International journal of pediatric otorhinolaryngology最新文献

{"title":"Bleeding potential and effectiveness of perioperative ketorolac administration in tonsillectomy: A systemic review and meta-analysis","authors":"Do Hyun Kim ,&nbsp;David W. Jang ,&nbsp;Se Hwan Hwang","doi":"10.1016/j.ijporl.2025.112608","DOIUrl":"10.1016/j.ijporl.2025.112608","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the safety and effectiveness of perioperative ketorolac administration in tonsillectomy.</div></div><div><h3>Methods</h3><div>In this analysis, we examined 15 studies encompassing 1249 patients, obtained from the PubMed, SCOPUS, Embase, Web of Science, and Cochrane databases up to June 2025. Among these, 13 studies included only children, whereas 2 studies included only adults. These studies investigated the perioperative administration of ketorolac in comparison with control applications (saline, acetaminophen, or opioids). The outcomes assessed were postoperative pain levels; utilization patterns of analgesic medication in terms of quantity and frequency; and the incidence rates of postoperative nausea, vomiting, and bleeding.</div></div><div><h3>Results</h3><div>Compared to the control group, incidence of primary (on operation day) postoperative bleeding (significant bleeding: odd ratio (OR) = 3.21, 95 % CI [0.43; 24.19], I² = 30.7 %/need surgery to control bleeding: OR = 2.71, 95 % CI [0.77; 9.56]; I² = 0.0 %) and secondary (after operation day) postoperative bleeding (significant bleeding: OR = 1.46, 95 % CI [0.63; 3.39], I² = 27.8 %/need surgery to control bleeding: OR = 2.10, 95 % CI [0.43; 10.21]; I² = 0.0 %) were not significantly higher in the ketorolac group. Compared to the control group, the ketorolac group experienced a significant decrease of postoperative nausea and vomiting (OR = 0.61, 95 % CI [0.41; 0.91], I² = 42.3 %). In addition, administration of ketorolac demonstrated efficacy in reducing postoperative pain and amount of analgesic drug compared with the control group.</div></div><div><h3>Conclusion</h3><div>This study demonstrated that administration of ketorolac for tonsillectomy did not appear to increase the incidence of postoperative bleeding in children or adults; however, further studies are needed to confirm this finding. Additionally, ketorolac could improve postoperative emesis and early pain control.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112608"},"PeriodicalIF":1.3,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic potential of intraperitoneal emodin on cisplatin ototoxicity in rats","authors":"Ozan Ozdemir ,&nbsp;Ezgi Keskin ,&nbsp;Mukaddes Esrefoglu ,&nbsp;Eray Metin Guler ,&nbsp;Emine Rumeysa Hekimoglu ,&nbsp;Enise Akdemir ,&nbsp;Kubra Bozalı ,&nbsp;Ozgur Yigit","doi":"10.1016/j.ijporl.2025.112581","DOIUrl":"10.1016/j.ijporl.2025.112581","url":null,"abstract":"<div><h3>Objectives</h3><div>Cisplatin is an effective chemotherapeutic agent used in the treatment of various types of cancer; however, it exhibits severe ototoxic side effects. The aim of this study is to investigate the potential protective effects of emodin, a natural anthraquinone derivative, against cisplatin-induced ototoxicity in a rat model.</div></div><div><h3>Methods</h3><div>Twenty-four female Wistar rats were divided into four groups: control, emodin, cisplatin, and emodin + cisplatin. Auditory brainstem responses (ABR) were measured on days 1, 3, and 7 using click and tone burst stimuli (8–32 kHz). Following sacrifice, cochlear tissues were evaluated through histological and biochemical analyses. For biochemical assessment, total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI) were measured. Histological changes were examined using light microscopy.</div></div><div><h3>Results</h3><div>A significant increase in hearing thresholds, severe damage to the histological structure of the cochlea, and elevated total oxidant levels were observed in the cisplatin group (p &lt; 0.05). In the emodin + cisplatin group, compared to the cisplatin group, the increase in hearing thresholds and histological damage were found to be less pronounced (p &lt; 0.05). Furthermore, the increase in total antioxidant levels and the decrease in oxidative stress index support the protective effect of emodin against oxidative stress (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Emodin has demonstrated protective effects against cisplatin-induced ototoxicity. These findings highlight the potential of emodin as an otoprotective agent and support its possible application during cisplatin therapy. However, further research is required for clinical implementation.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112581"},"PeriodicalIF":1.3,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evaluation of children with suspected airway foreign bodies and the association with viral illness","authors":"Ina A. Lee ,&nbsp;April A. Peterson ,&nbsp;Kalpnaben Patel ,&nbsp;Heidi Chen ,&nbsp;Amy S. Whigham ,&nbsp;Lyndy J. Wilcox","doi":"10.1016/j.ijporl.2025.112607","DOIUrl":"10.1016/j.ijporl.2025.112607","url":null,"abstract":"<div><h3>Introduction</h3><div>Foreign body aspiration (FBA) is a common and potentially life-threatening event in young children. While literature emphasizes management, less is known about potential risk factors. The authors hypothesized that viral upper respiratory infections (URIs) increase the risk of FBA and aimed to describe the clinical spectrum, outcomes, and complications of pediatric airway FBA.</div></div><div><h3>Methods</h3><div>The authors conducted a single-institution retrospective study through review of electronic medical records for all patients under 18 years of age who underwent endoscopic procedures for presumed airway foreign body between 2017 and 2022 at a quaternary children's hospital.</div></div><div><h3>Results</h3><div>Eighty patients were included in the study. Thirty-four (46 %) of the retrieved FBs were food particles. Nineteen (24 %) of the patients with FBA had caregiver reports of URI symptoms and three (7 %) of the FBA patients also had positive viral panels. Of the six patients who did not have a FB present, two had caregiver reports of URI symptoms prior to surgery, and two additional patients had positive viral panels at the time of presentation. Only three patients without FB had evidence of airway inflammation on endoscopic findings (edema or increased secretions). Sixty-six of the 74 (89 %) patients with FBA had abnormal chest radiographic findings on plain film imaging.</div></div><div><h3>Conclusion</h3><div>Concern for an association between URI and an increased risk of FBA amongst pediatric patients was not supported by this analysis. Further prospective studies with multi-center, standardized data collection would be helpful to further characterize this relationship and guide counseling for parents.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112607"},"PeriodicalIF":1.3,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145333317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic partial and total ossicular chain reconstruction in children: A multicentric study","authors":"Giulia Molinari ,&nbsp;Raffael Fink ,&nbsp;Nicola Bisi ,&nbsp;Sven Beckmann ,&nbsp;Arianna Burato ,&nbsp;Daniele Marchioni ,&nbsp;Livio Presutti ,&nbsp;Ignacio Javier Fernandez ,&nbsp;Lukas Anschuetz","doi":"10.1016/j.ijporl.2025.112606","DOIUrl":"10.1016/j.ijporl.2025.112606","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the surgical techniques and audiological outcomes from a cohort of pediatric endoscopic ossiculoplasty (OPL) procedures across three European tertiary referral centers.</div></div><div><h3>Methods</h3><div>A retrospective, multicentric study was conducted on pediatric patients undergoing endoscopic OPL. Audiological assessments conducted before and after surgery were compared, with postoperative evaluations performed at three months post-operatively and, when available, at the last follow-up (FU) visit.</div></div><div><h3>Results</h3><div>A total of 77 patients with a mean age of 11.36 years (range 4–17) were included, with the most frequent indication for OPL being cholesteatoma (62 %). 21 % required a combined approach with canal wall-up mastoidectomy, while OPL was performed endoscopically in all cases (Cohen 2b). Partial ossicular replacement prosthesis (PORP) was used in 48 cases, with significant improvement in air-bone gap (ABG) from 29.52 ± 13.11 dB preoperatively to 18.48 ± 11.18 dB at last FU (p &lt; 0.01). No significant difference in ABG improvement was observed among different PORP materials and techniques (p = 0.70). Total ossicular replacement prosthesis (TORP) was employed in 29 cases, with a non-significant ABG improvement (p = 0.12). However, titanium TORP yielded significantly better outcomes compared to bone and semi-synthetic materials (p &lt; 0.01 and p = 0.03, respectively). At last FU (mean 30.78 ± 24.44 months), ears with a healthy neotympanum (74 %) showed significantly better hearing outcomes than those with disease recurrence (p = 0.04).</div></div><div><h3>Conclusion</h3><div>This study supports the use of transcanal endoscopic ossiculoplasty (OPL) as a safe and effective technique for improving hearing in pediatric patients with conductive or mixed hearing loss due to middle ear disease. The preference for autologous materials in partial reconstruction reflects their biocompatibility and established performance. TORP outcomes varied significantly by material, with titanium prostheses providing the best hearing improvement. Disease recurrence significantly affects hearing outcomes, emphasizing the challenge of achieving a stable and ventilated middle ear to guarantee optimal OPL results.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112606"},"PeriodicalIF":1.3,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Auditory and language development in children with cochlear implants: A retrospective longitudinal study.","authors":"Merve İkiz Bozsoy, Esra Yücel","doi":"10.1016/j.ijporl.2025.112601","DOIUrl":"https://doi.org/10.1016/j.ijporl.2025.112601","url":null,"abstract":"","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"112601"},"PeriodicalIF":1.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of early outpatient follow-up on outcomes after pediatric tracheostomy: A retrospective cohort study","authors":"Viraj N. Shah ,&nbsp;Ajay Narayanan ,&nbsp;Felicity Lenes-Voit ,&nbsp;Cynthia S. Wang ,&nbsp;Yann-Fuu Kou ,&nbsp;Romaine F. Johnson ,&nbsp;Stephen R. Chorney","doi":"10.1016/j.ijporl.2025.112602","DOIUrl":"10.1016/j.ijporl.2025.112602","url":null,"abstract":"","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112602"},"PeriodicalIF":1.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145333316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of diagnostic sinus CT for diagnosis of invasive fungal sinusitis in immunocompromised children","authors":"Lisbeth Brooks ,&nbsp;Ryan Puccia ,&nbsp;Larisa Broglie ,&nbsp;Michael Gorelik ,&nbsp;Maria Park ,&nbsp;Robert H. Chun","doi":"10.1016/j.ijporl.2025.112593","DOIUrl":"10.1016/j.ijporl.2025.112593","url":null,"abstract":"<div><h3>Purpose/objective</h3><div>To investigate the utility of Sinus CT imaging in the diagnosis or suspicion of invasive fungal sinusitis in immunocompromised children.</div></div><div><h3>Study design</h3><div>Retrospective chart review.</div></div><div><h3>Setting</h3><div>Tertiary-care pediatric hospital.</div></div><div><h3>Subjects and results</h3><div>Between 2012 and 2020, the Otolaryngology service at Children's Wisconsin was consulted 102 separate times in 83 patients for concern for persistent fevers of unknown origin in immunocompromised patients with concern for invasive fungal infection (IFS). There was a CT scan associated with consultation in 82 (80 %) and 49 % had been obtained prior to Otolaryngology consultation. IFS was confirmed on biopsy on 8 (10 %) of patients and 6 (7 %) had concerning findings on bedside nasal endoscopy. The remaining two patients had congestion but lacked other findings on bedside nasal endoscopy. However, they were taken to the OR for facial swelling (1/8) for high clinical suspicion prompting a CT which demonstrated a septal abscess.</div></div><div><h3>Conclusions</h3><div>CT imaging is a highly used modality for the evaluation of invasive fungal sinusitis. Our data demonstrates no significant difference between the CTs ordered on patients with invasive fungal disease and those without. Bedside nasal endoscopy remained the primary driver for operative biopsy, though, one case was prompted by CT imaging. We advocate for bedside nasal endoscopy as the primary screening in these patients. However, for those with a negative bedside nasal exam but a high index of suspicion, CT imaging may play a role in further evaluation.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112593"},"PeriodicalIF":1.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145333315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing still matters: Auditory attention and verbal memory in children implanted before versus after age one","authors":"Maria Nicastri ,&nbsp;Hilal Dincer D'Alessandro ,&nbsp;Patrizia Consolino ,&nbsp;Flaminia Gianturco ,&nbsp;Diego Di Lisi ,&nbsp;Ilaria Giallini ,&nbsp;Miriana Ciferri ,&nbsp;Armando De Virgilio ,&nbsp;Patrizia Mancini","doi":"10.1016/j.ijporl.2025.112605","DOIUrl":"10.1016/j.ijporl.2025.112605","url":null,"abstract":"<div><h3>Objectives</h3><div>This study investigated the auditory attention and verbal memory patterns in school-age children with cochlear implants (CIs), comparing those who received implants within 12 months of life with those who received them later. The study also examined the impacts of audiological and demographic/personal factors on achieved skills.</div></div><div><h3>Methods</h3><div>Sixty-one participants aged 8–10 years were divided into two groups based on age at the time of implantation: the Infancy CI group (30 children implanted within 12 months of age) and the Toddlerhood CI group (31 children implanted between 13 and 24 months of age). All participants were assessed for sustained and selective auditory attention, as well as forward/backward digit span and verbal strategic memory. Attention and memory performance were compared between the two groups, and a hierarchical regression analysis was performed to identify significant predictors of performance.</div></div><div><h3>Results</h3><div>Significant differences were found between the two groups in auditory attention and verbal memory. The Infancy CI group outperformed the Toddlerhood CI group in both areas. CI age explained 43 % and 28 % of the observed variance in the attention and memory outcomes, respectively. Receptive vocabulary was a significant predictor of both attention and memory. Nonverbal intelligence was found to predict memory skills.</div></div><div><h3>Conclusion</h3><div>This study emphasized the critical role of early intervention and oral language competence in developing auditory attention and verbal memory skills in CI children. Efforts to ensure timely intervention and empower language skills after cochlear implantation should guide clinicians' decisions and the implementation of habilitative programs.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112605"},"PeriodicalIF":1.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiological predictors of surgical intervention and hospital outcomes in paediatric subperiosteal orbital abscess: A 10-year cohort study and decision tool","authors":"David M. Housley ,&nbsp;Seraphina Key ,&nbsp;Abarna Selvarajah ,&nbsp;Andrew Tan ,&nbsp;Damien Phillips ,&nbsp;Ramanan Daniel ,&nbsp;Zubair Hasan","doi":"10.1016/j.ijporl.2025.112603","DOIUrl":"10.1016/j.ijporl.2025.112603","url":null,"abstract":"<div><h3>Importance</h3><div>Paediatric subperiosteal orbital abscess (SPOA) is a serious complication of sinusitis. Unclear radiological criteria risk unnecessary or delayed surgery, prolonging hospitalisation.</div></div><div><h3>Design and measures</h3><div>Retrospective cohort study of 117 children with computed tomography (CT)-confirmed SPOA at an Australian quaternary children's hospital (2015–2025). Patients were grouped by treatment (surgery vs non-surgical) and, for surgical cases, by time from CT to operation (≤24 h, ≤48 h, &gt;48 h).</div></div><div><h3>Results</h3><div>Of 117 patients, 70 underwent surgery. Surgical patients had significantly larger median abscess volumes (1.03 mL [IQR 0.70–1.57] vs 0.14 mL [0.08–0.26]), proptosis (4.8 mm vs 2.3 mm; both <em>p</em> &lt; 0.001), and bony erosion (52.9 % vs 31.9 %; <em>p</em> = 0.04). Abscess volume was an independent predictor in multivariable analysis (OR 1.99 per 0.1 mL, <em>p</em> &lt; 0.001). Logistic regression using abscess volume predicted surgical need (AUC = 0.96), with 94.3 % sensitivity and 89.4 % specificity. Median hospital length of stay (LOS) was significantly longer in surgical patients (4.95 days [IQR 3.89–6.48] vs 3.92 days [IQR 2.93–5.05]; <em>p</em> &lt; 0.001) attributable to surgery &gt;48 h (5.09 days [4.77–6.42], <em>p</em> &lt; 0.001). Complications occurred in 34 % of surgical vs 17 % of non-surgical patients (<em>p</em> = 0.04), driven by surgical-only events; rates of shared complications were similar, and no permanent vision loss occurred.</div></div><div><h3>Conclusion</h3><div>Abscess volume independently predicts surgical need in paediatric SPOA. The logistic model achieved high discrimination, with timely surgery avoiding excess LOS. Wider use of this tool may promote consistent management and improve outcomes.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112603"},"PeriodicalIF":1.3,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of the Das-Naglieri cognitive assessment system in children with sleep-disordered breathing","authors":"Liqiang Yang,&nbsp;Jinhong Zeng,&nbsp;Shuyao Qiu,&nbsp;Jianwen Zhong,&nbsp;Jinhong Huang,&nbsp;Min Zhi,&nbsp;Dabo Liu","doi":"10.1016/j.ijporl.2025.112599","DOIUrl":"10.1016/j.ijporl.2025.112599","url":null,"abstract":"","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112599"},"PeriodicalIF":1.3,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145300858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}