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Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu 2021 ;24:37-43

Section of Pediatric Cardiovascular Surgery, Department of Cardiac Surgery, C.S. Mott Children's Hospital, University of Michigan Medicine, Ann Arbor, Michigan. Electronic address:

Tracheobronchomalacia is a condition of dynamic collapse of the trachea and mainstem bronchi. The clinical significance of tracheobronchomalacia depends on its severity. Mild cases may be medically managed with limited symptomology, while severe cases require advanced therapies, lengthy hospital stays, and carry significant morbidity and mortality. Read More

Ann Otol Rhinol Laryngol 2021 Jun 10:34894211024060. Epub 2021 Jun 10.

Department of Otolaryngology - Head & Neck Surgery, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.

Objectives: There are numerous well-described benefits to breastfeeding to both infant and mother. Even in healthy children with an uncomplicated perinatal course, there may be significant struggles maintaining a breastfeeding relationship. Infants with a complicated clinical course have been shown to benefit even more from the provision of breastmilk, however they are seldom encouraged to feed directly at the breast. Read More

Auris Nasus Larynx 2021 Jun 6. Epub 2021 Jun 6.

Department of Otorhinolaryngology, Head and Neck Surgery, Juntendo University School of Medicine, Tokyo, Japan.

Concurrent chemoradiotherapy (CCRT) is one of the most promising treatments for advanced head and neck cancer (HNC). On the other hand, CCRT may induce severe edema in laryngo-pharyngeal structures in association with radiation. This is a report of a 66-year-old man with severe obstructive sleep apnea (OSA) associated with edema in laryngo-hypopharynx after CCRT for advanced laryngeal and hypopharyngeal cancer. Read More

BMC Nurs 2021 Jun 9;20(1):93. Epub 2021 Jun 9.

Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA.

Background: Family caregivers of patients with cancer undergoing radiation therapy experience significant distress and challenges related to high symptom burden and complex care demands. This is particularly true for caregivers of patients with head and neck, esophageal, anal, rectal, and lung cancers, who are often receiving combined-modality treatment and may have tracheostomy tubes, gastrostomy tubes, or colostomies/ileostomies. This study aims to evaluate a simulation-based nursing intervention to provide information, support, and training to caregivers during radiation therapy. Read More

Medicine (Baltimore) 2021 May;100(19):e25771

Department of Internal Medicine-College of Medicine-Imam Abdulrahman Bin Faisal University -King Fahd Hospital of the University-Khobar-Eastern Province-Saudi Arabia.

Introduction: Corona virus disease-2019 (COVID-19) presents primarily with respiratory symptoms. However, extra respiratory manifestations are being frequently recognized including gastrointestinal involvement. The most common gastrointestinal symptoms are nausea, vomiting, diarrhoea and abdominal pain. Read More

Langenbecks Arch Surg 2021 Jun 9. Epub 2021 Jun 9.

Getting It Right First Time Programme, NHS England and NHS Improvement, 1 Lower Marsh, London, SE1 7NT, UK.

Purpose: The delivery of surgical care in England has seen a momentum towards centralisation within larger volume hospitals and surgical teams. The aim of this study was to investigate outcomes in England in relationship to hospital and surgeon annual volumes for total thyroidectomy.

Methods: Data were extracted from the Hospital Episodes Statistics (HES) database for England. Read More

Clin Med Insights Case Rep 2021 28;14:11795476211020590. Epub 2021 May 28.

Department of Otolaryngology, Lausanne University Hospital CHUV, Switzerland.

During the current COVID-19 pandemic, several emerging cases of laryngotracheal stenosis following prolonged intubation and tracheostomy are being reported. The patients' pre-existing comorbidities, the disease itself and the pronation maneuvers increase the risk for endolaryngeal and tracheal damage. In this commentary, we report 4 such patients with acquired severe laryngotracheal stenosis. Read More

J Anaesthesiol Clin Pharmacol 2021 Jan-Mar;37(1):127-129. Epub 2021 Apr 10.

Department of Anesthesia and Intensive Care, PGIMER, Chandigarh, India.

BMJ Case Rep 2021 Jun 8;14(6). Epub 2021 Jun 8.

Medicine Based Disciplines Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia

Tracheostomy is an aerosol-generating procedure and performing it in patients with COVID-19 requiring mechanical ventilation raises significant concerns of infection risk to healthcare workers. We herein report a case of tracheostomy in a critically ill patient with severe COVID-19 acute respiratory distress syndrome. This article depicts the use of personal protective equipment, highlighting the common challenges it presents and ways to address them. Read More

Head Neck 2021 Jun 8. Epub 2021 Jun 8.

Department of Otorhinolaryngology - Head & Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Background: Patients with human papillomavirus (HPV)-negative oropharyngeal squamous cell carcinoma (OPSCC) continue to experience disappointing outcomes following chemoradiotherapy (CRT) and appreciable morbidity following historical surgical approaches. We aimed to investigate the oncologic outcomes and perioperative morbidity of a transoral robotic surgery (TORS) approach to surgically resectable HPV-negative OPSCC.

Methods: Retrospective analysis HPV-negative OPSCC patients who underwent TORS, neck dissection and pathology-guided adjuvant therapy (2005-2017). Read More

J Clin Nurs 2021 Jun 8. Epub 2021 Jun 8.

Nursing School of Porto, Porto, Portugal.

Aims And Objectives: To map nursing interventions, their characteristics, and outcomes, in promoting self-care of the person with a tracheostomy.

Background: The development of competencies in self-care of a person with a tracheostomy is recognised as one of the most significant nursing intervention areas for the promotion of autonomy, prevention of complications and adaptation. Identifying nursing interventions for the promotion of self-care of the person with a tracheostomy enables enhanced clinical practice knowledge within different care contexts and the identification of gaps in the available evidence. Read More

CVIR Endovasc 2021 Jun 8;4(1):49. Epub 2021 Jun 8.

Interventional Radiology Service, Department of Radiology, Austin Hospital, Melbourne, Australia.

Purpose: Arteriovenous malformations (AVMs) are abnormal communications between arteries and veins without an intervening capillary system. The best endovascular treatment option for these is unclear and may involve multiple staged procedures using a variety of embolic materials. We report our initial experience using a modified version of a previously published neurointerventional technique to treat soft tissue AVMs with single-stage curative intent. Read More

Am J Otolaryngol 2021 May 25;42(6):103090. Epub 2021 May 25.

Instituto Chileno de Cabeza y Cuello, Chile; Hospital de la Fuerza Aérea de, Chile.

Introduction: Currently we are faced with countless patients with prolonged invasive mechanical ventilation as a result of the COVID-19 pandemic, with the consequent increase in the need for tracheostomies and the risks that this includes for both patients and staff.

Objective: It is necessary to establish a safety protocol for the performance of percutaneous tracheostomies in order to reduce the associated infections.

Material And Methods: 77 patients underwent tracheostomies between March 2020 and March 2021, evaluating the safety of the protocol and the rate of contagion among the staff. Read More

Respirol Case Rep 2021 Jul 26;9(7):e00787. Epub 2021 May 26.

Department of Respiratory Medicine Toranomon Hospital Kajigaya Kawasaki Japan.

Granulation tissue formation is one of the late complications of tracheostomy. It can cause stomal stenosis secondary to chondritis because of disproportionate excision of the anterior cartilage. Clinicians should carefully determine the incision point, which is typically located half way between the cricoid cartilage and the sternal notch. Read More

J Intensive Care Soc 2020 Nov 30;21(4):344-348. Epub 2019 Sep 30.

Speech and Language Therapy Department, St George's University Hospitals NHS Foundation Trust, London, UK.

National guidance recommends the involvement of speech and language therapists in intensive care particularly for those requiring tracheostomy and ventilation. However, the role of speech and language therapists is poorly understood especially in the context of critical care. This article aims to increase awareness of the background training and skills development of speech and language therapists working in this context to demonstrate their range of specialist abilities. Read More

Ear Nose Throat J 2021 Jun 6:1455613211014109. Epub 2021 Jun 6.

Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Ostrava, Ostrava-Poruba, Czech Republic.

Chondrosarcoma of the thyroid cartilage is a sporadic disease with nonspecific clinical presentation. Smooth swelling of the supraglottic area should arouse suspicion of possible pathology. In addition to laryngoceles, which usually do not have a significant impact, otolaryngologists should consider chondrosarcoma of the thyroid cartilage and indicate computed tomography (CT). Read More

Am J Phys Med Rehabil 2021 May 28. Epub 2021 May 28.

Institute of Respiratory Disease, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari "Aldo Moro", Italy Pulmonary Rehabilitation Unit, Don Carlo Gnocchi Foundation, Milan, Italy Department of Physical Medicine and Rehabilitation, Rutgers University New Jersey Medical School, Newark, USA.

Abstract: Noninvasive ventilation has become the initial treatment for symptomatic ventilatory pump failure (VPF) but when used at ventilatory support settings can be an alternative to tracheostomy mechanical ventilation. The intermittent abdominal pressure ventilator (IAPV), a corset with an internal air sack inflated by a ventilator, allows to increase tidal volumes through the raising of the diaphragm and its consequent passive descent. It has been used for daytime support for over 70 years but its knowledge among clinicians is scarce. Read More

Ann Chir Plast Esthet 2021 Jun 1. Epub 2021 Jun 1.

Department of Plastic and Reconstructive Surgery, La Conception Hôpital, Assistance Publique Hôpitaux de Marseille, 147, boulevard Baille, 13005 Marseille, France.

The tracheostomy procedure presents some long term complications such as the depressed scar. It can be responsible for a tracheal tug, invaginated scar, inaesthetic scar or all of them. No consensus has emerged in the treatment of this type of pathological scarring. Read More

J Surg Res 2021 Apr 27;266:361-365. Epub 2021 Apr 27.

Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey. Electronic address:

Background: Tracheostomy improves outcomes for critically ill patients requiring prolonged mechanical ventilation. Data are limited on the use and benefit of tracheostomies for intubated, critically ill coronavirus disease 2019 (COVID-19) patients. During the surge in COVID 19 infections in metropolitan New York/New Jersey, our hospital cared for many COVID-19 patients who required prolonged intubation. Read More

Clin Otolaryngol 2021 Jun 4. Epub 2021 Jun 4.

National Centre for Airway Reconstruction, Charing Cross Hospital, Fulham Palace Road, Hammersmith London, W68RF, United Kingdom.

Objectives: Airway reconstruction for laryngotracheal stenosis (LTS) encompasses several procedures. Dysphagia is a well-recognised sequela of LTS and airway surgery, however studies have employed mostly non-validated assessments post-operatively in small, heterogenous samples, perpetuating uncertainty around the contributions of LTS and its management to impaired deglutition. Consequently, considerable variation in LTS perioperative nutritional management exists. Read More

J Indian Assoc Pediatr Surg 2021 Mar-Apr;26(2):76-88. Epub 2021 Mar 4.

Department of Anaesthesiology, Government Medical College, Thiruvananthapuram, Kerala, India.

COVID-19 which emerged in Wuhan, China has rapidly spread all over the globe and the World Health Organisation has declared it a pandemic. COVID-19 disease severity shows variation depending on demographic characteristics like age, history of chronic illnesses such as cardio-vascular/renal/respiratory disease; pregnancy; immune-suppression; angiotensin converting enzyme inhibitor medication use; NSAID use etc but the pattern of disease spread is uniform - human to human through contact, droplets and fomites. Up to 3. Read More

World J Surg 2021 Jun 2. Epub 2021 Jun 2.

Department of Emergency Medicine, University of Colorado Anschutz Medical Center, Aurora, CO, USA.

Background: Tracheostomy is used for patients who require prolonged mechanical ventilation. Extensive research has described the provision and optimal timing of tracheostomy, but very little describes tracheostomy utilization in low- and middle-income countries, particularly in sub-Saharan Africa.

Methods: This prospective cohort study describes patients admitted to the intensive care unit (ICU) of a tertiary hospital in Malawi who received tracheostomy versus those who did not, with a primary outcome of hospital mortality. Read More

Rev Paul Pediatr 2021 26;40:e2020153. Epub 2021 May 26.

Universidade Federal do Triângulo Mineiro, Uberaba, MG, Brazil.

Objective: To describe an infant with craniofacial microsomia and recurrent respiratory distress associated with aberrant right subclavian artery in order to review its most frequent congenital anomalies and alert the pediatrician to its rarer and more severe complications.

Case Description: This case report involves an 18-month-old male infant, only son of non-consanguineous parents. At birth, the child presented craniofacial dysmorphisms (facial asymmetry, maxillary and mandibular hypoplasia, macrostomia, grade 3 microtia, and accessory preauricular tag) restricted to the right side of the face. Read More

Cleft Palate Craniofac J 2021 Jun 2:10556656211011886. Epub 2021 Jun 2.

Hagey Laboratory for Pediatric Regenerative Medicine, 10624Stanford University School of Medicine, Stanford, CA, USA.

Objective: Mandibular distraction osteogenesis (MDO) is frequently performed to address airway obstruction in patients with Pierre Robin sequence (PRS), though more recently the technique of orthodontic airway plating (OAP) has gained traction. We aimed to evaluate OAP compared to MDO for airway obstruction in PRS.

Design: A systematic literature search across PubMed, Embase, and Google Scholar identified all studies published in English, which involved MDO or any form of OAP as treatments for PRS. Read More

J Clin Med 2021 May 25;10(11). Epub 2021 May 25.

Department of Neurology, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu 42601, Korea.

Clinical implications of neurological problems during intensive care unit (ICU) care for coronavirus disease 2019 (COVID-19) patients are unknown. This study aimed to describe the clinical implications of preexisting neurological comorbidities and new-onset neurological complications in ICU patients with COVID-19. ICU patients who were isolated and treated for COVID-19 between 19 February 2020 and 3 May 2020, from one tertiary hospital and one government-designated branch hospital were included. Read More

Otolaryngol Head Neck Surg 2021 Jun 1:1945998211013778. Epub 2021 Jun 1.

Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA.

Objective: Surgical procedures that render patients acutely aphonic can cause them to experience significant anxiety and distress. We queried patient perceptions after tracheostomy or laryngectomy and investigated whether introducing augmentative technology was associated with improvement in patient-reported outcomes.

Methods: Participants included hospitalized patients who acutely lost the ability to speak due to tracheostomy or total laryngectomy from April 2018 to December 2019. Read More

Otolaryngol Head Neck Surg 2021 06;164(6):1358

Otolaryngol Head Neck Surg 2021 06;164(6):1357

J Surg Res 2021 May 28;266:328-335. Epub 2021 May 28.

Division of Trauma, Critical Care, Burns, and Acute Care Surgery, Department of Surgery, MetroHealth Medical Center, Cleveland, Ohio; Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio. Electronic address:

Background: It is well known that severely injured trauma patients have better outcomes when treated at centers that routinely treat high acuity trauma. The benefits of specialty treatment for chest trauma have not been shown. We hypothesized that patients with high risk rib fractures treated in centers that care for high acuity trauma would have better outcomes than patients treated in other centers. Read More

Am J Speech Lang Pathol 2021 May 31:1-9. Epub 2021 May 31.

Department of Otorhinolaryngology, Rush University Medical Center, Chicago, IL.

Purpose Upper airway patency is crucial in a patient's ability to tolerate a one-way speaking valve (SV). Traditional assessment of airway patency is mainly subjective. We developed four noninvasive methods to assess patency (leak volume, transtracheal pressure [TTP], end-tidal CO, and Mallampati score) in our institution. Read More