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Article ; Online: The presence of a submucous cleft palate in patients with isolated cleft lip and middle ear dysfunction.

Fairmont, Isabel / Tholen, Kaitlyn / Hanson, Romney / Patterson, Bryanne / Herrmann, Brian / Francom, Christian

2024 Volume 45, Issue 4, Page(s) 104281

Abstract: Purpose: Recent studies have suggested that children with an isolated cleft lip (CL) are more likely to develop middle ear disease and eustachian tube dysfunction (ETD) compared to the general population. This may be related to abnormal palatal ... ...

Abstract	Purpose: Recent studies have suggested that children with an isolated cleft lip (CL) are more likely to develop middle ear disease and eustachian tube dysfunction (ETD) compared to the general population. This may be related to abnormal palatal musculature or an undiagnosed submucosal cleft palate (SMCP). We aim to determine the prevalence of SMCP in patients with CL who exhibit ETD. Materials and methods: A retrospective chart review was performed for children with an isolated CL requiring tympanostomy tubes over a 20-year period at an academic tertiary care medical center. Demographic, clinical, and surgical data were collected. Results: Three hundred twelve patients had an isolated CL, and 29 (9.3 %) children required tympanostomy tubes. Of those, nine (31 %) were found to have a SMCP (7 males, 6 Caucasian). The average age at CL repair was 3.94 ± 1.03 months, and the average age at tympanostomy tube placement was 13.68 ± 13.8 months. All nine patients had chronic otitis media, with four having mild conductive hearing loss and three having moderate conductive hearing loss. The SMCP was diagnosed at the time of CL diagnosis (4), after CL diagnosis with the diagnosis of chronic otitis media/ETD (2) and after a diagnosis of chronic otitis media/ETD. Conclusion: Middle ear disease or eustachian tube dysfunction in a patient with an isolated cleft lip should raise suspicion for an accompanying undiagnosed SMCP.
Language	English
Publishing date	2024-04-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	604541-8
ISSN	1532-818X ; 0196-0709
ISSN (online)	1532-818X
ISSN	0196-0709
DOI	10.1016/j.amjoto.2024.104281
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Article ; Online: Tonsillectomy and hematologic malignancy: Should routine pediatric tonsillectomy specimens be sent to pathology?

Tholen, Kaitlyn / Kalmanson, Olivia / Francom, Christian R / Prager, Jeremy D

International journal of pediatric otorhinolaryngology

2021 Volume 151, Page(s) 110924

Abstract: Objectives: Routine pediatric tonsillectomy ± adenoidectomy (T ± A) is one of the most common procedures for children worldwide, accounting for approximately 2000 procedures per year at our institution. To determine the utility of pathologic analysis of ...

Abstract	Objectives: Routine pediatric tonsillectomy ± adenoidectomy (T ± A) is one of the most common procedures for children worldwide, accounting for approximately 2000 procedures per year at our institution. To determine the utility of pathologic analysis of routine, nonsuspicious pediatric tonsil specimens, we investigated the incidence of hematologic and lymphoid malignancy diagnosed at the time of or following T ± A. Methods: Retrospective review of patients 0-18 years undergoing T ± A between 2012 and 2020 with or without pathologic analysis. Results: Included were 14,141 patients who underwent routine T ± A (mean age 11 ± 4.6 years, 48% female). Of these, tonsils of 2464 patients were sent to pathology, where zero were found to harbor malignancy. Seven patients (0.050%) developed malignancy after T ± A. Of these, 4 had unremarkable tonsils per pathology, and 3 did not have tonsils analyzed. There were 5 cases of Acute Lymphocytic Leukemia (ALL, 0.035%), 1 case of Acute Myeloid Leukemia (0.007%), and 1 case of Lymphoma (0.007%). The average length of time from T ± A to diagnosis was 2.4 ± 1.8 years. Conclusion: No cases of occult malignancy were identified in specimens from routine T ± A with pathologic analysis, even among patients who later developed malignancy. This study suggests that sending routine pediatric T ± A specimens for formal pathologic analysis is an inefficient use of resources without appreciably improving the quality and safety of patient care.
MeSH term(s)	Adenoidectomy ; Adolescent ; Child ; Female ; Hematologic Neoplasms/diagnosis ; Hematologic Neoplasms/epidemiology ; Humans ; Male ; Palatine Tonsil/surgery ; Retrospective Studies ; Tonsillectomy/adverse effects
Language	English
Publishing date	2021-09-27
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.2021.110924
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Article ; Online: Aerodigestive Programs Enhance Outcomes in Pediatric Patients.

Wootten, Christopher T / Belcher, Ryan / Francom, Christian R / Prager, Jeremy D

Otolaryngologic clinics of North America

2019 Volume 52, Issue 5, Page(s) 937–948

Abstract: The early efforts of pediatric airway surgeons, gastroenterologists, and pulmonologists to optimize surgical outcomes involved evaluating multiple organ systems for diseases negatively affecting surgery. This resulted in coordinated clinics with multiple ...

Abstract	The early efforts of pediatric airway surgeons, gastroenterologists, and pulmonologists to optimize surgical outcomes involved evaluating multiple organ systems for diseases negatively affecting surgery. This resulted in coordinated clinics with multiple services, ancillary testing, and endoscopic procedures, known as aerodigestive programs. These programs have nationally increased the value of care, with multidisciplinary experts delivering organized and efficient care to children with complex needs. This article describes the origin and value of aerodigestive programs within the modern health care landscape, serving as a primer for providers and administrators investigating how to facilitate aerodigestive or similar programs.
MeSH term(s)	Ancillary Services, Hospital/organization & administration ; Child ; Cost-Benefit Analysis ; Efficiency, Organizational ; Gastrointestinal Diseases/therapy ; Humans ; Interdisciplinary Communication ; Models, Organizational ; Patient Care Team/organization & administration ; Program Development ; Respiratory System/surgery ; Respiratory Tract Diseases/therapy
Language	English
Publishing date	2019-08-07
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.2019.06.007
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Article ; Online: Head and neck pleomorphic myxoid liposarcoma in a child with Li-Fraumeni syndrome.

Francom, Christian R / Leoniak, Steven M / Lovell, Mark A / Herrmann, Brian W

International journal of pediatric otorhinolaryngology

2019 Volume 123, Page(s) 191–194

Abstract: Introduction: Pleomorphic myxoid liposarcoma is a rare and aggressive cancer seen in the pediatric population that has been previously associated with hereditable cancer disorders like Li Fraumeni syndrome. We present a case report and review of the ... ...

Abstract	Introduction: Pleomorphic myxoid liposarcoma is a rare and aggressive cancer seen in the pediatric population that has been previously associated with hereditable cancer disorders like Li Fraumeni syndrome. We present a case report and review of the relevant literature. Case presentation: Pleomorphic myxoid liposarcoma presenting as a second primary tumor in a child with a strong family history for cancer led to diagnosis of Li-Fraumeni syndrome, which is associated with TP53 tumor suppressor gene inactivation. Management and outcome: The tumor was fully excised, but postoperative radiation was deferred to limit future radiation-induced tumorgenesis. Discussion: Pleomorphic myxoid liposarcoma is rare but aggressive, and should prompt caregivers to test for potential hereditable cancer disorders. Li-Fraumeni syndrome is associated with early onset neoplasia and development of recurrent primary tumors. Its presence affects treatment decisions and methods of surveillance. Chemoradiation should be used judiciously in this population.
MeSH term(s)	Child ; Facial Neoplasms/diagnosis ; Facial Neoplasms/etiology ; Facial Neoplasms/therapy ; Humans ; Li-Fraumeni Syndrome/complications ; Li-Fraumeni Syndrome/diagnostic imaging ; Li-Fraumeni Syndrome/pathology ; Liposarcoma, Myxoid/diagnosis ; Liposarcoma, Myxoid/etiology ; Liposarcoma, Myxoid/therapy ; Magnetic Resonance Imaging ; Male
Language	English
Publishing date	2019-05-18
Publishing country	Ireland
Document type	Case Reports ; Journal Article
ZDB-ID	754501-0
ISSN	1872-8464 ; 0165-5876
ISSN (online)	1872-8464
ISSN	0165-5876
DOI	10.1016/j.ijporl.2019.05.016
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Zs.A 1507: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Prophylactic inhaled corticosteroids for the management of recurrent croup.

Sowa, Lauren E / Stillwell, Paul C / Houin, Paul R / Nguyen, Nathalie / Prager, Jeremy D / Wine, Todd / Teynor, Nathan J / Meier, Maxine / Hanson, Romney B / Francom, Christian / Gitomer, Sarah A

International journal of pediatric otorhinolaryngology

2023 Volume 170, Page(s) 111600

Abstract: Objectives: Croup is characterized by a barky cough, inspiratory stridor, hoarseness and varying degrees of respiratory distress. Acute croup episodes are often treated with oral, inhaled, or intravenous corticosteroids. Recurrent croup, defined as more ...

Abstract	Objectives: Croup is characterized by a barky cough, inspiratory stridor, hoarseness and varying degrees of respiratory distress. Acute croup episodes are often treated with oral, inhaled, or intravenous corticosteroids. Recurrent croup, defined as more than 2-3 episodes of acute croup in the same patient, can mimic asthma. We hypothesized that inhaled corticosteroids (ICS) given at the first sign of a respiratory viral prodrome can be a safe treatment to reduce the frequency of recurrent croup episodes in children without fixed airway lesions. Methods: A retrospective chart review of patients being treated over an 18-month period was performed at a large tertiary care pediatric hospital following Institutional Review Board (IRB) approval. Patients under 21 years old referred to Pediatric Pulmonology, Otolaryngology, or Gastroenterology for recurrent croup were analyzed for their demographics, medical history, evaluation, treatment and clinical improvement. A Fisher's two-tailed exact test was used to compare the number of croup episodes before and after interventions. Results: 124 patients were included in our analysis: 87 male and 34 female with a mean age of 54 months. Of these, 78 had >5 episodes of croup, 45 had 3-5, and 3 had 2 episodes prior to their first visit for recurrent croup. Operative direct laryngoscopy/bronchoscopy was performed in 35 patients (27.8%), with 60% showing a normal exam without fixed lesions. Ninety-two patients (74.2%) were treated with ICS, 24 were lost to follow up. Of the remaining 68 treated patients, 59 (86.7%) saw improvement with reduced severity and overall number of episodes of croup. Additionally, patients with >5 episodes of croup (47) as compared to <5 (12) were more likely to improve with ICS, (p = 0.003). There were no adverse reactions reported with ICS treatment. Conclusion: The novel initiation of ICS at the earliest sign of a viral upper respiratory infection shows promise as a safe preventative treatment to mitigate the frequency of recurrent croup episodes.
MeSH term(s)	Child ; Humans ; Male ; Female ; Child, Preschool ; Young Adult ; Adult ; Croup/diagnosis ; Retrospective Studies ; Adrenal Cortex Hormones/therapeutic use ; Cough ; Asthma/diagnosis ; Asthma/drug therapy
Chemical Substances	Adrenal Cortex Hormones
Language	English
Publishing date	2023-05-09
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.2023.111600
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Zs.A 1507: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Pediatric Head and Neck Tumors Associated with Li-Fraumeni Syndrome.

Rodriguez, Kenny D / Schneider, Kami Wolfe / Suttman, Alexandra / Garrington, Timothy / Jellins, Tennyson / Tholen, Kaitlyn / Francom, Christian R / Herrmann, Brian W

The Annals of otology, rhinology, and laryngology

2021 Volume 131, Issue 2, Page(s) 159–163

Abstract: Introduction: Cancer predisposition syndromes are germline pathogenic variants in genes that greatly raise the risk of developing neoplastic diseases. One of the most well-known is Li-Fraumeni syndrome (LFS), which is due to pathogenic variants in the !# ...

Abstract	Introduction: Cancer predisposition syndromes are germline pathogenic variants in genes that greatly raise the risk of developing neoplastic diseases. One of the most well-known is Li-Fraumeni syndrome (LFS), which is due to pathogenic variants in the Objective: To examine head and neck manifestations of LFS in children treated at a tertiary children's hospital over a 20-year period. Methods: A retrospective review of LFS children with neoplastic disease presenting in traditional Otolaryngologic head and neck subsites from 2000 to 2019, with patient charts reviewed for relevant clinical, imaging, and operative data. Results: Of the 40 LFS patients initially identified, 27 neoplastic tumors were identified in 20 children within this cohort (20 primary, 7 second primary). Head and neck subsites aside from the brain or orbit were involved in 22% (6/27) of these tumors, representing 20% (4/20) of primary tumors and 29% (2/7) of second primary tumors. Both second primaries within the head and neck were within the radiation fields of the first primary tumor. The mean ages at primary and second primary diagnosis were 4.6 years (SD 3.5) and 12 years (SD 1.4), respectively. The male/female ratio was 1:6 among all patients with head and neck tumors. All 6 head and neck tumors were sarcomas. Rhabdomyosarcoma ( Conclusion: This study identifies a high potential for head and neck involvement in children with LFS, which has not been previously described in the literature. Otolaryngological care should be included in a multidisciplinary care team surveilling these patients.
Language	English
Publishing date	2021-05-10
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	10.1177/00034894211014786
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Article ; Online: Pediatric Primary Tympanoplasty Outcomes With Autologous and Non-autologous Grafts.

Cass, Nathan D / Hebbe, Annika L / Meier, Maxene R / Kaizer, Alexander M / Kalmanson, Olivia A / Stevens, Christina / Tholen, Kaitlyn E / Haville, Salina / Handley, Elyse / Francom, Christian R / Herrmann, Brian W

Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology

2021 Volume 43, Issue 1, Page(s) 94–100

Abstract: Objective: To compare rates of successful tympanic membrane (TM) closure in primary pediatric tympanoplasty between various autologous and non-autologous tissues.: Methods: A retrospective chart review was performed examining all primary pediatric ... ...

Abstract	Objective: To compare rates of successful tympanic membrane (TM) closure in primary pediatric tympanoplasty between various autologous and non-autologous tissues. Methods: A retrospective chart review was performed examining all primary pediatric tympanoplasties over a 20-year period at a single institution. Results: In 564 pediatric tympanoplasties, no statistically significant difference existed between success rates of autologous and non-autologous grafts (p = 0.083). Compared with fascia, the hazard ratios (and 95% confidence intervals [CI]) for failure for each graft were as follows: human pericardial collagen (HR 0.90, CI 0.54-1.50, p = 0.680), porcine submucosal collagen (HR 1.07, CI 0.56-2.05, p = 0.830), human acellular dermal collagen (HR 1.66, CI 0.95-2.87, p = 0.073), and "multiple grafts" (HR 0.72, CI 0.26-1.98, p = 0.520). Survival curves demonstrated that 75% of graft failures occurred by 6 months after surgery, the rest occurring between 6 and 12 months postoperatively. Larger perforations encompassing more than or equal to 50% of the TM had lower success rates (HR 1.50, CI 1.02-2.21, p = 0.041) than smaller perforations encompassing less than 50% of the TM. Age was not correlated with success (HR 0.98, CI 0.93-1.03, p = 0.390). Conclusion: This study found that non-autologous collagen grafts provide equivalent rates of healing when compared with autologous tissue in primary pediatric tympanoplasty. In addition to the potential for reduced operative time and donor site morbidity, these materials provide a viable graft alternative in fascia-depleted ears.Level of Evidence: Level 4.
MeSH term(s)	Animals ; Child ; Collagen/therapeutic use ; Humans ; Retrospective Studies ; Swine ; Treatment Outcome ; Tympanic Membrane Perforation/surgery ; Tympanoplasty
Chemical Substances	Collagen (9007-34-5)
Language	English
Publishing date	2021-09-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2036790-9
ISSN	1537-4505 ; 1531-7129
ISSN (online)	1537-4505
ISSN	1531-7129
DOI	10.1097/MAO.0000000000003344
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Article ; Online: Pediatric laryngoscopy and bronchoscopy during the COVID-19 pandemic: A four-center collaborative protocol to improve safety with perioperative management strategies and creation of a surgical tent with disposable drapes.

Francom, Christian R / Javia, Luv R / Wolter, Nikolaus E / Lee, Gi Soo / Wine, Todd / Morrissey, Tyler / Papsin, Blake C / Peyton, James M / Matava, Clyde T / Volk, Mark S / Prager, Jeremy D / Propst, Evan J

International journal of pediatric otorhinolaryngology

2020 Volume 134, Page(s) 110059

Abstract: Aerosolization procedures during the COVID-19 pandemic place all operating room personnel at risk for exposure. We offer detailed perioperative management strategies and present a specific protocol designed to improve safety during pediatric laryngoscopy ...

Abstract	Aerosolization procedures during the COVID-19 pandemic place all operating room personnel at risk for exposure. We offer detailed perioperative management strategies and present a specific protocol designed to improve safety during pediatric laryngoscopy and bronchoscopy. Several methods of using disposable drapes for various procedures are described, with the goal of constructing a tent around the patient to decrease widespread contamination of dispersed droplets and generated aerosol. The concepts presented herein are translatable to future situations where aerosol generating procedures increase risk for any pathogenic exposure. This protocol is a collaborative effort based on knowledge gleaned from clinical and simulation experience from Children's Hospital Colorado, Children's Hospital of Philadelphia, The Hospital for Sick Children in Toronto, and Boston Children's Hospital.
MeSH term(s)	Betacoronavirus ; Bronchoscopy ; COVID-19 ; Child ; Clinical Protocols ; Coronavirus Infections/prevention & control ; Humans ; Laryngoscopy ; Pandemics/prevention & control ; Perioperative Period ; Pneumonia, Viral/prevention & control ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-04-21
Publishing country	Ireland
Document type	Journal Article ; Multicenter Study
ZDB-ID	754501-0
ISSN	1872-8464 ; 0165-5876
ISSN (online)	1872-8464
ISSN	0165-5876
DOI	10.1016/j.ijporl.2020.110059
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Article ; Online: Pediatric laryngoscopy and bronchoscopy during the COVID-19 pandemic

Francom, Christian R. / Javia, Luv R. / Wolter, Nikolaus E. / Lee, Gi Soo / Wine, Todd / Morrissey, Tyler / Papsin, Blake C. / Peyton, James M. / Matava, Clyde T. / Volk, Mark S. / Prager, Jeremy D. / Propst, Evan J.

International Journal of Pediatric Otorhinolaryngology

A four-center collaborative protocol to improve safety with perioperative management strategies and creation of a surgical tent with disposable drapes

2020 Volume 134, Page(s) 110059

Keywords	Pediatrics, Perinatology, and Child Health ; Otorhinolaryngology ; General Medicine ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
ZDB-ID	754501-0
ISSN	1872-8464 ; 0165-5876
ISSN (online)	1872-8464
ISSN	0165-5876
DOI	10.1016/j.ijporl.2020.110059
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Pediatric laryngoscopy and bronchoscopy during the COVID-19 pandemic: A four-center collaborative protocol to improve safety with perioperative management strategies and creation of a surgical tent with disposable drapes

Int J Pediatr Otorhinolaryngol

Abstract	Aerosolization procedures during the COVID-19 pandemic place all operating room personnel at risk for exposure. We offer detailed perioperative management strategies and present a specific protocol designed to improve safety during pediatric laryngoscopy and bronchoscopy. Several methods of using disposable drapes for various procedures are described, with the goal of constructing a tent around the patient to decrease widespread contamination of dispersed droplets and generated aerosol. The concepts presented herein are translatable to future situations where aerosol generating procedures increase risk for any pathogenic exposure. This protocol is a collaborative effort based on knowledge gleaned from clinical and simulation experience from Children's Hospital Colorado, Children's Hospital of Philadelphia, The Hospital for Sick Children in Toronto, and Boston Children's Hospital.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #98351
Database	COVID19

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