Routine Electrocardiography Request in Adenoidectomy: Is it necessary?

Short-term effect of adenotonsillectomy on growth and nutritional anthropometric parameters of children with obstructive adenotonsillar enlargement

Background

Obstructive adenotonsillar enlargement is known to cause failure to thrive in children. The effect of adenotonsillectomy is not well documented on the growth of affected children. The study was carried out to investigate the effect of adenotonsillectomy on growth of children with obstructive adenotonsillar enlargement. It was a quasi-experimental study consisting of 62 children (≤ 12 years) with obstructive adenotonsillar enlargement and 62 healthy controls. Variables measured at baseline, sixth week and 13th week post adenotonsillectomy, were weight, height, mid-upper arm circumference, and triceps skinfold thickness. The percent of weight-for-age and height-for-age were, respectively, calculated by dividing the child’s weight and height by the median expected weight and height (i.e., the 50th percentile) based on the child’s chronological age. The obtained weight-for-age and height-for-age values were used to determine the presence of failure to thrive and stunting, respectively.

Results

Majority (70.6%) of the patients with malnutrition were from a low socioeconomic class. At baseline, failure to thrive and stunting were found among 17 (26.4%) cases and 11 (17.7%) controls, but the proportion reduced to six (9.7%) and three (4.8%), respectively, at the 13th week post adenotonsillectomy. There was a steady increase in weight-for-age, height-for-age, mid-upper arm circumference, and triceps skinfold thickness in both cases and controls from baseline to the 13th week. However, there was a significant difference in percentage variation of these variables between the two groups.

Conclusions

Adenotonsillectomy improved the growth of children with obstructive adenotonsillar enlargement and hence recommended in cases with failure to thrive and stunting.

Pre-anesthetic echocardiographic findings in children undergoing non-cardiac surgery at the University of Benin Teaching Hospital, Nigeria

BACKGROUND

A pre-anaesthestic echocardiogram (echo) is requested for most non-cardiac surgeries to identify possible cardiac structural anomalies.

OBJECTIVE

To describe the prevalence and spectrum of structural cardiac abnormalities seen in various non-cardiac conditions.

METHODS

We carried out a retrospective review of pre-anaesthetic echos performed over five years on children scheduled for non-cardiac surgery. The requests were categorised according to referring specialities, and the biodata and echo findings were noted.

RESULTS

A total of 181 children and 181 echocardiograms were studied, and 100 (55.2%) of the patients were male. Most of the children (87, 48.1%) with oro-facial clefts were referred from dentistry. Of the 181 children, 39 (21.5%) had cardiac abnormalities, most (34, 87.2%) of whom had congenital heart disease (CHD). Ophthalmic requests with suspected congenital rubella syndrome (CRS) had the highest prevalence of 8/12 (66.7%) while the lowest was oro-facial clefts at 15/87 (17.2%). Atrial septal defect was the commonest abnormality, found in 14 patients (35.9%).

CONCLUSION

Pre-anaesthetic echo should be performed, especially for children with suspected CRS and other congenital anomalies, requiring non-cardiac surgery.

Comparing Oxygen Saturation of Normal Children with that of Children with Adenotonsillar Hypertrophy

To compare the nocturnal oxygen saturation profiles of children with adenotonsillar enlargement with that of normal children. A 1 year comparative study. The study was carried out at the Otorhinolaryngology Ward of the University College Hospital Ibadan. These comprise of 60 children (1-9 years) with clinically confirmed adenotonsillar enlargement admitted for adenotonsillectomy and 60 normal children matched for age and sex. The biodata and common clinical presentations of the study group were acquired with a structured proforma. The severity of nasopharyngeal obstruction was determined by the adenoidal-nasopharyngeal ratio while the degree of tonsillar enlargement was graded by the Brodsky's classification. The nocturnal oxygen saturation of all the participants were recorded with a wrist worn pulse oximeter. Recording was for at least for 4 h. Oxygen saturation <92 % was regarded as desaturation. The oximetric values of the study and control group were compared. The mean nocturnal SPO2 (peripheral saturation of oxygen) profiles of children with adenotonsillar enlargement were as follows: basal = 96.86 %, minimum = 84.99 %; maximum = 99 % and average SPO2 <92 % = 87.74 % while the saturation profiles of the control group were as follows; basal = 97.88 %, minimum = 89.71 %; maximum = 99 %, average SPO2 <92 % = 90.82 %. Normal children have better nocturnal saturation profiles than children with adenotonsillar enlargement.

An audit of ear, nose and throat diseases in a tertiary health institution in South-western Nigeria

Introduction

This study is aimed at determining the pattern of ear, nose and throat diseases and their relationship with socio-demographic factors with auditing intent in a tertiary hospital in South-western Nigeria.

Methods

Medical records of patients managed at the Department of Otorhinolaryngology, University College Hospital, Ibadan, Nigeria from 2006 to 2010 were reviewed for all essential clinical data.

Results

There were 2641 (52.8%) males and 2360 (47.2%) females. Two thousand and fifty (41%) patients had age ≤15years old. Sixty three percent of the patients were Christians, 37% were Muslims and less than 1% had other religions. There were more patients in lower occupational classes than those in the upper classes. The average number of patients with ear, nose and throat diseases managed per month was eighty three. Patients with ear diseases were 3136 (62.7%), the nose diseases were 1153 (23.0%), the throat diseases were 479 (9.6%) and head/neck diseases were 233 (4.7%).

Conclusion

This study showed that otitis media, obstructive adenoid, foreign bodies in the ear and throat infections were the common ear, nose, throat disorders seen in patients aged ≤15years whereas, hearing loss, rhinosinusitis and tumors were the common disorders of ear, nose and throat seen in patients aged 16 years and above. Although these disorders are not yet considered to be of public health importance, they contribute significantly to the existing burden of health problems in our environment. Therefore, there is a need for improved public awareness on ear, nose and throat diseases.