Cleft lip and palate are the second most common congenital malformation, and can cause significant functional compromise. While diagnosis is relatively straightforward, long term management is best performed with a multidisciplinary team. Successful care of these patients may involve orthodontic treatment, surgical repair, and speech and swallowing therapy. Long term complications such as chronic Eustachian tube dysfunction and velopharyngeal insufficiency are still possible even after surgical repair, and must be managed appropriately.

With advancing age, patients will have progressively different patterns of facial trauma injuries. In young children, the proportionately larger skull and high riding larynx, lead to a higher incidence of intracranial trauma and relatively fewer bony facial or cervical injuries. As the face grows in proportion to the intracranial vault, combined with increasing sports and other activities in older children, more facial skeleton trauma occurs.  Evaluation of the critically injured patient, including management & stabilization, is important before turning attention to the definitive manag

Pediatric patients frequently suffer from upper respiratory tract infections. Fortunately, most are self limited and only a rare few progress to complications such as a deep neck space infection. Prompt recognition and diagnosis of these infections, will allow earlier intervention and hopefully prevention of complications. Treatment will usually consist of antibiotic therapy combined with surgical drainage of any associated abscesses.

Although most head and neck masses in children are benign, malignant neoplasms can occur. If diagnosis is delayed, significant morbidity and mortality can result. Thus it is important to recognize common presenting signs and symptoms of head and neck malignant neoplasms in children in order to institute prompt diagnostic evaluation. Early diagnosis can lead to earlier therapeutic intervention with both medical and surgical treatments.

Swallowing is a complex action which occurs in most individuals effortlessly. Any dysfunction in the process of swallowing can affect both the intake of nutrition as well as respiratory function. It is important to recognize the anatomical and physiological disturbance in swallowing so as to better tailor the treatment regimen to the specific dysfunction. Treatment options range across a broad spectrum from long term rehabilitative options such as swallowing therapy, to medical management of underlying sialorrhea and GERD, and finally surgical options.

Gastroesophageal reflux (GERD) is extremely common in the pediatric patients, with a wide range of clinical manifestations.  Particularly in infants, it is so prevalent that it can be difficult to distinguish physiologic reflux from a pathologic process. Extraesophageal manifestations of reflux are commonly reported but poorly studied. Systematic clinical evaluation will help identify those patients with GERD which will most greatly benefit from treatment.

Children frequently present with hoarseness or changes in their voice. Prompt recognition of children with more worrisome symptoms is important, as voice disorders may sometimes be an early sign of impending airway compromise. Fortunately, many disorders of the vocal folds in children can be managed non-surgically, including watchful waiting and speech therapy. Surgical treatment is reserved for only specific cases. Therefore, it is important to make the correct diagnosis to match up with the correct treatments.

Caustic ingestions are much less frequent due to regulation of foreign substances. Nevertheless, otolaryngologists may encounter these patients, and it is critical to understand the pathophysiology behind the mechanisms of tissue damage associated with caustic ingestions. In understanding how the tissue damage occurs, the clinician can better understand the pattern of tissue injury and potential for both short and long term sequelae.

Small children have a tendency to place objects in their mouth. Because of relative immaturity of their aerodigestive function they are at an increased risk of aspiration of foreign bodies in the laryngotracheobronchial tree, or ingestion into the esophagus. Since many of these events may not be witnessed directly, it is important for the astute clinician to be alert to the signs and/or symptoms of possible foreign body aspiration or ingestion. Prompt diagnosis and subsequent surgical removal, preferably through the least invasive means possible, remains the predominant treatment. Delays in

Acquired laryngotracheal diseases in children are becoming increasingly common with the salvage of younger-gestation neonates of low birth weight. Though challenging, reconstructive techniques are available to correct even the most significant degrees of subglottic stenosis if appropriate diagnoses are made and proper patient selection is exercised. Infectious and inflammatory diseases are also treatable with prompt recognition and appropriate airway stabilization in conjunction with medical therapy.