A history of transtympanic drainage from antiquity from celsus and paulus of aegina to the present day.

Background: adenotonsillar hypertrophy is one of the most common causes of upper airway obstruction in children and the leading indication for otolaryngologic surgery in the pediatric population. While adenotonsillectomy is frequently performed, surgical indication should not rely solely on tonsillar size but on a comprehensive assessment integrating sleep-disordered breathing, recurrent infections, and the impact on growth, behavior, and quality of life. Pediatric otolaryngologists play a key role in interpreting clinical, endoscopic, and functional findings to guide individualized management. A structured, evidence-based decision-making approach is essential to balance risks and benefits, optimize timing of surgery, and avoid unnecessary interventions.

description: this work is based on a comprehensive review of current evidence and institutional practice guiding the decision-making process in the management of pediatric adenotonsillar hypertrophy at a tertiary pediatric otolaryngology center. The diagnostic pathway and surgical indications were defined through the analysis of international guidelines, institutional protocols, and multidisciplinary evaluation standards. Key assessment tools included detailed medical history, physical examination, and nasopharyngoscopy for upper airway assessment. When indicated, polysomnography and complementary studies such as cephalometry or imaging were incorporated. Clinical criteria considered included the severity of sleep-disordered breathing, infection frequency, comorbidities, craniofacial features, growth and behavioral effects, speech and swallowing alterations, and quality-of-life measures. The resulting framework reflects real-world clinical practice and expert consensus within our pediatric otolaryngology team, outlining decision points for adenotonsillectomy, adenoidectomy alone, or alternative management strategies.

outcome objectives: application of this framework provided a structured and reproducible approach to pediatric adenotonsillar hypertrophy. Integration of clinical, endoscopic, and functional findings improved consistency in surgical indications and reduced unnecessary interventions. Multidisciplinary discussion with pulmonology, speech therapy, orthodontics, and pediatrics optimized individualized management, particularly in complex or borderline cases. The model facilitated early identification of children who benefited from adenoidectomy alone versus those requiring complete adenotonsillectomy.

a structured, evidence-based decision-making model enhances precision and safety in surgical indications for adenotonsillar hypertrophy. By incorporating clinical severity, airway anatomy, and functional assessment, pediatric otolaryngologists can better tailor treatment to each child’s needs. This framework underscores the importance of multidisciplinary collaboration and individualized timing of surgery to improve outcomes and reduce risks. It may serve as a practical reference for standardizing management while maintaining flexibility for patient-centered care.

Managing complicated and non-complicated acute sinusitis in children

Airway compromise is one of the most critical and life-threatening challenges in pediatric burn injuries, especially in cases of inhalational trauma or facial burns. Timely recognition and appropriate surgical intervention are essential to reduce morbidity and mortality in this vulnerable population.

this presentation will focus on the principles and practice of surgical airway management in burned children, with an emphasis on emergent decision-making, technical modifications, and long-term care considerations. I will address key issues including airway edema, anatomic distortion due to burns, difficult intubation scenarios, and indications for surgical airway access such as tracheostomy or cricothyrotomy.

the session will also explore:

• the role of early airway assessment in thermal and chemical burns

• surgical techniques tailored for pediatric anatomy under burn conditions

• timing and technique of tracheostomy in acute and subacute phases

• multidisciplinary coordination in airway and wound care

• long-term sequelae such as subglottic stenosis and tracheal granulation, and their management

through case-based discussions and operative videos from my institution, i will demonstrate practical approaches and innovations that improve airway security while minimizing complications in burned children.

purpose of the proposal: the purpose of this proposal is to present current surgical strategies and clinical decision-making tools for managing complex airways in pediatric burn patients. This talk aims to enhance preparedness among otolaryngologists and surgical teams worldwide when faced with challenging airway scenarios in acute burn care, ultimately contributing to better outcomes through early intervention and interdisciplinary collaboration.

target audience: pediatric ENT specialists, general otolaryngologists, burn surgeons, intensivists, and trainees involved in airway or critical care.

presentation format: oral presentation with illustrative case studies, procedural video highlights, and audience q&a.

While balloon dilation of the airway is not new, the remarkable adoption of this over the last 20 years has caused a marked change in pediatric airway surgery. This talk would serve to not only describe the history of balloon dilation, but look at the evolution of balloon dilation, including indications, guidelines, adjunctive procedures, and novel tips and tricks. It will also discuss the pros and cons of compliant and non-compliant balloons, and the relevance of pressure vs diameter.