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Biomedical subjects

S E Stool

Publications and source records attributed to S E Stool.

At least 55 records · Page 3Linked to original sources
PubMed1988

Intubation techniques of the difficult airway.

Visualization and intubation of the larynx in the normal infant may be difficult, especially in a newborn who has a large tongue in relation to the size of the oral cavity and an oval epiglottis. There are a number of congenital and acquired conditions that virtually guarantee that establishment of an airway will be difficult; therefore the pediatric physicians should be equipped with and capable of using a wide range of instruments and techniques. This article will focus on the techniques available for handling the difficult airway and will emphasize a new instrument.

Fiber Optic Technology↗
PubMed1988

Croup syndrome: historical perspective.

The management of acute croup syndrome has undergone very interesting changes in the past century. Initially a number of conditions were thought to be synonymous with croup, but with identification of the bacterial and viral etiology these have been separated into different clinical entities: viral croup which is very common and frequently self-limited; bacterial tracheitis, a condition which is infrequently encountered and which may be a complication of viral croup; and epiglottitis or supraglottitis, a disease that has been identified as most frequently due to a specific organism, H. influenzae. The management of the child with airway obstruction has also changed. Before the past decade virtually all children with epiglottitis were treated with tracheotomy and currently very few children are thus treated. Intubation has been showed to be a safe procedure in these cases. There still exists some controversy regarding the treatment of the child with laryngotracheobronchitis. In the vast majority of cases medical management has been successful and in the remainder there is controversy regarding the use of intubation or tracheotomy.

Child↗
PubMed1988

Controversy over tubes and adenoidectomy.

Dr. Bluestone then summarized the panelists' discussion by stating that there is now evidence that myringotomy alone for chronic otitis media with effusion has some efficacy but is probably no better than watching the child and not performing surgery. He also stated there are now some data to show that myringotomy and tube insertion for chronic otitis media with effusion appear to be more beneficial than either watching a child over a long period of time or performing myringotomy alone. However, the panelists made a plea that each child should be individualized on the basis of the duration of the effusion, the child's response to medication, the time of the year, distance from health care providers and other factors. Dr. Gates stressed that hearing loss was an important factor, but if hearing loss is a deciding factor, then serial audiograms or at least some assessment of hearing in the clinician's office should be performed. He also stated that there is now evidence that adenoidectomy is effective in certain children, but there is still an 80% recurrence rate and a 15% rate of failure in which children require repeat surgery. Dr. Bluestone suggested that parents and the child (if old enough) should be informed of what is known about the risks, costs and benefits of these surgical procedures. He recommended the clinician discuss with the parents the pros and cons of performing or not performing surgery, including the complications and sequelae of otitis media and also of tube insertion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoidectomy↗
PubMed1986

Management of facial palsy caused by birth trauma.

We present a newborn with a unilateral complete facial palsy caused by birth trauma, and discuss the differential diagnosis, pathophysiology, and management of this common, usually benign, condition. This child made a rapid, complete, spontaneous recovery despite a severe initial injury. Surgical exploration of the facial nerve should be considered only for infants with complete paralysis, clinically and electrophysiologically, who demonstrate no improvement by 5 weeks of age.

Craniocerebral Trauma↗
PubMed1985

Nasal surgery in children with cystic fibrosis: complications and risk management.

Children with cystic fibrosis (CF) are predisposed to pansinusitis and nasal polyposis and, therefore, require frequent surgery by otolaryngologists. These children are at risk to have complications following surgery, both locally, at the surgical site, as well as systemically from their underlying pulmonary disease. A 20-year retrospective study of children (average census 219 per year) revealed 39 children developed nasal polyps and these children required 85 nasal polypectomies. No major complications occurred and only three minor complications (fever, minor bleeding) were noted. Over 95% of our CF children were able to return home in less than 48 hours, and extensive hospital stays appeared not to be required.

Adolescent↗
PubMed1985

Diagnosis and treatment of sinusitis.

Maxillary and ethmoid sinusitis may occur at any age. Frontal sinus infections first appear in adolescence. The bacteria that cause sinusitis are similar to those associated with otitis media. Streptococcus pneumoniae and Hemophilus influenzae are recovered from 50 to 70 percent of isolates. Anaerobes are also important pathogens in adults. Fungal sinusitis usually occurs only in diabetics or immunosuppressed individuals.

Humans↗
PubMed1984

Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized and nonrandomized clinical trials.

We studied the efficacy of tonsillectomy, or tonsillectomy with adenoidectomy, in 187 children severely affected with recurrent throat infection. Ninety-one of the children were assigned randomly to either surgical or nonsurgical treatment groups, and 96 were assigned according to parental preference. In both the randomized and nonrandomized trials, the effects of tonsillectomy and of tonsillectomy with adenoidectomy were similar. By various measures, the incidence of throat infection during the first two years of follow-up was significantly lower (P less than or equal to 0.05) in the surgical groups than in the corresponding nonsurgical groups. Third-year differences, although in most cases not significant, also consistently favored the surgical groups. On the other hand, in each follow-up year many subjects in the nonsurgical groups had fewer than three episodes of infection, and most episodes among subjects in the nonsurgical groups were mild. Of the 95 subjects treated with surgery, 13 (14 per cent) had surgery-related complications, all of which were readily managed or self-limited. These results warrant the election of tonsillectomy for children meeting the trials' stringent eligibility criteria, but also provide support for nonsurgical management. Treatment for such children must therefore be individualized.

Adenoidectomy↗
PubMed1984

The compleat otolaryngologist: Burton Alexander Randall.

The practicing otolaryngologist and resident is the beneficiary of a highly organized educational system which has evolved over the past 100 years. A number of social, scientific and technical advances were involved in the evolution of these training programs; however, one of the most important developments was the emergence of the Clinician Educator Concept. Burton Alexander Randall was prominent in the profession in the late nineteenth century and early twentieth century and is an example of the clinician-teacher who participated in the development of otorhinolaryngologic instruction. His unpublished memoirs, recently made available, illustrate the difficulties in obtaining appropriate training, organizing clinical services, and establishing professional relationships. These interesting documents provide insight into the present and illustrate that although there have been great technical advances, some problems in interpersonal relationships remain the same.

Education, Medical↗