There are many inherent challenges in the evaluation and management of children with laryngotracheal disorders, and it differs widely from one institution to another. The main challenges include access to suitable equipment, fully trained surgeon and, cooperation with the anesthetist and pediatrician. Material & Methods: The aim of the study was to analyze the pediatric laryngotracheal cases undergoing endoscopic examination in Hospital Universiti Sains Malaysia. A retrospective review of 73 cases undergoing microlaryngoscopy and bronchoscopy from 2004 to 2008 was done. Results: Laryngomalacia was the commonest diagnosis. The majority of the cases (45.2 %) were referred because of noisy respiration. Other reasons for referral were foreign body inhalation, unresolved lung disease, failed extubation, examination prior to decannulation and hoarseness. Conclusion: Management of pediatric laryngotracheal cases were varied and tailored to each problem. The endoscopic examination must be meticulous. The management include observation, medical treatment, closed (endoscopic)
techniques and open surgery.
Hairy polyps are rare developmental malformations. They are benign lesions presented as a pedunculated mass that may arise from the naso-oropharyngeal region. Larger mass can cause upper respiratory obstruction causing respiratory distress or feeding difficulty, while smaller mass will present as intermittent respiratory distress due to a ball-valve type of obstruction. They are commonly seen in female, with ratio of 6:1 and majority of the cases occur in the infantile period. We are reporting a case of hairy polyp in a female infant that causing intermittent respiratory distress.
Angiogenicity is one of the essential components to enable tissue function. It is important to develop a construct that would help in catering oxygen and nutrient to the engineered tissue area. Thus, this study aims to investigate the attachment, spreading and growth of stem cells from human exfoliated deciduous teeth (SHED) on human AM (HAM) with or without vascular endothelial growth factor (VEGF) using scanning electron microscope (SEM), and indirectly see the potential of the HAM as a scaffold to promote angiogenic micro-environment. Since day 1, there were continuous changes of the cell morphology until day 28, SHED treated with VEGF seemed to change its shape from fibroblast-like into a round-shape cell, similar structure as an endotheliallike cell. The structures of filopodia-like were also observed on the treated SHED. SHED without VEGF treatment showed only normal morphological growth on HAM. VEGF is a protein produced to stimulate angiogenesis, and is believed to contribute to the morphological changes of SHED seeded on HAM. This indicates that HAM could be used as a scaffold to allow SHED differentiation into endothelial-like cells with the induction of VEGF.