International journal of pediatric otorhinolaryngology最新文献

{"title":"Effect of surgery on vestibular system in pediatric patients with otitis media with effusion","authors":"Serdar Hanzala Yaman ,&nbsp;Ela Cömert ,&nbsp;Ziya Şencan ,&nbsp;Burak Mustafa Taş ,&nbsp;Nuray Bayar Muluk","doi":"10.1016/j.ijporl.2025.112560","DOIUrl":"10.1016/j.ijporl.2025.112560","url":null,"abstract":"<div><h3>Objective</h3><div>The objectives of the study were to evaluate the effect of middle ear fluid aspiration and ventilation tube insertion in pediatric patients with chronic otitis media with effusion on the vestibular system using the video head impulse (vHIT) test and compare their results with healthy subjects.</div></div><div><h3>Methods</h3><div>The study population included two groups of subjects, a patient group and healthy subjects. The patient group consisted of 40 patients with bilateral chronic otitis media with effusion who underwent paracentesis, aspiration of the mucoid fluid from the middle ear, and placement of bilateral ventilation tubes. Tympanogram curves, vHIT gains, and the presence of saccades for each semicircular canal were documented before surgery, and the vHIT test was repeated on the 2nd day and the 1st and 2nd weeks postoperatively. All vHIT parameters were compared within the patient group and between patients and healthy subjects.</div></div><div><h3>Results</h3><div>Preoperatively, patients with chronic otitis media with effusion had similar vHIT gains in all canals when compared with healthy subjects. In the patient group, 20 covert saccades were observed preoperatively, 11 on the 2nd day postoperatively, and 2 on the 1st week postoperatively, and all saccades were in the vertical canal planes. A significant decrease was detected between the number of preoperative and postoperative saccades in most of the vertical canal planes. No saccade was observed in healthy subjects.</div></div><div><h3>Conclusion</h3><div>Our results support that middle ear fluid drainage and ventilation tube placement might have a positive effect on the vestibular system, as all covert saccades disappeared at 2 weeks postoperatively.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112560"},"PeriodicalIF":1.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145045491","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":"Acute mastoiditis in pediatric cochlear implant patients – a systematic review","authors":"Sophia Marie Häußler ,&nbsp;Arne Böttcher ,&nbsp;Christian Stephan Betz ,&nbsp;Katharina Stölzel ,&nbsp;Friederike Meyer","doi":"10.1016/j.ijporl.2025.112551","DOIUrl":"10.1016/j.ijporl.2025.112551","url":null,"abstract":"<div><div>Acute mastoiditis (AM) is a rare but potentially life-threatening condition in pediatric patients, particularly those with cochlear implants (CI) seem to be at higher risk for complications. The aim of this study is to propose a diagnostic and treatment algorithm by analyzing common symptoms, incidence, microbiology, and management of AM in pediatric CI patients. This systematic review includes 20 studies and four own cases, therefore 86 pediatric CI patients diagnosed with AM were enrolled. The research databases Pubmed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase und Google Scholar were searched with the terms „acute mastoiditis“ and „cochlear implant“ and „complications“. Inclusion criteria were pediatric patients with CI (&lt;16 years of age) and AM in the CI ear. Exclusion criteria were redundant cases, cases with skin or wound infections.</div><div>The incidence of AM in this cohort was 1.7 %, with a mean age at the time of AM diagnosis of 45.9 months. Most cases occurred within the first year after CI surgery, with Streptococcus pneumoniae, Streptococcus pyogenes, and Haemophilus influenzae identified as the most common pathogens. Treatment predominantly involved intravenous antibiotics (i.v. AB), with ceftriaxone being the most commonly administered AB. Surgical interventions ranged from grommet insertion, incision and drainage to revision-mastoidectomy or in two cases (2.3 %) even explantation, depending on the severity and course of the infection. Radiological imaging was primarily performed if there was a clinical suspicion of subperiosteal abscess with the need of surgical intervention. Data collection was limited by the mostly retrospective study designs and therefore resulting in partially incomplete data. Based on the collected data we propose diagnostic criteria including swab results and radiological imaging to distinguish between mild and advanced AM leading to treatment recommendations, emphasizing early i.v. AB treatment and tailored surgical interventions to prevent complications and ensure favorable outcomes without the need for CI explantation.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112551"},"PeriodicalIF":1.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145106804","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":"Variant frequency of GJB2 c.109G>A (p.Val37Ile) in the general Chinese population: A systematic review and meta-analysis","authors":"Jiao Zhang ,&nbsp;Dayong Wang ,&nbsp;Jing Guan ,&nbsp;Jiajun Du ,&nbsp;Jin Li ,&nbsp;Lei Zhang ,&nbsp;Chunyan Liu ,&nbsp;Xiaonan Wu ,&nbsp;Qiuju Wang","doi":"10.1016/j.ijporl.2025.112558","DOIUrl":"10.1016/j.ijporl.2025.112558","url":null,"abstract":"<div><h3>Objective</h3><div>This study systematically evaluates the frequency and geographic distribution of the <em>GJB2</em> c.109G &gt; A (p.Val37Ile) variant in the Chinese population, providing a data-driven basis for hereditary hearing loss prevention and control.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted across seven databases-PubMed, Embase, Science Direct, Cochrane Library, Chinese Biomedical Literature Database, China National Knowledge Infrastructure and Wanfang Data System-from their inception through May 31, 2025. Studies were screened based on predefined inclusion and exclusion criteria. Data analysis was performed using R 4.4.2. Meta-analysis was applied to calculate the variant carrier rate, allele frequency, and corresponding 95 % confidence intervals. Funnel plots and Egger's test were employed to assess publication bias.</div></div><div><h3>Results</h3><div>A total of 37 studies were included, encompassing 364,088 individuals across 18 provinces in China. Meta-analysis indicated that the overall carrier rate of the <em>GJB2</em> c.109G &gt; A variant was 11.6 % (95 % CI: 9.5 %–14.1 %), and the allele frequency was 6.3 % (95 % CI: 5.2 %–7.7 %). Stratified analysis revealed that both the carrier rate (14.5 %, 95 % CI: 12.4 %–17.0 %) and allele frequency (8.1 %, 95 % CI: 7.0 %–9.3 %) were considerably higher in southern Chinese populations compared to northern regions (carrier rate 5.3 %, 95 % CI: 4.0 %–6.9 %; allele frequency 2.7 %, 95 % CI: 2.2 %–3.3 %), with statistically significant differences (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>The <em>GJB2</em> c.109G &gt; A (p.Val37Ile) variant exhibits a relatively high carrier rate and allele frequency within the general Chinese population, with significant regional variation. These findings offer valuable insights for genetic counseling, disease prevention, and hearing health policy, and they highlight the need to account for regional and ethnic diversity in genetic studies.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112558"},"PeriodicalIF":1.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145045511","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":"Employing a multidisciplinary tracheostomy team to improve the care process of pediatric patients","authors":"Amulya Vankayalapati ,&nbsp;Michelle Coleman ,&nbsp;Janet N. Germann ,&nbsp;Michelle A. Tate ,&nbsp;Theresia Tuttle ,&nbsp;Lisa Mack ,&nbsp;Dan Benscoter ,&nbsp;Catherine K. Hart ,&nbsp;Matthew M. Smith","doi":"10.1016/j.ijporl.2025.112557","DOIUrl":"10.1016/j.ijporl.2025.112557","url":null,"abstract":"<div><h3>Objective</h3><div>Describe the varied components (staff education, system capability, family education) of a multidisciplinary, inpatient pediatric tracheostomy team.</div></div><div><h3>Methods</h3><div>After its initiation in January 2019, a multidisciplinary tracheostomy team at a tertiary pediatric medical center developed an improvement plan with multiple interventions, utilizing a mixed methodology of features from Lean in Medicine and the Institute for Healthcare Model for Improvement. Interventions included education modules, the creation of a house-wide collaborative, adjustments to the electronic documentation tab, and the initiation of real-time reporting of adverse events. Outcomes included head-of-bed emergency equipment compliance, frequency of a pre-tracheostomy care talk, documentation accuracy in the electronic medical record, and adherence to standards-of-care regarding pediatric patients with tracheostomies.</div></div><div><h3>Results</h3><div>Interventions were implemented, and data was collected from January 2019 to June 2024. With the implementation of multiple tracheostomy team interventions, head-of-bed emergency equipment compliance increased from 55 % to 100 % over the course of 4 years. Additionally, the frequency of pre-tracheostomy care talks provided to patients scheduled to receive a tracheostomy increased by 400 % over the span of nine months. Changes in documentation accuracy and adherence to standards-of-care were variable.</div></div><div><h3>Conclusions</h3><div>The pediatric tracheostomy team succeeded in increasing head-of-bed emergency equipment compliance and opportunities for caregiver education. This study demonstrates the additive benefits of a multi-faceted project to improving care in pediatric tracheostomy patients.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112557"},"PeriodicalIF":1.3,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145045512","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":"Intranasal diclofenac sodium, ibuprofen and paracetamol for pain relief after pediatric tonsillectomy","authors":"Alper Yenigun ,&nbsp;Ramazan Bahadir Kucuk ,&nbsp;Muhammed Furkan Ozgan ,&nbsp;Harun Uysal ,&nbsp;Ali Asram Sagıroglu ,&nbsp;Vildan Betul Yeni̇gun ,&nbsp;Orhan Ozturan","doi":"10.1016/j.ijporl.2025.112552","DOIUrl":"10.1016/j.ijporl.2025.112552","url":null,"abstract":"<div><h3>Objectives</h3><div>Postoperative pain following pediatric tonsillectomy remains a significant clinical challenge. Concerns about the efficacy and safety of current analgesics have prompted interest in intranasal (IN) delivery of nonsteroidal anti-inflammatory drugs (NSAIDs) as a non-invasive, effective alternative with minimal side effects.</div></div><div><h3>Methods</h3><div>In this prospective, randomized study, we evaluated the analgesic efficacy and safety of IN diclofenac sodium, IN ibuprofen, and IN paracetamol, compared to intravenous (IV) paracetamol, in children aged 2–14 years undergoing tonsillectomy. Sixty patients were randomized into four equal groups. Postoperative pain was assessed using the CHEOPS, VAS, and Wong-Baker modified VAS scores at multiple time points up to 12 h post-surgery. Data were analyzed using the Kruskal–Wallis and Dunn's tests.</div></div><div><h3>Results</h3><div>At 15 min postoperatively, IN diclofenac sodium and IN ibuprofen resulted in significantly lower pain scores compared to IV paracetamol (p &lt; 0.05). However, this difference was not sustained at later time points. Across most other intervals, pain scores in the IN NSAID groups were numerically lower, but these differences did not reach statistical significance. IN paracetamol was less effective than IV paracetamol at several time points. No serious adverse events, including bleeding, were observed.</div></div><div><h3>Conclusion</h3><div>IN diclofenac sodium and IN ibuprofen provided a transient reduction in early postoperative pain after pediatric tonsillectomy, with significantly lower pain scores at 15 min compared to IV paracetamol. At subsequent time points, the analgesic efficacy of IN NSAIDs was similar to that of IV paracetamol. The clinical relevance of this short-term benefit remains uncertain, and larger studies with additional outcome measures are warranted.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112552"},"PeriodicalIF":1.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145045514","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 the effect of a standardized family history bleeding questionnaire on tonsillectomy outcomes in pediatric patients","authors":"Brevin J. Miller ,&nbsp;Meghan Tracy ,&nbsp;Pamela Nicklaus ,&nbsp;Jill M. Arganbright","doi":"10.1016/j.ijporl.2025.112554","DOIUrl":"10.1016/j.ijporl.2025.112554","url":null,"abstract":"<div><h3>Objectives</h3><div>The use of standardized questionnaires has been suggested as a technique to predict preoperative risk and reduce the incidence of post-tonsillectomy bleeding (PTB). This study assesses the association between the administration of a validated questionnaire regarding family history of various bleeding events and the rate of PTB, preoperative hematology referral, and bleeding disorder diagnoses.</div></div><div><h3>Methods</h3><div>A retrospective cohort study involving pediatric patients who underwent palatine tonsillectomy between January 1, 2014 and December 31, 2019, was conducted. Patients who had not been administered the standardized bleeding questionnaire were assigned to the pre-standardization cohort. Those who had been administered the standardized questionnaire made up the post-standardization cohort. Rates of PTB, preoperative hematology referral, and bleeding disorder diagnoses were compared between the cohorts.</div></div><div><h3>Results</h3><div>Following screening, 1477 patients were included with 1043 assigned to the pre-standardization cohort and 434 to the post-standardization cohort. PTB requiring operative intervention occurred at a rate of 3 % and 2 % in the pre- and post-standardization groups, respectively. Administration of the standardized questionnaire was associated with a 2.46 times greater rate of hematology referral compared to the pre-standardization cohort (95 % CI: 1.47 to 4.14). The rate of bleeding disorder diagnoses was not significantly different between the cohorts.</div></div><div><h3>Conclusions</h3><div>The use of a standardized questionnaire was not associated with a reduced rate of PTB. Administration of the questionnaire led to an increase in preoperative hematology referrals without an increased rate of bleeding disorder diagnoses. Further clinical investigation of PTB risk prediction and reduction strategies is necessary to optimize tonsillectomy outcomes.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112554"},"PeriodicalIF":1.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145045513","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":"Congenital hearing loss in Palestine: Mapping the socioeconomic and clinical factors on infant health in Gaza","authors":"Khalil El-Kahlout ,&nbsp;Abd Al-Karim Sammour ,&nbsp;Muath Alsarafandi ,&nbsp;Younis Elijla ,&nbsp;Bilal Irfan ,&nbsp;Wasiq Nadeem ,&nbsp;Aasif Kazi ,&nbsp;Jack Borders ,&nbsp;Mohamad Murad","doi":"10.1016/j.ijporl.2025.112555","DOIUrl":"10.1016/j.ijporl.2025.112555","url":null,"abstract":"<div><h3>Introduction</h3><div>Congenital hearing loss (CHL) is a significant chronic condition affecting children's development and communication skills. Globally, its incidence is 1.33 per 1000 newborns, but data from Gaza is limited, this study aims to investigate clinical profile, and risk factors associated with congenital hearing loss (CHL) in infants within the Gaza Strip, focusing on the period before the 2023 military escalation.</div></div><div><h3>Methods</h3><div>A descriptive, hospital-based, prospective study was conducted at Sheikh Hamad Hospital, involving 163 infants diagnosed with CHL. Data were collected through structured questionnaires covering socioeconomic status, clinical history, and family background. Statistical analysis was performed using SPSS version 25, employing tests such as the Kolmogorov-Smirnov, Kruskal-Wallis, Mann-Whitney, and multinomial logistic regression.</div></div><div><h3>Results</h3><div>The median age at diagnosis was 12 months. Socioeconomic disparities significantly impacted diagnosis timing, with lower-income families receiving earlier diagnoses. NICU admission was linked to delayed diagnosis, while neonatal jaundice accelerated it. A positive family history of hearing impairment was associated with earlier detection. Most infants (87.7 %) had profound hearing loss, and 42.3 % had a family history of hearing impairment.</div></div><div><h3>Conclusion</h3><div>CHL in Gaza is influenced by socioeconomic and clinical factors, with delayed diagnoses more common among infants with NICU admissions or lower socioeconomic status. The findings highlight the need for universal screening programs and consistent follow-up care to mitigate disparities and improve early detection in resource-limited settings like Gaza, especially amidst ongoing conflict and healthcare disruptions.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112555"},"PeriodicalIF":1.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011115","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":"Novel antihelix instrument guided folding technique: A modification of Mustarde otoplasty","authors":"Olivia Ginty ,&nbsp;Gabrielle Pundaky ,&nbsp;Agnieszka Dzioba ,&nbsp;Julie Strychowsky","doi":"10.1016/j.ijporl.2025.112550","DOIUrl":"10.1016/j.ijporl.2025.112550","url":null,"abstract":"<div><div>Prominauris is the most common congenital ear deformity, presenting in 5 % of the global population, and most patients endorse negative experiences or aesthetic dissatisfaction as motivation for corrective otoplasty. Mustarde-Furnas is a popular otoplasty technique among pediatric patients. Given the cosmetic intention, result consistency is highly important in otoplasty, which our modification of the Mustarde technique aims to address. A retrospective chart review of pediatric patients with prominauris treated with our modified Mustarde technique at Children's Hospital between 2018 and 2025 was undertaken. The technique utilizes a drill barrel to physically control the neo-antihelix fold, and the tension of the Mustarde sutures; combined with Furnas sutures, for conchal setback. Demographics, auricle measurements, operative details, complications, and revisions were evaluated with descriptive statistics and paired t-tests. Thirty-five patients were included (mean age 12 years, range: 4–19). Significant differences between the pre- and post-operative measurements for three auricular points (mm) were found including superior helical [<em>p</em> &lt; 0.001, mean difference (MD) = 7.67], and, superior and inferior external auditory canal [<em>p</em> &lt; 0.001, MD = 9.35; <em>p</em> &lt; 0.001, MD = 4.88, respectively]. No statistically significant differences were found between each measurement change and the measurement change in the corresponding contralateral auricle measurement (<em>p</em> &gt; 0.05). Revision rate was 5.7 % (2/35), indicated for scar revision and recurrence. The latter prompted a suture switch, and no recurrence followed. The significant differences found across all auricular measurements, and the consistency of results between each auricle pair, demonstrate the potential efficacy of this modified-Mustarde technique for reliable otoplasty for aesthetic satisfaction and applications to trainee education.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112550"},"PeriodicalIF":1.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011116","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":"Advanced practice providers in pediatric otolaryngology/head and neck surgery: A single-institution analysis of clinical and surgical productivity","authors":"Winston R. Owens ,&nbsp;Kristina P. Marsack ,&nbsp;Jessie Marcet-Gonzalez ,&nbsp;Matthew J. Parham ,&nbsp;Larry H. Hollier Jr. ,&nbsp;Anna H. Messner","doi":"10.1016/j.ijporl.2025.112549","DOIUrl":"10.1016/j.ijporl.2025.112549","url":null,"abstract":"<div><h3>Introduction</h3><div>Advanced practice providers (APPs) initially delivered primary care amidst physician shortages; however, they have since expanded their practice across various specialties. While benefits of APPs are known, there is a paucity of literature regarding how APPs can increase productivity within pediatric otolaryngology/head and neck surgery (OHNS). This study aims to identify the impact of APP integration within pediatric OHNS at a level I pediatric hospital in Houston, Texas.</div></div><div><h3>Methods</h3><div>Retrospective review of data from the Surgery Department Executive Committee annual reports from October 2011 to September 2024 was conducted. Descriptive analysis was completed with productivity in clinic and operative volumes, surgical conversion rates, and work relative value unit (wRVU) trends.</div></div><div><h3>Results</h3><div>Since fiscal year 2012, the ratio of APPs to MDs nearly doubled from 1 APP per 4.5 MDs to 1 APP per 2.45 MDs in 2024. The largest observed APP clinic volume was in 2024 at 16,881 visits, over 3.5x greater than in 2012. Operative volume increased by over 300 % from 2012 to 2024. APPs have significantly increased the number of inpatient consults, subsequent visits, and common OHNS procedures completed since 2012. Division wRVUs were observed to increase nearly four-fold from 2012 to 2024.</div></div><div><h3>Conclusion</h3><div>APPs promote surgeon scope of practice, producing clinical and financial benefits for pediatric otolaryngology/head and neck surgery practices. Structured training programs adequately prepare APP trainees to increase access to care, improve perioperative flow, and allow surgeons to function at the top of their licensure.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112549"},"PeriodicalIF":1.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145045492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of auditory steady-state response in differentiating pediatric auditory neuropathy spectrum disorders: with normal auditory nerve diameter versus with auditory nerve hypoplasia.","authors":"Josilene Luciene Duarte, Eliene Silva Araújo, Amanda Gonçalves Silveira, Elisabete Honda Yamaguti, Eduardo Boaventura Oliveira, Bárbara Cristiane Sordi Silva, Lilian Cássia Bórnia Jacob, Kátia de Freitas Alvarenga","doi":"10.1016/j.ijporl.2025.112509","DOIUrl":"10.1016/j.ijporl.2025.112509","url":null,"abstract":"<p><strong>Purpose: </strong>Evaluations of Auditory Evoked Potentials, more specifically Auditory Steady-State Responses (ASSR) in children having Auditory Neuropathy Spectrum Disorder (ANSD) with normal auditory nerve diameter and ANSD with auditory nerve hypoplasia were performed, to analyze the feasibility of using ASSR as a predictor of behavioral thresholds in this population.</p><p><strong>Methods: </strong>In total, 27 children were evaluated; 17 diagnosed as ANSD with normal auditory nerve diameter (group 1) and 10 diagnosed as ANSD with auditory nerve hypoplasia (group 2). The participants' ages ranged from six months to 10 years and 9 months, and all had bilateral alterations; therefore, 54 ears were analyzed. The evaluation included (i) ASSR thresholds, in carrier frequencies of 0.5, 1, 2 and 4 kHz, 100 % modulated for amplitude and 20 % for frequency and (ii) behavioral auditory thresholds.</p><p><strong>Results: </strong>Among children having ANSD with normal auditory nerve diameter, a high number of absent responses was identified in ASSR, even at frequencies with behavioral threshold records. Conversely, among children having ANSD with auditory nerve hypoplasia, consistent ASSR were recorded, making it possible to determine the electrophysiological threshold for most frequencies evaluated in this study.</p><p><strong>Conclusion: </strong>In ANSD with normal auditory nerve diameter, ASSR do not provide additional information for predicting behavioral thresholds, requiring follow-up until the obtainment behavioral thresholds. Conversely, ASSR were consistently recorded in cases of ANSD with auditory nerve hypoplasia. Therefore, ASSR is a promising complementary tool for differential diagnosis between hypoplasia and auditory nerve aplasia and even between ANSD with normal auditory nerve diameter and ANSD with auditory nerve hypoplasia.</p>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"196 ","pages":"112509"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804058","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}