Ossifying fibroma of the middle turbinate revealed by infection in a young child

SummaryIntroductionOssifying fibroma (OF) is a rare benign fibro-osseous tumor, mainly located in the head and neck region. Most often, it affects the mandible but rare involvement of paranasal sinuses has been reported, associated with more locally aggressive behavior.Case reportWe report the case of an 8-year-old boy with OF of the middle turbinate, revealed by ethmoiditis. Total resection was performed on an endoscopic approach. The patient was free of clinical or radiological recurrence at 3 years’ follow-up. This was the youngest patient with OF of the middle turbinate so far reported in the international literature.DiscussionPresumptive diagnosis is established by clinical examination and CT scan (location, oval-shaped mass, heterogeneous tumor with a thin bony rim). Definitive diagnosis is founded on histological examination (psammomatous bodies, osteoblastic rim, trabecular bone). Treatment in paranasal sinus OF is surgical, preferentially on an endoscopic approach. Resection should be as complete as possible to minimize risk of recurrence, especially in sinonasal locations, known to be more aggressive. Ethmoiditis in an unusual age-range should suggest tumoral etiology

International Pediatric ORL Group (IPOG) laryngomalacia consensus recommendations

Objective To provide recommendations for the comprehensive management of young infants who present with signs or symptoms concerning for laryngomalacia. Methods Expert opinion by the members of the International Pediatric Otolaryngology Group (IPOG). Results Consensus recommendations include initial care and triage recommendations for health care providers who commonly evaluate young infants with noisy breathing. The consensus statement also provides comprehensive care recommendations for otolaryngologists who manage young infants with laryngomalacia including: evaluation and treatment considerations for commonly debated issues in laryngomalacia, initial work-up of infants presenting with inspiratory stridor, treatment recommendations based on disease severity, management of the infant with feeding difficulties, post-surgical treatment management recommendations, and suggestions for acid suppression therapy. Conclusion Laryngomalacia care consensus recommendations are aimed at improving patient-centered care in infants with laryngomalacia

Heparins Sourced From Bovine and Porcine Mucosa Gain Exclusive Monographs in the Brazilian Pharmacopeia

Most of the unfractionated heparin (UFH) consumed worldwide is manufactured using porcine mucosa as raw material (HPI); however, some countries also employ products sourced from bovine mucosa (HBI) as interchangeable versions of the gold standard HPI. Although accounted as a single UFH, HBI, and HPI have differing anticoagulant activities (~100 and 200 IU mg−1, respectively) because of their compositional dissimilarities. The concomitant use of HBI and HPI in Brazil had already provoked serious bleeding incidents, which led to the withdrawal of HBI products in 2009. In 2010, the Brazilian Pharmacopeia (BP) formed a special committee to develop two complementary monographs approaching HBI and HPI separately, as distinct active pharmaceutical ingredients (APIs). The committee has rapidly agreed on requirements concerning the composition and presence of contaminants based on nuclear magnetic resonance and anion-exchange chromatography. On the other hand, consensus on the anticoagulant activity of HBI was the subject of long and intense discussions. Nevertheless, the committee has ultimately agreed to recommend minimum anti-FIIa activities of 100 IU mg−1 for HBI and 180 IU mg−1 for HPI. Upon the approval by the Brazilian Health Authority (ANVISA), the BP published the new monographs for HPI and HBI APIs in 2016 and 2017, respectively. These pioneer monographs represent a pivotal step toward the safest use of HBI and HPI as interchangeable anticoagulants and serve as a valuable template for the reformulation of pharmacopeias of other countries willing to introduce HBI

Antro-choanal polyp in children. Our experience since 1997.

peer reviewed[en] UNLABELLED: The antro-choanal polyp is a rather common pathology in children. OBJECTIVE: To discuss the diagnostic modalities, the risk factors, the differential diagnoses and treatment options. MATERIAL AND METHODS: This study was performed in an ENT department of a 3rd referal center Fifteen patients, 12 males and 3 females (8 to 16 year old), were treated for an antro-choanal polyp (Killian's polyp) between 1997 and 2007. RESULTS: All patients presented a nasal obstruction. Other signs of discovery were a rhinorrhea, a maxillary pain or a pharyngeal mass. Two patients presented a recurrence after a surgery in another center Atopy did not seem to be a risk factor. The imaging evaluation showed a tissular process developed in the maxillary sinus and extending through the maxillary ostium, or an accessory ostium, toward the nose. All patients were treated by intranasal endoscopic surgery. The middle meatal antrostomy was systematic, associated with a inferior antrostomy in 3 cases, with an anterior ethmoidectomy in one case and with a vestibular approach (Caldwell-Luc procedure) in 4 cases. Two patients presented a recurrence which necessited a new surgery. CONCLUSION: The antro-choanal polyp must be suspected in front of nasal obstruction in children. The imaging evaluation eliminates the main differential diagnoses. The endo-nasal removal seems to be the best procedure

Self- and parental assessment of quality of life in child cochlear implant bearers

International audienceThe aim of this study was to assess quality of life in children fitted with cochlear implants, using combined self-and parental assessment. Materials and methods: Thirty-two children, aged 6 to 17 years, with prelingual hearing loss and receiving cochlear implants at a mean age of 22 months, were included along with their families. The KIDSCREEN-27 questionnaire was implemented, in face-to-face interview, in its parents and children-adolescents versions, with 27 items covering physical well-being ("physical activities and health"), psychological wellbeing ("general mood and feelings about yourself"), autonomy & parents ("family and free time"), peers & social support ("friends") and school environment ("school and learning"). Parent and child responses were compared with a general population database, and pairwise. Results: Global scores were compared against the general population on Cohen d effect-size. For child self-assessment, the results were: physical well-being, 72.81 (d = 0); psychological well-being, 78.13 (d = −0.4); autonomy & parents, 63.84 (d = −0.2); peers & social support, 61.72 (d = −0.4); and school environment 73.83 (d = 0). For parent assessment, the respective results were 62.66 (d = −0.8), 74.89 (d = −0.3), 57.37 (d = −1.2), 51.56 (d = −0.8), and 68.95 (d = −0.4). Half of the children could not answer the questionnaire, mainly due to associated disability. Schooling and language performance were poorer in non-respondent than respondent children. Quality of life was comparable between implanted and nonimplanted children: Cohen d, 0 to 0.4. Early cochlear implantation in children with pre-lingual hearting loss provides quality of life comparable to that of the general population

Butterfly-cartilage tympanoplasty in children: A 28-case series and literature review

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Modelling sound production from an aerodynamical model of the human newborn larynx

International audienceConsidering on the one hand the important histological differences that exist between newborn and adult vocal folds and on the other hand the specifical subglottal pressure at birth, the sound production in a newborn larynx is studied. The laryngotracheal airflow has been numerically modelled in order to evaluate its role in voice production by the larynx in newborn. The FFT spectrum of the pressure signal acquired just above the vocal folds was calculated and compared to the spectrum of a sound generated by an excised larynx. It can be determined that first, the computed pressure signal has a fundamental frequency close to that obtained experimentally with an excised larynx, and second the FFT spectra are qualitatively similar to one another. Third, the computed pressure fluctuation is strong enough to be detected by the human ear. The conclusion is that the airflow and the aerodynamical phenomena observed in a rigid geometry are, by themselves, able to produce a sound and consequently, are one of the several elements leading to sound production in the newborn larynx.