Risk of death at home or on hospital readmission after discharge with pediatric tracheostomy.

Objective: To evaluate outcomes of patients discharged home following tracheostomy, including the timing and place of death for non-survivors.

Study Design: We retrospectively reviewed medical records of infants undergoing tracheostomy between 2006 and 2017, within the first year of life for congenital or acquired neonatal conditions.

Results: Of the 224 patients discharged after tracheostomy, 127 (57%) required home mechanical ventilation (MV).

Hospital Admissions in Pediatric Patients With Tracheostomies Based on Rurality and Insurance Status.

Objective: Determine whether rurality or public insurance status is associated with greater 30-day readmission after tracheostomy in pediatric patients.

Study Design: Retrospective cohort.

Setting: Pediatric Health Information System (PHIS) Database.

The Effect of Anonymity on Quality of Resident Feedback.

Objective: Quality feedback is critical to facilitate better performance and quicker learning. However, faculty may be hesitant to provide quality constructive feedback, especially in written form, due to fear of retaliation. We evaluated the impact of faculty anonymity on the quality of faculty-to-resident feedback.

Well-Differentiated Thyroid Cancer Invading the Trachea in a Pediatric Patient.

Objectives: Pediatric thyroid cancer is rare. Most cases are well-differentiated thyroid cancers (WDTCs). However, gross laryngotracheal invasion of WDTCs is unusual.

The Difficult Airway Navigator: Development and Implementation of a Health Care System's Approach to Difficult Airway Documentation Utilizing the Electronic Health Record.

Careful airway risk assessment and procedural planning are vital to ensure patients' safety during airway management. Patients with known procedural difficulty during previous airway management or new anatomical changes pose challenges and risks. To improve communication and the value of documented information regarding difficult airway management for future clinical encounters, we utilized existing electronic health record functions to develop a "difficult airway Navigator.

The low value of pre-decannulation capped overnight ICU monitoring for pediatric patients.

Objective: To determine the value of pre-decannulation capped overnight ICU monitoring for assessing decannulation-readiness in pediatric patients.

Methods: This study included all pediatric patients, age 18 and under, with a tracheostomy attempting decannulation at the University of Michigan between 2013 and 2018. Patients who underwent major airway reconstruction immediately prior to decannulation were excluded.

Neonatal Lateral Epiglottic Defects.

Introduction: Multiple congenital abnormalities of the epiglottis have been reported and iatrogenic injuries to the larynx and subglottis are well known. We present a new pattern of defect not previously reported in the literature.

Methods: Epiglottic abnormalities at two institutions are reviewed.

Association of Opioid Quantity and Caregiver Education with Pain Control after Pediatric Tonsillectomy.

Objective: To examine whether a service guideline reducing postoperative opioid prescription quantities and caregiver-reported education to use nonopioid analgesics first are associated with caregiver-reported pain control after pediatric tonsillectomy.

Study Design: Prospective cohort study (July 2018-April 2019).

Setting: Pediatric otolaryngology service at a tertiary academic children's hospital.

Evaluation of Safety of Intralesional Cidofovir for Adjuvant Treatment of Recurrent Respiratory Papillomatosis.

Importance: The use of intralesional cidofovir injections for recurrent respiratory papillomatosis (RRP) remains controversial owing to concern regarding the risks of its use, including increased risk of dysplasia or carcinogenesis.

Objective: To describe the rates of dysplasia, development of malignant lesions, and adverse events associated with use of intralesional cidofovir injections as adjuvant treatment for RRP compared with patients treated without adjuvant cidofovir.

Design, Setting, And Participants: In this case series performed at a tertiary care referral center, review of electronic medical records on all adult and pediatric patients (N = 154) treated for RRP with adequate follow-up from January 1, 2000, to December 31, 2016, was performed.

Eliminating Unnecessary Opioid Exposure After Common Children's Surgeries.

This study investigates patient-reported opioid consumption after pediatric operations.

Association of Perioperative Opioid Prescriptions With Risk of Complications After Tonsillectomy in Children.

Importance: Practice guidelines recommend nonopioid medications in children after tonsillectomy, but to date, studies have not used recent national data to assess perioperative opioid prescribing patterns or the factors associated with these patterns in this population. Closing this knowledge gap may help in assessing whether such prescribing and prescription duration could be safely reduced.

Objective: To assess national perioperative opioid prescribing patterns, clinical and demographic factors associated with these patterns, and association between these patterns and complications in children after tonsillectomy compared with children not using opioids.

Positive airway pressure ventilation and complications in pediatric tracheocutaneous fistula repair.

Objectives: Surgical repair of persistent tracheocutaneous fistula in children may be complicated by tracheal air leak with resultant subcutaneous emphysema, pneumomediastinum, and/or pneumothorax. We first sought to identify clinical risk factors for postoperative complications after primary repair of persistent tracheocutaneous fistula in children. Second, the type and frequency of complications in patients administered positive airway pressure ventilation (e.

Comparison of Outcomes in Medical Therapy vs Surgical Intervention of Esophageal Foreign Bodies.

Objectives (1) Compare efficacy of primary medical therapy vs primary surgical intervention in patients with esophageal foreign bodies (EFBs). (2) Investigate variables that may predict successful outcomes in patients treated for EFBs. Study Design Case series with chart review.

Monothermal Caloric Screening to Improve Healthcare Value.

Objectives: To evaluate whether monothermal caloric screening can reduce the number of caloric irrigations required in the vestibular testing battery while maintaining diagnostic accuracy.

Design: Prospective controlled cohort study. Three hundred and ninety patients referred for vestibular testing at this tertiary referral health system over a 1-year period were evaluated; 24 patients met exclusion or failure criteria and 366 patients were included in the study.

High-volume bilateral chylothorax presenting with hypoxemia and shock in a pediatric patient following tracheostomy revision: a case report.

Introduction: Chylothorax is a rare complication of surgical neck dissection. This is the first reported pediatric case of bilateral chylothorax following cervical surgery and the first to occur after tracheoplasty. Chylothorax can lead to significant complications, including hypoxemia and shock, and requires timely treatment.

ACEMg supplementation ameliorates progressive Connexin 26 hearing loss in a child.

Mutations in the gene encoding Connexin 26 are the most common cause of genetic hearing loss. The hearing loss is typically stable but may be progressive. The reason for progression is unknown.

Intensive care unit versus non-intensive care unit postoperative management of head and neck free flaps: comparative effectiveness and cost comparisons.

Background: Despite its widespread use, there is no consensus on the postoperative management in patients undergoing free flap reconstructions. We report the largest study comparing flap outcomes, morbidity, and cost in patients with head and neck cancer free flaps who recovered in the intensive care unit (ICU) versus a "specialty floor" setting.

Methods: This was a retrospective review of patients undergoing free flap surgery for head and neck defects over a 4-year period.