A Prospective Assessment of Nasopharyngolaryngoscope Recording Adaptor Use in Residency Training.

Flexible fiberoptic nasopharyngolaryngoscope (FN) examinations are important to the practice of otolaryngology (ENT). We sought to assess whether a portable recording adaptor for the FN can enhance resident learning and improve patient management. The adaptor was used prospectively on consultations by first- and second-year ENT residents, and changes in diagnosis and management were recorded in the patient care workflow. In 43 patients, we found a 23% change in diagnosis, 44% change in management, and 19% change in surgical management after an attending reviewed recorded videos. Residents and attendings reported that discussing the video enhanced learning in 88% and 81% of cases, respectively. A portable FN recording adaptor has the potential to improve resident training and perhaps lead to more prompt health care delivery.

Thyroglossal duct papillary carcinoma in a 15-year old female and review of pediatric cases of thyroglossal duct carcinoma.

Thyroglossal duct carcinoma is rare, occurring in approximately 1% of thyroglossal duct cysts. Excluding this case report there have been 25 cases of adolescent thyroglossal duct carcinoma reported in the English literature thus far. Most of the pathology reported has been papillary or follicular carcinoma, leading to the question of whether or not to perform concurrent thyroidectomy. Based on our review of the pediatric cases of thyroglossal duct carcinoma we elected not to perform a concurrent thyroidectomy and recommend close follow-up to monitor for signs of future thyroid involvement.

Characteristics of pilomatrixoma in children: a review of 137 patients.

OBJECTIVE: To describe our institutional experience with pilomatrixoma in the pediatric population, specifically examining its clinical presentation, associated conditions, surgical treatment and future implications. METHODS: This is a retrospective review of a single tertiary care center. Subjects included 137 patients with diagnosis of pilomatrixoma between the years of 2000 and 2013 up to the age of 19. Patient gender, age at excision, number of tumors, tumor size, tumor location, preoperative diagnosis, recurrence, patient race and zip code, along with associated medical conditions were assessed. RESULTS: There were a total of 174 tumors in 137 patients. The median age at excision was 7.1 years old, with the youngest patient at 6 months and the oldest at 19 years. Head and neck tumors predominated with 70% (n=122) of all pilomatrixomas, followed by the upper extremity with 22% (38). Other locations included the hair-bearing back, chest and lower extremities. A male to female ration of 1:1.2 was observed. Tumor diameter size ranged from 0.2 to 5.2 cm with an average diameter of 1.4 cm. There were no cases of recurrence. Associated diagnoses included Turner syndrome and Sticker syndrome. CONCLUSIONS: Pilomatrixoma, previously thought to be a rare lesion, is one of the most common causes of superficial head and neck masses in children. This study demonstrates clinical presentations that should help guide differential diagnoses. We demonstrate associations that are consistent with the proposed pathophysiology of pilomatrixoma. Surgical excision is curative.

Management of congenital muscular torticollis in a child: a case report and review.

Congenital muscular torticollis is a condition in which the sternocleidomastoid muscle is shortened on the involved side, leading to an ipsilateral tilt of the head and a contralateral rotation of the face and chin. Most of these patients present in infancy and are successfully treated with physical therapy. Occasionally, patients present in childhood at which time conservative management is rarely successful. Here we present a child with torticollis who was successfully managed with a unipolar release of the sternocleidomastoid. We then review the epidemiology, proposed etiologies, and various treatment options for torticollis and their rates of success.

Disk battery aspiration in a young child: a scarcely reported phenomenon.

Disk (or button) battery ingestion is not uncommon, with an estimated US incidence of 2 to 8 per million annually.(1) Reported serious adverse sequelae include esophageal stenosis, tracheoesophageal fistula, vocal cord paralysis, massive bleeding, and death.(1,2) There are, however, surprisingly few reports of aspirated batteries in the searchable literature; we found only 2. We present the diagnostic workup and treatment of a previously healthy 4-year-old boy with an aspirated disk battery in the bronchus.