Choanal Atresia: Birth Without Breath

AbstractBilateral Choanal atresia is a medical emergency. Corrective surgery is the mainstay of the treatment. Hegar ’s dilator was used in all cases to break the bony/membranous atretic plate. The 22 cases of choanal atresia all operated by the first author were included in this study. Eight cases were 1–5 year old with bilateral choanal atresia and all required immediate surgery as they had repeated attacks of respiratory distress and cycle of cyanosis. Eight cases were of CHARGE Syndrome. All the cases were operated under general anaesthesia. Hegar’s dilators were used and nasal stents were placed in all cases. Although complete nasal patency was achieved by surgery, in 8 cases, neonates could not survive due to the CHARGE Syndrome. The mortality was unrelated to the surgery. The 14 cases which were not related to CHARGE Syndroma had a good postoperative recovery. 3 cases were above 15 years old with unilateral complete bony/membranous choanal atresia and they presented with continuos nasal discharge. Hegar’s dilators are a safe and simple method of surgery for choanal atresia. Nasal stenting is mandatory to prevent restenosis.
Source: Indian Journal of Otolaryngology and Head and Neck Surgery - Category: ENT & OMF Source Type: research

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Pulmonary atresia witha ventricular septal defect and major aortopulmonary collateral arteries(PA/VSD/MAPCAs), is a cardiac malformation characterized by the lack of a pulmonary valve and a pulmonary vascular bed supplied by aortopulmonary collateral arteries.1 This rare cyanotic congenital heart disease is associated with a high mortality.2,3 Owing to deterioration of cardiac function during pregnancy, the anesthetic management for cesarean delivery is a particular challenge. As reported by Atanassoff,4 pre-labor decisions regarding preoperative, perioperative and postoperative management are vital for a successful delive...
Source: International Journal of Obstetric Anesthesia - Category: Anesthesiology Authors: Tags: Case report Source Type: research
We report the anesthetic care of a conjoined twin set in which one of the patients presented with tricuspid atresia, d-transposition of the great arteries, and both atrial and ventricular septal defect. A balloon atrial septostomy was performed to allow survival after a separation procedure.
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Reports Source Type: research
AbstractA comprehensive understanding of the native pulmonary blood supply is crucial in newborns with pulmonary atresia with ventricular septal defect and aortopulmonary collaterals (PA/VSD/MAPCA). We sought to describe the accuracy in terms of identifying native pulmonary arteries, radiation dose and anaesthetic time associated with multi-modality imaging in these patients, prior to their first therapeutic intervention. Furthermore, we wanted to evaluate the cumulative radiations dose and anaesthetic time over the study period. Patients with PA/VSD/MAPCA diagnosed at
Source: Pediatric Cardiology - Category: Cardiology Source Type: research
Pediatric Anesthesia,Volume 28, Issue 4, Page 367-369, April 2018.
Source: Pediatric Anesthesia - Category: Anesthesiology Source Type: research
ConclusionThe findings of laparoscopic cholangiogram were confirmed in all six children who underwent laparotomy for Kasai procedure. The laparoscopic cholangiogram using gallbladder hitch reliably demonstrates a patent biliary system (11/11) and was valuable in avoiding further invasive procedures in 70% (14/20) of babies.
Source: Pediatric Surgery International - Category: Surgery Source Type: research
Summary BackgroundLong gap oesophageal atresia occurs in approximately 10% of all oesophageal atresia infants and surgical repair is often difficult with significant postoperative complications. Our aim was to describe the perioperative course, morbidity, and early results following repair of long gap oesophageal atresia and to identify factors which may be associated with complications. MethodsThis is a single center retrospective cohort study of consecutive patients with oesophageal atresia undergoing surgical repair at The Royal Children's Hospital Melbourne from January 2006 to June 2017. ResultsTwo hundred and thirty‚...
Source: Pediatric Anesthesia - Category: Anesthesiology Authors: Tags: RESEARCH REPORT Source Type: research
Oesophageal atresia: Are "long gap" patients at greater anesthetic risk? Paediatr Anaesth. 2018 Feb 04;: Authors: Powell L, Frawley J, Crameri J, Teague WJ, Frawley GP Abstract BACKGROUND: Long gap oesophageal atresia occurs in approximately 10% of all oesophageal atresia infants and surgical repair is often difficult with significant postoperative complications. Our aim was to describe the perioperative course, morbidity, and early results following repair of long gap oesophageal atresia and to identify factors which may be associated with complications. METHODS: This is a single cente...
Source: Paediatric Anaesthesia - Category: Anesthesiology Authors: Tags: Paediatr Anaesth Source Type: research
By ANISH KOKA, MD No one knows who Bennie Solis is anymore. He had the misfortune of being born in the early 1960s marked for death. He had a rare peculiar condition called biliary atresia – a disease defined by the absence of a conduit for bile to travel from his liver to his intestinal tract. Bile acid produced in the liver normally travels to the intestines much like water from a spring travels via ever larger channels to eventually empty into the ocean. Bile produced in the liver with no where to go dams up in the liver and starts to destroy it. That the liver is a hardy organ was a fact known to the ancient Gree...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Uncategorized Source Type: blogs
Conclusion Neonatal thoracoscopic repair of CDH and EA using CO2-pneumothorax leads to severe acidosis. Cerebral rSO2 remained within clinical acceptable limits during intraoperative periods of acidosis. Neurodevelopmental outcome was favorable within the first 24 months. The potential of NIRS to further improve perioperative care and long-term outcome in this specific patient group deserves further investigation. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: European Journal of Pediatric Surgery - Category: Surgery Authors: Tags: Original Article Source Type: research
AbstractThe value of laryngotracheobronchoscopy (LTB) immediately prior to repair of esophageal atresia with or without tracheo-esophageal fistula is contentious. Currently, there is a wide range of opinion on the utility of this investigation which is reflected by huge variation in clinical practice. This review is a critical analysis of the arguments for and against performing routine LTB prior to esophageal atresia repair. Reserving LTB for selected cases only is potentially disadvantageous since it limits the surgeon ’s and anesthetist’s familiarity with the procedure, equipment, and range of potential find...
Source: Pediatric Surgery International - Category: Surgery Source Type: research
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