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  1. Article ; Online: Ethics in Practice: Laryngotracheoplasty Versus Tracheostomy in a Patient With Severe Hydranencephaly.

    Viaud-Murat, Estelle M / Bahra, Luka / Redmann, Andrew J / Buck, Lauren S / Carratola, Maria

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

    2024  Volume 170, Issue 5, Page(s) 1474–1477

    MeSH term(s) Humans ; Tracheostomy ; Laryngoplasty/methods ; Hydranencephaly/surgery ; Male ; Female
    Language English
    Publishing date 2024-02-14
    Publishing country England
    Document type Journal Article ; Case Reports
    ZDB-ID 392085-9
    ISSN 1097-6817 ; 0161-6439 ; 0194-5998
    ISSN (online) 1097-6817
    ISSN 0161-6439 ; 0194-5998
    DOI 10.1002/ohn.680
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  2. Article ; Online: Provider moral distress in caring for tracheostomy and ventilator dependent children: A single institution cross-sectional evaluation.

    Redmann, Andrew J / Hart, Catherine K / Smith, Matthew M / Martin, Carrie / Borschuk, Adrienne P / Cortezzo, DonnaMaria E / Benscoter, Dan

    Pediatric pulmonology

    2024  Volume 59, Issue 4, Page(s) 880–885

    Abstract: Objective: To determine levels of moral distress in a pediatric unit caring for patients with tracheostomy/ventilator dependence.: Hypothesis: Moral distress will be significant in a dedicated pediatric trach/vent unit.: Methods: The Moral ... ...

    Abstract Objective: To determine levels of moral distress in a pediatric unit caring for patients with tracheostomy/ventilator dependence.
    Hypothesis: Moral distress will be significant in a dedicated pediatric trach/vent unit.
    Methods: The Moral Distress Survey-Revised (MDS-R) is a 21-question survey measuring moral distress in pediatrics. The MDS-R was anonymously distributed to medical degree/doctor of osteopathy (MD/DOs), advanced practice practitioners (APPs), registered nurses (RNs), and respiratory therapists (RTs) in a unit caring for tracheostomy/ventilator dependent patients. Descriptive statistics, bivariate and multivariate analysis were performed.
    Results: Response rate was 48% (61/127). Mean MDS-R score was 83 (range 43-119), which is comparable to reported levels in the pediatric intensive care unit (ICU). APPs had the highest median rate of moral distress (112, interquartile range [IQR], 72-138), while MD/DOs had the lowest median score (49, IQR, 43-77). RNs and RTs had MDS-R scores between these two groups (medians of 91 and 84, respectively).
    Conclusions: Moral distress levels in a unit caring for long term tracheostomy and ventilator dependent patients are high, comparable to levels in pediatric ICUs. APPs. APPs had higher levels of distress compared to other groups. This may be attributable to the constant stressors of being the primary provider for complex patients, especially in a high-volume inpatient setting.
    MeSH term(s) Humans ; Child ; Cross-Sectional Studies ; Tracheostomy ; Morals ; Attitude of Health Personnel ; Surveys and Questionnaires ; Ventilators, Mechanical ; Stress, Psychological
    Language English
    Publishing date 2024-01-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632784-9
    ISSN 1099-0496 ; 8755-6863
    ISSN (online) 1099-0496
    ISSN 8755-6863
    DOI 10.1002/ppul.26839
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  3. Article ; Online: Response to: Objective Improvement After Frenotomy for Posterior Tongue Tie: A Prospective Randomized Trial.

    Jayawardena, Asitha D L / Redmann, Andrew / Roby, Brianne B / Chinnadurai, Sivakumar / Caloway, Christen L / Hartnick, Christopher J

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

    2023  Volume 169, Issue 1, Page(s) 194

    MeSH term(s) Humans ; Infant ; Female ; Ankyloglossia/surgery ; Prospective Studies ; Tongue ; Lingual Frenum/surgery ; Breast Feeding
    Language English
    Publishing date 2023-01-29
    Publishing country England
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 392085-9
    ISSN 1097-6817 ; 0161-6439 ; 0194-5998
    ISSN (online) 1097-6817
    ISSN 0161-6439 ; 0194-5998
    DOI 10.1177/01945998221112324
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  4. Article ; Online: The use of videos in preparation for pediatric otolaryngology cases-a national survey.

    Redmann, Andrew J / Willging, J Paul / Roby, Brianne B

    International journal of pediatric otorhinolaryngology

    2020  Volume 138, Page(s) 110329

    Abstract: Objective: 1) Review surgical preparation methods for pediatric otolaryngology fellows and fellowship directors, focusing on surgical video usage.: Study design: Cross sectional survey.: Methods: Structured survey querying preparation methods for ... ...

    Abstract Objective: 1) Review surgical preparation methods for pediatric otolaryngology fellows and fellowship directors, focusing on surgical video usage.
    Study design: Cross sectional survey.
    Methods: Structured survey querying preparation methods for surgical cases was distributed to current pediatric otolaryngology fellows and fellowship program directors (FD's).
    Results: 84 surveys were distributed (47 fellows, 37 FD). Overall response rate was 44% (37/84); fellow response rate was 55% (26/47) and FD response rate was 30% (11/37). Most respondents used videos (84%) and textbooks (95%) to prepare for surgery; fellows were more likely than FD's to use videos (96% vs. 55%, p < 0.01). 89% of respondents used YouTube to prepare; C-videos was the next most common platform used (27%). Fellows were more likely to have used YouTube than FD's (100% vs 63%, p < 0.01). 45% of FD's did not know or did not think their fellows use videos to prepare for cases. Mean helpfulness of surgical videos on a 5 point scale was 3.41 (95% CI 3.0-3.8). Videos were considered most helpful for illustrating technical portions of cases (51%), visualizing the case (27%) and reviewing anatomy (24%). Survey respondents mentioned poor quality (59%) and irrelevance to a particular institutions approach (19%) as weaknesses of available surgical videos.
    Conclusions: Surgical videos are commonly used by pediatric otolaryngology fellows to prepare for cases, and can assist in building anatomic knowledge and illustrating technical details of complex cases. YouTube is the most commonly utilized platform accessed by fellows, but poor quality and limited generalizability may restrict the usefulness of current video resources.
    Level of evidence: 4.
    MeSH term(s) Child ; Cross-Sectional Studies ; Education, Medical, Graduate ; Fellowships and Scholarships ; Humans ; Otolaryngology/education ; Surveys and Questionnaires
    Language English
    Publishing date 2020-08-29
    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.2020.110329
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  5. Article ; Online: Invasive fungal pharyngitis in a pediatric bone marrow transplant patient.

    Redmann, Andrew J / Myer, Charles M / Khandelwal, Pooja / Danzinger-Isakov, Lara

    Pediatric transplantation

    2021  Volume 25, Issue 5, Page(s) e13853

    Abstract: Invasive fungal disease of the head and neck is a potentially fatal infection most commonly seen in immunocompromised patients. Even in the setting of combined surgical and medical treatment, prognosis is generally poor. We report the first pediatric ... ...

    Abstract Invasive fungal disease of the head and neck is a potentially fatal infection most commonly seen in immunocompromised patients. Even in the setting of combined surgical and medical treatment, prognosis is generally poor. We report the first pediatric case of invasive fungal pharyngitis and summarize a review of the literature. A 10-year-old female patientwith aplastic anemia status post-bone marrow transplant and accompanying immunosuppression initially presented with a diagnosis of a peritonsillar abscess. Incision and drainage did not show purulence, but culture grew out Rhizopus species. Immediately after diagnosis, the patient was treated successfully with aggressive staged surgical debridement and antifungal medications and had an excellent functional outcome 2 years after initial presentation. Invasive fungal disease is most common in the sinonasal region, but alternative sites of disease must be considered in immunocompromised patients who present with atypical symptoms.
    MeSH term(s) Anemia, Aplastic/therapy ; Antifungal Agents/therapeutic use ; Bone Marrow Transplantation ; Child ; Combined Modality Therapy ; Debridement ; Female ; Humans ; Immunocompromised Host ; Mucormycosis/microbiology ; Mucormycosis/therapy ; Pharyngitis/microbiology ; Pharyngitis/therapy ; Rhizopus
    Chemical Substances Antifungal Agents
    Language English
    Publishing date 2021-01-23
    Publishing country Denmark
    Document type Case Reports
    ZDB-ID 1390284-2
    ISSN 1399-3046 ; 1397-3142
    ISSN (online) 1399-3046
    ISSN 1397-3142
    DOI 10.1111/petr.13853
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  6. Article ; Online: Moral distress in pediatric otolaryngology: A pilot study.

    Redmann, Andrew J / Smith, Matthew / Benscoter, Dan / Hart, Catherine K

    International journal of pediatric otorhinolaryngology

    2020  Volume 136, Page(s) 110138

    Abstract: Objectives: SUBJECTS/METHODS: Moral distress is defined as "when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action". The Moral Distress Survey-Revised (MDS-R) is a validated 21- ... ...

    Abstract Objectives: SUBJECTS/METHODS: Moral distress is defined as "when one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action". The Moral Distress Survey-Revised (MDS-R) is a validated 21-question survey measuring moral distress in pediatrics. The MDS-R was anonymously distributed to pediatric otolaryngology faculty and fellows at a tertiary institution. Descriptive statistics, bivariate and multivariate analysis were performed.
    Results: Response rate was 89% (16/18). Overall MDS-R score was 40 (range 14-94), which is lower than that found in the literature for pediatric surgeons (reported mean 72), pediatric intensivists (reported means 57-86), and similar to pediatric oncologists (reported means 42-52). Fellows had a significantly higher level of moral distress than faculty (mean 69 vs. 26, p < 0.05). Factors leading to higher degrees of distress involved communication breakdowns and pressure from administration/insurance companies to reduce costs.
    Conclusion: Pediatric Otolaryngologists at our institution have lower degrees of moral distress compared to other pediatric subspecialists. Fellows had higher levels of distress compared to faculty. Further research is necessary to determine degrees of distress across institutions and to determine its impact on the wellness of pediatric otolaryngologists.
    MeSH term(s) Adult ; Female ; Health Surveys ; Hospitals, Pediatric/ethics ; Humans ; Interprofessional Relations/ethics ; Male ; Middle Aged ; Morals ; Occupational Stress/diagnosis ; Occupational Stress/psychology ; Ohio ; Otolaryngologists/ethics ; Otolaryngologists/psychology ; Pediatricians/ethics ; Pediatricians/psychology ; Pilot Projects ; Psychological Distress
    Language English
    Publishing date 2020-05-29
    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.2020.110138
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  7. Article ; Online: Demographic Characteristics of Children Diagnosed with Bacterial Tracheitis.

    Barengo, Jenna H / Redmann, Andrew J / Kennedy, Patrick / Rutter, Michael J / Smith, Matthew M

    The Annals of otology, rhinology, and laryngology

    2021  Volume 130, Issue 12, Page(s) 1378–1382

    Abstract: Objectives: Examine the presentation and clinical course of patients with bacterial tracheitis (BT). Identify if socioeconomic differences exist among children who present with BT.: Methods: This was a retrospective case series from a tertiary care ... ...

    Abstract Objectives: Examine the presentation and clinical course of patients with bacterial tracheitis (BT). Identify if socioeconomic differences exist among children who present with BT.
    Methods: This was a retrospective case series from a tertiary care pediatric medical center. The study group included patients less than 18 years old who were diagnosed with BT from January 2011 to March 2019. Patients with a tracheostomy and those who developed BT after prolonged hospitalization were excluded. Patient demographics were compared with the demographics of the counties surrounding the hospital.
    Results: 33 patients with BT met inclusion criteria. The most common presenting symptoms were difficulty breathing, stridor, and sore throat (81.8% each), followed by cough (78.8%). Median length of stay was 3 days [interquartile range (IQR):2-4]. 19 patients (57.5%) were admitted to the intensive care unit. Intubation was required for 13 patients (39.4%), for a median length of 2 days [IQR:2-2]. Methicillin sensitive staphylococcus aureus was the most common bacterial etiology (33%). Mean presenting age was 8.58 years [95% confidence interval:7.3-9.9] and 14 patients were female (42.4%). 31 patients were white (93.9%), 1 was black (3%), and 1 was Hispanic (3%). BT patients were more likely to have private insurance compared to comparison (81.8% vs 63.4%,
    Conclusion: Children who presented with BT were more likely to be privately insured than a comparison population.
    MeSH term(s) Age Distribution ; Child ; Female ; Humans ; Intensive Care Units ; Male ; Morbidity/trends ; Retrospective Studies ; Sex Distribution ; Staphylococcal Infections/diagnosis ; Staphylococcal Infections/epidemiology ; Staphylococcal Infections/microbiology ; Staphylococcus/isolation & purification ; Tracheitis/diagnosis ; Tracheitis/epidemiology ; Tracheitis/microbiology ; United States/epidemiology
    Language English
    Publishing date 2021-04-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 120642-4
    ISSN 1943-572X ; 0003-4894
    ISSN (online) 1943-572X
    ISSN 0003-4894
    DOI 10.1177/00034894211007250
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  8. Article ; Online: The effect of postoperative steroid dosing on readmission rates following radiofrequency ablation tonsillectomy.

    Stafford, John Alan / Redmann, Andrew J / Singh, Eshita / Sarber, Kathleen / Ishman, Stacey L

    International journal of pediatric otorhinolaryngology

    2021  Volume 149, Page(s) 110862

    Abstract: Objective: To examine the effect of postoperative steroid dosage on postoperative telephone calls, emergency department (ED) visits, and hemorrhage rates for two groups receiving different steroid dosing following radiofrequency ablation tonsillectomy.!# ...

    Abstract Objective: To examine the effect of postoperative steroid dosage on postoperative telephone calls, emergency department (ED) visits, and hemorrhage rates for two groups receiving different steroid dosing following radiofrequency ablation tonsillectomy.
    Study design: Retrospective chart review between January 1, 2014 and January 1, 2019.
    Setting: Tertiary care pediatric hospital.
    Methods: Two postoperative steroid dosing protocols studied: 1) three postoperative doses of 0.5 mg/kg dexamethasone, or 2) three postoperative doses of 4 mg dexamethasone. Otherwise, postoperative care and pain control were similar for all patients. We hypothesized that standardized steroid dosing would achieve similar postoperative outcomes when compared to weight-based dosing with regards to patient phone calls, ED visits, readmission rates, and bleeding rates.
    Results: Overall, 279 patients were included (n = 100 at 4 mg, n = 179 at 0.5 mg/kg). There were no differences between groups in age, gender, race, BMI, or comorbidities (P > 0.05). Readmission and ED visit rates were 2.8% and 12.2% respectively, with no significant difference between groups (P > 0.05)). The overall hemorrhage rate was 6.3%, including those patients presenting to the ED but not requiring intervention for bleeding concerns. There was no difference in hemorrhage rates between groups (P = 0.22); the hemorrhage rate requiring operative intervention was 1.4% with no difference between groups (P = 0.27). Postoperative phone calls to physicians' office occurred in 13.3% of cases with no difference between groups (P = 0.41).
    Conclusion: Comparable rates of readmission, ED visits, hemorrhage, and patient phone calls were seen with a standard dose of 4 mg versus 0.5 mg/kg weight-based dosing of a short course of postoperative dexamethasone following radiofrequency ablation tonsillectomy.
    MeSH term(s) Child ; Humans ; Pain, Postoperative/drug therapy ; Pain, Postoperative/epidemiology ; Patient Readmission ; Postoperative Hemorrhage/epidemiology ; Radiofrequency Ablation ; Retrospective Studies ; Steroids ; Tonsillectomy/adverse effects
    Chemical Substances Steroids
    Language English
    Publishing date 2021-07-29
    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.2021.110862
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  9. Article ; Online: The impact of a resident-run review curriculum and USMLE scores on the Otolaryngology in-service exam.

    Redmann, Andrew J / Tawfik, Kareem O / Myer, Charles M

    International journal of pediatric otorhinolaryngology

    2018  Volume 104, Page(s) 25–28

    Abstract: Objective: Describe the association of USMLE Step 1 scores and the institution of a dedicated board review curriculum with resident performance on the Otolaryngology training examination.: Study design: Retrospective cross sectional study.: Methods! ...

    Abstract Objective: Describe the association of USMLE Step 1 scores and the institution of a dedicated board review curriculum with resident performance on the Otolaryngology training examination.
    Study design: Retrospective cross sectional study.
    Methods: We reviewed American Board of Otolaryngology Training Examination (OTE) scores for an otolaryngology residency program between 2005 and 2016. USMLE Step 1 scores were collected. In 2011 a resident-run OTE review curriculum was instituted with the goal of improving test preparation. Scores were compared before and after curriculum institution. Linear regression was performed to identify predictors of OTE scores.
    Results: 47 residents were evaluated, 24 before and 23 after instituting the curriculum. There was a moderate correlation between USMLE step 1 scores and OTE scores for all years. For PGY-2 residents, mean OTE scores improved from 25th percentile to 41st percentile after institution of the review curriculum (p = 0.05). PGY 3-5 residents demonstrated no significant improvement. On multivariate linear regression, after controlling for USMLE step 1 scores, a dedicated board review curriculum predicted a 23-point percentile improvement in OTE scores for PGY-2 residents (p = 0.003). For other post-graduate years, the review curriculum did not predict score improvement.
    Conclusion: USMLE step 1 scores are moderately correlated with OTE performance. A dedicated OTE review curriculum may improve OTE scores for PGY-2 residents, but such a curriculum may have less benefit for intermediate- and senior-level residents.
    Level of evidence: 4.
    MeSH term(s) Clinical Competence ; Cross-Sectional Studies ; Curriculum ; Educational Measurement/methods ; Humans ; Internship and Residency/methods ; Otolaryngology/education ; Physicians ; Retrospective Studies ; United States
    Language English
    Publishing date 2018-01
    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.2017.10.031
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  10. Article ; Online: Revision Endoscopic Posterior Costal Cartilage Grafting: Is It Feasible?

    Redmann, Andrew J / Moore, Charles / Kou, Yann-Fuu / Tabangin, Meredith E / Wilcox, Lyndy / Smith, Matthew M / Hart, Catherine K / Rutter, Michael J / de Alarcon, Alessandro

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

    2023  Volume 169, Issue 2, Page(s) 432–434

    Abstract: The objective of this work is to examine the feasibility of revision endoscopic posterior costal cartilage graft (EPCCG) placement for posterior glottic stenosis (PGS) and bilateral vocal fold immobility (BVFI). Revision and primary cases were compared ... ...

    Abstract The objective of this work is to examine the feasibility of revision endoscopic posterior costal cartilage graft (EPCCG) placement for posterior glottic stenosis (PGS) and bilateral vocal fold immobility (BVFI). Revision and primary cases were compared with respect to decannulation rates, and it was hypothesized that there would be no difference in outcomes. Twenty-one patients met inclusion criteria (14 primary, 7 revision). Thirteen (62%) had a primary indication of PGS, and 8 (42%) were for BVFI. There were no differences between revision and primary groups with respect to age, gender, or comorbidities (p > .05). There was no difference between groups with respect to decannulation rate (85% primary vs 100% revision, p = .32). Thus, revision EPCCG appears to have comparable results to primary EPCCG with respect to decannulation rate and time to decannulation. EPCCG may be a feasible alternative to open airway reconstruction for PGS and BVFI in selected patients.
    MeSH term(s) Humans ; Costal Cartilage/transplantation ; Laryngostenosis/surgery ; Endoscopy ; Larynx ; Constriction, Pathologic
    Language English
    Publishing date 2023-02-07
    Publishing country England
    Document type Journal Article
    ZDB-ID 392085-9
    ISSN 1097-6817 ; 0161-6439 ; 0194-5998
    ISSN (online) 1097-6817
    ISSN 0161-6439 ; 0194-5998
    DOI 10.1002/ohn.275
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