Rate and management of tympanic membrane perforations in children with Down syndrome and middle ear disorder.

Objective: To characterize the management and outcomes of observation versus surgical intervention of tympanic membrane (TM) perforations in children with Down syndrome (DS). In addition, to estimate the prevalence of TM perforations in children with DS.

Methods: Retrospective case review analysis of TM perforation rate in children with DS with history of tympanostomy tube (TT) insertion at a tertiary pediatric referral center.

Measuring the Impact of a Delay in Care on Pediatric Otolaryngologic Surgery Completion.

To determine if postponement of elective pediatric otorhinolaryngology surgeries results in a change in overall healthcare utilization and if there is any commensurate impact on disease progression. We identified patients ≤18 years of age whose surgeries were postponed at the onset of the COVID-19 pandemic-related shutdown. We then tracked patients' rate of and patterns of rescheduling surgery.

Extracapsular versus intracapsular tonsillectomy: Outcomes in children with a focus on developmental delay.

Introduction: Outcomes following intracapsular tonsillectomy (IT) have not been well established in children with developmental delays. The objective of this study was to compare outcomes and complications between intracapsular and extracapsular tonsillectomy (TT) in pediatric patients with developmental delay (DD) in comparison to non-developmentally delayed children.

Methods: This is a retrospective study of pediatric patients with DD undergoing tonsillectomy between 2016 and 2019 at a tertiary care hospital.

Continuous Positive Airway Pressure Titration During Pediatric Drug Induced Sleep Endoscopy.

Objective: To observe the degree of airway collapse at varying levels of continuous positive airway pressure (CPAP) during drug pediatric induced sleep endoscopy.

Methods: Using our institutional anesthesia protocol for pediatric DISE procedures, patients were anesthetized followed by evaluation of the nasal airway, nasopharynx, velum, hypopharynx, arytenoids, tongue base, and epiglottis. CPAP titration was performed under vision to evaluate the degree of airway collapse at the level of the velum.

Volumetric brain magnetic resonance imaging analysis in children with obstructive sleep apnea.

Objectives: Pediatric Obstructive Sleep Apnea (OSA) is associated with neurocognitive deficits. Cerebral structural alterations in the frontal cortex, cerebellum, and hippocampus have been reported in adult OSA patients. These brain areas are important for executive functioning, motor regulation of breathing, and memory function, respectively.

International Pediatric Otolaryngology group (IPOG) consensus on the diagnosis and management of pediatric obstructive sleep apnea (OSA).

Objective: To develop an expert-based consensus of recommendations for the diagnosis and management of pediatric obstructive sleep apnea.

Methods: A two-iterative Delphi method questionnaire was used to formulate expert recommendations by the members of the International Pediatric Otolaryngology Group (IPOG).

Results: Twenty-six members completed the survey.

Polysomnography in children with obstructive sleep apnoea and neurocognitive disorders.

Objective: The neurocognitive associations in paediatric obstructive sleep apnoea (OSA) are well known; however, whether polysomnographic features can predict these associations is unknown. Therefore, the primary objective of this study was to compare common polysomnographic parameters in children with OSA in the presence and absence of neurocognitive dysfunction.

Methods: Polysomnography data for children ages 3-6 years with mild-moderate OSA who as defined by AHI between 5 and 10 were analysed from a single sleep centre at a tertiary paediatric hospital from January 2016 to December 2018.

Pediatric otolaryngology workflow changes in a community hospital setting to decrease exposure to novel coronavirus.

Objectives: To develop a workflow algorithm for physicians and staff to decrease cross contamination and minimize exposure to Coronavirus Disease -19 (COVID-19) in pediatric otolaryngology at a community pediatric hospital.

Methods: PubMed and Google Scholar searches were carried out using the keywords. Pertinent clinical information related to pediatric otolaryngology was reviewed from journals, Texas Medical Board guidelines as well as institutional guidelines.

Pediatric obstructive sleep apnea: Preoperative and neurocognitive considerations for perioperative management.

Obstructive sleep apnea (OSA) affects up to 7.5% of the pediatric population and is associated with a variety of behavioral and neurocognitive sequelae. Prompt diagnosis and treatment is critical to halting and potentially reversing these changes.

Airway protection & patterns of dysphagia in infants with down syndrome: Videofluoroscopic swallow study findings & correlations.

Introduction: Down syndrome is a genetic condition that affects 1:737 births. Along with cardiac, otolaryngologic, and developmental anomalies, infants with Down syndrome can have swallowing difficulties resulting in respiratory infections. This study aims to characterize the airway protection and dysphagia seen in infants with Down syndrome.

Pediatric Drug Induced Sleep Endoscopy: A Simple Sedation Recipe.

Objective: To describe a minimalist approach to sedating children for DISE procedures.

Methods: We searched existing literature and derived and tested our algorithm on patients using evidence-based studies.

Results: We were able to successfully sedate, without airway intervention, 15 highly complex children with a variety of comorbidities for DISE procedures.

Screening for undiagnosed bleeding disorders in post-tonsillectomy bleed patients: Retrospective review and systematic review of the literature.

Objectives: There is currently no standard for screening children with post-tonsillectomy bleeds (PTB) for coagulopathy disorders. This study aims to identify children with occult coagulopathy diagnosed at PTB and to identify factors associated with diagnosis. A systematic review of the literature further identified trends in this topic.

Otolaryngologic management of Down syndrome patients: what is new?

Purpose Of Review: The management of children with Down syndrome as it pertains to the otolaryngologist continues to evolve. Obstructive sleep apnea (OSA) has dominated the recent literature, but other topics including hearing loss, swallowing, and perioperative considerations are also reported.

Recent Findings: The prevalence of OSA in children with Down syndrome ranges from 57 to 73% in certain cohorts, and, whereas adentonsillectomy can decrease Apnea-Hypopnea Index, up to 80% may have persistent OSA.