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Objectives: To provide an update on the microbiology, sensitivity rates and antibiotic prescribing patterns for superficial neck lymph node abscesses at Scotland's largest paediatric tertiary centre. Findings were compared to historical data from our institution. Methods: A retrospective case series was conducted of paediatric patients undergoing incision and drainage of a superficial neck lymph node abscess at the Royal Hospital for Children in Glasgow, from 2018 to 2021. Results: Thirty-nine abscesses were identified. Methicillin-susceptible Staphylococcus aureus was the commonest micro-organism (28 per cent), followed by Streptococcus pyogenes (13 per cent). Eighty-two per cent of patients were administered a drug regimen containing co-amoxiclav. Only three children required a change in their antibiotics. Conclusion: There was a significant change in causative micro-organisms, including a decrease in S aureus and an increase in the Streptococcus anginosus group. Empirical use of co-amoxiclav is recommended. In abscesses showing no clinical improvement, second-line options such as clindamycin, cefotaxime and vancomycin should be considered. [ABSTRACT FROM AUTHOR]

Background: More young children are undergoing tonsillectomy, driven by sleep-disordered breathing concerns. Their specific risks are not well described. Method: A retrospective review was conducted of children aged 1–23 months undergoing tonsillectomy at one institution between 2014 and 2018. Results: A total of 157 children were identified (3.9 per cent of all tonsillectomies in those aged 0–16 years). Sixty-seven per cent were male. The youngest child was six months old; the smallest weighed 6.9 kg. Sixty-eight (43.3 per cent) had co-morbidities. The indication for tonsillectomy was sleep-disordered breathing in 94 per cent; 29.9 per cent had co-existing airway lesions, mostly laryngomalacia and tracheobronchomalacia. Of the children, 83.4 per cent were managed post-operatively on the surgical ward, and 63.7 per cent stayed 1 night. Emergency paediatric intensive care unit admission occurred in 3.8 per cent. Early respiratory complications and emergency paediatric intensive care unit admission were more common if the patient was medically complex, aged less than 18 months or weighed less than 12 kg. Re-operation for bleeding occurred in 1.9 per cent. Conclusion: Most children stay 1 night on a general ward, with an uneventful course. Complications are occasionally severe, mostly in the very young and medically complex. [ABSTRACT FROM AUTHOR]

Objective:This paper presents our experience of managing children with a tracheostomy in a multidisciplinary team clinic consisting of an ENT consultant, paediatric respiratory consultant, a nurse specialist, and speech and language therapist.Method:A retrospective case note review was conducted of all children seen in the multidisciplinary team tracheostomy clinic (at a tertiary paediatric hospital) between February 2009 and September 2014.Results:Ninety-seven patients were examined. The most common indications for tracheostomy were: lower airway and respiratory problems (66 per cent), upper airway obstruction (64 per cent), and neurodevelopmental problems (60.8 per cent).Conclusion:Children with a tracheostomy are a diverse group of patients. The most common indications for paediatric tracheostomy have changed from infective causes to airway obstruction and anomalies, long-term ventilation requirement, and underlying neuromuscular or respiratory problems. Our unified approach empowers the carers and patient, as a home management plan, long-term plan and goals are generated at the end of each appointment. [ABSTRACT FROM PUBLISHER]

The article provides advice on how pediatric otolaryngologists should deal with the case of a two-month-old boy presented with noisy breathing. A guide for deciding which infants need an urgent referral to center with specialist expertise in pediatric airway surgery, and which infants can be safely managed in a general Ear, Nose and Throat (ENT) setting. The scope of the examination and the treatment that should be offered are also discussed.

Aims The aim of this paper was to review the indications, complications and outcomes for tracheostomy at a Scottish paediatric tertiary referral hospital. Methods All patients undergoing tracheostomy between January 2001 and September 2012 were identified. A retrospective case note analysis was performed. Results 111 tracheostomies were done in the study period. The mean number per year was 11 (3–12). Full data was available for 95 patients. There were 56 (59%) males and 39 (41%) females. Age at time of tracheostomy ranged from one day to 15 years, the mean age of tracheostomy insertion was 69 weeks. The majority of patients, 75 (79%), were under one year old when they had their tracheostomy. The most common indication was long-term ventilation (20%), followed by craniofacial abnormality causing airway obstruction (18%), followed by subglottic stenosis (14%). 37% of patients were decannulated. Conclusions This series reflects current trends in the indications for paediatric tracheostomy, with chronic lung disease of prematurity being the most common indication. [ABSTRACT FROM AUTHOR]

loughran s., spinou e., clement w.a., cathcart r., kubba h. & geddes n.k. (2004) Clin. Otolaryngol. 29, 266–269 A prospective, single-blind, randomized controlled trial of petroleum jelly/Vaseline for recurrent paediatric epistaxis The aim of the study was to determine if petroleum jelly was an effective treatment for paediatric epistaxis. A single-blind, prospective, randomized controlled trial was undertaken in an otolaryngology outpatient clinic of a paediatric hospital from March 2001 to March 2002. A total of 105 children referred with recurrent epistaxis were randomized into the study, 52 into the treatment arm and 53 into the control arm. Children in the treatment arm applied Vaseline twice a day bilaterally for 4 weeks and were monitored for any bleeds for the next 4 weeks. Children in the control arm were simply given an 8-week appointment and the number of bleeds were monitored for the 4 weeks prior to their appointment. The outcome measure was the proportion of children in each group without nosebleeds in the preceding 4 weeks. Both groups were equally distributed in age, duration of symptoms and duration of each bleed. Fourteen of 51 (27.5%) patients of the treatment arm and 18 of 53 (34%) of the control arm did not bleed in the 4 weeks before review (chi-square test, P = 0.472). It can be concluded that Vaseline alone confers no benefit over simple observation in recurrent childhood epistaxis. [ABSTRACT FROM AUTHOR]