The incidence of SCCOT in the young adult population is increasing in the United States. Appropriate surgical management for young adults with SCCOT includes resection of the primary tumor along with a selective node dissection.

Eighty-two children underwent polysomnography (PSG) for symptoms suggestive of obstructive sleep apnea (OSA). Symptoms reported included snoring, witnessed apneic episodes, daytime somnolence, mouth breathing, and enuresis. Tonsillar size, nasal airway patency, and percentile weight were recorded. OSA was diagnosed on PSG when obstructive events were noted and apnea + hypopnea index was five or more per hour. The overall predictive accuracy of clinical suspicion of OSA was 25 (30%) of 82. Predictive accuracies (as a percentage of those with symptoms/signs who have OSA) and prevalences (as a percentage of those with OSA who have the symptom/sign), respectively, were for moderate snoring 29% (12 of 41), 48%; loud snoring 31% (11 of 35), 44%; witnessed apneas 32% (22 of 69), 88%; enuresis 46% (11 of 24), 44%; 2+ tonsillar size 37% (21 of 57), 84%; 3+ tonsillar size 33% (3 of 9), 12%; 90th percentile weight or greater 26% (7 of 27), 28%; 10th percentile weight or less 33% (5 of 15), 20%. Multiple regression analysis did not reveal a significant association between clinical parameters and the presence of OSA as defined by PSG.

Tracheostomy plays an important role in ventilated patients by improving pulmonary toileting and ventilator weaning while reducing risks of airway stenosis from prolonged intubation. However, it is associated with a considerable aerosolization risk. 1,2 Severe acute respiratory syndrome coronavirus 2, which is responsible for coronavirus disease 2019 (COVID-19), concentrates in the upper aerodigestive tract and is transmitted through droplets or aerosols from aerosol-generating procedures (AGPs) performed in this region. 3 While these facts have driven recommendations for using negative-pressure rooms and higher-grade personal protective equipment, such as powered air-purifying respirators for AGPs, 4,5 there has not been a published study specifically investigating a technique of open tracheostomy that could further reduce aerosolization risks and improve safety. We demonstrate a fenestrated technique of tracheostomy that minimizes aerosolization risks by reducing risk of accidental decannulation and stomal infections while creating a tight seal around the tracheostomy tube.