Noise exposure in pediatric otolaryngology clinic: A sound survey of a single-institution tertiary care facility.

Background: The Occupational Safety and Health Administration (OSHA) considers acoustic exposure of 90 decibels (dB) an occupational risk for noise-induced hearing loss. Pediatric healthcare clinicians are exposed to considerable noise especially during invasive procedures, predisposing them to noise-induced hearing loss, increased work-related stress, and increased complications associated with intense noise exposure. While there has been extensive research in noise exposure in dentistry, to date there has been no research on noise exposure in the pediatric otolaryngology clinic setting.

Aerodigestive Approach to Pediatric Chronic Cough.

Chronic cough is defined as cough lasting more than 4 weeks in children aged 14 years or older. Normal children, without pathophysiology, can cough up to more than 30 times a day. When cough occurs pathologically, it is often more often and can be divided into specific and nonspecific cough types.

Evaluation of the inhibitory effects and the mechanism of terpenoids on Toxoplasma gondii tachyzoites.

Background: Currently, symptomatic toxoplasmosis is treated with a combination of sulfadiazine and pyrimethamine. However, significant adverse effects and drug resistance have been reported. Terpenoids are widely found in nature, with numerous studies demonstrating that they have effective inhibitory effects on a variety of parasites.

Reducing intraoperative time with laryngeal mask airway and stretcher in pediatric adenotonsillectomy.

Objectives: Adenotonsillectomy (T&A) is one of the most common surgical procedures performed in the United States. Several studies have defined the safety of laryngeal mask airway (LMA) during this surgery, and conflicting evidence exists describing the role it plays in reducing intraoperative times. Our objective is to describe the role LMA and operating on a stretcher have on reducing intraoperative time during pediatric T&A.

Visualization and quantification of cadmium accumulation, chelation and antioxidation during the process of vacuolar compartmentalization in the hyperaccumulator plant Solanum nigrum L.

Hyperaccumulators store metals in the vacuoles of leaf cells. To investigate the role of vacuolar compartmentalization in Cd accumulation, chelation and induced antioxidation, we quantified the amounts of total cadmium (Cd), Cd, glutathione (GSH) and reactive oxygen species (ROS) in leaf cells of Solanum nigrum L. The results confirmed that vacuoles were, indeed, the main storage compartments for Cd.

Contour Map Point Distribution and Surgeon Experience Level Affect Accuracy of Surgical Navigation in a Pilot Study.

Background: Reliable use of surgical navigation depends upon the registration process. The gold standard is paired-point registration with bone-anchored fiducials, but contour-map registration is more practical. Surgeons may employ variable contour maps and less experienced team members often perform this critical step.

N95 respirator reuse, decontamination methods, and microbial burden: A randomized controlled trial.

Purpose: To evaluate the effectiveness and ease of N95 respirator decontamination methods in a clinic setting and to identify the extent of microbial colonization on respirators associated with reuse.

Methods: In a prospective fashion, N95 respirators (n = 15) were randomized to a decontamination process (time, dry heat, or ultraviolet C light [UVC]) in outpatient clinics. Each respirator was re-used up to 5 separate clinic sessions.

Early Tracheostomy Change in Neonates: Feasibility and Benefits.

Objectives: To compare outcomes of early and late tracheostomy change in neonatal patients. Early tracheostomy change (ETC) occurred 3 to 4 days after surgery, and late tracheostomy change (LTC) occurred 5 to 7 days after surgery.

Study Design: Retrospective cohort.

Population-based survival of pediatric rhabdomyosarcoma of the head and neck over four decades.

Objectives: Clinical trials have reported increases in the survival of pediatric rhabdomyosarcoma (RMS) from 25% in 1970 to 73% in 2001. The purpose of this study was to examine whether survival of pediatric patients with RMS of the head and neck improved at the US population level.

Methods: A population-based cohort of patients with rhabdomyosarcoma of the head and neck aged 0-19 years in the Surveillance, Epidemiology, and End Results (SEER) registry from 1973 to 2013 was queried.

Double-blinded randomized prospective trial of intranasal capsaicin treatment for nonallergic rhinitis.

Background: Nonallergic rhinitis (NAR) is currently a diagnosis of exclusion with an unclear pathophysiologic mechanism and limited treatment options. In patients diagnosed with NAR based on symptoms, negative skin testing and positive optical rhinometry (ORM), the study's objective was to evaluate the therapeutic action of intranasal capsaicin in the management of rhinitic symptoms and the effect on ORM readings.

Methods: Patients with a history of NAR underwent screening by a diagnostic intranasal capsaicin challenge with ORM and skin-prick testing.

Pediatric tracheostomies in patients less than 2 years of age: Analysis of complications and long-term follow-up.

Purpose: Identify variables that are predictive of morbidity and mortality in children under the age of two undergoing tracheostomy and to provide longitudinal data on this patient population.

Methods: Patients were retrospectively identified using Current Procedural Terminology codes 31600, 31601, 31610 from 2009 to 2016.

Results: Median age at time of tracheostomy was 0.

PHQ-9 and SNOT-22: Elucidating the Prevalence of Depression in Chronic Rhinosinusitis.

Objective: Chronic rhinosinusitis (CRS) has been associated with comorbid depression, yet the prevalence of depression among all patients with CRS is not well described. The Patient Health Questionnaire-9 (PHQ-9), a validated instrument for diagnosing depression, has been used to assess depression in a variety of clinical settings. PHQ-9 scores ≥10 are the threshold for a depression diagnosis.

CXCR5CD8 T cells are a distinct functional subset with an antitumor activity.

CXCR5 mediates homing of both B and follicular helper T (T) cells into follicles of secondary lymphoid organs. We found that CXCR5CD8 T cells are present in human tonsils and follicular lymphoma, inhibit T-mediated B cell differentiation, and exhibit strong cytotoxic activity. Consistent with these findings, adoptive transfer of CXCR5CD8 T cells into an animal model of lymphoma resulted in significantly greater antitumor activity than CXCR5CD8 T cells.

Airway evaluation in children with single ventricle cardiac physiology.

Objective: Children with single ventricle cardiac physiology (SVC) often require airway procedures as an adjunct to their care. Descriptive analysis with a focus on outcomes of airway procedures in SVC patients have not been fully described in the literature.

Methods: Retrospective, single-center cohort review of 270 patients born between Aug-2007 and Jan-2017.

Surgical Outcomes and Postoperative Management in Spontaneous Cerebrospinal Fluid Rhinorrhea.

 The etiology of spontaneous cerebrospinal fluid (CSF) rhinorrhea remains unknown, though emerging evidence suggests that this likely represents a variant of idiopathic intracranial hypertension. Long-term success rates for repair and postoperative management strategies remain variable.  Retrospective review of patients undergoing surgical management of spontaneous CSF rhinorrhea was conducted over a 5-year period.

Effect of changing postoperative pain management on bleeding rates in tonsillectomy patients.

Purpose: To review rates of post-tonsillectomy hemorrhage (PTH) at a quaternary medical center, including the impact of narcotic versus nonsteroidal anti-inflammatory drug (NSAID) postoperative pain management.

Materials And Methods: A retrospective review was performed of tonsillectomies conducted at a single institution between 1/1/2013 and 1/1/2017. The rates of PTH and subsequent intervention were calculated.

Expeditious emergency room referral pathway improves patient access to otolaryngology care.

Objectives: Historically at a multi-hospital residency program, there was an unexpected number of non-urgent consults from the county hospital emergency room (ER) that caused residents to make more trips between hospitals and come closer to violating duty hours. Moreover, there was also a poor follow-up rate for these patients. An alternate pathway to redirect such consults to the Otorhinolaryngology-Head and Neck Surgery (ORL-HNS) clinic, staffed by an attending physician, was devised.

Endoscopic culture-directed antibiotic therapy: Impact on patient symptoms in chronic rhinosinusitis.

Background: Endoscopically guided cultures are frequently employed to guide antimicrobial therapy in refractory chronic rhinosinusitis (CRS) patients. The objective of this study was to determine the impact of culture-directed antibiotics on patient symptoms.

Methods: Retrospective review was conducted of 105 adult CRS patients undergoing evaluation in the ambulatory clinic of tertiary care academic medical center.

Utility of MRIs in adult cochlear implant evaluations.

Objectives: To determine the prevalence of MRI abnormalities in adults undergoing cochlear implantation and to correlate abnormalities to audiology data.

Study Design: Case series.

Setting: Academic medical center.

Clinical impact of early CT scans after lateral skull-base surgery.

Objective: To determine the frequency and clinical significance of abnormalities on postoperative computerized tomography (CT) scans performed within 24 hours after lateral skull base surgery.

Study Design: Case series with chart review. Setting Inpatient tertiary care hospital.

Inferior turbinate surgery in children: a survey of practice patterns.

Objectives/hypothesis: A variety of techniques for inferior turbinate reduction have been used in children, but to date practice patterns have not been studied. The purpose of this survey was to study the practice of inferior turbinate surgery among pediatric otolaryngologists.

Study Design: Cross-sectional survey study.