Trends in papillary thyroid carcinoma among U.S. Youth ages 10–19: A SEER database analysis

International Journal of Pediatric Otorhinolaryngology · 2025-06-21 · 2 citations

PURPOSE: This study aimed to evaluate trends in pediatric papillary thyroid carcinoma from 1975 to 2021, and to propose potential drivers of the observed trends via stratification by demographic characteristics. METHODS: A retrospective analysis was conducted of thyroid carcinoma cases in the Surveillance, Epidemiology, and End Results database for pediatric patients aged 10-19 years. Joinpoint Regression was used to identify significant changes in trends, calculating annual percent change and confidence intervals, stratified by sex, age, race/ethnicity, household income, and rural-urban continuum levels, with a null hypothesis of no change in incidence over time (ɑ = 0.05). Incidence rates were age-adjusted to the 2020 U S. standard population and household income was inflation-adjusted to 2022 U S. dollars. RESULTS: Among 2117 cases, 79.5 % were female and 76.3 % were aged 15-19. The Joinpoint regression model demonstrated that incidence per 100,000 among females aged 15-19 rose significantly from 2006 to 2012 (annual percent change = 9.61 %, p < 0.05) but declined significantly from 2012 to 2021 (annual percent change = -3.60 %, p < 0.05). Declines were observed across income levels and geographic regions, but racial disparities persisted, with non-Hispanic White females showing a decrease, while rates for Hispanic females continued to rise. CONCLUSIONS: Papillary thyroid carcinoma incidence among females aged 15-18 has declined significantly since 2012, the opposite of prior trends. Continued monitoring and further research are needed to understand these trends, including whether the observed decline may reflect changes in diagnostic practices or risk factor exposures.

Preoperative Rehearsal in the Removal of an Airway Foreign Body in a Preterm Septic Neonate

Case Reports in Otolaryngology · 2025-01-01

We report a case of a septic, 21 day old, former 26-week neonate who had clinical and x-ray concern for an airway foreign body. 3D CT remodeling was used to identify the foreign body as the tip of a suction catheter. Preoperative planning to confirm optimal bronchoscopic instrumentation was done, and the foreign body was successfully removed in a single attempt. This case highlights the importance of preoperative radiographic evaluation and instrument rehearsal in high-risk airway foreign body cases.

Value of Imaging Measurements in Micrognathia‐Related Fetal Airway Obstruction Within a Fetal Center

The Laryngoscope · 2024-09-06 · 1 citations

OBJECTIVE: Fetal imaging often identifies signs of upper airway obstruction due to micrognathia that may require airway intervention at delivery. This study investigated the role of quantitative fetal imaging measurements in predicting the need for otolaryngology consultation and intervention within a multidisciplinary Fetal Center. METHODS: Data were retrospectively collected from expectant mothers attending a multidisciplinary Fetal Center from January 2017 to October 2023. Cases of fetal micrognathia associated with potential upper airway obstruction were analyzed, focusing on prenatal ultrasound and magnetic resonance imaging (MRI) findings, genetic testing results, and interventions at birth. RESULTS: Among 25 pregnancies identified, diverse prenatal diagnoses were observed. Post hoc quantitative fetal ultrasound/MRI measurements included inferior facial angle, anteroposterior diameter, biparietal distance, and Jaw Index. Otolaryngology teams were present at delivery for a subset of cases, with various interventions performed, including tracheostomy and intubation. Lower gestational age at birth, rather than more severe quantitative measurements, was associated with the need for intervention. Intubation failure due to airway difficulty was also predicted by lower gestational age. CONCLUSION: While certain quantitative fetal imaging measurements are often used for clinical decision-making regarding airway management at birth, they did not clearly predict the need for airway intervention in our sample. Gestational age is an important consideration in decision-making for fetal teams and should be considered in preterm fetuses to plan for airway difficulties. The findings highlight the complexity of fetal micrognathia management and highlight the need for further research to refine predictive models and optimize clinical decision-making in this challenging clinical scenario. LEVEL OF EVIDENCE: 3 Laryngoscope, 135:393-401, 2025.

Comparing ATA guidelines vs TI-RADS for evaluation of pediatric thyroid lesions

International Journal of Pediatric Otorhinolaryngology · 2022-12-12 · 7 citations

Combined transnasal/transoral endoscopic odontoid resection in pediatric patients: Otolaryngologic considerations to airway management, endoscopic exposure, and complication management

International Journal of Pediatric Otorhinolaryngology · 2022-11-02 · 2 citations

Contributors

Elsevier eBooks · 2021-01-01

Endoscopic transnasal/transoral odontoid resection in children: results of a combined neurosurgical and otolaryngological protocolized, institutional approach

Journal of Neurosurgery Pediatrics · 2021 · 8 citations

• Medicine
• Surgery
• Anesthesia

OBJECTIVE: Odontogenic ventral brainstem compression can be a source of significant morbidity in patients with craniocervical disease. The most common methods for odontoidectomy are the transoral and endoscopic endonasal routes. In this study, the authors investigated the use of an institutional protocol for endoscopic transnasal/transoral odontoidectomy in the pediatric population. METHODS: From 2007 to 2017, a multidisciplinary institutional protocol was developed and refined for the evaluation and treatment of pediatric patients requiring odontoidectomy. Preoperative assessment included airway evaluation, a sleep study (if indicated), discussion of possible tonsillectomy/adenoidectomy, and thorough imaging review by the neurosurgery and otolaryngology teams. Further preoperative anesthesia consultation was obtained for difficult airways. Intraoperatively, adenoidectomy was performed at the discretion of otolaryngology. The odontoidectomy was performed as a combined procedure. Primary posterior pharyngeal closure was performed by the otolaryngologist. The postoperative protocol called for immediate extubation, advancement to a soft diet at 24 hours, and no postoperative antibiotics. Outcome variables included time to extubation, operative time, estimated blood loss, hospital length of stay, and postoperative complications. RESULTS: A total of 13 patients underwent combined endoscopic transoral/transnasal odontoid resection with at least 3 years of follow-up. All patients had stable to improved neurological function in the postoperative setting. All patients were extubated immediately after the procedure. The average operative length was 201 ± 46 minutes, and the average estimated blood loss was 44.6 ± 40.0 ml. Nine of 13 patients underwent simultaneous tonsillectomy and adenoidectomy. The average hospital length of stay was 6.6 ± 5 days. The first patient in the series required revision surgery for removal of a small residual odontoid. One patient experienced pharyngeal flap dehiscence requiring revision. CONCLUSIONS: A protocolized, institutional approach for endoscopic transoral/transnasal odontoidectomy is described. The use of a combined, multidisciplinary approach leads to streamlined patient management and favorable outcomes in this complex patient population.

Vascular Anomalies of the Head and Neck

Elsevier eBooks · 2021-01-01

Radiofrequency Ablation vs Electrocautery Blinded Randomized Trial: Impact on Clinically Meaningful Outcomes

Otolaryngology · 2020 · 4 citations

• Medicine
• Anesthesia
• Surgery

OBJECTIVE: To analyze patients' return to normal activity, pain scores, narcotic use, and adverse events after undergoing tonsillectomy or adenotonsillectomy with monopolar electrocautery or radiofrequency ablation. STUDY DESIGN: Randomized double-blinded clinical trial based on prospective parallel design. SETTING: Academic medical center and tertiary children's hospital between March 2018 and July 2019. METHODS: Inclusion criteria included patients aged ≥3 years with surgical indication of recurrent tonsillitis or airway obstruction/sleep-disordered breathing. Patients were randomly assigned to monopolar electrocautery or radiofrequency ablation. Patients were blinded to treatment assignment. Survey questions answered via text or email were collected daily until postoperative day 15. The primary outcome was the patient's return to normal activity. Secondary outcomes included daily pain score, total amount of postoperative narcotic use, and adverse events. RESULTS: = .13). CONCLUSIONS: As one of the largest randomized controlled trials examining instrumentation in tonsillectomy, our data do not show a difference between monopolar electrocautery and radiofrequency ablation with regard to return to normal activity, daily pain scores, total postoperative narcotic use, or adverse events.

Expanding the clinical and molecular findings in RASA1 capillary malformation-arteriovenous malformation

European Journal of Human Genetics · 2018-06-11 · 74 citations