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Article ; Online: A Nearly Obstructive Intratracheal Mass in a Pediatric Patient.

Hakimi, Amir A / Orobello, Nicklas C / Mudd, Pamela A

JAMA otolaryngology-- head & neck surgery

2023 Volume 149, Issue 4, Page(s) 368–369

MeSH term(s)	Child ; Humans ; Trachea/pathology
Language	English
Publishing date	2023-02-02
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2701825-8
ISSN	2168-619X ; 2168-6181
ISSN (online)	2168-619X
ISSN	2168-6181
DOI	10.1001/jamaoto.2022.4908
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Article ; Online: Exploring Mental Health in a Pediatric Paradoxical Vocal Fold Motion Sample Using Patient-Reported Outcomes.

Andrew, Lilia Mucka / Sandler, Claire B / Long, Courtney A / Bauman, Nancy M / Mudd, Pamela A

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

2024 Volume 170, Issue 4, Page(s) 1167–1172

Abstract: Objective: Paradoxical vocal fold motion (PVFM) is characterized by inappropriate adduction of vocal folds during inspiration causing dyspnea. While anxiety is suspected to be a predisposing factor, incidence has been understudied.: Study designs: ... ...

Abstract	Objective: Paradoxical vocal fold motion (PVFM) is characterized by inappropriate adduction of vocal folds during inspiration causing dyspnea. While anxiety is suspected to be a predisposing factor, incidence has been understudied. Study designs: Retrospective review. Setting: Multidisciplinary PVFM hospital clinic. Methods: We used patient-reported outcome measures to examine anxiety and depression in consecutive patients aged 10 to 17 years using Pediatric SFv1.1 Anxiety 8b and Level 2-Depression inventories (parents completed proxy forms). T-scores were classified as normal (none to slight <55) or elevated (mild 55-59.9, moderate 60-69.9, severe >70). Results: Twenty-three pediatric patients and 20 parents completed surveys. Mean age was 13.74 years. For anxiety, 69.6% of patients and 40% of parents identified elevated levels. For depression, 30.4% of patients and 15% of parents identified elevated levels. Therapy need for the sample was 65.2% (34.8% active in services and 30.4% referred). Child anxiety scores were significantly higher in the therapy need group, U = 17, P = .004. Conclusion: This study of adolescents with PVFM confirmed elevated anxiety and depression scores in 2/3 of the participants. Anxiety likely precedes diagnosis and is a predisposing factor. Referral for individualized intervention targeting anxiety and depression is indicated.
MeSH term(s)	Adolescent ; Humans ; Child ; Mental Health ; Vocal Cord Dysfunction ; Vocal Cords ; Dyspnea ; Patient Reported Outcome Measures
Language	English
Publishing date	2024-01-09
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.641
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Article ; Online: Examining the pediatric subglottic airway by ultrasound: A systematic review.

Saravia, Ari / Saravia, Rachel W / Mudd, Pamela / Jones, Joel W

International journal of pediatric otorhinolaryngology

2023 Volume 166, Page(s) 111482

Abstract: Objective: The purpose of this review was to determine the ability of ultrasound (US) to assess the subglottic airway in pediatric patients to estimate the appropriate size of endotracheal tube (ETT).: Data sources: Pubmed, Scopus, and Embase ... ...

Abstract	Objective: The purpose of this review was to determine the ability of ultrasound (US) to assess the subglottic airway in pediatric patients to estimate the appropriate size of endotracheal tube (ETT). Data sources: Pubmed, Scopus, and Embase databases. Methods: A search of the literature was performed for studies that utilized ultrasonography to examine the minimal transverse diameter of the subglottic airway (MTDSA) in the pediatric (age < 18) population to estimate endotracheal tube (ETT) size. Articles were excluded if they involved adults or non-humans, had no comparison method, or were case reports. The primary outcome was the successful use of ultrasound compared to the reference standard defined by the study. Results: Sixteen studies were included, for a total of 1,633 pediatric subjects in whom transcervical laryngeal ultrasound was used prospectively to examine the MTDSA to estimate ETT size prior to intubation. Ultrasound reliably predicted the clinically best fit endotracheal tube by air leak test in 48-100% of subjects, while age-based formulas were accurate 24-95% of the time. Ultrasound was highly predictive of proper size, with R2 ranging between 0.684 to 0.980. Of those reintubated (n = 104), 86 (83%) required larger-sized tubes, while 18 (17%) required smaller-sized tubes. Both methods tended to underestimate ETT size, but the age-based formulas accounted for most of these differences. Conclusion: Transcervical laryngeal ultrasound appears to be a reliable predictor of endotracheal tube size in children undergoing elective surgery, which has implications for preventing intubation-related trauma and ensuring adequate ventilation for those who may require prolonged intubation.
MeSH term(s)	Adult ; Child ; Humans ; Trachea/diagnostic imaging ; Intubation, Intratracheal/methods ; Ultrasonography/methods ; Larynx ; Equipment Design
Language	English
Publishing date	2023-02-09
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.2023.111482
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Article: Spatial Morphoproteomic Features Predict Uniqueness of Immune Microarchitectures and Responses in Lymphoid Follicles.

Hu, Thomas / Allam, Mayar / Kaushik, Vikram / Goudy, Steven L / Xu, Qin / Mudd, Pamela / Manthiram, Kalpana / Coskun, Ahmet F

bioRxiv : the preprint server for biology

2024

Abstract: Multiplex imaging technologies allow the characterization of single cells in their cellular environments. Understanding the organization of single cells within their microenvironment and quantifying disease-status related biomarkers is essential for ... ...

Abstract	Multiplex imaging technologies allow the characterization of single cells in their cellular environments. Understanding the organization of single cells within their microenvironment and quantifying disease-status related biomarkers is essential for multiplex datasets. Here we proposed SNOWFLAKE, a graph neural network framework pipeline for the prediction of disease-status from combined multiplex cell expression and morphology in human B-cell follicles. We applied SNOWFLAKE to a multiplex dataset related to COVID-19 infection in humans and showed better predictive power of the SNOWFLAKE pipeline compared to other machine learning and deep learning methods. Moreover, we combined morphological features inside graph edge features to utilize attribution methods for extracting disease-relevant motifs from single-cell spatial graphs. The underlying subgraphs were further analyzed and associated with disease status across the dataset. We showed that SNOWFLAKE successfully extracted significant low dimensional embedding from subgraphs with a clear separation between disease status and helped characterize unique cellular interactions in the subgraphs. SNOWFLAKE is a generalizable pipeline for the analysis of multiplex imaging data modality by extracting disease-relevant subgraphs guided by graph-level prediction.
Language	English
Publishing date	2024-01-07
Publishing country	United States
Document type	Preprint
DOI	10.1101/2024.01.05.574186
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Article ; Online: Ultrasound of the vocal cords in infants.

Sanchez-Jacob, Ramon / Cielma, Tara K / Mudd, Pamela A

Pediatric radiology

2021 Volume 52, Issue 9, Page(s) 1619–1626

Abstract: Vocal cord paralysis is a common cause of respiratory and feeding problems in the pediatric population. While the causes of vocal cord paralysis are multiple, iatrogenic injury of the recurrent laryngeal nerve after cardiovascular surgery is the most ... ...

Abstract	Vocal cord paralysis is a common cause of respiratory and feeding problems in the pediatric population. While the causes of vocal cord paralysis are multiple, iatrogenic injury of the recurrent laryngeal nerve after cardiovascular surgery is the most frequent cause. Vocal cord paralysis increases the risk of swallowing dysfunction, tracheal aspiration and pneumonia. It also increases the need for nasoenteric feeds and gastrostomy tube placement. Flexible nasopharyngolaryngoscopy is considered the gold standard for diagnosing vocal cord paralysis, but it has significant drawbacks: it is uncomfortable, it can trigger a cardiovascular event in children with unstable cardiovascular status, it can be challenging to perform, and it can be difficult to interpret. Laryngeal US has become a popular imaging modality to evaluate the function of the vocal cords. Laryngeal US is well-tolerated, easy to perform, simple to interpret and has a lower physiological impact compared to flexible nasopharyngolaryngoscopy. Laryngeal US is an accurate and low-cost diagnostic test for vocal cord paralysis. In this review, we describe the anatomy of the larynx and recurrent laryngeal nerve; the causes, symptoms and pathophysiology of vocal cord paralysis; laryngeal US technique; diagnostic criteria for vocal cord paralysis; and a reporting system.
MeSH term(s)	Child ; Humans ; Infant ; Laryngoscopy/adverse effects ; Larynx/diagnostic imaging ; Recurrent Laryngeal Nerve ; Vocal Cord Paralysis/diagnostic imaging ; Vocal Cord Paralysis/epidemiology ; Vocal Cords/diagnostic imaging
Language	English
Publishing date	2021-11-29
Publishing country	Germany
Document type	Journal Article ; Review
ZDB-ID	124459-0
ISSN	1432-1998 ; 0301-0449
ISSN (online)	1432-1998
ISSN	0301-0449
DOI	10.1007/s00247-021-05235-0
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Article ; Online: Managing the Destructive Foreign Body: Water Beads in the Ear (A Case Series) and Literature Review.

Zalzal, Habib G / Ryan, Matthew / Reilly, Brian / Mudd, Pamela

The Annals of otology, rhinology, and laryngology

2022 Volume 132, Issue 9, Page(s) 1090–1095

Abstract: Objective: To characterize our experience with super-absorbent polymer beads placed in the external auditory canal to better understand the damage caused and subsequent management required.: Methods: Retrospective chart review of pediatric patients ... ...

Abstract	Objective: To characterize our experience with super-absorbent polymer beads placed in the external auditory canal to better understand the damage caused and subsequent management required. Methods: Retrospective chart review of pediatric patients at 2 separate tertiary referral centers. Results: Seven patients were identified as having placed super-absorbent polymer beads in the external auditory canal, 6 of whom required removal under general anesthesia. Three patients did not suffer otologic trauma or hearing loss (average foreign body duration <72 hours). Four patients experienced severe otologic complications (average foreign body duration >1 week), all of whom were treated with otologic drops prior to bead identification. Of this severe complication group, 3 patients had restored hearing after surgical intervention, while 1 patient suffered profound hearing loss secondary to labyrinthitis ossificans. Conclusion: Early recognition of otologic foreign bodies is important, particularly if expansile water-bead is suspected. Depending on timeframe, water beads are highly destructive to the middle ear structures, and most patients will require surgical intervention.
MeSH term(s)	Humans ; Child ; Retrospective Studies ; Ear, Middle/surgery ; Ear Canal/surgery ; Hearing Loss ; Foreign Bodies/complications ; Foreign Bodies/diagnostic imaging ; Foreign Bodies/surgery ; Polymers
Chemical Substances	Polymers
Language	English
Publishing date	2022-11-07
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	120642-4
ISSN	1943-572X ; 0003-4894
ISSN (online)	1943-572X
ISSN	0003-4894
DOI	10.1177/00034894221133768
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Article ; Online: Vocal fold nodules in children.

Mudd, Pamela / Noelke, Carolyn

Current opinion in otolaryngology & head and neck surgery

2018 Volume 26, Issue 6, Page(s) 426–430

Abstract: Purpose of review: Vocal nodules are a common presentation in children, representing the most common cause of dysphonia.: Recent findings: Children with siblings, ADHD, and of male sex are most likely to be affected. Female children, however, tend to ...

Abstract	Purpose of review: Vocal nodules are a common presentation in children, representing the most common cause of dysphonia. Recent findings: Children with siblings, ADHD, and of male sex are most likely to be affected. Female children, however, tend to have more likely progression into adolescence. Quality-of-life indices can aid in screening for vocal nodules whereas stroboscopy, and possibly, ultrasound are required for definitive diagnosis. Summary: Management has not significantly changed over time and should begin with conservative behavioral and environmental modifications along with voice therapy in those more severely impacted. Though immediate outcomes vary somewhat depending on management direction, the overall prognosis seems to be good even with lack of intervention. It is most critical to ensure a definitive diagnosis, and offer management therapies that are appropriate for the level of impact the vocal nodules have on communication and voice production in the child.
MeSH term(s)	Child ; Dysphonia/etiology ; Dysphonia/therapy ; Humans ; Laryngeal Diseases/diagnosis ; Laryngeal Diseases/epidemiology ; Laryngeal Diseases/etiology ; Laryngeal Diseases/therapy ; Quality of Life ; Vocal Cords/injuries ; Vocal Cords/pathology
Language	English
Publishing date	2018-10-06
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1232518-1
ISSN	1531-6998 ; 1068-9508
ISSN (online)	1531-6998
ISSN	1068-9508
DOI	10.1097/MOO.0000000000000496
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Article ; Online: Pediatric tracheostomy surveillance.

Leonard, James A / Mamidi, Ishwarya S / Mudd, Pamela / Espinel, Alexandra

Pediatric pulmonology

2021 Volume 56, Issue 9, Page(s) 3047–3050

Abstract: We report an unusual case of a 14-month-old ex-28 week, ventilator-dependent male with a history of bronchopulmonary dysplasia and tracheostomy at 2 months of age. Lost to follow-up, at age 9 months, he presented to the emergency department with ... ...

Abstract	We report an unusual case of a 14-month-old ex-28 week, ventilator-dependent male with a history of bronchopulmonary dysplasia and tracheostomy at 2 months of age. Lost to follow-up, at age 9 months, he presented to the emergency department with worsening respiratory distress. The patient was taken to the operating room at which time direct visualization of the airway demonstrated a mass filling the entire glottic inlet without supraglottic or pharyngeal mucosal attachments. The solid, nonvascular, mass appeared to be emanating from a suprastomal site. Excision proved to relieve the airway obstruction and postoperatively the patient has thrived.
MeSH term(s)	Airway Obstruction/etiology ; Airway Obstruction/surgery ; Child ; Humans ; Infant ; Infant, Newborn ; Male ; Tracheostomy
Language	English
Publishing date	2021-06-29
Publishing country	United States
Document type	Case Reports ; Letter
ZDB-ID	632784-9
ISSN	1099-0496 ; 8755-6863
ISSN (online)	1099-0496
ISSN	8755-6863
DOI	10.1002/ppul.25515
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Article ; Online: Association of anosmia and neutralizing antibody production in adolescents with SARS-CoV-2.

Gitman, Lyuba / Newman, Daniel / Burak, Bahar / Reilly, Brian K / Mudd, Pamela

International journal of pediatric otorhinolaryngology

2022 Volume 164, Page(s) 111403

Abstract: Background: To monitor olfactory/gustatory dysfunction and its relationship to SARS-CoV-2 IgG antibody responses in an adolescent population.: Methods: Adolescents with changes in olfactory/gustatory functions were enrolled in a 15-month study. The ... ...

Abstract	Background: To monitor olfactory/gustatory dysfunction and its relationship to SARS-CoV-2 IgG antibody responses in an adolescent population. Methods: Adolescents with changes in olfactory/gustatory functions were enrolled in a 15-month study. The patients were evaluated with 1) SNOT-22, 2) pediatric smell wheel, and 3) SARS-CoV-2 antibody testing. The relationship between these scores and length of anosmia, and the amount of SARS-CoV-2 IgG antibodies were assessed. A brain MRI was performed in cases of persistent special sensory symptoms. Results: Eighteen patients were identified with smell and/or taste complaints. Most of the patients were female (67%) and median age was 15 years (range 11-17). Twelve patients had prior SARS-CoV-2 PCR testing, with only five patients with a positive result. The median SNOT-22 score was 16 (range 0-52) and the median smell wheel score was 6.5 (range 1-11). Patients with taste difficulty were more likely to have a score less than eight. 78% of the patients tested positive for antibodies and there was a strong negative correlation between smell wheel score and antibody level (Spearman, ρ = -0.798, p = 0.002). Five patients underwent MRI scan, and all resulted as normal olfactory bulb structures. 66% received nasal corticosteroids. 11 patients presented in follow up. Conclusions: Adolescents presenting to a pediatric ENT clinic during the SARS-CoV-2 pandemic were likely to have prolonged (>6 weeks) symptoms of SARS-CoV-2. The majority do not report positive PCR testing result but do report systemic symptoms including anosmia. This suggests that anosmia may be both a late and prolonged symptom of SARS-CoV-2.
Language	English
Publishing date	2022-11-25
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.2022.111403
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Article ; Online: Omission in Authorship.

Sterling, Megan / Mudd, Pamela

JAMA otolaryngology-- head & neck surgery

2017 Volume 143, Issue 2, Page(s) 196

Language	English
Publishing date	2017-02-16
Publishing country	United States
Document type	Journal Article ; Published Erratum
ZDB-ID	2701825-8
ISSN	2168-619X ; 2168-6181
ISSN (online)	2168-619X
ISSN	2168-6181
DOI	10.1001/jamaoto.2016.4494
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