Post-Intubation Acute Laryngeal Injuries: Analysis of Predictive Factors of Poor Prognosis Nicole Elen Lira, Leonardo Palma Kuhl, Paulo José Cauduro Maróstica, Claudia Schweiger Laryngoscope, 2025 ObjectiveThe objective of this study was to review the endoscopic management of post‐intubation acute laryngeal injuries in children, the outcome of these treatments, and the possible factors for a poor outcome.MethodsThe study included all pediatric patients aged 0–14 years with an endoscopic diagnosis of post‐intubation acute laryngeal injuries, treated at the Hospital de Clínicas de Porto Alegre from January 2018 to December 2022. The endoscopic techniques used for the treatment of injuries were balloon laryngoplasty and reintubation with a smaller tube with antibiotic and corticosteroid ointment coating around the tube. Possible predictive factors for poor prognosis and the need for a tracheostomy were investigated by reviewing medical records.ResultsOf the 59 patients included, 50 (84.74%) comprised the “success” group and 9 (15.25%) the “failure” group. Predictive factors for poor prognosis are: short time for symptoms returning between airway endoscopic interventions, number of reintubations with antibiotic and corticosteroid ointment, number of airway endoscopies with interventions, and number of total airway endoscopies. Furthermore, when evaluating lesion types found in airway endoscopy, severe glottic edema, subglottic edema, and posterior glottic stenosis were shown to be associated with a worse prognosis.ConclusionThis is the first review in literature that adds reintubation with corticosteroid and antibiotic ointment coating around the tube to balloon laryngoplasty for the management of post‐intubation acute laryngeal injuries. Almost 85% of our patients were managed with success with such approaches. Injuries such as generalized edema and posterior glottic stenosis were factors associated with a poor prognosis.
Sensory-Motor-Oral Stimulation Combined with Early Sucking During the Mandibular Distraction Osteogenesis Process in Children with Robin Sequence Marisa Gasparin, Fabiola Luciane Barth, Cláudia Schweiger, Marcus Vinícius Martins Collares, Deborah Salle Levy, et al. Cleft Palate Craniofacial Journal, 2025 Objective To describe the findings of children with Robin Sequence (RS) who received sensory-motor-oral stimulation combined with early sucking during mandibular distraction osteogenesis (MDO), compared with children who did not receive the intervention. Design A quasi-experimental study. Setting: A tertiary public hospital. Patients: Children with RS referred to MDO. A historical group from the same population but managed according to the institution's standard protocol (no sucking) served as a control group. Interventions: Sensory-motor-oral stimulation, including sucking, starting 24 h after MDO (intervention group). Main Outcome Measure: Our hypothesis is that sensory-motor-oral stimulation, including sucking during the DOM process, do not negatively affect surgical outcomes. Results Twenty-nine children were included. Eight (72.7%) of the 11 patients in the intervention group and 13 (72.2%) of the 18 controls had MDO complications, with no significant difference between the groups ( p = 1.000). The most common surgical outcome was antibiotic therapy for surgical site infection (76.2%). Six months after MDO, 22 (75.9%) children attained full oral feeding or associated with alternative feeding methods. Conclusion The intervention group did not have higher complication rates, from a surgical point of view, than control group. The protocol adopted by some centers that contraindicates sucking during MDO should be revised to consider the benefits of such stimulation. Keywords: Pierre Robin Syndrome, deglutition, therapeutics, child development.
Clinical outcomes before and after videofluoroscopic swallow study in children 24 months of age or younger Fabiola Luciane Barth1, Deborah Salle Levy1, 2, Marisa Gasparin1, Cláudia Schweiger1, et al. Jornal Brasileiro De Pneumologia, 2024 Objective: To evaluate the combined impact of videofluoroscopic swallow study (VFSS) and therapeutic feeding and swallowing interventions on clinical outcomes in children with oropharyngeal dysphagia (OPD). Methods: This was an uncontrolled longitudinal analytical study in which OPD patients were evaluated before and after VFSS. Children = 24 months of age diagnosed with OPD in a clinical setting and undergoing VFSS for investigation and management of OPD were included in the study. The study participants received therapeutic feeding and swallowing interventions after having undergone VFSS, being followed at an outpatient clinic for pediatric dysphagia in order to monitor feeding and swallowing difficulties. Respiratory and feeding outcomes were compared before and after VFSS. Results: Penetration/aspiration events were observed in 61% of the VFSSs (n = 72), and therapeutic feeding and swallowing interventions were recommended for 97% of the study participants. After the VFSS, there was a reduction in the odds of receiving antibiotic therapy (OR = 0.007) and in the duration of antibiotic therapy (p = 0.014), as well as in the odds of being admitted to hospital (p = 0.024) and in the length of hospital stay (p = 0.025). A combination of oral and enteral feeding became more common than oral or enteral feeding alone (p = 0.002). Conclusions: A high proportion of participants exhibited penetration/aspiration on VFSS. Therapeutic feeding and swallowing interventions following a VFSS appear to be associated with reduced respiratory morbidity in this population.
Congenital Absence of Tracheal or Bronchial Rings Matthew M. Smith, Yann‐Fuu Kou, Claudia Schweiger, David G. Lehenbauer, Alessandro de Alarcon, et al. Otolaryngology Head and Neck Surgery United States, 2021
