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At least 1,135 records · Page 63Linked to original sources
PubMed2001

Management of outpatient ear, nose and throat surgery.

In the year under review there have been steady advances in anaesthesia. Premedication in children is best achieved with oral midazolam formulated in flavoured syrups, and the inhalational induction of anaesthesia may be accomplished using sevoflurane. Pain management of the most common surgical procedure performed in children, tonsillectomy/adenoidectomy, is still sub-optimal, but combinations of opioids and non-steroidal anti-inflammatory drugs are helpful. There are, however, some concerns regarding the possible increases in postoperative blood loss after tonsillectomy when non-steroidal anti-inflammatory drugs are used. Middle ear surgery leads to a high incidence of postoperative nausea and vomiting, and these are best managed by utilizing a total intravenous anaesthetic technique with propofol, the avoidance of nitrous oxide, and administration of dexamethasone and a 5-hydroxytryptamine receptor antagonist such as ondansetron.

Journal Article↗
PubMed2003

Ear, nose and throat disorders in children with Down syndrome.

OBJECTIVE: To document the reasons for which children with Down syndrome were referred to a pediatric otolaryngology practice, the underlying causes for these referrals, and the complications of routine surgical therapy. STUDY DESIGN: The study is a retrospective review of children referred to the Pediatric Otolaryngology Clinic at the University of New Mexico Health Sciences Center (Albuquerque, NM) during a period of 2.5 years. METHODS: Data were collected on 55 parameters related to ethnicity, demographics, diagnosis, surgical therapy, complications, and systemic comorbid conditions. RESULTS: The ethnicity of the study population was predominantly Hispanic or Latino (62%). The majority of children (76%) were referred for upper airway obstruction. Obstructive sleep apnea and laryngomalacia were the most common disorders in these children. An otological disorder was diagnosed in 70% of the children. Complications occurred after 27% of procedures for insertion of pressure equalization (PE) tubes to treat recurrent otitis media. Systemic comorbid conditions were present in 93% of the children, and the most common was gastroesophageal reflux disease. CONCLUSIONS: Obstructive sleep apnea and laryngomalacia were the most common reasons for referral of children with Down syndrome. Routine surgical procedures that required general anesthesia caused complications that are not common in other children. Treatment for systemic comorbid conditions should be considered as a component of therapy for otolaryngological disorders in children with Down syndrome.

Child↗