scholarly journals Analysis of tracheotomy indications in children treated in the Department of Pediatric Otolaryngology of Medical University of Warsaw between 2015-2020

New Medicine ◽  
2020 ◽  
Vol 24 (2) ◽  
Author(s):  
Małgorzata Chromniak ◽  
Maria Koziołek ◽  
Katarzyna Pawlik ◽  
Monika Jabłońska-Jesionowska ◽  
Lidia Zawadzka-Głos
Keyword(s):  
Autoimmune Diseases ◽  
Congenital Malformation ◽  
Vocal Folds ◽  
Congenital Defects ◽  
Perinatal Complications ◽  
Airway Patency ◽  
Pediatric Otolaryngology ◽  
Post Intubation ◽  
Malformation Syndromes ◽  
Medical University

Introduction. Tracheostomy is the opening enabling breathing without the larynx, throat and mouth, which aims to restore and sustain airway patency. Indications of this intervention have changed over the years. The selection of patients for this procedure, as well as the moment, when it has to be performed are still not clearly defined. Those require a multidisciplinary approach and a standardized protocol. More analyses are necessary to create widely available guidelines. Aim. Analysis of tracheotomy indications in children performed between 2015-2020 in the Department of Pediatric Otolaryngology, Medical University of Warsaw. Material and methods. During the 5-year period (2015-beginning of 2020) 64 children with tracheostomy were treated in the Department of Pediatric Otolaryngology. Groups of tracheotomy indications were separated after a retrospective overview of the 64 cases from our clinic and after manual and electronic search through medical databases for indications for tracheotomy in previous years. Then patient’s data (age at the time of surgery, concomitant diseases and/or disabilities) was collated, which allowed to present the characteristics of children and compare the tracheotomy indications in previous years with the results of this research. Results. Tracheotomy was performed among 64 children. The median patients’ age was 0.5 year and the average age was 4.26 years. Our patients were affected by many various conditions. We divided them into 8 main groups: congenital malformation syndromes, trauma, vocal folds palsy, perinatal complications, infection, autoimmune diseases, oncological and post-intubation subglottic stenosis. Currently, congenital malformation syndromes turned out to be the most common indication for tracheotomy. Conclusions. 1. Tracheotomy indications in children have changed over the years. 2. There is increasing number of tracheotomies due to various congenital defects. 3. New groups of tracheotomy indications among children are autoimmune diseases and injuries; those groups have the highest average of age. 4. The result of effective pharmacological treatment of laryngeal hemangiomas is the lack of tracheotomy performed in this indication. 5. The number of tracheotomies performed due to post-intubation stenosis has decreased. 6. Vocal cords palsy as an indication for tracheotomy in children is most often a complication of cardiac surgery due to congenital heart defect; this group of patient’s is the youngest among all. 7. Viral infections are still the tracheotomy indication among children.

Congenital malformation syndromes and elevation of amniotic fluid α1-fetoprotein

Teratology ◽  
1981 ◽  
Vol 24 (2) ◽  
pp. 125-130 ◽  
Author(s):  
Uta Burck ◽  
Karsten R. Held ◽  
Hans-J. Kitschke ◽  
Martin Carstensen
Keyword(s):  
Amniotic Fluid ◽  
Congenital Malformation ◽  
Malformation Syndromes

scholarly journals SPECIFICS AND DIAGNOSTIC PROCEDURE IN REFLUX-RELATED DYSPHONIA

2020 ◽  
Vol 73 (4) ◽  
pp. 814-817
Author(s):  
Klaudia Sowa ◽  
Anna Łobaczuk-Sitnik ◽  
Bartosz Piszczatowski ◽  
Emilia Duchnowska ◽  
Bożena Kosztyła-Hojna ◽  
...  
Keyword(s):  
Chronic Diseases ◽  
Reflux Disease ◽  
Laryngopharyngeal Reflux ◽  
Morphological Changes ◽  
Voice Disorders ◽  
Vocal Folds ◽  
Congenital Defects ◽  
Upper Respiratory Tract ◽  
Laryngopharyngeal Reflux Disease ◽  
Pharynx Cancer

Voice is a work tool for many professional groups. Currently, cases of dysphonia of multiple origin consist a growing issue. Voice disorders may result from disturbed voice production process, congenital defects, post-traumatic conditions, chronic diseases or hormonal disorders. Chronic diseases causing voice disorders include laryngopharyngeal reflux disease and esophageal reflux disease. The chronic character of reflux causes the formation of numerous morphological changes of the larynx, including: hyperemia of the mucosa limited to arytenoid and intraarytenoid area, edema of the vocal folds, edema of the larynx mucosa. These changes contribute to voice disorders. Among the pathological changes of voice organ etiologically associated with reflux, the following disease units may be distinguished: reflux laryngitis, subglottic edema, contact ulceration, larynx granuloma, larynx and pharynx cancer. Many of disorders in the upper respiratory tract are etiologically related to reflux, e.g. dysphonia, grunting, coughing and dyspnoea.

THE CARPALS IN CONGENITAL MALFORMATION SYNDROMES

1971 ◽  
Vol 112 (3) ◽  
pp. 443-459 ◽  
Author(s):  
ANDREW K. POZNANSKI ◽  
JOHN F. HOLT
Keyword(s):  
Congenital Malformation ◽  
Malformation Syndromes

scholarly journals Diagnostic difficulties in children with iatrogenic vocal cord paralysis in the material of the Department of Pediatric Otolaryngology of the Medical University of Warsaw

New Medicine ◽  
2018 ◽  
Vol 22 (1) ◽  
Author(s):  
Monika Jabłońska-Jesionowska ◽  
Lidia Zawadzka-Głos
Keyword(s):  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Signs And Symptoms ◽  
Diagnostic Methods ◽  
Prolonged Intubation ◽  
Pediatric Otolaryngology ◽  
Diagnostic Difficulties ◽  
Integrated Interpretation ◽  
Medical University ◽  
Unilateral Vocal Cord Paralysis

Introduction. The causes of vocal cord paralysis in children include congenital malformations, nervous system disorders, and iatrogenic causes. The paralysis may affect one or both cords. The signs of bilateral vocal cord paralysis include respiratory stridor of varying severity, and even acute respiratory failure. The signs and symptoms of unilateral vocal cord paralysis include phonation and swallowing disorders, as well as respiratory stridor associated with partial stenosis of already physiologically narrow airways in children. Diagnosing the cause for vocal cord paralysis in children is difficult. Aim. The aim of the study was to analyze the causes of iatrogenic vocal cord paralysis, as well as to assess the usefulness of diagnostic methods used in children with iatrogenic vocal chords paralysis. Material and methods. A retrospective analysis of clinical data of 20 children with iatrogenic vocal cord paralysis under the care of the Department of Pediatric Otolaryngology of the Medical University of Warsaw in 2017 was conducted. Results. The study group included 13 boys and 7 girls aged from 1 month of age to 10 years of age; median age at the diagnosis was 3 months. In 17 children, bilateral paralysis was diagnosed, and 3 children were diagnosed with unilateral paralysis. The cause of iatrogenic vocal cord paralysis in 7 children was cardiac surgery, in 1 ? thoracic surgery, in 7 ? prolonged intubation, in 3 ? perinatal hypoxia, and in 2 ? vincristine chemotherapy. Conclusions. The diagnosis of iatrogenic vocal cord paralysis is difficult. The applied diagnostic methods require an integrated interpretation. The larynx ultrasound (US) examination remains very useful in the assessment of the vocal cords mobility in children, however, it is not possible to perform this examination in intubated patients. Fiberoscopy, performed under local anesthesia, is widely available, however, performing it on a narrow larynx of a child may cause respiratory disorders. US and fiberoscopy in infants should be supplemented by direct laryngoscopy in order to exclude congenital airway defects that may have symptoms similar to them. In any case, neurological disorders and genetic defects causing vocal cord paralysis must be excluded.

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