Single stage pediatric airway reconstruction in solid organ transplant recipients.

Objectives: To describe results of single stage laryngotracheal reconstruction (ssLTR) in patients with solid organ transplants and to discuss modifications which need to be considered in this subset of patients pre-operatively, intra-operatively and post-operatively.

Study Design: We performed a retrospective case series review of children undergoing single stage laryngotracheal reconstruction in the context of prior solid organ transplant.

Setting: A tertiary care academic setting.

Transcervical Epiglottopexy: A versatile technique for managing epiglottic prolapse.

Objective: Epiglottic prolapse (EP) presents a unique management challenge. The objective of the present case series is to present clinical outcomes using a novel technique of transcervical epiglottopexy (TCE) in etiologically diverse cases of EP and to discuss the evolution of the surgical technique with technical modifications to optimize the surgical procedure.

Study Design: A retrospective case series review.

Preoperative Transfusion in Sickle Cell Disease Children Undergoing Adenotonsillectomy.

Objective: To perform a systematic review and meta-analysis comparing two pre-operative transfusion regimens (conservative versus aggressive) in children with sickle cell disease(SCD) undergoing adenotonsillectomy in terms of post-operative complications, complications related to SCD and transfusion related complications.

Data Sources And Review Methods: A literature review was performed through PubMed, EMBASE, Cochrane, and Ovid databases using the following phrases: (Adenotonsillectomy OR Tonsillectomy) AND (Sickle Cell Disease OR Sickle Cell Trait). Using predetermined inclusion and exclusion criteria, seven articles were selected for systemic review and two control trials were included in meta-analysis.

Endoscopic Versus Open Surgical Intervention for Congenital Laryngeal Webs: A Systematic Review and Meta-Analysis.

Objectives: To examine and compare the outcomes of various surgical interventions for congenital laryngeal webs in terms of avoidance of tracheostomy, rate of decannulation, web recurrence, revision surgery, and mortality in children.

Data Sources: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was conducted on December 10, 2021, using a comprehensive search in PubMed, Web of Science, Cochrane library, and Embase with no date restriction.

Review Methods: Articles on surgical intervention for congenital laryngeal webs in pediatric (<18 years) patients were included in the analysis.

Extended External Rhinoplasty Approach For Nasal Dermoids With Intracranial Extension.

We present an extended external rhinoplasty approach with bilateral marginal and alar base incisions for removal of a nasal dermoid cyst with intracranial extension in a 3-year-old patient. This approach provides adequate exposure, enables nasal bone osteotomies, and allows access to the skull base while achieving a cosmetically acceptable scar. Laryngoscope, 133:2798-2802, 2023.

Optimal laser usage improves surgical efficiency in pediatric supraglottoplasty.

Objectives: To compare patient specific and surgical efficiency outcomes in children undergoing supraglottoplasty (SGP) with flexible fiber CO2 laser in Ultrapulse mode versus cold steel at a tertiary care center.

Methods: A single surgeon retrospective cohort study of pediatric patients with laryngomalacia undergoing SGP without concomitant or prior airway surgery. We reviewed perioperative complications, total hospital stay including intensive care admission, symptom resolution and the need for revision surgery.

Case Report: Ultrasound Guided Mucosal Fold Lateralization for Laryngeal Webs.

The surgical management of Laryngeal webs is challenging and is associated with a high recurrence rate due the presence of opposing raw mucosal surfaces of the vocal cords, especially near the anterior commissure which causes re-scarring. We describe an endoscopic technique of mucosal flap lateralization (MFL) with ultrasound guidance, which prevents the apposition of the anterior raw surfaces of the vocal cords after web incision, thus avoiding recurrence.

Transcervical Epiglottopexy for the Management of Type 3 Laryngomalacia.

Type 3 laryngomalacia (LM) is characterized by prolapse of the epiglottis into the airway. Endolaryngeal suturing is technically challenging considering the limited exposure. In the present article, we describe a simple technique of transcervical epiglottopexy (TE) via an exo-endolaryngeal technique using an 18-G needle prethreaded with a 2-0 Prolene suture in a looped fashion inserted through the inferior epiglottis.

Surgical Management of Bilateral Vocal Fold Paralysis in Children: A Systematic Review and Meta-analysis.

Objectives: To examine and compare the outcomes of various types of glottic widening surgery (GWS) for initial management of bilateral vocal fold paralysis (BVFP) in children, the outcomes of different GWS procedures in children who underwent initial tracheostomy, and the rate of decannulation in children who underwent tracheostomy alone versus tracheostomy followed by GWS.

Data Sources: PubMed, Web of Science, Cochrane Library, and Embase were searched following the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses) on September 9, 2019, with no date restriction.

Review Methods: Articles focusing on GWS or tracheostomy for initial management of BVFP were included.

Swallowing outcomes after pediatric epiglottopexy.

Introduction: Persistent sleep apnea following tonsillectomy and adenoidectomy in children requires additional evaluation. One of the common areas of persistent upper airway obstruction in these children is the base of the tongue and lingual tonsils as well as epiglottic prolapse. Depending on the site of obstruction on sleep endoscopy or a cine MRI, surgical procedures include base of tongue reduction and lingual tonsillectomy with or without epiglottopexy.

Pediatric Tracheal Rhabdomyosarcoma Masquerading as a Granuloma.

We describe a posterior wall intratracheal embryonal rhabdomyosarcoma (RMS) arising in a 6-year-old tracheostomized child masquerading as reactive granulation tissue and review all reported cases of pediatric intratracheal RMS. The child underwent laser debulking of the tumor and postoperative radiation and chemotherapy with no evidence of recurrence at 2-year follow-up. A literature review revealed four previous cases of pediatric primary tracheal or intratracheal RMS, and remission was achieved in all but one case with surgery, chemotherapy, and radiation.

Endoscopic management of a prolapsed posterior costal cartilage graft in laryngotracheal reconstruction.

Laryngotracheal reconstruction is the standard of care for management of high grade pediatric laryngotracheal stenosis. One of the complications of a reconstruction with a posterior costal cartilage graft is graft prolapse. Typically, a revision laryngotracheal reconstruction will be needed to correct this complication.

Impact of supraglottoplasty on parental preception of swallowing using a 10 question swallowing index.

Introduction: Laryngomalacia can have a significant impact on swallowing function. Most of the studies in literature have focused on evaluating swallowing dysfunction in children with Laryngomalacia using clinical assessment and swallowing studies i.e.

Open resection and laryngotracheal reconstruction in a case of subglottic hemangioma in PHACE syndrome.

We describe a 1 month old infant with PHACE syndrome who underwent successful management of subglottic hemangioma by open resection and laryngotracheal reconstruction using a thyroid ala graft. Propranolol is typically the treatment of choice for subglottic hemangiomas however, recent reports have suggested adverse complications with the use of propranolol in children with PHACE syndrome. The child had cerebral and cervical vascular anomalies associated with her PHACE syndrome making her at an increased risk of stroke with the use of propranolol.

Chemoradiation in Advanced Head and Neck Cancers: A Comparison of two Radiosensitizers, Paclitaxel and Cisplatin.

To compare the locoregional control rates, survival outcome and toxicity profiles between two groups of patients of squamous cell carcinoma (SCC) of Head and Neck (Stage III & IV) receiving concomitant chemo-radiotherapy with Paclitaxel and Cisplatin. A prospective study was done on 94 previously untreated patients of histopathologically proved squamous cell carcinoma of head and neck region-AJCC stage III & IV (T3 & T4 with N0 -N3, M0) treated with concomitant chemoradiation. The patients were divided into two groups.

Endoscopic management of posterior epistaxis.

The traditional method of management of posterior epistaxis has been with anteroposterior nasal packing. Apart from the high failure rate of 26-50% reported in various series, nasal packing is associated with marked discomfort and several complications. In order to avoid nasal packing, we started doing endoscopic cauterization in cases of posterior epistaxis.

Cleft palate secondary to an ingested foreign body: a learning experience.

Background: Cleft palate has usually been described as a congenital anomaly. Acquired clefting of the palate is rare and is usually due to penetrating trauma.

Objective: To report a case of cleft palate developing after ingestion of a coin due to prolonged impaction in the nasopharynx.

Pseudocyst of pinna: a recurrence-free approach.

Objective: The aims of the article were to study the epidemiological profile of pseudocyst of pinna in non-Chinese population, to propose a hormonal basis of pseudocyst formation, and to compare 2 commonly used treatment modalities of incision drainage with compression and deroofing with compression, so as to ascertain the definitive treatment of this frequently recurring condition.

Material And Methods: Twenty-nine patients were diagnosed with pseudocyst of the auricle between June 2005 and December 2006 in a medical college hospital. All the patients were initially subjected to aspiration with contour dressing.

Congenital epulis.

Congenital epulis or gingival granular cell tumour is a rare lesion occurring in the newborn, affecting females eight times more than males and arising more commonly from the maxillary than the mandibular alveolar ridge. We report the case of a five-day-old girl who presented to us with a large mass arising from the gingival mucosa of the mandible, causing feeding difficulty. Immediate surgical excision was followed by an uneventful recovery.