International journal of pediatric otorhinolaryngology最新文献

{"title":"The effect of (val)ganciclovir on hearing in children with congenital cytomegalovirus infection","authors":"Elise De Cuyper ,&nbsp;Frederic Acke ,&nbsp;Annelies Keymeulen ,&nbsp;Els De Leenheer ,&nbsp;Helen Van Hoecke ,&nbsp;An Boudewyns ,&nbsp;Annick Gilles ,&nbsp;Marie Muylle ,&nbsp;Rudolf Kuhweide ,&nbsp;Liesbeth Royackers ,&nbsp;Christian Desloovere ,&nbsp;Margriet Verstreken ,&nbsp;Isabelle Schatteman ,&nbsp;Ingeborg Dhooge","doi":"10.1016/j.ijporl.2025.112491","DOIUrl":"10.1016/j.ijporl.2025.112491","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the effect of (val)ganciclovir on long-term hearing outcome.</div></div><div><h3>Methods</h3><div>This matched cohort study presents multicentric data of the Flemish CMV registry (Belgium) collected over 16 years. Treated and untreated cCMV-infected children with a minimal four-year audiological follow-up were included. Primary outcome was hearing evolution. Exact matching for risk factors of spontaneous hearing evolution was performed between the treated and untreated group. The average marginal treatment effect was calculated using a pooled regression model.</div></div><div><h3>Results</h3><div>Of the 525 children, 98 (18.7 %) were treated. Antiviral therapy did not significantly result in more hearing improvement (RR,1.56; 95 % CI,0.48 to 4.93) or less hearing deterioration (RR,0.89; 95 % CI,0.61 to 1.25). Treatment of children with unilateral congenital hearing loss with valganciclovir for six weeks prevented contralateral late-onset hearing loss compared to untreated children (RR,2.49∗10⁻⁸; 95 % CI,9.19∗10⁻⁹ to 7.71∗10⁻⁸). Similarly, late-onset hearing loss could be prevented in symptomatic children with bilateral normal hearing treated with ganciclovir for six weeks (RR,3.65∗10⁻⁷; 95 % CI,2.16∗10⁻⁷ to 6.21∗10⁻⁷). Prolongation from six weeks to six months showed no beneficial effect on hearing improvement (RR,4.61∗10⁻⁸; 95 % CI,1.07∗10⁻⁸ to 2.32∗10⁻⁷), hearing deterioration (RR,1.21; 95 % CI,0.43 to 2.25), or late-onset hearing loss (RR,1.95; 95 % CI,0.63 to 5.93).</div></div><div><h3>Conclusions</h3><div>(Val)ganciclovir for six weeks prevented late-onset hearing loss. No additional benefit of a six-month therapy was found. These novel findings can aid in treatment decision making. Future studies with a larger sample size and investigation on the effect of valganciclovir on long-term neurological outcome are needed.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"196 ","pages":"Article 112491"},"PeriodicalIF":1.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653359","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":"Metagenomic analysis of the middle ear microbiome: A next-generation sequencing approach in pediatric patients with and without effusion","authors":"Safiye Göçer ,&nbsp;Oğuz Arı ,&nbsp;Celil Göçer ,&nbsp;Rıza Durmaz","doi":"10.1016/j.ijporl.2025.112487","DOIUrl":"10.1016/j.ijporl.2025.112487","url":null,"abstract":"<div><h3>Objectives</h3><div>Otitis media with effusion (OME) is one of the most common causes of reversible hearing loss in childhood. In recent years, host-microbiota interactions and alterations in microbiota composition associated with health and disease have gained increasing attention in the context of OME. This study aimed to investigate the bacterial microbiota composition of middle ear cavity (MEC) samples obtained from pediatric patients with and without OME. Microbiome differences were analyzed according to clinical groups and variables such as age and gender.</div></div><div><h3>Methods</h3><div>16S rRNA-based metagenomic sequencing was performed on MEC samples (n = 80) and nasopharyngeal samples (n = 20) obtained from 80 children—40 diagnosed with bilateral or unilateral OME (OME group) and 40 undergoing cochlear implant surgery without any history of otitis media (control group). The study cohort included 37 males and 43 females, aged between 2 and 11 years (mean age: 5.2 years).</div></div><div><h3>Results</h3><div>Sequencing analysis revealed that the phyla <em>Firmicutes</em> and <em>Proteobacteria</em> were dominant in MEC samples. In the OME group, <em>Firmicutes</em> were significantly more abundant, whereas <em>Proteobacteria</em> levels were reduced. At the genus level, <em>Alloiococcus</em> was significantly enriched in the OME group, while genera considered potentially protective, such as <em>Lactobacillus</em> and <em>Propionibacterium</em>, were significantly decreased. Age was not significantly associated with microbial richness or evenness, suggesting stability of microbiota composition across age groups. However, a significantly higher relative abundance of <em>Ralstonia</em> was observed in female patients, suggesting that gender-related hormonal or immunological differences may influence the middle ear microbiota.</div></div><div><h3>Conclusion</h3><div>This study identifies a distinct microbiota profile associated with OME and suggests that host factors, particularly gender, may contribute to shaping the microbial and immunological landscape of the middle ear. These findings also indicate that the microbial environment in OME may shift toward a low-diversity, pathobiont-dominant state.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"196 ","pages":"Article 112487"},"PeriodicalIF":1.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653437","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":"Diagnostic role of Galectin-3 with routine blood parameters in PFAPA syndrome: prospective cohort study","authors":"Sanem Burc Dagli ,&nbsp;Murat Gumussoy ,&nbsp;Ali Kanik ,&nbsp;Murat Aksit ,&nbsp;İbrahim Cukurova","doi":"10.1016/j.ijporl.2025.112478","DOIUrl":"10.1016/j.ijporl.2025.112478","url":null,"abstract":"","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"196 ","pages":"Article 112478"},"PeriodicalIF":1.2,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653358","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":"Is there a role for whole genome sequencing in idiopathic vocal fold immobility?","authors":"Michelle M. Florentine ,&nbsp;Kastley Marvin ,&nbsp;Matthew T. Brigger","doi":"10.1016/j.ijporl.2025.112493","DOIUrl":"10.1016/j.ijporl.2025.112493","url":null,"abstract":"<div><div>Pediatric bilateral vocal fold immobility (BVFI) is most commonly congenital and idiopathic. Establishing an etiology is critical to providing appropriate management to prevent respiratory insufficiency and death. Genetic diseases may be an under-diagnosed cause of idiopathic BVFI. Here we report on two pediatric cases in which whole genome sequencing played a key role in the diagnosis of BVFI—in one case, BVFI resulted in a mortality and in the other case, the diagnosis of a genetic mutation altered the management and potentially the course of BVFI.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"196 ","pages":"Article 112493"},"PeriodicalIF":1.2,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653360","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":"Evaluation of Eustachian tube function with dynamic and static tests in children undergoing adenotonsillectomy: A prospective clinical study","authors":"Sumeyra Doluoglu ,&nbsp;Aybuke Zuhal Gazeloglu ,&nbsp;Nilgun Ulger ,&nbsp;Burcu Vural Camalan ,&nbsp;Muharrem Dagli","doi":"10.1016/j.ijporl.2025.112488","DOIUrl":"10.1016/j.ijporl.2025.112488","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate Eustachian function in the immediate and early late period after adenotonsillectomy.</div></div><div><h3>Methods</h3><div>The study sample comprised children aged 4–14 years, who were diagnosed with adenotonsillar hypertrophy, then underwent adenotonsillectomy. All patients included in the study had normal preoperative Eustachian tube function. Tympanometry using 226 Hz and 1000 Hz probe tone, Eustachian function test (EFT), and audiometric examination were performed one day before and was then repeated on the first and 15th days after adenotonsillectomy.</div></div><div><h3>Results</h3><div>A total of 256 ears of 128 patients were evaluated. According to the tympanometry results, on postoperative day one, Eustachian dysfunction in the right ear was determined in 80 (62.5 %) patients with 226 Hz probe tone and in 76 (59.3 %) with 1000 Hz probe tone, and these rates for the left ear were 79 (61.7 %) and 73 (57 %) patients, respectively. On the 15th day postoperatively, Eustachian function was determined to have recovered in the right ear of 75 of 80 (90.3 %) patients with 226 Hz probe tone and in 72 of 76 patients (94.7 %) with 1000 Hz probe tone (p = 0.0001). In the left ear, Eustachian function was determined to have recovered in the right ear of 73 of 79 (92 %) patients with 226 Hz probe tone and in 68 of 73 patients (93 %) with 1000 Hz probe tone (p = 0.0001).</div></div><div><h3>Conclusion</h3><div>The study results showed that Eustachian dysfunction is common in the early period after adenotonsillectomy but almost all of these cases completely recovered by the 15th day postoperatively.</div></div><div><h3>Clinical trials number</h3><div>NCT06577051.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"196 ","pages":"Article 112488"},"PeriodicalIF":1.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632355","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 outcomes after cochlear implantation in children with additional disabilities: A grading-based evaluation of inner ear malformations","authors":"Shujiro Minami ,&nbsp;Chieko Enomoto ,&nbsp;Hidetoshi Kato ,&nbsp;Natsumi Tachibana ,&nbsp;Motoko Ihara ,&nbsp;Masae Shiroma ,&nbsp;Kimitaka Kaga","doi":"10.1016/j.ijporl.2025.112490","DOIUrl":"10.1016/j.ijporl.2025.112490","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate auditory and speech outcomes after cochlear implantation (CI) in children with additional disabilities (ADs), including autism spectrum disorder (ASD), with a particular focus on the impact of inner ear malformation (IEM) grading based on modiolus and cochlear nerve integrity.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 58 children with bilateral severe-to-profound sensorineural hearing loss and at least one AD who underwent CI between 2007 and 2022 at a national cochlear implant center. ADs included ASD, intellectual disability (ID), and attention-deficit/hyperactivity disorder (ADHD). IEMs were classified into Grades 0–III based on radiological evaluation. Auditory outcomes were assessed using the Revised Categories of Auditory Performance (R-CAP) and Speech Intelligibility Rating (SIR) scales. Statistical analyses included non-parametric tests and multivariable logistic regression.</div></div><div><h3>Results</h3><div>Among the 58 children, 60 % had ASD and 83 % had ID. IEMs of Grade II or higher were observed in 26 %. Median age at implantation was 29.5 months, and median age at evaluation was 86.5 months. R-CAP scores were significantly higher in children with Grade 0– I IEM than in those with Grade ≥ II (median 8 vs. 2, <em>p</em> &lt; 0.01). R-CAP ≥8, indicating conversational speech understanding, was achieved by 60 % of Grade 0– I cases but only 13 % of those with more severe IEMs. Multivariable analysis showed that mild ID and severe IEMs were independent negative predictors of achieving R-CAP ≥8, while age at assessment was positively associated with better outcomes.</div></div><div><h3>Conclusion</h3><div>CI can provide meaningful auditory development for children with ADs, but outcomes vary by cognitive and anatomical factors. Early implantation remains essential despite challenges in diagnosing conditions like ASD before surgery, supporting the need for ongoing developmental surveillance and individualized habilitation planning.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"196 ","pages":"Article 112490"},"PeriodicalIF":1.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633745","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":"Recognizing hypertrophy of torus tubaris: Implications for pediatric hypoglossal nerve stimulation in down syndrome children","authors":"E’ Ching Shih,&nbsp;Christopher J. Hartnick","doi":"10.1016/j.ijporl.2025.112492","DOIUrl":"10.1016/j.ijporl.2025.112492","url":null,"abstract":"<div><h3>Objective</h3><div>Pediatric hypoglossal nerve stimulation (HGNS) is an effective treatment for severe obstructive sleep apnea (OSA) in children with Down syndrome (DS). However, candidacy for HGNS requires the absence of concentric velopharyngeal collapse on drug-induced sleep endoscopy (DISE). A subset of children with DS with hypertrophic torus tubaris (HTT) may appear to have velopharyngeal collapse, making diagnosis difficult. We propose a method to differentiate HTT and anteroposterior collapse from true circumferential velopharyngeal collapse.</div></div><div><h3>Study design</h3><div>Retrospective case series from 2016 to 2024.</div></div><div><h3>Setting</h3><div>Single tertiary centre.</div></div><div><h3>Methods</h3><div>Four children with DS and severe OSA underwent DISE as part of HGNS evaluation. HTT were noted to cause velopharyngeal narrowing, mimicking concentric collapse. A 120-degrees endoscope was used to visualize the velopharynx revealing the HTT. These cases were reviewed and subsequently approved for HGNS implantation.</div></div><div><h3>Results</h3><div>All four children (median age 14.5, range 11–17years, all male) went on to have successful and uncomplicated HGNS, with resolution of OSA defined by a ≥50 % reduction in pre-operative obstructive apnea-hypopnea index (OAHI) and a post-operative OAHI &lt;10 events/h. The median reduction in pre-operative OAHI was 85.2 (range 55.6–93.1 %) and the median post-operative OAHI was 3.85 (range 2.9–7.9 events/h).</div></div><div><h3>Conclusion</h3><div>Accurate DISE evaluation is crucial to avoid misdiagnosing HTT with anteroposterior velopharyngeal collapse as concentric velopharyngeal collapse, ensuring appropriate HGNS candidacy for children with DS and OSA, who often fail conventional treatments.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"196 ","pages":"Article 112492"},"PeriodicalIF":1.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633746","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":"Pott's puffy tumor in pediatric Patients: Our surgical experience","authors":"Udi Shapira ,&nbsp;Fares Butrus ,&nbsp;Nidal Muhanna ,&nbsp;Avraham Abergel ,&nbsp;Forsan Jahshan","doi":"10.1016/j.ijporl.2025.112486","DOIUrl":"10.1016/j.ijporl.2025.112486","url":null,"abstract":"<div><h3>Background</h3><div>Pott's puffy tumor (PPT) is a rare complication of frontal sinusitis defined as subperiosteal abscess of the anterior table of the frontal sinus with associated osteomyelitis. Its complications can be harmful to the patient, therefore immediate treatment is necessary. Surgical drainage and systemic antibiotics are considered as integral parts of the overall treatment. However, surgical approaches can differ between different centers and surgeons.</div></div><div><h3>Methods</h3><div>We retrospectively evaluated the electronic records of 13 pediatric patients with PPT between 2018 and 2023.Clinical, laboratory radiology, and demographic findings were evaluated as well as surgical and post op data.</div></div><div><h3>Results</h3><div>Thirteen patients were included in the study (M/F: 7/6), the median age was 11.3 (6–15) years old. eight (61.5 %) patients had an intracranial complication. All patients were treated with intravenous antibiotics. One patient was treated conservatively and the other 12 were operated on. In the first operation 3/12 (25 %) underwent only frontal sinus trephination, 5/12 (41.66 %) underwent endoscopic sinus surgery (ESS) and 4/12 (33.33 %) underwent combined endoscopic and trephination surgery. Repeated surgery was needed for 5 patients, four of them underwent only endoscopic drainage and one underwent combined endoscopic and trephination surgery. The media hospitalization time (days) after the 1st surgical intervention was 8.3 for the combined approach, 9.6 for the external approach and 14.75 for the endoscopic approach. All patients recovered uneventfully.</div></div><div><h3>Conclusions</h3><div>Herein, we report our surgical experience in pediatric patients with PPT treated in a tertiary hospital. Ideally, PPT should be managed with a combination of broad-spectrum antibiotic therapy and surgical intervention.</div><div>Traditionally, open approaches served as the primary surgical route to access frontal sinus in PPT patients. However, the emergence of endoscopes instrumentation has supplemented these approaches in dealing with PPT. Our database reveals that open approach still has an important role in PPT treatment as patients who underwent only endoscopic drainage faced a higher risk of inadequate improvement and necessitating reintervention.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"196 ","pages":"Article 112486"},"PeriodicalIF":1.2,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632356","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":"Assessment of tongue structure and function in infants for the diagnosis of ankyloglossia: A systematic review","authors":"Emma Necus ,&nbsp;Mary Claessen ,&nbsp;Neville Hennessey ,&nbsp;Sharon Smart","doi":"10.1016/j.ijporl.2025.112485","DOIUrl":"10.1016/j.ijporl.2025.112485","url":null,"abstract":"<div><h3>Background</h3><div>Ankyloglossia, commonly referred to as tongue tie, has become a topic of increasing interest for health care professionals and families. Global data reports a significant increase in surgical intervention to treat ankyloglossia. It is essential that professionals can identify ankyloglossia in infants accurately and reliably as a basis for providing evidence-based recommendations and intervention, and to understand better its potential impact and outcomes for infants and children.</div></div><div><h3>Aims</h3><div>The systematic review aimed to (i) identify assessments of tongue structure and function used to diagnose ankyloglossia in infants from birth to 12 months; (ii) evaluate the psychometric properties of these tools, and (iii) identify a comprehensive assessment tool based on the review's findings.</div></div><div><h3>Methods</h3><div>The Preferred Reporting Systems for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used to guide this systematic review. Searches for peer-reviewed articles were conducted on five electronic databases: Nursing and Allied Health Literature (CINAHL), ProQuest, Web of Science (WOS), Medline and Maternal and Infant Care (OVID).</div></div><div><h3>Results</h3><div>A total of 117 studies met the inclusion criteria and were included in a narrative synthesis of extracted data. Nine assessment tools were identified with varying parameters of appearance and function included, as well as inconsistency in reporting of reliability and validity. Few studies used a measure of feeding as a diagnostic feature when identifying ankyloglossia in study participants.</div></div><div><h3>Conclusion</h3><div>Based on the findings from this review, the Lingual Frenulum Protocol for Infants (LFPI) had the most reported reliability and validity for the assessment of tongue structure and function and is the most comprehensive tool for ankyloglossia diagnosis. Other tools are useful screeners in clinical practice, but do not provide an in-depth assessment of feeding function. The literature overall supports the notion that a comprehensive assessment of both structure and function, including feeding impact, is required to diagnose ankyloglossia. Based on this evaluation, recommendations for surgical and/or non-surgical intervention pathways can then be considered.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"196 ","pages":"Article 112485"},"PeriodicalIF":1.2,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715750","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":"Paediatric tracheostomy: Can we predict time to decannulation?","authors":"David Brinkman,&nbsp;Roisin Mullan,&nbsp;Rania Mehanna,&nbsp;Lina Woods,&nbsp;John Russell","doi":"10.1016/j.ijporl.2025.112484","DOIUrl":"10.1016/j.ijporl.2025.112484","url":null,"abstract":"<div><h3>Introduction</h3><div>Paediatric tracheostomy is associated with a significant burden of care on health systems and primary caregivers. Decannulation is regularly part of the discussion during insertion. Being fully aware of factors that affect successful decannulation and time to decannulation is important for consenting primary caregivers, but there is a paucity of comprehensive evidence.</div></div><div><h3>Aim</h3><div>Our objective was to try and establish important predictive criteria.</div></div><div><h3>Methods</h3><div>A retrospective review of all tracheostomy patients in a national tertiary paediatric referral centre over 20 years with data on factors drawn from existing literature and additional factors significant for paediatric otolaryngologists was performed. Univariable and multivariable analysis for decannulation success and cox regression analysis on time to decannulation was performed. We included all patients that were cared for at our facility and excluded only patients that had incomplete data available.</div></div><div><h3>Results</h3><div>153 patients were included for analysis. Corrected age at insertion of less than 6 weeks and sole tube feeding were found to be significant predictors of successful decannulation on univariable analysis, with maintenance of significance of feeding route on multivariable analysis. There was no significant effect on decannulation success with presence of comorbidities, long term ventilation, gestation, emergency status, EXIT procedure or requirement for intervention pre-decannulation on univariable analysis. There was no significant difference in time to decannulation with sole upper airway obstruction or long-term ventilation, mixed oral and tube feeding route, cardiac, respiratory, or genetic comorbidities, or requirement for intervention pre-decannulation. Significantly shorter time to successful decannulation was seen with age at insertion of greater than 12 months, while a significantly longer time was seen with sole tube feeding route, age of less than six weeks at insertion, indication for insertion of a combination of upper airway obstruction and long-term ventilation, neurological co-morbidities and two or more comorbidities on Cox regression analysis.</div></div><div><h3>Conclusion</h3><div>Our analysis demonstrated feeding route to be a significant predictor of decannulation success on multivariable analysis. We also demonstrated multiple predictors of time to decannulation. These findings should aid in the discussion around decannulation with primary caregivers.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"196 ","pages":"Article 112484"},"PeriodicalIF":1.3,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721166","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}