Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P121
Oral Presentations
Accuracy of Pediatric Tracheostomy Tube
Position Measurement Methods
Allison Keane, MD (Presenter); Robert A. Saadi, MD; Einat
Slonimsky, MD; Meghan N. Wilson, MD; Jason G. May, MD
Objectives: The position of a pediatric tracheostomy tube,
defined here as the distance from the tube tip to the carina, can
be measured intraoperatively by tracheoscopy and postoperatively by chest x-ray. Both methods assist in selecting the
appropriate tracheostomy tube length. The purpose of this
study was to investigate inconsistencies between tracheostomy tube position measurements.
Methods: A retrospective study of all pediatric patients
younger than 1 year at the time of procedure who underwent
tracheotomy by the otolaryngology department at our institution between 2014 and 2019 was conducted. Patients were
included if they had both intraoperative measurement of tracheostomy tube position and postoperative chest x-ray within
24 hours of the procedure. The distance from the tip of the
tracheostomy tube to the carina was measured on chest
-anterior-posterior x-ray by an attending radiologist blinded to
the intraoperative measurements.
Results: The study included 66 patients; 30 patients (14:16,
male/female) had available data. The mean distance from the tracheostomy tube tip to the carina measured by tracheoscopy was
8.88 mm (range, 3.5-20 mm) and measured radiographically was
11.71 mm (range, 2.4-23.3 mm). The mean difference between
the measurements was 2.82 mm (95% CI, 0.56-5.086). A paired t
test revealed t = 2.55 (P = .016), which was statistically significant. A Wilcoxon signed-rank test revealed S = 115 (P = .015).
Conclusions: Significant discrepancy exists between intraoperative measurement and x-ray evaluation of tracheostomy tube
position in the pediatric population. Clinical decisions should
mostly rely on intraoperative measurement, and awareness of
overestimation of the distance from the tracheostomy tube tip to
the carina by imaging should be taken into consideration.
Analysis of the Clinical Course of Children
With Initial Negative Polysomnography
Arman Maqsudlu (Presenter); Elizabeth Abraham, MS;
Jessica R. Levi, MD
Objectives: Physicians often obtain polysomnography (PSG)
to rule out positional obstructive sleep apnea (POSA), but it
is unclear whether children with negative PSG tests continue
to not have POSA. The aim of this project was to determine
the clinical course of children with initial negative PSG; we
believe a significant percentage of these children proceed to
POSA over time, and thus should continue to be monitored.
Methods: A retrospective chart review was performed on all
patients who underwent a PSG between October 2012 and
March 2019. An apnea-hypopnea index <2.0 was used as the
cutoff for a negative PSG for this study. Only patients for whom
this was their first PSG, were younger than 18 years at the time
of their initial PSG, and who did not have prior adenoidectomy
or tonsillectomy surgery were included. Data, including demographics, follow-up PSG tests, and surgeries, were collected.
Results: Of the initial 2018 patients undergoing PSG, 535
were negative for POSA and had no prior adenotonsillectomy.
Of those 535, 408 (76.26%) did not obtain follow-up testing
or surgeries, 69 (12.90%) underwent adenotonsillectomy
instead of a repeat PSG, and 58 (10.84%) obtained 1 or multiple follow-up PSG tests. Of these 58, 25 (43.10%) obtained
a repeat PSG that was positive, with 17 of those (29.31% of
58) undergoing subsequent adenotonsillectomy. Thirty-three
of the 58 patients (56.90%) had negative repeat PSG tests.
Conclusions: A sizable percentage of children who initially
tested negative for POSA tested positive on repeat PSG testing. In addition, several other children who tested negative
went on to receive surgery (indicating worsening disease) in
lieu of repeat PSG. A total of 127 (23.7% of 535) patients had
worsening symptoms following a negative initial PSG. Thus,
children with negative PSG should continue to be monitored
for disease progression over time.
Audiological Outcomes in Pediatric Patients
Who Underwent Mastoidectomy for Acute
Coalescent Mastoiditis
Dhruv Sharma, MD (Presenter); Brady Jay Tucker;
Kolin Rubel; William Bennett, MD; Sarah J. Burgin, MD
Objectives: Studies assessing hearing outcomes in pediatric
patients who undergo mastoidectomy for acute mastoiditis
(AM) are absent from the literature.
Pediatric
an affordable anatomic model of the sinuses for both trainee
education and preoperative surgical planning.
Methods: Eleven 3D-printed models of the pediatric sinuses
were created using resin. Six models were used for defining the
frontal outflow pathway. Five additional 3D models were created of upcoming surgical procedures, which included
2 obstructing mucoceles, 2 silent sinus syndromes, and 1 recurrent juvenile ossifying fibroma of the maxilla. The models
were dissected in the laboratory to facilitate surgical planning,
technique, and instrumentation selection. Endoscopic videos
and pictures were taken while performing dissection.
Results: Eleven models were created and dissected to trial
the feasibility of using 3D models for surgical planning, training, and anatomic accuracy. All models were extremely accurate to the actual computed tomography scan that they were
created from. The ethmoid sinuses were the easiest to dissect
and remove bony septations. The consistency of the 3D-printed
models was firmer than true anatomic specimens. The ability
to paint sinonasal pathology and the frontal outflow pathway
was extremely helpful in identifying these structures in the
laboratory and subsequently in the operating room.
Conclusions: The 3D-printed models are a useful tool to
study and plan for uncommon sinonasal pathology. They can
also serve as a useful trainee instrument for learning frontal
sinus anatomy. This feasibility study shows that 3D sinus
models are affordable and accurate in preserving and identifying important anatomic landmarks.
P121
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts
Table of Contents for the Digital Edition of Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts
Contents
Accreditation Information
2020 President Duane J. Taylor, MD
2020 Annual Meeting Program Committee
2020 Star Reviewers
2020 Distinguished Service Award Recipients
2020 Honor Award Recipients
Honorary Guest Lecturers 2020
Panel Presentations
Oral Presentations
Poster Presentations
Author Index
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Intro
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Cover2
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - A1
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - A2
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - A3
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Contents
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - A5
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - A6
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Accreditation Information
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - 2020 President Duane J. Taylor, MD
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - 2020 Annual Meeting Program Committee
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P4
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - 2020 Star Reviewers
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - 2020 Honor Award Recipients
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P7
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Honorary Guest Lecturers 2020
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P9
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Panel Presentations
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P11
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P12
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P13
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P14
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P15
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Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P45
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Oral Presentations
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P47
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P48
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P49
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Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Poster Presentations
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P152
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P153
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Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P272
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P273
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P274
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P275
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P276
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P277
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P278
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P279
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P280
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P281
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P282
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P283
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P284
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P285
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P286
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P287
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P288
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P289
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P290
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P291
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P292
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P293
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P294
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P295
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P296
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P297
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P298
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P299
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P300
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P301
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P302
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P303
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P304
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P305
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P306
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P307
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P308
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P309
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P310
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P311
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P312
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Author Index
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P316
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P317
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P318
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P319
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P320
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P321
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P322
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P323
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P324
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P325
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P326
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P327
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P328
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P329
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P330
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P331
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P332
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Cover3
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Cover4
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