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At least 937 records · Page 52Linked to original sources
PubMed2005

Gastroesophageal reflux disease: its importance in ear, nose, and throat practice.

OBJECTIVE: Gastroesophageal reflux disease (GERD) has been implicated in various extra-gastroesophageal diseases, especially in the upper and lower airways (atypical GERD). The objective of the present study was to determine the frequency of gastroesophageal and extra-gastroesophageal symptoms in pediatric patients with GERD and their response to the general treatment. MATERIAL AND METHODS: A retrospective study was conducted on 45 children of both sexes aged 3 months-12 years with GERD diagnosed by clinical examination and 24h single-channel pHmetry. The gastroesophageal and extra-gastroesophageal symptoms, the treatment instituted and the response of the patients to the latter were determined. RESULTS: Five symptomatologic groups were identified: gastroesophageal (51.11%), pulmonary (recurrent pneumonia, 40%, and bronchial asthma, 46.67%), chronic cough (64.44%), rhinologic (chronic nasal obstruction, 68.88%, nasal secretion, 55.55%, and nose itching, 46.66%), and pharyngo-otologic (recurrent acute middle ear infection, 35.56%, and recurrent tonsillitis, 24.44%). The response to treatment (antireflux drugs, antiallergic drugs, and surgical procedures) resulted in cure in 24 patients (53.34%), while 21 continued to be symptomatic. The cure rate was 69.56% for the gastroesophageal group, 100% for the recurrent pneumonia group, 80.95% for the bronchial asthma group, 68.96% for the chronic cough group, 83.87% for the chronic nasal obstruction group, 80% for the nasal secretion group, 85.71% for the nose itching group, 100% for the recurrent acute middle ear infection group, and 90.90% for the recurrent tonsillitis group. Total treatment time was 1.8 times longer for the remission of extra-gastroesophageal symptoms. Exclusive antireflux treatment promoted full remission of the otorhinolaryngologic symptoms in 38.89% of patients (nasal-41.17%, recurrent acute middle ear infection-12.5%, and recurrent tonsillitis-18.18%). CONCLUSION: GERD can cause otorhinolaryngologic symptoms in children and remission of these symptoms can be obtained with antireflux therapy.

Anti-Allergic Agents↗
PubMed2005

The influence of tonsillitis on oral and throat muscles in children.

OBJECTIVES: Surface electromyography (sEMG) studies were performed on 80 children with acute tonsillitis (AT) and 110 children with recurrent tonsillitis (RT), age 4-12 years, to trace sEMG changes of duration and amplitude of muscle activity during swallowing and continuous drinking. STUDY DESIGN: Prospective observational study of randomly chosen patients compared to normative database. METHODS: Timing and amplitude (in muV) of activity of masseter, submental and infrahyoid muscles were evaluated during voluntary single swallows of saliva ("dry" swallow), water swallows, swallows of excessive amount of water (up to 15 ml), and continuous drinking of 50 ml of water. These parameters were measured for two age groups for both conditions: 4-8 and 9-12 years old. The previously established normative database was taken for control. RESULTS: AT presents prolonged duration of swallowing and electric hyperactivity of infrahyoid muscles but this activity returns to normal after recovery. RT affects masseter and infrahyoid muscles even during periods of remission but do not affect duration of swallowing activity. CONCLUSION: AT and RT in children age 4-12 years affects muscle activity during swallowing significantly by involving additional muscles (mainly infrahyoid) in this process. AT presents temporary electric hyperactivity of infrahyoid muscles. RT affects masseter and infrahyoid muscles even during periods of remission (pathologic changes are fixed). Abnormally high electric activity of masseter and infrahyoid muscles in patients with RT might serve as an additional indicator for tonsillectomy. Surface EMG of swallowing is a simple, non-invasive and reliable method for diagnostic and preoperative evaluation of dysphagia complaints associated with tonsillitis.

Child↗
PubMed2006

Performance and customization of 4 prognostic models for postoperative onset of nausea and vomiting in ear, nose, and throat surgery.

OBJECTIVE: To evaluate the performance of 4 published prognostic models for postoperative onset of nausea and vomiting (PONV) by means of discrimination and calibration and the possible impact of customization on these models. DESIGN: Prospective, observational study. SETTING: Tertiary care university hospital. PATIENTS: 748 adult patients (>18 years old) enrolled in this study. Severe obesity (weight > 150 kg or body mass index > 40 kg/m) was an exclusion criterion. INTERVENTIONS: All perioperative data were recorded with an anesthesia information management system. A standardized patient interview was performed on the postoperative morning and afternoon. MEASUREMENTS: Individual PONV risk was calculated using 4 original regression equations by Koivuranta et al, Apfel et al, Sinclair et al, and Junger et al Discrimination was assessed using receiver operating characteristic (ROC) curves. Calibration was tested using Hosmer-Lemeshow goodness-of-fit statistics. New predictive equations for the 4 models were derived by means of logistic regression (customization). The prognostic performance of the customized models was validated using the "leaving-one-out" technique. MAIN RESULTS: Postoperative onset of nausea and vomiting was observed in 11.2% of the specialized patient population. Discrimination could be demonstrated as shown by areas under the receiver operating characteristic curve of 0.62 for the Koivuranta et al model, 0.63 for the Apfel et al model, 0.70 for the Sinclair et al model, and 0.70 for the Junger et al model. Calibration was poor for all 4 original models, indicated by a P value lower than 0.01 in the C and H statistics. Customization improved the accuracy of the prediction for all 4 models. However, the simplified risk scores of the Koivuranta et al model and the Apfel et al model did not show the same efficiency as those of the Sinclair et al model and the Junger et al model. This is possibly a result of having relatively few patients at high risk for PONV in combination with an information loss caused by too few dichotomous variables in the simplified scores. CONCLUSIONS: The original models were not well validated in our study. An antiemetic therapy based on the results of these scores seems therefore unsatisfactory. Customization improved the accuracy of the prediction in our specialized patient population, more so for the Sinclair et al model and the Junger et al model than for the Koivuranta et al model and the Apfel et al model.

Adolescent↗
PubMed2005

Bilateral peritonsillar abscesses: not your usual sore throat.

We describe a rare case of a previously healthy 30-year-old man who presented to the Emergency Department (ED) with bilateral peritonsillar abscesses. The clinical presentation of fever, trismus and odynophagia was consistent with pertonsillar abscess (PTA), but the presence of symmetric tonsillar swelling and midline uvula confounded the diagnosis. The true incidence of bilateral peritonsillar abscesses is unknown, but the incidence of unsuspected contralateral peritonsillar abscess identified at tonsillectomy has been reported to be between 1.9% and 24%. The diagnosis of bilateral peritonsillar abscesses should be considered when the clinical presentation suggests the diagnosis of PTA, but the physical examination reveals bilateral swollen tonsils with a midline uvula.

Adult↗