Surgical management of otologic disease in pediatric patients with Turner syndrome

Purpose: To describe surgical management and establish visual outcomes of open globe injury (OGI) in pediatric patients requiring vitrectomy. Methods: Forty-eight eyes of 48 pediatric patients underwent vitrectomy for OGI with secondary vitreoretinal complications in the eye center of Jilin University were included. Characteristics of patients, details of ocular examination and operation, presenting and final visual acuity were recorded. Results: Presenting visual acuity less than 20/400 was found in 44 eyes (91.7%), which included no light perception (NLP) in four eyes. At last visit, there was no eyes with visual acuity of NLP, and 19 eyes (39.6%) had a vision recovery to 20/400 or better. Mechanisms of injury, intraocular contents prolapse, presence of hyphema, intraocular foreign body, vitreous hemorrhage, retinal detachment, and total time from injury to PPV > 2 weeks were significant predictors of visual prognosis. Logistic regression analysis showed that hyphema was a significant predictive factor for poor visual outcome. Conclusion: Visual acuity was improved in most of the patients with OGI in this study. Hyphema is an important presenting ocular sign in estimating the post-vitrectomy visual outcome for OGI in children. Proper timing of vitrectomy is suggested, and in this study patients may benefit more with early vitrectomy as less proliferative vitreoretinopathy (PVR) was found together with a better visual acuity.

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0897 Sleep Disordered Breathing In Pediatric Patients With Turner Syndrome

SLEEP ◽

10.1093/sleep/zsaa056.893 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A341-A342

Author(s):

Y A Yu ◽

B V Vaughn

Keyword(s):

Sleep Apnea ◽

Turner Syndrome ◽

Sleep Disordered Breathing ◽

Pediatric Patients ◽

Genetic Disorder ◽

Case Series ◽

Growth Failure ◽

Retrospective Chart Review ◽

Upper Airway Resistance Syndrome ◽

Disordered Breathing

Abstract Introduction Turner syndrome (TS) is a common genetic disorder that affects phenotypic females with partial or complete absence of one X chromosome. It typically presents with characteristic facial appearance, neck webbing, lymphedema, linear growth failure, and ovarian insufficiency. TS is also associated with other disorders, though sleep related disorders are not commonly reported. We present a case series of pediatric patients diagnosed with TS and assess their risk for sleep disordered breathing. Methods This study utilized retrospective chart review of the electronic medical record at the University of North Carolina at Chapel Hill from April 2014 to January 2019. Only pediatric patients under the age of 18 years who had previously undergone polysomnography and carrying the diagnosis of Turner syndrome were included in this study. Polysomnography results were reviewed. Results Retrospective chart analysis yielded ten (10) patients who qualified for inclusion. The mean age was 8.3 years (age range 1-15 years). Nine (9) patients were found to have sleep disordered breathing ranging from upper airway resistance syndrome to moderate sleep apnea (AHI range 1.2 to 6.2). Six (6) patients were found to have elevated periodic limb movement indices (PLM index range 5.1 to 30). Parasomnias and hypoventilation were not seen. Conclusion Our case series illustrates that sleep disordered breathing may be more common in TS than previously realized. Eklund et al. found that females with TS had more retrognathic mandibles and maxillas, shorter mandibles, and larger cranial base angles. These findings may indicate elevated risk of sleep apnea. Further studies are needed to define the overall risk of sleep disordered breathing in TS. Support None.

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Clinical implications and surgical management of intussusception in pediatric patients with Burkitt lymphoma

Journal of Pediatric Surgery ◽

10.1016/j.jpedsurg.2007.01.033 ◽

2007 ◽

Vol 42 (6) ◽

pp. 998-1001 ◽

Cited By ~ 46

Author(s):

Himesh Gupta ◽

Andrew M. Davidoff ◽

Ching-Hon Pui ◽

Stephen J. Shochat ◽

John T. Sandlund

Keyword(s):

Surgical Management ◽

Burkitt Lymphoma ◽

Pediatric Patients ◽

Clinical Implications

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Surgical management of pediatric patients with congenital fibrosis of the extraocular muscles

Japanese Journal of Ophthalmology ◽

10.1007/s10384-019-00707-1 ◽

2019 ◽

Vol 64 (1) ◽

pp. 86-92 ◽

Cited By ~ 1

Author(s):

Yoichi Okita ◽

Akiko Kimura ◽

Mana Okamoto ◽

Osamu Mimura ◽

Fumi Gomi

Keyword(s):

Surgical Management ◽

Pediatric Patients ◽

Extraocular Muscles ◽

Congenital Fibrosis

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Laser and the Tuber: Thermal Dynamic and Volumetric Factors Influencing Seizure Outcomes in Pediatric Subjects With Tuberous Sclerosis Undergoing Stereoencephalography-Directed Laser Ablation of Tubers

Neurosurgery ◽

10.1093/neuros/nyz310_422 ◽

2019 ◽

Vol 66 (Supplement_1) ◽

Author(s):

Michael A Stellon ◽

Kelsey Diva Cobourn ◽

Matthew Whitehead ◽

Nancy Elling ◽

William McClintock ◽

...

Keyword(s):

Tuberous Sclerosis ◽

Surgical Management ◽

Pediatric Patients ◽

Dynamic Properties ◽

Invasive Technique ◽

Tuber Tissue ◽

Ablation Volume ◽

Depth Analysis ◽

Cortical Tubers

Abstract INTRODUCTION Tuberous Sclerosis (TSC) is a well-known cause of Medically Refractory Epilepsy (MRE). It is well documented that early surgical management can improve patient outcomes. Stereoencephalography-directed Magnetic Resonance guided Laser Interstitial Thermal Therapy (SEEG-directed MRgLITT) is an emerging minimally invasive technique that appears aptly suited for the surgical management of this condition. Our aims are to present our experiences with patients who had undergone prior SEEG-directed MRgLITT to identify and treat cortical tubers responsible for clinical seizures and to perform an in-depth analysis of volumetric and thermal dynamic factors that may be related to seizure outcomes. METHODS We studied all pediatric patients with MRE due to TSC who underwent SEEG-directed MRgLITT, investigating seizure outcomes in relationship to thermal dynamic and volumetric factors of MRgLITT when applied to cortical tubers. RESULTS About 8 cortical tubers from 3 pediatric patients were analyzed. About 2 out of 3 patients had Engel I outcomes at last follow-up. Median follow-up was 15 mo. Average A/T (ablation volume/tuber volume) ratio for Engel I outcomes was 1.28 (variance, 0.16) and 0.84 (variance < 0.01) for all other outcomes (P = .035). When assessing thermal dynamic properties of cortical tuber tissue, there was a moderate positive correlation when comparing ablation energy to ablation volume (R2 = 0.65). When the calcified tuber is excluded from regression analysis, the correlation is stronger (R2 = 0.77). Thus, the calculated volume to ablate 1 cm3 of cortical tuber tissue is 1263.6 J (calcified tuber) or 1089.5 J (noncalcified tuber). CONCLUSION SEEG-directed MRgLITT is a safe and effective technique in the management of pediatric patients with MRE due to TSC. It appears that the A/T ratio is a useful indicator in predicting seizure outcomes.

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Anxiolysis in the Surgical Management of a Compound Odontoma in a Pediatric Patient

Case Reports in Dentistry ◽

10.1155/2019/1385150 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Pier Paolo Poli ◽

Luca Creminelli ◽

Emma Grecchi ◽

Silvia Pieriboni ◽

Gregorio Menozzi ◽

...

Keyword(s):

Pediatric Patient ◽

Surgical Management ◽

Pediatric Patients ◽

Present Report ◽

Outpatient Basis ◽

Conservative Approach ◽

The Common ◽

Oral Premedication ◽

Negative Feelings ◽

Compound Odontoma

Among odontogenic tumors, odontoma is the most frequent. The common treatment contemplates a conservative approach. While this procedure is generally accepted and tolerated, some difficulties may be encountered in the case of pediatric patients. Indeed, negative feelings of tension, apprehension, nervousness, and fear are likely to occur. The present report is aimed at discussing the management of a compound odontoma in a pediatric patient under anxiolysis with diazepam on an outpatient basis. The surgery was carried out without complications, and the discharge was completed safely. Oral premedication with diazepam should be considered to avoid more invasive sedation procedures in anxious pediatric patients.

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