Diagnosis: Ears/Nose/Throat
Treatment: Inpatient hospital stay
The patient is a child with a history of recurrent respiratory papillomatosis. The medical history is significant for previous papilloma removal.
It was noted that there was an anterior glottic web, but no significant regrowth of papilloma. The child had significant dysphonia; thus it was decided to treat the glottic web. The child was brought to the operating room on an elective basis. There was no reported pre-operative stridor or difficulty breathing. The patient underwent a suspension laryngoscopy/bronchoscopy, excision of glottic web, and steroid injection into the anterior glottis. There were no complications. The child was admitted under an inpatient status. There were no peri-operative complications. The patient was discharged the next day. The health plan's determination of medical necessity is upheld in whole. The child had an elective vocal fold surgery to help with a hoarse voice. This type of surgery is usually performed in an outpatient status or ambulatory basis which may require a period of overnight observation in the hospital at a lower level of care. There is no documentation that the child had any breathing concerns or unstable vital signs prior to the surgery. There were no operative complications noted. There were no peri-operative breathing concerns noted. There was no documentation that this child had any breathing concerns or unstable vital signs immediately after surgery. It is not considered standard of care for an inpatient admission status as there is very little risk to airway concerns with a surgery on the anterior portion of the vocal folds.