{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T09:44:03Z","timestamp":1784195043717,"version":"3.55.0"},"reference-count":12,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,9,1]],"date-time":"2016-09-01T00:00:00Z","timestamp":1472688000000},"content-version":"vor","delay-in-days":5298,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2002,3]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>The study goal was to understand the incidence, etiology, and management of airway complications in infant botulism.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>We conducted a retrospective review of the period from January 1, 1987, to December 31, 1997.<\/jats:p><\/jats:sec><jats:sec><jats:title>SETTING<\/jats:title><jats:p>Urban tertiary care children's hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Of 60 children with infant botulism, 37 (61.7%) required endotracheal intubation for a mean of 21\u00a0days. No patient required a tracheostomy. Airway complications (stridor, subglottic stenosis, granuloma formation) occurred in 5 (13.5%) of 37 patients, with 3 requiring surgical bronchoscopy. Of the 37 children, 14 (37.8%), including 4 with airway complications, had endotracheal tube leak pressures recorded. In 3 (50%) of 6 patients with measured leak pressures of greater than 40\u00a0cm H<jats:sub>2<\/jats:sub>O, airway complications developed. Complications did not develop in patients with leak pressures of less than 20\u00a0cm H<jats:sub>2<\/jats:sub>O. No correlation between length of intubation and complications could be established.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>Airway complications in infant botulism may be accompanied by high leak pressures and can be managed with endoscopic techniques. The study data suggest that leak pressures should be measured on a regular basis and maintained at less than 20 to 25\u00a0cm H<jats:sub>2<\/jats:sub>O. A prospective trial to study this issue is warranted. Tracheotomy is not routinely necessary. A high index of suspicion, early diagnosis, and prompt intervention are required for the optimal management of airway complications in infant botulism.<\/jats:p><\/jats:sec>","DOI":"10.1067\/mhn.2002.122385","type":"journal-article","created":{"date-parts":[[2003,2,4]],"date-time":"2003-02-04T21:49:09Z","timestamp":1044395349000},"page":"234-239","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Airway Complications of Infant Botulism: Ten\u2010Year Experience with 60 Cases"],"prefix":"10.1002","volume":"126","author":[{"given":"Timothy D.","family":"Anderson","sequence":"first","affiliation":[{"name":"Division of Pediatric Otolaryngology The Children's Hospital of Philadelphia Philadelphia Pennsylvania"},{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery University of Pennsylvania Medical Center Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Udayan K.","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology The Children's Hospital of Philadelphia Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark S.","family":"Schreiner","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine The Children's Hospital of Philadelphia University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian N.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology The Children's Hospital of Philadelphia Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,9]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197609302951407"},{"key":"e_1_2_6_3_1","first-page":"861","article-title":"Tracheotomy for infant botulism","volume":"88","author":"Wolfe JA","year":"1979","journal-title":"Ann Otol"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.87.2.159"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199211000-00009"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03011335"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198207000-00018"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-197912000-00049"},{"key":"e_1_2_6_9_1","first-page":"197","article-title":"Botulism immune globulin for infant botulism arrives: one year and a Gulf War later","volume":"156","author":"Schwarz PJ","year":"1992","journal-title":"West J Med"},{"key":"e_1_2_6_10_1","first-page":"221","volume":"129","author":"Shapiro RL","year":"1998","journal-title":"Botulism in the United States: a clinical and epidemiologic review"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(09)90016-6"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1754.1992.tb02632.x"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1099\/00222615-39-2-114"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1067\/mhn.2002.122385","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1067\/mhn.2002.122385","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1067\/mhn.2002.122385","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:18:52Z","timestamp":1760955532000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1067\/mhn.2002.122385"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,3]]},"references-count":12,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2002,3]]}},"alternative-id":["10.1067\/mhn.2002.122385"],"URL":"https:\/\/doi.org\/10.1067\/mhn.2002.122385","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,3]]},"assertion":[{"value":"2016-09-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}