No abstract

No abstract

Introduction: Vestibular disorders in pediatric patients is still a controversial subject but has gained relevance over the years. In recent studies, its prevalence varied between 0.7% and 15%. Nevertheless, the true prevalence can be underestimated given that its clinical presentation is expressed compared to adults; it can present as rotatory vertigo, but It can also cause vision complaints, headaches, motor delay, and learning disability. Although middle ear effusion is considered the main cause of vestibular dysfunction in this age group, other diagnoses should be considered. The aim of this study was to describe clinical features of the pediatric population referred to a subspecialist Otorhinolaryngology vertigo clinic in a tertiary hospital between 2013 and 2017. We also aimed to compare the results and carry out a literature about the most common causes, diagnostic features and treatment approach.Material and Methods: Clinical records of patients referred to a subspecialist Otorhinolaryngology vertigo clinic with suspicion of vestibular dysfunction aged between 0 and 18 years old were reviewed. Patients with middle ear effusion were excluded.Results: Thirty-seven patients met the inclusion criteria. From these, 59% were female, with a mean age of 10.9 years old during the first consultation. The most common reason for referral was rotatory vertigo. Nausea and headache were also frequent complaints in our population. All patients performed audiometry; videonistagmography was performed in 41% of the cases; imaging studies were done in 59% of patients. The most common causes of vestibular dysfunction were vestibular migraine and benign paroxysmal vertigo of childhood (both in 27% of the cases), followed by vestibular neuritis (in 22% of the cases).Discussion: Although our findings partially concur with the literature, compared with other specialist centers, the range of reasons for referral and of conditions is not as diverse, which may suggest that there is underdiagnosis of vestibular dysfunction in this age group.Conclusion: Vestibular dysfunction in the pediatric age can have several causes; pediatricians, neurologists, physiatrists, family doctors and otorhinolaryngologists must be aware of the different forms of presentation. Referral and evaluation protocols addressing pediatric patients should be created.

No abstract

<p class="abstract">Choanal and nasopharyngeal stenosis in adults are extremely rare. They usually are detected and treated in pediatric age as they typically result from congenital malformations. In adulthood, they mostly result from acquired causes such as iatrogenic trauma after surgeries, infectious or autoimmune diseases, or radiotherapy. However, sometimes it is not possible to determine the exact etiology. Treatment is challenging, with restenosis being the most feared and frequent complication. With this case report, we aimed to highlight the diagnostic and treatment approaches for choanal and nasopharyngeal stenoses in adults. We present a 61-year-old patient with persistent bilateral nasal obstruction and discharge, snoring, and recurrent frontal headaches for years which turned out to be a bilateral choanal and nasopharyngeal stenosis. Previously, the patient had been diagnosed with chronic rhinosinusitis without any other relevant medical history. Additionally, no previous surgical procedures or radiation therapy were found to be associated with the etiology. The patient was treated with surgery. A combined modality of trans-nasal endoscopic excision of choanal and nasopharynx fibrous tissue using cold cutting instruments and posterior septectomy followed by the topical application of Mitomycin-C, without stenting, was an effective option.</p>