Milan P. Fehrenbach , Asher C. Park , Payton O. Abney , Mackenzie N. Sweatt , Alyssa J. Smith
{"title":"A geospatial analysis of the pediatric otolaryngology workforce in the United States","authors":"Milan P. Fehrenbach , Asher C. Park , Payton O. Abney , Mackenzie N. Sweatt , Alyssa J. Smith","doi":"10.1016/j.ijporl.2025.112536","DOIUrl":"10.1016/j.ijporl.2025.112536","url":null,"abstract":"","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"197 ","pages":"Article 112536"},"PeriodicalIF":1.3,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144903341","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}
Katie Holland , Abbey L. Landini , Tanner Parsons , Inbal Hazkani , Maura E. Ryan , Corey Bregman , Ben Z. Katz , John Maddalozzo
{"title":"Fistulas don't tell the whole story: Predicting the need for surgery in pediatric patients with non-tuberculous mycobacterial cervicofacial lymphadenitis","authors":"Katie Holland , Abbey L. Landini , Tanner Parsons , Inbal Hazkani , Maura E. Ryan , Corey Bregman , Ben Z. Katz , John Maddalozzo","doi":"10.1016/j.ijporl.2025.112531","DOIUrl":"10.1016/j.ijporl.2025.112531","url":null,"abstract":"<div><h3>Introduction</h3><div>Cervicofacial lymphadenitis (CFL) in children is commonly caused by non-tuberculous mycobacterium (NTM). NTM presents as lymphadenopathy, which can result in violaceous skin changes, necrosis, and fistulas in later stages. Multiple therapeutic modalities are available, encompassing conservative management, antimicrobial treatment, and surgical procedures of varying complexity, with considerable inter-institutional and intra-institutional practice variation.This study aimed to evaluate whether the radiographic presence of fistulous tracts in patients with NTM CFL is associated with an increased probability of requiring surgery.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of patients with clinical or histopathologic diagnosis of NTM at a single tertiary care urban pediatric hospital between 2010 and 2024. Demographic, physical examination, medical and surgical treatment, laboratory findings, and follow-up data were collected. Available imaging was blindly reviewed by pediatric neuroradiologists for the presence of cutaneous fistula (CF). Patients were excluded if they were over 18 years of age, did not have imaging, and had presentation/pathology/culture data inconsistent with NTM. Descriptive statistics, analysis of variance (ANOVA), and logistic regression tests were used for group comparisons.</div></div><div><h3>Results</h3><div>Sixty-six patients were found to have proven or presumed NTM CFL, available imaging, and disease resolution at the time of chart review. Forty-seven (71.2 %) had evidence of cutaneous fistulas. For those 47 with CF, 15 underwent primary surgical treatment while 32 had primary antibiotic treatment, although ultimately 28 of the latter required surgery. For those with and without CF there were significantly more patients who required surgical treatment for resolution (p < 0.001). There was no significant difference in the likelihood of surgical intervention for disease resolution between patients with CF compared to those without.</div></div><div><h3>Conclusions</h3><div>While the radiographic presence of CF did not significantly predict the likelihood of requiring surgical intervention, most patients with and without CF ultimately required surgery for disease resolution rather than responding to long-term antibiotic therapy alone. These findings suggest that surgical intervention remains a critical component of NTM CFL management regardless of initial imaging findings. This information can help clinicians counsel families that while medical therapy may be attempted initially, surgical treatment should be anticipated as part of the treatment course for optimal disease resolution.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"197 ","pages":"Article 112531"},"PeriodicalIF":1.3,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893278","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}
Alhanouf A. Alhedaithy , Zahra Almoumen , Mohammed Y. Alyousef , Deema R. Alhudaithi , Mohammed Sulaiman Alsayyari , Ahmed Alammar
{"title":"Endoscopic posterior cricoid split with costal cartilage graft in pediatric bilateral vocal cord paralysis: A retrospective institutional series and literature comparison","authors":"Alhanouf A. Alhedaithy , Zahra Almoumen , Mohammed Y. Alyousef , Deema R. Alhudaithi , Mohammed Sulaiman Alsayyari , Ahmed Alammar","doi":"10.1016/j.ijporl.2025.112533","DOIUrl":"10.1016/j.ijporl.2025.112533","url":null,"abstract":"<div><h3>Objective</h3><div>The study aimed to evaluate the clinical outcomes of endoscopic posterior cricoid split with costal cartilage grafting (EPCSCG) in pediatric patients with bilateral vocal cord paralysis (BVCP) and compare these results with those in the existing literature.</div></div><div><h3>Methods</h3><div>This retrospective case series included pediatric patients (≤18 years) who underwent EPCSCG between 2017 and 2024 at a tertiary care center. Data were extracted from operative reports, clinical notes, and endoscopy records. The primary outcomes included tracheostomy status, decannulation rate, breathing function (Empey Index), swallowing outcomes (dysphagia outcome and severity scale [DOSS]), and voice assessment (Voice Handicap Index–10 [VHI-10]). A structured literature review was also conducted for comparison.</div></div><div><h3>Results</h3><div>The study included nine patients (median age: 3 years, interquartile range: 1–6 years). Four patients underwent preoperative tracheostomy, and all underwent successful decannulation. Tracheostomy was avoided entirely in the remaining five patients, resulting in a 100 % tracheostomy-free rate. The Empey Index improved postoperatively in two-thirds of the tested patients. Voice outcomes remained impaired with a moderately elevated mean VHI-10 score of 20.7. No major complications occurred, and additional surgeries were performed in four patients, including balloon dilations for subglottic stenosis, partial laser arytenoidectomy, right vocal cord suture lateralization, adenoidectomy, and tracheocutaneous fistula repair. A literature comparison revealed a wide variability in decannulation rates (28.6–100 %) and inconsistent reporting of voice and swallowing outcomes.</div></div><div><h3>Conclusion</h3><div>EPCSCG is a safe and effective surgical option for pediatric patients with BVCP that achieves excellent decannulation and swallowing outcomes. Persistent dysphonia remains a limitation, highlighting the need for comprehensive preoperative and postoperative functional assessments.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"197 ","pages":"Article 112533"},"PeriodicalIF":1.3,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144902690","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}
Emma Necus , Mary Claessen , Neville Hennessey , Sharon Smart
{"title":"Corrigendum to “Assessment of tongue structure and function in infants for the diagnosis of ankyloglossia: A systematic review” [Int. J. Pediatr. Otorhinolaryngol., 196, 112485]","authors":"Emma Necus , Mary Claessen , Neville Hennessey , Sharon Smart","doi":"10.1016/j.ijporl.2025.112527","DOIUrl":"10.1016/j.ijporl.2025.112527","url":null,"abstract":"","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"197 ","pages":"Article 112527"},"PeriodicalIF":1.3,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954178","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}
Claudia Alarcón Avila , Angie Tatiana Saenz González , Luisa Fernanda Vivas Gómez , Maira Alejandra Rivero Centeno , María José Silva Ortiz , Laura Camila Salazar Vera , Daniela Alejandra Osorio Beltrán , David Díaz-Báez
{"title":"Diagnostic performance and clinical follow-up of a universal newborn hearing screening program using OAE and ABR in a middle-income country","authors":"Claudia Alarcón Avila , Angie Tatiana Saenz González , Luisa Fernanda Vivas Gómez , Maira Alejandra Rivero Centeno , María José Silva Ortiz , Laura Camila Salazar Vera , Daniela Alejandra Osorio Beltrán , David Díaz-Báez","doi":"10.1016/j.ijporl.2025.112511","DOIUrl":"10.1016/j.ijporl.2025.112511","url":null,"abstract":"<div><h3>Background</h3><div>Congenital hearing loss (CHL) affects language development and quality of life of children. Although high-income countries have implemented neonatal hearing screening (NHS) programs, data regarding the implementation of such programs in middle-income countries are limited. This study evaluated NHS coverage and the incidence of hearing loss, the diagnostic performance of two screening tests, and the associated risk factors (RFs), characterizations, and two-year follow-up data of affected infants in a middle-income country.</div></div><div><h3>Methods</h3><div>An ambispective cohort study was conducted in a high-complexity hospital in Bogotá, Colombia (2020–2023). Screening was performed in two stages using otoacoustic emissions (OAE) and automated brainstem response (ABR) evaluations. Infants who failed both stages were referred to otolaryngological assessments. Poisson regression was used to identify the associated RFs, and the diagnostic performance metrics for OAE assessment were estimated using the ABR data as the reference.</div></div><div><h3>Results</h3><div>The NHS coverage was 69.8 %. CHL was diagnosed in four children (3/1.000). The follow-up rate was 75 %. Neonatal unit admission was associated with a higher risk of CHL (relative risk: 10.77, 95 % confidence interval: 2.10–5.18). In the first stage, OAE assessment showed 72.2 % sensitivity and 99.4 % specificity, while in the second stage, their sensitivity and specificity were 71.4 % and 100 %, respectively. The agreement between OAE and ABR assessments was substantial in the first stage (κ = 0.791) and moderate in the second stage (κ = 0.397).</div></div><div><h3>Conclusions</h3><div>These findings emphasize the importance of implementing strategies to improve NHS coverage and ensure comprehensive follow-up in middle-income countries, thereby improving the quality of life of patients in these countries. Despite the high specificity and sensitivity, the variability in test agreement highlights the need for structured two-stage screening protocols combining OAE and ABR assessments.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"197 ","pages":"Article 112511"},"PeriodicalIF":1.3,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912547","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":"Comprehensive staging system for nasopharyngeal angiofibroma: Integrating anatomical and functional parameters","authors":"Anupam Mishra , Subhash Chandra Mishra","doi":"10.1016/j.ijporl.2025.112524","DOIUrl":"10.1016/j.ijporl.2025.112524","url":null,"abstract":"<div><h3>Background</h3><div>Staging systems for nasopharyngeal angiofibroma (NA) have traditionally shown inconsistencies in anatomical prioritization and have not adequately incorporated functional considerations.</div></div><div><h3>Methods</h3><div>A novel, comprehensive staging system was developed through expert consensus (N = 8) using the Delphi method. This system consists of three components: (1) Composite Anatomical Status (CAS) comprising of tumor extensions in all anterior, posterior, lateral, and superior directions; (2) Composite Symptom Score (CSS) that grades the patient's clinical symptomatology; and (3) Functional Performance Status (FPS) that describes subjective assessment of surgical feasibility based on day to day functional wellbeing. This comprehensive system was retrospectively validated using chart reviews of 145 patients, evaluating demographic data, clinical presentation, and radiological imaging. Six existing staging systems were also applied to this cohort and correlated with CAS, CSS, FPS, and clinical outcomes. This comprehensive staging was further compared with 7 existing classifications.</div></div><div><h3>Results</h3><div>All 7 staging systems demonstrated mutual correlation. CSS significantly correlated with lateral and superior tumor extension, while FPS was associated with anterior extension. Tumor recurrence showed a significant association with lateral extension and the Onerci staging system. CSS effectively reflected advanced disease as identified by CAS, particularly in the lateral and superior extensions. FPS closely paralleled CSS and also showed correlation with anterior extension.</div></div><div><h3>Conclusion</h3><div>The proposed comprehensive staging approach offers a more comprehensive framework for evaluating NA. CAS accurately reflects anatomical progression in all directions, enhancing surgical planning and risk stratification. This integrated staging model overcomes limitations of existing systems not only anatomically but also by unifying it with functional disease assessment.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"197 ","pages":"Article 112524"},"PeriodicalIF":1.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144912546","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}
Sairisheel Gabbireddy , Ruifeng Cui , Zulkifl Jafary , Mythili Pulavarthi , John Dewey , Pavithra Ellison , Erik Olness , Hussein Jaffal
{"title":"Determining the optimal postoperative observation time for outpatient pediatric tonsillectomy","authors":"Sairisheel Gabbireddy , Ruifeng Cui , Zulkifl Jafary , Mythili Pulavarthi , John Dewey , Pavithra Ellison , Erik Olness , Hussein Jaffal","doi":"10.1016/j.ijporl.2025.112525","DOIUrl":"10.1016/j.ijporl.2025.112525","url":null,"abstract":"<div><h3>Objective</h3><div>Evidence-based recommendations for the duration of postoperative monitoring for outpatient tonsillectomy are not established in the literature. This study aims to determine the safety of a 2-h postoperative observation time compared to a 3-h time.</div></div><div><h3>Methods</h3><div>We completed a prospective chart review of children between 3 and 18 years of age who underwent outpatient tonsillectomy with or without other procedures between August 2023 and February 2024 at a tertiary Children's Hospital. Patients were observed in the Post-Anesthesia Care Unit (PACU) and discharged following a 3-h institutionally required minimum observation period and meeting all discharge criteria. This observation period was compared to what length of stay (LOS) could have been if using a reduced 2-h-minimum period.</div></div><div><h3>Results</h3><div>The sample consisted of 223 patients aged 3–18 years, with 50.7 % females. The average PACU LOS was 185.8 min. If the minimum-required observation time was reduced to 2 h, the average LOS could have been reduced to 143.84 min, saving 42.0 min on average per patient. No adverse events would have been missed if we had followed a 2-h minimum policy instead of the current 3-h policy. Older and female patients were more likely to meet all discharge criteria by 2 h (p < 0.05).</div></div><div><h3>Conclusion</h3><div>Adverse events after 2 h are rare following outpatient tonsillectomy, and these are unlikely to be missed if the observation time is reduced from 3 h to 2 h. These findings support the safety of a 2-h minimum observation period in addition to other clinical criteria.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"197 ","pages":"Article 112525"},"PeriodicalIF":1.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879552","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}
Ola K. Soliman , Matthew S. Sitton , Elton M. Lambert
{"title":"Sialoendoscopy and the management of pediatric sialolithiasis","authors":"Ola K. Soliman , Matthew S. Sitton , Elton M. Lambert","doi":"10.1016/j.ijporl.2025.112526","DOIUrl":"10.1016/j.ijporl.2025.112526","url":null,"abstract":"<div><h3>Objective</h3><div>Pediatric sialolithiasis can be managed effectively through both intraoral approaches, including sialoendoscopy, and extraoral approaches, such as gland removal. This study assesses factors in the evaluation and management of salivary stones in children.</div></div><div><h3>Methods</h3><div>A descriptive retrospective study of patients diagnosed with sialolithiasis and treated with sialoendoscopy at a tertiary care pediatric hospital from October 2008 to August 2022 was conducted. Presenting symptoms at the time of diagnosis, the distribution of stone locations, size, and the method of stone removal based on stone location were evaluated.</div></div><div><h3>Results</h3><div>Seventeen patients were included in the final review. All patients had salivary gland stones diagnosed through imaging or visualized intraoperatively. The most common presenting complaint of sialolithiasis was facial swelling (82 %). Eighty-eight percent had submandibular duct stones, and 11 % had parotid duct stones. 50 % of stones were proximal, 22 % were distal, 6 % were at the hilum, and 11 % intraglandular. Forty-seven percent of patients underwent stone removal via sialoendoscopy and intraoral incision, 35 % through sialoendoscopy alone, and 18 % required gland removal. Chi-square testing was performed to evaluate differences in removal rates based on the location of the stone. Among patients with submandibular gland stones, distal stones (100 %) were more likely to be removed via sialoendoscopy with or without an intraoral incision compared to proximal (75 %), hilar (0 %), and intraglandular stones (0 %) (p = 0.005). Proximal (25 %), hilar (100 %), and intraglandular (100 %) submandibular stones were more likely to require gland removal than distal stones (0 %) (p = 0.026).</div></div><div><h3>Conclusion</h3><div>The findings in this review suggest that distal stones in the submandibular gland are more likely to be removed via sialoendoscopy with an intraoral incision as opposed to proximal, hilar, and glandular stones, which were more likely to necessitate gland excision.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"197 ","pages":"Article 112526"},"PeriodicalIF":1.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887448","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":"Survey on language rehabilitation methods in deaf Italian children with cochlear implants","authors":"Giorgia Mari , Felicia Zagari , Alessandro Scorpecci , Angelo Tizio , Alessandra Resca , Emilia Cascio , Pasquale Marsella , Jacopo Galli , Lucia D'Alatri","doi":"10.1016/j.ijporl.2025.112513","DOIUrl":"10.1016/j.ijporl.2025.112513","url":null,"abstract":"<div><h3>Purpose</h3><div>To survey the rehabilitation methods of deaf Italian children implanted in two tertiary care referral centers; to investigate on associations between rehabilitation method and patients’ clinical features.</div></div><div><h3>Method</h3><div>Inclusion criteria were age ≤16 years, diagnosis of pre-perilingual bilateral deafness of severe-profound degree, use of cochlear implants (CIs) for at least 8 h a day, ongoing speech therapy. Children's Speech and Language Therapists (SLTs) were emailed a questionnaire created for the study purpose and consisting of 39 yes/no questions exploring five fundamental areas of speech and language rehabilitation. For each questionnaire, a separate score was obtained for the following Italian methods: Auditory Verbal Therapy (AVT), Cognitive Oralism (CO), Bimodal (B) and Dreazancic (D). AVT and CO were considered as oral methods, whereas B and D were categorized as mixed methods.</div></div><div><h3>Results</h3><div>100 SLTs responded to the questionnaire. The rehabilitation method was composite in the majority (69 %) of cases. The most prevalent method was CO (32.5 %), followed by D (28.4 %), B (18.7 %), and AVT (15.4 %); in 6 cases (4.9 %) AVT and CO scored equally high. No association was found between patients’ demographic and clinical features and rehabilitation method.</div></div><div><h3>Conclusions</h3><div>AVT resulted as the least prevalent method, whereas mixed methods covered almost 50 % of cases in our population. The majority of children in our sample were rehabilitated with combined approaches that did not seem to be related to any specific patients' characteristics, but possibly to therapists’ education and background.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"197 ","pages":"Article 112513"},"PeriodicalIF":1.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144863492","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}
Beth Osterbauer , Ramon Durazo-Arvizu , Christian Hochstim , Mary Roz Timbang
{"title":"Influence of obesity and socio-linguistic factors on otitis externa treatment outcomes in children","authors":"Beth Osterbauer , Ramon Durazo-Arvizu , Christian Hochstim , Mary Roz Timbang","doi":"10.1016/j.ijporl.2025.112514","DOIUrl":"10.1016/j.ijporl.2025.112514","url":null,"abstract":"<div><h3>Background</h3><div>Established risk factors for the development of otitis externa (OE) include stenotic ear canals, dermatologic disease and insertion of foreign objects. The link between obesity and susceptibility to different systemic diseases have been demonstrated, but not yet with OE.</div></div><div><h3>Objective</h3><div>This study was aimed at determining whether obese patients had OE infections that were more difficult to treat compared to normal weight children and investigate other measurable patient factors contributing to OE infection resolution in our unique patient population.</div></div><div><h3>Methods</h3><div>A chart review was conducted of all children diagnosed with OE between April 2015 and February 2024. Children with cholesteatoma, canal stenosis, or Down Syndrome were exlcuded. The time to infection resolution distribution was estimated using the Kaplan-Meier estimator, and multivariate Cox PH models measured factors influencing time to infection resolution.</div></div><div><h3>Results</h3><div>Of the 93 children included in the analysis, 29 (31 %) were overweight or obese, with a median age of 12.1 years. A higher percentage of overweight/obese patients were Hispanic (86 %, p < 0.001), Spanish-speaking (59 %, p = 0.005), and had public insurance (100 %, p = 0.004). Normal weight children whose parents spoke primarily Spanish, had the longest median days to infection resolution (57, IQR 196), followed by obese children with English speaking parents (52, IQR 329), then obese children with Spanish-speaking parents (48.5days, IQR124). Normal weight children of English-speaking parents had the lowest median days to infection resolution in our study (33 days, IQR 61). A multivariable Cox PH model confirmed these two factors were potentially associated with days to infection resolution (p-value of interaction = 0.053; effect size HR = 3.97,95 %CI: 0.98,16.1).</div></div><div><h3>Conclusion</h3><div>The results of this study suggest that patients who are overweight or obese, and those whose parental primary language was Spanish had a prolonged course of disease – with a median of 48.5 days to resolve their symptoms. Obesity was associated with increased days to OE infection resolution among children with English-speaking parents but not among children with Spanish-speaking parents, where parental language was associated with longer infection.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112514"},"PeriodicalIF":1.3,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011114","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}