsaw from the years 2012-2017 was performed. Results. In 8 girls and 7 boys aged between 4 months and 17 years, the following diagnoses were established: 6 mixed tumors, 3 hemangiomas, 1 lymphangioma, 1 rhabdomyosarcoma, and 1 mucoepidermoid carcinoma. In all of the patients, ultrasound (US) of salivary gland, computed tomography (CT) and/or magnetic resonance imaging (MRI) of the head were performed. US examination enabled to diagnose the majority (66%) of mixed tumors. US and CT or MRI with contrast enabled to recognize angiomas in all 4 patients with this lesion. In 2 patients, malignant neoplasm was diagnosed based on the histological examination. Conclusions. US remains the primary diagnostic test in patients with tumors of major salivary gland. When necessary, it can be supplemented with CT or MRI. In some cases, imaging studies do not enable to establish a definite diagnosis. The definite diagnosis of salivary gland tumors is established based on the results of the pathological examination (except for angiomas). The most common salivary gland tumor in older children is mixed tumor, and in infants – angioma. It must be remembered that very rare salivary gland tumors, such as sarcomas and carcinomas, may also occur in children. Keywords
介绍大唾液腺肿瘤由于发病率低,诊断范围广,对医生来说是一个挑战。影像学研究是诊断过程的关键要素,尽管它们的结果往往不能提供明确的诊断。目标该研究的目的是评估额外测试在诊断儿童大唾液腺肿瘤中的有用性。材料和方法。对2012-2017年华沙医科大学儿童耳鼻喉科住院的腮腺或下颌下唾液腺肿瘤儿童的医学数据进行了回顾性分析。后果在年龄在4个月至17岁之间的8名女孩和7名男孩中,确定了以下诊断:6例混合肿瘤、3例血管瘤、1例淋巴管瘤、1名横纹肌肉瘤和1例粘液表皮样癌。在所有患者中,进行了唾液腺超声(US)、头部计算机断层扫描(CT)和/或磁共振成像(MRI)。超声检查能够诊断大多数(66%)混合肿瘤。超声和CT或MRI造影能够识别所有4名患者的血管瘤。在2例患者中,根据组织学检查诊断为恶性肿瘤。结论。US仍然是大唾液腺肿瘤患者的主要诊断测试。必要时可辅以CT或MRI检查。在某些情况下,影像学研究无法确定诊断。唾液腺肿瘤的明确诊断是基于病理检查的结果(血管瘤除外)。年龄较大的儿童最常见的唾液腺肿瘤是混合肿瘤,婴儿最常见的是血管瘤。必须记住,非常罕见的唾液腺肿瘤,如肉瘤和癌症,也可能发生在儿童身上。关键词
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引用次数: 0
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New Medicine
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