Objectives/Hypothesis: Infantile vocal cord paralysis (VCP) is an uncommon but potentially dangerous condition with a significant potential for both short and long-term deleterious sequelae. Our objectives were to utilize a population-based resource to characterize hospitalized children with VCP. Furthermore, we compare these characteristics between live born infants and infants subsequently readmitted and discharged with VCP. Study Design: Cross Sectional Study of Pediatric Hospital Admission during the years 2006, 2009, and 2012. Methods: The study examined inpatient admissions for pediatric patients with VC Pusing the Kids ́ Inpatient Database (KID), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality. Infants (age ≤ 3 years old) with VCP were characterized with respect to demographics and outcomes. Results: An estimated 8,527 (0.06%) infants were diagnosed with VCP during their hospitalization. Of these hospitalizations, 10.1% were live born. The majority was male (52%) and Caucasian (51%). Unilateral VCP was most common (51.5%). Patients with VCP were significantly more likely to have associated intrauterine and birth co-morbidities. Concurrent neurologic and cardiac congenital anomalies were also more common. Tracheostomy was more common, even among newborns with unilateral immobility. Conclusions: VCP is one of the most common causes of pediatric airway obstruction. Patients identified at birth have worse outcomes, specifically in terms of intubation requirements and more complicated hospital courses, compared to those diagnosed on subsequent hospitalizations. Continued inquiry into natural history, particularly among newborns, is indicated The Journal of Laryngology, Rhinology & Otology [2018; 1(1): 33-41] Citation: Sheyn A, Svider PF, Stocks R and Johnson RF. Infant vocal cord paralysis: A population-based perspective. The Journal of Laryngology, Rhinology & Otology [2018] 1(1): 33-41. Research Article Level of Evidence: Level II observation study
OBJECTIVES:To examine the national rates of complications, readmission, reoperation, death and length of hospital stay after laryngectomy. To explore the risks of neck dissection with laryngectomy using outcomes.METHODS:The American College of Surgeons National Quality Improvement Program (ACS-NSQIP) database was reviewed retrospectively. The database was analyzed for patients undergoing laryngectomy with and without neck dissection. Demographic, perioperative complication, reoperation, readmission, and death variables were analyzed.RESULTS:754 patients who underwent total laryngectomy during this time were found. Demographic analysis showed average age was 63 years old, 566 (75.1%) were white, and 598 (79.3%) were male. Of these patients, 520 (69.0%) included a neck dissection while 234 (31.0%) did not. When comparing patients who received a neck dissection to those who did not, there were no significant differences in median length of hospital stay (12.5 days w/vs. 13.3 days w/o, P = 0.99), rates of complication (40% w/vs. 35% w/o, P = 0.23), reoperation (13.5% w/vs. 14% w/o, P = 0.81), readmission (14% w/vs. 18% w/o, P = 0.27), and death (1.3% w/vs. 1.3% w/o, P > 0.99). Furthermore, neck dissection did not increase the risk of complication (P = 0.23), readmission (P = 0.27), reoperation (P = 0.81), death (P = 0.94), or lengthened hospital stay (P = 0.38).CONCLUSIONS:Concurrent neck dissection does not increase postoperative morbidity or mortality in patients undergoing total laryngectomies. These results may help physicians make decisions regarding concurrent neck dissection with total laryngectomy.
s—• TONSILS.—Bacillus Tuberculosis in the Tonsils of Children clinically Nontuberculous. — Mechanical and Physiological Considerations in Tonsillectomy.—Anterior Dislocation of Atlas following Tonsillectomy.—Some Clinical Observations on the Lingual Tonsil concerning Goitre, Glossodynia and Focal Infections 187 EAR.—A Study of the Aural Complications of the Recent Influenza Epidemic with Special Reference to the Clinical Picture.—Severe and Uncontrollable Hoemorrhage following Mastoidectomy in a Patient Suffering from Purpura ... ... ... ... 189 MISCELLANEOUS.—The Bacteriology of Mumps ... 191 Notes and Queries 192 INSTRUMENTS AND EQUIPMENT for Examination of Ear, Nose and Throat, Operation on Tonsils, Adenoids, Mastoid, Nasal Septum, As supplied to and used in EAR, NOSE AND THROAT DEPARTMENT, ROYAL INFIRMARY, EDINBURGH, THE EDINBURGH EYE, EAR AND THROAT INFIRMARY, ETC., ETC. ARCHD. YOUNG & SON, 57-61, Forrest Rd., EDINBURGH. Surgical Instrument Makers to Royal Infirmary, Edinburgh. 'Phone : Central 669. Telegrams: " Bandage, Edinburgh," A.B.C. Code, 5th Ed.
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hypaesthesia, hyperaesthesia, paraesthesia; Mouravjeff, described the occurrence of fat granules in the posterior roots at their entrance into the cord, the condition described is probably a normal condition commonly present in ; children, and to a lesser degree in adults. In conclusion, the author regards the dominant lesion in diphtheritic paralysis as a parenchymatous ' degeneration of the myelin sheath affecting both sensory and motor elements.
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