International journal of pediatric otorhinolaryngology最新文献

{"title":"Auditory modulation processing in children with mild to moderate hearing loss","authors":"Ferdous Rasouli ,&nbsp;Parisa Jalilzadeh Afshari ,&nbsp;Enayatollah Bakhshi","doi":"10.1016/j.ijporl.2025.112330","DOIUrl":"10.1016/j.ijporl.2025.112330","url":null,"abstract":"<div><h3>Background and objective</h3><div>Children with hearing loss often have difficulty understanding speech in noisy environments like classrooms, leading to educational and communication challenges. Detecting and discriminating auditory spectro-temporal fundamentals is essential for speech comprehension. So, in this study, we investigated how children with mild to moderate hearing loss (MMHL) process these auditory modulations and their relation to speech perception in noise, comparing their performance to that of children with normal hearing.</div></div><div><h3>Methods</h3><div>This cross-sectional study selected 31 children with mild to moderate sensorineural hearing loss (SNHL) and 34 normally hearing (NH) children, aged 8 to 12. After obtaining consent, participants underwent tests, including the Spectral Modulation Ripple Test (SMRT), Amplitude Modulation Detection Tests (AMDTs) at 10, 50, and 200 Hz, and Speech Perception in Noise (SPiN) assessments using Word-in-Noise (WIN) and BKB-SIN tests, conducted monaurally. Results were compared between the two groups, evaluating the effects of hearing loss severity and correlations among the tests, as well as score comparisons from both ears within each group.</div></div><div><h3>Results</h3><div>Significant differences were observed between groups (MMHL and NH) in SMRT, AMDTs, and SPiN tests (p &lt; 0.05), with the NH group scoring better. However, no significant differences were observed between mild and moderate hearing loss (p &gt; 0.05). There was no correlation between SMRT and AMDTs with the WIN test (p &gt; 0.05). Notably, significant correlations were found between SMRT and BKB tests in both groups. Sporadic correlations were also identified between AMDTs at higher rates and BKB results for both groups (p &lt; 0.05). Scores between the two ears showed no significant differences across all tests (p &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>Children with Mild to moderate SNHL have a lesser ability to use spectral and temporal modulation information, making it difficult for them to understand speech in noisy environments. Nonverbal spectral and temporal modulation tests require minimal cognitive effort and are valuable for evaluating perceptual disorders and developing auditory rehabilitation programs for these children.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112330"},"PeriodicalIF":1.2,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143748714","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":"Associations between retinopathy of prematurity and the risks of hearing loss: A propensity matched analysis","authors":"Hejin Jeong ,&nbsp;Chelsea Cleveland ,&nbsp;Todd Otteson","doi":"10.1016/j.ijporl.2025.112322","DOIUrl":"10.1016/j.ijporl.2025.112322","url":null,"abstract":"<div><h3>Purpose</h3><div>While retinopathy of prematurity (ROP) and hearing loss (HL) share many risk factors, whether patients with ROP have a higher risk of HL remains largely unknown. Therefore, this study aimed to explore the association between ROP and the risk of having HL.</div></div><div><h3>Methods</h3><div>The electronic medical records contained in a United States national database were retrospectively reviewed. Patients younger than 18 years old with a record of receiving hearing screening were included. Eligible patients with a history of ROP were assigned to the ROP cohort, while those without ROP diagnosis after vision screening served as controls. After adjusting for covariates via propensity score matching, the two cohorts were compared to evaluate the odds ratios (OR) of having hearing loss. To assess the impact of ROP severity and treatment on the OR, secondary analyses were additionally performed by further stratifying the ROP cohort based on the severity and treatment status.</div></div><div><h3>Results</h3><div>The primary analysis revealed that, compared to controls (<em>n</em> = 2,978, mean age: 2.34 ± 2.77 years; 51.1 % female) the ROP cohort (<em>n</em> = 2,978, mean age: 2.40 ± 3.13 years; 50.9 % female) had higher odds of having HL (OR = 1.42, CI = 1.25–1.61). However, among patients with ROP, the odds of HL did not differ between the mild and severe cohorts (OR = 0.99, CI = 0.73–1.34) or between the treated and untreated cohorts (OR = 0.79, CI = 0.50–1.24).</div></div><div><h3>Conclusion</h3><div>HL was more common among children with ROP after adjusting for other risk factors of HL. Confirmation of this association in future controlled research settings could provide a rationale for increasing the frequency of hearing screening in children with ROP.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112322"},"PeriodicalIF":1.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143748713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors and predictive models for secondary hemorrhage in pediatric coblation tonsillectomy","authors":"Bin Xu ,&nbsp;Jing Bi ,&nbsp;Yong Fu ,&nbsp;Yilong Xu ,&nbsp;Lulu Yu ,&nbsp;Yiyuan Han ,&nbsp;Xiaoyan Lin ,&nbsp;Mingyan Hong","doi":"10.1016/j.ijporl.2025.112327","DOIUrl":"10.1016/j.ijporl.2025.112327","url":null,"abstract":"<div><h3>Objective</h3><div>To identify risk factors for secondary post-tonsillectomy hemorrhage (SPTH) in pediatric patients undergoing Coblation procedures and develop a predictive model to support perioperative management.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on 15,729 children who underwent low-temperature Coblation tonsillectomy at the Children's Hospital, Zhejiang University School of Medicine, between June 2019 and June 2024. Univariate and multivariate analysis were employed to identify factors associated with the occurrence of SPTH. A prediction model was developed based on the identified independent risk factors. To enhance the model's predictive performance and calibration, Weighted Logistic Regression was applied to construct a Nomogram model. The model was validated and evaluated using bootstrap resampling, the consistency index (C-index), Receiver Operating Characteristic (ROC) curve, and Brier Score.</div></div><div><h3>Results</h3><div>Among the 15,729 patients, 9834 (62.52 %) were boys, and 5895 (37.48 %) were girls.The mean age was 6.55 ± 2.38 years, and the average length of hospitalization was 3.94 ± 1.51 days. Among the 15,729 children, 235 (1.5 %) experienced SPTH, and 42 (0.3 %) required additional general anesthesia for surgical hemostasis. Univariate analysis identified that gender, age, surgical indication, degree of tonsillar embedding, Body Mass Index (BMI), postoperative diet, and surgeon experience were significantly associated with SPTH (<em>P</em> &lt; 0.05).Multivariate logistic regression analysis revealed that severe tonsillar embedding, junior surgeon, obesity, poor postoperative diet, and age ≥12 years were independent risk factors for SPTH. A Nomogram model was developed based on these independent risk factors. The model was internally validated using bootstrap resampling (1000 iterations). The results showed that the C-index was 0.817, indicating good calibration and stability; ROC curve analysis revealed an Area Under the Curve(AUC)of 0.816, demonstrating strong discriminatory ability; and the Brier Score was 0.0155, indicating minimal error between predicted probabilities and actual outcomes.</div></div><div><h3>Conclusion</h3><div>Severe tonsillar embedding, junior surgeon, obesity, poor postoperative diet, and age ≥12 years are independent risk factors for Coblation SPTH in children. The Nomogram model can quickly and efficiently calculate the bleeding rate of SPTH in children, providing valuable guidance for clinical practice.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112327"},"PeriodicalIF":1.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715965","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":"Audiological assessment using click auditory brainstem response and chirp auditory steady-state response in pediatric patients with congenital microtia under 36 months: A single-center experience","authors":"Yuan Wang,&nbsp;Jikai Zhu,&nbsp;Danni Wang,&nbsp;Shouqin Zhao","doi":"10.1016/j.ijporl.2025.112320","DOIUrl":"10.1016/j.ijporl.2025.112320","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the audiological characteristics of congenital microtia (CM), and explores the effectiveness of click auditory brainstem responses (c-ABR) and chirp auditory steady-state responses (chirp-ASSR) in assessing hearing loss in affected children.</div></div><div><h3>Methods</h3><div>Audiological assessments were performed using c-ABR and chirp-ASSR in infants and toddlers under 36 months with CM who were unable to cooperate for behavioral testing. We used c-ABR to assess the nature of hearing loss. Spearman coefficients were used to evaluate correlations, and differences were assessed by subtracting c-ABR air conduction (AC) thresholds from chirp-ASSR AC thresholds. Additionally, differences were analyzed based on the external auditory canal status, auricle status, unilateral or bilateral CM.</div></div><div><h3>Results</h3><div>The findings indicate that most CM patients experience conductive hearing loss (CHL, 90.36 %) and mixed hearing loss (MHL, 8.21 %), with a smaller number exhibiting normal (0.71 %) or sensorineural hearing loss (SNHL, 0.71 %). Across the entire sample, ABR thresholds showed the strongest correlation with ASSR thresholds at an average of 2–4 kHz (r = 0.723). Chirp-ASSR was found to be a complementary test to c-ABR for screening hearing loss in CM patients, particularly when behavioral testing is not feasible. Significant differences were found in patients with external auditory canal atresia and stenosis, as well as in those with different auricle statuses (Grade I + II, and Grade III).</div></div><div><h3>Conclusion</h3><div>The study supports the use of c-ABR and chirp-ASSR as valuable tools in the audiological assessment of congenital microtia, aiding in early diagnosis and appropriate intervention for hearing loss in pediatric patients.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112320"},"PeriodicalIF":1.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697275","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":"Clinical significance and audiological outcomes in bilateral microtia: Simultaneous auricle reconstruction and BONEBRIDGE implantation via retrosigmoid sinus approach","authors":"Mengshuang Lv ,&nbsp;Danni Wang ,&nbsp;Yujie Liu ,&nbsp;Yuan Wang ,&nbsp;Jikai Zhu ,&nbsp;Wenxi Qiu ,&nbsp;Qingguo Zhang ,&nbsp;Shouqin Zhao","doi":"10.1016/j.ijporl.2025.112324","DOIUrl":"10.1016/j.ijporl.2025.112324","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effectiveness and safety of using the retrosigmoid sinus approach for BONEBRIDGE implantation in patients undergoing auricle reconstruction with tissue expansion flap.</div></div><div><h3>Methods</h3><div>44 patients who accepted BONEBRIDGE implantation through the retrosigmoid sinus approach were included. Audiological outcomes were measured before and after the BONEBRIDGE implantation. Long-term hearing and complications were also evaluated.</div></div><div><h3>Results</h3><div>After surgery, there was no significant change in bone conduction hearing thresholds compared to pre-surgery levels. Sound field thresholds after being aided with BONEBRIDGE showed a significant decrease of 27.2 dB HL. Speech recognition scores of monosyllabic words, disyllabic words, and short sentences in quiet environments significantly increased to 72 %, 84 %, and 98 %, respectively. During the 8–51 months follow-up, audiological results remained stable, and all patients were satisfied with the aesthetics of auricle reconstruction.</div></div><div><h3>Conclusion</h3><div>Patients with bilateral microtia, undergoing auricle reconstruction with expanded postauricular flap, were chosen for the retrosigmoid sinus approach during BONEBRIDGE implantation and achieved safety, good hearing results as well as improved aesthetics.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112324"},"PeriodicalIF":1.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705850","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":"Open access 3D printed open airway reconstruction and rib cartilage carving simulation model","authors":"Parker Tumlin,&nbsp;Ian Sunyecz,&nbsp;Erica McArdle,&nbsp;Johnathan Castaño,&nbsp;Hussein Jaffal","doi":"10.1016/j.ijporl.2025.112321","DOIUrl":"10.1016/j.ijporl.2025.112321","url":null,"abstract":"<div><h3>Objective</h3><div>To create a cost-effective, high-fidelity, and easily reproducible model for open airway reconstruction simulation.</div></div><div><h3>Methods</h3><div>3D printing and molding techniques were used to create silicone-based laryngotracheal and rib cartilage models. Models were utilized in an open airway reconstruction and cartilage graft carving simulation lab at a tertiary academic center in January 2024. Participants were surveyed regarding their confidence in performing key portions of the surgery (carving of anterior and posterior grafts, parachuting suture technique, tracheal resection and anastomosis). Surveys were collected at three time points (baseline, post-lecture, and post-simulation lab). Impact on participant confidence was analyzed using paired <em>t</em>-test.</div></div><div><h3>Results</h3><div>The airway and cartilage models were able to be fashioned quickly with a very low cost. The cost per model for the airway and rib cartilage models were $0.53 and $0.13, respectively. Thirteen participants completed the lab and surveys. When the simulation and post-lecture surveys were compared to the baseline survey, a statistically significant improvement in confidence was noted. Comparison of post-simulation and post-lecture surveys demonstrated statistically significant improvement (p &lt; 0.001) with a large effect size (Cohen's d ≥ 1.58) for all survey items. Models were found to be of high fidelity based on the assessment questions.</div></div><div><h3>Conclusion</h3><div>With this simulation study, we demonstrated increased confidence for residents in understanding of key steps involved in open airway reconstruction and cartilage carving using cheap and high-fidelity models. All files will be made open source to increase accessibility and reproducibility.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112321"},"PeriodicalIF":1.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739867","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":"Management of paediatric neck abscess with needle aspiration against surgical drainage: Systematic review and meta-analysis","authors":"Seraphina Key ,&nbsp;Michael Lee ,&nbsp;Matthew Kwok ,&nbsp;Ramanan Daniel ,&nbsp;Phillip Michael","doi":"10.1016/j.ijporl.2025.112318","DOIUrl":"10.1016/j.ijporl.2025.112318","url":null,"abstract":"<div><h3>Aims</h3><div>Paediatric neck abscesses can lead to complications such as airway obstruction, thrombophlebitis, and sepsis. While open incision and drainage (I&amp;D) is the gold standard for patients unresponsive to medical treatment, needle aspiration is increasingly gaining interest. This systematic review and meta-analysis aim to evaluate the effectiveness and safety of needle aspiration compared to I&amp;D in managing paediatric neck abscesses.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis of databases (Ovid Medline, Embase, SCOPUS) and clinical trial registries (Cochrane CENTRAL, ANZCTR) was conducted unto and including August 31, 2024 for MeSH terms pertaining to “paediatric”, “neck abscess”, “aspiration” and “drainage”. Studies investigating paediatric patients who underwent needle aspiration for management of lateral neck abscess were included. The primary outcome was log odds ratio for recurrence rate and the comparator was incision and drainage (I&amp;D). PROSPERO CRD42024585424.</div></div><div><h3>Results</h3><div>Of 2464 studies, 13 studies with 741 patients (n = 314 needle, 427 I&amp;D) underwent data analysis. Seven studies directly compared needle aspirations against I&amp;D (106 vs 427 patients respectively). Needle aspiration showed a statistically significant higher failure rate (OR -1.86, 95 %CI -2.19 to −0.81). While the pooled failure rate of a single needle aspiration in 314 patients was 15.83 % (95 %CI 3.61 to 32.32, I2 86.12 %), readmission rates &lt;30 days were higher in the I&amp;D group (1.64 %, n = 7/427) compared with needle aspiration (0.96 %, n = 3/314). There were no major complications reported. Sensitivity analysis did not change the conclusion.</div></div><div><h3>Conclusions</h3><div>While open I&amp;D remains the gold standard, needle aspiration may be considered as a treatment option for paediatric neck abscesses based upon institution preferences, patient selection, and resources.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112318"},"PeriodicalIF":1.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705852","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":"Histopathological features of tissue damage after button battery ingestion over time","authors":"Yarden Tenenbaum Weiss ,&nbsp;Din Haim Ben Hayoun ,&nbsp;Oded Cohen ,&nbsp;Aino Shperber ,&nbsp;Aleksandra Zimina ,&nbsp;Pierre Attal ,&nbsp;Yehuda Schwarz","doi":"10.1016/j.ijporl.2025.112309","DOIUrl":"10.1016/j.ijporl.2025.112309","url":null,"abstract":"","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112309"},"PeriodicalIF":1.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705853","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 differential impact of bilingualism on stuttering severity, language-specific patterns, and therapy outcomes in children: A systematic review and meta-analysis","authors":"Amir Hossein Rasoli Jokar ,&nbsp;Sadaf Salehi ,&nbsp;Kiana Tanghatar ,&nbsp;Ladan KhoshbinSarokalaee","doi":"10.1016/j.ijporl.2025.112314","DOIUrl":"10.1016/j.ijporl.2025.112314","url":null,"abstract":"<div><h3>Aims</h3><div>This systematic review and meta-analysis aimed to evaluate (1) if bilingual children differ from monolingual peers in stuttering severity, (2) if severity varies between their first (L1) and second (L2) languages, and (3) how bilingualism affects treatment outcomes.</div></div><div><h3>Methods</h3><div>Twenty-six empirical studies were analyzed after a comprehensive search and screening. Random-effects models compared stuttering severity between bilingual and monolingual children, assessed L1 versus L2 differences, and evaluated fluency post-treatment.</div></div><div><h3>Results</h3><div>Bilingual children showed significantly greater stuttering severity than monolingual peers, likely due to heightened cognitive and speech motor demands of managing two languages. Severity was higher in L2 than L1, reflecting proficiency and dominance effects. Treatment outcomes revealed substantial fluency improvements in bilingual children, comparable to monolingual results. However, inconsistent bilingualism definitions and severity measures limited comparisons.</div></div><div><h3>Conclusion</h3><div>Bilingualism increases stuttering severity, particularly in L2, but does not impair treatment success. Comprehensive bilingual assessments and culturally responsive interventions are essential. Future research should use longitudinal designs, diverse language pairs, and standardized criteria to improve clinical practices for bilingual children who stutter.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112314"},"PeriodicalIF":1.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734775","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":"Spontaneous tonsillar hemorrhage in a patient with PTEN mutation: A case report and systematic literature review","authors":"Molly O. Meeker ,&nbsp;Logan F. McColl ,&nbsp;Prashant S. Malhotra","doi":"10.1016/j.ijporl.2025.112315","DOIUrl":"10.1016/j.ijporl.2025.112315","url":null,"abstract":"<div><h3>Introduction</h3><div>Phosphatase and tensin homolog hamartoma tumor syndrome (PTEN Syndrome), an autosomal dominant group of disorders caused by PTEN dysregulation, predisposes patients to hamartomas, lipomas, vascular tumors/malformations, and potential malignancies. A link between PTEN syndrome and early onset enlargement of tonsillar tissue has been described. Presented is the case of a child with PTEN syndrome who experienced spontaneous tonsillar hemorrhage (STH), followed by a systematic review of the literature.</div></div><div><h3>Case description</h3><div>A 9-year-old female with PTEN syndrome presented with sore throat, globus sensation, and oral bleeding. After a positive rapid-streptococcus swab, and exam demonstrating an exophytic, highly irregular left tonsil with hemorrhagic changes, a diagnosis of STH was made. Computed-tomography-angiography (CTA) of the neck showed no major vascular malformations, with extravasation from a small vessel of the left tonsil, and she subsequently underwent bilateral total tonsillectomy. A systematic review was performed and yielded 41 total cases of STH, none involving PTEN syndrome.</div></div><div><h3>Discussion</h3><div>STH is a rare phenomenon commonly associated with acute or chronic tonsilitis. The presented patient had group A streptococcus pharyngitis but also evidence of arterial bleeding on CTA, suggesting contribution of PTEN syndrome. Within the systematic review, tonsillar pathologies in PTEN syndrome such as early tonsil enlargement were identified, but this is the first case of STH reported. Further, PTEN syndrome may lead to vascular anomalies, but their role in the presented case remains unknown. Further investigation is required to determine whether vascular anomalies and early tonsil enlargement associated with PTEN syndrome increase the risk of STH.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112315"},"PeriodicalIF":1.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682534","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}