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Katzel EB, Shakir S, Naran S, et al. Speech outcomes after clinically indicated posterior
pharyngeal flap takedown.
Ann Plast Surg
. 2016; 77(4):420-424. EBM level 4............41-45
Summary
: This is a retrospective review of 64 patients who had pharyngeal flap takedown
due to hyponasality and obstructive sleep apnea. The authors primarily took down the
pharyngeal flap, but occasionally also performed a Furlow palatoplasty at the time of flap
take down. The speech results after flap take down were compared using objective speech
analysis, which demonstrated that 90% of patients who have their pharyngeal flap taken
down will not suffer from poorer speech.
Pawar SS, Koch CA, Murakami C. Treatment of prominent ears and otoplasty: a
contemporary review.
JAMA Facial Plast Surg
. 2015; 17(6):449-454. EBM
level 5..................................................................................................................................46-51
Summary
: This is a comprehensive review of the development, anatomy, and surgical
considerations for surgery for the prominent ear. The authors review the specific physical
findings and their relevance to the surgical approach, and then provide a reconstructive
paradigm for addressing the specific ear deformity. The article includes wonderful diagrams
illustrating the most common surgical approaches, which give very specific details about the
surgery.
III.
Adenotonsillar Disease and Sleep Disorders
Dahl JP, Miller C, Purcell PL, et al. Airway obstruction during drug-induced sleep
endoscopy correlates with apnea-hypopnea index and oxygen nadir in children.
Otolaryngol
Head Neck Surg
. 2016; 155(4):676-680. EBM level 4.....................................................52-56
Summary
: This article correlates drug-induced sleep endoscopy (DICE) scores using the
Chan-Parikh (C-P) scoring system with the preprocedural polysomnogram apnea-hypopnea
index (AHI) and oxygen nadir in 127 children with obstructive sleep apnea. Fifty-six patients
were syndromic and 21 had previous adenotonsillectomy. The mean C-P score positively
correlated with the mean AHI and negatively correlated with mean oxygen nadir. The study
provides further evidence that DICE is a useful tool to identify the location and severity of
obstruction in pediatric obstructive sleep apnea.
Farhood Z, Ong AA, Discolo CM. PANDAS: a systematic review of treatment options.
Int J
Pediatr Otorhinolaryngol
. 2016; 89:149-153. EBM level 3............................................57-61
Summary
: This is a systematic review of the treatment for Pediatric Autoimmune
Neuropsychiatric Disorder Associated with Streptococcus (PANDAS) focusing on
tonsillectomy, antibiotic treatment/prophylaxis, intravenous immunoglobulin, and cognitive-
behavioral therapy with or without selective serotonin reuptake inhibitors. A paucity of high-
level studies was identified. Overall, tonsillectomy was not found to be an effective
treatment modality. Antibiotics remain an option, although their efficacy is uncertain.
Cognitive behavior therapy is a low-risk option for management of symptoms. Two studies
support the use of intravenous immunoglobulin, but additional trials are needed given its
potential risks.