The trajectory of Pediatric Otolaryngology

Otolaryngology–Head and Neck Surgery, 2013

Objectives: 1) Study pediatric temporal bone anatomy using high resolution temporal bone imaging. 2) Analyze the anatomical differences in infant (< 2 years old) versus toddler (2-5 years old) versus child (6-10 years old) versus preadolescent and adolescent (>10 years old) as it pertains to cochlear implantation Methods: A retrospective chart and radiologic review was done of pediatric patients at our institution undergoing high resolution computed tomography (CT) scan of the temporal bones from April 2001 to February 2013. Charts were reviewed for clinical and demographic information. Scans were reviewed by experienced surgeons, radiologists, or both to study the Cobb angle between an ideal trajectory of a cochlear implant into the basal turn of the cochlea and a realistic approach for surgical insertion. Results: Seven hundred fifty patients were identified. Seven hundred and twenty-three charts and scans (1446 ears) were reviewed, and 27 patients were eliminated due to poo...

Otolaryngology–Head and Neck Surgery, 2021

Otolaryngologists often care for patients at the end of their lives but are rarely comfortable with switching from curative treatment to a palliative treatment paradigm. In addition, otolaryngologists are often uncomfortable treating common conditions that arise in this patient population, including chronic pain, depression/anxiety, and decision making at the end of life. Discussions surrounding end-of-life issues often arise in residency, but current residency education models provide little formal education on how to approach patients at the end of life. Recent evidence suggests that only about 5% of terminal otolaryngology patients receive palliative care consultation, indicating an opportunity for quality improvement in this setting. This session will describe the most current research on end-of-life care and discuss how the principles of palliative care can be applied to patients to improve the quality of care otolaryngologists provide. Foundational ethical principles of autonomy, beneficence, nonmaleficence, and justice will be described so that surgeons have tools to approach difficult patient encounters. A case-based approach will be used to illustrate how otolaryngologists experienced with treating terminal patients approach patient care in this situation. Cases will be used as a springboard to discuss the unique considerations for otolaryngology patients at the end of life, such as disfigurement, communication difficulties, and dysphagia in head and neck cancer, and issues of substituted judgment in terminal pediatric patients. Cases on how COVID-19 affects care at the end of life will also be discussed. Finally, a framework on how to approach terminal patients will be shared as a practical takeaway for improving care at the bedside. Outcome Objectives: (1) Understand the principles of medical ethics as they relate to terminal otolaryngology patients. (2) Recognize the unique challenges in otolaryngology patients at the end of life. (3) Explain the role of palliative care in the treatment of otolaryngology patients at the end of life.

International Journal of Pediatric Otorhinolaryngology, 2009

2016

Polysomnography is the goldstandard exam for child OSAS. When possible, polysomnography clearly distinguishes between those with isolated primary snoring and patients with sleep apnea (obstructive, central and mixed). The most common cause of OSAS in childhood is adenotonsillar hypertrophy. Laryngomalacia is the most common cause of stridor in childhood, though its physiopathology remains unknown. Among the most prominent theories are immaturity of the cartilaginous framework of the larynx and/or neuromuscular immaturity. Objective: Our proposal was to describe polysomnographic findings in children with laryngomalacia or other isolated laryngeal alterations, that is, without other alterations in the upper airways. Methods: The sample included 29 children with exclusively laryngeal alterations. All of them underwent an

International journal of pediatric otorhinolaryngology, 2009

The first pediatric otorhinolaryngological department was set up in Hungary at the Heim Pál Children's Hospital, Budapest in 1948. The first head of the department and the founder of Hungarian pediatric otorhinolaryngology was Ferenc Kallay. He was followed in leadership by Jeno Hirschberg, and at present Gábor Katona. In Budapest 10 pediatric otolaryngological departments and in other parts of the country seven departments have been working until recently with overall 344 beds. The Pediatric Otorhinolaryngological Section was developed in 1977. The discipline is independent specialty since 1978. Conferences with various special topics have been organized every year since then. Two international congresses were held in Hungary: the first one in Eger, 1986 presided by Jeno Hirschberg and Zoltán Lábas; and the second in Budapest in 2008, organized by Gábor Katona. The Hungarian pediatric otorhinolaryngologists assumed initiative role in the development of this special discipline s...

The Laryngoscope, 2008

To assess the residency experience in pediatric otolaryngology, determine the impact of pediatric fellowship programs on residency training, and evaluate the need for fellowship training in pediatric otolaryngology.

International Journal of Pediatric Otorhinolaryngology, 2006

International Journal of Pediatric Otorhinolaryngology, 2009

Acta Oto-laryngologica, 2000

Data were collected from 178 consecutively operated children during a 6-week period at an Oslo hospital in order to study disease profile and routines for referral and treatment in outpatient otorhinolaryngologic surgery. Median time from referral to surgery was less than 4 months. The majority of the children subjected to operation for recurrent acute otitis media, tonsillitis or upper respiratory infections had suffered from the disease for 12 months or less. Obstructive symptoms were registered in 18% of the children. Hospital referrals and controls came mainly from ENT (ear, nose and throat) specialists or paediatricians. Significantly more boys were subjected to surgery. Median age at the time of surgery was 4.2 years, and there was an equal distribution of pharyngeal and middle ear surgery. The numerous combinations of middle ear surgery reflect the non-specific treatment guidelines for otitis media.