Faculty Bibliography

OBJECTIVES/UNASSIGNED:This ASPO survey investigates pediatric peri-operative tracheostomy care practices through a nationwide survey. It aims to identify challenges, explore opportunities for standardization across institutions, and recommend strategies that could reduce complications and enhance patient care. METHODS/UNASSIGNED:A 19-question survey was administered online to pediatric otolaryngologists. Descriptive statistics summarized respondent demographics and responses. RESULTS/UNASSIGNED:Of 138 respondents, 90% practiced in the US, primarily in the Mid-Atlantic and Great Lakes. Over 60% performed fewer than 10 pediatric tracheostomies annually. A majority (98%) used stay sutures for accidental decannulation, and 25% did not mature the stoma. Notably, 92% adhered to standardized post-operative protocols. Bivona tracheostomy tubes were most commonly used (72%). First tube changes were typically on postoperative Days 5 and 7, with false passage creation (46%) and bleeding (41%) as primary complications. Routine surveillance bronchoscopy was conducted by 63%, mainly twice in the first year (34%). CONCLUSION/UNASSIGNED:The survey highlights wide variation in pediatric tracheostomy practices and underscores the importance of standardized protocols. Most respondents perform fewer than 10 procedures each year, yet adherence to institutional guidelines reflects a strong commitment to safety. This study identifies key areas of variability such as the timing of the first tube change, use of surveillance bronchoscopy, and reported complications-and outlines opportunities for further research and standardization aimed at improving consistency and clinical outcomes. LEVEL OF EVIDENCE/UNASSIGNED:5.

OBJECTIVE(S)/OBJECTIVE:Previous literature has established a high prevalence of upper airway obstruction in children with craniofacial abnormalities. This study aims to perform quantitative airway volume measurements in patients with craniofacial abnormalities and compare them to age and sex-matched controls. METHODS:We performed a retrospective review of the records of all children with craniofacial abnormalities who underwent head-and-neck computed tomography (CT) imaging at a single tertiary-care center between 1/1/13 and 12/31/20 using the ICD-10 codes Q75.1, Q75.4, and Q87.0. These patients were then matched by age and sex to patients with isolated craniosynostosis (Q75.0). CT scans were imported into Dolphin Imaging software, and airway volumes were measured for the nasal cavity, nasopharynx, oropharynx, and hypopharynx. The primary outcome was the total airway volume, defined as the sum of these measurements. RESULTS:Thirty subjects with craniofacial syndromes were matched to 30 patients with isolated craniosynostosis (controls). In both groups, 18 subjects (60%) were male (p = 0.99). The average ages for syndromic patients and controls were 12.1 and 12.9 months, respectively (p = 0.84). On average, the total airway volumes of syndromic patients were 25% lower than those of controls (p = 0.02). Syndromic patients had 39% smaller nasal cavity volumes (p < 0.001) and 32% smaller nasopharyngeal volumes (p < 0.01). Significant volume differences were not observed for the oropharynx or hypopharynx. CONCLUSION/CONCLUSIONS:We present a unique technique to measure airway volumes in patients with craniofacial abnormalities. These findings will help practitioners to further understand the anatomy and pathophysiology of disturbed breathing in children with craniofacial syndromes. LEVEL OF EVIDENCE/METHODS:III Laryngoscope, 2023.