An increased prevalence of SDB and/or OSA exists in the population with cleft palate, with an even greater prevalence in patients with Pierre Robin syndrome. Definitive diagnosis of OSA by PSG is underused. We suggest that surgical management of SDB and/or OSA be followed by PSG to demonstrate resolution or persistence of symptoms to ensure appropriate further management.

Objective To investigate the association between mucosal fibroblast activity and subglottic stenosis (SGS) development. Design Animals were assigned to either cricothyroidotomy and CO2 laser injury, or cricothyroidotomy and silver nitrate (AgNO3) injury groups. Airways were excised for histologic analysis and the establishment of primary fibroblast cultures. Surgical excision of established SGS followed by recovery was used to analyze SGS recurrence in this animal model. Subjects New Zealand white rabbits. Interventions The subglottis was approached via cricothyroidotomy and subjected to either CO2 laser or AgNO3 injury prior to closure. The SGS lesions were excised between 8 and 10 weeks and used to establish explants for fibroblast culture. The animals underwent recovery for an additional 14 days to follow recurrence of SGS. After 14 days all the animals were euthanized and subglottic tissue was harvested for histological evaluation. Rates of migration and contraction of SGS and normal airway fibroblasts were assayed using established in vitro methods under basal conditions and with prostaglandin (PG) E2 treatment. Results 1) Mucosal injury resulted in acute fibroplasia and chronic SGS. 2) Surgical excision of mature SGS at 8 weeks resulted in rapid recurrence of stenosis. 3) SGS derived fibroblasts were relatively refractory to the effects of PGE2 on migration and contraction. Conclusion SGS represents a fibrotic airway repair process, involving fibroblasts that produce recurrent, excessive scar formation. We suggest that SGS development and recurrence may be partially dictated by altered fibroblast responsiveness to anti-fibroplastic signals during mucosal repair.

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During the coronavirus 2019 pandemic, there has been a surge in production of remote learning materials for continued otolaryngology resident education. Medical students traditionally rely on elective and away subinternship experiences for exposure to the specialty. Delays and cancellation of clinical rotations have forced medical students to pursue opportunities outside of the traditional learning paradigm. In this commentary, we discuss the multi-institutional development of a robust syllabus for medical students using a multimodal collection of resources. Medical students collaborated with faculty and residents from 2 major academic centers to identify essential otolaryngology topics. High-quality, publicly available, and open-access content from multiple sources were incorporated into a curriculum that appeals to a variety of learners. Multimodal remote education strategies can be used as a foundation for further innovation aimed at developing tomorrow’s otolaryngologists.