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  1. Article ; Online: Effect of an Outbound Scheduling Team on the Timeliness of Scheduling Referrals to Pediatric Otolaryngology.

    Allred, Caleb M / Nakamura, Rina / Mull, Helen / Wang, Xing / Jio, Jason / Messner, Jack / Parikh, Sanjay R / Sie, Kathleen / Bonilla-Velez, Juliana

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

    2024  

    Abstract: Objective: Families preferring to receive care in a language-other-than-English have disparities in access to care. We studied the effect of implementing an ambulatory outbound scheduling team on the timeliness of scheduling referrals to pediatric ... ...

    Abstract Objective: Families preferring to receive care in a language-other-than-English have disparities in access to care. We studied the effect of implementing an ambulatory outbound scheduling team on the timeliness of scheduling referrals to pediatric otolaryngology. We hypothesized this intervention could increase access to care.
    Study design: Retrospective cohort analysis.
    Setting: Tertiary care academic center.
    Methods: Data were abstracted from the hospital's enterprise database for patients referred to Otolaryngology over 3 years (October 2019-August 2022; 7675 referrals). An outbound scheduling team was created April 2021 and tasked with calling out to schedule referrals within one business day of receipt. Referral lag was compared across patient cohorts before and after the scheduling intervention. Log-transformed linear regression models were used to assess the impact of the scheduling intervention on referral lag for language cohorts.
    Results: The median preintervention referral lag was 6 days (interquartile range [IQR] 2-18), which was reduced to 1 day postintervention (IQR 0-5; P < .001). Preintervention language-other-than-English families had a median referral lag of 8 days (IQR 2-23), which was 1.27 times higher than for patients speaking English (P < .001). With implementation of the scheduling intervention, language-other-than-English families were scheduled in a median of 1 day (IQR 0-6), and the disparity in timeliness of scheduling was eliminated (P = .131). Postintervention, referral lag was reduced by 58% in the English and 64% in the language other than English cohorts.
    Conclusion: Implementation of an outbound ambulatory scheduling process reduces referral lag for all patients and eliminated a disparity in referral lag for language-other-than-English families.
    Language English
    Publishing date 2024-02-08
    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.660
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  2. Article ; Online: Does supraglottoplasty improve outcomes in children with laryngomalacia?

    Miller, Craig / Parikh, Sanjay R

    The Laryngoscope

    2018  Volume 129, Issue 2, Page(s) 285–287

    MeSH term(s) Adenoidectomy ; Child ; Epiglottis/surgery ; Humans ; Laryngomalacia/complications ; Laryngomalacia/surgery ; Polysomnography ; Sleep Apnea Syndromes/etiology ; Sleep Apnea Syndromes/surgery ; Tonsillectomy
    Language English
    Publishing date 2018-10-17
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Review
    ZDB-ID 80180-x
    ISSN 1531-4995 ; 0023-852X
    ISSN (online) 1531-4995
    ISSN 0023-852X
    DOI 10.1002/lary.27127
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  3. Article ; Online: Persistent OSA After Adenotonsillectomy in CPAP-Intolerant Children: What To Do Next?

    Evans, Sean S / Pattisapu, Prasanth / Parikh, Sanjay R

    The Laryngoscope

    2020  Volume 131, Issue 5, Page(s) 950–951

    MeSH term(s) Adenoidectomy/adverse effects ; Child ; Clinical Decision-Making/methods ; Continuous Positive Airway Pressure/adverse effects ; Endoscopy/methods ; Humans ; Magnetic Resonance Imaging/methods ; Polysomnography ; Severity of Illness Index ; Sleep Apnea, Obstructive/diagnosis ; Sleep Apnea, Obstructive/therapy ; Tonsillectomy/adverse effects ; Treatment Failure
    Keywords covid19
    Language English
    Publishing date 2020-07-15
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 80180-x
    ISSN 1531-4995 ; 0023-852X
    ISSN (online) 1531-4995
    ISSN 0023-852X
    DOI 10.1002/lary.28839
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  4. Article ; Online: Do Antivirals Improve Hearing Outcomes in Neonates With Congenital Cytomegalovirus Infection?

    Liu, C Carrie / Parikh, Sanjay R / Horn, David L

    The Laryngoscope

    2020  Volume 130, Issue 7, Page(s) 1609–1612

    MeSH term(s) Antiviral Agents/therapeutic use ; Cytomegalovirus Infections/congenital ; Cytomegalovirus Infections/drug therapy ; Female ; Hearing/drug effects ; Hearing Loss, Sensorineural/virology ; Humans ; Infant, Newborn ; Male ; Treatment Outcome
    Chemical Substances Antiviral Agents
    Language English
    Publishing date 2020-02-03
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 80180-x
    ISSN 1531-4995 ; 0023-852X
    ISSN (online) 1531-4995
    ISSN 0023-852X
    DOI 10.1002/lary.28525
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  5. Article ; Online: Robotics in Pediatric Otolaryngology-Head and Neck Surgery and Advanced Surgical Planning.

    Konuthula, Neeraja / Parikh, Sanjay R / Bly, Randall A

    Otolaryngologic clinics of North America

    2020  Volume 53, Issue 6, Page(s) 1005–1016

    Abstract: Robotic surgery has been shown to be feasible and successful in several areas of pediatric head and neck surgery. However, adoption has been limited. Robotic surgery may be better integrated into practice with advanced preoperative surgical planning and ... ...

    Abstract Robotic surgery has been shown to be feasible and successful in several areas of pediatric head and neck surgery. However, adoption has been limited. Robotic surgery may be better integrated into practice with advanced preoperative surgical planning and the design of new robotic platforms with instrumentation specific for the application. With continued investigations, computer-aided surgical planning techniques including three-dimensional printing, virtual reality, multiobjective cost function for optimization of approach, mirror image overlay, and flexible robotic instruments may demonstrate value and utility over current practice.
    MeSH term(s) Child ; Head/surgery ; Humans ; Neck/surgery ; Otolaryngology ; Printing, Three-Dimensional ; Robotic Surgical Procedures/methods ; Robotics/instrumentation
    Language English
    Publishing date 2020-09-08
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 417489-6
    ISSN 1557-8259 ; 0030-6665
    ISSN (online) 1557-8259
    ISSN 0030-6665
    DOI 10.1016/j.otc.2020.07.011
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  6. Article ; Online: Virtually Assisted Personalized Tracheostomy Tube Design in Pediatric Complex Airway Anomalies.

    Evans, Sean S / Richardson, Clare / Friedman, Seth D / Bly, Randall A / Johnson, Kaalan E / Dahl, John P / Parikh, Sanjay R / Bonilla-Velez, Juliana

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

    2023  Volume 168, Issue 4, Page(s) 893–897

    Abstract: We sought to assess the feasibility of virtually assisted personalized tracheostomy tube (vapTT) implementation for patients with congenital airway anomalies (CAAs) and persistent tracheostomy tube (TT)-related respiratory failure at a tertiary pediatric ...

    Abstract We sought to assess the feasibility of virtually assisted personalized tracheostomy tube (vapTT) implementation for patients with congenital airway anomalies (CAAs) and persistent tracheostomy tube (TT)-related respiratory failure at a tertiary pediatric hospital. Three patients (0-18 years) with CAAs and recurrent TT-related respiratory complications were managed with vapTT over 5 years. Patients underwent airway computed tomography acquisition with 3-dimensional reconstruction and TT virtual modeling for shape customization. Models were transferred to Bivona for fabrication based on industry-standard materials and processes. Clinical information and tracheoscopies assessing position, obstruction, and granulation were reviewed. Patients demonstrated resolution of visualized TT-related obstruction, granulation, or ulceration and de-escalation of respiratory support. Clinical events requiring urgent tracheoscopy decreased in all 3 patients. Sufficient relief of critical airway obstruction allowed progression of medical care and/or discharge. VapTTs are feasible for patients with CAA. This new frontier in personalized devices may serve uniquely challenging patient populations for whom standard treatments have failed.
    MeSH term(s) Humans ; Child ; Tracheostomy/methods ; Airway Obstruction/etiology ; Tomography, X-Ray Computed ; Postoperative Complications/surgery ; Retrospective Studies
    Language English
    Publishing date 2023-01-29
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
    ZDB-ID 392085-9
    ISSN 1097-6817 ; 0161-6439 ; 0194-5998
    ISSN (online) 1097-6817
    ISSN 0161-6439 ; 0194-5998
    DOI 10.1177/01945998221126180
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  7. Article ; Online: Multidisciplinary Advanced Surgical Planning for Slide Tracheoplasty Using 3D-Printed Models.

    Richardson, Clare M / Walton, Scott / Park, Jason S / Bonilla-Velez, Juliana / Bly, Randall A / Dahl, John P / Parikh, Sanjay R / Friedman, Seth / Johnson, Kaalan E

    The Laryngoscope

    2024  

    Abstract: Objective: The objective of this study was to develop and assess multidisciplinary advanced surgical planning (ASP) sessions using three dimensional (3D) printed models for cervicothoracic slide tracheoplasty (CST). We hypothesized that these sessions ... ...

    Abstract Objective: The objective of this study was to develop and assess multidisciplinary advanced surgical planning (ASP) sessions using three dimensional (3D) printed models for cervicothoracic slide tracheoplasty (CST). We hypothesized that these sessions would improve surgeon confidence, streamline intraoperative planning, and highlight the utility of 3D modeling.
    Methods: 3D-printed patient-specific trachea models were used in pre-operative ASP sessions consisting of a multidisciplinary case discussion and hands-on slide tracheoplasty simulation. Participants completed a survey rating realism, utility, impact on the final surgical plan, and pre- and post-session confidence. Statistical analysis was performed via Wilcoxon and Kruskal-Wallis tests.
    Results: Forty-eight surveys were collected across nine sessions and 27 different physicians. On a 5-point Likert scale, models were rated as "very realistic", "very useful" (both median of 4, IQR 3-4 and 4-5, respectively). Overall confidence increased by 1.4 points (+/- 0.7, p < 0.0001), with the largest change seen in those with minimal prior slide tracheoplasty experience (p = 0.005). Participants felt that the sessions "strongly" impacted their surgical plan or anticipated performance (median 4, IQR 4-5), regardless of training level or experience.
    Conclusion: 3D-printed patient-specific models were successfully implemented in ASP sessions for CST. Models were deemed very realistic and very useful by surgeons across multiple specialties and training levels. Surgical planning sessions also strongly impacted the final surgical plan and increased surgeon confidence for CST.
    Level of evidence: IV Laryngoscope, 2024.
    Language English
    Publishing date 2024-03-07
    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.31327
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  8. Article ; Online: Surface Reconstruction of the Pediatric Larynx via Structure from Motion Photogrammetry: A Pilot Study.

    Barbour, Michael C / Amin, Shaunak N / Friedman, Seth D / Perez, Francisco A / Bly, Randall A / Johnson, Kaalan E / Parikh, Sanjay R / Richardson, Clare M / Dahl, John P / Aliseda, Alberto

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

    2024  Volume 170, Issue 4, Page(s) 1195–1199

    Abstract: Endoscopy is the gold standard for characterizing pediatric airway disorders, however, it is limited for quantitative analysis due to lack of three-dimensional (3D) vision and poor stereotactic depth perception. We utilize structure from motion (SfM) ... ...

    Abstract Endoscopy is the gold standard for characterizing pediatric airway disorders, however, it is limited for quantitative analysis due to lack of three-dimensional (3D) vision and poor stereotactic depth perception. We utilize structure from motion (SfM) photogrammetry, to reconstruct 3D surfaces of pathologic and healthy pediatric larynges from monocular two-dimensional (2D) endoscopy. Models of pediatric subglottic stenosis were 3D printed and airway endoscopies were simulated. 3D surfaces were successfully reconstructed from endoscopic videos of all models using an SfM analysis toolkit. Average subglottic surface error between SfM reconstructed surfaces and 3D printed models was 0.65 mm as measured by Modified Hausdorff Distance. Average volumetric similarity between SfM surfaces and printed models was 0.82 as measured by Jaccard Index. SfM can be used to accurately reconstruct 3D surface renderings of the larynx from 2D endoscopy video. This technique has immense potential for use in quantitative analysis of airway geometry and virtual surgical planning.
    MeSH term(s) Humans ; Child ; Pilot Projects ; Larynx/diagnostic imaging ; Larynx/surgery ; Endoscopy/methods ; Respiratory System ; Imaging, Three-Dimensional/methods ; Photogrammetry/methods
    Language English
    Publishing date 2024-01-03
    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.635
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  10. Article ; Online: Injection Medialization in Infants with Vocal Fold Immobility Improves Dysphagia.

    Siu, Jennifer M / Amin, Shaunak N / Colyer, Jessica / Horner, Cassie / Bhat, Aarti / Bohuta, Lyubomyr / Chan, Titus / Dahl, John P / Fridgen, Jennifer / Johnson, Kaalan / Yip, Caitlin / Parikh, Sanjay R

    The Laryngoscope

    2024  

    Abstract: Background: Unilateral vocal fold immobility (VFI) is a known cause of morbidity amongst children following congenital heart surgery. Injection medialization (IM) provides medial distraction and improves glottic closure. Limited objective data is ... ...

    Abstract Background: Unilateral vocal fold immobility (VFI) is a known cause of morbidity amongst children following congenital heart surgery. Injection medialization (IM) provides medial distraction and improves glottic closure. Limited objective data is available for the effect of IM in young children (<2 years-old) with VFI.
    Methods: Retrospective case series of infants <2 who underwent IM for VFI after congenital cardiac surgery. Primary outcome was objective reduced risk of aspiration based on Dysphagia and Outcome Severity Scores (DOSS) on Video swallow study (VFSS) performed prior to and within 4 weeks following IM. Secondary analysis included perioperative complications and number of children who were able to avoid NG or G tube placement.
    Results: 17 children <2 years of age had unilateral VFI after congenital cardiac surgery and underwent IM. The median age at time of initial cardiac surgery was 6 days (IQR 3-7). There was no intraoperative or postoperative stridor or associated complications. All 17 patients had preoperative aspiration noted on VFSS. Average swallowing outcomes on VFSS improved after IM with an increase in DOSS score (preop score 3 (IQR 2-4) to postop score 6.5 (IQR 5-7) [P = 0.001]). At 2 months following IM, of the patients who had improvement in swallowing function, 50% (n = 6) were able to feed completely orally, 25% (n = 3) were fed orally with an NG wean, and 3 (25%) had a G tube placed.
    Conclusion: Initial results suggest that IM is safe and improves early objective swallowing outcomes in children <2 years old with VFI after congenital cardiac surgery.
    Level of evidence: IV Laryngoscope, 2024.
    Language English
    Publishing date 2024-04-27
    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.31462
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