Scheffler, Patrick

ABSTRACT Objectives Tongue base obstruction is a cause of persistent sleep apnea after adenotonsillectomy in pediatric patients. The internet is the most used tool by patients for gathering healthcare information. This study aims to assess the quality and readability of websites directed to patients regarding tongue base procedures for pediatric obstructive sleep apnea. Methods Queries for the terms “lingual tonsillectomy,” “posterior midline glossectomy,” “tongue reduction,” “tongue base suspension,” and “hypoglossal nerve stimulator” were entered into Google on September 11, 2023. Thirty sites were pulled for each, and up to 10 sites per query meeting inclusion criteria were included for analysis. The DISCERN tool was used to evaluate quality. Flesch Reading Ease Score (FRES) and Flesch–Kincaid Grade Level (FKGL) were used to measure readability. Sites were analyzed for mention of pediatrics. Results Thirty‐five unique sites were analyzed. The mean DISCERN score was 44.7 (range 28.5–64.0) or “fair.” The mean FRES was 46.3 (range 9.6–66.6) and FKGL 11.5 (range 7.4–19.2), indicating college and 12th‐grade reading levels. Only 8/35 sites mentioned pediatrics. The average number per query of relevant sites directed towards patients on the first search engine page was 3.6. Despite tongue base procedures being relevant to pediatrics, only one in five sites mentioned children. Conclusion Websites directed at patients regarding tongue base procedures are of “fair” quality and at readability grade levels far above what is recommended. The majority of sites available for tongue base procedures are geared to professionals rather than patients. This study demonstrates a need for high‐quality information for patients about these procedures.

Objectives To assess the impact of body mass index (BMI) on hypoglossal nerve stimulator (HNS) implantation outcomes in pediatric patients with Down syndrome (DS). We compare outcomes of HNS implantation when comparing children based on overweight or obese status. Methods Retrospective cohort study of patients at a single tertiary pediatric hospital who underwent HNS implantation between 2022 and 2024. Patients with DS under 21 years of age at time of implantation were included. One child with Wolf‐Hirschhorn syndrome was also included. The main outcome measured was reduction in apnea‐hypopnea index (AHI). Results Twenty patients were implanted with HNS during the study period. Eleven patients were implanted with a BMI considered overweight and 8 patients with a BMI considered obese. No significant correlation was found between BMI percentile and AHI reduction ( r = 0.06, p = 0.8). No significant differences were found between obese and non‐obese groups for preoperative AHI, postoperative AHI, or AHI reduction. Both groups responded favorably to HNS therapy with AHI reduction of 83.8% in obese patients and 81.9% in non‐obese patients. Conclusion We demonstrate no difference in postoperative AHI outcomes when comparing patients with obesity defined as BMI >95th percentile compared to those without. Level of Evidence 3 Laryngoscope , 135:1223–1226, 2025

Objectives/HypothesisThe purpose of this study is to develop consensus on key points that would support the use of systemic bevacizumab for the treatment of recurrent respiratory papillomatosis (RRP), and to provide preliminary guidance surrounding the use of this treatment modality.Study DesignDelphi method‐based survey series.MethodsA multidisciplinary, multi‐institutional panel of physicians with experience using systemic bevacizumab for the treatment of RRP was established. The Delphi method was used to identify and obtain consensus on characteristics associated with systemic bevacizumab use across five domains: 1) patient characteristics; 2) disease characteristics; 3) treating center characteristics; 4) prior treatment characteristics; and 5) prior work‐up.ResultsThe international panel was composed of 70 experts from 12 countries, representing pediatric and adult otolaryngology, hematology/oncology, infectious diseases, pediatric surgery, family medicine, and epidemiology. A total of 189 items were identified, of which consensus was achieved on Patient Characteristics (9), Disease Characteristics (10), Treatment Center Characteristics (22), and Prior Workup Characteristics (18).ConclusionThis consensus statement provides a useful starting point for clinicians and centers hoping to offer systemic bevacizumab for RRP and may serve as a framework to assess the components of practices and centers currently using this therapy. We hope to provide a strategy to offer the treatment and also to provide a springboard for bevacizumab's use in combination with other RRP treatment protocols. Standardized delivery systems may facilitate research efforts and provide dosing regimens to help shape best‐practice applications of systemic bevacizumab for patients with early‐onset or less‐severe disease phenotypes.Level of Evidence5 Laryngoscope, 131:E1941–E1949, 2021