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Mai Thy Truong, MD

  • “Every encounter with a child and their family is special.”

I chose to be an Ear, Nose and Throat doctor because I like helping people with such essential senses and aspects of life — hearing, breathing, and smelling. I believe the care of a child should always be in context of his or her family and culture, and I strive to create strong connections and lasting relationships with all my patients and families. Every encounter with a child and their family is special.

One of my most memorable moments was when I cared for a child who needed a tracheostomy to breathe. He was scared of doctors, and at first would cry every time he saw me. After several procedures, we were able to remove his tracheostomy and have him breathe on his own. At one of his last checkups, he saw me from down the hall and did a running leap to hug me with a big smile on his face. It makes me proud any time a child has a good medical experience.

Specialties

Otolaryngology

Work and Education

Professional Education

University of California at Irvine School of Medicine Registrar, Irvine, CA, 5/30/2003

Internship

Stanford University General Surgery Residency, Stanford, CA, 6/30/2004

Residency

Stanford University Otolaryngology Residency, Stanford, CA, 06/30/2008

Fellowship

Stanford University Pediatric Otolaryngology Fellowship, Stanford, CA, 06/30/2009

Board Certifications

Otolaryngology, American Board of Otolaryngology

Conditions Treated

Ankyloglossia (tongue-tie)

Branchial Cleft Cyst

Head and Neck Tumors and Masses

Laryngomalacia/Tracheomalacia

Lymphadenopathy

Microtia

Obstructive Sleep Apnea

Otitis Media

Preauricular Cysts

Sinusitis

Stridor and Noisy Breathing

Thyroglossal Duct Cyst

Tonsil and Adenoid Hypertrophy

Vascular Malformations

All Publications

Major complications after tongue-tie release: A case report and systematic review. International journal of pediatric otorhinolaryngology Solis-Pazmino, P., Kim, G. S., Lincango-Naranjo, E., Prokop, L., Ponce, O. J., Truong, M. T. 2020; 138: 110356

Abstract

INTRODUCTION: The diagnosis of ankyloglossia, or tongue-tie, and the number of frenotomies performed has increased over 10-fold from 1997 to 2012 in the United States. The sharpest increase has been in neonates. For parents considering frenotomy for their breastfeeding newborn, there is controversy surrounding the evaluation of tongue-tie and the benefit of a frenotomy. Complications from tongue-tie procedures are thought to be low, though it is not well reported nor studied.OBJECTIVES: The aim of this study is to describe a case of a sublingual mucocele after laser frenotomy in a neonate with tongue-tie and to investigate major complications reported after tongue-tie release in pediatric patients through a systematic review of the literature.CASE REPORT: We present a 6-week-old female who underwent a laser frenotomy procedure performed by a dentist who presented with a new cyst under her tongue.MATERIAL AND METHODS: A systematic literature search of articles published from 1965 to April 2020 was conducted in Ovid MEDLINE(R), Ovid EMBASE, and Scopus. Citations were uploaded into a systematic review software program (DistillerSR, Ottawa, ON, Canada), followed by full text screening.RESULTS: 47 major complications were reported in 34 patients, including our patient. Most of the cases were located in the United States and Europe. The most frequent indications for the procedure were breastfeeding problems (n=18) and speech impediment (n=4). The procedure was performed by dentists (n=6), lactation consultants (n=5), and otolaryngologists (n=4). The bulk of the major complications after frenotomy included poor feeding (n=7), hypovolemic shock (n=4), apnea (n=4), acute airway obstruction (n=4), and Ludwig angina (n=2).CONCLUSIONS: Reporting of complications after frenotomy is lacking. Risks to neonates may be different than risks to older children and adults. Practitioners across different specialties should be monitoring and studying this more rigorously to better guide patients and families on the risks and benefits of this procedure.

View details for DOI 10.1016/j.ijporl.2020.110356

View details for PubMedID 32927351

Congenital Orocutaneous Fistula Associated With Ectopic Salivary Glands and Submandibular Gland Aplasia. The Laryngoscope Trieu, V., Hosseini, D. K., Kim, G. S., Truong, M. T., Cheng, A. G. 2020

View details for DOI 10.1002/lary.28921

View details for PubMedID 33059385

The Social Perception of Microtia and Auricular Reconstruction. The Laryngoscope Nuyen, B. A., Kandathil, C. K., Saltychev, M., Firmin, F., Most, S. P., Truong, M. T. 2020

Abstract

To examine the social perception of microtia and quantify the effect of reconstruction on socially perceived attributes.Parental consent was obtained for peri-reconstruction photographs in a patient with unilateral grade 3 microtia without an underlying craniofacial syndrome. With computer simulation, the normal, preoperative microtia, and postoperative reconstruction ear were isolated and blended into the oblique and lateral views of that volunteer's face to isolate ear morphology as a variable against a constant facial baseline. These photographs were embedded into Web-based surveys with visual analogue scales to capture social perception data and then were sourced to general population adults.Survey respondents totaled 631. On average, the face with the microtia ear was perceived to be less friendly (P = .015), less healthy (P = .022), and less successful (P = .005) than the same face with the "normal" ear. There were no statistically significant differences in socially perceived attributes between the face with the normal ear and the face with the reconstructed ear.This is the first study to examine the social perception consequences of microtia and microtia reconstruction in children. These findings may explain the significant psychosocial distress experienced by these patients by exploring the social perception of specific attributes perceived. Lastly, this study may better inform microtia patients and their physicians on the impact of auricular reconstruction on third party's perception of social attributes.N/A Laryngoscope, 2020.

View details for DOI 10.1002/lary.28619

View details for PubMedID 32275329

Management of Complex Arteriovenous Malformations Using a Novel Combination Therapeutic Algorithm. JAMA dermatology Chelliah, M. P., Do, H. M., Zinn, Z., Patel, V., Jeng, M., Khosla, R. K., Truong, M., Marqueling, A., Teng, J. M. 2018; 154 (11): 131619

Abstract

Importance: Current therapeutic options for patients with extracranial head and neck arteriovenous malformations are limited. Surgical intervention, such as sclerotherapy or resection, often result in rapid recurrence and progression of disease.Objective: To assess the efficacy and tolerability of sirolimus as an adjuvant therapy for endovascular embolization in the management of complicated extracranial head and neck arteriovenous malformations.Design, Setting, and Participants: This case series examined 6 patients with extracranial head and neck arteriovenous malformations treated from January 1, 2013, to December 31, 2017, at a multidisciplinary vascular anomalies clinic within Stanford Hospital and Clinics.Intervention: Initiation of sirolimus at least 1 month prior to endovascular embolization, targeting a trough level of 10 to 15 ng/mL throughout the course of the endovascular embolization series and continued for at least 1 month after the series.Main Outcomes and Measures: Clinical manifestations; disease progression and overall response to treatment were assessed via clinical evaluation and radiographic imaging.Results: All 6 patients (4 male and 2 female patients; mean age, 24.5 years [range, 9-44 years]) responded favorably to the combination of sirolimus therapy followed by endovascular embolization, and 4 patients exhibited a near-complete response. The median duration of follow-up was 19 months (range, 6-40 months). One patient discontinued sirolimus soon after embolization and experienced regrowth of the arteriovenous malformation after 1 year. Sirolimus was resumed, which has stabilized his disease for more than 2 years. Mild adverse effects were noted in 4 patients. The combination therapy was well tolerated in all patients. One patient developed skin ulceration after embolization and required surgical debridement. Another patient developed pulmonary microthrombi after embolization with cyanoacrylate glue that resolved with a brief course of anti-inflammatory therapy.Conclusions and Relevance: Although further prospective trials are needed, this report suggests the benefit of a mammalian target of rapamycin inhibitor as an adjuvant therapy for surgical embolization of complex, extracranial head and neck arteriovenous malformations. The optimal dosing and therapeutic duration of sirolimus treatment before and after embolization remain to be determined.

View details for PubMedID 30326494

Renal ultrasound abnormalities in children with syndromic and non-syndromic microtia. International journal of pediatric otorhinolaryngology Koenig, J. L., Amoils, M., Grade, M. M., Chang, K. W., Truong, M. T. 2018; 113: 17376

Abstract

OBJECTIVE: Renal abnormalities are commonly considered in the work up of pediatric patients with external ear malformations. However, there is little consensus regarding an appropriate renal screening protocol for patients with microtia. We sought to characterize renal abnormalities detected on ultrasonography in pediatric patients with microtia.METHODS: We conducted a retrospective cohort study of pediatric patients diagnosed with microtia who underwent renal ultrasound from 1991 to 2014at a single tertiary academic institution. Renal ultrasound reports and medical records were reviewed to assess for renal abnormalities and to determine whether patients required specialist follow-up or interventions. Audiograms and otolaryngology notes were used to determine patterns of hearing loss. The following additional information was recorded from the electronic medical records: patient sex, microtia grade (I-IV), microtia laterality, and known associated syndromes. Characteristics were compared between those who did and did not have renal ultrasound findings using Fisher's exact test. Univariate logistic regression analysis was performed to determine factors associated with renal ultrasound findings.RESULTS: The majority of patients in this cohort were syndromic (n=51, 64%) with grade III microtia (n=46, 58%) and conductive hearing loss (n=58, 72%). Syndromic children with microtia demonstrated a higher crude rate of renal ultrasound abnormalities (22%) than children with isolated microtia (7%). Of these patients, 69% required specialist follow-up. Univariate logistic regression analysis did not identify predictors that were significantly associated with renal ultrasound findings.CONCLUSION: Fairly high rates of abnormalities in syndromic and non-syndromic patients may warrant screening renal ultrasound in all patients with microtia, especially given the high percentage of findings requiring renal follow-up. A prospective study to formally evaluate screening efficacy is needed.

View details for PubMedID 30173979

The Superior Labial Frenulum in Newborns: What Is Normal? Global pediatric health Santa Maria, C., Aby, J., Truong, M. T., Thakur, Y., Rea, S., Messner, A. 2017; 4: 2333794X17718896

Abstract

Introduction and Objectives: There has been an emergence of procedures to release the superior labial frenula in infants, yet little is known about the normal appearance or incidence of severe attachment, or "lip-tie." The objective of this article was to develop a classification system for superior labial frenula and to estimate the incidence of different degrees of attachment. Methods: A prospective cross-sectional study. Newborns were examined and had photographs taken of their upper frenula. Relevant medical professionals rated the appearance of the labial frenula using a previously described Kotlow classification system. The raters assessed each photograph twice and were blinded to their previous rating and to other raters' scores. Results: All newborns have a labial frenula, with most attached at the gingival margins (83%). Raters had poor intra- and interrater reliability (64% to 74% and 8%, respectively), using the Kotlow classification system, which improved when the classification system was simplified. Conclusions: The Kotlow classification of lip-tie fails to be reproducible by relevant experts. The majority of infants had a significant level of attachment of the labial frenulum. As more procedures are done to release the upper lip frenulum, it is important to understand what degree of attachment is normal, or more common.

View details for PubMedID 28812052

A child with silent sinus syndrome and spontaneous improvement after sinus surgery INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY Chang, D. T., Mai Thy Truong, M. T. 2014; 78 (11): 1993-1995

Abstract

Silent sinus syndrome is characterized by an asymptomatic hypoplastic maxillary sinus with progressive enophthalmos and hypoglobus. This is a disease rarely affecting children with the majority of reported cases involving adult patients. Treatment is primarily surgical with endoscopic sinus surgery to restore aeration of the sinus along with orbital reconstruction to restore facial symmetry. In this report, we describe a 7 year old child with facial asymmetry and no sinonasal symptoms. CT showed an opacified hypoplastic right maxillary sinus. One year after endoscopic sinus surgery, there was spontaneous improvement of facial asymmetry and relative maxillary sinus size.

View details for DOI 10.1016/j.ijporl.2014.08.002

View details for Web of Science ID 000343840600035

A child with silent sinus syndrome and spontaneous improvement after sinus surgery. International journal of pediatric otorhinolaryngology Chang, D. T., Truong, M. T. 2014; 78 (11): 1993-1995

Abstract

Silent sinus syndrome is characterized by an asymptomatic hypoplastic maxillary sinus with progressive enophthalmos and hypoglobus. This is a disease rarely affecting children with the majority of reported cases involving adult patients. Treatment is primarily surgical with endoscopic sinus surgery to restore aeration of the sinus along with orbital reconstruction to restore facial symmetry. In this report, we describe a 7 year old child with facial asymmetry and no sinonasal symptoms. CT showed an opacified hypoplastic right maxillary sinus. One year after endoscopic sinus surgery, there was spontaneous improvement of facial asymmetry and relative maxillary sinus size.

View details for DOI 10.1016/j.ijporl.2014.08.002

View details for PubMedID 25218341

beta-Adrenergic receptor expression in vascular tumors MODERN PATHOLOGY Chisholm, K. M., Chang, K. W., Truong, M. T., Kwok, S., West, R. B., Heerema-McKenney, A. E. 2012; 25 (11): 1446-1451

Abstract

Propranolol has recently emerged as an effective therapy for infantile hemangiomas causing regression. The -adrenergic receptor (AR) antagonist is thought to cause vasoconstriction by its effect on nitric oxide, block angiogenesis by its effect on vascular endothelial growth factor (VEGF), and induce apoptosis. In a prior report, we identified expression of 2-AR (B2-AR) and its phosphorylated form (B2-ARP) in a case of infantile hemangioma that responded to propranolol treatment. We now explore the expression of ARs on a variety of vascular lesions utilizing a tissue microarray containing 141 lesions, including infantile hemangiomas, angiosarcomas, hemangiomas, hemangioendotheliomas, and various vascular malformations. The array was immunostained for B2-AR, B2-ARP, and 3-AR (B3-AR), and the results scored for the intensity of endothelial cell expression as negative, weak positive, or strong positive. All phases of infantile hemangiomas had strong expression of all three receptors, with the exception of only weak expression of B2-ARP in the proliferative phase infantile hemangioma. Strong expression of all three receptors was present in many hemangiomas, hemangioendotheliomas, and vascular malformations. Absent to weak expression of all three receptors was seen in glomus tumor, hobnail hemangioendothelioma, pyogenic granuloma, and reactive vascular proliferations. This is the first study to report -AR expression in a variety of vascular lesions. Although immunohistochemical expression of the receptors does not necessarily indicate that similar pathways of responsiveness to -blockade are present, it does raises the possibility that -blockade could potentially affect apoptosis and decrease responsiveness to VEGF. Additional study is warranted, as therapeutic options are limited for some patients with these lesions.

View details for DOI 10.1038/modpathol.2012.108

View details for PubMedID 22743651

Sleep endoscopy as a diagnostic tool in pediatric obstructive sleep apnea INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY Truong, M. T., Woo, V. G., Koltai, P. J. 2012; 76 (5): 722-727

Abstract

Ten to twenty percent of children have persistent obstructive sleep apnea (OSA) after adenotonsillectomy (T&A). We hypothesize that sleep endoscopy, a flexible fiberoptic examination of the pharynx under anesthesia, is an effective tool for identifying sites of persistent obstruction.In this retrospective cohort study, we reviewed records of children who had symptoms consistent with OSA and a positive polysomnogram (PSG) who underwent sleep endoscopy followed by sleep endoscopy directed surgery. Data collection included age, BMI and co-morbidities. Apnea-hypopnea index (AHI) was compared to pre and post surgery for each child using a paired t-test.Of the 80 children who underwent sleep endoscopy followed by directed surgery, 65% were male, mean age was 6 years (SD 3.75 years), average BMI was 19 (SD 0.43 years) and 28% had co-morbidities. For the 51% of patients who had persistent OSA after T&A, the mean AHI after sleep endoscopy directed surgery was significantly lower then before surgery (7.9 vs. 15.7, p<.01). For the 49% of patients who had never undergone surgery for OSA, or who were surgically nave, and underwent sleep endoscopy directed surgery, the mean AHI was significantly lower then before surgery (8.0 vs. 13.8, p<.01).Sleep endoscopy is a consistently reliable tool for identifying the sites of obstruction in both surgically naive children and those with persistent OSA after T&A.

View details for DOI 10.1016/j.ijporl.2012.02.028

View details for PubMedID 22421163

Supraglottoplasty for Occult Laryngomalacia to Improve Obstructive Sleep Apnea Syndrome ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY Chan, D. K., Mai Thy Truong, M. T., Koltai, P. J. 2012; 138 (1): 50-54

Abstract

To evaluate the polysomnographic outcomes after supraglottoplasty (SGP) performed for obstructive sleep apnea syndrome (OSAS) associated with occult laryngomalacia.Retrospective case series with medical chart review.Tertiary pediatric medical center.Twenty-two patients aged 2 to 17 years met the inclusion criteria of polysomnography-proven OSAS and occult laryngomalacia seen on flexible fiber-optic sleep endoscopy. Infants with congenital laryngomalacia were excluded.Carbon dioxide laser SGP was performed either alone or in conjunction with other operations for OSAS.Preoperative and postoperative nocturnal polysomnographic data were paired and analyzed statistically.Supraglottoplasty for occult laryngomalacia resulted in statistically significant reduction in the apnea-hypopnea index (AHI) (from 15.4 to 5.4) (P <.001). Subgroup analysis of children who underwent either SGP alone or in combination with other interventions showed comparable reductions in AHI. Medical comorbidities were associated with worsened postoperative outcomes, although still significantly improved compared with baseline. Overall, 91% of children had an improvement in AHI, and 64% had only mild or no residual OSAS after SGP.Supraglottoplasty is an effective technique for the treatment of OSAS associated with occult laryngomalacia.

View details for PubMedID 22249629

Propranolol for the treatment of airway hemangiomas: A case series and treatment algorithm INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY Truong, M. T., Perkins, J. A., Messner, A. H., Chang, K. W. 2010; 74 (9): 1043-1048

Abstract

(1) To present six patients with symptomatic airway hemangiomas treated with oral propranolol. (2) To review the diagnostic and treatment options for airway hemangiomas and propose a new management protocol.Retrospective review.Tertiary care children's hospital.Pediatric patients diagnosed with obstructive airway hemangiomas treated with oral propranolol. Patients were followed for symptomatic improvement and relief of airway obstruction on imaging or laryngoscopy.Seven patients presenting with airway obstruction were treated with propranolol. One patient had a focal hemangioma confined to the subglottis. Four patients had airway hemangiomas that extended beyond the confines of the larynx and trachea. A sixth patient had a bulky supraglottic hemangioma. A seventh patient with an extensive maxillofacial lesion failed propranolol therapy and was found to have a pyogenic granuloma on final pathology after excision. Six patients had failed standard medical therapy and/or surgical interventions and were treated successfully with oral propranolol with improvements in airway symptoms and oral intake, requiring no further surgical intervention. Treatment was initiated as early as 1.5 months of age, and as late as 22 months. No adverse side effects of propranolol were noted.Oral propranolol was successfully used to treat airway hemangiomas, resulting in rapid airway stabilization, obviating the need for operative intervention, and reducing the duration of systemic corticosteroid therapy while causing no obvious adverse effects. These outstanding results enable the possibility of use of a standardized diagnostic and treatment algorithm for airway hemangiomas that incorporates systemic propranolol.

View details for DOI 10.1016/j.ijporl.2010.06.001

View details for Web of Science ID 000281615300015

View details for PubMedID 20674045

Propranolol for the Treatment of a Life-Threatening Subglottic and Mediastinal Infantile Hemangioma JOURNAL OF PEDIATRICS Truong, M. T., Chang, K. W., Berk, D. R., Heerema-McKenney, A., Bruckner, A. L. 2010; 156 (2): 335-338

Abstract

An infant with a subglottic hemangioma remained in respiratory distress after multiple treatments failed and was found to have an enlarging mediastinal infantile hemangioma compressing the trachea. Treatment with oral propranolol resulted in resolution of symptoms within 2 days and a 50% reduction in lesion size within 1 week.

View details for DOI 10.1016/j.jpeds.2009.10.010

View details for PubMedID 20105647

Primary Hyperparathyroidism in Pregnancy: A Case Series and Review Annual Meeting of the Western Section of the Triological-Society Truong, M. T., Lalakea, M. L., Robbins, P., Friduss, M. WILEY-BLACKWELL. 2008: 196669

Abstract

To review the clinical significance of primary hyperparathyroidism during pregnancy including the maternal, fetal, and neonatal sequelae. Additionally, to discuss treatment options and describe three cases where surgical parathyroidectomy was successful for treatment of hyperparathyroidism refractory to medical management during pregnancy.Retrospective.We reviewed three cases of hyperparathyroidism during pregnancy and reviewed the literature.Three women underwent surgical parathyroidectomy during their second and third trimester of pregnancy without any maternal, fetal, or neonatal complications.Hyperparathyroidism during pregnancy may be safely treated with surgical parathyroidectomy if refractory to medical management with low operative risk when performed during the second trimester. This surgical option should be considered in light of the known maternal, fetal, and neonatal risks because of the hypercalcemic state in pregnancy.

View details for DOI 10.1097/MLG.0b013e318180276f

View details for Web of Science ID 000260874700011

View details for PubMedID 18758377

Pediatric vocal fold paralysis after cardiac surgery: Rate of recovery and sequelae OTOLARYNGOLOGY-HEAD AND NECK SURGERY Truong, M. T., Messner, A. H., Kerschner, J. E., Scholes, M., Wong-Dominguez, J., Milczuk, H. A., Yoon, P. J. 2007; 137 (5): 780-784

Abstract

To determine the rate of recovery of pediatric vocal fold paralysis (VFP) after cardiac surgery.Retrospective case series from January 2000 to 2005 at 4 tertiary care pediatric hospitals.A total of 109 children with VFP were identified. Of 80 patients with follow-up >3 months, 28 (35%) recovered vocal fold function with a median time to diagnosis of recovery of 6.6 months. Fifty-two (65%) patients had persistent vocal fold paralysis with a median follow-up time of 16.4 months. Twenty-five (45%) of 55 patients demonstrated aspiration or laryngeal penetration with modified barium swallow. Twenty-nine (27%) of the 109 patients underwent surgical intervention for their airway, feeding, or voice.Pediatric VFP is not an uncommon complication after cardiac surgery and can result in serious sequelae. This study demonstrates a 35% rate of recovery, 45% rate of aspiration, and 27% rate of complications that require surgical intervention.

View details for DOI 10.1016/j.otohns.2007.07.028

View details for Web of Science ID 000250821700017

View details for PubMedID 17967646

Recovery from cisplatin-induced ototoxicity: A case report and review INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY Truong, M. T., Winzelberg, J., Chang, K. W. 2007; 71 (10): 1631-1638

Abstract

We present a pediatric case report of cisplatin-induced ototoxicity with subsequent recovery. The patient experienced tinnitus and fluctuating mild high-frequency sensorineural hearing loss (SNHL) with a concomitant decrease in distortion product otoacoustic emissions (DPOAE). There was recovery of hearing loss and return of DPOAE at 1 year after completion of cisplatin therapy. Reports of recovery from cisplatin-induced ototoxicity in humans are limited in the literature, especially in the pediatric population. A review of cisplatin ototoxicity and mechanisms of recovery are discussed, with an emphasis on the particular chemotherapy regimen and dosing schedule in this case, given at 4-11 week intervals.

View details for DOI 10.1016/j.ijporl.2007.06.021

View details for Web of Science ID 000249906900021

View details for PubMedID 17706797