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Fulltext The use of biologics in children with allergic rhinitis and chronic rhinosinusitis: Current updates

Shinee T, Sutikno B, Abdullah B

Pediatr Investig, 2019 Sep;3(3):165-172.

The therapeutic goals of the treatment of allergic rhinitis (AR) and chronic rhinosinusitis (CRS) are symptom relief, avoiding complications, and improving quality of life. In the treatment of AR and CRS, several limitations of currently prescribed medicines have been identified. Antihistamine administration (both oral and topical) together with intranasal corticosteroids bring relief to the majority of patients, but their dependency on the medications and a necessity to maintain strict compliance with regular medication regimes pose a challenge. Immunotherapeutic agents are an option in some patients, but polysensitized patients, the risk of anaphylaxis, and the need for daily administration for years are limiting it from becoming the main therapy modality. Immunotherapy in any form requires commitment by the patient, which renders adherence and compliance issues particularly relevant. The procedure involved are generally time-consuming and entail an associated risk of severe adverse reactions. The use of biologics could overcome the limitations of other therapeutic modalities. They could be used as a monotherapy or combined with pre-existing medications. The benefits of targeted therapy include less adverse effects and optimal efficacy. The aim of the present review was to investigate the collective literature to date pertaining to the role of biologics in managing children with AR and CRS.

Fulltext Foreign body ingestion in an infant: A high index of suspicion is required

Mohamad Ishak LA, Khor KG, Tan SN

Pediatr Investig, 2019 Sep;3(3):188-190.

PMID: 32851316 DOI: 10.1002/ped4.12149

INTRODUCTION: The incidence of foreign body ingestion in the upper gastrointestinal tract accounts for 75%-85% of foreign body ingestions in pediatric patients.

CASE PRESENTATION: An 8-month old boy presented with vomiting and was referred to the otorhinolaryngology team based on his mother's suspicion that her child might have ingested a foreign body. Flexible laryngoscopy revealed a phone screen protector at the vallecular region. The foreign body was removed in the operating theatre.

CONCLUSION: Foreign body ingestion should always be suspected in young patients. Consideration of the patient's symptoms, level of lodgement, and type of foreign body will determine whether immediate intervention or a conservative approach is warranted.

Fulltext Isolated congenital tracheal stenosis: A rare and deadly condition

Arunathan R, Ariffin AHZ, Khor KG, Tan SN

Pediatr Investig, 2019 Sep;3(3):191-193.

PMID: 32851317 DOI: 10.1002/ped4.12148

INTRODUCTION: Congenital tracheal stenosis (CTS) is a serious and rare condition. In most cases, CTS is associated with cardiopulmonary abnormalities; however, isolated CTS is present in 10%-30% of patients. The severity of the disorder is dependent on the symptoms, which correlate with the CTS classification.

CASE PRESENTATION: We discuss our findings in an infant who presented with severe respiratory compromise where incidental intra-operative findings revealed CTS with no cardiopulmonary abnormalities. Because of a lack of resources in the emergency department, we created a tracheostoma and inserted an endotracheal tube.

CONCLUSION: The main aim in treating CTS is to secure the airway and provide sufficient oxygen.

Fulltext Multidisciplinary approach to children with sinonasal tumors: A review

Lazim NM, Abdullah B

Pediatr Investig, 2019 Sep;3(3):173-179.

PMID: 32851313 DOI: 10.1002/ped4.12147

Sinonasal tumors in children are rare and difficult to manage. These tumors can be broadly categorized into congenital or acquired and benign or malignant. The tumors mainly arise from the mucosa, cartilage, or bone of the nasal cavity and may occupy areas of the nasal septum, turbinates, osteomeatal complex, sinuses, and nasopharynx. The management of pediatric sinonasal tumors is challenging, especially in cases of malignancy. Malignant tumors pose a treatment dilemma because most such tumors tend to be aggressive and carry a poor prognosis. Multiple complications associated with the primary disease or treatment may occur, and such complications need to be fully addressed to provide optimal care. In most cases, a multidisciplinary team approach will offer the best possible outcome for children with sinonasal tumors.

Fulltext Quality of life in children following nasal septal surgery: A review of its outcome

Saniasiaya J, Abdullah B

Pediatr Investig, 2019 Sep;3(3):180-184.

PMID: 32851314 DOI: 10.1002/ped4.12145

Nasal septal surgery among children remains controversial because of its adverse effect on craniofacial development. Recent studies, however, have demonstrated that early nasal septal correction prevents the midfacial and nasal growth deformity that is the inevitable consequence of nasal septal abnormality. Nasal septal surgery in children has been reported to lead to significant improvement in quality of life. We reviewed the existing literature to evaluate the outcomes of pediatric nasal septal surgery.

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