On the basis of the findings of this case series, lymphatic malformations that are found to be nonencapsulated and infiltrative by intraoperative or histologic assessment are more likely to recur.

Objectives To compare tympanostomy tube insertion for children with otitis media in 2002 with the recommendations of two sets of expert guidelines. Design Retrospective cohort study. Setting New York metropolitan area practices associated with five diverse hospitals. Participants 682 of 1046 children who received tympanostomy tubes in the five hospitals for whom charts from the hospital, primary care physician, and otolaryngologist could be accessed. Results The mean age was 3.8 years. On average, children with acute otitis media had fewer than four infections in the year before surgery. Children with otitis media with effusion had less than 30 consecutive days of effusion at the time of surgery. Concordance with recommendations was very low: 30.3% (n=207) of all tympanostomies were concordant with the explicit criteria developed for this study and 7.5% (n=13) with the

No abstract

This study demonstrates for the first time the presence of biofilm on the outer surface of neonatal endotracheal tubes. The data suggest that the presence of bacteria and/or biofilm does not correlate with other traditional indicators of microbial colonization.

Financial and utilization concerns have focused on reducing hospitalization costs for many procedures, including tonsillectomy. However, the safety of ambulatory tonsillectomy for all patients remains questionable. At our institution, tonsillectomy has essentially been an inpatient procedure by policy. We have reviewed the charts of 153 consecutive patients under 19 years of age who underwent this procedure between 1989 and 1990, in an attempt to identify "high-risk" subgroups. Variables examined were: indication for surgery, hours to adequate oral intake and to discharge, age, sex, surgeon status, underlying medical condition, complications, and concomitant procedures. Statistically significant differences (p < 0.05) were found in the time to adequate oral intake and discharge for children under 4 years of age as compared to older patients. Furthermore, 7% of patients with a preoperative diagnosis of obstructive sleep apnea showed clinical evidence of significant airway compromise postoperatively. No patient in the study group experienced postoperative bleeding before discharge. Our results have identified high-risk subgroups of children undergoing tonsillectomy who are at greater risk for these complications, and therefore may benefit from an inpatient setting.