Pediatric Otolaryngology

Unexpected cholesteatoma in a very young child with a congenital aural duplication anomaly

April 27, 2015     Moo Kyun Park, MD
article

Cholesteatoma can develop in very young children with congenital aural stenosis and a duplication anomaly, and physicians should consider this condition in affected children with otalgia and otorrhea.

Distortion-product otoacoustic emissions testing in neonates treated with an aminoglycoside in a neonatal intensive care unit

April 27, 2015     Iosif Vital, MD; George Psillas, MD; Nikolaos Nikolaides, MD; George Kekes, MD; Stavros Hatzopoulos, MD; John Constantinidis, MD
article

Abstract

We evaluated the ototoxic effect of aminoglycosides on the outer hair cells of newborns in a neonatal intensive care unit (NICU) by means of distortion-product otoacoustic emissions (DPOAE) testing. Our study population was made up of 164 newborns who were divided into three groups: group A consisted of 105 infants who were given aminoglycoside therapy (either gentamicin or amikacin, or a combination of the two) as treatment for suspected or proven bacterial infection and septic states; group B included 30 newborns who were not given an antibiotic or who were given an antibiotic other than an aminoglycoside; group C, a control group, was made up of 29 healthy neonates who were hospitalized in the well-baby nursery. All the neonates underwent DPOAE testing in both ears (the f2 primary tone was presented at 2.0, 2.5, 3.2, and 4.0 kHz). We found that 41 patients in group A (39.0%) and 13 in group B (43.3%) failed the DPOAE test in one or both ears; the difference between these two groups was not statistically significant (p = 0.673). In group C, the DPOAE fail rate was 13.8% (4 newborns). In group A, there was no statistically significant association between the pass/fail rate and the specific aminoglycoside that was administered, or in the duration of antibiotic treatment, the number of doses, and the size of the mean daily dose and the mean total dose. In clinical practice, DPOAE testing is a sensitive method of evaluating the integrity of the outer hair cells in the basal turn of the cochlea after exposure to ototoxic drugs such as aminoglycosides. However, our study did not demonstrate that the aminoglycosides had any ototoxic effect on the hearing of neonates in the NICU.

Unusual presentation of a midline neck mass

January 19, 2015     Yann-Fuu Kou, MD; Gopi Shah, MD, MPH; Ronald Mitchell, MD; Larry L. Myers, MD
article

Venous malformations are usually visible at birth, although deeper lesions may have normal overlying skin or a bluish discoloration. They grow proportionately with the child and can expand in adulthood.

Cherubism

January 19, 2015     Lester D.R. Thompson, MD
article

When there is significant infraorbital maxillary involvement, the inferior rim of the sclera is more prominent, resulting in the classic “eyes to heaven” appearance.

Congenital airway anomaly of double aortic arch in a 2-day-old infant

October 17, 2014     Seo Moon, MD; Jessica Mayor, MD; Ramzi Younis, MD
article

Double aortic vascular ring is a complete vascular ring that is formed when the distal portion of the right dorsal aorta fails to regress and the ascending aorta bifurcates to surround and compress both trachea and esophagus and rejoins to form the descending aorta.

Lingual hamartoma associated with a cleft palate in a newborn

October 17, 2014     Opeyemi O. Daramola, MD; Mariko Suchi, MD, PhD; Robert H. Chun, MD
article

Abstract

A hamartoma is a benign malformation of native tissue that may occur in any area of the body. Hamartoma of the tongue is a rare developmental lesion. We describe the case of a pendulant lingual hamartoma in a 2-day-old girl that had not been identified on prenatal ultrasonography. We also review the utility of prenatal imaging options, the role of preoperative imaging, the mechanical relationship between lingual hamartoma and cleft palate, the histopathology of this tumor, surgical treatment, and emergency airway management.

Evidence-based update on tympanostomy tube placement for otitis media in children

July 13, 2014     Jeffrey Cheng, MD; Lisa Elden, MD
article

Controversy has grown over the indications, timing, and efficacy of tympanostomy tube placement compared with watchful waiting.

Pediatric rhabdomyosarcoma

July 13, 2014     Rosemary Ojo, MD; Si Chen, MD; Liset Pelaez, MD; Ramzi Younis, MD
article

All children with rhabdomyosarcoma require multimodality therapy to maximize local tumor control. This can involve different combinations of chemotherapy, surgery, and radiation therapy.

Pediatric sensorineural hearing loss

June 8, 2014     Dennis J. Kitsko, DO, FACS, FAOCO
article

Children with hearing loss should avoid noise exposure, and families should be counseled to protect their child's hearing environment and to educate their children about the long-term need to avoid excessive noise exposure.

How do pediatric adenoidectomy and adenotonsillotomy influence maternal psychological status?

June 8, 2014     Olaf Zagolski, MD, PhD and Jan Kulisiewicz, MD, PhD
article

Abstract

We conducted a study to determine the impact that pediatric adenoidectomy or adenotonsillotomy (adenoidectomy with a partial tonsillectomy) had on the short-term psychological status of the children's mothers. Mothers of 100 treated children were examined with the 14-item Hospital Anxiety and Depression Scale (HADS) questionnaire immediately before the operation and 3 days afterward; to establish a baseline for control purposes, they completed another questionnaire 10 days postoperatively. We also compiled data for the mothers' demographic information and the children's physical status. In the preoperative period, we found that (1) the anxiety scores of half the mothers were abnormal, (2) depression scores were higher in the adenotonsillotomy group, and (3) anxiety and depression scores were lower in the mothers with more education and in the mothers who had a personal or family history of previous surgery. At 3 days postoperatively, anxiety and depression scores were again lower in the more educated mothers, and lower in the absence of postoperative fever. We conclude that mothers whose children are undergoing adenoidectomy or adenotonsillotomy, particularly the latter, and those with less education may require some psychological intervention. Such help may also be needed when postoperative complications occur.

A "nail-biting" case of an airway foreign body

May 7, 2014     Parker A. Velargo, MD; Jennifer D. McLevy, MD
article

While cases of large, completely obstructing foreign bodies in the subglottis would lead to sudden respiratory distress, the initial presentation of smaller foreign bodies in the subglottis can be quite similar to croup, presenting with biphasic stridor, cough, and/or the steeple sign.

Pediatric cervical sympathetic chain schwannoma with Horner syndrome: A rare case presentation

March 18, 2014     Sanjeev Bhagat, MS; Saurabh Varshney, MS; Sampan S. Bist, MS; and Nitin Gupta, MS
article

Abstract

Schwannomas are rare, benign, slowly growing neurogenic tumors that originate in peripheral, spinal, or cranial nerves other than the optic and olfactory nerves. In the head and neck, these tumors usually arise from the vagus nerve and the cervical sympathetic chain in the parapharyngeal space. Cervical sympathetic chain schwannomas represent a rare subgroup of schwannomas; fewer than 60 cases have been reported in the literature. These tumors are rarely seen in children and adolescents. Because patients typically present with an asymptomatic neck mass and vague complaints, clinical suspicion is important in making the diagnosis. Neural deficits at presentation are uncommon. The presence of features of Horner syndrome before excision is very rare, having been previously reported in only 10 cases of cervical sympathetic chain schwannoma. We report an extremely rare case of a cervical sympathetic chain schwannoma in a child who presented with Horner syndrome. The lesion was successfully excised.

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