This study compares outcomes of open versus percutaneous tracheostomies in coronavirus disease 2019 patients to guide clinical decision-making based on disease severity.

A retrospective cohort study using the 2020 National Readmissions Database identified 4810 coronavirus disease 2019 patients (International Statistical Classification of Diseases and Related Health Problems 10th Revision code U071) who underwent tracheostomy. Of these, 2061 had open and 2749 had percutaneous tracheostomies. Patient demographics, severity (All Patient Refined-Diagnosis Related Groups) and outcomes (mortality, readmission, complications) were analysed using chi-squared tests, both overall and by severity.

Mortality was higher in the percutaneous group (29.25 per cent) compared to the open group (26.35 per cent) (p = 0.0265). For severe cases (All Patient Refined-Diagnosis Related Groups 3–4), open tracheostomies had significantly lower mortality, readmission and complication rates (p < 0.05).

Open tracheostomies are associated with better outcomes in severe coronavirus disease 2019 cases. Percutaneous tracheostomies are effective in mild cases, but patient selection and procedural planning should consider disease severity. Future research should validate these findings.

This study investigates the seasonal and regional distribution of paediatric laryngomalacia admissions in the United States, hypothesizing higher admission rates in winter and colder regions due to reduced sunlight exposure affecting vitamin D levels.

We analyzed data from the 2016 Kids’ Inpatient Database (KID), focusing on children under three years old. Laryngomalacia cases were identified using International Classification of Diseases and Related Health Problems 10th Revision (ICD-10) code Q31.5. Seasonal and regional differences in admission rates were assessed using Pearson’s chi-squared test, with a significance level of p less than 0.05.

Of 4,512,196 estimated national admissions, 11,638 were due to laryngomalacia. Admissions increased by 10.0 per cent in winter and decreased by 10.9 per cent in summer (p < 0.005). Regionally, admissions were higher in the Midwest/Central (18.6 per cent) and Northeast (9.3 per cent) and lower in the South (7.4 per cent) and West (11.1 per cent) (p < 0.005).

Laryngomalacia admissions are significantly influenced by seasonal and regional factors, likely related to environmental conditions affecting vitamin D synthesis.

This study investigated the influence of socioeconomic factors on the incidence of laryngomalacia in paediatric in-patients.

Data from the 2016 Healthcare Cost and Utilization Project Kid Inpatient Database were analysed. Variables included zip code median income, race and/or ethnicity, primary expected payer and associated International Statistical Classification of Diseases and Related Health Problems 10th Revision codes in admission.

Lower median income zip codes showed a 6.4 per cent increase in laryngomalacia admissions, while higher-income zip codes had an 8.0 per cent decrease. Black patients exhibited a 24.5 per cent increase and Asian or Pacific Islander patients showed a 42.5 per cent decrease in laryngomalacia admissions. Medicaid and other government programme payers had a 22.1 per cent increase, while Medicare, private insurance and self-pay patients had decreases of 35.5, 20.9 and 55.7 per cent, respectively. Laryngomalacia was associated with a number of disease processes from a multitude of organ systems in a statistically significant manor.

Socioeconomic status, race, primary expected payer and co-morbid disease process significantly impact laryngomalacia admissions.

Eustachian tube dysfunction is prevalent in both paediatric and adult populations. Current clinical guidelines recommend observation over topical intranasal corticosteroids for Eustachian tube dysfunction management, which remains controversial. This study aimed to systematically review randomised, controlled trials assessing topical intranasal corticosteroid efficacy in Eustachian tube dysfunction, and analyse effect through tympanometric normalisation.

PubMed, EMBASE, Web of Science and Cochrane Library databases were searched. All randomised, controlled trials assessing intranasal corticosteroids in adult or paediatric Eustachian tube dysfunction patients were included. A meta-analysis of proportions was used to evaluate tympanogram normalisation.

Of 330 results, eight randomised, controlled trials met inclusion criteria and underwent qualitative data synthesis and risk-of-bias analysis. Meta-analysis of tympanometry data from four eligible trials (n = 512 ears) revealed no significant difference in tympanometric normalisation between intranasal corticosteroids and control (odds ratio 1.21, 95% confidence interval 0.65–2.24).

Study results do not strongly support intranasal corticosteroids for Eustachian tube dysfunction. Data were limited, emphasising the need for larger, higher quality, randomised, controlled trials.