Climate change and environmental sustainability in otolaryngology: A state-of-the-art review.

Background: Climate change has been identified by the World Health Organization (WHO) as the greatest existing threat to human health. Given the direct exposure of the upper aerodigestive system to pollutants, patients in otolaryngology are at high risk for increased disease burden in the setting of climate change and worsening air quality. Given this and the environmental impact of surgical care, it is essential for surgeons to understand their role in addressing climate health through quality-driven clinical initiatives, education, advocacy, and research.

Impact of a postgraduate year one (PGY-1) otolaryngology bootcamp on procedural skill development.

To measure the impact of an intensive eight-week postgraduate year one (PGY-1) otolaryngology bootcamp on the acquisition and retention of otolaryngology residents' procedural skills compared to the traditional method of skill acquisition through clinical exposure. Residents at our institution were evaluated on their performance of flexible laryngoscopy, suture ligature, and rigid bronchoscopy setup at three time points: pre-bootcamp, one-week post-bootcamp, and one-year post-bootcamp. Video recordings were scored by two blinded faculty reviewers using a multipoint rating system.

Completion of an Individualized Learning Plan for Otology-Related Milestone Subcompetencies Leads to Improved Otology Section Otolaryngology Training Exam Scores.

Objective: To examine the relationships among self-assessment of knowledge in otology via an individualized learning plan (ILP), otology milestone achievement rate, and otolaryngology training exam (OTE) otology scores.

Study Design: Prospective study.

Setting: One otolaryngology residency covering a tertiary care facility, trauma and hospital center, outpatient ambulatory surgery center, and outpatient clinics.

Evaluating butterfly inlay tympanoplasty.

Objective: To compare closure rate, reduction in air-bone-gap, and operative time of butterfly tympanoplasty (BT) to underlay tympanoplasty (UT).

Methods: Retrospective cohort study of children (age <18y) undergoing Type I tympanoplasty between 2009 and 2017. Patients were excluded if they had <6 months of follow up, mastoidectomy, fat graft or cholesteatoma.

Impact of a Formal Patient Safety and Quality Improvement Curriculum: A Prospective, Controlled Trial.

Objective: To assess the impact of implementing a dedicated Patient Safety and Quality Improvement (PSQI) curriculum for otolaryngology residents.

Methods: Residents in two otolaryngology residency programs were recruited to participate in the study. Residents at institution A (intervention group) participated in a formal, newly developed, year-long PSQI curriculum.

The Prevalence of Ultrarapid Metabolizers of Codeine in a Diverse Urban Population.

Objective: To examine the prevalence of ultrarapid metabolizers of codeine among children in an ethnically diverse urban community.

Study Design: Cross-sectional study.

Setting: A tertiary care academic children's hospital in the Bronx, New York.

Individualized Learning Plan (ILP) Is an Effective Tool in Assessing Achievement of Otology-related Subcompetency Milestones.

Objective: To investigate the individualized learning plan (ILP) as a tool in assessment of residents' milestone achievements as they pertain to Otology subcompetencies: Chronic Ear Disease, Pediatric Otitis Media, and Hearing Loss.

Study Design: Prospective study.

Methods: Twenty otolaryngology residents were instructed to use an ILP and identify six milestones from three otology-related subcompetencies to focus on during the course of a 3-month rotation.

An app to enhance resident education in otolaryngology.

Objective: Technological change is leading to an evolution in medical education. The objective of our study was to assess the impact of a medical knowledge app, called PulseQD, on resident education within our otolaryngology-head and neck surgery department at Montefiore Medical Center, Albert Einstein College of Medicine (Bronx, NY).

Methods: A prospective cohort study was conducted within the Department of Otolaryngology-Head and Neck Surgery from July 2016 to June 2017.

Sleep and Breathing the First Night After Adenotonsillectomy in Obese Children With Obstructive Sleep Apnea.

Study Objectives: There are few studies measuring postoperative respiratory complications in obese children with obstructive sleep apnea (OSA) undergoing adenotonsillectomy (AT). These complications are further compounded by perioperative medications. Our objective was to study obese children with OSA for their respiratory characteristics and sleep architecture on the night of AT.

Leadership Training in Otolaryngology Residency.

Although residency training offers numerous leadership opportunities, most residents are not exposed to scripted leadership instruction. To explore one program's attitudes about leadership training, a group of otolaryngology faculty (n = 14) and residents (n = 17) was polled about their attitudes. In terms of self-perception, more faculty (10 of 14, 71.

From Morbidity and Mortality to Quality Improvement: Effects of a Structured and Interactive Otolaryngology Conference.

Objective: Measure the effects of a structured morbidity and mortality conference format on the attitudes of resident and faculty participants.

Study Design: Prospective cohort study.

Setting: Otorhinolaryngology-head and neck surgery residency training program.

Tonsillectomies and respiratory complications in children: A look at pre-op polysomnography risk factors and post-op admissions.

Objective: To identify predictors of post-operative respiratory complications in children undergoing tonsillectomy.

Methods: Consecutive case series with chart review of children who underwent polysomnography (PSG) and subsequent tonsillectomy with or without adenoidectomy for obstructive sleep apnea (OSA). Patients with craniofacial anomalies or significant cardiopulmonary comorbidities were excluded.

Intracapsular and Extracapsular Tonsillectomy and Adenoidectomy in Pediatric Obstructive Sleep Apnea.

Importance: Limited information exists regarding clinical outcomes of children undergoing extracapsular tonsillectomy and adenoidectomy (ETA) or intracapsular tonsillectomy and adenoidectomy (ITA) for treatment of obstructive sleep apnea syndrome (OSAS).

Objectives: To quantify polysomnography (PSG) and clinical outcomes of ETA and ITA in children with OSAS and to assess the contribution of comorbid conditions of asthma and obesity.

Design, Setting, And Participants: Retrospective cohort study using medical records at a tertiary pediatrics inner-city hospital.

Securing stent during multi-stage laryngotracheoplasty--an evolved technique.

Background: Multi-stage laryngotracheoplasty (LTP) typically requires a stent be secured to the airway for 2-6 weeks. Our technique has evolved over time to securing the stent to the strap muscles and tying a series of knots long enough to leave the suture tail protruding through the skin incision, which simplifies stent removal.

Methods: Retrospective chart review.

The role of tonsillectomy in the treatment of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS).

Importance: Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) in children describes neuropsychiatric symptom exacerbations that relate temporally to streptococcal infections. Recent case reports suggest tonsillectomy may effectively reduce these symptoms; however, no consensus treatment guidelines exist. This study examines whether tonsillectomy improves neuropsychiatric symptoms in children with PANDAS who have incomplete response to antibiotic therapy.

The use of mitomycin C in pediatric airway surgery: does it work?

Purpose Of Review: To describe the efficacy of mitomycin C in combating airway stenosis.

Recent Findings: Recent publications discussing mitomycin C utility have not altered the mixed results previously established by prospective trials.

Summary: Mitomycin C has been used for the past 16 years to inhibit pediatric airway fibroblast proliferation.

Tracheal rupture in complicated delivery: a case report and review of the literature.

A case of distal tracheal rupture is described, literature review reveals two previously reported cases of neonatal distal tracheal rupture, as well as 14 cases of anterior subglottic rupture. All patients had shoulder dystocia, and 59% had associated brachial plexus injury. Delayed diagnosis (>3 days) was common in the distal tracheal group (66%), compared to 0% in the anterior subglottic group.

Laryngotracheal reconstruction outcomes in hypotonic children.

Importance: Children with poor muscle tone may demonstrate upper airway obstruction due to several mechanisms including obstructive sleep apnea, laryngopharyngeal reflux, and laryngomalacia. Though hypotonia has been shown to compromise the pediatric airway, and some authors suggest that neurologic deficits can compromise the success of laryngotracheal reconstruction (LTR), to our knowledge no studies have evaluated the effect of neurologic diagnoses or hypotonia on outcomes in LTR.

Objective: To determine whether hypotonic children with subglottic stenosis have lower rates of successful decannulation after LTR compared with children without neurologic deficit.

Adjunctive procedures after pediatric single-stage laryngotracheoplasty.

Objectives: We report the frequency and success rates of adjunctive airway procedures after pediatric single-stage laryngotracheoplasty (LTP) and review different adjunctive techniques in a prospectively enrolled and retrospectively reviewed case series.

Methods: Of 31 LTP procedures performed from 2008 to 2011 at an academic tertiary care children's hospital, 10 were single-stage LTP procedures. These 10 cases were analyzed to determine the number and type, if any, of adjunctive procedures required after LTP, as well as the subglottic response and decannulation rates.

A randomized trial of adenotonsillectomy for childhood sleep apnea.

Background: Adenotonsillectomy is commonly performed in children with the obstructive sleep apnea syndrome, yet its usefulness in reducing symptoms and improving cognition, behavior, quality of life, and polysomnographic findings has not been rigorously evaluated. We hypothesized that, in children with the obstructive sleep apnea syndrome without prolonged oxyhemoglobin desaturation, early adenotonsillectomy, as compared with watchful waiting with supportive care, would result in improved outcomes.

Methods: We randomly assigned 464 children, 5 to 9 years of age, with the obstructive sleep apnea syndrome to early adenotonsillectomy or a strategy of watchful waiting.

Endotracheal nitinol stents: lessons from the learning curve.

Objective: To reflect on lessons learned placing endotracheal nitinol stents in children.

Study Design: Case series with chart review.

Setting: Tertiary care children's hospital.

Pediatric nasal lobular capillary hemangioma.

Background. LCH is a benign vascular growth of the skin and mucous membranes commonly affecting the head and neck. Since it was first described in the nineteenth century, this entity has been variously known as "human botryomycosis" and "pyogenic granuloma.

Powered debridement of suprastomal granulation tissue to facilitate pediatric tracheotomy decannulation.

Objective: To compare suprastomal granulation tissue (SSGT) removal using the microdebrider with other common methods of excision.

Methods: Retrospective review (n=21) of SSGT excision at a tertiary care pediatric hospital (2004-10). Outcome measures included intraoperative blood loss, operative time, decannulation rates, and complications.

Laryngomalacia: the role of gender and ethnicity.

Introduction: The vast majority of infants in published studies regarding laryngomalacia are Caucasian. These studies suggest affected infants are likely to be male, of term pregnancies, and not of low birth weight. Our study seeks to identify possible associations among different genders and ethnicities with laryngomalacia as well as differences between our diverse population and published Caucasian-predominant studies.

Otolaryngology resident selection: do rank lists matter?

Objectives: To examine the relationship between National Residency Matching Program (NRMP) rank list position and future otolaryngology residency performance.

Study Design: Cohort study.

Methods: Eight consecutive residency classes (starting 2001-2008; 4 residents/y) were reviewed.