Myringoplasty Using Human Birth Tissue Allografts to Repair Large Tympanic Membrane Perforations.

Objective: Examine outcomes among a series of pediatric patients who underwent myringoplasty using human birth tissue (BT) for repair of large tympanic membrane (TM) perforations.

Study Design: Case series.

Setting: Single-institution pediatric hospital.

Is There Utility in Preoperative Testing of Hemoglobin Before Primary Cheiloplasty?

Objective: To examine whether a preoperative hemoglobin of less than 10 g/dL is associated with a higher rate of perioperative complications.

Design: Retrospective review.

Setting: Tertiary academic hospital at Arkansas Children's Hospital of Little Rock, Arkansas.

Improved Confidence and Clinical Application: The Effects of a Longitudinal Suture Curriculum for Medical Students.

Objective: The ability to competently suture is an expected skill for graduating medical students, but many graduates report feeling unprepared to perform this skill. This study aimed to improve student confidence and clinical readiness for third-year clerkships by implementing a novel, mandatory 7.5-hour longitudinal suturing skills curriculum across the first 3 years of medical school.

Outcomes After Pharyngeal Flap Surgery in Children: A Comparison of Lined Versus Unlined Flaps.

Objective: The addition of a uvular flap (PFU) was hypothesized to improve outcomes over standard pharyngeal flap (PF) for correction of velopharyngeal dysfunction. We report differences in outcomes of PF vs PFU at our institution.

Design: Retrospective cohort study.

The First Hybrid International Educational Comprehensive Cleft Care Workshop.

Objective: Describe the first hybrid global simulation-based comprehensive cleft care workshop, evaluate impact on participants, and compare experiences based on in-person versus virtual attendance.

Design: Cross-sectional survey-based evaluation.

Setting: International comprehensive cleft care workshop.

Retrospective Examination of the GILLS Algorithm Applied to Mandibular Distraction.

The GILLS (gastroesophageal reflux, preoperative intubation, late intervention (>14 days), low birth weight (<2500 g), and syndromic diagnosis) score is a validated predictor of success for tongue-lip adhesion (TLA) in patients with Robin sequence (RS). To evaluate the application of the GILLS score to mandibular distraction osteogenesis (MDO) for airway management in patients with RS and the associated syndromes. A retrospective chart review of 21 patients diagnosed with RS and treated with MDO surgery between the years 2006 and 2016 was performed.

Clinical Significance of Screening Electrocardiograms for the Administration of Propranolol for Problematic Infantile Hemangiomas.

Objective: Low-dose nonselective blockade is an effective treatment for problematic infantile hemangioma (PIH). Screening electrocardiograms (ECG) are performed prior to the initiation of propranolol to minimize the risk of exacerbating undiagnosed heart block. How ECG results affect subsequent propranolol usage and patient management remains unclear.

Impact of Surgery for Velopharyngeal Insufficiency on Eustachian Tube Function in Children: Pharyngeal Flap Versus Sphincter Pharyngoplasty.

Objective: Velopharyngeal insufficiency (VPI) is a common speech disorder in patients with a history of cleft palate (CP) or 22q11.2 deletion syndrome. Pharyngeal flap (PF) and sphincter pharyngoplasty (SP) are 2 common surgeries to treat this disorder by decreasing unwanted nasal air emission and hypernasal resonance.

Multicenter Interrater Reliability in the Endoscopic Assessment of Velopharyngeal Function Using a Video Instruction Tool.

Objective: Assess interrater agreement of endoscopic assessment of velopharyngeal (VP) function before and after viewing the video instruction tool (VIT). We hypothesized improvement in interrater agreement using the Golding-Kushner scale (GKS) after viewing the VIT.

Study Design: Prospective study.

Microtia and Related Facial Anomalies.

Infants may be born with external ear deformities or malformations that can present a diagnostic clue to an affiliated syndrome while also presenting the possibility of surgical intervention. Microtia is a malformation of the ear that is associated with other craniofacial or systemic anomalies in 50% of cases. Surgical correction of microtia and associated facial anomalies is complex and must be integrated thoughtfully into the overall care plan for children with complex medical needs.

Dental radiographic findings in 18 individuals with SATB2-associated syndrome.

Objective: To characterize the radiographic dental phenotype of individuals with SATB2-associated syndrome (SAS).

Materials And Methods: Participants were evaluated by a multidisciplinary team during a concurrent clinic conducted during the 1st international SAS family meeting held in 2017 at a single institution. Whenever possible, panoramic and/or periapical radiographs were obtained in clinic or previously obtained and provided by the caregiver.

The Arkansas Tessier Number 3 Cleft Experience: Soft Tissue and Skeletal Findings With Primary Surgical Management: Four-Step Approach.

Tessier No 3 facial cleft (oro-nasal-ocular clefts) is the rarest and most challenging of all the Tessier clefts. Reports on Tessier No 3 clinical findings, surgical techniques, and outcomes are varied due to the scarcity of patients and the wide range of phenotypic findings. The authors present our experience of 2 children born with Tessier No 3 clefts who were both managed at the Arkansas Children's Hospital.

Chronic Rhinosinusitis in Children: Pathophysiology, Evaluation, and Medical Management.

Purpose Of Review: Pediatric chronic rhinosinusitis (CRS) is a common disorder that carries significant morbidity. The diagnosis requires sinus symptoms that persist despite standard medical therapy greater than 3 months. Viral infections, allergies, and anatomic differences in children lead to chronic obstruction of the osteomeatal complex.

Combined Tongue-Palate Fusion With Alveolar Bands in a Patient With Pierre Robin Sequence and Van der Woude Syndrome.

This report describes the presentation of a newborn male with circumferential tongue-palate fusion associated with cleft palate and alveolar bands. After intraoral adhesions lysis, the patient was diagnosed with Pierre Robin sequence. A family history of cleft lip and palate was noted, and interferon regulatory factor 6 ( IRF6) sequencing revealed a heterozygous variant, confirming the diagnosis of van der Woude syndrome.

Diagnosis and management of patients with clefts: a comprehensive and interdisciplinary approach.

This article reviews the most current practice guidelines in the diagnosis and management of patients born with cleft lip and/or palate. Such patients frequently have multiple medical and social issues that benefit greatly from a team approach. Common challenges include feeding difficulty, nutritional deficiency, speech disorders, hearing problems, ear disease, dental anomalies, and both social and developmental delays, among others.

Enhanced tracheostomy wound healing using maltodextrin and silver alginate compounds in pediatrics: a pilot study.

Background: Tracheostomy wounds are commonly encountered in children but rarely reported. Relatively few treatments are available or have been investigated to manage this problem. Healing times for pediatric tracheostomy wounds are often unpredictable and protracted.

Cartilage tympanoplasty in children with cleft palate repair.

Objective: To determine outcomes of type 1 cartilage tympanoplasty in a cohort of pediatric patients with a history of cleft palate repair.

Patients And Outcome Measures: Retrospective chart review and comparison with a historical control group of patients with no cleft palate anomaly undergoing the same procedure by the same surgeon at a tertiary care pediatric hospital. A total of 37 patients between ages 4 and 19 years inclusive (45 ears), with a history of repaired cleft palate, underwent type 1 cartilage tympanoplasty with or without primary tube insertion from September 2004 to October 2012.

Prospective quality of life assessment in congenital laryngomalacia.

Purpose Of Study: Disturbances in breathing or feeding may profoundly affect parental perceptions of a newborn's health. Previous research into quality of life for patients with laryngomalacia is limited to retrospective analysis. The purpose of this study is to prospectively evaluate the quality of life of families of infants with laryngomalacia and the impact of surgical and non-surgical treatments.

Tongue base suspension in children with cerebral palsy and obstructive sleep apnea.

Objective: Children with cerebral palsy (CP) are commonly affected by obstructive sleep apnea (OSA). This study examines the efficacy of combined surgical techniques for OSA including tongue base suspension (TBS), using perioperative polysomnograms (PSG) in pediatric patients with CP.

Study Design: Case series with outcome analysis.

Current management of infantile hemangiomas and their common associated conditions.

This article reviews the most current practice guidelines in the diagnosis and treatment of infantile hemangiomas. Several systemic conditions that can be associated with hemangiomas, such as PHACES syndrome, are also discussed. Propranolol has become an effective first-line treatment, and protocols for its use as well as its potential risks are outlined.

Timing of tympanoplasty in children with chronic otitis media with effusion.

Purpose Of Review: Children with chronic otitis media with effusion resulting in repeat ventilation tube placement are at increased risk for perforation, an atelectatic ear, cholesteatoma, and hearing loss. The timing of intervention is controversial, and management strategies are variable. This update reviews the recent literature with a focus on groups at greater risk for requiring tympanoplasty, such as patients with craniofacial abnormalities including cleft palate and Down syndrome.

Accuracy and safety of tracheoscopy for infants in a tertiary care clinic.

Objective: To assess the diagnostic accuracy and safety of office-based tracheoscopy when combined with flexible fiberoptic laryngoscopy (FFLT). Flexible laryngoscopy on infants is routinely performed by otolaryngologists in the clinic. The addition of tracheoscopy may improve overall airway assessment but is rarely performed due to the suspected risk of airway compromise.

Free tissue reconstruction following excision of head and neck arteriovenous malformations.

Objective: To evaluate free tissue transfer (FTT) as a safe and effective reconstructive technique to treat arteriovenous malformations. Vascular lesions that present a significant clinical challenge to the head and neck reconstructive surgeon are often difficult to treat and can leave large, complex defects.

Methods: Retrospective, single-institution case series.