Management of Pediatric Persistent Asymptomatic Cervical Lymphadenopathy.

Objective: Persistent asymptomatic cervical lymphadenopathy (PACL) is a common outpatient referral diagnosis for pediatric otolaryngologists. Historically, excisional biopsy under general anesthesia has been the gold standard for diagnosis but is associated with some risks. Current literature provides little guidance on less invasive monitoring.

Airway Hemangiomas in PHACE Syndrome: A Multicenter Experience.

Objective: To describe the prevalence and clinical characteristics of airway findings in a multi-institutional cohort of PHACE patients.

Study Design: Multicenter retrospective case series.

Setting: Multidisciplinary vascular anomalies clinics at 2 institutions.

Advanced practice providers and children's hospital-based pediatric otolarynology practices.

Introduction: Advanced practice providers (APPs), including nurse practitioners and physician assistants, have been deployed in children's hospital-based academic pediatric otolaryngology practices for many years. However, this relationship in terms of prevalence, roles, financial consequences and satisfaction has not been examined. The objective of this study is to explore how APPs impact healthcare delivery in this setting.

Cryoprobe retrieval of an airway foreign body: A case report and literature review.

We report a case of a 7-year-old boy with clinical and radiographic evidence of foreign body (FB) aspiration with a 2-week delay in diagnosis. The retrieval of the pushpin with traditional bronchoscopic instrumentation was made difficult by granulation tissue formation. A cryoprobe through a flexible bronchoscope was used to successfully remove the FB.

Hearing loss in PHACE syndrome: clinical and radiologic findings.

Purpose: To characterize the types of hearing loss, auditory-related imaging findings, and hemangioma characteristics in patients with Posterior fossa malformations, Hemangiomas, Arterial anomalies, Cardiac defects, and abnormalities of the Eye (PHACE) syndrome.

Methods: Retrospective medical records, audiologic data, and imaging review of all patients presenting to a tertiary care children's hospital with a proven diagnosis of PHACE syndrome from 2005 to 2016.

Results: Twelve patients were identified with hearing and imaging data.

Sirolimus for management of complex vascular anomalies - A proposed dosing regimen for very young infants.

Neonates with vascular anomalies causing airway compromise and other complications require early initiation of medical therapy. Sirolimus has emerged as a safe and effective treatment, but standard recommendations for dosing start at seven months. Guidelines are needed for dosing in very young infants, who have reduced hepatic metabolism of sirolimus.

Sleep-disordered breathing in pediatric head and neck vascular malformations.

Objectives: To determine the prevalence of sleep-disordered breathing (SDB) symptoms among children with head and neck vascular malformations and to compare obstructive sleep apnea (OSA)-18 scores between children with head and neck vascular malformations and children with non-head and neck vascular malformations.

Study Design: Retrospective cohort and prospective cross-sectional studies METHODS: Forty-three pediatric subjects with head and neck vascular malformations evaluated at a tertiary-care multidisciplinary vascular anomalies center were included in a retrospective cohort study. Eighty-three consecutive pediatric subjects with vascular malformations evaluated at the same center were included in the prospective cross-sectional study.

Pediatric sialendoscopy indications and outcomes.

Purpose Of Review: Chronic sialadenitis can affect patients of all age ranges and typically presents as recurrent or chronic painful swelling of the salivary glands. In children, the most common cause of sialadenitis is juvenile recurrent parotitis. Salivary stones, or sialolithiasis, are a much less common cause.

Pneumothorax after tracheostomy closure with successful nonsurgical management.

A 3-year-old girl presented for routine closure of her tracheostomy site. She was intubated easily for the procedure, and the wound was closed with a drain in place. In recovery, the mother noticed fullness in the patient's submandibular region, and on examination, the girl had subcutaneous emphysema in the neck bilaterally.

Airway response to sirolimus therapy for the treatment of complex pediatric lymphatic malformations.

Head and neck lymphatic malformations can create airway management challenges requiring tracheotomy. Sirolimus, an inhibitor of mammalian target of rapamycin (mTOR), may inhibit growth of lymphatic malformations. We describe two patients born with large lymphatic malformations with improved airway symptoms following sirolimus therapy.

MRI phenotypes of localized intravascular coagulopathy in venous malformations.

Background: The incidence of localized intravascular coagulopathy (LIC) in venous malformations varies with lesion size and location, as well as the presence of palpable phleboliths. The development of LIC can cause pain and hemorrhage and can progress to disseminated intravascular coagulopathy (DIC) and thromboembolic disease resulting in death in some cases. Early recognition of LIC can relieve symptoms and prevent progression to life-threatening complications.

Effectiveness and costs of sialendoscopy in pediatric patients with salivary gland disorders.

Objectives/hypothesis: This study aimed to characterize the common salivary gland disorders presenting in the pediatric population and to describe the diagnostic and therapeutic outcomes of sialendoscopy in this population.

Study Design: Retrospective observational study in a tertiary care pediatric medical center.

Methods: Medical records review of patients under 18 years of age who presented to pediatric otolaryngology with symptoms related to a salivary gland disorder from 2002 to 2014.

Infantile hemangiomas of the head and neck.

Infantile hemangiomas (IHs) are benign vascular tumors. Clinical history and physical examination are the most important factors for diagnosis, with most IHs having a typical presentation. Treatment is required for some IHs that cause significant cosmetic deformity or functional compromise.

Clinical consensus statement: appropriate use of computed tomography for paranasal sinus disease.

Objective: To develop a consensus statement on the appropriate use of computed tomography (CT) for paranasal sinus disease.

Subjects And Methods: A modified Delphi method was used to refine expert opinion and reach consensus by the panel.

Results: After 3 full Delphi rounds, 33 items reached consensus and 16 statements were dropped because of not reaching consensus or redundancy.

Airway hemangiomas in PHACE syndrome.

Objectives/hypothesis: To describe the clinical presentation and airway characteristics of infants with airway hemangiomas and concomitant PHACE syndrome and to determine the prevalence of airway hemangiomas in PHACE subjects at our institution.

Study Design: Case series.

Methods: Retrospective review including clinical presentation, airway findings, treatment measures, and outcomes.

Drug-induced sleep endoscopy in persistent pediatric sleep-disordered breathing after adenotonsillectomy.

Objectives: To demonstrate the feasibility of drug-induced sleep endoscopy (DISE) in the pediatric population and to examine DISE results in children with persistent sleep-disordered breathing (SDB) after tonsillectomy and adenoidectomy (T&A).

Design: Retrospective case series with medical chart review.

Setting: Tertiary pediatric medical center.

Comparison of imaging modalities in pediatric thyroglossal duct cysts.

Objectives/hypothesis: To determine and compare the accuracy of different imaging modalities including ultrasound (US), magnetic resonance imaging (MRI), and computed tomography (CT) in the diagnosis of thyroglossal duct cysts (TGDC) in children.

Study Design: Retrospective chart review.

Methods: A retrospective chart review was performed on patients under the age of 18 years who had undergone surgical excision of midline neck masses between January 2002 and June 2011.

Masseteric venous malformations: diagnosis, treatment, and outcomes.

Objective: To describe a typical presentation of venous malformation within the masseter muscle, including physical findings and imaging, and to present the University of California, San Francisco's (UCSF) Vascular Anomalies and Birthmark Center's (VABC) experience with sclerotherapy for these lesions.

Study Design: Case series with chart review.

Setting: Tertiary care medical center.

Propranolol in the management of airway infantile hemangiomas.

Objective: To report our experience with propranolol in managing airway infantile hemangiomas.

Design: Case series of 3 consecutive patients who had extensive, symptomatic airway infantile hemangiomas treated with propranolol.

Setting: Tertiary academic medical center.

Extensive airway hemangiomas in two patients without beard hemangiomas.

Airway hemangiomas are most often seen in association with cutaneous hemangiomas involving the "beard area." We report two unusual cases of extensive airway hemangiomas developing in patients with facial hemangiomas predominantly involving the upper face, emphasizing the need to consider the possibility of airway hemangiomas even in the absence of "beard area" hemangiomas.

Airway management in children with mucopolysaccharidoses.

Objective: To review of the natural history of airway disease in children with muccopolysaccharidoses (MPSs), which represent a group of hereditary progressive disorders caused by excessive accumulation of glycosaminoglycans in various tissues.

Design: Retrospective medical chart review.

Setting: Tertiary referral academic medical center.