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A New Approach for Diagnosis and Surveillance of Infantile Subglottic Hemangioma in the Era of Propranolol Use: A Case Series

Ezeh, Uche C; Ben-Dov, Tom; Taufique, Zahrah M; Gaffey, Megan M; Blei, Francine; April, Max M
OBJECTIVE/UNASSIGNED:To report our institutional experience in diagnosing and surveilling patients with infantile subglottic hemangioma (SGH) using in-office flexible fiberoptic laryngoscopy (FFL) with video technology, without requiring operative endoscopy in the era of propranolol use. METHODS/UNASSIGNED:A retrospective case series was conducted on 4 children diagnosed with SGH between 2016 and 2022 at our institution. RESULTS/UNASSIGNED:Awake FFL with video technology provided adequate visualization of SGH lesions for diagnosis, without any complications. Serial examinations of the airway were performed in the outpatient setting and each SGH gradually regressed, with marked improvement in respiratory symptoms within 48 hours of oral propranolol initiation. CONCLUSION/UNASSIGNED:Our findings showed that in select patients, FFL with video technology can successfully identify SGH lesions without general anesthesia exposure. FFL may be used as a low-risk screening tool for propranolol therapy initiation in some patients, but operative endoscopy should remain the gold standard procedure for others. By utilizing FFL in this manner, it is possible to diagnose SGH lesions and start propranolol therapy without exposing all patients to the risks of operative endoscopy.
PMID: 37551026
ISSN: 1943-572x
CID: 5619052

Cutaneous hyperpigmentation following bleomycin sclerotherapy for vascular malformations [Case Report]

Davis, Kyle P; Gaffey, Megan M; Kompelli, Anvesh R; Richter, Gresham T
Systemic bleomycin therapy is associated with pulmonary fibrosis and cutaneous side effects. While it is believed that there is little to no systemic distribution of bleomycin when utilized to treat vascular malformations (VMs), we present a case series in which cutaneous, adhesive-related hyperpigmentation suggests that there is systemic egress of bleomycin following direct puncture sclerotherapy (DPS). This risk of hyperpigmentation after intralesional bleomycin should be discussed with patients, and steps to minimize the chances of it occurring should be implemented.
PMID: 34897790
ISSN: 1525-1470
CID: 5082912

Sinus Endoscopic Surgery

Chapter by: Homsi, Marie Therese; Gaffey, Megan M.
in: StatPearls by
Tresure Island FL : StatPearls, 2021
pp. -
CID: 5032182

A novel surgical treatment for posterior glottic stenosis using thyroid ala cartilage - A case report and literature review

Gaffey, Megan M; Sun, Ravi W; Richter, Gresham T
Posterior glottic stenosis (PGS) describes a laryngeal disorder in which worsening degrees of scarring limit abduction of the vocal folds and/or arytenoids. It can be congenital or acquired. Generally, the acquired form is the result of chronic endotracheal tube trauma to the posterior larynx. Symptoms of acquired PGS usually begin four to eight weeks after extubation, and present as gradually worsening stridor and shortness of breath as the laryngeal obstruction becomes more severe. Without intervention, PGS can cause total obstruction and respiratory failure. The mainstay of treatment for PGS is surgery. We present a case in which an infant patient with PGS was treated with a posterior cricoid split and insertion of a thyroid ala graft. The graft was bolstered in place with an appropriately-sized endotracheal tube during a six-day period of postoperative intubation. We report this as a novel surgical approach, as a literature review did not uncover that this technique has been previously described. Our patient has had excellent airway and voice outcomes. His swallow outcomes have been difficult to assess, as the patient has shown signs of global delay.
PMID: 30262350
ISSN: 1872-8464
CID: 3314502

Mandibular Distraction for Micrognathia in a Neonate [Video Recording]

Sun, Ravi W; Gaffey, Megan M; Johnson, Adam B; Hartzell, Larry D
ISSN: 2372-0395
CID: 3292702

Spontaneous cerebrospinal fluid rhinorrhea of the foramen cecum in adulthood [Case Report]

Gaffey, Megan M; Friedel, Mark E; Fatterpekar, Girish M; Liu, James K; Eloy, Jean Anderson
PMID: 22249635
ISSN: 0886-4470
CID: 379342

Nasoseptal cholesterol granuloma: a case report and review of pathogenesis [Case Report]

Kuperan, Arjuna B; Gaffey, Megan M; Langer, Paul D; Mirani, Neena M; Liu, James K; Eloy, Jean Anderson
PMID: 22249636
ISSN: 1538-361x
CID: 3217742