AIM To assess the feasibility and parental acceptance of diagnostic microlaryngobronchoscopy(MLB) as day case surgery.METHODS A prospective study was performed over a 26 moperiod at a tertiary paediatric ENT centre. P...AIM To assess the feasibility and parental acceptance of diagnostic microlaryngobronchoscopy(MLB) as day case surgery.METHODS A prospective study was performed over a 26 moperiod at a tertiary paediatric ENT centre. Patients were selected in clinic using set criteria. All MLBs were performed using a standardised anaesthetic protocol and patients monitored post-operatively. Six weeks following surgery, parents underwent questionnaire surveys.RESULTS Ninety-four out of 101 MLBs was successfully performed as day case surgery over the set period. Seven patients required an overnight stay for further observation. Fiftyseven parents took part in the questionnaire of which 68.4% were highly satisfied with same day discharge. CONCLUSION MLB is feasible, safe and acceptable as day case surgery in carefully selected patients.展开更多
AIM： To examine the presentation, diagnosis and out-comes of patients with laryngeal cleft.METHODS： An 18 mo （from mid-2012 to 2013） pro-spective longitudinal study was performed at the Barts Children’s and Royal...AIM： To examine the presentation, diagnosis and out-comes of patients with laryngeal cleft.METHODS： An 18 mo （from mid-2012 to 2013） pro-spective longitudinal study was performed at the Barts Children’s and Royal London Hospital, a tertiary referral centre. Chart review was performed for all patients including data extraction of demographics, outpatient clinic review documentation, speech therapy findings, medication list, operative findings alongside technique and follow up. A systematic review of contemporary English medical literature was also reviewed to compare series. The study was approved and registered by the hospital clinical governance and audit board. Biosta-tistician review was not required.RESULTS： Twenty-two children aged 1 to 72 mo （mean age 23.5 mo） with a 7：4 male-female ratio. Twenty had Benjamin-Evans type 1 clefts and 2 had a type 2 cleft. All were symptomatic despite medical management including anti-reflux therapy. Patients presented with dyspnoea （81%）, feeding diffculty （63%）, stridor （54%） and recurrent pneumonia （36%）. Several patients had concomitant aerodigestive abnormalities including 7 with laryngomalacia, 4 subglottic stenosis, 2 subglottic webs and 1 tracheo-oesophageal fstula. To date, 18 patients have undergone endoscopic repair, all of whom have shown radiological and/or clinical signs of improvement. All endoscopic repairs were performed with the novel use of a Negus knot pusher, with Baby Benjamin rigid suspension, to more reliably and easily suture at depth.CONCLUSION： This is a significant single unit series demonstrating the strong association of laryngeal cleft with combined aerodigestive symptoms and other laryngeal abnormalities. Endoscopic management of type 1 and 2 laryngeal clefts is successful. We recommend the use of a Negus knot pusher to facilitate endoscopic repair.展开更多
文摘AIM To assess the feasibility and parental acceptance of diagnostic microlaryngobronchoscopy(MLB) as day case surgery.METHODS A prospective study was performed over a 26 moperiod at a tertiary paediatric ENT centre. Patients were selected in clinic using set criteria. All MLBs were performed using a standardised anaesthetic protocol and patients monitored post-operatively. Six weeks following surgery, parents underwent questionnaire surveys.RESULTS Ninety-four out of 101 MLBs was successfully performed as day case surgery over the set period. Seven patients required an overnight stay for further observation. Fiftyseven parents took part in the questionnaire of which 68.4% were highly satisfied with same day discharge. CONCLUSION MLB is feasible, safe and acceptable as day case surgery in carefully selected patients.
文摘AIM： To examine the presentation, diagnosis and out-comes of patients with laryngeal cleft.METHODS： An 18 mo （from mid-2012 to 2013） pro-spective longitudinal study was performed at the Barts Children’s and Royal London Hospital, a tertiary referral centre. Chart review was performed for all patients including data extraction of demographics, outpatient clinic review documentation, speech therapy findings, medication list, operative findings alongside technique and follow up. A systematic review of contemporary English medical literature was also reviewed to compare series. The study was approved and registered by the hospital clinical governance and audit board. Biosta-tistician review was not required.RESULTS： Twenty-two children aged 1 to 72 mo （mean age 23.5 mo） with a 7：4 male-female ratio. Twenty had Benjamin-Evans type 1 clefts and 2 had a type 2 cleft. All were symptomatic despite medical management including anti-reflux therapy. Patients presented with dyspnoea （81%）, feeding diffculty （63%）, stridor （54%） and recurrent pneumonia （36%）. Several patients had concomitant aerodigestive abnormalities including 7 with laryngomalacia, 4 subglottic stenosis, 2 subglottic webs and 1 tracheo-oesophageal fstula. To date, 18 patients have undergone endoscopic repair, all of whom have shown radiological and/or clinical signs of improvement. All endoscopic repairs were performed with the novel use of a Negus knot pusher, with Baby Benjamin rigid suspension, to more reliably and easily suture at depth.CONCLUSION： This is a significant single unit series demonstrating the strong association of laryngeal cleft with combined aerodigestive symptoms and other laryngeal abnormalities. Endoscopic management of type 1 and 2 laryngeal clefts is successful. We recommend the use of a Negus knot pusher to facilitate endoscopic repair.
