Katherine Hart

48 timestamped statements across 2 collections — auto-found in recorded discussions, each timestamp jumps to the exact moment.

Featured diaries

▶ Ep 22 · 1:22
There's a lot of controversy about the timing of all of this, but really what it boils down to is if you have a child who's got ongoing respiratory symptoms, they're having aspiration, they're failing to thrive, they're having recurrent pulmonary infections, and they've failed all the other stuff, or in some instances before you even try all the other stuff, you operate on them.
quote · Aerodigestive / ENT
▶ Ep 2 · 1:22
There's a lot of controversy about the timing of all of this, but really what it boils down to is if you have a child who's got ongoing respiratory symptoms, they're having aspiration, they're failing to thrive, they're having recurrent pulmonary infections, and they've failed all the other stuff, or in some instances before you even try all the other stuff, you operate on them.
quote · Laryngeal Cleft
▶ Ep 22 · 1:09
So I think this really speaks to the importance of these combined evaluations that we do, and those two evaluations are truly complementary, and you miss stuff if you don't do them both.
quote · Aerodigestive / ENT
▶ Ep 2 · 1:09
So I think this really speaks to the importance of these combined evaluations that we do, and those two evaluations are truly complementary, and you miss stuff if you don't do them both.
quote · Laryngeal Cleft

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Aerodigestive / ENT 24 entries

QUAD #20: Endoscopic Repair of Minor Laryngeal Clefts with Dr. Catherine Hart

▶ Ep 22 · 0:48
quote This is a child. We had a really high index of suspicion had a cleft, and you can see there that that looks. Incredibly normal on that flexible bronchoscopy. ↗
▶ Ep 22 · 0:48
clinical A type 1 laryngeal cleft can appear normal on flexible bronchoscopy but be visible on rigid bronchoscopy using less sophisticated identification techniques. ↗
▶ Ep 22 · 0:56
quote And even here using the less sophisticated technique that we use to identify cleft in Cincinnati, you can see this kid's got a type 1 cleft. ↗
▶ Ep 22 · 1:09
clinical Combined flexible and rigid bronchoscopy evaluations are complementary and necessary to avoid missing laryngeal clefts. ↗
▶ Ep 22 · 1:09
quote So I think this really speaks to the importance of these combined evaluations that we do, and those two evaluations are truly complementary, and you miss stuff if you don't do them both. ↗
▶ Ep 22 · 1:22
quote There's a lot of controversy about the timing of all of this, but really what it boils down to is if you have a child who's got ongoing respiratory symptoms, they're having aspiration, they're failing to thrive, they're having recurrent pulmonary infections, and they've failed all the other stuff, or in some instances before you even try all the other stuff, you operate on them. ↗
▶ Ep 22 · 1:22
clinical Surgical indications for laryngeal cleft repair include ongoing respiratory symptoms, aspiration, failure to thrive, recurrent pulmonary infections, and failure of conservative measures (or in some instances before trying conservative measures). ↗
▶ Ep 22 · 1:52
quote It doesn't matter if you do this in a mass closure technique or a layered closure technique, but the key is when you're done, you have to make sure that your edges are inverted. ↗
▶ Ep 22 · 1:52
clinical Mass closure or layered closure technique can be used for laryngeal cleft repair, but the key requirement is that edges must be inverted when finished. ↗
▶ Ep 22 · 2:30
opinion Cold steel is preferred over laser for minor cleft resection because it is simpler to set up, faster, and eliminates the risk of laser fire. ↗
▶ Ep 22 · 2:30
quote I always prefer to go with cold steel, especially on the minor ones, because it's more simple to set up, and you can't have a laser fire if you don't use the laser. ↗
▶ Ep 22 · 2:39
quote That's why we typically do it this way, and it's just a heck of a lot faster. ↗
▶ Ep 22 · 2:52
clinical Closure is performed using interrupted sutures, typically PDS on an RB1 or P3 needle depending on child size. ↗
▶ Ep 22 · 3:10
clinical Postoperatively, children are observed overnight on the airway unit and resume their preoperative diet, which is continued until postoperative evaluation. ↗
▶ Ep 22 · 3:15
clinical Postoperative evaluation is typically performed 6 to 8 weeks after surgery and includes repeat video swallow study and repeat endoscopy to ensure healing. ↗
▶ Ep 22 · 3:29
clinical Failure of endoscopic cleft repair is not super common. ↗
▶ Ep 22 · 3:32
clinical Incomplete demucosalization at the apex can result in healing at the top but a gap remaining at the back. ↗
▶ Ep 22 · 3:46
opinion Layered closure technique (closing anterior and posterior portions separately) seems like more effort in minor clefts but is a more reasonable option for type 2 or 3 clefts to ensure good closure. ↗
▶ Ep 22 · 4:09
epidemiological Conservative management (not surgery) achieves resolution over time in 51% of children with laryngeal clefts. ↗
▶ Ep 22 · 4:09
quote When you compare conservative management. Other different therapies in either injection or surgical closure, get resolution over time in 51% of kids. ↗
▶ Ep 22 · 4:19
quote So by doing not nothing, but not doing surgery, you can still get improvement in a lot of patients. ↗
▶ Ep 22 · 4:24
epidemiological Injection laryngoplasty achieves improvement in symptoms in two-thirds of children and resolution in one-third. ↗
▶ Ep 22 · 4:24
quote When you look at injection laryngoplasty in this big group, they get improvement in symptoms in 2/3 of kids with resolution in 1/3. ↗
▶ Ep 22 · 4:45
clinical Complications of surgical cleft repair are often not terrible but include reports of laryngeal scarring, supraglottic infections, and lacerations. ↗
Laryngeal Cleft 24 entries

QUAD #20: Endoscopic Repair of Minor Laryngeal Clefts with Dr. Catherine Hart

▶ Ep 2 · 0:48
clinical A type 1 laryngeal cleft can appear normal on flexible bronchoscopy but be visible on rigid bronchoscopy using less sophisticated identification techniques. ↗
▶ Ep 2 · 0:48
quote This is a child. We had a really high index of suspicion had a cleft, and you can see there that that looks. Incredibly normal on that flexible bronchoscopy. ↗
▶ Ep 2 · 0:56
quote And even here using the less sophisticated technique that we use to identify cleft in Cincinnati, you can see this kid's got a type 1 cleft. ↗
▶ Ep 2 · 1:09
clinical Combined flexible and rigid bronchoscopy evaluations are complementary and necessary to avoid missing laryngeal clefts. ↗
▶ Ep 2 · 1:09
quote So I think this really speaks to the importance of these combined evaluations that we do, and those two evaluations are truly complementary, and you miss stuff if you don't do them both. ↗
▶ Ep 2 · 1:22
clinical Surgical indications for laryngeal cleft repair include ongoing respiratory symptoms, aspiration, failure to thrive, recurrent pulmonary infections, and failure of conservative measures (or in some instances before trying conservative measures). ↗
▶ Ep 2 · 1:22
quote There's a lot of controversy about the timing of all of this, but really what it boils down to is if you have a child who's got ongoing respiratory symptoms, they're having aspiration, they're failing to thrive, they're having recurrent pulmonary infections, and they've failed all the other stuff, or in some instances before you even try all the other stuff, you operate on them. ↗
▶ Ep 2 · 1:52
quote It doesn't matter if you do this in a mass closure technique or a layered closure technique, but the key is when you're done, you have to make sure that your edges are inverted. ↗
▶ Ep 2 · 1:52
clinical Mass closure or layered closure technique can be used for laryngeal cleft repair, but the key requirement is that edges must be inverted when finished. ↗
▶ Ep 2 · 2:30
quote I always prefer to go with cold steel, especially on the minor ones, because it's more simple to set up, and you can't have a laser fire if you don't use the laser. ↗
▶ Ep 2 · 2:30
opinion Cold steel is preferred over laser for minor cleft resection because it is simpler to set up, faster, and eliminates the risk of laser fire. ↗
▶ Ep 2 · 2:39
quote That's why we typically do it this way, and it's just a heck of a lot faster. ↗
▶ Ep 2 · 2:52
clinical Closure is performed using interrupted sutures, typically PDS on an RB1 or P3 needle depending on child size. ↗
▶ Ep 2 · 3:10
clinical Postoperatively, children are observed overnight on the airway unit and resume their preoperative diet, which is continued until postoperative evaluation. ↗
▶ Ep 2 · 3:15
clinical Postoperative evaluation is typically performed 6 to 8 weeks after surgery and includes repeat video swallow study and repeat endoscopy to ensure healing. ↗
▶ Ep 2 · 3:29
clinical Failure of endoscopic cleft repair is not super common. ↗
▶ Ep 2 · 3:32
clinical Incomplete demucosalization at the apex can result in healing at the top but a gap remaining at the back. ↗
▶ Ep 2 · 3:46
opinion Layered closure technique (closing anterior and posterior portions separately) seems like more effort in minor clefts but is a more reasonable option for type 2 or 3 clefts to ensure good closure. ↗
▶ Ep 2 · 4:09
quote When you compare conservative management. Other different therapies in either injection or surgical closure, get resolution over time in 51% of kids. ↗
▶ Ep 2 · 4:09
epidemiological Conservative management (not surgery) achieves resolution over time in 51% of children with laryngeal clefts. ↗
▶ Ep 2 · 4:19
quote So by doing not nothing, but not doing surgery, you can still get improvement in a lot of patients. ↗
▶ Ep 2 · 4:24
epidemiological Injection laryngoplasty achieves improvement in symptoms in two-thirds of children and resolution in one-third. ↗
▶ Ep 2 · 4:24
quote When you look at injection laryngoplasty in this big group, they get improvement in symptoms in 2/3 of kids with resolution in 1/3. ↗
▶ Ep 2 · 4:45
clinical Complications of surgical cleft repair are often not terrible but include reports of laryngeal scarring, supraglottic infections, and lacerations. ↗