A two-stage in vivo approach for implanting a 3D printed tissue-engineered tracheal replacement graft: A proof of concept.

Objectives: To optimize a 3D printed tissue-engineered tracheal construct using a combined in vitro and a two-stage in vivo technique.

Methods: A 3D-CAD (Computer-aided Design) template was created; rabbit chondrocytes were harvested and cultured. A Makerbot Replicator™ 2x was used to print a polycaprolactone (PCL) scaffold which was then combined with a bio-ink and the previously harvested chondrocytes.

The use of laryngeal mask airway for tonsillectomy and adenoidectomy.

Purpose: Patients undergoing tonsillectomy and adenoidectomy traditionally receive anesthesia with endotracheal intubation (ETT) for airway management. The laryngeal mask airway (LMA) may be used instead and may be associated with less airway stimulation and shorter operating room times. The purpose of this study was to report on a large cohort of patients undergoing tonsillectomy and/or adenoidectomy while using the LMA for airway maintenance during anesthesia.

Systemic Bevacizumab for Treatment of Respiratory Papillomatosis: International Consensus Statement.

Objectives/hypothesis: The purpose of this study is to develop consensus on key points that would support the use of systemic bevacizumab for the treatment of recurrent respiratory papillomatosis (RRP), and to provide preliminary guidance surrounding the use of this treatment modality.

Study Design: Delphi method-based survey series.

Methods: A multidisciplinary, multi-institutional panel of physicians with experience using systemic bevacizumab for the treatment of RRP was established.

Reducing fire and burn risk in the operating room-testing of a novel device.

Background: Burn injury and operating room fires are significant risks for both surgical patients and staff. The purpose of this study was to examine the fire and burn risks associated with two types of fiberoptic light cables and evaluate the efficacy of a novel device in reducing the risk of these fire and burn injuries.

Methods: A 300-W light source was connected sequentially to two standard fiberoptic cables (Storz and Olympus).

A 3-dimensional bioprinted tracheal segment implant pilot study: Rabbit tracheal resection with graft implantation.

Objectives: Surgical reconstruction of tracheal disease has expanded to include bioengineering and three dimensional (3D) printing. This pilot study investigates the viability of introducing a living functional tracheal replacement graft in a rabbit animal model.

Methods: Seven New Zealand White rabbits were enrolled and six completed participation (one intraoperative mortality).

Preventing and Managing Operating Room Fires in Otolaryngology-Head and Neck Surgery.

Otolaryngologists are at high risk of surgical fire. During surgery in the head and neck region there is close proximity of 3 essential elements: an ignition source, a fuel, and an oxidizing agent. In this article, the authors highlight the scenarios where fire may occur and offer steps that surgeons can take to minimize risk for their patients.

Pediatric Cervical Lymphadenopathy.

Cervical lymphadenopathy affects as many as 90% of children aged 4 to 8 years. With so many children presenting to doctors' offices and emergency departments, a systematic approach to diagnosis and evaluation must be considered. In the following review, we aim to provide the pediatric clinician with a general framework for an appropriate history and physical examination, while giving guidance on initial diagnostic laboratory testing, imaging, and potential need for biopsy.

The use of laryngeal mask airway for adenoidectomy.

Objectives: Airway management during adenoidectomy is traditionally performed through endotracheal intubation (ETT). Laryngeal mask airway (LMA) may be less stimulating to the airway and allow for shorter overall operating room time. Previous studies report LMA use during adenotonsillectomy.

External airway splint to treat tracheomalacia following laryngotracheal reconstruction.

This observation reports the use of an external airway splint to treat tracheomalacia in a pediatric patient. The patient underwent a double stage laryngotracheal reconstruction however was unable to be decannulated due to severe tracheomalacia. Our purpose is to further support the use of external splinting in the treatment of tracheomalacia in a unique case involving isolated nighttime airway obstruction following laryngotracheal reconstruction.

Feasibility of Bioprinting with a Modified Desktop 3D Printer.

Numerous studies have shown the capabilities of three-dimensional (3D) printing for use in the medical industry. At the time of this publication, basic home desktop 3D printer kits can cost as little as $300, whereas medical-specific 3D bioprinters can cost more than $300,000. The purpose of this study is to show how a commercially available desktop 3D printer could be modified to bioprint an engineered poly-l-lactic acid scaffold containing viable chondrocytes in a bioink.

Three dimensional printing: A review on the utility within medicine and otolaryngology.

Three dimensional (3D) printing is a novel technique that has evolved over the past 35 years and has the potential to revolutionize the field of medicine with its inherent advantages of customizability and the ability to create complex shapes with precision. It has been used extensively within the fields of orthopedics, dentistry, and craniofacial reconstruction with wide ranging utility including, medical modeling, surgical planning and the production of custom plates, screws and surgical guides. Furthermore, it has been used for similar means in the field of Otorhinolaryngology and also has potential to revolutionize the treatment of airway malacia.

Ex vivo tracheomalacia model with 3D-printed external tracheal splint.

Objective: To design and evaluate an ex vivo model of tracheomalacia with and without a three-dimensional (3D)-printed external tracheal splint.

Study Design: Prospective, ex vivo animal trial.

Methods: Three groups of ex vivo porcine tracheas were used: 1) control (unmanipulated trachea), 2) tracheomalacia (tracheal rings partially incised and crushed), and 3) splinted tracheomalacia (external custom tracheal splint fitted onto group 2 trachea).

Coblation-assisted management of pediatric airway stenosis.

Objectives: The treatment of pediatric airway stenosis represents a major challenge for the otolaryngologist. The aim of this study is to evaluate the use of bipolar radiofrequency plasma ablation (Coblation) in the treatment of pediatric airway stenosis.

Study Design: Retrospective case series.

Endoscopic management of congenital anterior glottic stenosis.

Introduction: Congenital anterior glottic stenosis (web) is a rare condition usually presenting with airway obstruction, stridor or dysphonia. Symptomatic infants may require tracheotomy to bridge the neonatal period. Early open surgical reconstruction may have significant risks and failure may still result in tracheotomy.

Introducing a 3-dimensionally Printed, Tissue-Engineered Graft for Airway Reconstruction: A Pilot Study.

Objective: To use 3-dimensional (3D) printing and tissue engineering to create a graft for laryngotracheal reconstruction (LTR).

Study Design: In vitro and in vivo pilot animal study.

Setting: Large tertiary care academic medical center.

Endoscopic surgical management of inspiratory stridor in newborns and infants.

Objective: Compare the incidence of endoscopic surgical treatment of patients with laryngomalacia to other aerodigestive pathology who may present with similar symptoms.

Methods: Consecutive case series with chart review of endoscopic surgical intervention in infants, aged 12 months or less, presenting with inspiratory stridor, in the absence of syndromic condition or prior history of intubation.

Results: A total of 30 patients were identified.

Pediatric patients with chronic cough and recurrent croup: the case for a multidisciplinary approach.

Objective: To evaluate the results of our multidisciplinary approach to recurrent croup and chronic cough.

Methods: Retrospective chart review of all patients with recurrent croup and chronic cough managed at a tertiary care children's hospital by our Comprehensive Airway, Respiratory, and Esophageal (CARE) Team. Charts were reviewed for all patients who carried a diagnosis of recurrent croup or chronic cough.

Patient selection in congenital pyriform aperture stenosis repair - 14 year experience and systematic review of literature.

Purpose: Congenital nasal pyriform aperture stenosis (CNPAS) is a rare cause of respiratory distress in neonates that may necessitate early surgical intervention. Restenosis and granulation are postoperative concerns that may prompt a return to the operating room. Reoperation places children at increased risk of perioperative complications and prolonged hospital stays.

Prevention of airway fires: testing the safety of endotracheal tubes and surgical devices in a mechanical model.

Objectives: This study was designed to assess the ability of carbon dioxide (CO2) lasers and radiofrequency ablation devices (Coblator) (ArthoCare Corporation, Sunnyvale, CA) to ignite either a non-reinforced (polyvinylchloride) endotracheal tube (ETT) or an aluminum and fluoroplastic wrapped silicon ("laser safe") ETT at varying titrations of oxygen in a mechanical model of airway surgery.

Methods: Non-reinforced and laser safe ETTs were suspended in a mechanical model imitating endoscopic airway surgery. A CO2 laser set at 5-30 watts was fired at the ETT at oxygen concentrations ranging from 21% to 88%.

Surgical fires in laser laryngeal surgery: are we safe enough?

Objective: Laser surgery of the larynx and airway remains high risk for the formation of operating room fire. Traditional methods of fire prevention have included use of "laser safe" tubes, inflation of a protective cuff with saline, and wet pledgets to protect the endotracheal tube from laser strikes. We tested a mechanical model of laser laryngeal surgery to evaluate the fire risk.

Horner syndrome after tonsillectomy: an anatomic perspective.

Background: Horner syndrome after tonsillectomy has been reported rarely in the literature. Furthermore, postoperative Horner syndrome lasting more than a 1 month is an even more rare occurrence.

Patient: We present a persistent postoperative Horner syndrome in a 5-year-old child following tonsillectomy.