The Laryngoscope最新文献

{"title":"Influences of GABAergic Inhibition in the Dorsal Medulla on Contralateral Swallowing Neurons in Rats.","authors":"Shota Kinoshita, Yoichiro Sugiyama, Keiko Hashimoto, Shinya Fuse, Shigeyuki Mukudai, Toshiro Umezaki, Mathias Dutschmann, Shigeru Hirano","doi":"10.1002/lary.29242","DOIUrl":"https://doi.org/10.1002/lary.29242","url":null,"abstract":"We aimed to examine the effect of unilateral inhibition of the medullary dorsal swallowing networks on the activities of swallowing‐related cranial motor nerves and swallowing interneurons.","PeriodicalId":400976,"journal":{"name":"The Laryngoscope","volume":" ","pages":"2187-2198"},"PeriodicalIF":2.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/lary.29242","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38565354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Transverse Cordotomy- Anteromedial Arytenoidectomy for Isolated Glottic Stenosis.","authors":"Ameer Ghodke,&nbsp;Lauren F Tracy,&nbsp;Alison Hollis,&nbsp;Katherine Adams,&nbsp;Rupali N Shah,&nbsp;Robert A Buckmire","doi":"10.1002/lary.29438","DOIUrl":"https://doi.org/10.1002/lary.29438","url":null,"abstract":"<p><strong>Objectives/hypothesis: </strong>Glottic stenosis is a discrete cause of airway compromise. We aimed to determine the surgical outcomes of transverse cordotomy with anteromedial arytenoidectomy (TCAMA), performed in the setting of isolated glottic stenosis resulting from two discrete etiologies: bilateral vocal fold paralysis (BVFP) and posterior glottic stenosis (PGS).</p><p><strong>Study design: </strong>Retrospective, analytic cohort study.</p><p><strong>Methods: </strong>Twenty-six patients with isolated glottic stenosis were treated with TCAMA between 2006 and 2019. A retrospective analysis determined decannulation rates and intervals, voice outcomes, swallowing outcomes, and reoperation rates postoperatively. Outcomes between the two etiologic cohorts were compared.</p><p><strong>Results: </strong>Of the 26 patients, 16/26 patients were diagnosed with PGS and 10/26 with BVFP. Eighteen patients required tracheotomies during their clinical course (11/16 PGS, and 7/10 BVFP), and 100% were ultimately decannulated. The PGS cohort required two-sided interventions more frequently than the BVFP cohort (45.5% vs. 0%, P = .066). Trach-dependent PGS patients required a longer time to achieve decannulation than BVFP patients by a factor of 2.38, although the difference was not statistically significant (102.3 days vs. 42.9 days, respectively, P = .113). Patients demonstrated a significant change in maximum phonation time but no statistically significant differences with preoperative versus postoperative voice outcomes like voice-related quality of life. All patients ultimately returned to their baseline swallow function postoperatively.</p><p><strong>Conclusion: </strong>TCAMA is an effective treatment for surgical rehabilitation of glottic stenosis caused by both BVFP and PGS. Patient-reported outcomes of postoperative vocal function remain consistent following surgical intervention. Additional, prospective studies with greater power are warranted to validate the contrasting outcomes observed when applying this discrete surgical technique across two distinct diagnostic cohorts in this retrospective study.</p><p><strong>Level of evidence: </strong>4. Laryngoscope, 131:2305-2311, 2021.</p>","PeriodicalId":400976,"journal":{"name":"The Laryngoscope","volume":" ","pages":"2305-2311"},"PeriodicalIF":2.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/lary.29438","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25362265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term Oral Steroids Significantly Improves Chronic Rhinosinusitis Without Nasal Polyps.","authors":"April P De Silva,&nbsp;Mark A Schembri,&nbsp;Angus H Sarah,&nbsp;Jessica Chao,&nbsp;Kwok Ho Yip,&nbsp;Gökhan Cildir,&nbsp;Angel Lopez,&nbsp;Damon J Tumes,&nbsp;Harshita Pant","doi":"10.1002/lary.29495","DOIUrl":"https://doi.org/10.1002/lary.29495","url":null,"abstract":"<p><strong>Objectives/hypothesis: </strong>The efficacy of short-term oral corticosteroids in chronic rhinosinusitis without nasal polyps (CRSsNP) is unknown. The aim of this controlled study was to assess the immediate and long-term outcomes from a short course of a commonly used oral corticosteroid, prednisolone, in well-defined CRSsNP patients.</p><p><strong>Study design: </strong>Prospective, observational controlled study.</p><p><strong>Methods: </strong>A prospective-controlled study of CRSsNP patients treated with prednisolone at 0.5 mg/kg tapered over 10 days and non-prednisolone treated CRSsNP patients (controls) and follow-up at 2, 6, and 12 months. Baseline and follow-up SinoNasal Outcome Test (SNOT)-22, nasal endoscopy (Lund-Kennedy), and sinus CT scan scores (Lund-Mackay) were compared.</p><p><strong>Results: </strong>At 2 months, there was a significant improvement in the SNOT-22, nasal endoscopy, and sinus CT scan scores in the prednisolone group (P < .0001) compared with controls (p = ns, Mann-Whitney U test). 52.5% of prednisolone-treated CRSsNP patients had improved symptoms and did not require sinus surgery at 12 months compared with 14.3% of controls (P < .001). Side-effects were reported in 8.9% of prednisolone-treated patients. Patients who benefited from prednisolone had a median symptom duration of 7.25 (99% confidence, upper limit of 11) months compared with 18 months in those requiring surgery.</p><p><strong>Conclusions: </strong>Short-term oral prednisolone significantly improved all three clinical measures of disease in CRSsNP patients and avoided surgical intervention in 52.5% patients in the first 12 months. Patients with symptoms for less than 11 months were most likely to benefit. The side-effects of oral steroids require careful consideration and further studies are needed to ascertain appropriate dosage and treatment duration.</p><p><strong>Level of evidence: </strong>3 Laryngoscope, 131:E2618-E2626, 2021.</p>","PeriodicalId":400976,"journal":{"name":"The Laryngoscope","volume":" ","pages":"E2618-E2626"},"PeriodicalIF":2.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/lary.29495","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25435845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adenotonsillectomy Does not Alter the Risk of Upper Airway Infections in Children.","authors":"Jong-Yeup Kim,&nbsp;Inseok Ko,&nbsp;Dong-Kyu Kim,&nbsp;Myeong Sang Yu","doi":"10.1002/lary.29506","DOIUrl":"https://doi.org/10.1002/lary.29506","url":null,"abstract":"<p><strong>Objective: </strong>Given the conflicting evidence regarding adenotonsillectomy and the risk of upper airway infections (UAIs), including acute pharyngitis (APT), rhinosinusitis (ARS), and otitis media (AOM), we evaluated the risk of developing UAIs following adenotonsillectomy in a childhood population.</p><p><strong>Methods: </strong>In this population-based follow-up study, we used data from the National Health Insurance Service-National Sample Cohort. The adenotonsillectomy group (n = 2,377) included patients aged <10 years who underwent an adenotonsillectomy. For every patient with APT (n = 2,309), ARS (n = 2,308), and AOM (n = 2,207) who had an adenotonsillectomy, four participants were randomly selected for the control groups (n = 9,204, n = 9,196, and n = 8,788, respectively) using propensity score matching. The number of postoperative hospital visits for UAIs was recorded for 1 to 9 years, and the equivalence test was used to compare the number of visits between the adenotonsillectomy and control groups.</p><p><strong>Results: </strong>There were no significant differences in the incidence of APT, ARS, or AOM at the margin of equivalence of difference (-0.5 < 95% confidence interval of difference < 0.5) between the two groups from postoperative year 1 to year 9. The hospital visits for these diseases gradually decreased over time in both groups. There was a significant decrease in the number of visits for APT, ARS, and AOM in the 5-9 years age group when compared with those in the <4 years age group (P < .01).</p><p><strong>Conclusion: </strong>Our results suggest that adenotonsillectomy does not alter the frequency of UAIs in children.</p><p><strong>Level of evidence: </strong>NA Laryngoscope, 131:2376-2383, 2021.</p>","PeriodicalId":400976,"journal":{"name":"The Laryngoscope","volume":" ","pages":"2376-2383"},"PeriodicalIF":2.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/lary.29506","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25479591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic, comorbidity, lifestyle, and quality of life comparisons between chronic rhinosinusitis phenotypes.","authors":"Carl Philpott,&nbsp;Ngan Hong Ta,&nbsp;Claire Hopkins,&nbsp;Jaydip Ray,&nbsp;Shazhada Ahmed,&nbsp;Robert Almeyda,&nbsp;Naveed Kara,&nbsp;Sean Carrie,&nbsp;Sally E Erskine,&nbsp;Russell Cathcart,&nbsp;Vishnu Sunkaraneni,&nbsp;Alasdair Robertson,&nbsp;Shahram Anari,&nbsp;Balasubrahmanyam Nirmal Kumar,&nbsp;Allan Clark","doi":"10.1002/lary.29527","DOIUrl":"https://doi.org/10.1002/lary.29527","url":null,"abstract":"<p><strong>Background: </strong>Chronic rhinosinusitis (CRS) is a heterogeneous group of inflammatory sinonasal disorders with key defining symptoms, but traditionally separated into phenotypes by clinical/endoscopic findings. It is not known whether the two phenotypes have differing socioeconomic, comorbidity, and lifestyle differences. This analysis of the Chronic Rhinosinusitis Epidemiology Study (CRES) database sought to analyze any key differences in the socioeconomic variables between those with CRS with nasal polyps (CRSwNPs) and those without nasal polyps (CRSsNPs). We also sought to analyze differences in comorbidities, lifestyle, and quality of life.</p><p><strong>Methods: </strong>Patients with a confirmed diagnosis of CRS in secondary and tertiary care outpatient settings in the UK were invited to participate in a questionnaire-based case-control study. Variables included demographics, socioeconomic factors, comorbidities, lifestyle factors, and health-related quality of life (HRQoL) (level 3 evidence).</p><p><strong>Results: </strong>A total of 1204 patients' data were analyzed: 553 CRSsNP and 651 CRSwNP participants. The key socioeconomic variables did not demonstrate any notable differences, nor did lifestyle variables other than alcohol consumption being higher in those with CRSwNP (P = .032), but the latter was not significant after adjusting for age and sex. Aside from confirmation of asthma being more common in CRSwNP, it was notable that this group complained less of upper respiratory tract infections (URTIs), and CRSsNP participants showed evidence of worse HRQoL scores in respect of body pain (P = .001).</p><p><strong>Conclusions: </strong>Patients with CRSwNP experience higher rates of asthma and lower rates of URTIs; patients with CRSsNP have worse body pain scores. Otherwise, there are no demonstrable significant socioeconomic, comorbidity, lifestyle, or quality of life differences between the two phenotypes.</p><p><strong>Level of evidence: </strong>3 Laryngoscope, 131:2179-2186, 2021.</p>","PeriodicalId":400976,"journal":{"name":"The Laryngoscope","volume":" ","pages":"2179-2186"},"PeriodicalIF":2.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/lary.29527","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25521007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing Decisional Conflict in Patients Presenting to Sleep Surgery Clinic and an Exploration of Resource Limitations.","authors":"Arushi Gulati,&nbsp;Erika M Stephens,&nbsp;Yi Cai,&nbsp;Jolie L Chang","doi":"10.1002/lary.29695","DOIUrl":"https://doi.org/10.1002/lary.29695","url":null,"abstract":"<p><strong>Objectives: </strong>Numerous therapies exist for adult obstructive sleep apnea (OSA), creating potential for patient decisional conflict (DC) that impacts treatment adherence and post-treatment regret. We evaluated the prevalence of elevated DC in OSA patients presenting for positive airway pressure (PAP) alternative therapies and identified gaps in available resources about OSA therapies.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>A cross-sectional study was performed based on questionnaires completed by adult OSA patients presenting to an academic sleep surgery clinic from March to October 2020. Surveys examined sleep symptoms, sleep apnea treatment history, goals of therapy, and the SURE checklist, a validated 4-item DC screening scale. Additional qualitative data about OSA decision tool needs were queried with structured interviews in a smaller subset of patients.</p><p><strong>Results: </strong>Among 100 respondents, 60 were open to multiple treatment options, whereas 22 were not interested in surgical treatment. Eighty-one respondents (81%) had elevated DC (SURE score < 4). High DC was not associated with CPAP history, OSA severity, or daytime sleepiness (Epworth Sleepiness Scale score ≥ 10). Elevated DC was related to uncertainty regarding optimal treatment choice in 54% of respondents (n = 54), and lack of knowledge regarding risks and benefits of each treatment option in 71% (n = 71). Common themes identified in 9 interviewed patients suggested helpful resources should ideally compare treatment modalities and educate on surgery details, efficacy, and recovery.</p><p><strong>Conclusions: </strong>The majority of OSA patients presenting to sleep surgery clinics have elevated decisional conflict influenced by limited knowledge about options and the risks and benefits of each therapy. There is a need for decision tools that can reduce decisional conflict and promote equitable knowledge about PAP alternative OSA treatments.</p><p><strong>Level of evidence: </strong>4 Laryngoscope, 131:2384-2390, 2021.</p>","PeriodicalId":400976,"journal":{"name":"The Laryngoscope","volume":" ","pages":"2384-2390"},"PeriodicalIF":2.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/lary.29695","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39253436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Margin Determination in the Era of HPV-Positive Oropharyngeal Cancer.","authors":"Christopher Pool, Taelor Weaver, Junjia Zhu, David Goldenberg, Neerav Goyal","doi":"10.1002/lary.29533","DOIUrl":"10.1002/lary.29533","url":null,"abstract":"<p><strong>Objectives/hypothesis: </strong>The goal of head and neck cancer surgery is the complete resection of tumor with a cuff of healthy tissue. A 5-mm margin is optimal but not always achievable in the oropharynx. We aimed to identify a consensus of definition and management of close margins for human papilloma virus (HPV)-associated oropharyngeal cancer without other risk factors.</p><p><strong>Study design: </strong>Descriptive survey.</p><p><strong>Methods: </strong>A survey of the American Head and Neck Society (AHNS) was conducted to evaluate the abovementioned objectives by presenting hypothetical scenarios and asking questions regarding management.</p><p><strong>Results: </strong>One-hundred fifty-five AHNS members completed the survey (18% response rate). Close margins were defined as <5 mm, <3 mm, and <1 mm by 27.7%, 32.3%, and 32.3% of respondents. There was no significant difference in margin determination with experience level (P = .186). In an HPV-positive tumor with close margins, 51% chose postoperative observation. The remainder chose adjuvant radiation (22.6%), chemoradiation (1.9%), or re-excision of the wound bed (19.4%). There was no association between postoperative close margin management and experience level (P = .80).</p><p><strong>Conclusion: </strong>Heterogeneity exists in the definition and management of close margins in HPV-mediated oropharyngeal carcinoma (OPSCC). Establishing a standard regarding close margins in HPV-mediated OPSCC may allow for the optimization of outcomes and help define best practices.</p><p><strong>Level of evidence: </strong>5 Laryngoscope, 131:E2650-E2654, 2021.</p>","PeriodicalId":400976,"journal":{"name":"The Laryngoscope","volume":" ","pages":"E2650-E2654"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10797598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25541641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First Experience of ARTip Cruise VITOM-assisted OPF Removal of Frontal Fibro-osseous Lesion: Operative Video.","authors":"Maurizio Bignami,&nbsp;Alberto Daniele Arosio,&nbsp;Gianluca Dalfino,&nbsp;Giorgio Sileo,&nbsp;Camilla Czaczkes,&nbsp;Valerio Valenzise,&nbsp;Stefano Zannella,&nbsp;Laura Demelas,&nbsp;Paolo Castelnuovo,&nbsp;Luca Volpi","doi":"10.1002/lary.29546","DOIUrl":"https://doi.org/10.1002/lary.29546","url":null,"abstract":"INTRODUCTION The ever-expanding use of the endoscopes, coupled with dedicated instrumentation, has reshaped the panorama of surgical approaches to the frontal sinus, reducing indications for craniofacial procedures to be performed. Nonetheless, external approaches, such as the osteoplastic flap (OPF), must be part of the otorhinolaryngologist’s armamentarium. In this regard, exoscopeswere recently introduced as analternative or support to operating microscopes (OMs), with the intent of improving the surgeon’s field of vision and ergonomics. In this article, we present, to the best of our knowledge, the first case of in vivo application of VITOM 3D-4K (KARL STORZ GmbH & Co, Tuttlingen, Germany) coupled with a dedicated robotic arm (ARTip CruiseTM) to remove an extensive left frontal sinus fibrous dysplasia via a combined OPFendonasal approach. Advantages and disadvantages of the exoscope’s assistance will be discussed and a surgical step-bystep video of the procedurewill be provided.","PeriodicalId":400976,"journal":{"name":"The Laryngoscope","volume":" ","pages":"2219-2223"},"PeriodicalIF":2.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/lary.29546","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25536803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inverted Nasal Papilloma Affecting Ears and Pulmonary Parenchyma: Case Report.","authors":"Tiago Fraga Vieira,&nbsp;Mariana Moreira de Castro Denaro,&nbsp;Camila Braz Rodrigues da Silva,&nbsp;Lilia Gama de Pinho,&nbsp;Luiza Costa Villela Ferreira,&nbsp;Luis Eduardo Ribeiro Coelho,&nbsp;Mirian Cabral Moreira de Castro","doi":"10.1002/lary.29550","DOIUrl":"https://doi.org/10.1002/lary.29550","url":null,"abstract":"<p><p>Inverted papilloma is a rare sinonasal neoplasm. It can be locally invasive and potentially degenerate to a malignant tumor. We present a case report of a 36-year-old woman who was treated for nasal inverted papilloma for over 10 years and presented bilateral temporal bone, and pulmonary involvement. Several procedures were performed to completely remove the tumor. Even without evidence of malignant degeneration, the patient continued battling tumor recurrences. To the best of our knowledge, this report presents the first case of a multicentric inverted papilloma with nasal, bilateral temporal bone, and pulmonary metachronous localization. Laryngoscope, 131:E2640-E2642, 2021.</p>","PeriodicalId":400976,"journal":{"name":"The Laryngoscope","volume":" ","pages":"E2640-E2642"},"PeriodicalIF":2.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/lary.29550","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25554581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sublabial Approach for Repair of Congenital Nasal Pyriform Aperture Stenosis: How I Do It.","authors":"Martha Luitje,&nbsp;Nathan Vandjelovic,&nbsp;Margo McKenna Benoit,&nbsp;John Faria","doi":"10.1002/lary.29472","DOIUrl":"https://doi.org/10.1002/lary.29472","url":null,"abstract":"INTRODUCTION Congenital nasal pyriform aperture stenosis (CNPAS) is a rare congenital narrowing of the anterior aspect of the nose at the pyriform aperture due to bony overgrowth of the frontal process of the maxilla. Clinical suspicion is raised in infants who have noisy, stertorous breathing, desaturations with feeding, or cyclical cyanosis relieved by crying. Infants with CNPAS present similarly to those with choanal atresia; however, a flexible suction catheter (8 French, 2.67 mm diameter) or pediatric flexible fiberoptic laryngoscope (2.5 mm diameter), will not easily pass past 1 cm to 2 cm in the nares. Maxillofacial computed tomography (CT) is used to confirm a suspected diagnosis. Mild cases can be managed with supportive care including a combination of nasal steroids, nasal saline, bulb suctioning, and/or supplemental oxygen. Surgical intervention is pursued when there is persistence of respiratory distress, feeding difficulties, or failure to thrive for at least 2 weeks despite conservative measures. As CNPAS is rare, pediatric otolaryngologists will not have the opportunity to do this surgery routinely. We demonstrate the sublabial drill-out technique with limited postoperative stenting and present lessons learned from doing five cases in a short time frame.","PeriodicalId":400976,"journal":{"name":"The Laryngoscope","volume":" ","pages":"2352-2355"},"PeriodicalIF":2.6,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/lary.29472","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25432281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}