Watering of Eyes in babies (Epiphora)

Doc, Why my newborn has excessive watering from his/ her eyes?  

Ans. Watering of eyes from new born is of serious concern to parents. Usually the passage between eyes and nose for tear drainage is formed by the age of 6 months of fetus. In few cases, this may persist after birth. Most of such cases responds to special massage over lacrimal sac area known by name Criggler hydrostatic massage.

Technique is important. It should be behind the anterior lacrimal crest. search video on youtube. 

Till what age should parents do massage?

Ans.  1 year

When to refer such cases to eye doctor? 

Depends upon severity of symptoms 

Does early probing has any contraindication? 

No

Concerns

How to check vision in babies 🤱 

Can be done with special cards

Infantile glaucoma can also cause epiphora and photophobia

Botox dosages in spasmodic dysphonia

Botox dosages are practioner dependent.

To start with, use low dosage. 1 U for women and 1.5 Unit for man. 

Average dose 3 units per side. 

This maximize benefits (fluency) 

And minimize side effects (breath voice) 

Basal cell carcoma (Atrophic Variant)

Paediatric auditory brainstem implant

Implant is placed in the lateral recess of the 4tb ventricle close to foramen of Luschka and stimulates dorsal and ventral nuclei. 

The cochlear nucleus has tonotopicity. 

Flocculus of cerebellum is variable in size and hides the entry into lateral recess.

Switch on of cochlear Auditory brainstem implant is done after 3-4 months.

Vestibular dysfunction is seen I. Few patients.

Indication of cochlear implant

(From lecture of Dr. Mohan Kameshwaran)


It take 2-3 year for child to learn after implant and it varies. This is unlike Cochlear implant where it takes less than 1 year.

Fasting guidelines prior to Anaesthesia

Latest guidelines on Fasting prior to Anaesthesia.

Clear liquids allowed upto 2 hours prior to Anaesthesia.

Other liquids allowed upto 4 hours prior to Anaesthesia

Light diet allowed upto 6 hours prior to Anaesthesia.

If a patient has taken a heavy meal,then 10 hours must elapse prior to Anaesthesia.

Endoscopic excision of right maxillary sinus Odontogenic cyst having a tooth within it. 

Nose pack with airway is best

in laying down of fears of suffocation.