Head and neck dog bites in children.

Objectives: 1) Demonstrate patterns of dog bite injury to the head and neck in children. 2) Identify treatment outcomes of dog bite injuries to the head and neck.

Study Design: Case series with chart review.

Cochlear implantation and meningitis.

Objective: Study clinical presentation, diagnosis and treatment of cochlear implant patients diagnosed with bacterial meningitis.

Background: Cochlear implantation in children is necessary for the optimal development of speech in the developing child diagnosed with profound sensorineural hearing loss. Approximately 60,000 devices have been inserted in adults and children worldwide to date.

A new technique (the NOW test) for the detection of Streptococcus pneumoniae in the effusions of otitis media.

The presence of Streptococcus pneumoniae in chronic otitis media was determined with a new antigen detection kit, the NOW test. The NOW test was originally designed as a urinary antigen test but was adapted to middle-ear effusions for the present study. Middle-ear effusions from 52 children were studied.

Incidence of reflux in young children undergoing adenoidectomy.

Objective: To compare the incidence of gastroesophageal reflux disease (GERD) in children under 2 years of age who have symptomatic adenoid hypertrophy requiring surgical removal or who have otitis media with effusion requiring ventilation tube insertion without adenoidectomy.

Study Design: Retrospective chart review.

Setting: An academic pediatric otolaryngology unit.

Complications in pediatric tracheostomies.

Objective: To examine complications of pediatric tracheostomy.

Study Design: Retrospective.

Methods: Chart review of children undergoing tracheotomy or laryngeal diversion between 1990 and 1999.

Success rates in paediatric tympanoplasty.

Objective: To determine if the success of paediatric tympanoplasty is dependent on certain criteria, which are determinable prior to surgery.

Design: Retrospective chart review.

Setting: An academic paediatric otolaryngology department.

Correlation of findings at direct laryngoscopy and bronchoscopy with gastroesophageal reflux disease in children: a prospective study.

Objective: To correlate direct laryngoscopic and bronchoscopic findings with the presence of positive test results for gastroesophageal reflux disease (GERD) in children.

Design: Prospective collection of structured data.

Setting: An academic pediatric otolaryngology department.

Optimizing effectiveness of laser tympanic membrane fenestration in chronic otitis media with effusion. Clinical and technical considerations.

Objective: To describe the patient, disease and clinical characteristics that optimize the effectiveness of laser tympanic membrane fenestration (LTMF) to treat chronic otitis media with effusion (OME).

Setting: Four pediatric otolaryngology tertiary referral centers. IRB approved; participation by informed consent.

Effectiveness of adenoidectomy and laser tympanic membrane fenestration.

Objective: Adenoidectomy alone or with tonsillectomy (A+/-T) is an effective surgical intervention in the management of otitis media in children, especially when it is performed in conjunction with insertion of pressure equalization tubes (PETs). Otorrhea and persistent tympanic membrane (TM) perforation are frequent complications. This study evaluates the effectiveness of intermediate duration middle ear ventilation using laser tympanic membrane fenestration (LTMF) without tube insertion and as an adjunct to adenoidectomy in resolving middle ear disease within the first 90 days after surgery.

Correlation of findings on direct laryngoscopy and bronchoscopy with presence of extraesophageal reflux disease.

Objective: To determine the correlation between findings at direct laryngoscopy and bronchoscopy and presence of extraesophageal reflux disease (EERD).

Study Design: Retrospective chart review

Methods: Operative notes of 155 children undergoing direct laryngoscopy and bronchoscopy between 1996 and 1999 for airway symptoms for whom there was a suspicion of EERD were examined. Gastroesophageal reflux disease (GERD) was considered present if at least one test was positive (including upper GI series, pH probe, gastric scintiscan, or esophageal biopsy).

Clinical presentation as a guide to the identification of GERD in children.

Objective: to determine if there is a correlation between common otolaryngologic symptoms and presence of gastroesophageal reflux disease (GERD) in children.

Methods: charts of 295 children presenting with suspicion of GERD were reviewed for presenting symptoms including: (1) airway symptoms: stertor, stridor, frequent cough, recurrent croup, wheezing, nasal congestion, obstructive apnea, blue spells, hoarseness, throat clearing; (2) feeding symptoms: wet burps, globus sensation, frequent emesis, dysphagia, choking/gagging, sore throat, halitosis, food refusal, stomach aches, arching, drooling, chest pain, irritability, and failure to thrive. At least one positive test of barium esophagram, gastric scintiscan, pH probe or esophageal biopsy resulted in inclusion in the GERD positive group.

Sinusitis-associated epidural abscess presenting as posterior scalp abscess--a case report.

Complications of paranasal sinusitis constitute true surgical and medical emergencies. These complications appear to be more prevalent and seem to present in a more fulminant manner in the pediatric age group. The most common complication of paranasal sinusitis is orbital cellulitis followed collectively by all the intracranial complications.

Persistent cerebrospinal fluid otorrhea: a case of Munchausen's syndrome by proxy.

A case is presented of a young child who initially presented with recurrent bacterial meningitis 1 year after significant head trauma and was found to have cerebrospinal fluid (CSF) leakage into the middle ear. Surgical procedures were devised to attempt to stop this abnormal flow, but inexplicably clear otorrhea biochemically identical to CSF persisted for weeks. The child's mother was apparently soaking the surgical dressings with CSF obtained through a lumbar drain and confessed to this activity after she was found to have tampered with an intravenous catheter.

Cochlear nerve activity after intense sound exposure in neonatal chicks.

1. Single-neuron behavior in the cochlear nerve of neonatal (3-day-old) chicks was examined after exposure to a 120-dB SPL pure tone (0.9 kHz) for 48 h.

The effects of exposure to intense sound on the DC endocochlear potential in the chick.

Chicks were exposed to an intense pure tone (0.9 kHz, 120 dB SPL) for 48 h. The DC endocochlear potential was measured with a microelectrode inserted into scala media in six separate groups of animals between 0 and 12 days post exposure.

Recovery of auditory function and structure in the chick after two intense pure tone exposures.

Groups of neonatal chicks were examined in three experimental conditions that differed in the age and number of times they were exposed to a pure tone of 0.9 kHz at 120 dB SPL for 48 h. Several animals were exposed once at 2 or 16 days of age, while others were subjected twice to the above stimulus, first at 2 days and then at 16 days.

Tracheo-gastric fistula following gastric pull-up.

Tissue damage from gastric acid may be more prevalent than currently believed following gastric pull-up. An intense anti-acid medical regimen should be instituted peri- and postoperatively. In cases where significant peptic ulcer disease exists preoperatively, an alternative means of reconstruction following laryngo-pharyngo-esophagectomy should be considered.