International journal of pediatric otorhinolaryngology最新文献

{"title":"Corrigendum to \"Predictive value of preoperative neutrophil-to-lymphocyte ratio for post-tonsillectomy hemorrhage: Age-Specific insights from a pediatric cohort\" [Int. J. Pediatr. Otorhinolaryngol. 196 (2025) 112480].","authors":"Mustafa Ibas, Muruvvet Paksoy, Mehmet Nuri Elgormus, Hafize Uzun, Erkan Karatas","doi":"10.1016/j.ijporl.2025.112505","DOIUrl":"https://doi.org/10.1016/j.ijporl.2025.112505","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the predictive value of preoperative neutrophil-to-lymphocyte ratio (NLR) for postoperative hemorrhage following pediatric tonsillectomy and to explore its age-specific performance.</p><p><strong>Methods: </strong>This retrospective study included 100 pediatric patients who underwent tonsillectomy at a single tertiary center between January 2021 and December 2025. Fifty patients with postoperative hemorrhage and 50 without bleeding were analyzed. Preoperative NLR values were compared between groups. Receiver operating characteristic (ROC) curve analysis and multivariate logistic regression were performed to assess the predictive capacity of NLR. Subgroup analysis was conducted for patients aged ≤7 years.</p><p><strong>Results: </strong>The bleeding group had significantly higher preoperative NLR values compared to controls (2.72 ± 2.21 vs. 1.79 ± 0.72, p = 0.023). ROC analysis yielded an AUC of 0.632 for all patients and 0.697 for those aged ≤7 years. An NLR threshold of 2.35 provided 40 % sensitivity and 86 % specificity for predicting hemorrhage, while an NLR cut-off of 2.08 improved sensitivity (64 %) and specificity (83 %) in younger children. Multivariate analysis confirmed NLR as an independent predictor of postoperative bleeding (OR = 1.68, p = 0.016).</p><p><strong>Conclusion: </strong>Elevated preoperative NLR is associated with an increased risk of postoperative hemorrhage after pediatric tonsillectomy, particularly in children aged ≤7 years. Preoperative NLR measurement may serve as a useful adjunct in perioperative risk stratification.</p>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":" ","pages":"112505"},"PeriodicalIF":1.3,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768654","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":"Microplastic presence in the fluid of otitis media with effusion","authors":"Kerem Kökoğlu ,&nbsp;Hamdi Mıhçıokur ,&nbsp;Ibrahim Uyanık ,&nbsp;Dilşad Öztürk ,&nbsp;Halit Yıldız ,&nbsp;Onat Berkay Taş ,&nbsp;Rabia Aybüke Kaplan","doi":"10.1016/j.ijporl.2025.112501","DOIUrl":"10.1016/j.ijporl.2025.112501","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the presence and characterize microplastics in middle ear effusions from children with otitis media with effusion.</div></div><div><h3>Methods</h3><div>Middle ear effusions were collected from 24 patients (13 males, 11 females; mean age 5.4 years) with bilateral OME (≥3 months duration) or unilateral OME (≥9 months duration) undergoing myringotomy. Effusions were aspirated, washed with filtered distilled water, treated with 10 % KOH, and incubated. Samples were then filtered through a 0.7 μm glass fiber filter, washed with acetone, and stained with rose Bengal. Microplastic presence and characterization were assessed using Fourier transform infrared spectroscopy and Raman microscopy.</div></div><div><h3>Results</h3><div>Microplastics were detected in 11 of 40 MEE samples (27.5 %). Two patients exhibited bilateral microplastic presence. Identified microplastics included acrylonitrile butadiene styrene, polyurethane glycol, polymethyl siloxane, polypropylene, polyethylene diethyl chlorophosphite, and polyamide.</div></div><div><h3>Conclusion</h3><div>This study provides preliminary evidence for the presence of microplastics in MEEs of patients with OME, warranting further investigation into potential implications.</div></div><div><h3>Clinical trials number</h3><div>NCT06316635.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"196 ","pages":"Article 112501"},"PeriodicalIF":1.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764020","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":"Antibiotic stewardship in pediatric head and neck surgery","authors":"Mary Grace Robichaux ,&nbsp;Zhide Fang ,&nbsp;Jill N. D'Souza","doi":"10.1016/j.ijporl.2025.112503","DOIUrl":"10.1016/j.ijporl.2025.112503","url":null,"abstract":"<div><h3>Objective</h3><div>This study seeks to determine the rate of postoperative surgical site infections (SSI) among clean head and neck surgeries and review perioperative antibiotic administration practices.</div></div><div><h3>Study design</h3><div>Retrospective review.</div></div><div><h3>Setting</h3><div>Pediatric tertiary care institution in New Orleans over a ten-year period.</div></div><div><h3>Methods</h3><div>A retrospective review was undertaken to identify clean head and neck surgical procedures performed at Manning Family Children's between 2013 and 2023. EPIC SlicerDicer™ was used to identify patients between ages 0–18 who underwent clean head and neck surgeries. Each chart was reviewed for perioperative antibiotic administration and occurrence of postoperative SSI. Rates of SSI were compared between the control group that received no perioperative antibiotics and the study group that received perioperative antibiotics using Chi-square test. Exact Binomial proportion confidence intervals were obtained.</div></div><div><h3>Results</h3><div>99 patients were identified for the control group, while 93 patients were included in the study group. In the control group, the infection rate was determined to be 3.03 %, with 95 % CI = (0.0063, 0.086). In the study group, the infection rate was found to be 0 with 95 % CI = (0, 0.0389). There was no statistically significant difference in infection rate between the groups (p = 0.2468).</div></div><div><h3>Conclusion</h3><div>There are no current pediatric studies to guide evidence-based antibiotic prophylaxis in clean head and neck procedures. This small study did not find a statistically significant difference in infection rate between groups, and that empiric perioperative antibiotic treatment may not change the rate of SSI development in pediatric clean head and neck surgeries. Further studies with larger sample sizes are needed to confirm these findings.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"196 ","pages":"Article 112503"},"PeriodicalIF":1.3,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738020","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":"Housing and economic insecurity leads to decreased rates of tympanostomy tube placement","authors":"Allison Epstein ,&nbsp;Jamil Hayden ,&nbsp;Ross Rosen ,&nbsp;Emily Youner ,&nbsp;Todd Otteson","doi":"10.1016/j.ijporl.2025.112502","DOIUrl":"10.1016/j.ijporl.2025.112502","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess socioeconomic differences in tympanostomy tube (TT) placement for pediatric patients with otitis media (OM). The primary objective is to determine if there is a lower rate of TT placement for children with OM and housing and economic insecurity (HEI). The secondary objective was to assess rates of concurrent speech delay at time of TT placement.</div></div><div><h3>Methods</h3><div>The TriNetx Analytics Network was queried using CPT and ICD-10 codes for pediatric patients with a history of OM. An analysis using propensity-matched cohorts was performed to assess the relationship between HEI and the rates of TT placement, and speech delay.</div></div><div><h3>Results</h3><div>A total of 1,978,773 pediatric patients with OM were identified. Of those, 13,030 patients were identified as having HEI. After matching by demographics, patients with HEI were less likely to undergo TT placement than those without HEI (2.93 % vs. 6.15 %, p &lt; 0.001). Housing insecurities had the greatest association with decreased TT placement (OR 0.449, 95 % CI 0.362,0.557), followed by transportation insecurities (OR 0.545, 95 % CI 0.39,0.762) and financial insecurities (OR 0.907, 95 % CI 0.691, 1.193). Patients with HEI had higher odds of having speech delays prior to TT placement (OR 1.8171, p &lt; 0.0001) rather than those without HEI.</div></div><div><h3>Conclusions</h3><div>Patients with housing and economic insecurity have significantly lower rates of tympanostomy tube placement after otitis media, but higher rates of speech delay prior to tympanostomy tube placement.</div></div><div><h3>Level of evidence</h3><div>Level 1.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"196 ","pages":"Article 112502"},"PeriodicalIF":1.3,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724783","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":"Long-term results and surgical indication of ventilating tube insertion during cleft palate surgery","authors":"Na-Kyum Park ,&nbsp;Tae Suk Oh ,&nbsp;Woo Seok Kang ,&nbsp;Hong Ju Park ,&nbsp;Jong Woo Chung ,&nbsp;Joong Ho Ahn","doi":"10.1016/j.ijporl.2025.112500","DOIUrl":"10.1016/j.ijporl.2025.112500","url":null,"abstract":"<div><h3>Background</h3><div>s: While ventilating tube insertion (VTI) is often performed, its necessity in cleft palate (CP) children without otitis media with effusin (OME) remains unclear.</div></div><div><h3>Objective</h3><div>We aim to reassess the safety of refraining from early VTI in CP children who do not have evidence of OME.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 1026 children with CP who underwent surgery at the Asan Medical Center (Jan 2000–Dec 2015). Among these, 69 patients (34 males, 35 females) had no history of otitis media and no middle ear effusion during preoperative endoscopic examination; they did not receive VTI. Factors such as age, gender, CP type, follow-up duration, and OME prevalence were analyzed.</div></div><div><h3>Results</h3><div>Of the 69 enrolled patients, the incomplete CP type was the most common (43.5 %). Only 5 (7.2 %) developed OME postoperatively, with the complete CP type being most frequent (60 %). One patient required VTI, while the remaining cases showed spontaneous resolution within six months.</div></div><div><h3>Conclusions</h3><div>Watchful waiting appears to be a safe approach for children with CP who do not exhibit preoperative OME. Despite a 7.2 % incidence of late-onset OME, male patients with complete CP may require closer monitoring.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"196 ","pages":"Article 112500"},"PeriodicalIF":1.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724434","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":"Hypoglossal nerve stimulator for obstructive sleep apnea in children with down syndrome younger than 13","authors":"Minjee Kim ,&nbsp;Lucy J. Xu ,&nbsp;E'Ching Shih ,&nbsp;Kevin S. Gipson ,&nbsp;Brian G. Skotko ,&nbsp;Patrick Scheffler ,&nbsp;Christopher J. Hartnick","doi":"10.1016/j.ijporl.2025.112497","DOIUrl":"10.1016/j.ijporl.2025.112497","url":null,"abstract":"<div><h3>Objective</h3><div>Obstructive Sleep Apnea (OSA) is prevalent among children with Down syndrome (DS). While adenotonsillectomy is the first-line treatment for these patients, many do not achieve resolution of OSA. The U.S. Food and Drug Administration has approved HGNS implantation for children with DS, ages 13 and above. However, there remains a need for HGNS implantation in children under 13 with severe OSA. The objective of this study was to determine the safety and efficacy of HGNS placement in children &lt;13 years of age with DS and severe OSA.</div></div><div><h3>Study design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Two academic institutions.</div></div><div><h3>Methods</h3><div>This study included children &lt;13 years of age with DS and severe OSA who had HGNS implantation. Patient characteristics, postoperative complications, and response to therapy were recorded.</div></div><div><h3>Results</h3><div>A total of 29 children were included. The median age of the patients was 10 years old (range 4–12 years), with 19 patients (65.5 %) male. All 29 children were safely implanted with no serious adverse events. There was one mild wound dehiscence (Adverse Event), which resolved with antibiotic ointment and pressure dressing, and no adverse device effects. The median pre-op OAHI was 18.4 (IQR 13.2–22.3), and the median post-op OAHI was 3.9 (IQR 2.3–5.5) (<em>p</em> &lt; 0.001). At 6 months post-op, 20 patients (95.2 %) had OAHI reduction of 50 % or more.</div></div><div><h3>Conclusion</h3><div>HGNS implantation in children with DS and severe OSA can be safely performed in children ages 4–13, and initial efficacy studies demonstrate outcomes similar to children over 13.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"196 ","pages":"Article 112497"},"PeriodicalIF":1.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703709","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":"Preclinical assessment of agreement between optical frequency domain imaging and pathology in rabbit subglottic mucosal lesions","authors":"Yuki Komyo ,&nbsp;Yuichiro Tomioka ,&nbsp;Yuichi Okata ,&nbsp;Harunori Miyauchi ,&nbsp;Taichi Nakatani ,&nbsp;Shino Inuzuka ,&nbsp;Tomoo Itoh ,&nbsp;Yuko Bitoh","doi":"10.1016/j.ijporl.2025.112499","DOIUrl":"10.1016/j.ijporl.2025.112499","url":null,"abstract":"<div><h3>Objective</h3><div>The pediatric subglottic airway is susceptible to various pathological conditions, both congenital and acquired. Accurate imaging of subglottic mucosal lesions is essential for appropriate treatments, but existing methods such as bronchoscopy or computed tomography (CT) often lack resolution or objectivity. Optical coherence tomography (OCT) has been used, but the correlation between OCT-based imaging and histopathological findings has not been evaluated. Optical frequency domain imaging (OFDI), a clinical-grade variant of OCT, offers higher resolution and faster acquisition. We aimed to evaluate whether OFDI can safely and clearly visualize subglottic mucosal structures and examine how well the imaging findings correspond to histological features in an animal model.</div></div><div><h3>Methods</h3><div>Twelve rabbits weighing approximately 3 kg were used. Under anesthesia, brush scrubbing was performed to induce mucosal lesions in the subglottic space. The resected larynx was pathologically examined. The primary efficacy endpoints were circumferential visualization of the subglottic space and concordance with pathology in differentiating between the cartilage, mucosa, and lesions. The primary safety endpoints were the absence of mucosal injury and catheter dislodgement during OFDI.</div></div><div><h3>Results</h3><div>Clear images of the subglottic space were obtained, and OFDI clearly distinguished the cartilage from the mucosa and lesions. The interobserver reliability of the OCT assessment was 0.87, and the agreement between OCT and the histological assessment was 0.94. No mucosal hemorrhage or catheterization-induced dehiscence was observed.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that OFDI can be used safely and has a diagnostic performance comparable to that of histological assessment of mucosal lesions in the subglottic space.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"196 ","pages":"Article 112499"},"PeriodicalIF":1.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738019","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":"Corrigendum to \"Speech Perception in noise in adolescents with cochlear implant\" [Int. J. Pediatric Otorhinolaryngol. 193 (2025) 112317].","authors":"Letizia Guerzoni, Chiara Falzone, Sara Ghiselli, Maria Nicastri, Patrizia Mancini, Enrico Fabrizi, Domenico Cuda","doi":"10.1016/j.ijporl.2025.112496","DOIUrl":"https://doi.org/10.1016/j.ijporl.2025.112496","url":null,"abstract":"","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":" ","pages":"112496"},"PeriodicalIF":1.2,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682623","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":"Surgery for recurrent croup? A new therapeutic tool","authors":"Valeria Godoy,&nbsp;Sahba Sedaghat","doi":"10.1016/j.ijporl.2025.112498","DOIUrl":"10.1016/j.ijporl.2025.112498","url":null,"abstract":"","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"196 ","pages":"Article 112498"},"PeriodicalIF":1.2,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680021","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":"Stented and non-stented endoscopic techniques in bilateral choanal atresia repair: A systematic review and meta-analysis","authors":"Raisa Chowdhury ,&nbsp;Deema Almutawa ,&nbsp;Nasser K. Almutairi ,&nbsp;Ostap Orishchak ,&nbsp;Hamad Almhanedi ,&nbsp;Marc A. Tewfik ,&nbsp;Sam J. Daniel","doi":"10.1016/j.ijporl.2025.112494","DOIUrl":"10.1016/j.ijporl.2025.112494","url":null,"abstract":"<div><h3>Background</h3><div>Bilateral choanal atresia is a rare congenital obstruction of the posterior nasal apertures that causes severe respiratory distress and feeding difficulties in neonates and infants. While endoscopic surgical repair is the standard of care, the use of postoperative nasal stents remains controversial due to potential complications.</div></div><div><h3>Objectives</h3><div>This systematic review and meta-analysis compared outcomes of stented versus non-stented endoscopic approaches in bilateral choanal atresia to evaluate efficacy and safety for pediatric clinical decision-making.</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines, a comprehensive librarian-assisted search was conducted across PubMed, Cochrane Library, CINAHL, Scopus, and Web of Science up to December 2024. Studies comparing stented and non-stented endoscopic repairs in pediatric or neonatal populations were included. Two reviewers independently performed data extraction and quality assessment using ROB 2 for randomized trials and the Newcastle-Ottawa Scale for observational studies.</div></div><div><h3>Results</h3><div>Nine studies involving 336 patients for restenosis and 295 for granulation tissue analysis were included. Most patients were neonates or young infants (age range: 3–28 days). Stented procedures had significantly higher rates of restenosis (RR 2.21, 95 % CI 1.53–3.18, p &lt; 0.01) and granulation tissue formation (RR 1.95, 95 % CI 1.31–2.90, p &lt; 0.01). No significant differences were found in surgical success (RR 0.63, p = 0.05), bleeding (RR 0.26, p = 0.14), or polyp formation (RR 1.25, p = 0.79). Heterogeneity and publication bias were low.</div></div><div><h3>Conclusions</h3><div>Stenting after endoscopic repair of bilateral choanal atresia increases restenosis and granulation risks without clear benefit in surgical success or complication reduction. Routine stenting may not be warranted in neonates and infants.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"196 ","pages":"Article 112494"},"PeriodicalIF":1.2,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144680020","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}