Findings on drug-induced sleep endoscopy in infants with laryngomalacia.

Introduction: Obstructive sleep apnea (OSA) is highly prevalent in infants with laryngomalacia (LM). Previous studies have reported high rates of persistent OSA following supraglottoplasty (SGP). The objective of this study is to describe the findings on drug-induced sleep endoscopy (DISE) in infants with LM.

Safety and efficacy of lingual tonsillectomy in multilevel airway surgery for pediatric obstructive sleep apnea.

Study Objectives: Prior studies have demonstrated the efficacy of lingual tonsillectomy in treating pediatric obstructive sleep apnea. The goal of this study is to describe the postoperative outcomes following lingual tonsillectomy as a part of drug-induced sleep endoscopy-directed multilevel sleep surgery.

Methods: A retrospective review was performed for pediatric patients with obstructive sleep apnea who underwent lingual tonsillectomy as a part of drug-induced sleep endoscopy-directed sleep surgery.

Cochlear Implant Salvage in Case of Grounding Wire Extrusion.

Objectives: Cochlear implantation (CI) is a safe and effective procedure for hearing rehabilitation, with few major complications. Device exposure or extrusion is a rare but major complication that often necessitates explantation due to wound dehiscence or infection. The objective of this report is to present a previously undescribed case in which the cochlear implant grounding wire extruded in 16-month-old patient 3 months post-operatively in the absence of trauma or infection.

Reliability of a pediatric sleep endoscopy scoring system.

Introduction: The surgical management of Obstructive Sleep Apnea (OSA) may be guided by Drug Induced Sleep Endoscopy (DISE), but there is no universally accepted scoring system for DISE in children. The purpose of this study is to compare a novel system to the more commonly used VOTE (Velum, Oropharynx, Tongue base, Epiglottis) system.

Methods: A total of thirty pediatric DISE videos were reviewed and scored twice by 5 raters with a range of experience levels.

Late Retropharyngeal and Parapharyngeal Abscess in Patients with a History of Anterior Cervical Discectomy and Fusion.

Objective: Anterior cervical discectomy and fusion is a common procedure performed by spine surgeons with rare complications and high treatment success. Late presentation of retropharyngeal abscess in patients with a history of anterior cervical discectomy and fusion is rare but can have devastating consequences. There is a paucity of data to guide medical and surgical management of retropharyngeal abscess in these patients.

Base of Tongue Surgery and Pediatric Obstructive Sleep Apnea.

Objective: Drug-induced sleep endoscopy-directed lingual tonsillectomy and midline posterior glossectomy have been employed for the treatment of obstructive sleep apnea in children. The purpose of this study is to evaluate outcomes in children undergoing lingual tonsillectomy, midline posterior glossectomy, or combined base of tongue reduction procedures for obstructive sleep apnea.

Study Design: Case series with chart review.

Development of a Decision Aid for Parents Who Elect Tonsillectomy for Obstructive Sleep Apnea.

Objective: To develop a novel patient decision aid (PtDA) for parents considering tonsillectomy for their children diagnosed with obstructive sleep apnea (OSA) and compare it to validated scales related to decision making in this context. These included scales for decisional conflict (DC) and shared decision making (SDM).

Methods: A parental survey during 2017 to 2018 in a tertiary care pediatric otolaryngology clinic was conducted comparing a validated Decisional Conflict Scale (DCS) with a new PtDA that included an SDM scale, parental treatment goals, and knowledge about adenotonsillectomy and OSA.

Impact of Oral Steroids on Tonsillectomy Postoperative Complications and Pain.

Objectives: To analyze the impact of steroids on postoperative tonsillectomy recovery and implement findings for improvement in postoperative management.

Methods: Institutional review board approved prospective study with retrospective analysis of private practice setting tonsillectomy patients (November 2015 to January 2017). A questionnaire was provided postoperatively to patients undergoing tonsillectomy with or without adenoidectomy.

Pediatric Drug-Induced Sleep Endoscopy: Technique and Scoring System.

Drug-induced sleep endoscopy (DISE) is an invaluable tool for identifying sites of obstruction for patients with obstructive sleep apnea (OSA). During DISE, the patient is in a state of drug-induced sleep, and a flexible laryngoscope is passed through the nose into the upper airway. Sites of obstruction are visualized and scored to guide surgical management.

Surgical Intervention for Laryngomalacia: Age-Related Differences in Postoperative Sequelae.

Objective: Identify risk factors and determine perioperative morbidity of children undergoing surgery for laryngomalacia (LM).

Methods: A retrospective analysis of the multi-institutional American College of Surgeons National Surgical Quality Improvement Program-Pediatric Database (ACS-NSQIP-P) was performed to abstract patients aged <18 years with LM (ICD-10 code Q31.5) who underwent laryngeal surgery (CPT code 31541) from 2015 to 2017.

Role of monoaminergic systems and ambient temperature in bath salts constituent 3,4-methylenedioxypyrovalerone (MDPV)-elicited hyperthermia and locomotor stimulation in mice.

3,4-Methylenedioxypyrovalerone (MDPV) is a common constituent of illicit bath salts products, and in vitro studies implicate monoamine transporters as mediators of its pharmacological effects. Locomotor and thermoregulatory effects of MDPV depend on ambient temperature, so the current studies aimed to gauge the involvement of dopamine (DA), norepinephrine (NE), and serotonin (5-HT) in MDPV-induced locomotor stimulation and hyperthermia in the mouse at different ambient temperatures. Mice were pretreated with the selective 5-HT-reuptake inhibitor fluoxetine (3 mg/kg), the NE-reuptake inhibitor desipramine (3 mg/kg), the DA-reuptake inhibitor bupropion (10 mg/kg), or saline, followed by 10 mg/kg MDPV while thermoregulation and locomotor activity were monitored via radiotelemetry.

Stereoselective Effects of Abused "Bath Salt" Constituent 3,4-Methylenedioxypyrovalerone in Mice: Drug Discrimination, Locomotor Activity, and Thermoregulation.

3,4-Methylenedioxypyrovalerone (MDPV) is a common constituent of illicit "bath salts" products. MDPV is a chiral molecule, but the contribution of each enantiomer to in vivo effects in mice has not been determined. To address this, mice were trained to discriminate 10 mg/kg cocaine from saline, and substitutions with racemic MDPV, S(+)-MDPV, and R(-)-MDPV were performed.