Ben Hamm

29 statements · 2 topics

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Lobectomy for pediatrics is recommended rather. Than, uh, molecular testing or repeat FNA currently because there is a little bit higher, uh, rate of malignancy, uh, in those populations compared to adults.
quote · Thyroid Nodules
One recent study published the rate of recurrent laryngeal nerve injury decreasing from 8 to 1.5%. With monitoring.
quote · Thyroid Nodules
So what would you recommend?
quote · Fecal Incontinence
A Cochrane review in adults suggests that sacral nerve stimulation can help with fecal incontinence and avoid an ACE procedure.
clinical · Fecal Incontinence

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Ben's statements about Fecal Incontinence 9 statements

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Update Course Rewind 2025: Sacral Nerve Stimulation for Refractory Pediatric Fecal Incontinence

Statement A 13-year-old male with idiopathic functional constipation presented with daytime and nighttime fecal incontinence despite more than 4 years of enema and laxative therapy. Open
Quotation So what would you recommend? Open
Statement In a sacral nerve stimulator trial, the rate of wearing a diaper during the day decreased from 19% to 2%. Open
Statement Sacral nerve stimulation is not FDA approved in kids. Open
Statement A Cochrane review in adults suggests that sacral nerve stimulation can help with fecal incontinence and avoid an ACE procedure. Open
Statement Side effects of sacral nerve stimulation include pain and neurological symptoms. Open
Statement About 40% of patients require re-operation within about 3 years for dead battery of the stimulator. Open
Statement The stimulator is placed through the 3rd sacral foramen and sends signals to the sacral nerves. Open
Statement The patient is observed for a couple of weeks during the trial period to assess symptom improvement. Open
Ben's statements about Thyroid Nodules 20 statements

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Update Course Rewind 2025: Nerve Monitoring in Pediatric Thyroid Surgery

Quotation Lobectomy for pediatrics is recommended rather. Than, uh, molecular testing or repeat FNA currently because there is a little bit higher, uh, rate of malignancy, uh, in those populations compared to adults. Open
Statement For Bethesda 3 thyroid nodules in pediatrics, lobectomy is recommended rather than molecular testing or repeat FNA because there is a higher rate of malignancy in pediatric populations compared to adults Open
Statement For a nodule with intermediate risk of cancer (approximately 30% malignancy rate), hemithyroidectomy rather than total thyroidectomy is recommended Open
Statement The 2015 pediatric guidelines recommend thyroid surgery be done by a high volume thyroid surgeon Open
Quotation The 2015 pediatric guidelines recommend it being done by a high volume thyroid surgeon. Open
Statement One recent study published the rate of recurrent laryngeal nerve injury decreasing from 8% to 1.5% with nerve monitoring Open
Quotation One recent study published the rate of recurrent laryngeal nerve injury decreasing from 8 to 1.5%. With monitoring. Open
Statement Studies in adults have shown that nerve monitoring helps identify the nerve more, but maybe doesn't change injury rates Open
Quotation Studies in adults that have shown that helps you identify the nerve more, but maybe doesn't change injury rates. Open
Statement There are no studies in pediatrics showing significant decrease in injury rates with nerve monitoring, but there are several that show absolute decrease Open
Statement The evidence on whether intraoperative nerve monitoring prevents recurrent laryngeal nerve injury is mixed and open for meta-analysis Open
Quotation It's open for a meta-analysis to be done. Open
Statement Recurrent laryngeal nerve injury rate in children is 9% versus about 6% in adults, possibly because it's a smaller nerve that may be harder to identify Open
Quotation It's a smaller nerve may be harder to identify. Open
Statement If injury is detected on one side with nerve monitoring, the surgeon may want to wait and see if it's a transient injury that can recover later Open
Statement Expense is one consideration as a downside to nerve monitoring Open
Statement Some have questioned why use nerve monitoring if it doesn't change injury rates or outcomes Open
Statement Recent endotracheal tube electrode publications show nerve monitoring has been tried in patients down to age 0 Open
Statement Nerve monitoring is most beneficial when doing a total thyroidectomy where the contralateral cord is at risk, to help decrease the risk of tracheotomy with bilateral paralysis Open
Statement A recent paper suggested that if you adjust the size criteria in TIRRADS, it actually performs better than the 2015 pediatric guidelines Open