Systematic Review and Meta-analysis of the Change in Pharyngeal Bacterial Cultures After Pediatric Tonsillectomy.

Objective: To review all available biomedical literature to assess published data regarding the effect of pediatric tonsillectomy on the culture results of potentially pathogenic respiratory pharyngeal bacteria before and after surgery.

Data Sources: Biomedical literature databases (PubMed, Embase, Web of Science) from January 1970 to December 2019.

Review Methods: A systematic review of the literature was performed with the assistance of a medical librarian.

Clinical Consensus Statement: Ankyloglossia in Children.

Objective: To identify and seek consensus on issues and controversies related to ankyloglossia and upper lip tie in children by using established methodology for American Academy of Otolaryngology-Head and Neck Surgery clinical consensus statements.

Methods: An expert panel of pediatric otolaryngologists was assembled with nominated representatives of otolaryngology organizations. The target population was children aged 0 to 18 years, including breastfeeding infants.

Association of Preoperative, Subjective Pediatric Tonsil Size With Tonsillectomy Outcomes: A Systematic Review.

Importance: Tonsil size assessment on physical examination is often used as a key component of clinical decision-making, specifically in estimating the success or failure of adenotonsillectomy surgery. The accuracy of this approach is not specifically known.

Objective: To systematically review the biomedical literature for data comparing subjective preoperative tonsil (and adenoid) size (0- to >4-point scale) with adenotonsillectomy outcomes using polysomnography and/or quality of life outcomes.

Cost Benefit and Utility Decision Analysis of Turbinoplasty with Adenotonsillectomy for Pediatric Sleep-Disordered Breathing.

Objectives: Use decision analysis techniques to assess the potential utility gains/losses and costs of adding bilateral inferior turbinoplasty to tonsillectomy/adenoidectomy (T/A) for the treatment of obstructive sleep-disordered breathing (oSDB) in children. Use sensitivity analysis to explore the key variables in the scenario.

Study Design: Cost-utility decision analysis model.

Injection laryngoplasty in neonates and young children with unilateral vocal fold immobility.

Introduction: Although injection laryngoplasty (IL) is a well-accepted treatment strategy in older children and adults with unilateral vocal fold immobility (UVFI), its efficacy and safety have not been well studied in neonates and young children.

Objectives: The main objective of this study was to evaluate the clinical and radiographic effects of IL on aspiration & dysphagia in neonates and young children with UVFI.

Methods: This was a retrospective chart review of infants and children who underwent IL at a tertiary children's hospital.

The relationship of the uvula with snoring and obstructive sleep apnea: a systematic review.

Currently, the relationship between uvula size and sleep-disordered breathing (snoring and obstructive sleep apnea) lacks data for objective interpretation. This study conducted a systematic review of the international literature for research describing the measurable characteristics of the uvula (i.e.

Comparison of Pediatric Intracapsular Tonsillectomy and Extracapsular Tonsillectomy: A Cost and Utility Decision Analysis.

Objectives To use decision analysis modeling to compare utility and cost outcomes of intracapsular tonsillectomy (ICT) and extracapsular tonsillectomy (ECT). To use sensitivity analysis to determine the most important factors influencing outcomes favoring one surgical method versus another. Study Design Decision analysis model.

Polysomnography results versus clinical factors to predict post-operative respiratory complications following pediatric adenotonsillectomy.

Objective: Systematically review the published literature comparing the presence of clinical features (age, BMI, co-morbidities, etc.) versus polysomnogram (PSG) results in the prediction of major post-operative respiratory complications following pediatric adenotonsillectomy (T/A) for the treatment of Obstructive Sleep Apnea Syndrome (OSAS).

Methods: A systematic review of the PUBMED and EMBASE databases was performed to identify studies containing both clinical and PSG data predicting major post-operative respiratory complications following T/A.

National Database Analysis of Single-Level versus Multilevel Sleep Surgery.

Objective Recent evidence suggests that multilevel sleep surgery improves outcomes when compared with palate surgery alone for most patients. The study objective was to compare demographic and outcomes data for palate surgery (uvulopalatopharyngoplasty [UPPP]) alone versus multilevel surgery through a national insurance claims database. Study Design Retrospective cohort study.

Reliability of a Standardized Nasal Anatomic Worksheet and Correlation With Subjective Nasal Airway Obstruction.

Importance: Nasal obstruction is a common chief concern; however, a comprehensive standardized worksheet for evaluating nasal obstruction has not been developed.

Objective: To evaluate the interrater reliability between staff surgeons and otolaryngology residents using a worksheet-based standardized nasal examination and to identify specific examination findings correlated with the Nasal Obstruction Symptom Evaluation quality-of-life score.

Design, Setting, And Participants: This cross-sectional study conducted from June to July 2012 involved 50 adults presenting to an otolaryngology clinic at a tertiary care hospital.

Transpalatal advancement pharyngoplasty for obstructive sleep apnea: a systematic review and meta-analysis.

The objective is to determine if apnea-hypopnea index (AHI) and lowest oxygen saturation (LSAT) improve after transpalatal advancement pharyngoplasty (TPAP) with obstructive sleep apnea (OSA) in adults, using a systematic review and meta-analysis. Nine databases, including PubMed/MEDLINE, were searched through April 1, 2016. All studies that included patients who underwent TPAP alone were included in this analysis.

Tonsillectomy for adult obstructive sleep apnea: A systematic review and meta-analysis.

Objectives/hypothesis: To determine if sleepiness and sleep study variables (e.g., Apnea-Hypopnea Index [AHI] and lowest oxygen saturation) improve following isolated tonsillectomy for adult obstructive sleep apnea (OSA).

Transoral Robotic Surgery for Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis.

Objective: To perform a systematic review of the international biomedical literature evaluating the effectiveness, complications, and safety of transoral robotic surgery (TORS) for the treatment of obstructive sleep apnea (OSA).

Data Sources: PubMed/MEDLINE, Embase, and EMB Reviews databases were searched up to November 27, 2015.

Review Methods: Two authors systematically and independently searched for articles on TORS for the treatment of OSA in adults that reported either outcomes for the apnea-hypopnea index (AHI), lowest oxygen saturation percentage (LSAT) or changes in the Epworth Sleepiness Scale (ESS), and/or rates and types of complications associated with the operation.

Cleft Lip and Cleft Palate Surgery: Malpractice Litigation Outcomes.

Objective: This study examined malpractice claims related to cleft lip and cleft palate surgery to identify common allegations and injuries and reviewed financial outcomes.

Design: The WestlawNext legal database was analyzed for all malpractice lawsuits and settlements related to the surgical repair of cleft lip and palate.

Main Outcomes Measures: Inclusion criteria included patients undergoing surgical repair of a primary cleft lip or palate or revision for complications of previous surgery.

Radiofrequency Ablation Turbinoplasty versus Microdebrider-Assisted Turbinoplasty: A Systematic Review and Meta-analysis.

Objective: To critically review published literature for treatment-related outcomes for bilateral inferior turbinate reduction (IFTR) via either microdebrider-assisted turbinoplasty (MAT) or radiofrequency turbinoplasty. The primary outcomes were relief of nasal obstruction according to visual analog scale and nasal airflow, volume, and resistance measures based on acoustic rhinomanometry.

Data Sources: MEDLINE, EMBASE, The Cochrane Catalog, and CINAHL.

How much does the type of tympanostomy tube matter? A utility-based Markov decision analysis.

Objectives: To use a utility-based Markov decision analysis model to compare outcomes of short-term grommet tympanostomy tubes (TTs), intermediate-type tubes, and permanent T-Tubes and to use a detailed sensitivity analysis to determine the most important factors influencing outcomes with one type of TT versus another.

Study Design: Markov decision analysis.

Setting: Hypothetical cohort.

Tonsillectomy versus tonsillotomy: a study of parental preference.

Objective: To directly sample the preference of representative parents who would be hypothetically considering tonsillotomy versus tonsillectomy for their child and assess the role of parental age, educational level, and risk aversion in making this choice.

Methods: Parents in a pediatric otolaryngology waiting room were asked to complete an anonymous survey which presented hypothetical scenarios for their child and described the specifics of tonsillectomy and tonsillotomy in terms of post-operative recovery, tonsil regrowth rates, and future strep throat risk. Other questions gathered parental demographic data and assessed risk tolerance.

An anatomically based analysis of objectively measured pediatric snoring: a pilot study.

Objective: To assess pediatric habitual snoring (PS) using home sleep test (HST) technology and attempt to correlate the objective components of PS to specific upper airway anatomy. In addition, the effects of adenotonsillectomy (±turbinoplasty) on objective measures of PS were evaluated.

Study Design: Prospective cohort study.

Clinical consensus statement: pediatric chronic rhinosinusitis.

Objective: To develop a clinical consensus statement on the optimal diagnosis and management of pediatric chronic rhinosinusitis (PCRS).

Methods: A representative 9-member panel of otolaryngologists with no relevant conflicts of interest was assembled to consider opportunities to optimize the diagnosis and management of PCRS. A working definition of PCRS and the scope of pertinent otolaryngologic practice were first established.

Inferior turbinate classification system, grades 1 to 4: development and validation study.

Objectives/hypothesis: To develop a validated inferior turbinate grading scale.

Study Design: Development and validation study.

Methods: Phase 1 development (alpha test) consisted of a proposal of 10 different inferior turbinate grading scales (>1,000 clinic patients).

Tracheostomy as treatment for adult obstructive sleep apnea: a systematic review and meta-analysis.

Objectives/hypothesis: To systematically review outcomes for polysomnography, sleepiness, and mortality in patients who undergo tracheostomy for the treatment of adult obstructive sleep apnea (OSA).

Data Sources: MEDLINE, Scopus, and the Cochrane Library were searched from inception to March 2013, followed by extensive hand searching for the identification of relevant English language studies that met predefined criteria.

Review Methods: Adult studies of tracheostomies or tracheotomies as treatment for OSA with outcomes for apnea index (AI), apnea-hypopnea index (AHI), oxygen desaturation index (ODI), effect on daytime sleepiness or mortality were identified, abstracted and pooled (as appropriate).