Bioinformatics characterization of variants of uncertain significance in pediatric sensorineural hearing loss.

Introduction: Rapid advancements in Next Generation Sequencing (NGS) and bioinformatics tools have allowed physicians to obtain genetic testing results in a more rapid, cost-effective, and comprehensive manner than ever before. Around 50% of pediatric sensorineural hearing loss (SNHL) cases are due to a genetic etiology, thus physicians regularly utilize targeted sequencing panels that identify variants in genes related to SNHL. These panels allow for early detection of pathogenic variants which allows physicians to provide anticipatory guidance to families.

Transient Auditory Neuropathy with Resurgence of Electrophysiological Waveforms Observed between the Neonatal Period and Age 3 Years.

Auditory neuropathy spectrum disorder (ANSD) is a spectrum of conditions marked by diminished auditory function and believed to be caused by the impaired neural transmission of auditory stimulation in the setting of functional outer hair cells. There are reports of "spontaneously resolving" or "transient" ANSD (transient auditory neuropathy [TAN]) in the literature. In this case report of TAN, we demonstrate the resurgence of the auditory brainstem response waveform morphology over a 3-year period to reveal electrophysiological testing consistent with the patient's functional hearing level by age 3 years.

Non-protective immunity after standard pneumococcal vaccination series identified as a potential contributing risk factor for refractory otolaryngologic conditions in children.

Objective: To examine the relationship between conferred immunity after standard pneumococcal series and refractory otolaryngologic infections in pediatric patients using post-vaccination antibody titers, and to identify contributory underlying conditions revealed when vaccination/re-vaccination fails to confer protective immunity.

Study Design: IRB-reviewed and "exempt" retrospective case series with chart review using the Epic Electronic Medical Record system from 2013 to 2021.

Setting: Dedicated tertiary referral children's hospital.

Telehealth Adoption and Perspectives Among Pediatric Otolaryngologists Following the COVID-19 Pandemic.

Objectives: To assess use of and physician experiences with pediatric otolaryngology telehealth visits as impacted by the COVID-19 pandemic.

Study Design/setting: Cross sectional survey.

Methods: A 15-question survey was electronically distributed to 656 members of the American Society of Pediatric Otolaryngology in August 2021, addressing member demographics, experiential practice elements, and use pre-pandemic, during the initial shutdown period of March-May 2020, and current use at the time of survey inquiry.

Racial identification represents significant risk factor for healthcare disparity among patients with severe bronchopulmonary dysplasia treated with tracheostomy.

Objectives: To characterize the patient population with severe bronchopulmonary dysplasia (BPD) requiring tracheostomy in a large tertiary level 4 neonatal intensive care unit (NICU) and to identify potential targets for improvement in the delivery of high-quality healthcare.

Methods: An IRB-exempt but IRB-registered retrospective review of medical records. Study inclusion criteria: patients treated for severe BPD with tracheostomy under 2 years of age in our tertiary referral center NICU.

Multifractal Analysis to Determine the Effect of Surface Topography on the Distribution, Density, Dispersion and Clustering of Differently Organised Coccal-Shaped Bacteria.

The topographic features of surfaces are known to affect bacterial retention on a surface, but the precise mechanisms of this phenomenon are little understood. Four coccal-shaped bacteria, , , , and , that organise in different cellular groupings (grape-like clusters, tetrad-arranging clusters, short chains, and diploid arrangement, respectively) were used. These differently grouped cells were used to determine how surface topography affected their distribution, density, dispersion, and clustering when retained on titanium surfaces with defined topographies.

Practical recommendations for planning and running live online education workshops for the rural health workforce.

Aim: This commentary presents practical and evidenced based guidelines for the development and delivery of real-time online training workshops aimed at rural health professionals.

Context: Online learning is increasingly being used as an avenue for delivering education, particularly to rural and remote sites where barriers persist in upskilling health workers. Further, online learning has become essential during the coronavirus disease 2019 (COVID-19) pandemic.

The Removal of Meat Exudate and from Stainless Steel and Titanium Surfaces with Irregular and Regular Linear Topographies.

Bacterial retention and organic fouling on meat preparation surfaces can be influenced by several factors. Surfaces with linear topographies and defined chemistries were used to determine how the orientation of the surface features affected cleaning efficacy. Fine polished (irregular linear) stainless steel (FPSS), titanium coated fine polished (irregular linear) stainless steel (TiFP), and topographically regular, linear titanium coated surfaces (RG) were fouled with mixed with a meat exudate (which was utilised as a conditioning film).

Health literacy rates among pediatric tracheostomy caregivers.

Introduction: As health outcomes and disparities become more important in national healthcare, physicians must be aware of every patient's health literacy in order to deliver effective care. Our goal was to measure the health literacy rates in the caregivers of our pediatric tracheostomy population. These caregivers specifically have an immense responsibility that requires a certain capacity for understanding and learning complex skills.

Bronchopulmonary dysplasia requiring tracheostomy: A review of management and outcomes.

Bronchopulmonary Dysplasia (BPD) is a pulmonary disease affecting newborns, commonly those with prematurity or low birth weight. Its pathogenesis involves underdevelopment of lung tissue with subsequent limitations in ventilation and oxygenation, resulting in impaired postnatal alveolarization. Despite advances in care with improved survival, BPD remains a prevalent comorbidity of prematurity.

A Surgical Simulator for Tympanostomy Tube Insertion Incorporating Capacitive Sensing Technology to Track Instrument Placement.

We describe a device engineered for realistic simulation of myringotomy and tympanostomy tube insertion that tracks instrument placement and objectively measures operator proficiency. A 3-dimensional computer model of the external ear and cartilaginous external auditory canal was created from a normal maxillofacial computed tomography scan, and models for the bony external auditory canal and tympanic cavity were created with computer-aided design software. Physical models were 3-dimensionally printed from the computer reconstructions.

Extracellular matrix for repair of type IV laryngotracheo-esophageal cleft.

Type IV laryngotracheo-esophageal cleft (LTEC) extending to the level of the carina presents unique challenges to operative repair, particularly with respect to soft tissue durability. This is the first report of CorMatrix(®) extra-cellular matrix (ECM) material use as an interposition graft in a four-layered LTEC repair. At day seven post-operatively, there was epithelialization along the surface of the trachea.

Otopathogens Detected in Middle Ear Fluid Obtained during Tympanostomy Tube Insertion: Contrasting Purulent and Non-Purulent Effusions.

Otitis media is a prominent disease among children. Previous literature indicates that otitis media is a polymicrobial disease, with Haemophilus influenzae, Streptococcus pneumoniae, Alloiococcus otitidis and Moraxella catarrhalis being the most commonly associated bacterial pathogens. Recent literature suggests that introduction of pneumococcal conjugate vaccines has had an effect on the etiology of otitis media.

Suppurative cervical lymphadenitis in infancy: microbiology and sociology.

Objective: To investigate the associations between patient age, sociological factors, and the microbiology of pediatric neck infections.

Methods: Retrospective chart review of children up to 5 years old who underwent surgical management of suppurative cervical lymphadenitis.

Results: A total of 76 individuals met inclusion criteria; 93% of culture-positive infections were caused by Staphylococcus aureus in infants, compared with 59% in children between 13 months and 5 years of age (P = .

Compliance with recommendations for tympanostomy tube follow-up: patient characteristics.

Objectives: (1) To determine the percentage of otherwise healthy patients achieving "graduation," or postoperative compliance achieving complete problem resolution and discharge from the otolaryngologist's care, after tympanostomy tube placement. (2) To analyze follow-up behaviors and patient characteristics influencing the likelihood of graduation.

Study Design: Retrospective cohort study.

Simulation model for tracheotomy education for primary health-care providers.

Objectives: We performed this study to evaluate the competency of health-care providers managing patients with tracheotomies, and assess the need for, and efficacy of, a multidisciplinary educational program incorporating patient simulation.

Methods: The prospective observational study included 87 subjects who manage patients with tracheotomies within a tertiary-care hospital. The subjects completed self-assessment questionnaires and objective multiple-choice tests before and after attending a comprehensive educational course using patient simulation.

Computed tomography supports histopathologic evidence of vestibulocochlear sexual dimorphism.

Objective: To investigate whether the effects of sex (male/female) that have been demonstrated in the pathology literature using 0.1 mm histopathologic slices are measurable and statistically significant using high-resolution (0.625 mm slice) computed tomography (CT).

A review of unilateral hearing loss and academic performance: is it time to reassess traditional dogmata?

Objective: The aim of this paper was to review traditional approaches to habilitation of unilateral hearing losses as well as new research concerning management of unilateral hearing loss.

Data Sources: Literature review/systematic review.

Review Methods: A PubMed search was performed for articles pertaining to unilateral hearing loss and academic loss and academic performance.

Disk battery ingestion: case series with assessment of clinical and financial impact of a preventable disease.

Background: Commonly, foreign objects are incidentally ingested and pass harmlessly through the gastrointestinal tract; however, disk batteries present exceptional risk. In 2009, the American Association of Poison Control Centers listed disk batteries as the number 1 cause of fatal ingestions in children younger than 5 years. Lithium batteries are the most dangerous, and they are rapidly rising in use by manufacturers.

One third of middle ear effusions from children undergoing tympanostomy tube placement had multiple bacterial pathogens.

Background: Because previous studies have indicated that otitis media may be a polymicrobial disease, we prospectively analyzed middle ear effusions of children undergoing tympanostomy tube placement with multiplex polymerase chain reaction for four otopathogens.

Methods: Middle ear effusions from 207 children undergoing routine tympanostomy tube placement were collected and were classified by the surgeon as acute otitis media (AOM) for purulent effusions and as otitis media with effusion (OME) for non-purulent effusions. DNA was isolated from these samples and analyzed with multiplex polymerase chain reaction for Haemophilus influenzae, Streptococcus pneumoniae, Alloiococcus otitidis, and Moraxella catarrhalis.

Detection of group A Streptococcus in tonsils from pediatric patients reveals high rate of asymptomatic streptococcal carriage.

Background: Group A Streptococcus (GAS) causes acute tonsillopharyngitis in children, and approximately 20% of this population are chronic carriers of GAS. Antibacterial therapy has previously been shown to be insufficient at clearing GAS carriage. Bacterial biofilms are a surface-attached bacterial community that is encased in a matrix of extracellular polymeric substances.