Evaluation of Cholesteatoma.

Evaluation of cholesteatoma depends on clinical history and examination, with microscope and/or endoscope. A history of hearing loss with a chronic draining ear, refractory to ototopical medication, raises suspicion for cholesteatoma. Symptoms of Eustachian tube dysfunction or prior ear surgery including ear tubes should be elicited.

Cochlear Implantation Can Improve Auditory Skills, Language and Social Engagement of Children With Autism Spectrum Disorder.

Objective: To review outcomes of cochlear implantation (CI) in children diagnosed with autism spectrum disorder (ASD).

Study Design: Retrospective case review and parent survey.

Setting: Tertiary care children's hospital.

Transcanal Endoscopic Ear Surgery for Congenital Cholesteatoma: A Multi-institutional Series.

Objective: To assess outcomes of transcanal endoscopic ear surgery (TEES) for congenital cholesteatoma.

Study Design: Case series with chart review of children who underwent TEES for congenital cholesteatoma over a 10-year period.

Setting: Three tertiary referral centers.

Early Identification and Management of Congenital Cytomegalovirus.

Congenital cytomegalovirus (cCMV) is the most common nongenetic cause of sensorineural hearing loss. Despite its prevalence, universal screening for cCMV is not currently performed. Hearing loss caused by cCMV is most often severe to profound, often bilateral, and may be fluctuating or progressive.

Congenital Cytomegalovirus Infection: Epidemiology, Timely Diagnosis, and Management.

Congenital cytomegalovirus (cCMV) infection is common because of the ubiquitous nature of the virus and the lack of an effective prevention strategy during pregnancy. Most infants with cCMV are asymptomatic, although a notable subset can have sequelae including, most commonly, sensorineural hearing loss and neurodevelopmental disability, which may not be present at birth. Timely screening for cytomegalovirus in the first weeks after birth is critical to appropriately diagnose congenital infection, evaluate affected infants, and determine the treatment course.

Impact of Cochlear Implant With Diametric Magnet on Imaging Access, Safety, and Clinical Care.

Objectives/hypothesis: Review safety and effectiveness of magnetic resonance imaging (MRI) of patients implanted with a cochlear implant (CI) containing a diametric magnet housed within the undersurface of the device.

Study Design: Retrospective chart review with additional review of MRI at a tertiary-care children's hospital.

Methods: Seven patients with mean age of 8.

Telemedicine During the COVID-19 Pandemic: A Pediatric Otolaryngology Perspective.

The COVID-19 pandemic has created a situation unparalleled in our lifetime. As the medical community has attempted to navigate a sea of ever-changing information and policies, this uncertainty has instead bred creativity, community, and evolution. Necessity is the mother of invention, and one of the by-products of our rapidly changing environment is the increased reliance on telemedicine.

International Pediatric Otolaryngology Group (IPOG) Consensus Recommendations: Congenital Cholesteatoma.

Objective: To provide recommendations to otolaryngologists and allied physicians for the comprehensive management of children who present with signs and symptoms of congenital cholesteatoma.

Methods: A two-iterative Delphi method questionnaire was used to establish expert recommendations by the members of the International Pediatric Otolaryngology Group, on the preoperative work-up, the perioperative considerations, and follow-up.

Results: Twenty-two members completed the survey, in 14 tertiary-care center departments representing 5 countries.

Safety and Effectiveness of Cochlear Implantation of Young Children, Including Those With Complicating Conditions.

Objective: Determine safety and effectiveness of cochlear implantation of children under age 37 months, including below age 12 months.

Study Design: Retrospective review.

Setting: Tertiary care children's medical center.

Transcutaneous Osseointegrated Implants for Pediatric Patients With Aural Atresia.

Importance: Patients with aural atresia typically have maximal conductive hearing loss, which can have negative academic and social consequences. Transcutaneous osseointegrated implants (TOIs) can potentially restore hearing on the affected side.

Objectives: To review the demographic, audiological, and surgical outcomes of TOI placement in pediatric patients with aural atresia and to describe a modification in incision technique in anticipation of later auricular reconstruction.

Outcomes and Time to Emergence of Auditory Skills After Cochlear Implantation of Children With Charge Syndrome.

Objective: Review perioperative complications, benefits, and the timeframe over which auditory skills develop in children with CHARGE syndrome who receive a cochlear implant (CI).

Study Design: IRB-approved retrospective chart review of children with CHARGE syndrome who had at least 12 months of cochlear implant use.

Setting: Tertiary care children's hospital.

Endoscopic transcanal approach to the middle ear for management of pediatric cholesteatoma.

Objectives: To describe outcomes for endoscopic ear surgery (EES) for pediatric cholesteatoma at a tertiary pediatric hospital.

Methods: Retrospective case series of 65 pediatric cholesteatoma cases in 38 ears. Subgrouping based on cholesteatoma type and EES type.

Endoscopic middle ear exploration in pediatric patients with conductive hearing loss.

Objective: To describe our indications, findings, and outcomes for transcanal endoscopic middle ear exploration in pediatric patients with conductive hearing loss of unknown etiology, without effusions.

Methods: Prospective case series for all pediatric patients undergoing totally endoscopic transcanal middle ear exploration between April 2012 and October 2015 at a pediatric tertiary care referral hospital. Demographic data, operative findings, and hearing results were reviewed.

Management of acute complicated mastoiditis at an urban, tertiary care pediatric hospital.

Objectives/hypothesis: To describe the presentation and management of acute complicated mastoiditis in children.

Study Design: Retrospective case series.

Methods: An analysis of pediatric patients with acute complicated mastoiditis treated at an urban, tertiary care children's hospital from 2007 to 2014 was performed.

Management of hearing loss and the normal ear in cases of unilateral Microtia with aural atresia.

Objectives/hypothesis: To identify the rate of hearing loss related to middle ear disease and the frequency of tympanostomy tube (TT) insertion in the contralateral ear of patients with unilateral microtia/aural atresia.

Study Design: Retrospective case series of patients less than 3 years of age with unilateral microtia/aural atresia treated at an urban, tertiary care children's hospital from 2008 to 2013.

Methods: Clinical and audiologic data were reviewed.

Head and neck vascular lesions.

Vascular lesions of the head and neck are complex and diverse. These include infantile hemangioma, venous malformations, lymphatic malformations, and arteriovenous malformations, among others. Vascular malformations and tumors display different growth patterns and require different approaches to treatment.

The transpalatal approach to repair of congenital Basal skull base cephaloceles.

Basal skull base herniations, including meningoceles and encephaloceles, are rare and may present with characteristic facial and neurologic features. The traditional craniotomy approach has known morbidity, and nasal endoscopy may not allow for control of large posterior basal defects, especially in newborns. We present two cases of successful repair of basal transsphenoidal meningoceles using an oral-transpalatal approach.

The proximal bronchoplasty retrieval technique for removal of embedded distal airway foreign bodies.

Objectives: To describe a novel technique for removal of embedded distal airway foreign bodies with emphasis on procedural steps and management.

Methods: The proximal bronchoplasty retrieval (PBR) technique is described including indications, rationale, surgical technique, and clinical decision making. Two representative cases are described in detail in order to demonstrate the technique.

The "postcricoid cushion": observations on the vascular anatomy of the posterior cricoid region.

Objective: To describe the cyclical vascular enlargement that occurs in the postcricoid region during the expiratory phase on an infant's cry, and to consider the anatomic, physiologic, and clinical implications of this phenomenon, which we term the "postcricoid cushion."

Design: A total of 125 consecutive office fiber-optic laryngoscopic examinations in children and infants were reviewed for engorgement and vascular discoloration of the postcricoid region. Presence of a postcricoid cushion in relation to patient age was reviewed.

Aspiration before and after Supraglottoplasty regardless of Technique.

Objective. To determine the incidence of preoperative and postoperative aspiration in infants who undergo supraglottoplasty. To determine the effect of cold steel and CO(2) laser supraglottoplasty on aspiration in infants with severe laryngomalacia.

Supraglottoplasty outcomes in relation to age and comorbid conditions.

Objective: To determine if age and comorbid conditions effect outcomes in children undergoing supraglottoplasty for severe laryngomalacia.

Design: Retrospective study.

Setting: Urban tertiary-care children's hospital.

Monitoring and modeling of emissions from concentrated animal feeding operations: overview of methods.

Accurate monitors are required to determine ambient concentration levels of contaminants emanating from concentrated animal feeding operations (CAFOs), and accurate models are required to indicate the spatial variability of concentrations over regions affected by CAFOs. A thorough understanding of the spatial and temporal variability of concentration levels could then be associated with locations of healthy individuals or subjects with respiratory ailments to statistically link the presence of CAFOs to the prevalence of ill health effects in local populations. This workgroup report, which was part of the Conference on Environmental Health Impacts of Concentrated Animal Feeding Operations: Anticipating Hazards-Searching for Solutions, describes instrumentation currently available for assessing contaminant concentration levels in the vicinity of CAFOs and reviews plume dispersion models that may be used to estimate concentration levels spatially.