Safety of Percutaneous Dilatational Tracheostomy in Critically Ill Adults With Obesity: A Retrospective Cohort Study.

Objective: This study aimed to assess the safety and efficacy of endoscopic percutaneous dilatational tracheostomy (PDT) in obese and nonobese critically ill adults.

Methods: A retrospective study of all cases of PDT performed at two academic health centers between 2016 and 2023 was conducted. Primary outcomes included peri- and postoperative complications stratified by both timing and severity.

Ceftazidime Poloxamer Gel: Expanding the Therapeutic Armamentarium for Ciprofloxacin-Resistant Pseudomonas Mastoid Cavity Otorrhea.

Objective: To present and evaluate the treatment of ciprofloxacin-resistant Pseudomonas mastoid cavity otorrhea with a ceftazidime thermosensitive poloxamer gel.

Study Design: A retrospective clinical capsule report.

Patients: Three patients diagnosed with ciprofloxacin-resistant Pseudomonas otorrhea in the setting of a previous canal-wall-down mastoidectomy between March 2019 and June 2023 visiting our tertiary care institution were retrospectively reviewed.

Endoscopic repair of tracheoesophageal fistulas: A contemporary multi-institutional case series and literature review.

Objectives: Recurrent and primary tracheoesophageal fistulas (TEFs) are a challenging surgical pathology to treat, as standard open surgical approaches are associated with high morbidity and mortality. As such, endoscopic modalities have gained interest as an alluring alternative, yet variable success rates have been reported in the literature. The aim of this study was to provide a contemporary update of the literature and describe our institutional experience with the bronchoscopic obliteration of recurrent and primary TEFs.

Patient-Reported Outcome Measures of Psychosocial Quality of Life in Oropharyngeal Cancer Patients: A Scoping Review.

Oropharyngeal squamous cell carcinoma (OPSCC) patients are burdened by the effect of the disease process and treatment toxicities on organs important in everyday activities, such as breathing, speaking, eating, and drinking. There is a rise in OPSCC due to human papilloma virus (HPV)-associated OPSCC, affecting younger and healthier patients and with a better overall prognosis. Emphasis must be shared between oncologic outcomes and the effects on quality of life.

International Pediatric Otolaryngology Group: Consensus guidelines on the diagnosis and management of non-tuberculous mycobacterial cervicofacial lymphadenitis.

Introduction: Non-tuberculous mycobacterial (NTM) infection commonly manifests as subacute or chronic cervicofacial lymphadenitis in immunocompetent children. The optimal management of this pathology remains controversial.

Objectives: This international consensus guideline aims to understand the practice patterns for NTM cervicofacial lymphadenitis and to address the primary diagnostic and management challenges.

Complication Rate of Percutaneous Dilatational Tracheostomy in Critically Ill Adults With Obesity: A Systematic Review and Meta-analysis.

Importance: Obesity has traditionally been described as a relative contraindication to percutaneous dilatational tracheostomy (PDT). Increased familiarity with the technique and use of bronchoscopy or real-time ultrasonography to enhance visualization have led many practitioners to expand the indication for PDT to patients historically deemed to have high risk of perioperative complications.

Objective: To assess the reported complication rate of PDT in critically ill adults with obesity and compare it with that of open surgical tracheostomies (OSTs) in this patient population and with that of PDT in their counterparts without obesity.

Herpes Zoster of The Larynx: A Narrow Diagnostic and Therapeutic Window.

We hereby present a rare case of laryngeal zoster presenting with unilateral odynophagia and hemifacial pain in an immunocompetent host. Visualization of the characteristic vesicles is challenging given their short-lived and at times delayed appearance; thus, laryngeal zoster may be a largely unrecognized cause of laryngitis and cranial neuropathies. Heightened awareness may improve prompt diagnosis, referral and initiation of antiviral therapy, while guiding patient counselling on the associated long-term sequelae such as voice and swallowing impairments, and post-herpetic neuralgia.

Effect of Perioperative Patient Education via Animated Videos in Patients Undergoing Head and Neck Surgery: A Randomized Clinical Trial.

Importance: Patient education and engagement is a pivotal component of surgical recovery. Ensuring proper patient education involves a thorough understanding of one's diagnosis and recovery plan, while reducing language and learning barriers to help patients make informed decisions and improve their hospital experience.

Objective: To assess whether using an animated surgical guide will help patients who are undergoing head and neck surgery feel more satisfied with their surgery and recovery process.

Metastatic Clear Renal-Cell Carcinoma Mimicking Anaplastic Thyroid Cancer: A Case Report.

Metastatic renal cell carcinoma to the thyroid is a rare yet aggressive histopathologic diagnosis, which may often be omitted from the initial clinical differential. This is in part due to the long latency period between the initial renal primary and appearance of metastatic disease, coupled with the diagnostic limitations of fine-needle aspiration biopsies. We herein present an interesting case of a metastatic clear-cell renal-cell carcinoma mimicking an aggressive primary thyroid neoplasm, 10 years after a nephrectomy for a renal primary, highlighting key diagnostic and management considerations.

Procedural Sedation in Minor Procedure Rooms for Pediatric Myringotomy and Tympanostomy: A Quality Improvement Initiative.

Objective: Lengthy wait times for elective surgery is a widespread health care system conundrum that may increase patient distress and jeopardize health outcomes. The primary aim of this quality improvement project was to reduce the surgical wait time in patients undergoing tympanostomy tube insertion.

Methods: As of January 2018, our tertiary care institution implemented a novel protocol whereby healthy children may undergo tympanostomy tube insertion in a minor procedure room under ketamine sedation administered by pediatric emergency physicians to address lack of both physical and anesthesia staffing resources.

Aerosolization in Endoscopic Sinus Surgery and Risk Mitigation in the COVID-19 Era: A Scoping Review.

 The continually evolving coronavirus disease 2019 (COVID-19) pandemic has created a dire need for rapid reorganization of health care delivery within surgical services. Ensuing initial reports of high infection rates following endoscopic sinus and skull base surgery, various expert and societal guidelines have emerged. We hereby provide a scoping review of the available literature on endoscopic sinus and skull base surgery, exploring both the risk of aerosolization and expert recommendations on surgical management during the pandemic.

Hickam's dictum: Angiosarcoma-to-meningioma metastasis.

Tumor-to-tumor metastasis is a seldom reported phenomenon whereby a neoplasm seeds within another histologically distinct tumor, with only 84 cases documented in the literature. We hereby describe the case of a 95-year-old woman who died of widespread metastases identified as a primary hepatic angiosarcoma on autopsy, and the interesting finding of a seeding foci within a dural meningioma. Although meningiomas are the most common intracranial neoplasms to harbor such a phenomenon, this is to our knowledge the first case where an angiosarcoma was identified as the donor tumor.

A pediatric medulloblastoma presenting as isolated sensorineural hearing loss: Case report and review of the literature.

Medulloblastoma is the most common pediatric malignant brain tumor and carries a relatively grim prognosis despite recent advances in multimodality therapy. Delays in diagnosis and treatment initiation may contribute to worst outcomes. Signs of increased intracranial pressure and ataxia are known presentations of posterior fossa tumors, but sensorineural hearing loss (SNHL) is a seldom reported symptom.

Cutaneous squamous cell carcinoma arising in hidradenitis suppurativa: A case report.

We present a case of a 64-year-old man who presented with a rapidly growing tumor in the left buttock and intergluteal cleft area, which was affected by hidradenitis suppurativa. The patient was on tumor necrosis factor-alpha inhibitors for hidradenitis suppurativa for 2 years prior to the development of the mass. Initial biopsy of the mass showed a well-differentiated squamous cell carcinoma with spindle cells and positive epithelial immunomarkers.