Platelet gel used as a packing material after endoscopic sinus surgery offers efficient hemostatic properties, as well as growth factors that can advance the healing process. The quality of life of the patient may be improved by the use of platelet gel packing.

The incidence of obstructive sleep apnea (OSA) has reached epidemic proportions, and it is an often unrecognized cause of perioperative morbidity and mortality. Profound hypoxic injury from apnea during the postoperative period is often misdiagnosed as cardiac arrest due to other causes. Almost a quarter of patients entering a hospital for elective surgery have OSA, and >80% of these cases are undiagnosed at the time of surgery. The perioperative period puts patients at high risk of apneic episodes because of drug effects from sedatives, narcotics, and general anesthesia, as well as from the effects of postoperative rapid eye movement sleep changes and postoperative positioning in the hospital bed.

Adenotonsillectomy is widely considered to be an effective treatment for sleep-disordered breathing (SDB) and obstructive sleep apnea (OSA) in the pediatric population. However, in some patients, SDB and OSA can persist despite surgical treatment with adenotonsillectomy. Options to manage persistent SDB/OSA depend on symptoms and severity. Many patients with mild residual OSA can be managed with nasal steroids and observed. Those with more moderate-to-severe residual pathology often can be managed with conservative measures that usually include continuous positive airway pressure (CPAP) therapy. However, some patients cannot tolerate CPAP, and are therefore candidates to be evaluated for addition surgical therapies. [Pediatr Ann. 2016;45(5):e180-e183.].

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tients do not require airway intervention; however, multiple studies have shown that as many as 35% of patients may require urgent airway intervention. A reasonable percentage of these patients may require urgent tracheotomy. A history of laryngeal cancer and treatment with radiation and/or chemotherapy in an adult with supraglottitis strongly correlates with the need for urgent tracheotomy.Significance: Adult supraglottitis has been well reported and studied in the literature; however, there has not been any study to date identifying clinical features of this condition that correlate with the need for a tracheotomy. Our study identifies a high-risk variable strongly correlating with the need for tracheotomy.Support: None reported.