September 2019 HSC Section 1 Congenital and Pediatric Problems

Dao AM, Goudy SL. Cleft palate repair, gingivoperiosteoplasty, and alveolar bone grafting. Facial Plast Surg Clin North Am . 2016; 24(4):467-476. EBM level 4..................................................75-84

Summary : This is a review that covers the etiology, techniques, and timing for assessing and planning surgical management of cleft alveolus and palate repair. The authors introduce the genetics and embryology of palate formation. They then describe the feeding and airway issues that may be present at birth. Last, they describe the appropriate timing and management of surgical approaches and what to do when there are complications. Gupta A, Svider PF, Rayess H, et al. Pediatric rhinoplasty: a discussion of perioperative considerations and systematic review. Int J Pediatr Otorhinolaryngol . 2017; 92:11-16. EBM level 1............................................................................................................................................85-90 Summary : This is a systematic review comparing 7 studies with a total of 253 patients to evaluate perioperative and postoperative outcomes. They compared the age and indication for surgery and how the surgery was performed. They noted the type of cartilage used for nasal reconstruction. Comparison of postoperative outcomes demonstrated that younger age at surgery may affect the revision rate for rhinoplasty. Manteghi A, Din H, Bundogji N, Leuin SC. Pediatric septoplasty and functional septorhinoplasty: a quality of life outcome study. Int J Pediatr Otorhinolaryngol . 2018; 111:16-20. EBM level 2............................................................................................................................................91-95 Summary : This is a prospective evaluation of pediatric patients undergoing septoplasty vs functional septorhinoplasty (FSR) to address nasal obstruction. The patients self-reported nasal function score was compared using the NOSE QOL survey. In this paper, the authors describe the improvements associated with septoplasty alone compared to FSR and the associated complications. Adenotonsillar Disease and Sleep Disorders Baker M, Scott B, Johnson RF, Mitchell RB. Predictors of obstructive sleep apnea severity in adolescents. JAMA Otolaryngol Head Neck Surg . 2017; 143(5):494-499. EBM level 4........96-101 Summary : Using a retrospective uncontrolled case series design, this study correlates demographics and clinical characteristics with the apnea-hypopnea index severity in adolescents. Male gender, body mass index z-score, and tonsillar hypertrophy were significantly associated with severe sleep apnea as measured by the apnea-hypopnea index. A low threshold for obtaining overnight polysomnography should be applied to obese, adolescent males with tonsillar hypertrophy and symptoms of obstructive sleep-disordered breathing.

IV.