The evidence suggests that for pediatric patients undergoing total thyroidectomy, postoperative admission for serial calcium monitoring and supplementation based on institutional protocol remains best practice.
Imaging Before Velopharyngeal Dysfunction Surgery in Patients with 22qDS?
Routine universal imaging before velopharyngeal dysfunction operations in patients with 22qDS is not recommended. Rather, the surgical technique and careful dissection should be the priority.
Is Prophylactic Peri-Operative Antibiotic Indicated in Cochlear Implantation?
The risk of complications after CI surgery is low, but severity may impact antibiotic prescribing patterns, despite limited evidence. Studies indicate that a single intra-operative dose of antibiotics can prevent post-operative infections in both children and adults, though they have limitations such as retrospective designs and differing surgical practices. Until more randomized controlled trials are conducted, antibiotic use will likely depend on individual provider choice, especially for children who have higher rates of otitis media. Future research should focus on controlled trials at single centers to better understand the role of prophylactic antibiotics in CI surgery.
Management of Pediatric Tracheocutaneous Fistulae
Tracheocutaneous fistulae (TCF) involve a remnant skin tract that connects the external cervical skin with the anterior trachea following decannulation of a tracheostomy tube (TT). Due to the young age at insertion, length of TT dependence, and propensity for removal with aging, persistent pediatric TCF (PPTCF) are more frequent than in adults. Methods of management are varied, and ideal approaches to management are debated.
When Should We Recommend Intracapsular Tonsillectomy in Pediatric Patients?
Intracapsular tonsillectomy is a safe and effective method for performing tonsillectomy and should be included in future clinical practice guidelines for tonsillectomy.
Laryngeal Reinnervation Is Recommended Surgical Intervention for Pediatric Unilateral Vocal Fold Paralysis
Laryngeal reinnervation should be offered to all patients independent of patient age or duration of denervation, as it can improve voice and swallowing. Long-term denervation, however, may result in a smaller degree of improvement.
Is There a Role for Adjuvant Therapy in Patients with Large Juvenile Nasopharyngeal Angiofibromas?
Adjuvant therapy may have a limited role in select patients with advanced JNAs to achieve acceptable outcomes while minimizing serious morbidity and mortality.
Repair of Type 1 Laryngeal Cleft
There is significant debate in the literature on diagnosis and the ideal approach to treatment when sequelae are present with congenetial laryngal cleft.
Videofluoroscopic Swallow Study and Fiberoptic Endoscopic Evaluation of Swallow—Which Is Superior?
Accurate assessment of the safety of oral feeds is essential in the pediatric population to avoid the risks of unsafe feeding or unnecessary restrictions.
When is the Optimal Time to Reduce Pediatric Nasal Bone Fractures?
Historically, nasal fractures have been reduced within seven days as pediatric patients are thought to undergo rapid osseous healing. Delayed nasal fracture reduction, however, allows soft tissue edema to abate, potentially aiding intraoperative result assessment.
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