Browsing by Author "Discolo, Christopher"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Feeding Performance and Outcomes in Infants With Robin Sequence Undergoing Mandibular Distraction Osteogenesis
    (Sage, 2024) McGhee, Heather; Gehle, Daniel; Shope, Chelsea; Wen, Chun-Che; Marston, Alexander P.; Discolo, Christopher; Pecha, Phayvanh P.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Objective: To describe perioperative feeding performance in infants with Robin sequence (RS) who underwent mandibular distraction osteogenesis (MDO). Design: A retrospective study of infants that underwent MDO from May 2010 to December 2019. Setting: Tertiary pediatric hospital. Patients: A total of 40 patients underwent MDO and 20 met inclusion criteria. Of the included infants, 6 had an associated syndrome and 80% were male. Main Outcome Measures: Time to full oral feeds, rate of G-tube placement, and change in weight percentile following MDO. Results: Average oral intake prior to MDO was 22.1% of individual goal feeds. Among the 15 (75%) children that did not require G-tube placement, mean time to full oral feeds after MDO was 11 days ± 5.7 days, with 80% of infants reaching full oral feeds within 2 weeks after extubation. The proportion of G-tube placement in patients with a syndrome was higher than in isolated RS (−0.6; 95% CI: −1.0, −0.2). Mean percentages of weight-for-age percentile decreased during the first 3 months after the procedure. This was followed by a mean upturn in weight starting after the third month after MDO with a recovery to preoperative mean weight-for-age percentiles by 6 months after surgery. Conclusions: This study suggests that infants with RS may achieve full oral feeds despite poor feeding performance before MDO. Infants with syndromic RS are more likely to require G-tube. These findings may be used to inform G-tube discussion and offer a timeline to work toward goal oral feeds for infants with RS after MDO.
  • Thumbnail Image
    Item
    Simulation of laryngotracheal reconstruction with 3D-printed models and porcine cadaveric models
    (Wiley, 2022-08-09) Falls, Megan; Vincze, Jonathan; Brown, Joshua; Witsberger, Chelsey; Discolo, Christopher; Partain, Matthew; Rosen, Philip; Ting, Jonathan; Zopf, David; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Objectives: Laryngotracheal reconstruction (LTR) is a complex operation used to treat subglottic stenosis. The use of simulator models is a valuable tool in surgical trainee education, particularly for operations such as LTR that are less common outside high-volume centers. Three-dimensional (3D) printing of the human airway may provide an effective and more accessible alternative to porcine cadaveric models. The objective of this study is to compare the educational value of a 3D-printed model and a porcine cadaveric model as LTR simulation methods. Methods: Simulated LTR procedures were completed by 12 otolaryngology residents and a faculty physician on the cadaveric model and the 3D-printed simulator model. Both models were evaluated by fellowship-trained pediatric otolaryngologists to establish construct validity. Pre-procedure surveys of participants evaluated confidence and attitude toward models and post-procedure surveys evaluated confidence, overall impressions, relevance, content validity, and face validity. Results: Participants reported a similar mean increase in confidence after performing LTR on the 3D-printed model (14%) and cadaveric model (11%). Participants rated both models similarly for utility as an overall training tool and in teaching surgical planning and improving operative techniques. However, participants found the 3D-printed model more useful for teaching anatomy (p = .047). Conclusion: 3D-printed models have practical benefits over cadaveric models; they do not decompose and can be custom made to model a disease state such as subglottic stenosis. Participants reported a similar mean increase in confidence after using either simulation. The 3D-printed model is a promising simulation candidate as it compares well to an animal model and has the advantage of being more anatomically true to pediatric patients.