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  1. Article ; Online: Suspension Microesophagoscopy for Endoscopic Suture Closure of Pediatric Tracheoesophageal Fistula.

    Propst, Evan J / Siu, Jennifer M / Wolter, Nikolaus E

    The Laryngoscope

    2024  

    Abstract: A 15-year-old male with previous open tracheoesophageal fistula (TEF) repair presented with a large, short recurrent TEF. The TEF was denuded with cautery on the tracheal side and the patient was intubated with a cuffed endotracheal tube. Suspension ... ...

    Abstract A 15-year-old male with previous open tracheoesophageal fistula (TEF) repair presented with a large, short recurrent TEF. The TEF was denuded with cautery on the tracheal side and the patient was intubated with a cuffed endotracheal tube. Suspension microesophagoscopy allowed excellent exposure of the TEF from the esophageal side, which was cauterized. Four sutures were placed endoscopically from the esophageal side, and the TEF remained closed 6 months postoperatively. Laryngoscope, 2024.
    Language English
    Publishing date 2024-04-13
    Publishing country United States
    Document type Case Reports
    ZDB-ID 80180-x
    ISSN 1531-4995 ; 0023-852X
    ISSN (online) 1531-4995
    ISSN 0023-852X
    DOI 10.1002/lary.31432
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  2. Article: Respiratory distress in a neonate: Inflation of a third branchial anomaly with positive airway pressure.

    Li, Chantal / Siu, Jennifer M / Woodward, Mary-Angela / Wolter, Nikolaus E

    Clinical case reports

    2024  Volume 12, Issue 4, Page(s) e8752

    Abstract: Positive airway pressure from noninvasive ventilation is an essential tool for many pediatric patients with respiratory distress. We present a case of an unknown third branchial anomaly that was diagnosed following inflation with continuous positive ... ...

    Abstract Positive airway pressure from noninvasive ventilation is an essential tool for many pediatric patients with respiratory distress. We present a case of an unknown third branchial anomaly that was diagnosed following inflation with continuous positive airway pressure (CPAP), which exacerbated the infant's respiratory distress.
    Language English
    Publishing date 2024-04-17
    Publishing country England
    Document type Case Reports
    ZDB-ID 2740234-4
    ISSN 2050-0904
    ISSN 2050-0904
    DOI 10.1002/ccr3.8752
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  3. Article ; Online: Endoscopic Transnasal Management of Meningoceles and Encephaloceles in Children: A Systematic Review.

    Li, Alyssa Y / Gaebe, Karolina / Quon, Jennifer L / Vescan, Allan / James, Adrian L / Wolter, Nikolaus E

    Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

    2024  

    Abstract: Objective: To review surgical techniques used in the endoscopic transnasal repair of pediatric basal meningoencephaloceles and compare perioperative outcomes in children <2 and ≥2 years old.: Data sources: MEDLINE, EMBASE, and CENTRAL.: Review ... ...

    Abstract Objective: To review surgical techniques used in the endoscopic transnasal repair of pediatric basal meningoencephaloceles and compare perioperative outcomes in children <2 and ≥2 years old.
    Data sources: MEDLINE, EMBASE, and CENTRAL.
    Review methods: Data sources were searched from inception to August 22, 2022, using search terms relevant to endoscopic transnasal meningoencephalocele repair in children. Reviews and Meta-analyses were excluded. Primary outcomes were the incidence of intraoperative and postoperative complications, including cerebrospinal fluid leak, recurrence, and reintervention. Quality assessments were performed using Newcastle-Ottawa Scale, ROBIN-I, and NIH.
    Results: Overall, 217 patients across 61 studies were identified. The median age at surgery was 4 years (0-18 years). Fifty percent were female; 31% were <2 years. Most defects were meningoencephaloceles (56%), located transethmoidal (80%), and of congenital origin (83%). Seventy-five percent of repairs were multilayered. Children ≥2 years underwent multilayer repairs more frequently than those <2 years (P = 0.004). Children <2 years more frequently experienced postoperative cerebrospinal fluid leaks (P = 0.02), meningoencephalocele recurrence (P < 0.0001), and surgical reintervention (P = 0.005). Following multilayer repair, children <2 years were more likely to experience recurrence (P = 0.0001) and reintervention (P = 0.006).
    Conclusion: Younger children with basal meningoencephaloceles appear to be at greater risk of postoperative complications following endoscopic endonasal repair, although the quality of available evidence is weakened by incomplete reporting. In the absence of preoperative cerebrospinal fluid leak or meningitis, it may be preferable to delay surgery as access is more conducive to successful repair in older children.
    Language English
    Publishing date 2024-03-17
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 392085-9
    ISSN 1097-6817 ; 0161-6439 ; 0194-5998
    ISSN (online) 1097-6817
    ISSN 0161-6439 ; 0194-5998
    DOI 10.1002/ohn.711
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  4. Article: Practical tips for paediatricians: Esophageal button battery impaction in children.

    Hamour, Amr F / Ostrow, Olivia / James, Adrian L / Wolter, Nikolaus E

    Paediatrics & child health

    2021  Volume 27, Issue 2, Page(s) 72–74

    Language English
    Publishing date 2021-10-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 2106767-3
    ISSN 1918-1485 ; 1205-7088
    ISSN (online) 1918-1485
    ISSN 1205-7088
    DOI 10.1093/pch/pxab078
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  5. Article ; Online: Oral Sucrose in Infants Undergoing Flexible Nasolaryngoscopy: A Blinded Randomized Pilot Study.

    Wolter, Nikolaus E / Tepsich, Meghan E / Daien, Ellie S / Levinsky, Justin T / Vanderpost, Mary-Elizabeth / Propst, Evan J / Siu, Jennifer M

    The Laryngoscope

    2024  

    Abstract: Introduction: Flexible nasolaryngoscopy (FNL) is a common, uncomfortable procedure performed to assess the upper airway in infants. Oral sucrose is used during various painful procedures in infants but has not been used during FNL. Our objective was to ... ...

    Abstract Introduction: Flexible nasolaryngoscopy (FNL) is a common, uncomfortable procedure performed to assess the upper airway in infants. Oral sucrose is used during various painful procedures in infants but has not been used during FNL. Our objective was to understand the impact of oral sucrose on discomfort in infants undergoing FNL.
    Methods: Infants (<12-months-old) undergoing FNL in the otolaryngology clinic were randomized to treatment (0.5 mL 24% oral sucrose) or standard management (no sucrose). Sucrose was administered <2 min prior to FNL performed by a single endoscopist. Outcome measures included: EVENDOL pain scale and cry duration and visit duration. Infant discomfort was measured by a second observer who was blinded to treatment group.
    Results: Forty-seven infants were included, 23 were treated with sucrose and 24 with standard management. The median (IQR) age was 3.0 (2-5.7) months. There were no significant differences in age, weight, or sex across groups. The median (IQR) duration of FNL was 35.2 (26.5-58.4) and 36.4 (28.9-51.8) seconds for treatment and standard management groups, respectively. Mean (SD) EVENDOL scores were significantly lower in the sucrose group [4.9 (2.0)] than standard group (6.7 [2.1]) (p = 0.003). Mean cry duration after FNL was significantly shorter in the sucrose group (29.9 [20.4] seconds) than the standard group (52.7.0 [40.6] seconds) (p = 0.02). Median (IQR) visit duration did not differ across groups (1.1 [0.9-1.3] vs. 1.1 [0.7-1.4] h [p = 0.15]).
    Conclusion: Oral sucrose given before FNL reduced EVENDOL scores and cry duration after FNL and did not prolong clinic visits in this randomized pilot study.
    Level of evidence: 2 Laryngoscope, 2024.
    Language English
    Publishing date 2024-02-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80180-x
    ISSN 1531-4995 ; 0023-852X
    ISSN (online) 1531-4995
    ISSN 0023-852X
    DOI 10.1002/lary.31371
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  6. Article ; Online: Pediatric Esophageal Foreign Bodies: The Role of Socioeconomic Status in Ingestion Patterns.

    Chen, Tanya / M Siu, Jennifer / Madan, Yasmine / Ma, Gar-Way / Gill, Peter J / Carman, Nicholas / Propst, Evan J / Wolter, Nikolaus E

    The Laryngoscope

    2024  

    Abstract: Objective: Pediatric esophageal foreign bodies (EFBs) are common and can result in serious complications. Little is known about the influence of socioeconomic status (SES) on EFB ingestion in children. The goal was to study SES as a risk factor for ... ...

    Abstract Objective: Pediatric esophageal foreign bodies (EFBs) are common and can result in serious complications. Little is known about the influence of socioeconomic status (SES) on EFB ingestion in children. The goal was to study SES as a risk factor for dangerous foreign body ingestion and in-hospital complications in children.
    Methods: This was a retrospective cohort study of children presenting to a tertiary care pediatric hospital with an esophageal foreign body from 2010 to 2021. SES was assessed for each patient by linking their postal code to the Ontario Marginalization Index to determine a quintile score across four dimensions of deprivation: residential instability, material deprivation, dependency, and ethnic concentration. Dangerous EFBs were defined as magnets, batteries, sharp objects, or bones. In-hospital complications included: intensive care unit admission, prolonged length of stay, and postoperative sequelae.
    Results: A total of 680 patients were included. Dangerous EFB ingestion was higher for children with increased residential instability (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.2-3.6) and increased material deprivation (OR, 2.2; CI, 1.9-2.8), which was similarly true for odds of complications. Odds of dangerous EFB ingestion were higher in older children (OR, 1.1; CI, 1.0-1.1) and odds of complications were higher in children with comorbidities (OR, 1.1; CI, 1.0-1.3).
    Conclusion: Higher levels of housing instability and material deprivation are associated with dangerous EFB ingestion and complications related to EFB ingestion. These findings emphasize the role that SES plays on child health outcomes and the need for initiatives to mitigate these disparities.
    Level of evidence: 3 Laryngoscope, 2024.
    Language English
    Publishing date 2024-01-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80180-x
    ISSN 1531-4995 ; 0023-852X
    ISSN (online) 1531-4995
    ISSN 0023-852X
    DOI 10.1002/lary.31274
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  7. Article ; Online: Percutaneous tracheostomy in the pediatric population: A systematic review.

    Namavarian, Amirpouyan / Levy, Ben B / Tepsich, Meghan / McKinnon, Nicole K / Siu, Jennifer M / Propst, Evan J / Wolter, Nikolaus E

    International journal of pediatric otorhinolaryngology

    2024  Volume 177, Page(s) 111856

    Abstract: Objective: Percutaneous tracheostomy is routinely performed in adult patients but is seldomly used in the pediatric population due to concerns regarding safety and limited available evidence. This study aims to consolidate the current literature on ... ...

    Abstract Objective: Percutaneous tracheostomy is routinely performed in adult patients but is seldomly used in the pediatric population due to concerns regarding safety and limited available evidence. This study aims to consolidate the current literature on percutaneous tracheostomy in the pediatric population.
    Methods: A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. MEDLINE, EMBASE, CINAHL, and Web of Science were searched for studies on pediatric percutaneous tracheostomy (age ≤18). The Joanna Briggs Institute and ROBINS-I tools were used for quality appraisal.
    Results: Twenty-one articles were included resulting in 143 patients. Patient age ranged from 2 days to 17 years, with the largest subpopulation of patients (n = 57, 40 %) being adolescents (age between 12 and 17 years old). Main indications for percutaneous tracheostomy included prolonged ventilation (n = 6), respiratory insufficiency (n = 5), and upper airway obstruction (n = 5). One-third (n = 47) of percutaneous tracheostomies were completed at the bedside in an intensive care unit. Select studies reported on surgical time and time from intubation to tracheostomy with a mean of 13.8 (SD = 7.8) minutes (n = 27) and 8.9 (SD = 2.8) days (n = 35), respectively. Major postoperative complications included tracheoesophageal fistula (n = 4, 2.8 %) and pneumothorax (n = 3, 2.1 %). There were four conversions to open tracheostomy.
    Conclusion: Percutaneous tracheostomy had a similar risk of complications to open surgical tracheostomy in children and adolescents and can be performed at the bedside in a select group of patients if necessary. However, we feel that consideration must be given to the varying anatomical considerations in children and adolescents compared with adults, and therefore suggest that this procedure be reserved for adolescent patients with a thin body habitus and clearly demarcated and palpable anatomical landmarks who require a tracheostomy. When performed, we strongly support using endoscopic guidance and a surgeon who has the ability to convert to an open tracheostomy if required.
    MeSH term(s) Adult ; Adolescent ; Humans ; Child ; Infant, Newborn ; Tracheostomy/adverse effects ; Tracheostomy/methods ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Endoscopy/adverse effects ; Intensive Care Units ; Operative Time
    Language English
    Publishing date 2024-01-04
    Publishing country Ireland
    Document type Systematic Review ; Journal Article ; Review
    ZDB-ID 754501-0
    ISSN 1872-8464 ; 0165-5876
    ISSN (online) 1872-8464
    ISSN 0165-5876
    DOI 10.1016/j.ijporl.2024.111856
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  8. Article ; Online: Olfaction and Gustation in Children With Primary Ciliary Dyskinesia.

    Zawawi, Faisal / Dell, Sharon / Wolter, Nikolaus E / Papsin, Blake C / Propst, Evan J

    OTO open

    2023  Volume 7, Issue 1, Page(s) e28

    Abstract: Objective: Primary ciliary dyskinesia (PCD) is a rare autosomal recessive disorder whereby abnormal cilia cause a wide array of respiratory tract manifestations including chronic rhinosinusitis. The purpose of this study was to determine whether ... ...

    Abstract Objective: Primary ciliary dyskinesia (PCD) is a rare autosomal recessive disorder whereby abnormal cilia cause a wide array of respiratory tract manifestations including chronic rhinosinusitis. The purpose of this study was to determine whether olfaction and gustation are impaired in children with PCD.
    Study design: Cross-sectional study.
    Setting: Tertiary pediatric academic hospital.
    Methods: Children with confirmed PCD based on having at least 1 of 3 approved diagnostic criteria as per The American Thoracic Society guidelines were recruited from The PCD Clinic in our tertiary care pediatric hospital. Odor identification ability was tested using the Universal Sniff (U-Sniff) test and taste threshold was measured using an electrogustometer. The main outcome of this study is to determine the incidence of olfactory dysfunction in children with PCD and investigate if there is an associated gustatory dysfunction.
    Results: Twenty-five children participated (14 male, 11 female), The median age was 10.8 years (range: 4.1-17.9 years). Only 4/25 (16%) complained of olfactory dysfunction prior to testing. None of the patients complained of dysgeusia. However, 48% (12/25) scored less than 7 on the U-Sniff, signifying hyposmia or anosmia. In contrast, scores obtained by electrogustometry were in the normal range. There was no correlation between performance on the U-Sniff and electrogustometry testing.
    Conclusion: Olfactory impairment in children with PCD is common but underrecognized by patients. This is not associated with abnormal gustation. Among other, this places children with PCD at an increased risk with respect to smelling a fire or detecting spoiled or poisonous food.
    Language English
    Publishing date 2023-02-17
    Publishing country United States
    Document type Journal Article
    ISSN 2473-974X
    ISSN (online) 2473-974X
    DOI 10.1002/oto2.28
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  9. Article ; Online: Public knowledge of button battery ingestions: A social media based cross-sectional analysis.

    Philteos, Justine / Madan, Yasmine / James, Adrian L / Propst, Evan J / Ostrow, Olivia / McKinnon, Nicole / Everett, Tobias / Siu, Jennifer / Wolter, Nikolaus E

    International journal of pediatric otorhinolaryngology

    2024  Volume 179, Page(s) 111902

    MeSH term(s) Child ; Humans ; Infant ; Cross-Sectional Studies ; Social Media ; Foreign Bodies/epidemiology ; Foreign Bodies/etiology ; Foreign Bodies/prevention & control ; Esophageal Diseases/complications ; Electric Power Supplies ; Eating
    Language English
    Publishing date 2024-03-02
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 754501-0
    ISSN 1872-8464 ; 0165-5876
    ISSN (online) 1872-8464
    ISSN 0165-5876
    DOI 10.1016/j.ijporl.2024.111902
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  10. Article ; Online: Post-tonsillectomy outcomes in children with mucopolysaccharidosis and obstructive sleep apnea.

    Elwell, Zachary / Mancuso, David / Wolter, Nikolaus E / Propst, Evan J / Valdez, Tulio / Scheffler, Patrick

    Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale

    2023  Volume 52, Issue 1, Page(s) 87

    Abstract: Objective: To describe the incidence of respiratory complications, postoperative hemorrhage, length of stay, and cost of care in children with mucopolysaccharidosis (MPS) undergoing adenotonsillectomy (AT).: Methods: Analysis of the 2009, 2012, and ... ...

    Abstract Objective: To describe the incidence of respiratory complications, postoperative hemorrhage, length of stay, and cost of care in children with mucopolysaccharidosis (MPS) undergoing adenotonsillectomy (AT).
    Methods: Analysis of the 2009, 2012, and 2016 editions of the Healthcare Cost and Utilization Project Kids' Inpatient Database (HCUP KID) identified 24,700 children who underwent AT (40 children with MPS). Demographics, respiratory complications, postoperative hemorrhage, length of stay, and total cost were compared across children with and without MPS.
    Results: Children with MPS had a higher likelihood of being male (P < 0.017). There was a higher rate of respiratory complications in children with MPS compared with children without MPS [6/40 (15%) vs. 586/24,660 (2.4%), P < 0.001], which remained significant after adjusting for sex [adjusted odds ratio 6.88 (95% CI 2.87-16.46)]. There was also a higher risk of postoperative hemorrhage [4/40 (10%) vs. 444/24,660 (1.8%), P < 0.001), with sex-adjusted odds ratio of 5.97 (95% CI 2.12-16.86). Median (IQR) length of stay was increased in children with MPS (3 days, 1-4) compared with children without MPS (1 day, 1-2, P < 0.001). There was an increase in median (IQR) charges for hospital stay in children with MPS compared with their peers [$33,016 ($23,208.50-$72,280.50 vs. $15,383 ($9937-$24,462), P < 0.001].
    Conclusions: Children with MPS undergoing AT had an increased risk of respiratory complications, postoperative hemorrhage, longer length of stay, and a higher cost of treatment when compared with children without MPS. This information may help inform interventional, perioperative, and postoperative decision making.
    MeSH term(s) Child ; Humans ; Male ; Female ; Tonsillectomy ; Sleep Apnea, Obstructive/surgery ; Adenoidectomy ; Postoperative Hemorrhage/epidemiology ; Postoperative Hemorrhage/etiology ; Mucopolysaccharidoses/surgery ; Postoperative Complications/epidemiology ; Postoperative Complications/surgery ; Retrospective Studies
    Language English
    Publishing date 2023-12-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 2434004-2
    ISSN 1916-0216 ; 1916-0208 ; 0381-6605
    ISSN (online) 1916-0216
    ISSN 1916-0208 ; 0381-6605
    DOI 10.1186/s40463-023-00685-y
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