Fourth branchial cleft anomalies are rare head and neck congenital lesions seen in children. They present as a neck inflammatory mass and arise essentially on the left side of the neck. We report the case of a 7-month-old female with a mass of the neck associated with respiratory distress. The mass was diagnosed as an incomplete fourth branchial cleft fistula. Surgical revision of the neck abscess from an external approach and plasma coblation of the orifice in the pyriform fossa by an endoscopic approach were performed.
- MeSH
- absces chirurgie MeSH
- branchiální krajina * abnormality chirurgie MeSH
- kojenec MeSH
- kraniofaciální abnormality chirurgie MeSH
- krk abnormality chirurgie patologie MeSH
- lékařské ilustrace MeSH
- lidé MeSH
- nemoci faryngu MeSH
- píštěle chirurgie MeSH
- Check Tag
- kojenec MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- přehledy MeSH
Parapharyngeal abscess in an infant is a very rare condition. We present the case of a 4-month-old girl with large masses on the neck's left side. Computed tomography showed an extensive parapharyngeal abscess. Left tonsillectomy was performed under general anesthesia from a transoral approach, followed by an incision and evacuation of the abscess from the parapharyngeal space. Microbiological analysis identified a massive occurrence of Streptococcus intermedius.
- MeSH
- absces * mikrobiologie chirurgie MeSH
- kojenec MeSH
- lidé MeSH
- nemoci faryngu mikrobiologie chirurgie MeSH
- počítačová rentgenová tomografie MeSH
- spatium parapharyngeum * chirurgie diagnostické zobrazování mikrobiologie MeSH
- Streptococcus intermedius izolace a purifikace MeSH
- streptokokové infekce * mikrobiologie chirurgie MeSH
- tonzilektomie MeSH
- Check Tag
- kojenec MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
OBJECTIVES: The young population requires early rehabilitation of their hearing loss for normal cognitive, auditive hence social development. All of which, in turn, may have an impact on quality of life (QoL). This study aims to evaluate QoL between two different bone conduction (BC) hearing devices: a noninvasive adhesive hearing aid (Adhear [ADH]) vs. an active transcutaneous implant (Bonebridge [BB]). METHODS: This study composed of 12 BB and 15 ADH users. Pure tone as well as speech in noise and quiet measurements were evaluated and compared to the Assessment in QoL questionnaire (AQoL-6d). RESULTS: Freefield results showed significant improvements for both devices compared to the unaided condition (p < .0001). Emphasis needs to be drawn on the different unaided level of conductive hearing loss as well as the indication range for both evaluated device groups: the ADH subjects exhibited a mean BC value of 9.50 ± 7.96 dB HL (the indication range up to 25 dB) and the BB subjects a mean of 23.33 ± 25.66 dB HL (the indication range up to 45 dB). Speech perception in quiet and in noise was significantly improved (p < .05; p < .001, respectively). QoL was significantly improved for both treatments (p < .05) but was not different among the devices, and the values were similar to their normal hearing, age, and sex-matched control group. High correlations were found between QoL utility scores and improved PTA4 in the aided condition (r2 = .8839 and .7810 for BB and ADH, respectively). CONCLUSION: Our results show that both devices offer significant beneficial audiological rehabilitations with significantly increased QoL. However, the underlying condition and the unaided degree of hearing loss, hence the required higher stimulation must be the deciding factor when opting for a hearing device, and this should be independent of age. LEVEL OF EVIDENCE: 2c.
- Publikační typ
- časopisecké články MeSH
Nedoslýchavost různého stupně lze u dětí hodnotit z mnoha různých pohledů a rozdělení. U novorozenců a nejmenších dětí diagnostikujeme vrozené vady sluchu, při genetickém vyšetření lze nalézt mutaci conexinu. U starších dětí pak převažují zánětlivé stavy a jejich komplikace. U nejstarších dětí jsou pak příčinou nedoslýchavosti nejčastěji chronické záněty, v menší míře pak úrazy a idiopatické důsledky poruchy sluchu. V přehledu jsou prezentovány jednotlivé formy nedoslýchavosti a mechanismus jejich vzniku. Vyšetřovací metody poruchy sluchu jsou různé dle věkových kategorií a nutnosti spolupráce dítěte při vyšetřování. Možnosti terapie jsou uváděny u příslušného typu nedoslýchavosti a vhodnosti použité metody konzervativní i chirurgické.
Hearing loss of varying degrees can be assessed in children from many different perspectives and divisions. In newborns and the smallest children, we diagnose congenital hearing defects, during a genetic examination a conexin mutation can be found. In older children, inflammatory conditions and their complications predominate. In the oldest children, the most common cause of hearing loss is chronic inflammation, to a lesser extent, injuries and idiopathic consequences of hearing impairment. The overview presents individual forms of hearing loss and the mechanism of their occurrence. Hearing impairment investigation methods are different according to age categories and the necessity of the child's cooperation during the investigation. Therapy options are listed for the respective type of hearing loss and the appropriateness of the conservative and surgical method used. Brief anatomical and physiological notes on the structure and function of the auditory system complement the understanding of the development of hearing impairment according to the topography and complexity of the individual parts of the hearing analyzer.
- MeSH
- diagnostické techniky otologické MeSH
- dítě MeSH
- lidé MeSH
- poruchy sluchu * diagnóza klasifikace terapie MeSH
- ucho anatomie a histologie fyziologie MeSH
- věkové faktory MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- přehledy MeSH
PURPOSE: The study aimed to evaluate audiological benefits, quality of hearing and safety of two Bonebridge generation: BCI601 and BCI602 (MED-EL, Innsbruck, Austria) in children. METHODS: Twelve children were implanted: five BCI601 and seven BCI602 comprising of ten conductive hearing loss, and two single sided deaf SSD subjects. Audiological outcomes tested were sound field audiometry, functional gain, speech recognition threshold (SRT50), speech recognition in noise (SPRINT) and localisation abilities. Subjective measures were Speech, Spatial and Qualities of Hearing Scale (SSQ12). RESULTS: The mean FG with the BCI601 was 25.0 dB and with the BCI602 28.0 dB. The benefit in SRT50 was 23.2 dB and 33.8 dB, respectively. The mean benefit in SPRINT was 15% and 6.7% and the localisation ability improved from 33.3° to 16° and from 26.2° to 17.6°, respectively. The two SSD subjects reported a FG of 17 dB, a benefit in SRT50 of 22.5 and a benefit in SPRINT of 20%. Subjective outcomes improved significantly and even exceeded the values of their age-and sex matched normal hearing peers. One revision was reported: a retroauricular emphysema above the implant occurred 12 months post-OP, it was resolved operatively with the implant still being functional. CONCLUSION: The pediatric cohort reports significant audiological benefit, even exceeding that of the age- and sex matched control. The combination of the high safety and audiological benefit makes the Bonebridge a comfortable and effective option in hearing rehabilitation in children.
- MeSH
- dítě MeSH
- kostní vedení zvuku MeSH
- lidé MeSH
- percepce řeči * MeSH
- převodní nedoslýchavost chirurgie MeSH
- sluch MeSH
- sluchové pomůcky * MeSH
- sluchové testy MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
(1) Objectives: For full benefit in children implanted with a cochlear implant (CI), wearing the device all waking hours is necessary. This study focuses on the relationship between daily use and audiological outcomes, with the hypothesis that frequent daily device use coincides with high device satisfaction resulting in better functional gain (FG). Confounding factors such as implantation age, device experience and type of device were considered. (2) Results: Thirty-eight CI children (65 ears) were investigated. In total, 76.92% of the children were using their device for >12 h per day (h/d), 18.46% for 9-12 h/d, the remaining for 6-9 h/d and one subject reported 3 h/d. The revision rate up to the 90-month follow-up (F/U) was 4.6%. The mean FG was 59.00 ± 7.67 dB. The Audio Processor Satisfaction Questionnaire (APSQ) separated for single unit (SU) versus behind the ear (BTE) devices showed significantly better results for the latter in terms of wearing comfort (WC) (p = 0.00062). A correlation between device use and FG was found with a device experience of <2 years (n = 29; r2 = 0.398), whereas no correlation was seen with ≥2 years of device experience (n = 36; r2 = 0.0038). (3) Conclusion: This study found significant relationships between daily device use and FG, wearing comfort and long-term safety (90 months).
- Publikační typ
- časopisecké články MeSH
Úvod: Náhle vzniklá percepční nedoslýchavost (SSHL) u dětí patří mezi akutní stavy. Univerzální diagnosticko-terapeutický algoritmus není definován. Správně stanovená diagnóza klade vysoké nároky na přesně provedené vyšetření sluchu ověřené objektivními vyšetřovacími metodami. Pro adekvátní kompenzaci ztráty sluchu je nezbytná dobře organizovaná následná péče. Metodika a materiál: Retrospektivní analýza 14 dětí se SSHL léčených v letech 2016–2019 v terciárním centru. Hodnocené parametry: věk, pohlaví, stranové postižení, tíže sluchové ztráty, projevy, předpokládaná příčina a léčebný postup. Tíže vstupního postižení byla klasifikována podle metodiky WHO (World Health Organization). Míra zotavení byla hodnocena podle Siegla. Výsledky: Všechny děti byly léčeny methylprednisolonem v iniciální dávce 5 mg/kg/den. K úplné restituci sluchu došlo v 6 (43 %) případech. K částečnému nebo úplnému selhání léčby došlo v 8 (57 %) případech (v 75 % u levostranné a v 16,7 % u pravostranné SSHL). U pacientů s tinitem došlo ke zlepšení sluchu v 54,5 %, oproti 35,3 % u případů bez tinitu. Věková kategorie 5–10 let vykazovala riziko neúspěchu léčby v 33 %, 10–15 let v 83 % a 15–18 let ve 20 %. Ostatní sledované parametry neměly vliv na efektivitu léčby. Závěr: V našem souboru byla spojena vyšší šance na restituci sluchu u pacientů s přítomností tinitu, pravostranným postižením a s těžší vstupní poruchou sluchu. Věková kategorie 10–15 let vykazovala 3× vyšší riziko neúspěchu léčby oproti ostatním.
Introduction: Sudden sensorineural hearing loss (SSHL) is an acute condition in children. Universal guidelines for treatment and diagnosis are not defined. Use of objective diagnostic methods in hearing threshold level verification is necessary. Standardized follow-up care is essential for adequate correction of hearing impairment. Methods and material: This retrospective study analysed 14 patients suffering from SSHL, hospitalized between 2016 and 2019 in a tertiary centre. Age, gender, affected side, hearing threshold level, symptoms, cause and treatment were compared. Hearing loss was classified according to the WHO methodology. The recovery rate was assessed by Siegel’s criteria. Results: All children were treated with an initial dose of 5 mg/kg/day of methylprednisolone intravenously. A complete recovery in our group was achieved in 6 cases (43%). The rate of treatment failure was 75% for the left side and 16.7% for right side SSHL. Patients with the presence of tinnitus have a 54.5% chance of hearing restitution, as compared to 35.3% in patients without tinnitus. The risk of treatment failure for children aged 5–10 years, 10–15 years and 15–18 years is 33%, 83% and 20% respectively. We did not observe any effect on hearing recovery for the other analysed parameters. Conclusions: Better hearing recovery was observed in children with tinnitus, the right affected side and a higher severity of initial hearing loss. At the age of 10–15 years, the chance of hearing recovery was three times lower than in other age groups.
Vrozené vývojové vady vnitřního ucha zahrnují celou řadu rozmanitých postižení labyrintu. Jsou jedním z důvodů těžkého poškození sluchu, převážně senzorineurálního typu. Přibližně 80 % nedoslýchavosti je následkem poškození membranózního labyrintu, zbývajících 20 % připadá na anomálie kostěného labyrintu. Projevit se mohou dědičné faktory a vliv prostředí. Vyskytují se samostatně, nebo jsou součástí syndromů. Léčba závisí na závažnosti poruchy sluchu, na případných anomáliích zevního a středního ucha, na přidružených vadách a na přítomnosti sluchového nervu. Podle situace volíme z výběru několika naslouchacích přístrojů a implantabilních systémů. Pokud je u dítěte z jakéhokoliv důvodu implantace kontraindikována nebo ji rodiče odmítají, lze dítě naučit znakové řeči a odezírání z úst. Součástí článku je přehled pacientů s vrozenými vadami vnitřního ucha na našem pracovišti v letech 2010–2020. Hodnotili jsme četnost výskytu pacientů s příslušnou diagnózou, četnost výskytu vad v závislosti na věku a pohlaví a následnou rehabilitaci. Naše výsledky dokazují, že i děti s těžkými sluchovými vadami podstupují na naší klinice úspěšnou kochleární implantaci a většině z nich lze sluch navrátit.
Congenital malformations of the inner ear consist of many different anomalies of the labyrinth. They often cause hearing loss, mostly of the sensorineural type. Eighty percent of hearing loss is caused by an anomaly of the membranous labyrinth, and 20% by an anomaly of the bone labyrinth. The role in pathogenesis is played by hereditary factors and influence of the environment. The treatment depends on the severity of the hearing loss, abnormalities of the external and middle ear, associated defects, and presence and function of the auditory nerve. We have modern hearing aids or implantable systems. Another options include a sign language and mouth-reading. The article includes a retrospective analysis of patients with congenital inner ear malformations at our tertiary center in 2010–2020. In conclusion, our patients clearly prove that even children with profound hearing loss are successfully implanted and restored hearing can be achieved in most of them.
- MeSH
- lidé MeSH
- poruchy sluchu etiologie terapie MeSH
- vnitřní ucho * abnormality růst a vývoj MeSH
- vrozené vady * diagnóza epidemiologie etiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
Pleomorfní adenom se řadí mezi primární epitelové nádory slinných žláz. Nejčastější lokalizací tohoto nádoru bývá žláza příušní. Kazuistika prezentuje raritní případ desetiletého chlapce s pleomorfním adenomem příušní žlázy diagnostikovaném po úraze.
Pleomorphic adenoma is one of the primary epithelial tumors of the salivary glands. The most common localization of this tumor is the parotid gland. The case report presents a rare case of a ten-year-old boy with pleomorphic adenoma of the parotid gland diagnosed after injury.
- MeSH
- diferenciální diagnóza MeSH
- dítě MeSH
- lidé MeSH
- nádory slinných žláz chirurgie diagnostické zobrazování MeSH
- pleomorfní adenom * chirurgie diagnostické zobrazování MeSH
- tvář diagnostické zobrazování zranění MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
PURPOSE OF THE STUDY Diagnosis and treatment of fractures of the facial skeleton in children can be difficult due to the skeletal growth. MATERIAL AND METHODS The 9-year retrospective study included patients admitted with the orbital fracture diagnosis to the University Hospital Brno, Children s Hospital, Department of Paediatric ENT, Department of Paediatric Anaesthesiology and Resuscitation, and Department of Paediatric Surgery, Orthopaedics and Traumatology. We looked into the number of patients admitted to the hospital with the orbital fracture diagnosis and the cause of the injury, the age of patients, and the used treatment method - surgical or non-operative treatment were analysed. The following assumptions were applied: 1. Incidence of the injury (orbital fracture) increases with the age of the patient, 2. Incidence of the injury in individual years is constant. RESULTS In the followed-up period, between 2010 and 2018, a total of 47 patients, of whom 8 girls and 39 boys, with the orbital fracture diagnosis were treated. 12 patients underwent surgery, 35 patients were treated non-operatively. The study group included 47 patients with the age range of 1 to 18 years, with the median age 12 years. When the results were processed, a trend was revealed showing an increase in the number of injuries as well as an in the age of patients at the time of injury. The number of injuries increases with age and year. Both the correlations, however, are statistically insignificant and the trend can be considered statistically insignificant. DISCUSSION Both the non-operative and surgical treatment of patients lead to excellent results, even in the long-term follow-up. In paediatric patients, the surgical approach should be opted for only in cases when the non-operative approach is impossible due to the extent and characteristics of fracture and damage to soft tissues. CONCLUSIONS The surgical treatment aims at the best possible anatomical reconstruction of the orbit with no subsequent functional or cosmetic defects. If surgical treatment is necessary, then the transconjunctival approach is most appropriate in children, namely because of the good overview over the operating field, simple procedure as well as the cosmetic outcome. In most cases it is enough to reposition the orbital soft tissues. In complicated cases, with an orbital floor defect, it needs to be covered with a suitable material. Also, the non-operative approach has its place in therapy and the case-by-case approach must be applied. Orbital fractures should always be treated by experienced specialists (ENT, dental surgeon, traumatologist) specialising in paediatric patients. Key words: fracture, orbit, childhood, surgical, non-operative treatment.
- MeSH
- dítě MeSH
- fraktury očnice * diagnóza epidemiologie chirurgie MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- ortopedické výkony * MeSH
- pooperační komplikace MeSH
- předškolní dítě MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
