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[The implementation of non-effective care - how and why].
Ned Tijdschr Geneeskd
December 2023
Amsterdam UMC, afd. Public and Occupational Health, Amsterdam.
Increasing pressure on the healthcare system makes it essential that we use limited resources efficiently. In addition to implementation of (cost-)effective care, de-implementation, the abolishment of ineffective care, is important. In two recent Dutch examples, on de-implementation of back pain care and tonsillectomies/adenotomies, it appears that can take up to decades.
View Article and Find Full Text PDFEarly Surgery: Le Fort I Advancement in a 6-Year-Old Patient-A Therapeutic Approach Using a Modified Le Fort I Osteotomy.
J Maxillofac Oral Surg
June 2023
Clinic for Oral and Maxillofacial Surgery, Zeppelinstr. 24, 61352 Bad Homburg, Germany.
Orthognathic surgery in young patients before completion of skeletal growth is still sharply discussed today. In the following case report of a 6-year-old patient, however, there was a vital indication for treatment. The main clinical symptoms were characterized by impaired hearing as a result of constantly recurring seromucotympanum and adenoids, persistent rhinorrhea and otorrhea, chronic tonsillitis and chronic otitis media.
View Article and Find Full Text PDFEvaluation of sleeping parameters with peripheral arterial tonometry in childhood sleep apnea and snoring: a clinical feasibility study.
Eur Arch Otorhinolaryngol
August 2023
Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Innsbruck, Anichstr.35, 6020, Innsbruck, Austria.
Purpose: The influence of adenoidectomy ± tonsillotomy/tonsillectomy on objective sleep parameters in children with Obstructive Sleep Apnea (OSA) was determined with the help of ambulatory polygraphy (WatchPat300, Neucomed Ltd., Vienna, Austria). These results were compared with the findings of the OSA-18 questionnaire.
View Article and Find Full Text PDF[The combination of recurrent otitis media and adenotomy in early childhood as diagnostic marker of mucopolysaccharidosis type II (Hunter syndrome)].
Vestn Otorinolaringol
September 2022
Tyumen State Medical University, Tyumen, Russia.
Mucopolysaccharidoses are a group of rare lysosomal accumulation diseases caused by a deficiency of the lysosomal enzyme and the accumulation of mucopolysaccharides in various organs and tissues. Children with mucopolysaccharidosis type II (Hunter syndrome) develop multisystem dysfunction, including severe airway obstruction. At the same time, 34% of patients already at an early age (2-3 years) undergo surgical manipulations related to ENT organs (tonsillectomy, adenotomy).
View Article and Find Full Text PDFTo summarize the results of a study of the clinical and polygrapic features of sleep in children with pathologic conditions of the tonsillar ring and obstructive sleep apnea. Tonsillar hypertrophy is the most common cause of obstructive sleep apnea in children. Using the data of overnight polysomnographic study and/or nocturnal pulse oximetry, groups of patients were distinguished depending on the presence and severity of their sleep breathing disorders.
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