RESUMO
Postoperative depression has been reported in adults undergoing open heart surgery and mastectomy. Tonsillectomy is a commonly performed procedure and can be associated with significant morbidity including pain, difficulty swallowing, dehydration, and bleeding. While adults may be able to express their feelings about the postoperative course, children often are unable to express themselves. Because postoperative depression may manifest itself in unusual behavior that is dismissed as "expected," it may go unrecognized. We present three case reports in which the child demonstrated signs of depression following tonsillectomy. We believe that depression following tonsillectomy occurs more frequently than has been recognized. We describe the diagnosis and management of posttonsillectomy depression to increase the otolaryngologist's awareness of this entity.
Assuntos
Transtorno Depressivo/etiologia , Tonsilectomia/psicologia , Criança , Pré-Escolar , Humanos , Masculino , Tonsilectomia/efeitos adversosRESUMO
Congenital tracheal stenosis is a rare congenital anomaly, with less than 70 reported cases in the literature. The presenting signs and symptoms of stridor, recurrent pneumonia, and respiratory distress are commonly seen in other conditions. The rarity of congenital tracheal stenosis and the diverse presentations make accurate early diagnosis difficult and frequently lead to inappropriate treatment. We treated three patients with congenital tracheal stenosis who presented with different sites of stenosis. Each patient displayed different symptoms and required individualized management. The treatment of congenital tracheal stenosis depends on identifying the site and extent of the stenosis. We reviewed the embryogenesis and treatment of this abnormality and developed a new classification system that will aid in the management of congenital tracheal stenosis.
Assuntos
Estenose Traqueal/congênito , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estenose Traqueal/diagnóstico , Estenose Traqueal/terapiaRESUMO
Tracheobronchomalacia (TBM) is an important cause of airway distress during infancy, but it generally resolves as the airway enlarges. To assess the origin and natural history of TBM, a chart review and telephone survey were conducted for 50 patients with TBM at the Children's Hospital of Philadelphia (Pa). This study revealed that TBM is a relatively common airway abnormality and is found on 15% of all diagnostic bronchoscopies. Prematurity, low birth weight, bronchopulmonary dysplasia, and prolonged ventilation predispose patients to the most severe symptoms. In our study, a tracheotomy with continuous positive airway pressure was required by 75% of the premature infants and 25% of the full-term infants with TBM. Seventy-one percent of all patients underwent decannulation without any other surgical intervention and remained nearly asymptomatic. Some patients could not undergo decannulation because of other airway lesions. In most instances, TBM is a self-limited disease that resolves without surgery.