Search Our Scientific Publications & Authors

Am J Perinatol 2021 May 11. Epub 2021 May 11.

Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan.

Objective:  We evaluate patient characteristics, hospital course, and outcome by type discharge pulmonary support; mechanical ventilation (MV) or with tracheotomy masks (TM).

Study Design:  We reviewed records of infants admitted to the neonatal intensive care unit (NICU) that underwent tracheotomy within their first year of life between 2006 and 2017. We evaluated patient characteristics, referral pattern, destination of discharge, and outcome by type of pulmonary support at discharge (MV vs. Read More

Int J Pediatr Otorhinolaryngol 2021 Apr 27;146:110746. Epub 2021 Apr 27.

Department of Otorhinolaryngology H & N Surgery, University of Maryland School of Medicine and University of Maryland Children's Hospital, Baltimore, MD, USA.

Objectives: Advances in neonatal intensive care have allowed successful resuscitation of children born at the border of viability. However, there has been little change in the incidence of bronchopulmonary dysplasia (BPD) and anatomical upper airway obstruction which may require a tracheostomy in that group. The benefits of the procedure are accompanied by sequelae that impact outcomes. Read More

Tex Heart Inst J 2021 Jan;48(1)

Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, Texas.

Del Nido cardioplegic solution (DNC), used chiefly in pediatric patients, rapidly induces prolonged cardiac arrest during cardiac surgery. To determine whether surgical outcomes after coronary artery bypass grafting in a United States military veteran population differed when DNC was used instead of our standard Plegisol cardioplegia, we retrospectively reviewed 155 consecutive operations performed from July 2016 through June 2017. Del Nido cardioplegia was used to induce cardiac arrest in 70 patients, and Plegisol in 85. Read More

N Engl J Med 2021 Apr;384(17):1647-1655

From the Departments of Pediatrics (D.K., K.A.S.), Radiology (R.S.), and Pathology (P.M.S.), Massachusetts General Hospital, and the Departments of Pediatrics (D.K., K.A.S.), Radiology (R.S.), and Pathology (P.M.S.), Harvard Medical School - both in Boston.

Am J Otolaryngol 2021 Apr 22;42(6):103074. Epub 2021 Apr 22.

Texas Children's Hospital, Department of Pediatric Otolaryngology, 6701 Fannin St, Suite 640, Houston, TX 77030, USA; Baylor College of Medicine, Department of Otolaryngology - Head and Neck Surgery, One Baylor Plaza Suite NA-102, Houston, TX 77030, USA. Electronic address:

Objective: Sialorrhea and tracheal secretions can be present in patients with a tracheostomy. The current study seeks to survey the severity of sialorrhea and tracheal secretions in infants and toddlers with a tracheostomy, and to correlate this severity with quality of life.

Methods: Prospective cross-sectional survey pilot study: 26 patients (ages 0. Read More

Int J Pediatr Otorhinolaryngol 2021 Apr 18;145:110704. Epub 2021 Apr 18.

University of Pittsburgh Medical Center, Department of Otolaryngology, USA; UPMC Children's Hospital of Pittsburgh, Division of Pediatric Otolaryngology, USA. Electronic address:

Objectives: Pediatric patients who undergo tracheostomy tube placement are medically complex with a high risk of morbidity and mortality. They are often premature with multiple cardiopulmonary comorbidities. This study reviews the demographics and outcomes within this population to identify at-risk patient groups at our hospital. Read More

Int J Pediatr Otorhinolaryngol 2021 Apr 18;145:110713. Epub 2021 Apr 18.

Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Objective: Measure the prevalence of and factors associated with financial toxicity (FT) and caregiver burden in families of tracheostomy-dependent children. FT is defined as the objective and subjective patient-level impact of the costs of medical care and has been associated with lower quality of life, decreased compliance with treatment, and increased mortality.

Methods: A medical record review was performed on all children with a tracheostomy tube placed from 2009 to 2018 at a tertiary children's hospital to identify and include children younger than 18 years old, not deceased, and not decannulated at the time of review. Read More

Facial Plast Surg Aesthet Med 2021 Apr 20. Epub 2021 Apr 20.

College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.

The GILLS (gastroesophageal reflux, preoperative intubation, late intervention (>14 days), low birth weight (<2500 g), and syndromic diagnosis) score is a validated predictor of success for tongue-lip adhesion (TLA) in patients with Robin sequence (RS). To evaluate the application of the GILLS score to mandibular distraction osteogenesis (MDO) for airway management in patients with RS and the associated syndromes. A retrospective chart review of 21 patients diagnosed with RS and treated with MDO surgery between the years 2006 and 2016 was performed. Read More

Curr Otorhinolaryngol Rep 2021 Apr 15:1-12. Epub 2021 Apr 15.

Department of Otolaryngology, Head and Neck Surgery, University of Arkansas for Medical Sciences, 1 Children's Way, Little Rock, AR 72202 USA.

Purpose Of Review: Tracheostomy in a child demands critical pre-operative evaluation, deliberate family education, competent surgical technique, and multidisciplinary post-operative care. The goals of pediatric tracheostomy are to establish a safe airway, optimize ventilation, and expedite discharge. Herein we provide an update regarding timing, surgical technique, complications, and decannulation, focusing on a longitudinal approach to pediatric tracheostomy care. Read More

BMC Anesthesiol 2021 Apr 19;21(1):121. Epub 2021 Apr 19.

Department of Anesthesiology, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing, China.

Background: Orthopedic surgery for cervical torticollis poses potential threat to airway management both in tracheal intubation and extubation. Klippel-Feil syndrome (KFS) is a complex syndrome of osseous and visceral anomalies. The anatomical characteristics of KFS might have significant implications for airway management. Read More

Acta Myol 2021 Mar 31;40(1):8-42. Epub 2021 Mar 31.

Neurorehabilitation Unit, the NEMO Clinical Center in Milan, University of Milan, Italy.

Respiratory complications are common in the patient with muscular dystrophy. The periodic clinical and instrumental respiratory evaluation is extremely important. Despite the presence in the literature of updated guidelines, patient associations often report lack of knowledge of these pathologies, particularly in peripheral hospitals. Read More

Laryngoscope Investig Otolaryngol 2021 Apr 6;6(2):332-339. Epub 2021 Feb 6.

Department of General Pediatrics and Interdisciplinary medicine National Center for Child Health and Development Tokyo Japan.

Objectives: The present study analyzed surgical outcomes of laryngotracheal separation (LTS) in children with neurological disorders. The purpose of this study was to investigate respiratory impairment and severe complications after LTS in children, and identify the possibility of permanent tracheostomy without a tracheostomy tube as the safest respiratory management method.

Methods: Twenty-eight patients (male:female = 16:12) with neurological disorders (6 months to 32 years) who underwent LTS between January 2012 and April 2018 were reviewed. Read More

Respir Med 2021 Apr 11:106392. Epub 2021 Apr 11.

Department of Pediatric Cardiology, Pulmonology and Pediatric Intensive Care Medicine, University Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tuebingen, Germany.

Background: Advances in medical care and ventilator technologies increase the number of children with tracheostomy and home mechanical ventilation (HMV). Data on severe adverse events in home care and in specialized nursing care facilities are limited.

Patients And Methods: Retrospective analysis of incidence and type of severe adverse events in children with tracheostomy and HMV in home care compared to a specialized nursing care facility over a 7-year period. Read More

J Pediatr Surg 2021 Mar 26. Epub 2021 Mar 26.

Division of Pediatric Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.

Introduction: Simultaneous gastrostomy tube (GT) and tracheostomy placement in young children offers potential benefit in limiting anesthetic exposure, but it is unknown whether combining these procedures introduces additional morbidity. This study compared outcomes after combined GT and tracheostomy placement versus GT placement alone among similar ventilator-dependent patients.

Methods: Ventilator-dependent children <2-years-old who underwent GT placement alone (MV-GT), simultaneous GT and tracheostomy placement (GT+T), and GT placement alone with a pre-existing tracheostomy (T-GT) were identified using 2012-2018 NSQIP-Pediatric Participant User Files. Read More

Int J Pediatr Otorhinolaryngol 2021 Mar 29;145:110687. Epub 2021 Mar 29.

Department of Paediatric Otolaryngology, The Children's Hospital at Westmead, The University of Sydney, Westmead, NSW, Australia; Discipline of Child and Adolescent Health, Faculty of Medicine and Health, University of Sydney, NSW, Australia. Electronic address:

Objective: To report on our experience with open pediatric laryngotracheal reconstruction (LTR) with cartilage interposition grafts over the past 15 years and document setbacks and factors that affect postoperative outcomes.

Method: A retrospective chart review was performed on all pediatric patients who underwent single and double-stage LTR at The Children's Hospital in Westmead between August 2004 and July 2019. The outcomes measured include the overall decannulation rate, rates of postoperative complications, need for subsequent procedures and postoperative functional results (dyspnea, stridor, voice impairment). Read More

Rev Chil Pediatr 2020 Dec 13;91(6):961-967. Epub 2020 Dec 13.

Hospital de Niños Roberto del Río, Universidad de Chile, Santiago, Chile.

Stridor is an abnormal respiratory sound caused by obstruction or collapse of the laryngotracheal airway, either acutely or chronically. There are different causes, both congenital and acquired, that can produce shortness of breath which may be severe and potentially life-threatening. The clini cal diagnosis must be complemented with an endoscopic airway assessment and sometimes with imaging, to try to determine the areas involved and possible associated malformations. Read More

Laryngoscope 2021 Apr 16. Epub 2021 Apr 16.

Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A.

Objectives: To determine if socioeconomic disadvantage impacts perioperative outcomes after tracheostomy.

Methods: We performed a retrospective case series of children who underwent tracheostomy. Children were divided into less and more disadvantaged groups based on their community's Area Deprivation Index (ADI), a validated socioeconomic vulnerability measure. Read More

Front Pediatr 2021 29;9:648927. Epub 2021 Mar 29.

Pediatric Pulmonology & Respiratory Intermediate Care Unit, Sleep, and Long-Term Ventilation Unit, Academic Department of Pediatrics and Genetic Research Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Congenital central hypoventilation syndrome (CCHS) is a rare disorder whose clinical phenotype is closely related to genotype. A retrospective analysis has been conducted on 22 patients with CCHS, who were referred to the Pediatric Pulmonology and Respiratory Intermediate Care Unit of Bambino Gesù Children's Hospital (Italy) for a multidisciplinary follow-up program between 2000 and 2020. Apnea and cyanosis were the most frequent symptoms at onset (91%). Read More

Sleep Breath 2021 Apr 14. Epub 2021 Apr 14.

Division of Pediatric Pulmonology and Sleep Medicine, Emory University School of Medicine, Children's Healthcare of Atlanta, 1400 Tullie Road NE, Atlanta, GA, 30329, USA.

Purpose: Noninvasive positive pressure ventilation (NPPV) may permit tracheostomy decannulation (TD) in patients with congenital central hypoventilation syndrome (CCHS) requiring nocturnal positive pressure ventilation via tracheostomy (PPV-T). There is limited evidence on optimal strategies for transitioning patients from PPV-T to NPPV. This study aimed to describe the clinical course and outcome of children with CCHS who underwent TD and transitioned from PPV-T to NPPV. Read More

Ann Otol Rhinol Laryngol 2021 Apr 9:34894211007250. Epub 2021 Apr 9.

Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati Medical Center, Cincinnati, OH, USA.

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. Read More

Ann Plast Surg 2021 Apr 5. Epub 2021 Apr 5.

From the University of Alabama at Birmingham School of Medicine, Birmingham, AL Division of Plastic Surgery, Baylor College of Medicine, Houston, TX Department of Genetics, University of Alabama at Birmingham School of Medicine Divisions of Pediatric Hospital Medicine Pediatric Pulmonary & Sleep Medicine, University of Alabama at Birmingham, Birmingham, AL Division of Plastic Surgery, New York University, New York, NY Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL.

Background: Pierre Robin sequence (PRS) is a triad of congenital facial abnormalities that can present as a syndrome (syndromic PRS [sPRS]) or an isolated entity (isolated PRS [iPRS]). Patients with PRS can develop airway and feeding problems that may result in failure to thrive. Mandibular distraction osteogenesis (MDO) is a method for improving the functional issues associated with breathing and feeding. Read More

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021 Apr;56(4):356-362

Department of Otolaryngology Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck Surgery, National Center for Children's Health (NCCH), Beijing 100045, China.

To discuss the complications and postoperative outcomes of tracheotomy with different etiology in children. One hundred and eighty-six patients underwent tracheotomy were retrospectively analyzed from January 2016 to December 2018,including 117 males and 69 females. The children aged from 4 days to 14 years (median age 31. Read More

Pediatr Pulmonol 2021 Apr 8. Epub 2021 Apr 8.

Department of Pediatrics, Stony Brook Children's Hospital, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA.

Background And Objectives: Shared decision making (SDM) before nonurgent tracheostomy in a child with chronic respiratory failure (CRF) is often recommended, but has proven challenging to implement in practice. We hypothesize that utilization of the microsystem model for analysis of the complex ecosystem in which SDM occurs will yield insights that enable formation of a reproducible, measurable SDM process.

Methods: Retrospective chart review of a case series of children with CRF in whom a SDM process was pursued. Read More

Laryngoscope Investig Otolaryngol 2021 Mar 1. Epub 2021 Mar 1.

Department of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA.

At the height of the coronavirus pandemic in New York City, at our hospital (NYC Health/Hospitals-Elmhurst) 95% of inpatients tested positive for COVID-19 and it operated at 500% surge ICU capacity-one of the greatest impacted centers in the nation. In the face of this we established a systematic multidisciplinary approach to manage ventilated ICU patients and select those appropriate for tracheostomy. Members from Pulmonary Critical Care, Anesthesiology, Surgery, Ethics, and Otolaryngology, created a protocolized way to assess all ICU patients in our hospital and, if deemed appropriate, help them towards weaning or tracheostomy and subsequent discharge. Read More

Minerva Pediatr (Torino) 2021 Apr 2. Epub 2021 Apr 2.

Neurophysiology Unit, Neurology Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Encephalopathy of different etiologies in infants is often the reason for central respiratory insufficiency which eventually leads patients to the paediatric intensive care unit. Magnetic resonance imaging (MRI) and brainstem auditory evoked potentials (BAEPs) may be useful to identify brainstem alterations among patients with respiratory insufficiency of central origin. MRI is a compulsory technique to identify brain abnormalities, but may fail to detect brainstem lesions of small dimensions. Read More

J Pediatr Nurs 2021 Apr 1;61:96-101. Epub 2021 Apr 1.

Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States of America; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America. Electronic address:

Purpose: To describe the proportion of children with an index hospitalization in 2014 who had established long-term invasive ventilator dependence (LTVD), and determine regional variation in hospital length of stay, charges, and readmissions.

Design And Methods: Multicenter, longitudinal, retrospective cohort study using a recently established algorithm to identify children with LTVD from the Pediatric Health Information System database with an index hospitalization at least once during 2014, excluding normal newborn care or chemotherapy, and the subset with established LTVD. Hospitals were grouped by geographic regions. Read More

World Neurosurg 2021 Mar 31. Epub 2021 Mar 31.

Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran; Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

Objective: This study is aimed at identifying factors predicting tracheostomy requirement in children diagnosed with a posterior fossa medulloblastoma postoperatively.

Methods: A retrospective chart review of all patients younger than 18 undergoing medulloblastoma resection from 2012 to 2020 at Namazi Hospital was conducted.

Results: Forty-five patients (26%) needed tracheostomy after the operation. Read More

Children (Basel) 2021 Mar 25;8(4). Epub 2021 Mar 25.

Pediatric Otolaryngology Head Neck Surgery, Children Hospital "ASST Spedali Civili", 25123 Brescia, Italy.

We discuss two cases of congenital airway malformations seen in our neonatal intensive care unit (NICU). The aim is to report extremely rare events characterized by immediate respiratory distress after delivery and the impossibility to ventilate and intubate the airway. The first case is a male twin born at 34 weeks by emergency caesarean section. Read More

ORL J Otorhinolaryngol Relat Spec 2021 Mar 31:1-9. Epub 2021 Mar 31.

Maxillo-Facial Surgery Unit, AOU-Careggi, Florence, Italy.

Introduction: Mandibular defects reconstruction could result challenging in childhood, due to facial and mandibular growth patterns. For these reasons, the choice of the most suitable reconstructive option in pediatric patients, affected by mandibular malignancies, still objects of debate.

Objective: The aim of our study was to compare our reconstructive schedules to the existing literature in order to give a personal contribute to the present panorama. Read More