Endoscopic balloon dilatation of esophageal strictures in children
Children; Pediatrics; experience; management; Dysphagia; Otorhinolaryngology; atresia; Balloon dilatation; conservative treatment; dilation; epidermolysis bullosa; Esophageal strictures; ingestion; repair; feeding difficulties; surgical intervention; endoscopic balloon dilatation
Aim of the study: To assess the efficacy and safety of endoscopic balloon dilatation of esophageal strictures in children. Material and methods: Design: retrospective case series; population: 49 patients under 18 years of age referred to our center for esophageal strictures; treatment: endoscopic balloon dilatation: outcome parameters: residual dysphagia, weight gain, iatrogenic esophageal perforation, assessment of the esophageal lumen by endoscopy or esophagogram. Results: The three main etiologies were esophageal atresia (49%; n = 24), corrosive injury (25%; n = 12), and epidermolysis bullosa (14%; n = 7), followed by a heterogeneous group of rarer causes (12%; n = 6). The number of dilatations ranged from 1 to 8 sessions per patient (median +/- SEM: 2 +/- 0.3). The length of the follow-up period ranged from 20 to 109 months (median +/- SEM: 40 +/- 4 months). Treatment was successful in 86% of cases (n = 42). Twelve percent of patients (n = 6) had a residual stenosis requiring surgery, and a further one still experienced swallowing difficulties requiring enteral nutrition via gastrostomy in spite of the absence of significant residual stricture. Results were less satisfactory in cases of corrosive injury than with other etiologies. Three esophageal perforations were observed (6% of patients; 2% of procedures). All were medically treated. Conclusions: Endoscopic balloon dilatation is a simple, safe and efficacious treatment of esophageal strictures in children. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
Alshammari J; Quesnel S; Pierrot S; Couloigner V
International Journal of Pediatric Otorhinolaryngology
2011
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.ijporl.2011.07.031" target="_blank" rel="noreferrer noopener">10.1016/j.ijporl.2011.07.031</a>
Sleep-disordered breathing and its management in children with achondroplasia
retrospective study; school child; preschool child; human; child; clinical article; surgery; prevalence; apnea hypopnea index; achondroplasia; adenotonsillectomy; neurosurgery; polysomnography; sleep disordered breathing; apnea monitoring; bone dysplasia; upper respiratory tract; breathing difficulties; surgical interventions; physical interventions; ENT surgery; CPAP; BiPAP; cervical decompression; obstructive sleep apnea
Sleep-disordered breathing is a common feature in children with achondroplasia. The aim of our study was to review the poly(somno)graphic (P(S)G) findings and consequent treatments in children with achondroplasia followed in the national reference center for skeletal dysplasia. A retrospective review of the clinical charts and P(S)G of 43 consecutive children (mean age 3.9 +/- 3.5 years) with achondroplasia seen over a period of 2 years was performed. Twenty four (59%) children had obstructive sleep apnea (OSA). Thirteen children had an obstructive apnea-hypopnea index (OAHI) < 5/hr, four had an OAHI between 5 and 10/hr, and seven had an OAHI > 10/hr. Ten of the 15 children who had previous upper airway surgery still had an abnormal P(S)G. All the patients with an AHI > 10/hr were under 7 years of age and none had a prior tonsillectomy. The children who underwent adeno-tonsillectomy, coupled in most cases with turbinectomy, were significantly older (mean age 7.5 +/- 3.5 vs. 3.5 +/- 1.7 years old, P = 0.015) and had significantly better P(S)G results than those who underwent only adeno-turbinectomy. No correlation was observed between the mean AHI value at the baseline P(S)G and the type of academic course (standard, supported or specialized). In conclusion, OSA is common in children with achondroplasia. The observation of a reduced prevalence of OSA after (adeno-)tonsillectomy is in favor of this type of surgery when possible. Copyright © 2017 Wiley Periodicals, Inc.
Tenconi R; Khirani S; Amaddeo A; Michot C; Baujat G; Couloigner V; De Sanctis L; James S; Zerah M; Cormier-Daire V; Fauroux B
American Journal of Medical Genetics Part A
2017
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1002/ajmg.a.38130" target="_blank" rel="noreferrer noopener">10.1002/ajmg.a.38130</a>