Giant haemangioma of the tongue is a disease which can obstruct the oropharyngeal airway and is presented with obstructive symptoms. Due to its vascularity, inserting laryngoscope for intubation can cause high risks, such as inducing bleeding. Hypoxia and excessive bleeding must be anticipated while securing the airway. We present a case of novel usage of dexmetomidine as a conscious sedation agent for awake fibre optic intubation in a 9-year-old child with obstructive symptoms secondary to a huge tongue haemangioma, who was presented for interventional sclerotherapy of the lesion.
Tongue

PURPOSE: This study assessed whether 99mtechnetium dimercaptosuccinic acid (DMSA) scintigraphy used for the assessment of renal sequelae after febrile urinary tract infection (UTI) has any prognostic value for outcome measurement of vesicoureteral reflux (VUR) by retrospectively evaluating the correlation between abnormal DMSA scintigraphy results and persistence of VUR in children with febrile UTI. MATERIALS AND METHODS: The medical records of 142 children (57 boys, 85 girls) admitted with febrile UTI from January 2004 to December 2006 and who were followed up for more than 1 year were retrospectively reviewed. At the initial and follow-up visits, renal ultrasound and DMSA scans were performed within 7 days from the diagnosis and voiding cystourethrography (VCUG) was performed within 1 month in all case and follow-up evaluations. RESULTS: The children's mean age was 4.8+/-3.6 years (range, 0.3 to 14 years). The mean follow-up was 28.2+/-4.8 months. At the initial examination, VUR was more often associated with an abnormal DMSA scan result (83.3%) than with a normal DMSA scan result (16.7%, p=0.02). The frequency of VUR with an abnormal DMSA scan during acute UTI was significantly higher than the frequency of VUR with a normal DMSA scan (38.8% vs, 25.8%, respectively, p=0.004). Also, high-grade VUR was associated with an abnormal DMSA scan result (32.5%) more often than with a normal DMSA scan result (0%, p=0.01). Children with an abnormal DMSA scan had a lower resolution rate of VUR (17.5%) than did children with a normal DMSA scan (75.0%) at the follow-up VCUG (p=0.02). CONCLUSIONS: An abnormal result on a DMSA scan during febrile UTI is associated with high-grade and persistent VUR. DMSA scans performed during febrile UTI are useful in reflux resolution in childhood.
Child ; Follow-Up Studies ; Humans ; Medical Records ; Retrospective Studies ; Succimer ; Technetium Tc 99m Dimercaptosuccinic Acid ; Urinary Tract ; Urinary Tract Infections ; Vesico-Ureteral Reflux