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Common ENT Disorders in Children, An Issue of Otolaryngologic Clinics of North America, E-Book

Common ENT Disorders in Children, An Issue of Otolaryngologic Clinics of North America, E-Book

Charles M. Bower

(2014)

Abstract

National health statistics indicate that pediatric ear, nose, and throat disorders remain among the primary reasons children visit a physician, with ear infections ranking as the number one reason. From earaches to choking hazards, from nosebleeds to speech irregularities, children can present with a variety of problems that cause concern to parents and caregivers, who want prompt diagnosis and treatment. The presentation of topics in this issue is clinically ppropriate for Otolaryngologists, Pediatricians, Allergy specialists, and Family Physicians. Topics in this issue of Otolaryngologic Clinics include: Hearing screening and hearing loss; Acute otitis media; Chronic adenotonsilitis; Pediatric dysphagia; Lymphadenopathy; Rhinosinusitis; Facial trauma; Sialadenitis; Behavior and otolaryngology; Stridor; Otolaryngologic management of severe neurodevelopmental delay; Pediatric craniofacial problems.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Common ENT Disordersin Children i
Copyrights ii
Contributors v
Contents vii
Otolaryngologic Clinics Of North America x
Common ENT Disorders in Pediatrics xi
The Otolaryngologist's Role in Newborn Hearing Screening and Early Intervention 631
Key points 631
Introduction 631
Incidence and Program Development 632
Screening Tools 633
Diagnostic Testing 634
Follow-up Challenges 635
Otolaryngologist role in infant hearing 636
Middle Ear Effusion 638
Counseling and Follow-up 639
Diagnostic Testing and Referrals 640
Management 641
Early intervention 642
The importance of early language access 642
ENT Community Education 643
Summary 644
References 645
Contemporary Concepts in Management of Acute Otitis Media in Children 651
Key points 651
Introduction and definitions 651
Epidemiology 652
Pathophysiology and microbiology 653
Diagnosis 653
Otoscopy 654
Management 655
Analgesia 655
Antibiotic Therapy 655
Antibiotic Choice 659
Complications 659
Recurrent AOM and tympanostomy tubes 659
Tympanostomy Tubes 662
Tympanostomy Tube Otorrhea 664
Prevention 665
Complementary and alternative medicine 665
“At-risk” children and otitis media 666
Summary 667
References 667
Pediatric Tonsillectomy 673
Key points 673
Introduction 673
Developmental anatomy 674
Intrauterine Development 674
Tonsillectomy healing 677
Clinical decision making 679
Indications 679
Obstructive sleep apnea 679
Recurrent severe sore throat 679
Procedure 680
Which Tonsillectomy to Do 680
Extracapsular tonsillectomy 680
Intracapsular tonsillectomy and tonsillotomy 681
How to Prevent and Manage Posttonsillectomy Problems 682
Perioperative care 682
Pain 683
Local anesthetics intraoperatively 683
Oral analgesics posttonsillectomy 683
Nonpharmacologic pain relief posttonsillectomy 683
Bleeding 684
Coagulopathies 684
Diet and activity 684
Emergency care 684
Summary 685
References 686
Oropharyngeal Dysphagia in Children 691
Key points 691
Introduction 691
Mechanism of normal and dysfunctional swallowing 692
Age-Related Differences—Maturation of Swallow with Age 694
Etiology of oropharyngeal dysphagia 695
Prematurity 695
Neurologic Disorders 697
Anatomic Contributors to OPD 698
Inflammatory Conditions 700
Evaluation of pediatric oropharyngeal dysphagia 700
History and Physical Examination 700
Chest Radiograph 702
High-Resolution CT Scan 702
MR imaging Scan of Head and Cervical Spine 702
Lipid-Laden Macrophage Index 702
Microlaryngobronchoscopy and Esophagoscopy 703
Instrumental Evaluations of Swallowing 703
Videofluoroscopic swallow study 704
Fibreoptic endoscopic evaluation of swallowing 705
Management of pediatric oropharyngeal dysphagia 706
Initial Management 706
Introducing Safe Alimentation 709
OPD Follow-Up 710
Neurologic OPD 712
Clinical Course 713
Weaning and Precautions 714
Summary 715
References 715
Pediatric Cervical Lymphadenopathy 721
Key points 721
Introduction 721
Anatomic and physiologic considerations 722
Clinical presentation and physical examination 722
Differential diagnosis 723
Diagnostic modalities 727
Fine-needle aspiration biopsy 728
Indications for open biopsy 728
Summary 729
Acknowledgments 729
References 729
Pediatric Rhinosinusitis 733
Key points 733
Overview 733
Pathophysiology 734
Acute rhinosinusitis 735
Diagnosis 735
Treatment 736
Chronic rhinosinusitis 737
Diagnosis 737
Treatment 738
Gastroesophageal reflux 739
Surgery for CRS 739
Subperiosteal abscess of the orbit 741
Evaluation of the patient with CRS 741
Surgery for CF 742
Allergic fungal sinusitis 743
Summary 744
References 744
Facial Fractures in Children 747
Key points 747
Introduction 747
Growth and development 747
Epidemiology 748
Diagnosis and initial management 749
Fronto-Orbital Fractures 751
Naso-Orbito-Ethmoid Fractures 751
Orbital Fractures 752
Nasal Fractures 753
Midface and Zygomaticomaxillary Fractures 754
Mandibular Fractures 755
Resorbable fixation 757
Summary 758
References 758
Pediatric Sialadenitis 763
Key points 763
Introduction 763
Anatomy and pathophysiology 764
Clinical presentation and diagnosis 766
Diagnostic modalities 768
Management 769
Preoperative Planning and Anesthetic Considerations 773
Patient Positioning 774
Procedural Approach 774
Postoperative Care 775
References 776
Comorbid Psychosocial Issues Seen in Pediatric Otolaryngology Clinics 779
Key points 779
Introduction 779
Common disorders seen in pediatric otolaryngology clinics with psychosocial comorbidities 779
Hearing loss 780
Obstructed sleep-disordered breathing 781
Cleft lip and palate 782
Psychosocial functioning in the surgery patient 783
ADHD 784
ASD 785
Screening algorithm 787
Summary 789
References 789
Pediatric Stridor 795
Key points 795
Introduction 795
Anatomy and pathophysiology of stridor 796
Physics of Stridor 796
Anatomy of Stridor 798
Supraglottis and pharynx 798
Glottis 799
Subglottis 800
Trachea 800
Evaluation of the stridorous patient 802
History 802
Physical Examination 804
Diagnostic Radiography 806
Multidisciplinary Assessment 808
Gastroenterology 809
Pulmonology 809
Operative Endoscopy 809
Common and illustrative causes of stridor 810
Laryngomalacia 811
Vocal Cord Paralysis 811
Croup 812
Subglottic Stenosis 812
Subglottic Hemangioma 813
Recurrent Respiratory Papillomatosis 814
Tracheomalacia 814
Complete Tracheal Rings 815
Summary 815
References 816
Diagnosis and Management of Patients with Clefts 821
Key points 821
Introduction 821
Embryology 822
Epidemiology 822
Classification 824
Initial evaluation 827
Prenatal Evaluation 827
Nutritionist 829
Nursing 830
Surgeon 830
Infant Evaluation 831
Primary care 831
Cleft team evaluation 831
Speech pathology 832
Nutrition 832
Audiology 833
Genetics 833
Social work 833
Childhood/adolescent new patient evaluation 833
Airway and Breathing 833
Otology and Audiology 834
Speech 834
Dental/Orthodontics 834
Cleft Surgery 835
Neuropsychology 835
Social Work 835
Nutrition 835
Early interventions 835
Airway and Breathing 835
Feeding 836
Ears 836
Presurgical Orthopedics 837
Surgical management 837
Lip Adhesion 837
Cheiloplasty (with or Without Primary Rhinoplasty) 838
Palatoplasty 840
Columellar Lengthening 840
Secondary Speech Surgery 841
Lip Revision and/or Intermediate Tip Rhinoplasty 842
Alveolar Ridge Bone Grafting 842
Septorhinoplasty 843
Orthognathic Surgery 843
Follow-up care 843
Summary 843
Summary of key points 843
References 844
Index 853