An Evidence-Based Practical Approach to Pediatric Otolaryngology in the Developing World

Belcher, Ryan; Molter, David W.; Goudy, Steven L.

doi:10.1016/j.otc.2018.01.007

Cited by 6 publications

(9 citation statements)

References 64 publications

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“…In terms of bronchoscopic data, our findings were consistent with those of Belcher and colleagues [15], who claimed that rigid bronchoscopy is the gold standard for locating and extracting an aspirated FB.…”

Section: Discussionsupporting

confidence: 91%

Bronchotomy as a Safe and Feasible Alternative to Failed Bronchoscopic Removal of Foreign Body Inhalation in Pediatrics. A Seven-Year Review

Elaziz¹,

Eltaweel²,

Elsayed³

et al. 2021

OJTS

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Background: Aspiration of foreign body is popular in pediatric age group and is considered as an important cause of respiratory distress and chocking in these children. Management strategies are different according to the mode of presentation. This study aims to assess the efficacy of rigid bronchoscopy and the role of bronchotomy as a safe alternative for failed removal of inhaled foreign body. Methods: We enrolled 254 patients with foreign body aspiration (FBA) up to 14 years old in a retrospective observational study. Our patients were reviewed from the Cardiothoracic Surgery Department and cases referred from Otorhinolaryngology Department, Menoufia University Hospital between June 2010 and July 2017. Using jet ventilation technique, foreign body was removed by the rigid bronchoscopy with either extracting forceps or postural drainage. Surgical interference such as bronchotomy needed in distally impacted foreign bodies (FBs). Results: Our study included 254 patients prepared for bronchoscopic FBs extraction. Most of cases (68.8%) presented early within first week (174 cases). No FBs detected in 44 cases by rigid bronchoscopy, although it was successful in 176 (69.5%) cases with nonimpacted inhaled FBs. 14 cases only needed postural drainage due to inaccessible FBs, another 12 cases failed to extract FB with rigid bronchoscopy but they were managed with flexible bronchoscopy. Bronchotomy was needed for impacted FBs in eight cases (3%). Conclusion: This study's findings support that rigid bronchoscopy is the gold standard in the diagnosis and removal of foreign body aspirations in pediatrics, but rigid bronchoscopy demonstrated less capability in the diagnosis and removal of small distally located foreign bodies. Bronchotomy is safe and effective alternative.

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Section: Discussionsupporting

confidence: 91%

Bronchotomy as a Safe and Feasible Alternative to Failed Bronchoscopic Removal of Foreign Body Inhalation in Pediatrics. A Seven-Year Review

Elaziz¹,

Eltaweel²,

Elsayed³

et al. 2021

OJTS

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“…[26][27][28] In LMICs, patients typically stay overnight after T&As for 24-hour observation due to concern for bleeding in the immediate postoperative period. 29 CL/CP repairs comprise a large share of global humanitarian service projects due to the low potential for life-threatening side effects and significant quality of life improvement for young children. 29 While this data set demonstrates that the Moore Center reaches patients from across Guatemala, most patients come from the Department of Guatemala City.…”

Section: Discussionmentioning

confidence: 99%

Pediatric Otolaryngology Short‐Term Mission Outcomes at a Surgical Mission Hospital in Guatemala

Richard

Sanchez²,

Amado³

et al. 2023

Otolaryngol.--head neck surg.

Self Cite

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ObjectiveThe frequency of humanitarian surgical mission trips has grown over recent decades. Unfortunately, research on patient outcomes from these trips has not increased proportionately. We aim to analyze the safety and efficacy of surgeries in a low‐ and middle‐income country missions‐based surgery center in Guatemala City, Guatemala, and identify factors that influence surgical outcomes.Study DesignRetrospective cohort study.SettingGuatemalan surgery center is called the Moore Center.MethodsPediatric patients underwent otolaryngology surgery between 2017 and 2019. All patients required follow up. We analyzed the effect of patient, surgical, and geographic factors on follow up and complications with univariate and multivariate analyses.Results A total of 1094 otolaryngologic surgeries were performed between 2017 to 2019, which comprised 37.4% adenotonsillectomies, 26.8% cleft lip (CL)/cleft palate (CP) repairs, 13.6% otologic, and 20% “other” surgeries. Patients traveled on average 88 km to the center (±164 km). Eighty‐nine percent attended their first follow up and 55% attended their second. The 11% who missed their first follow up lived farther from the center (p < .001) and had a higher ASA classification (p < .001) than the 89% who did attend. Sixty‐nine (6.3%) patients had 1 or more complications. CL/CP surgery was associated with more complications than other procedures (p < .001). Of 416 tonsillectomies, 4 patients (1%) had a bleeding episode with 2 requiring reoperation.ConclusionThis surgical center models effective surgical care in low‐resource areas. Complications and follow‐up length vary by diagnosis. Areas to improve include retaining complex patients for follow up and reducing complications for CL/CP repair.

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“…Out of these infectious causes, congenital CMV is the most common cause of non-hereditary SNHL in childhood. Most estimates from studies conducted in Europe, the United States, and Japan show the prevalence of congenital CMV varies from 0.2 to 2.0%, but much higher in developing countries at 6-14% (5). CMV infection is congenital if diagnosed within 21 days postnatally.…”

Section: Non-genetic Etiology Work-upmentioning

confidence: 99%

Genetic and Non-genetic Workup for Pediatric Congenital Hearing Loss

et al. 2021

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Hearing loss is one of the most common concerns for presentation for a geneticist. Presentation prior to the age of one (congenital hearing loss), profound sensorineural hearing loss (SNHL), and bilateral hearing loss are sensitive and should raise concern for genetic causes of hearing loss and prompt referral for genetic testing. Genetic testing particularly in this instance offers the opportunity for anticipatory guidance including possible course of the hearing loss over time and also connection and evaluation for additional congenital anomalies that may be associated with an underlying syndrome vs. isolated genetic hearing loss.

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An Evidence-Based Practical Approach to Pediatric Otolaryngology in the Developing World

Cited by 6 publications

References 64 publications

Bronchotomy as a Safe and Feasible Alternative to Failed Bronchoscopic Removal of Foreign Body Inhalation in Pediatrics. A Seven-Year Review

Bronchotomy as a Safe and Feasible Alternative to Failed Bronchoscopic Removal of Foreign Body Inhalation in Pediatrics. A Seven-Year Review

Pediatric Otolaryngology Short‐Term Mission Outcomes at a Surgical Mission Hospital in Guatemala

Genetic and Non-genetic Workup for Pediatric Congenital Hearing Loss

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