Având în vedere rata crescută a morbidităţii şi mortalităţii traheotomiei la copil, se consideră o intervenţie chirurgicală dificilă.
În lucrare se prezintă managementul şi dificultăţile tehnice ale traheotomiei pediatrice. Material şi metodă.
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În Clinica ORL Timişoara, în perioadaau fost efectuate 18 traheotomii la copii cu vârsta cuprinsă între 1 și 15 ani. Indicaţiile traheotomiilor au fost pentru obstrucţie de căi aeriene superioare, ventilaţie asistată sau toaletă pulmonară.
Au fost utilizate diferite tipuri de canule traheale.
Alegerea canulelor trebuie să ţină cont de indicaţia traheotomiei. Canula ideală trebuie să fie din silicon, uşor de curăţat şi disponibilă în diferite dimensiuni.
Toate traheotomiile au fost efectuate pe incizie cervicală inferioară orizontală. S-a utilizat anestezia generală cu sondă de intubaţie orotraheală, regiunea cervicală fiind în hiperextensie.
Complicaţiile intraoperatorii au fost minime: vestibular papillomatosis definition hemoragii şi probleme cu canulele traheale.
Complicaţiile postoperatorii s-au manifestat ca: decanulare accidentală, emfizem subcutanat, dificultăţi de alimentaţie, infecţie.
Patient repartition per years and complications Conclusion Mucocele is not a surgical emergency with the exception of the complications judging from the fact that it takes time for it to reach great dimensions and in clinical examination must be ruled out any cause of rhinological headache. There have been presented some entities such as early mucocele and some rare cases of vestibular papillomatosis definition of middle turbinate and superior turbinate. Mucoceles mostly develop in the frontal sinus and less commonly in the ethmoid cell system or in the maxillary and sphenoid sinuses. The two most frequent causes of frontal mucoceles are: inflammatory changes and posttraumatic or post-interventional induced scarring of the nasofrontal duct after FESS Sphenoidal mucocele In vestibular papillomatosis definition, the endonasal marsupialization technique is nowadays the surgical approach of choice in most of the cases.
Traheotomia este considerată o intervenţie cu risc vital, neavând contraindicaţii absolute. Este o intervenţie dificilă din cauza particularităţilor anatomice la aceste vârste.
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Traheotomia ar trebui efectuată în situaţii controlate cu vestibular papillomatosis definition vestibular papillomatosis definition pe sondă sau bronhoscop. Cuvinte-cheie: traheotomie, copil, canulă, complicaţii Eustachian tube causes Adriana Neagoş MD, PhD, University of Medicine and Pharmacy Târgu-Mureş, Otorhinolringology Department, Târgu-Mureş, Romania Eustachian tube is an important source of middle ear pathogenesis and has been linked to causing middle ear and mastoid aeration pathology.
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It vestibular papillomatosis definition appear alone or in association with other factors as sinusitis and epipharingeal tumours. Otitis media with effusion is the most frequent pathology that appears after Eustachian tube disfunction. The tympanic membrane retraction is one of objective symptomathology.
Many causes of Eustachian tube function and dysfunction are described in the literature including cleft palate, surfactants, tympanic membrane athelectasis, and long term middle ear ventilation. The epidemiological studies illustrated poor Eustachian tube function plays a major role in the pathogenesis of otits media, so it is very important to have a good function of the tube before and after a surgical procedures.
Evaluation of hearing results demonstrates that preoperative and postoperative tubal function is important for a good surgical outcome in case of chronic otitis media and cholesteatoma. In children the Eustachian tube dysfunction evaluated by impedance audiometer is important to document neutralization of positive and negative middle ear pressures. This can be the explanation that Eustachian tube is an essential part of the pressure regulating system of the middle ear.
The physiologic function of the tube is to equalize the pressure from the middle ear with the atmosphere.
Congenital anomalies of the heart and vessels 10 Heart malformations are determined by various factors, some with severe movement vestibular papillomatosis definition and oxygen that are incompatible with life, other compatible although initially not generally allow a long-term survival. They occur in animals as lack or excess malformations by malformations of position, or structural alterations septs or the heart valves. Shows theoretical and practical importance: Acardia total lack of heartlack of closing the pericardial sac, diplocardia double vestibular papillomatosis definition multiplicitas cordis multiple cordsdextrocardia heart on the right side of the mediastinumcardiac ectopia presence of heart in the cervical region, pectoral or abdominaletc. Septs structural defects are common to all species.
vestibular papillomatosis definition The Eustachian tube closing failure and the induction of negative middle ear pressure are important factors in the development of chronic ear disease. Pediatric Resident doctor First described indeafness caused by congenital cytomegalovirus infection - a major problem of public health - is today the most frequent cause of sensorineural deafness in children.
The prevalence of congenital cytomegalovirus infection is between 0. Diagnosis of congenital cytomegalovirus infection is vestibular papillomatosis definition if the virus is isolated during the first 3 weeks of life or if the serum IgM antibodies are found at birth or shortly after birth.
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Deafness caused by cytomegalovirus infection can be progressive or with late onset at preschoolers or in the first years of schoolrequiring more frequent audiology monitoring vestibular papillomatosis definition birth, at 3, 6, 9, 12, 18, 24, vestibular papillomatosis definition, and 36 months and annually until school age in order to detect and to treat deafness.
Pathophysiology of deafness caused by cytomegalovirus infection is not completely understood impaired endolymphatic structures, cytopathic effect of the virus, host immune response to the inner ear structures.
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Hearing loss can be unilateral frequency of kHz or bilateral, and vestibular papillomatosis definition from medium to severe. Hearing impairment has an impact on social and cognitive development of the child and his family, acquisition of speech being often delayed.
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The risk of permanent sequelae in case of symptomatic infection vestibular papillomatosis definition higher in children from mothers suffering of primary infection, but disabilities were observed also in children from mothers with non-primary infections. In children with asymptomatic congenital cytomegalovirus infection, increased virulence in the first month of life is associated with sensorineural deafness.
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Balance problems involving acoustic nerve should be taken in consideration in children with sensorineural deafness. The relation between high viral charge in infants and deafness probability suggests the role of antiviral therapy in decreasing the incidence and the severity of deafness caused by cytomegalovirus.
Oral Valganciclovir represents today an alternative to Ganciclovir, priory used intravenous. Valganciclovir has adverse effects neutropeniathus the decision to initiate the antiviral therapy is difficult to make.