Safety and efficacy of lingual tonsillectomy in multilevel airway surgery for pediatric obstructive sleep apnea.

Study Objectives: Prior studies have demonstrated the efficacy of lingual tonsillectomy in treating pediatric obstructive sleep apnea. The goal of this study is to describe the postoperative outcomes following lingual tonsillectomy as a part of drug-induced sleep endoscopy-directed multilevel sleep surgery.

Methods: A retrospective review was performed for pediatric patients with obstructive sleep apnea who underwent lingual tonsillectomy as a part of drug-induced sleep endoscopy-directed sleep surgery.

Acute Emphysematous Epiglottitis: A Case Report.

Epiglottitis is a bacterial infection of the upper respiratory tract that can be rapidly progressive and life-threatening. Though predominantly seen in unvaccinated children, there seems to be a shift with the incidence of adult cases rising following the Haemophilus Influenza B (HiB) vaccine. There are several reports of epiglottitis manifesting as an abscess, but few cases report on the formation of an emphysematous abscess.

Reliability of a pediatric sleep endoscopy scoring system.

Introduction: The surgical management of Obstructive Sleep Apnea (OSA) may be guided by Drug Induced Sleep Endoscopy (DISE), but there is no universally accepted scoring system for DISE in children. The purpose of this study is to compare a novel system to the more commonly used VOTE (Velum, Oropharynx, Tongue base, Epiglottis) system.

Methods: A total of thirty pediatric DISE videos were reviewed and scored twice by 5 raters with a range of experience levels.

Base of Tongue Surgery and Pediatric Obstructive Sleep Apnea.

Objective: Drug-induced sleep endoscopy-directed lingual tonsillectomy and midline posterior glossectomy have been employed for the treatment of obstructive sleep apnea in children. The purpose of this study is to evaluate outcomes in children undergoing lingual tonsillectomy, midline posterior glossectomy, or combined base of tongue reduction procedures for obstructive sleep apnea.

Study Design: Case series with chart review.

Effects of Soft Tissue Sleep Surgery on Morbidly Obese Patients.

Introduction: Morbidly obese patients with obstructive sleep apnea (OSA) are often intolerant of continuous positive airway pressure (CPAP). The effects of sleep surgery in this population is not well documented, and sleep surgery is generally avoided due to the expectation of poor outcomes, leaving these patients untreated.

Methods: This retrospective study included 42 patients with a body mass index (BMI) ≥40.

Does length of time between cases affect resident operative time for tonsillectomy and adenoidectomy?

Objective: To evaluate the effect of prolonged time intervals between tonsillectomy and adenoidectomy (TA) on resident operative time and complications.

Study Design: Retrospective cohort.

Setting: Tertiary academic hospital.

Variables predictive of surgical outcomes after hyoid myotomy with suspension to thyroid cartilage.

Objectives: To evaluate variables predicting improvement in obstructive sleep apnea (OSA) with hyoid suspension to thyroid cartilage 4-suture technique.

Methods: Sixty adult patients (age range 23-78 years) with OSA underwent hyoid suspension to thyroid cartilage with or without concurrent multi-level surgery over an eight-year period from 2011 to 2019 at a tertiary academic center. All patients had a preoperative apnea hypopnea index (AHI) ≥ 5.

Depression and Intolerance of Uncertainty: Association with Decisional Conflict in Otolaryngology Patients.

Objective: To determine if anxiety, stress, depression, worry, and intolerance of uncertainty were related to pre-operative decisional conflict (DC), shared decision making (SDM), or demographic variables in adult otolaryngology surgical patients.

Methods: Consecutive adult patients meeting criteria for otolaryngological surgery were recruited and completed DC and SDM scales, Penn State Worry Questionnaire (PSWQ), Intolerance of Uncertainty Scale (IUS-12), and Depression, Anxiety and Stress Scale-21 (DASS-21).

Results: The cohort included 118 patients, 61 (51.

Pediatric Drug-Induced Sleep Endoscopy: Technique and Scoring System.

Drug-induced sleep endoscopy (DISE) is an invaluable tool for identifying sites of obstruction for patients with obstructive sleep apnea (OSA). During DISE, the patient is in a state of drug-induced sleep, and a flexible laryngoscope is passed through the nose into the upper airway. Sites of obstruction are visualized and scored to guide surgical management.

Adult Palatopharyngoplasty: Trends in Morbidity and Mortality from the NSQIP Database.

Objectives: Describe the postop morbidity of adults undergoing palatopharyngoplasty (PPP).

Method: Adults who underwent PPP were studied using ACS-NSQIP (American College of Surgeons National Surgical Quality Improvement Program) database (2016-2017) via CPT code 42145. Analyzed outcomes included length of stay (LOS), readmission, reoperation, and postop complications.

Epiglottopexy with or without aryepiglottic fold division: Comparing outcomes in the treatment of pediatric obstructive sleep apnea.

Objective: To determine the success of epiglottopexy with or without aryepiglottic fold division for treatment of patients with obstructive sleep apnea (OSA) with epiglottic obstruction.

Study Design: Retrospective chart review.

Setting: Tertiary care academic hospital.

Palatine Tonsil Stenting of the Airway as Determined by Drug-Induced Sleep Endoscopy.

Objective: To demonstrate lateral pharyngeal wall collapse and increased apnea-hypopnea index in a child posttonsillectomy.

Background: Some children have worsening of their sleep symptoms after tonsillectomy for obstructive sleep apnea. This case report demonstrates an open airway on drug-induced sleep endoscopy (DISE) in a child with tonsillar hypertrophy followed by more pronounced airway obstruction related to lateral pharyngeal wall collapse after tonsillectomy.

Adenoid size by drug induced sleep endoscopy compared to nasopharyngeal mirror exam.

Objective: To establish how assessment of adenoid size is correlated between drug-induced sleep endoscopy (DISE) with indirect mirror nasopharyngoscopy (IMN).

Study Design: Retrospective chart review.

Setting: Tertiary care academic hospital.

Drug Induced Sleep Endoscopy Identification of Adenoid Regrowth in Pediatric Obstructive Sleep Apnea.

Objective: To establish the incidence and possible contributing factors leading to adenoid regrowth in children with pediatric sleep apnea using drug induced sleep endoscopy (DISE).

Methods: Children treated for obstructive sleep apnea following previous adenoidectomy were evaluated using DISE. Adenoid regrowth was scored by the same attending physician using a 5-point grading scale.

Sleep endoscopy findings in children with persistent obstructive sleep apnea after adenotonsillectomy.

Objectives: Describe the patterns of obstruction in persistent pediatric OSA and their relationship with patient weight.

Study Design: Retrospective review.

Methods: All pediatric DISE procedures performed at a tertiary care hospital between October 2010 and October 2015 were reviewed.