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Objective: To evaluate the psychometric properties of the nasal obstruction symptom scale within a sample of pediatric patients undergoing septoplasty or functional septorhinoplasty.Study Design: This was a prospective study with nasal obstruction symptom scale evaluations conducted pre- and postoperatively.Setting: A tertiary care pediatric hospital.Subjects and Methods: Pediatric patients underwent septoplasty or functional septorhinoplasty (FSR) from January 2013 to January 2017. Reliability of the scale was assessed through measures of internal consistency. In addition, item response models of each item were evaluated to assess how well each item captured individuals with varying levels of nasal obstruction. Study authors assessed face validity, and construct validity was assessed by correlation measures between items and exploratory factor analysis.Results: A total of 136 patients, ages 8 to 18 years with a mean age of 15.7 ± 2.1 years, completed pre- and postoperative evaluations. Internal consistency of the scale was high (Cronbach's α = 0.83). Predominantly a unidimensional scale resulted from exploratory factor analyses. Item response models indicate questions capture low to moderate levels of nasal obstruction within this population. Additional analyses show the scale functions similarly between septoplasty and FSR patients.Conclusion: The Nasal Obstruction Symptom Evaluation scale is a robust tool that may be incorporated as a subjective evaluation of severity of nasal obstruction among pediatric patients undergoing a septoplasty or functional septorhinoplasty. [ABSTRACT FROM AUTHOR]

Summary: Tumors of the accessory parotid gland are rare, extremely so in the pediatric population. This is only the second reported case of an acinic cell carcinoma of the accessory parotid gland in a child. His clinical presentation, physical examination, unusual radiographic features, and confirmatory histopathologic findings are described. The preferred treatment is complete surgical excision with adjuvant radiotherapy in certain “at risk” patients. [Copyright &y& Elsevier]

Placement of a tracheoesophageal puncture prosthesis in the post-laryngectomy patient has significantly improved voice rehabilitation in this population. Rarely, the prosthesis may become dislodged, necessitating medical evaluation. We present the case of a 61-year-old man who presented to our Emergency Department with a missing prosthesis. We describe the evaluation and management of this patient and review the relevant literature. We conclude with the following algorithm: When a patient presents with a missing prosthesis, evaluation of the tracheobronchial tree must be performed. Once the pulmonary system is cleared, the prosthesis can be presumed in the gastrointestinal tract and allowed to pass. A new prosthesis or catheter should be placed in the tract to prevent aspiration. [ABSTRACT FROM AUTHOR]