wall was reconstructed by gluing one side of the TPFF to the reverse side of the preserved posterior meatal wall skin.Results: Mean time to complete epithelialization of the meatal skin in these 6 patients was shorter than that of 27 patients who underwent the meatal reconstruction using the free deep temporal fascia (26 days vs 37 days) statistically. No postoperative infection in operated ears occurred. CT scans performed 1 year after the surgery revealed that recovery of mastoid aeration was observed in 2 patients despite thorough removal of the mucosa in the mastoid cavity Conclusion: The TPFF can provide optimal blood supply to the middle ear and external meatal skin. It is possible that the TPFF works positively not only for quick epithelialization and prevention of postoperative infection, but also for recovery of mastoid aeration. Objectives: Down syndrome (DS) is the most common aneuploid disorder at birth. Phenotypic characteristics include general axial hypotonia and maxillary hypoplasia with relative macroglossia contributing to constricted maxillary arch and nasal obstruction. This prospective study assesses the effect of rapid maxillary expansion (RME) on nasal permeability of DS children using acoustic rhinometry (AR) data. To our knowledge this is the first such study performed in a DS population.
P036
Rapid Maxillary Expansion and Nasal Patency of the Down Syndrome Pediatric PopulationMethods: AR have been performed in 24 DS children aged between 5 and 12 years (who were randomly allocated to RME and control groups) prior to expansion (T0), immediately after maximum expansion (approximately 1 month) (T1) and after a 5-month period of retention (T2); the data between the 2 groups were compared.Results: On average, RME children showed a significant increase in the nasal volume from T0 to T1, which persisted through T2. A significant difference was noticed in the evolution of the minimal cross-sectional area (MCA) for RME children. Children in the control group did not show any significant improvement. The distance from the MCA does not show any significant difference with time in both groups. Nevertheless, in the RME group a noticeable change is observed, becoming more anterior, between T0 and T1, with almost no change at the last stage (T2); in contrast, results from the control group are not consistent with time.Conclusion: Rapid maxillary expansion produced a significant augmentation of nasal volume, P Ͻ 0.05, compared to the control group; these results were stable through the period of retention.
Urgent tracheostomy is a life-saving procedure for patients with acute airway obstruction or with difficult intubation. It is a safe and effective procedure, with a low complication rate, and should be performed before the patient's clinical status turns into a surgical emergency situation.
PFAPA syndrome is characterized by periodic fever, pharyngitis, cervical adenitis and aphthous stomatitis. The bouts of fever can last for days or even weeks. Between crises, patients remain asymptomatic for variable periods. It appears before the age of five and has limited duration (4-8 years). Its aetiopathogeny is unknown. Corticoids are the treatment of choice. Tonsillectomy has been proposed as a solution but remains controversial. We present the case of a 4-year-old girl with PFAPA syndrome who underwent tonsillectomy in January, 2008, and we review the literature.
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