Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com

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Πέμπτη 31 Δεκεμβρίου 2020

Psychomotor development of 4-year-old deaf children with cochlear implants: Three case studies.

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Psychomotor development of 4-year-old deaf children with cochlear implants: Three case studies.

Int J Pediatr Otorhinolaryngol. 2020 Dec 16;141:110570

Authors: Ganc M, Kobosko J, Jedrzejczak WW, Kochański B, Skarzynski H

Abstract
OBJECTIVES: Hearing is one of our most important senses, and hearing ability has an enormous impact on a child's psychomotor development. Children with auditory perception disorders may show abnormal development in terms of speech, language, and communication skills, as well as other disorders involving the cognitive sphere, social-emotional interactions, and motor development. This paper describes different paths of psychomotor development in three 4-year-old children. All were born with bilateral profound sensorineural hearing loss and were implanted early on with a cochlear implant. A longitudinal study of the children's psychomotor development was done for 3 years from the time of cochlear implantation.
METHODS: We present three children with congenital, profound bilateral sensorineural hearing loss. Psychomotor development was evaluated using the Children Development Scale (CDS) and the Psychomotor Development Evaluation Cards (PDEC). The three children were: Girl A (4 years 2 months 17 days) - a user of one CI, last assessment of psychomotor development (PDEC) was 37 months after CI activation; Boy B (4 years 3 months 21 days) - a user of two CIs, last assessment of psychomotor development (PDEC) was 39 months after activation of first CI; Boy C (4 years 1 month 5 days) - user of two CIs, last assessment of psychomotor development (PDEC) was 36 months after activation of the first CI.
RESULTS: Analysis of the results from Girl A showed very poor dynamics of development from the age of 12 months, when the first CDS evaluation was performed, up to the PDEC evaluation performed at age 4 years. The CDS score of Boy B showed a very high level of psychomotor development. The PDEC evaluation performed after 39 months of using the first CI showed that the psychomotor development of Boy B was consistent with his chronological age. Boy C presented an average level of psychomotor development (compared to typically developing children) in his CDS scores in the perioperative period and then at 4, 9, and 14 months after cochlear implantation. After 24 months, his CDS scores showed a high level of psychomotor development. After 3 years of CI use, the PDEC evaluation showed that Boy C had an average score in five tested areas, a high score in the area of fine motor skills and lateralization, and a low score in knowledge and learning competencies.
CONCLUSIONS: Children with bilateral profound hearing loss can present different paths of psychomotor development. Children who receive a CI may show an age-appropriate level of psychomotor development compared to typically developing children. However, a hearing, speech, and language rehabilitation specialist responsible for the child still needs to perform regular checkups to monitor all areas of psychomotor development. Also, the effects of the deaf child's environmental determinants on psychomotor development should be studied in detail. These determinants include the parents' emotional state, the parents' involvement in the child's rehabilitation, the family's quality of life, and the presence of deaf siblings. In particular, the difficulties encountered by the mother (or father) in being the parent of a deaf child may hinder the family from receiving adequate support.

PMID: 33348125 [PubMed - as supplied by publisher]

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Carotid artery mobilization prior to pharyngeal flap inset for patients with 22q11.2 deletion syndrome.

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Carotid artery mobilization prior to pharyngeal flap inset for patients with 22q11.2 deletion syndrome.

Int J Pediatr Otorhinolaryngol. 2020 Dec 19;141:110573

Authors: Patel KR, Partain M, Ryan DP, Hersh C, Goldenberg P, Hartnick CJ

Abstract
The management of velopharyngeal insufficiency (VPI) in patients with 22q11.2 deletion syndrome (22q11DS) poses a significant clinical challenge due to presence of a large velopharyngeal gap and a relatively high rate of internal carotid artery (ICA) medialization. To our knowledge, we are the first group to have successfully managed VPI in a series of seven pediatric patients with 22q11DS with medialized ICAs via a novel surgical technique involving carotid artery mobilization followed by pharyngeal flap insertion. Thus far, we have found this technique to be reliably safe with no significant morbidity and caregivers have reported postoperative improvement in speech, swallowing and nasal regurgitation symptoms. Herein, we provide a detailed description of our novel surgical approach, including an instructional video, for correction of VPI in patients with medialized ICAs, who have previously had limited management options.

PMID: 33359933 [PubMed - as supplied by publisher]

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Factors influencing time to operating room in children presenting with post-tonsillectomy hemorrhage.

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Factors influencing time to operating room in children presenting with post-tonsillectomy hemorrhage.

Int J Pediatr Otorhinolaryngol. 2020 Dec 20;141:110581

Authors: Michel M, Preciado D, Allen S, Behzadpour H, Pestieau S, Espinel A

Abstract
OBJECTIVES: We aimed to evaluate factors associated with time to return to OR in children presenting with post-tonsillectomy hemorrhage to a tertiary children's hospital.
METHODS: Retrospective study of pediatric patients presenting to a single institution from January 2012 to January 2020, with post-tonsillectomy hemorrhage (PTH) requiring surgical intervention for control of bleeding. Correlation, univariate, and multivariate analysis were conducted.
RESULTS: Of 15,984 tonsillectomies performed at our institution during the study period, 144 required return to the OR for bleeding control, in addition to 15 other children whose tonsillectomy had been performed at an outside institution. Mean time to the OR was 119.7 min (SD 101.5) in the morning, 77.4 min (SD 60.6) in the afternoon, 55.6 min (SD 34.8) in the evening, and 49.4 min (SD 26.4) overnight (ANOVA p < 0.0001). The mean hemoglobin decline from pre-to post-tonsillectomy was 1.3 g/dl (SD 1.7). Primary hemorrhages had a mean time to OR of 62.39 min (SD 63.42) while secondary hemorrhages mean time to OR was 85.54 min (SD 76.21) (p = 0.0064). There was no significant difference in time to OR among race/ethnicity (p = 0.928), insurance status (p = 0.359), weekday (p = 0.557), surgeon seniority (p = 0.8104) or by hemoglobin drop (p = 0.2773). When controlling for ea ch of these variables, multiple linear regression showed that only time of day had significant correlation with time to OR (p = 0.0003).
CONCLUSION: At a tertiary children's hospital, patients presenting with PTH requiring revision surgery waited the longest to get to the OR in the morning versus all other times of day. These results can aid in individualization of anticipatory guidance in order to reduce morbidity and mortality from complications requiring revision in the operating room.

PMID: 33359934 [PubMed - as supplied by publisher]

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International Pediatric Otolaryngology Group (IPOG) survey: Efforts to avoid complications in home tracheostomy care.

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International Pediatric Otolaryngology Group (IPOG) survey: Efforts to avoid complications in home tracheostomy care.

Int J Pediatr Otorhinolaryngol. 2020 Dec 18;141:110563

Authors: Caloway C, Balakrishnan K, Boudewyns A, Chan KH, Cheng A, Daniel SJ, Fayoux P, Garabedian N, Hart C, Moreddu E, Muntz H, Nicollas R, Nuss R, Pransky S, Rahbar R, Russell J, Rutter M, Sidell D, Smith RJ, Soma M, Spratley J, Thompson D, Ward RF, Watters K, Wyatt M, Zalzal G, Hartnick C

Abstract
OBJECTIVE: To provide guidance for home care tracheostomy management in the pediatric population. The mission of the IPOG is to develop expertise-based recommendations for the management of pediatric otolaryngologic disorders with the goal of improving patient care.
METHODS: Survey of expert opinion by the members of the International Pediatric Otolaryngology Group (IPOG).
RESULTS: Survey results provide guidance for caregiver teaching, the reuse of tracheostomies and suction catheters while inpatient and following discharge, acceptable sterilization practices for tracheostomies, tracheitis workup and management, and outpatient follow-up practices.
CONCLUSION: This presentation of common home tracheostomy care practices are aimed at improving patient-centered care in the pediatric population.

PMID: 33360407 [PubMed - as supplied by publisher]

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Masticatory muscles electrical activity, stress and posture in preadolescents and adolescents with and without temporomandibular dysfunction.

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Masticatory muscles electrical activity, stress and posture in preadolescents and adolescents with and without temporomandibular dysfunction.

Int J Pediatr Otorhinolaryngol. 2020 Dec 15;141:110562

Authors: Miranda LS, Graciosa MD, Puel AN, Raulino de Oliveira L, Sonza A

Abstract
OBJECTIVE: To verify the difference between the masticatory muscles' electrical activity, stress signals and the posture of preadolescents and adolescents with and without temporomandibular dysfunction (TMD).
METHODS: 24 preadolescents and adolescents aged between 11 and 18 years old were divided into two groups, TMD group (TMDG) and control group (CG). All subjects were submitted to anthropometric measurements, psychological stress analysis, temporomandibular joint clinical evaluation and TMD verification; postural evaluation and masseter and temporal muscles electrical activity analysis during chewing. For statistical analysis, the Student's t-test or Mann-Whitney U test were used according to data distribution.
RESULTS: There was a significant difference between the groups for the electrical activity of the right temporal muscles (7.43% ± 2.92 vs. 11.71% ± 5.37) and left (7.70% ± 4.04 vs.11.44% ± 4.03) in the inactive period of chewing between CG and TMDG, respectively. There was no difference in stress or posture variables between groups.
CONCLUSIONS: During the inactive period of chewing, there was greater activation of the temporal muscles in the TMDG. Female gender was prevalent in TMDG. The study participants showed signs of stress, regardless of the group. The posture and TMD relationship still need to be studied.

PMID: 33360408 [PubMed - as supplied by publisher]

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What are the current practices employed by audiologists in early hearing detection

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What are the current practices employed by audiologists in early hearing detection and intervention in the South African healthcare context?

Int J Pediatr Otorhinolaryngol. 2020 Dec 24;141:110587

Authors: Khoza-Shangase K, Kanji A, Ismail F

Abstract
BACKGROUND: Universal access to early hearing detection and intervention (EHDI) forms part of the audiology community's goal. Evidence on current practices employed by South African audiologists in EHDI in order to ensure this universal access and success for children with hearing impairment is therefore required, hence this study.
METHODS: A quantitative survey research methodology with a cross-sectional design was employed. An online survey was completed by 49 qualified audiologists and dually qualified speech therapists and audiologists. Data were analysed using descriptive statistics.
RESULTS: Results identified gaps in the implementation of EHDI within the South African context. A total of 83.7% of the participants were involved in newborn hearing screening (NHS), with over half adopting the targeted screening approach instead of universal NHS services (UNHS). Capacity versus Demand challenges play a significant role in the lack of successful implementation of NHS with over 60% of the audiologists in the sample reporting that NHS is and should only be conducted by audiologists only; with minimal evidence of task shifting found. No standardised screening protocol was found, with challenges around budget allocation for EHDI revealed.
CONCLUSIONS: Although progress has been noted, a) gaps between public and private healthcare sector resources allocations and availability, b) limited contextually responsive strategic planning, as well as c) lack of translation of knowledge, policies and guidelines into practice, are glaring areas that require attention by the South African audiology community.

PMID: 33360694 [PubMed - as supplied by publisher]

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Hearing screening in neonates with hyperbilirubinemia.

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Hearing screening in neonates with hyperbilirubinemia.

Int J Pediatr Otorhinolaryngol. 2020 Dec 23;142:110591

Authors: Ezzeldin ZM, Sharaf E, Hamdy HS, Abdelwahab Selim YA

Abstract
BACKGROUND: Hyperbilirubinemia is toxic to the auditory pathways and to the central nervous system, leaving sequelae such as hearing loss and encephalopathy. The damage to the auditory system occurs primarily within the brainstem and cranial nerve VIII, and manifests clinically as auditory neuropathy spectrum disorder.
AIM: to establish the relationship that exists between hyperbilirubinemia at birth as a risk factor of neonatal hearing loss in children born in ABOU-EL-REISH hospital.
MATERIALS AND METHODS: we carried out of 60 neonates categorized into two groups: Group (A n = 30), neonates with hyperbilirubinemia; Group (B n = 30), neonates without hyperbilirubinemia.
RESULTS: Ten neonates were boys and twenty were girls from group A and eleven boys and nigh-teen girls from group B.There was significant statistical difference between group A and group B regarding ABR (P-value = 0.001) and a statistical difference regarding OAE (P-value = 0.103 in the right ear and 0.028 in the left ear). Also, our study shows the area under the curve and the diagnostic accuracy of total serum bilirubin (TSB) level for detection of hearing screening results (ABR) at a cut-off point 21 mg/dl (P-value = 0.008 and 0.009 in the right and left ears respectively.) CONCLUSIONS: Our study showed a relevant association between bilirubin levels and abnormal hearing screening results and the importance of combined screening with OAE and ABR tests.

PMID: 33360868 [PubMed - as supplied by publisher]

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