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Congenital Nasal Disorders
Published in Raymond W Clarke, Diseases of the Ear, Nose & Throat in Children, 2023
In some children, choanal atresia is an isolated anomaly, but it may be associated with a series of linked congenital defects – CHARGE association. Features may include some or all of: coloboma, heart anomalies, atresia of the choanae, renal anomalies, genital hypoplasia, ear anomalies, and it is important that babies are screened by a paediatrician.
Fetal and neonatal medicine
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
4.20. Which of the following conditions is/are recognized as being associated with respiratory difficulties in newborn infants?Funnel chest (pectus excavatum).Oesophageal atresia.Oligohydramnios.Bilateral choanal atresia.Micrognathia (receded chin) with cleft palate.
Non-Allergic Perennial Rhinitis
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Jameel Muzaffar, Shahzada K. Ahmed
Allergic rhinitis is the major disease to differentiate from non-allergic rhinitis and may be excluded by appropriate allergy tests. However, the possibility of a local IgE production within the nasal mucosa may account for some cases where skin prick tests or IgE antibodies to common allergens are not positive. Several other conditions, including polyps, sinusitis, congenital and acquired anatomical abnormalities (e.g. nasal septal deviation, adenoid hypertrophy, hypertrophy of nasal turbinates, choanal atresia), benign and malignant tumours, granulomas, ciliary defects and cerebrospinal rhinorrhoea,1,2 are known to mimic symptoms of non-allergic non-infectious rhinitis and therefore have to be excluded by careful examination in order to make the correct diagnosis. Anatomical nasal abnormalities block the flow of nasal secretions and lead to rhinorrhoea, post-nasal drip and nasal blockage. In children, congenital choanal atresia can lead to reduced nasal airflow, resulting in nasal blockage. Tumours are not very common in the nasal passages, but when established and growing rapidly they often lead to unilateral nasal obstruction, bleeding and pain. Rhinorrhoea and nasal congestion, in the absence of pruritis, are also characteristic features of nasal mastocytosis, an extremely rare condition, in which eosinophils are absent and tests for IgE-mediated disease are negative.
Congenital bilateral nasolacrimal duct cysts with respiratory distress in a newborn
Published in Acta Oto-Laryngologica Case Reports, 2022
Haruo Yoshida, Chiharu Kihara, Kyoko Kitaoka, Chisei Satoh, Yoshihiko Kumai
Nasal endoscopy is the most useful and important diagnostic examination in such cases. Even if only unilateral dacryocystocele is suspected, both sides of the nose should be closely examined because the possibility of contralateral intranasal cysts is high [1,4,5]. Excessive accumulation of secretions in the nasopharynx and resistance during nasal aspiration indicate congenital NLD cysts, as observed in the present case. However, a differential diagnosis of congenital NLD cysts as a cause of neonatal respiratory distress is needed despite no abnormal CDC-associated findings, such as a bluish cutaneous mass inferior and lateral to the lacrimal sac. Thus, in such cases, intranasal examination by an otolaryngologist is recommended, and comprehensive examinations to determine other respiratory disorder indications, such as choanal atresia and laryngomalacia, are important.
A Comprehensive Assessment of Co-occurring Birth Defects among Infants with Non-Syndromic Anophthalmia or Microphthalmia
Published in Ophthalmic Epidemiology, 2021
Jeremy M. Schraw, Renata H. Benjamin, Daryl A. Scott, Brian P. Brooks, Robert B. Hufnagel, Scott D. McLean, Hope Northrup, Peter H. Langlois, Mark A. Canfield, Angela E. Scheuerle, Christian P. Schaaf, Joseph W. Ray, Han Chen, Michael D. Swartz, Laura E. Mitchell, A.J. Agopian, Philip J. Lupo
We summarized two-way birth defect combinations involving anophthalmia/microphthalmia as a chord diagram (figure 1). Among these, many of the largest O:Eadj ratios were for central nervous system (CNS) defects, head/neck defects, and orofacial clefts. We observed few combinations involving anomalies of the respiratory system except for choanal atresia (BPA4 code 748.0; N = 12 cases, O:Eadj = 10.0). In our evaluation of gastrointestinal (GI) anomalies, only “anomalies of the mouth and pharynx” (BPA4 code 750.2, which includes anomalies of the gum, lip, palate, pharynx, and philtrum) were associated with anophthalmia/microphthalmia (N = 6 cases, O:Eadj = 7.7). We observed multiple combinations with relatively large O:Eadj ratios involving anophthalmia/microphthalmia and musculoskeletal defects, predominantly limb and rib cage anomalies as presented in table 2. Finally, we observed combinations involving anophthalmia/microphthalmia and cutis aplasia of the scalp (BPA4 code 757.8; N = 5 cases, O:Eadj = 5.0) and anomalies of the thymus, pituitary, thyroid, and parathyroid glands (BPA4 code 759.2; N = 6 cases, O:Eadj = 5.8).
Manuscript title: the maxillary swing approach – the first Scandinavian experience
Published in Acta Oto-Laryngologica, 2021
Hani Ibrahim Channir, Magnus Balslev Avnstorp, Irene Wessel, Jørgen Rostgaard, Niclas Rubek, Katalin Kiss, Christian von Buchwald, Jimmy Yu Wai Chan, Birgitte Wittenborg Charabi
Hospitalization rates and postoperative complications are listed in Table 3. The median duration at the intensive care unit postoperatively was 1 day (range: 1 − 3 days) and the median total hospitalization was 13 days (range: 9 − 29 days). Nine patients experienced postoperative complications, of which refeeding syndrome was the most common and diagnosed in four of the patients (#2, #5, #6, #10). Refeeding was anticipated and treated according to local guidelines with no sequelae. One of these patients (#6) required central venous catheter placement due to malfunction of nasogastric tube in order to administer parenteral nutrition. A second (#10) had dysphagia and developed an aspiration pneumonia. Two patients (#14 and #15) experienced severe choanal atresia due to flap shrinkage requiring surgery two months after the maxillary swing procedure. Of the ten patients with reconstruction performed, only one patient (#5) had a minor partly flap necrosis measuring 5 cm which was removed without compromising the complete flap (vastus lateralis free flap). One patient (#4) developed a retromaxillary hematoma which was evacuated under secondary surgery. No serious bleeding was experienced postoperatively. None of the patients developed a carotid blowout.