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.
Intracapsular tonsillectomy is a safe and effective method for performing tonsillectomy and should be included in future clinical practice guidelines for tonsillectomy.
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.
Adjuvant therapy may have a limited role in select patients with advanced JNAs to achieve acceptable outcomes while minimizing serious morbidity and mortality.
There is significant debate in the literature on diagnosis and the ideal approach to treatment when sequelae are present with congenetial laryngal cleft.
Accurate assessment of the safety of oral feeds is essential in the pediatric population to avoid the risks of unsafe feeding or unnecessary restrictions.
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.
Genetic testing should be considered when the most common nongenetic causes (congenital cytomegalovirus, negative imaging for structural inner ear, or cochlear nerve abnormality) are ruled out as subtle phenotypic manifestations of syndromic hearing loss.
The gold standard in the evaluation of VFI in children is awake flexible fiberoptic laryngoscopy (FFL) but over the past decade, ultrasound (US) has gained increasing attention as a modality for assessing vocal fold mobility in children.
Currently, there are no guidelines for the management of retained tubes in asymptomatic patients. Should they be removed?