International journal of pediatric otorhinolaryngology最新文献

{"title":"Evaluating utility of allergy testing in management of nasal obstruction following inferior turbinate reduction.","authors":"Joseph Lee, Logan F McColl, Molly O Meeker, Tony Satroplus, Natalie Kelly, Kevin Liu, Amanda Onwuka, Tendy Chiang","doi":"10.1016/j.ijporl.2024.112177","DOIUrl":"https://doi.org/10.1016/j.ijporl.2024.112177","url":null,"abstract":"<p><strong>Introduction: </strong>Allergic rhinitis (AR) within the pediatric population affects more patients than any other chronic disease. Inferior turbinate hypertrophy (ITH) is a common cause of nasal obstruction in children and is strongly associated with AR. Inferior turbinate reduction (ITR) surgery is used in patients with ITH who have failed medical management. While surgery is curative for most, there remains a subset of patients who continue to have symptoms of nasal obstruction despite ITR, which can cause discomfort and significant impacts on quality of life. Additionally, some patients with persistent disease go on to require revision surgery. The objectives in this study were to assess the impact of allergy testing results in patients undergoing ITR and evaluate if they predict long-term durability of surgical outcome.</p><p><strong>Methods: </strong>A retrospective chart review of patients undergoing ITR between January and December of 2015 was performed. Data pertaining to demographics, allergy testing results, surgical technique, and medical management was collected. Patients who underwent concomitant procedures at the time of ITR were excluded. Data analysis included descriptive statistics, chi-squared tests, and t-test analyses.</p><p><strong>Results: </strong>297 patients who underwent ITR were included for data analysis. Overall, 20.9 % of patients had recurrent nasal obstruction after ITR and 5.4 % required revision surgery. Among all included patients, 37.7 % underwent allergy testing of which 53 (47.3 %) tested positive and 54 (48.2 %) tested negative; results were unknown for 5 (4.5 %) patients. In patients with positive allergy tests, 36 % had recurrent nasal obstruction and 11 % required revision surgery. In patients with negative allergy tests, 41 % had recurrent nasal obstruction and 13 % required revision surgery. There were no significant associations among those with positive and negative allergy tests and recurrence of nasal obstruction or need for revision surgery. Patients with a documented clinical diagnosis of AR were more likely to have recurrence of nasal obstruction after surgery than those without (28 % vs 12 %, p = 0.001) and were more likely to require revision surgery (9 % vs 1 %, p = 0.001).</p><p><strong>Conclusions: </strong>ITR is a reasonable choice for the treatment of nasal obstruction in children. However, there remains a subset of patients who have recurrent nasal obstruction following initial surgery. Allergy testing results do not appear to impact the rate of recurrent nasal obstruction or the need for revision surgery. Therefore, the utility of allergy testing may have a limited benefit in the management of nasal obstruction in children. However, a clinical diagnosis of allergic rhinitis does appear to be a prognostic factor for experiencing post-operative recurrent nasal obstruction and requiring revision surgery.</p>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"188 ","pages":"112177"},"PeriodicalIF":1.2,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785427","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 impact of endoscopic sinus surgery in pediatric patients with sinogenic intracranial infection: A systematic review and meta-analysis","authors":"Elysia Grose ,&nbsp;Jenny B. Xiao ,&nbsp;Evan Fang ,&nbsp;Brigitte Routhier-Chevrier ,&nbsp;Jennifer M. Siu ,&nbsp;Nikolaus E. Wolter","doi":"10.1016/j.ijporl.2024.112176","DOIUrl":"10.1016/j.ijporl.2024.112176","url":null,"abstract":"<div><h3>Objective</h3><div>This review aims to elucidate the role of endoscopic sinus surgery (ESS) on the outcomes of pediatric patients with sinogenic intracranial infections.</div></div><div><h3>Methods</h3><div>MEDLINE, Embase, and the Cochrane library were searched for articles that described the outcomes in pediatric patients who had intracranial complications of acute rhinosinusitis (ARS) and underwent ESS with or without open neurosurgical approaches (ONA) or external sinus approaches (ESA). Primary outcomes of interest include mortality, revision surgery, length of stay and neurological sequelae. Random effects meta-analysis was performed.</div></div><div><h3>Results</h3><div>Forty-eight articles met the final eligibility criteria, totaling 710 pediatric patients and 905 intracranial complications. The most common complications were subdural empyema (n = 261, 29 %), epidural abscess (n = 213, 24 %), and Pott's Puffy tumor (PPT) (n = 95, 10 %). When comparing patients who underwent ESS (alone or combined with ONA) to those who underwent ONA only, there was a decreased risk of revision surgery (RR = 0.66, 95 % CI = 0.38–1.12 and RR = 0.63, 95 % CI = 0.36–1.09, respectively) and decreased risk of neurological sequelae (RR = 0.65, 95 % CI = 0.15–2.74 and RR = 0.50, 95 % CI = 0.20–1.26, respectively), however these differences were not statistically significant. When patients who underwent combined intervention were compared to ESS only, the risk of revision surgery (RR = 1.04, 95 % CI = 0.62–1.72) and neurological sequelae (RR = 0.99, 95 % CI = 0.37–2.64) were similar. Risk of mortality was minimal and similar across all interventions.</div></div><div><h3>Conclusion</h3><div>The current study including primarily small retrospective studies found no statistically significant differences between children who received ESS alone, ESS with ONA or ONA alone, on mortality, revision surgery, length of stay and neurological sequelae. Although ESS may be beneficial for managing certain pediatric sinogenic intracranial infections, its true effectiveness is difficult to determine due to the variability in the types of intracranial complications and the inconsistent extent of ESS procedures reported in the literature.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"187 ","pages":"Article 112176"},"PeriodicalIF":1.2,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142720710","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":"Assessing robotic-assisted procedures in pediatric otolaryngology: A systematic review and meta-analysis","authors":"Drew C. Gottman ,&nbsp;Michaele Francesco Corbisiero ,&nbsp;Arman Saeedi ,&nbsp;Samantha Bothwell ,&nbsp;Ellie Svoboda ,&nbsp;Andy Ai ,&nbsp;Soham Roy","doi":"10.1016/j.ijporl.2024.112175","DOIUrl":"10.1016/j.ijporl.2024.112175","url":null,"abstract":"<div><h3>Background</h3><div>Robotic-assisted surgery is increasingly used in pediatric otolaryngology, offering potential benefits like improved cosmetic outcomes. However, challenges such as longer operative times, higher costs, and a steep learning curve remain.</div></div><div><h3>Objectives</h3><div>This systematic review and meta-analysis assess whether robotic-assisted surgery offers advantages in operative time, complication rates, hospital stay, and cosmetic outcomes compared to traditional methods in pediatric patients.</div></div><div><h3>Methods</h3><div>A literature search identified 20 studies, with six focused on thyroidectomy. Data on operative time, complications, hospital stay, and cosmetic outcomes were extracted and analyzed.</div></div><div><h3>Results</h3><div>No significant differences in operative time or complications were found for robotic-assisted thyroidectomy, but it showed superior cosmetic outcomes and, in some cases, shorter hospital stays. Additional analyses suggested feasibility and functional benefits of other robotic procedures.</div></div><div><h3>Conclusions</h3><div>Robotic-assisted surgery in pediatric otolaryngology is as safe and efficient as traditional methods, with added cosmetic and functional benefits. Further large-scale trials are needed.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"187 ","pages":"Article 112175"},"PeriodicalIF":1.2,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142720708","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 characteristics of occult foreign body aspiration and predicting factors in children","authors":"Yi Zhang ,&nbsp;Yan Li ,&nbsp;Rui Zhang ,&nbsp;Lin Zhong ,&nbsp;Lina Chen","doi":"10.1016/j.ijporl.2024.112169","DOIUrl":"10.1016/j.ijporl.2024.112169","url":null,"abstract":"<div><h3>Objective</h3><div>To summarize the clinical characteristics and risk factors of occult foreign body aspiration (FBA) in children, which can help with early diagnosis and timely intervention, potentially preventing further exacerbations.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed the clinical data of the children with a final diagnosis of FBA by flexible bronchoscopy in our hospital from 2017 to 2023. The patients were divided into occult and typical groups, and two groups were compared. Multivariate binary logistic regression analysis was employed to identify risk factors associated with the occurrence of occult FBA.</div></div><div><h3>Results</h3><div>Among 1031 patients, the incidence of occult FBA was 4.3 % (44 cases). Compared to the typical group, children in the occult group had higher odds of ventilator management (P = .006) and longer postoperative hospitalization time (P &lt; .001). Risk factors for predicting occult FBA were identified as age greater than 3 years old [OR: 6. 918; 95%CI (3.150–15.191)], fever [OR: 2.323; 95%CI (1.092–4.939)], inspiratory laryngeal stridor [OR: 6.514; 95%CI (1.863–22.781)], atelectasis [OR: 3.372; 95%CI (1.418–8.020)], and infiltration [OR: 2.749; 95%CI (1.195–6.323)].</div></div><div><h3>Conclusions</h3><div>Unlike typical FBA, the diagnosis of occult FBA is far more challenging, and occult foreign bodies are linked to a further exacerbation. This study identifies a few risk factors that have the potential to facilitate an early diagnosis of occult FBA in children. Further multicenter studies should be conducted to validate the findings.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"187 ","pages":"Article 112169"},"PeriodicalIF":1.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692990","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":"Hearing loss and vestibular dysfunction in congenital CMV infection: Could it be due to endolymphatic pressure anomaly? A preliminary study.","authors":"Laureline Kahn, Guillaume Poillon, Monique Elmaleh-Bergès, Luca Litman-Roventa, Emilien Chebib, Natacha Teissier, Audrey Maudoux","doi":"10.1016/j.ijporl.2024.112172","DOIUrl":"https://doi.org/10.1016/j.ijporl.2024.112172","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the inner ear sectors after an inner ear MRI protocol and search for the presence of endolymphatic pressure anomaly in patients presenting with a congenital CMV infection and audio-vestibular dysfunction.</p><p><strong>Methods: </strong>A 3D FLAIR MRI sequence, 4 h after gadolinium injection, was performed in patients with sensory-neural hearing loss secondary to a congenital CMV infection in order to analyse the morphology of the endolymphatic space.</p><p><strong>Results: </strong>Two patients presented with a unilateral SNHL and 4 patients a bilateral SNHL. Seven ears with SNHL demonstrated an endolymphatic hydrops on MRI images and 2 showed a membranous labyrinth atelectasis. All ears but two had a marked enhancement in the perilymph of the basal turn of the cochlea. One ear, with a normal hearing threshold but altered vestibular function, demonstrated cochlear and saccular hydrops. Two ears with normal or near normal hearing and normal vestibular function were radiologically normal on the MRI.</p><p><strong>Conclusion: </strong>The compartmental endolymphatic study using delayed contrast-enhanced MRI sequences in children with cCMV infection suggests a relationship between inner ear involvement and endolymphatic pressure anomaly.</p>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"188 ","pages":"112172"},"PeriodicalIF":1.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791722","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":"Comparison of current staging systems for predicting pediatric cholesteatoma outcomes","authors":"Soorya Todatry ,&nbsp;Robert Newsom ,&nbsp;James Wald ,&nbsp;Manuela Fina","doi":"10.1016/j.ijporl.2024.112170","DOIUrl":"10.1016/j.ijporl.2024.112170","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aims to assess the utility of the European Academy of Otology &amp; Neurotology – Japanese Otologic Society (EAONO-JOS) and Potsic staging systems in predicting recidivism in pediatric patients with congenital (CC), primary acquired (PA), and secondary acquired (SA) cholesteatoma.</div></div><div><h3>Methods</h3><div>This is a retrospective study on 31 ears from 30 pediatric patients (≤18 years old) treated from 2015 to 2023 for CC, PA, and SA cholesteatoma. Surgical ears were classified according to EAONO-JOS and Potsic staging system. Surgery included transcanal endoscopic ear surgery (TEES), canal-wall up (CWU) or canal-wall down (CWD) mastoidectomy. Primary outcomes included the rate of residual disease at second-look surgery and the rate of recurrence at clinical observation. In addition, stapes erosion, incus erosion, labyrinthine fistula, and extension of disease in the mastoid at primary surgery were investigated for predictivity for recidivism. Descriptive statistics, Kaplan-Meier estimators (KM), and Fisher's Exact tests were used for statistical analysis.</div></div><div><h3>Results</h3><div>Based on EAONO-JOS staging, the majority (87 %) of cholesteatoma were stage II (100 % for CC, 86.7 % for PA, and 60 % for SA). The rate of residual disease was 45 % for CC, 60 % for PA, and 40 % for SA cholesteatoma. The rate of recurrent disease among the entire cohort was 6.5 %. Univariate analysis on stapes or incus erosion or mastoid extension did not predict residual disease. Within the CC cohort, outcomes suggest a potential correlation between Potsic stage and the risk of residual disease. Insufficient variability in EAONO-JOS stages precluded statistical analysis of the system's ability to predict residual disease. Among the EAONO-JOS stage II cases, those presenting with all three variables (mastoid extension, incus erosion, and stapes erosion) at primary surgery had lower KM survivability (p = 0.010). The type of surgery was predictive of residual disease: CWU was associated with a lower KM survivability compared to TEES (p = .009). CWD was not predictive, given the insufficient sample size. Among all ears, 58 % were managed with TEES.</div></div><div><h3>Conclusions</h3><div>In this limited cohort of pediatric CC, PA, and SA cholesteatoma, the majority of cases were managed with TEES. Among EAONO-JOS stage II cases, the simultaneous presence of mastoid extension, incus erosion, and stapes erosion at primary surgery demonstrated statistically significant decreased residual-free survivability; TEES approach at primary surgery also has a statistically significant improved residual-free survivability compared to CWU approach.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"187 ","pages":"Article 112170"},"PeriodicalIF":1.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695489","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":"Temporal cue based categorization and speech perception in noise among pediatric cochlear implant users","authors":"Anuj Kumar Neupane,&nbsp;C.S. Vanaja","doi":"10.1016/j.ijporl.2024.112171","DOIUrl":"10.1016/j.ijporl.2024.112171","url":null,"abstract":"<div><h3>Objectives</h3><div>Voice onset time (VOT) has been identified as a potential temporal cue for predicting children's performance in speech-in-noise tasks, yet the relationship between these two factors has never been explored among children using CI. Hence, the present study aimed to explore the performance of children using CI on temporal cue-based syllable categorization test and speech perception in noise and examine the relationship between the two.</div></div><div><h3>Methods</h3><div>Temporal cue-based syllable categorization test was developed with the manipulation of /ba/ sound in 10 steps continuum with VOT varied between −74 ms to 26 ms. The developed test and revised speech in noise for Marathi-speaking children (0 and 5 dB SNR) were administered to thirty children with unilateral cochlear implant and thirty children with normal hearing, aged between 5 to 7 years.</div></div><div><h3>Results</h3><div>The Mann-Whitney U test showed significant differences between groups in temporal cue-based categorization and speech in noise tests at 0 dB and 5 dB SNR. Kendall Tau B revealed a moderate correlation between implant age and scores on the temporal cue-based categorization and speech in noise tests at 0 dB SNR, with a strong correlation at 5 dB SNR. Additionally, there was a significant moderate relationship between temporal cue-based categorization and speech in noise test scores at both 0 dB and 5 dB SNR.</div></div><div><h3>Conclusion</h3><div>The present study highlights the importance of temporal cues in speech perception and the need for temporal processing for children using cochlear implants. It reinforces the evidence that speech perception skills improve with implant age.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"187 ","pages":"Article 112171"},"PeriodicalIF":1.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686866","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":"Tracheostomy in children with mucopolysaccharidosis: A systematic review","authors":"Francesca Galluzzi ,&nbsp;Werner Garavello","doi":"10.1016/j.ijporl.2024.112167","DOIUrl":"10.1016/j.ijporl.2024.112167","url":null,"abstract":"<div><h3>Objectives</h3><div>Children with mucopolysaccharidosis (MPS) with difficult airways may require tracheostomy, and surgery can be challenging. This review aims to study the indications, surgical aspects, postoperative complications and outcomes of tracheostomy in MPS children.</div></div><div><h3>Methods</h3><div>A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. Pubmed and Embase were searched for studies on tracheostomy in children with MPS. The Joanna Briggs Institute was used for quality appraisal.</div></div><div><h3>Results</h3><div>A total of 9 studies were included. Three were retrospectives<em>,</em> one was prospective, and five were case series. Overall, 34 subjects who underwent a tracheostomy were included. The mean age was 11 years and the male/female ratio was 1.7. MPS II was the most common type included (16/34). The percentage of tracheotomized MPS children was 10 % (ranging from 3.5 % to 15.5 %). Indications for tracheostomy were: progressive or urgent airway obstruction unresponsive to conservative treatments, before a planned surgical procedure, and in case of failed intubation/extubation. Characteristics clinical features make surgery difficult and predispose complications such as tracheal granulations, wound infection, stomal narrowing, persistent of abundant secretions and tracheitis. Considering tracheostomy outcome, two patients underwent decannulation, but one of them required reinsertion tracheostomy after one year. The duration of follow-up was 8.4 and 9.98 years.</div></div><div><h3>Conclusion</h3><div>Tracheostomy is an effective means of ensuring airway patency in children with MPS and is considered essentially permanent. Management can be challenging due to typical clinical features and progression of MPS. A planned multidisciplinary approach may prevent complications.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"187 ","pages":"Article 112167"},"PeriodicalIF":1.2,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706383","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":"Differential sleep subtypes in children with OSA of different ages","authors":"Chenxi Luo,&nbsp;Wenbo Chen,&nbsp;Qi Li","doi":"10.1016/j.ijporl.2024.112168","DOIUrl":"10.1016/j.ijporl.2024.112168","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to evaluate the variations in sleep architecture and types of sleep disturbances in preschool and school-age children diagnosed with obstructive sleep apnea (OSA).</div></div><div><h3>Methods</h3><div>Children who underwent polysomnography (PSG) were enrolled and divided into two groups based on age: a preschool group and a school-age group. We analyzed differences in sleep architecture and types of sleep disturbances between these groups.</div></div><div><h3>Results</h3><div>Total sleep time was significantly higher in the preschool group compared to the school-age group (P &lt; 0.05). The percentage of Stage N1 sleep (N1%) was also higher in the preschool group (p &lt; 0.05). Conversely, the percentage of Stage N2 sleep (N2%) was lower in the preschool group (p &lt; 0.05). Additionally, the average and minimum heart rates were higher in the preschool group, while the minimum oxygen saturation, including during non-rapid eye movement (NREM) and REM stages, was lower compared to the school-age group (P &lt; 0.05). The prevalence of positional OSA (P-OSA) was lower, and the prevalence of REM OSA (R-OSA) was higher in the preschool group (P &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>The prevalence of P-OSA was lower, and R-OSA was higher in preschool children compared to school-age children. Furthermore, the types of sleep disturbances in preschool children with OSA showed significant differences from those in school-age children with OSA.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"187 ","pages":"Article 112168"},"PeriodicalIF":1.2,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706438","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 demographics and social vulnerability on outcomes in pediatric medullary thyroid cancer","authors":"Arifeen Rahman,&nbsp;Christopher Low,&nbsp;Alice Huang,&nbsp;Kara Meister,&nbsp;Karthik Balakrishnan","doi":"10.1016/j.ijporl.2024.112166","DOIUrl":"10.1016/j.ijporl.2024.112166","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the impact of social vulnerability and social determinants of health on outcomes in pediatric medullary thyroid cancer.</div></div><div><h3>Methods</h3><div>A SEER database review looking at cases of pediatric medullary thyroid cancer from 1975 to 2016 was conducted and analyzed including data from the American Community Survey.</div></div><div><h3>Results</h3><div>A total of 174 patients were included in analysis. Five-year overall survival was 97.7 % and the disease specific survival (DSS) was 98.3 %. On univariate analysis, male sex was associated with worsened overall survival (HR = 4.2, CI 1.1–15.5, p &lt; 0.05) but did not reach statistical significance on multivariate analysis. Asian or Pacific Islander race was associated with worsened overall survival on both univariate and multivariate analysis (HR = 5.5, CI 1.4–22.2, p &lt; 0.05). Presenting with localized disease without nodal or distant metastasis was found to be a protective factor (HR = 0.2, CI 0.05–0.53, p &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Asian American/Pacific Islander patients and male patients may have poorer survival in pediatric medullary thyroid cancer. More research should be completed to better understand underlying factors.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"187 ","pages":"Article 112166"},"PeriodicalIF":1.2,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692988","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}