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Presentation belief, creation and intelligibility in French-speaking children with deep hearing problems as well as early cochlear implantation following hereditary cytomegalovirus disease.
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To investigate the feasibility of an endoscopic surgical approach through the neck to the jugular foramen, to determine the relevant techniques and extent of exposure, and to provide a new surgical approach with minimal trauma.

Nine cadaveric head specimens with attached necks were fixed with 10% formalin solution. Two of the heads were fixed and injected withcolored silicone rubber. Through the dissection of these cadaver head and neck specimens, we designed a surgical approach from the neck to the jugular foramen area with the use of a neuroendoscope and performed simulated surgery to determine which anatomical structures were encountered in the approach.

The posterior aspect of the internal jugular vein is adjacent to the rectus capitis lateralis. The internal carotid artery is anteromedial to the internal jugular vein, with the glossopharyngeal nerve, accessory nerve, vagus nerve and hypoglossal nerve in between. Removal of the rectus capitis lateralis can reveal the jugular process, and exposing ththe future. Nonetheless, this approach is still in development in a laboratory setting, and further research and improvements are needed before facing more complicated situations in clinical practice.
This study aimed to report cases of high-lying azygos arch and discuss the embryological basis of its development by a thorough evaluation of the anatomical features assessed using computed tomography (CT) images.

This study was approved by our institutional review board. We retrospectively reviewed chest CT images between November 2011 and November 2018. To determine high-lying azygos arch, we set the upper margin of the T4 vertebral body as the reference level. Regarding the embryological development of high-lying azygos arch, we retrospectively reviewed the CT images of 105 patients with tracheal bronchus to identify the location of the azygos arch.

We noted that on three cases CT images, the azygos arch was located higher than the upper margin of the right main bronchus, and drained into the proximal superior vena cava (SVC) at a level higher than the conventional T4 or T5 vertebral level. All 105 patients with right tracheal bronchus showed azygos arch above the tracheal bronchus.

This variation in the location of the azygos arch can mimic pathological lesion on plain radiographs, and, therefore, it is important to be aware of high-lying azygos arch. Our findings show that the azygos arch may have possibly migrated downward during embryological development.
This variation in the location of the azygos arch can mimic pathological lesion on plain radiographs, and, therefore, it is important to be aware of high-lying azygos arch. Our findings show that the azygos arch may have possibly migrated downward during embryological development.Kawasaki disease (KD) is an acute vasculitis predominantly affecting the small arteries of young children. Up to 25% of untreated patients suffer from coronary artery (CA) complications. Early diagnosis and treatment is mandatory in incomplete KD to reduce the risk of coronary involvement. Between 2002 and 2018, 124 patients have been diagnosed suffering from KD at the University Children's Hospital Regensburg (KUNO). We assessed luminal diameters of both CAs normalized as Z-scores by 2D-echocardiography. A total of 94 patients were analyzed. Of them, 31 (33%) were affected by an incomplete form of KD. In 24 children (26%), serial echocardiography was necessary in order to confirm diagnosis. Mean Z-scores for the left main coronary artery (LMCA), right main coronary artery (RMCA), and left anterior descending artery increased significantly between the initial (LMCA 0.79z, RMCA 0.15z, LAD 0.49z) and second (LMCA 1.69z, RMCA 0.99z, LAD 1.69z) examination (p  less then  0.05).ConclusionTo confirm diagnosis of KD, it might not be necessary to detect dilation or aneurysms. Our observation suggests that patients suspected having KD should be monitored with serial echocardiography in order to detect a possible enlargement of the CA diameters, even if Z-scores are within the normal range. What is Known • Kawasaki disease (KD) is an acute vasculitis predominantly affecting the small arteries of young children. Up to 25% of untreated patients suffer from coronary artery (CA) complications. • Due to less classic clinical criteria in patients with incomplete KD, the risk for CA pathology is even higher. What is New • A significant progression of patients' CA Z-scores in serial echocardiographic measurements may be helpful to ensure diagnosis of KD early even if Z-scores are within the normal range. • Twenty-seven patients (90%) with incomplete KD could be diagnosed within 10 days of fever, early enough to prevent significantly higher rates of CA aneurysm.Myocarditis and Kawasaki disease are common but usually distinct diseases in children. During the coronavirus pandemic (COVID-19), reports of a new form of myocarditis with clinical features of Kawasaki appeared. We investigated the place of this new disease in the spectrum encompassing Kawasaki disease and myocarditis.Thirty two consecutive children referred to our centre for a suspicion of Kawasaki or a diagnosis of myocarditis were included and eventually divided into four groups 11 Kawasaki diseases, 6 Kawasaki syndromes (children with another diagnosis), 7 myocarditis without Kawasaki clinical feature and 7 myocarditis with incomplete Kawasaki clinical features. All were treated with immunoglobulins except those of the myocarditis group. The survival rate was 91%. The 7 children with myocarditis and clinical features of incomplete Kawasaki were all positive for SARS-CoV-2. They had a transient myocardial failure with a favourable course and none had coronary artery disease.Conclusion Every COVID-19 child within our population had a mild to severe myocarditis and presented with fever plus two or three Kawasaki clinical features. Short-term evolution was good for these children. This new disease seems to fill the gap between isolated myocarditis and Kawasaki disease. What is Known • A new paediatric disease close to Kawasaki disease appeared during the COVID-19 pandemic What is New • In our population, children presented with fever, vivid Kawasaki clinical features (although the Kawasaki syndrome was always incomplete) and a myocarditis without coronary abnormalities. • The new disease fills the gap between paediatric myocarditis and Kawasaki disease but its prognosis is much better.
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