High microbiome variability in pediatric tracheostomy cannulas in patients with similar clinical characteristics.

Objectives: To evaluate the bacterial microbiome found in tracheostomy cannulas of a group of children diagnosed with glossoptosis secondary to Robin Sequence (RS), and its clinical implications.

Methods: Pediatric patients were enrolled in the study at the time of the cannula change in the hospital. During this procedure, the removed cannula was collected and stored for amplicon sequencing of 16s rRNA.

Sialendoscopy for Improvement of Salivary Flow in Patients with Sjögren Syndrome - Comparative Analysis of Intraglandular Washing Solutions.

 Among the potential diseases that present altered salivary flow and activity is Sjögren syndrome. Sialendoscopy seems to be an important therapeutic option.  To compare the results obtained with sialendoscopy for improving salivary flow measured by scintigraphy in patients with primary Sjögren syndrome to those obtained with other intraglandular washing solutions.

Accuracy of stridor-based diagnosis of post-intubation subglottic stenosis in pediatric patients.

Objective: To assess the accuracy of stridor in comparison to endoscopic examination for diagnosis of pediatric post-intubation subglottic stenosis.

Method: Children who required endotracheal intubation for >24h were included in this prospective cohort study. Children were monitored daily and underwent flexible fiberoptic laryngoscopy after extubation.

Impact of balloon laryngoplasty on management of acute subglottic stenosis.

Purpose: To assess the impact of balloon laryngoplasty on clinical and surgical outcomes in pediatric patients with acute subglottic stenosis.

Methods: Two case series were included and compared. The first group included patients treated initially either with tracheostomy (if severe symptoms) or with close follow-up (if mild symptoms).

The effect of mandibular distraction osteogenesis on airway obstruction and polysomnographic parameters in children with Robin sequence.

Introduction: The optimal surgical technique for the management of patients with Robin Sequence (RS) has not been established. One of the most commonly used surgical techniques, mandibular distraction osteogenesis (MDO), is still controversial because of its potential risks and the lack of clear evidence of its efficacy.

Objectives: To assess variations in airway patency, clinical symptoms, and polysomnographic parameters in children with RS who underwent MDO.

Association of polysomnographic parameters with clinical symptoms severity grading in Robin sequence patients: a cohort nested cross-sectional study.

Objectives: To evaluate the association of polysomnographic parameters with clinical symptom severity in Robin sequence (RS) patients.

Methods: All patients diagnosed as presenting with RS at Hospital de Clínicas de Porto Alegre from October 2012 to June 2016 were enrolled. They were classified as isolated RS, RS-plus, and syndromic RS.

Diagnostic accuracy of current glossoptosis classification systems: A nested cohort cross-sectional study.

Objectives/hypothesis: To assess the performance of endoscopic grading systems of glossoptosis in identifying severe clinical manifestations in children with Robin sequence (RS).

Study Design: Nested cohort cross-sectional study.

Methods: All RS patients diagnosed at Hospital Clinics of Porto Alegre from October 2012 to June 2016 were enrolled in this cohort.

Maxillary Hypoplasia: Differential Diagnosis of Nasal Obstruction in Infants.

Maxillary hypoplasia (MH) is a rare cause of respiratory dysfunction in infants and may occur in association with genetic abnormalities or as an isolated condition. It is included in the differential diagnosis of congenital nasal obstruction. This paper seeks to report a case series of infants with MH, discuss methods for its diagnosis, and compare computed tomography (CT) measurements of nasal cavities of infants with MH and without craniomaxillofacial abnormalities.

Laryngeal surgical treatment in transgender women: A systematic review and meta-analysis.

Objective: To identify the effects of laryngeal surgical treatment in the voice of transgender women, especially on the fundamental frequency (f0).

Study Design: We performed a systematic review in PubMed and Scopus in July 2016, covering the period between 2005 and 2016.

Methods: Inclusion criteria were studies in English or Portuguese about the laryngeal surgical treatment in transgender women, featuring experimental design, title, year of publication, country of origin, journal of publication, participants, intervention, results.

Association of endotracheal tube repositioning and acute laryngeal lesions during mechanical ventilation in children.

The objective of this study is to determine the incidence of post-extubation acute laryngeal lesions in a pediatric intensive care unit (PICU) and potential risk factors. Children, aged 28 days to 5 years, admitted to the PICU who required endotracheal intubation for at least 24 h were enrolled. Exclusion criteria were a previous intubation, history of laryngeal disease, current or past tracheostomy, the presence of craniofacial malformations and patients considered on palliative care.

Influence of dietary and physical activity restriction on pediatric adenotonsillectomy postoperative care in Brazil: a randomized clinical trial.

Introduction: Although culturally food and physical activity restriction are part of the routine postoperative care of many Brazilian surgeons, current evidences from other countries support no such recommendations.

Objective: To determine whether dietary and physical restriction effectively lead to a decrease on postoperative complications of adenotonsillectomy in children when compared to no restriction.

Methods: We have designed a randomized clinical trial comparing two intervention: no specific counseling on diet or activity (Group A), and restriction recommendations on diet and physical activities (Group B).

Undersedation is a risk factor for the development of subglottic stenosis in intubated children.

Objective: To analyze the level of sedation in intubated children as a risk factor for the development of subglottic stenosis.

Methods: All patients between 30 days and 5 years of age who required endotracheal intubation in the pediatric intensive care unit between 2013 and 2014 were included in this prospective study. They were monitored daily and COMFORT-B scores were obtained.

The role of flexible fiberoptic laryngoscopy in Robin Sequence: A systematic review.

Objective: Systematically search literature for flexible fiberoptic laryngoscopy (FFL) use in Robin Sequence (RS) patients, in diverse clinical scenarios.

Data Sources: Pubmed, LILACS and SCIELO.

Review Methods: Systematic review using a sensitive search strategy focused on RS patients and FFL.

Severity of clinical manifestations and laryngeal exposure difficulty predicted by glossoptosis endoscopic grades in Robin sequence patients.

Objective: To evaluate the performance of two glossoptosis airway obstruction classifications in predicting symptom severity and laryngeal exposure difficulty in Robin Sequence (RS) patients.

Setting: Public tertiary hospital otolaryngology section (Hospital de Clínicas de Porto Alegre - HCPA).

Patients: All RS patients diagnosed at HCPA from October 2012 to February 2015 were enrolled, a total of 58 individuals.

Tracheostomy in children: a ten-year experience from a tertiary center in southern Brazil.

Introduction: Children may require tracheostomy due to many different health conditions. Over the last 40 years, indications of tracheostomy have endorsed substantial modifications.

Objective: To evaluate pediatric patients warranted tracheostomy at our Hospital, in regard to their indications, associated comorbidities, complications and decannulation rates.

Glossoptosis.

Glossoptosis causes varying degrees of airway obstruction and feeding difficulties. It can occur as a consequence of micrognathia in Robin Sequence, but can also occur in children with hypotonia. Despite several attempts to classify severity in Robin Sequence patients, taking into account symptoms, presence of concomitant syndromes or malformations, and even endoscopic findings, there is still no general consensus.

Post-intubation acute laryngeal injuries in infants and children: A new classification system.

Objective: To compare the Classification of Acute Laryngeal Injuries (CALI) with other classifications to determine which of these offers the greatest sensitivity and specificity in predicting the development of subglottic stenosis.

Methods: All children intubated for the first time in the pediatric intensive care unit were included and subjected to flexible fiber-optic laryngoscopy (FFL) within 8 h of extubation. Their injuries were categorized using the CALI, as well as adapted classifications from Lindholm, Colice and Benjamin.

Accuracy of clinical swallowing evaluation for diagnosis of dysphagia in children with laryngomalacia or glossoptosis.

Objective: To investigate the accuracy of clinical evaluation of swallowing in a sample of children with laryngomalacia or glossoptosis and describe the prevalence of dysphagia in each of these diseases, as well as characterize the swallow response to speech and language therapy interventions.

Study Design: Children aged 1 month to 11 years receiving care at the Department of Otolaryngology, Hospital de Clínicas de Porto Alegre, Brazil, were evaluated in a cross-sectional design. Evaluation of swallowing was performed at two time points by two blinded speech-language pathologists, one responsible for clinical evaluation and the other for videofluoroscopic study.

Transsexual Voice Questionnaire for Male-to-female Brazilian Transsexual People.

Objectives: The aim of the study was to verify the answers to the transsexual voice questionnaire for male-to-female transsexual (TVQ) people given to individuals who participated in the Gender Identity Program (PROTIG) at the Hospital de Clínicas de Porto Alegre, Brazil, in relation to some of their demographic characteristics, visual-perceptual evaluations of the face, laryngeal prominence, and auditoryperceptual judgments of voice.

Methods: In this cross-sectional study, 47 transsexual women aged between 18 and 50 responded to the (TVQ). The demographic data and perceptual ratings were selected from the PROTIG database.

Incidence and endoscopic characteristics of acute laryngeal lesions in children undergoing endotracheal intubation.

Introduction: Acute laryngeal lesions after intubation appear to be precursors of chronic lesions.

Objective: To describe the incidence and type of acute laryngeal lesions after extubation in a pediatric intensive care unit (PICU).

Methods: A cohort study involving children from birth to <5 years, submitted to intubation for more than 24h in the PICU of an university hospital.

Correlation Between Flexible Fiberoptic Laryngoscopic and Polysomnographic Findings in Patients with Mucopolysaccharidosis Type VI.

This study aimed to compare flexible fiberoptic laryngoscopy (FFL) and polysomnography (PSG) findings in patients with mucopolysaccharidosis (MPS) type VI and to describe upper airway anatomical findings and abnormal PSG results in these patients. In this cross-sectional study, all MPS VI patients followed up at the genetic division of a hospital in southern Brazil were included. Overnight PSG was performed, and the results were classified as normal or mildly, moderately, or severely abnormal.

Retrospective study of a series of choanal atresia patients.

Introduction Although it has been more than 250 years since the first description of choanal atresia (CA), there are still doubts about this abnormality. The differences between unilateral and bilateral forms are seldom discussed. Objectives Aggregate data from patients diagnosed with CA, grouping patients with unilateral and bilateral forms.

Dermoid of the nasopharynx causing neonatal respiratory distress.

The dermoid is a rare and benign malformation of bigerminal origin. It is seen frequently in the neonatal period, and the clinical presentation depends on the site and on the size of the lesion, and the classical clinical picture is of a tumor derived from the naso- or oropharynx, leading to respiratory distress and/or feeding disorders. A female newborn was born cyanotic requiring intubation.

Association between length of intubation and subglottic stenosis in children.

Objectives/hypothesis: To investigate the role of the length of intubation and other risk factors in the development of laryngeal lesions in children undergoing endotracheal intubation in an intensive care unit and to determine the incidence of subglottic stenosis (SGS).

Study Design: Prospective study.

Methods: Children aged from birth to <5 years admitted to the Pediatric Intensive Care Unit of Hospital de Clinicas de Porto Alegre who required endotracheal intubation for more than 24 hours were eligible.