Predictors of Surgical Site Infection in Pediatric Cochlear Implantation.

Objective: To determine risk factors for surgical site infection (SSI) after cochlear implantation (CI) in pediatric patients.

Study Design: Case-control study.

Setting: A total of 150 hospitals contributing data to the ACS-NSQIP Pediatric database (American College of Surgeons National Surgical Quality Improvement Program) in North America and worldwide.

Quality indicators for the diagnosis and management of pediatric tonsillitis.

Introduction: Pediatric tonsillitis is encountered frequently across specialties, and while high quality guidelines exist, there is persistent evidence of care which is not evidence based, including antibiotic overprescribing and surgical practice variability. Quality indicators (QIs) can be utilized for initiatives to improve the quality of care and subsequent patient outcomes. We sought to develop pediatric tonsillitis QIs that are applicable across specialties and that cover aspects of both diagnosis and the spectrum of management options.

Competency-Based Assessment Tool for Pediatric Esophagoscopy: International Modified Delphi Consensus.

Objectives/hypothesis: Create a competency-based assessment tool for pediatric esophagoscopy with foreign body removal.

Study Design: Blinded modified Delphi consensus process.

Setting: Tertiary care center.

The Feasibility of Magnetic Resonance Imaging Without General Anesthesia Using the "Bundle and Scan" Technique for Infants With Sensorineural Hearing Loss.

Objective: The purpose of this study is to determine the feasibility of magnetic resonance imaging (MRI) without general anesthesia (GA) for infants being evaluated for sensorineural hearing loss (SNHL) using the bundle and scan technique.

Study Design: Retrospective study.

Setting: Pediatric tertiary care hospital.

Development and validation of an algorithm of diagnostic and procedural codes for the identification of children hospitalized with a tracheostomy in Ontario, Canada.

Background: The requirement for a tracheostomy in children is associated with significant morbidity, mortality, and healthcare utilization. Easy identification of children with tracheostomies would facilitate important research on this population and provide quality improvement initiatives.

Aim: The purpose of this study is to determine whether an algorithm of diagnostic and procedural codes can accurately identify children hospitalized with a tracheostomy using routinely collected health data.

Factors Impacting Physician Recommendation for Tracheostomy Placement in Pediatric Prolonged Mechanical Ventilation: A Cross-Sectional Survey on Stated Practice.

Objectives: To characterize the stated practices of qualified Canadian physicians toward tracheostomy for pediatric prolonged mechanical ventilation and whether subspecialty and comorbid conditions impact attitudes toward tracheostomy.

Design: Cross sectional web-based survey.

Subjects: Pediatric intensivists, neonatologists, respirologists, and otolaryngology-head and neck surgeons practicing at 16 tertiary academic Canadian pediatric hospitals.

Crowdsourcing the Citation Screening Process for Systematic Reviews: Validation Study.

Background: Systematic reviews (SRs) are often cited as the highest level of evidence available as they involve the identification and synthesis of published studies on a topic. Unfortunately, it is increasingly challenging for small teams to complete SR procedures in a reasonable time period, given the exponential rise in the volume of primary literature. Crowdsourcing has been postulated as a potential solution.

Immediate versus delayed surgery in congenital choanal atresia: A systematic review.

Objectives: To evaluate immediate versus delayed surgical intervention on treatment outcomes in the management of congenital choanal atresia.

Methods: This study adhered to Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines in reporting a systematic review of the literature. OVID Medline, EMBASE and Pubmed databases were searched using relevant key terms.

Congenital Trismus From Brainstem Dysgenesis: Case Report and Review of Literature.

Trismus refers to any condition inducing limited mouth opening and may present as a result of acquired or congenital pathology. We present the case of a newborn who presented with severe, congenital trismus due to brainstem dysgenesis. We describe the course of his investigations, and a multidisciplinary approach to the management of his care and follow-up.

Direct molecular detection of a broad range of bacterial and viral organisms and Streptococcus pneumoniae vaccine serotypes in children with otitis media with effusion.

Background: Otitis media with effusion (OME) causes significant morbidity in children, but the causes of OME and methods for prevention are unclear. To look for potential infectious etiologies, we performed a pilot study using multiple-target real-time polymerase chain reaction (qPCR) for 27 infectious agents, including nine bacterial organisms and 18 respiratory viruses in middle ear fluids (MEFs) from children with OME. QPCR was also performed for the 13 Streptococcus pneumoniae serotypes contained in the current vaccine.

Does neck-to-waist ratio predict obstructive sleep apnea in children?

Objectives: Central adiposity and large neck circumference are associated with obstructive sleep apnea (OSA) in adults but have not been evaluated in children as predictors of OSA. Study objectives were to determine whether (1) anthropometric measures including neck-to-waist ratio are associated with OSA in older children; (2) body fat distribution, measured by neck-to-waist ratio, is predictive of OSA in overweight/obese children.

Methods: Cross-sectional study involving children 7-18 years scheduled to undergo polysomnography at a tertiary care children's hospital.

The effectiveness of webcast compared to live lectures as a teaching tool in medical school.

Objective: The purpose of this study is to investigate whether webcast lectures are comparable to live lectures as a teaching tool in medical school.

Methods: Three Otolaryngology-Head&Neck Surgery (OTO-HNS) lectures were given to third year medical students through their regular academic curriculum with one group receiving lectures in a live lecture format and the other group in a webcast format. All lectures (live or webcast) were given by the same lecturer and contained identical material.

Creation of a reference dataset of neck sizes in children: standardizing a potential new tool for prediction of obesity-associated diseases?

Background: Neck circumference (NC), is an emerging marker of obesity and associated disease risk, but is challenging to use as a screening tool in children, as age and sex standardized cutoffs have not been determined. A population-based sample of NC in Canadian children was collected, and age- and sex-specific reference curves for NC were developed.

Methods: NC, waist circumference (WC), weight and height were measured on participants aged 6-17 years in cycle 2 of the Canadian Health Measures Survey.

Connexin gene mutations among Ugandan patients with nonsyndromic sensorineural hearing loss.

Objectives/hypothesis: Congenital deafness occurs in approximately 1 in 1,000 live births, and 50% of these cases are hereditary. Connexin mutations have been identified as the most common cause of hereditary hearing loss in many populations. The prevalence of this mutation in African patients has not been adequately studied.

Neck circumference percentile: A screening tool for pediatric obstructive sleep apnea.

Rationale: Large neck circumference (NC) is associated with obstructive sleep apnea (OSA) in adults, especially males. Since NC changes with age and sex, a lack of reference ranges makes neck size difficult to assess as a screening tool in children.

Methods: Using a population-based dataset of 1,913 children, we developed reference ranges for NC by age and sex for children aged 6-17 years.

Success of supraglottoplasty for severe laryngomalacia: the experience from Northeastern Ontario, Canada.

Objectives: To review the outcomes of supraglottoplasty performed in children with severe laryngomalacia at a pediatric university teaching hospital and to determine if these outcomes are influenced by gender, age at time of supraglottoplasty, or medical comorbidities.

Methods: Retrospective chart review of children who underwent supraglottoplasty for severe laryngomalacia between 2001 and 2010 at the Children's Hospital of Eastern Ontario in Ottawa, Canada. Statistical significance was obtained using 2-tailed Fisher's exact test.

A case-control study of repeated adenoidectomy in children.

Objectives: To determine the rate of repeated adenoidectomy in children and examine the risk factors associated with this condition. DESIGN A retrospective nested case-control study was performed. All cases of adenoidectomy performed at a single pediatric institution between 1990 and 2010 were examined.

Inter- and intra-rater reliability of neck circumference measurements in children.

Rationale: Increased neck circumference is a risk factor for obstructive sleep apnea in adults. With rising obesity prevalence in children, it may be an important identifier of obstructive sleep apnea in children. The reliability of measuring neck circumference in children has not been systematically evaluated.