Vincristine-induced vocal cord paresis and paralysis in children.

Objectives: To describe three new cases of vincristine-induced vocal cord paresis or paralysis (VIVCPP) in children and to review the diagnosis and management of this neuropathy.

Methods: Retrospective case series. Diagnosis of VIVCPP was confirmed by laryngoscopy in all children.

Surgical Outcomes for the Treatment of Velopharyngeal Insufficiency in 22q11.2 Deletion Syndrome.

This study aimed to compare outcomes of concomitant palatoplasty and sphincter pharyngoplasty with pharyngeal flap and sphincter pharyngoplasty alone for the treatment of velopharyngeal insufficiency in patients with 22q11.2 deletion syndrome. Thirty-one cases were identified for inclusion in the study.

Congenital and iatrogenic laryngeal and vocal abnormalities in patients with 22q11.2 deletion.

Background: Voice abnormalities often go unrecognized in patients with 22q11.2 deletion because speech abnormalities become the focus of evaluation.

Objective: To analyze voice and vocal fold abnormalities in patients with 22q11.

Upper airway obstruction in neonates: Does sleep exacerbate symptoms?

Objective: Describe the factors that exacerbate upper airway obstructions (UAOs) in neonates.

Study Design: Retrospective chart review.

Setting: Pediatric tertiary care hospital.

Sleep and Speech Outcomes After Superior Adenoidectomy in Children with Cleft Palate.

Objective To describe the sleep and speech outcomes in patients with cleft palate who underwent superior adenoidectomy. Subjectives and methods This is a case series with chart review of patients with diagnoses of cleft palate and sleep disordered breathing (SDB), obstructive sleep apnea (OSA) or nasal obstruction treated with superior adenoidectomy from 1991-2015 at the Children's Hospital of Minnesota. Postoperative clinic notes documented the changes in symptoms following surgery.

Assisted Reproduction is Not Associated with Increased Risk of Congenital Head and Neck Defects.

This abstract was presented at the American Academy of Otolaryngology-Head and Neck Surgery Annual Meeting, Orlando, FL, September 2014 with the abstract published (Neumann C, Thompson D, and Sidman J; Assisted reproduction is not associated with increased risk of head and neck defects; Otolaryngology-Head and Neck Surgery; Vol 151, Issue 1, supplement, 2014). Objectives - Compare the rate of head and neck anomalies between children conceived via artificial reproductive technology (ART) versus those conceived via natural methods. - Determine the risk of congenital head and neck abnormalities associated with ART.

Neuroradiographic findings in 22q11.2 deletion syndrome.

22q11.2 deletion syndrome (22q11.2DS) is a common genetic disorder with enormous phenotypic heterogeneity.

Excision of sublingual gland as treatment for ranulas in pediatric patients.

Objective: The aim of this case study is to demonstrate that post-operative complication rates of sublingual gland excision for treatment of ranulas are equal to or less than alternative methods with a lower recurrence rate than other surgical methods.

Methods: This was a retrospective review of pediatric patients from 2004 to 2015 at Children's Hospitals and Clinics of Minnesota. Sixteen ranulas and 6 plunging ranulas were treated via sublingual gland excision during this time frame.

Early Airway Intervention for Craniofacial Anomalies.

This article reviews the presentation of children with craniofacial anomalies by the most common sites of airway obstruction. Major craniofacial anomalies may be categorized into those with midface hypoplasia, mandible hypoplasia, combined midface and mandible hypoplasia, and midline deformities. Algorithms of airway interventions are provided to guide the initial management of these complex patients.

Prevention and Treatment of Pain in Children: Toward a Paradigm Shift.

Rosenfeld et al in their recent article "Office Insertion of Tympanostomy Tubes without Anesthesia in Young Children" describe using a "papoose board for restraint" while performing a procedure resulting in severe pain for a significant number of children: a myringotomy and tube insertion. In 2016, it is inappropriate to perform elective painful procedures in children without treatment to avoid or minimize pain. We strongly disagree with the authors' conclusion "that office insertion of tubes in young children is a feasible alternative to general anesthesia for caregivers and clinicians who are comfortable with this choice.

Clefting of the Alveolus: Emphasizing the Distinction from Cleft Palate.

Oral clefting is one of the most common significant fetal abnormalities. Cleft lip and cleft palate have drastically different clinical ramifications and management from one another. A cleft of the alveolus (with or without cleft lip) can confuse the diagnostic picture and lead to a false assumption of cleft palate.

A Pediatric Decannulation Protocol: Outcomes of a 10-Year Experience.

Objectives: (1) Describe an institutional protocol that focuses on the essential steps for decannulation of pediatric patients with long-term tracheostomies. (2) Discuss the preliminary observations of the safety of this protocol in regard to decannulation failures and successes in a selected patient population.

Study Design: Case series with chart review.

Use of External Distractors and the Role of Imaging Prior to Mandibular Distraction in Infants With Isolated Pierre Robin Sequence and Stickler Syndrome.

Importance: Computed tomographic (CT) scans are often obtained before mandibular distraction osteogenesis in patients with isolated Pierre Robin sequence. There is concern regarding the risk of radiation exposure from CT in children.

Objective: To evaluate whether preoperative CT is necessary for adequate airway, feeding, and aesthetic outcomes following mandibular distraction with external distraction devices in infants with isolated Pierre Robin sequence.

Patterns of Pediatric Mandible Fractures in the United States.

Importance: The mandible is arguably the most frequently fractured facial bone in children. However, facial fractures are rare in children compared with adults, resulting in few large studies on patterns of pediatric facial fractures.

Objective: To report the patterns, demographics, and cause of pediatric mandible fractures across the United States.

Tramadol versus codeine/acetaminophen after pediatric tonsillectomy: A prospective, double-blinded, randomized controlled trial.

Objective: Tonsillectomy is one of the most common pediatric surgical procedures performed in the United States. The postoperative period can be particularly painful, and there is currently no consensus on an optimal analgesic regimen. The objective of this study was to evaluate efficacy and safety of the single drug tramadol versus codeine/acetaminophen post-tonsillectomy.

Bone conduction noise exposure via ventilators in the neonatal intensive care unit.

Objectives/hypothesis: To demonstrate that neonatal ventilators can expose patients to high noise levels through bone conduction (BC) as well as air conduction (AC).

Study Design: Observational study.

Methods: Three ventilators and various settings on a positive airway pressure machine (continuous, high bilevel, and low bilevel pressure) were tested.

Dynamic facial reanimation with orthodromic temporalis tendon transfer in children.

Importance: To our knowledge, orthodromic temporalis tendon transfer (OTTT) for dynamic facial reanimation has not been described for use in children.

Observations: Three pediatric patients with permanent facial paralysis underwent OTTT using our modified technique between August 30, 2010, and January 23, 2012. Outcomes were assessed by the surgeons, patients, and patient families, with the longest follow-up period being 13 months after surgery.

Hearing outcomes in children with cleft palate and referred newborn hearing screen.

Objectives/hypothesis: To determine the prevalence of long-term hearing loss in patients with cleft palate who fail their universal newborn hearing screen.

Study Design: The study is a retrospective chart review from a tertiary pediatric center and tertiary children's hospital.

Methods: Newborns with cleft palate born between January 2002 and July 2012 were identified from a pediatric otolaryngology practice database.

Prenatal consultation with the pediatric otolaryngologist.

Objectives: To examine the spectrum of fetal head and neck anomalies that may prompt prenatal referral and to determine the frequency of these consultations.

Study Design: Case series with chart review.

Methods: The billing databases of two urban pediatric otolaryngology practices were queried for ICD-9 codes corresponding to fetal anomalies between January 2010 and December 2012.

Outcomes of combined Furlow palatoplasty and sphincter pharyngoplasty for velopharyngeal insufficiency.

Objective: To compare surgical outcomes between pharyngeal flap, sphincter pharyngoplasty, and combined Furlow palatoplasty and sphincter pharyngoplasty in the management of pediatric velopharyngeal insufficiency.

Study Design: Case series with chart review.

Setting: Tertiary care pediatric hospital.

Distraction osteogenesis.

James Sidman, MD, and Sherard A. Tatum, MD, address the following questions for discussion and debate. Is neonatal distraction osteogenesis (DO) better than lip-tongue adhesion or tracheotomy for micrognathic airway compromise? What role does DO have in adult orthognathic surgery situations? In monobloc and Le Fort III procedures, are internal or external devices preferable? What role does DO play in craniofacial microsomia? Is endoscopic DO better than open procedures for synostosis management? How has your technique changed or evolved over the past 5 years and what has doing this technique taught you?

Children with limited oral opening can be safely managed without a tracheostomy.

Objective: To describe airway management of children with limited oral opening that does not allow for routine orotracheal intubation by direct laryngoscopy. To analyze the incidence and outcome of airway compromise or loss in patients without a tracheostomy in place.

Study Design: Case series with chart review.

Surgery for pediatric invasive fungal sinonasal disease.

Objectives/hypothesis: To evaluate the management and outcomes of children with invasive fungal sinonasal disease treated with radical surgery.

Study Design: Retrospective case series.

Methods: From 1994 to 2007, 11 pediatric patients were identified with invasive fungal sinonasal disease treated surgically by the same pediatric otolaryngologist.

Assessment of pulsed-dye laser therapy for pediatric cutaneous vascular anomalies.

Importance: Although facial vascular malformations are often treated by facial plastic surgeons, no reliable validated assessment tool exists for surgeons to assess results.

Objectives: To use our assessment tool to analyze results from pulsed-dye laser therapy used for pediatric facial vascular malformations, and to determine interrater reliability of our assessment tool in a standard clinical environment without the use of professional photography.

Design: A blinded retrospective review of pediatric patients who underwent pulsed-dye laser therapy for treatment of hemangiomas of infancy (HOIs) and port-wine stains.