Perioperative considerations for children undergoing bone anchored hearing device surgery: an observational study
| Autor: | Ann-Louise McDermott, Rupan Banga, Monica Stokes, David W. Proops, Andrew P. Reid |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Intraoperative Complication Adolescent Craniofacial abnormality Anesthesia General Laryngeal Masks Cohort Studies Craniofacial Abnormalities Prosthesis Implantation Tertiary Care Centers Hearing Aids Postoperative Complications Suture Anchors medicine Intubation Intratracheal Humans General anaesthesia Craniofacial Child Hearing Loss Retrospective Studies business.industry Postoperative complication General Medicine Perioperative medicine.disease Surgery Otorhinolaryngology Child Preschool Female Neurosurgery business |
| Zdroj: | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery. 271(6) |
| ISSN: | 1434-4726 |
| Popis: | The objective of the study was to identify important factors in the perioperative management of children undergoing bone anchored hearing device (BAHD) surgery in a paediatric tertiary centre. We also aim to compare current practice and identify any changes in practice with the previous study carried out in the same paediatric tertiary centre in 2000. Children undergoing BAHD surgery between January 2008 and January 2011 were identified on a departmental database. A retrospective case note review was performed and compared with data collected prior to 2000. In the study period, 194 children were identified to have had BAHD surgery. 134 case notes were available for analysis and of these children, 353 anaesthetics were identified. 45.5 % of the children had a recognised syndrome or dysmorphism and 17 % had a congenital cardiac anomaly. 16 % of the children were classified as a grade 3 or 4 laryngoscopy, but 83.3 % were managed with a laryngeal mask. 11.9 % of the children had an intraoperative complication and 4.8 % a postoperative complication. 88.4 % of children were managed as day cases. Compared with the previous study in 2000, there was a smaller proportion of syndromic or dysmorphic children and a larger proportion of children were managed with a laryngeal mask. As BAHD surgery has become more common and as its indications have expanded, the perioperative management has evolved. The proportion of children with congenital heart disease has remained constant, but there has been a marked reduction in the number of children with syndromes involving the head and neck. We have found that even in complex craniofacial cases, the laryngeal mask is increasingly being used with good results. However, advanced paediatric airway experience was still required in a small number of cases, heightening the awareness that specialised paediatric support services are necessary for a comprehensive BAHD programme. |
| Databáze: | OpenAIRE |
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