International journal of pediatric otorhinolaryngology最新文献

{"title":"Navigating ChatGPT's alignment with expert consensus on pediatric OSA management","authors":"Eileen C. Howard ,&nbsp;Jonathan M. Carnino ,&nbsp;Nicholas Y.K. Chong ,&nbsp;Jessica R. Levi","doi":"10.1016/j.ijporl.2024.112131","DOIUrl":"10.1016/j.ijporl.2024.112131","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the potential integration of artificial intelligence (AI), specifically ChatGPT, into healthcare decision-making, focusing on its alignment with expert consensus statements regarding the management of persistent pediatric obstructive sleep apnea.</div></div><div><h3>Methods</h3><div>We analyzed ChatGPT's responses to 52 statements from the 2024 expert consensus statement (ECS) on the management of pediatric persistent OSA after adenotonsillectomy. Each statement was input into ChatGPT using a 9-point Likert scale format, with each statement entered three times to calculate mean scores and standard deviations. Statistical analysis was performed using Excel.</div></div><div><h3>Results</h3><div>ChatGPT's responses were within 1.0 of the consensus statement mean score for 63 % (33/52) of the statements. 13 % (7/52) were statements in which the ChatGPT mean response was different from the ECS mean by 2.0 or greater, the majority of which were in the categories of surgical and medical management. Statements with ChatGPT mean scores differing by more than 2.0 from the consensus mean highlighted the risk of disseminating incorrect information on established medical topics, with a notable variation in responses suggesting inconsistencies in ChatGPT's reliability.</div></div><div><h3>Conclusion</h3><div>While ChatGPT demonstrated a promising ability to align with expert medical opinions in many cases, its inconsistencies and potential to propagate inaccuracies in contested areas raise important considerations for its application in clinical settings. The findings underscore the need for ongoing evaluation and refinement of AI tools in healthcare, emphasizing collaboration between AI developers, healthcare professionals, and regulatory bodies to ensure AI's safe and effective integration into medical decision-making processes.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112131"},"PeriodicalIF":1.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446667","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":"Pediatric non-nasopharyngeal head and neck squamous cell carcinoma: Analysis of the Surveillance, Epidemiology, and End Results (SEER) program with review of the literature","authors":"Sara E. Bressler ,&nbsp;Adele K. Evans","doi":"10.1016/j.ijporl.2024.112135","DOIUrl":"10.1016/j.ijporl.2024.112135","url":null,"abstract":"<div><h3>Background</h3><div>Despite its prevalence in adults, head and neck squamous cell carcinoma (HNSCC) is considered a rare entity in pediatrics where lymphomas, neural tumors, and soft tissue sarcomas predominate in the head and neck. Given the association of squamous cell carcinoma with the human papillomavirus, a risk factor that may be present from birth, and the difficulties in staging this disease for prognostication in children, it is important to revisit nationally collected data for prevalence and outcomes assessments.</div></div><div><h3>Objective</h3><div>To examine a publicly available national database to describe the incidence, pathology, treatment, and survival of pediatric HNSCC. To review the available literature regarding management, outcomes, and risk factors for this disease process.</div></div><div><h3>Methods</h3><div>The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) tumor database was queried to identify pediatric subjects ages 0 to 19 diagnosed HNSCC between 1973 and 2019.</div></div><div><h3>Results</h3><div>Two-hundred ninety-two cases were identified. Subjects were 62.7 % male (n = 183) and the average age was 15.4 years (range 2–19, median 16). Subjects were 65.8 % white (n = 192), 22.9 % black (n = 67), 8.9 % Asian/Pacific Islander (n = 26), 1 % American Indian (n = 3), and 1.4 % unknown (n = 4). The most common primary sites were nasopharynx (45.9 %), oral cavity (30.5 %), larynx (8.6 %), salivary gland (4.1 %), nasal cavity &amp; paranasal sinus (3.4 %), and lip (2.7 %). There was no statistically significant difference between primary subsite and age, race, histologic grade, or extent of disease. The 5-year overall survival was 83.6 %.</div></div><div><h3>Discussion</h3><div>Head and neck squamous cell carcinoma is more likely to present in older children and is more prevalent in White populations. The nasopharynx is the most common subsite involved, which differs from adult populations in which non-nasopharyngeal subsites including the larynx, oral cavity, and oropharynx are most frequently affected.</div></div><div><h3>Conclusion</h3><div>Head and neck squamous cell carcinoma is rare in pediatric patients but should not be overlooked by physicians in the differential diagnosis, particularly in teenagers. Further study is needed to determine whether this represents a unique entity or can be staged and treated according to adult guidelines.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112135"},"PeriodicalIF":1.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500548","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":"Glottic widening procedures (GWPs) to avoid tracheostomy in infants’ bilateral vocal cord paralysis: A systematic review and meta-analysis","authors":"Talal Al-Khatib ,&nbsp;Leenah Turkistani ,&nbsp;Shahad Hani Abdu ,&nbsp;Rana A. Alahmadi ,&nbsp;Muhnnad A. AlGhamdi ,&nbsp;Nadeem Butt","doi":"10.1016/j.ijporl.2024.112133","DOIUrl":"10.1016/j.ijporl.2024.112133","url":null,"abstract":"<div><h3>Objective</h3><div>This systematic review and meta-analysis evaluated the efficacy of various glottic widening procedures (GWPs) in avoiding tracheostomy in infants with bilateral vocal cord paralysis (BVCP).</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted in PubMed, Scopus, Web of Science, and Cochrane Library from inception to July 2023, without any timeframe limitations. Studies reporting GWPs (Endoscopic anterior-posterior cricoid split, Botox injection, suture lateralization, and other procedures including laser posterior cordotomy/arytenoidectomy) in infants with BVCP were included. Meta-analysis was performed to assess tracheostomy avoidance and secondary outcomes including voice, swallowing, and resolution of airway symptoms.</div></div><div><h3>Results</h3><div>Thirteen studies with 100 patients were included. The mean age was 51.6 days. The etiology of BVCP was idiopathic (83 %), neurologic (10 %), and acquired (7 %). The GWP interventions were successful in 88 % of patients, with only 12 % requiring tracheostomy after surgery. The pooled proportion for avoiding tracheostomy was 0.88 (95 % CI 0.82–0.94) across interventions, with no significant differences between techniques. Among patients who avoided tracheostomy, 64 % had normal voice, 86 % tolerated oral feeding, 77 % had airway symptom resolution, and 70 % had recovery of vocal cord mobility.</div></div><div><h3>Conclusion</h3><div>GWPs prevent a majority of infants with BVCP from undergoing tracheostomy, without permanent alterations to laryngeal function. All interventions were comparable in efficacy. Further research with larger sample sizes is warranted.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112133"},"PeriodicalIF":1.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446668","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 VOR function with vHIT in unilateral pediatric cochlear implant users","authors":"A.A. Aygun ,&nbsp;B.C. Cinar ,&nbsp;L. Sennaroglu","doi":"10.1016/j.ijporl.2024.112132","DOIUrl":"10.1016/j.ijporl.2024.112132","url":null,"abstract":"<div><h3>Objective</h3><div>The changes in the inner ear affect both the cochlea and the vestibule and these effects are observed after cochlear implantation surgery. The aim of the current study is to evaluate the effect of unilateral cochlear implant use on vestibulo-ocular reflex (VOR) in children.</div></div><div><h3>Methods</h3><div>In the current study, 29 cochlear implanted children, aged 7–18 years, were include as the study group and 32 children, in the same age range, were included with normal-hearing as the control group. vHIT was used to evaluate VOR and the results of unilateral CI users were compared with the control group. The study group was evaluated in two different situations: cochlear implant sound processor on (CI-ON) and cochlear implant sound processor off (CI-OFF). The data obtained in the evaluations were compared between the implanted ear and the non-implanted ear between the CI-ON and CI-OFF states within the study group and between the study group and the control group.</div></div><div><h3>Results</h3><div>When the CI-ON and CI-OFF conditions in the study group were compared, no significant difference was found (p &gt; 0.05). Similarly, no significant difference was found between the implanted ear and the non-implanted ear (p &gt; 0.05). Also, there was no significant difference in the comparisons between the study group and the control group (p &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>vHIT is a functional test method that can be used in children to test vestibular function after cochlear implant. vHIT is a comfortable test to use after cochlear implantation to demonstrate the functionality of the vestibular system. And it provides consistent results regardless of whether the speech processor is on or off.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112132"},"PeriodicalIF":1.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433613","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 maturation sutures on false passage formation in pediatric tracheostomy","authors":"Yasmine Madan ,&nbsp;Jennifer M. Siu ,&nbsp;Meghan E. Tepsich ,&nbsp;Nicole K. McKinnon ,&nbsp;Jackie Chiang ,&nbsp;Evan J. Propst ,&nbsp;Nikolaus E. Wolter","doi":"10.1016/j.ijporl.2024.112130","DOIUrl":"10.1016/j.ijporl.2024.112130","url":null,"abstract":"<div><h3>Introduction</h3><div>False passage (FP) after tracheostomy is an infrequent but potentially life-threatening complication. The practice of tracheal stomal maturation at the time of tracheostomy is variable amongst surgeons in pediatric patients, and it remains unknown whether or not maturation sutures decrease the risk of FP. Our objective was to evaluate the impact of maturation sutures on the incidence of FP after pediatric tracheostomy.</div></div><div><h3>Materials and methods</h3><div>A retrospective review of children who underwent tracheostomy (2001–2024) was performed. Records were reviewed for demographics and procedural details including use of maturation sutures. Outcomes included incidence of FP, time to FP and associated complications resulting from FP.</div></div><div><h3>Results</h3><div>One-hundred and twenty-five children met study criteria [median (IQR) age 0.5 (0.2–3.2) years]. Fifty-five children (44.0 %) received maturation sutures, with 31 (56.4 %) of these being four-point sutures, 10 (18.2 %) being two-point sutures (70 % of which were placed inferiorly), and 14 (25.5 %) being unrecorded. Four out of 125 (3.2 %) patients developed FP at a median (IQR) of 12.8 (4.6–13.5) days following tracheostomy insertion, and they all occurred within the first two tracheostomy changes. None of the patients who developed FP had maturation sutures. Of the four children who developed FP, three (75 %) had no further complications, and one (25 %) developed subcutaneous emphysema and pneumomediastinum. No deaths associated with FP were identified.</div></div><div><h3>Conclusion</h3><div>This large single institution study evaluating the relationship between maturation sutures and FP in children undergoing tracheostomy suggests that maturation sutures may help prevent FP; however, ongoing work is required to validate these findings and guide clinical practice.</div></div><div><h3>Level of evidence</h3><div>3.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112130"},"PeriodicalIF":1.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433489","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":"Rates of tracheostomy in patients with complex skeletal dysplasia: A 32-year institutional experience","authors":"Seth C. Eckhardt ,&nbsp;Clare M. Richardson ,&nbsp;Klane K. White ,&nbsp;Sanjay R. Parikh ,&nbsp;Juliana Bonilla-Velez ,&nbsp;John P. Dahl","doi":"10.1016/j.ijporl.2024.112129","DOIUrl":"10.1016/j.ijporl.2024.112129","url":null,"abstract":"<div><h3>Objective</h3><div>Respiratory failure secondary to multilevel airway compromise may present complex airway challenges in patients with specific skeletal dysplasia diagnoses. This study sought to identify and characterize subgroups of skeletal dysplasia diagnoses that more frequently undergo operative airway evaluations and tracheostomy placement.</div></div><div><h3>Methods</h3><div>Retrospective electronic medical record review of pediatric patients with an ICD-10 associated skeletal dysplasia diagnosis and CPT-specified airway intervention at a tertiary pediatric hospital from 1990 to 2022. Patients without a defined skeletal dysplasia diagnosis, subjects with craniosynostosis syndromes, and those with limited clinical data were excluded. Collected variables included demographics, age at diagnosis, comorbidities, operative procedures, and airway interventions. Descriptive statistical analysis was utilized to evaluate data distribution.</div></div><div><h3>Results</h3><div>From the initial population of 313 patients, 41 subjects were confirmed to have clinical features and/or genetic testing consistent with a skeletal dysplasia diagnosis. A tracheostomy was placed in 19/41 subjects and these patients’ records were further analyzed. Skeletal dysplasia groups with more frequent tracheostomy placement included Filamins and related disorders, Sulfation disorders, and Chondrodysplasia punctata. In the patients with a tracheostomy, skeletal dysplasia was diagnosed at a median age of 0.3 years (IQR 4.8 years), and tracheostomy was initiated at a median age of 1.8 years (IQR 2.2 years). Only four of these patients were successfully decannulated, and two subjects are deceased.</div></div><div><h3>Conclusion</h3><div>Over 32 years, nearly half of the skeletal dysplasia patients who underwent airway interventions eventually had a tracheostomy placed. Respiratory insufficiency and complex airway management challenges are common manifestations of skeletal dysplasia.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112129"},"PeriodicalIF":1.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433482","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":"Comparing sinonasal quality of life in pediatric nasal obstruction: Inferior turbinate cauterization vs turbinoplasty – A pilot study","authors":"Tayebeh Kazemi ,&nbsp;Sara S. Nabavizadeh ,&nbsp;Reza Kaboodkhani ,&nbsp;Ali Faramarzi ,&nbsp;Erfan Sadeghi ,&nbsp;Akram Rahmanipour","doi":"10.1016/j.ijporl.2024.112127","DOIUrl":"10.1016/j.ijporl.2024.112127","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study is to evaluate and compare the impacts of inferior turbinate monopolar submucosal cauterization and microdebrider-assisted inferior turbinoplasty on the sinonasal quality of life in pediatric patients with chronic nasal obstruction.</div></div><div><h3>Study design</h3><div>A pilot randomized controlled trial.</div></div><div><h3>Setting</h3><div>Tertiary hospital.</div></div><div><h3>Methods</h3><div>This pilot clinical trial enrolled pediatric patients, all of whom had persistent inferior nasal turbinate hypertrophy. They were assigned to undergo either inferior turbinate monopolar submucosal cauterization or microdebrider-assisted turbinoplasty. The procedures were conducted under general anesthesia for both groups. Patient-reported sinonasal symptoms were assessed using the SNOT-22 questionnaire at baseline and during follow-ups.</div></div><div><h3>Results</h3><div>The study enrolled 52 pediatric participants aged 4–14 years for turbinate reduction, ending with 40 after follow-up losses. Nineteen underwent cauterization, and 21 had turbinoplasty. Both groups showed significant SNOT-22 score improvements at 1, 3, and 6 months post-surgery, though the turbinoplasty group had initially greater improvements. No significant differences were found in postoperative complications, except a higher malodor sensation incidence at one week in the cauterization group.</div></div><div><h3>Conclusion</h3><div>In conclusion, both monopolar submucosal cautery and microdebrider-assisted turbinoplasty improved sinonasal quality of life in pediatric patients. Monopolar cautery was associated with more early postoperative malodor but may offer potential cost-effectiveness and simplicity. Further research is needed to validate these findings and refine surgical approaches.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112127"},"PeriodicalIF":1.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142421462","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 processing abilities of children with congenital blindness","authors":"Isha Dhondekar,&nbsp;C.S. Vanaja","doi":"10.1016/j.ijporl.2024.112126","DOIUrl":"10.1016/j.ijporl.2024.112126","url":null,"abstract":"<div><h3>Background</h3><div>Children with visual challenges rely on their hearing ability to accomplish daily tasks more efficiently. Many investigations show changes in the auditory pathway in children and adults with early blindness. It can be hypothesized that the auditory processing abilities of children with congenital blindness will be superior to those of typically developing children without any visual challenges.</div></div><div><h3>Purpose</h3><div>The current study was designed to compare some of the auditory processing abilities of children with congenital blindness and typically developing children who do not have any visual challenges. Specifically, the study compared the perception of speech in noise, temporal patterning ability, binaural integration ability as well as auditory memory and sequencing abilities of children in two groups.</div></div><div><h3>Research design</h3><div>It was a prospective cross-sectional study comparing two groups.</div></div><div><h3>Study sample</h3><div>A total of 160 children, 80 typically developing children without any visual challenges (reference group) and 80 children with congenital blindness, in the age range of 7–11 years, participated in the study.</div></div><div><h3>Data collection and analysis</h3><div>Pitch pattern test (PPT), perception of speech perception in noise test in Marathi (PSIN-M), dichotic digit test in Marathi (DDT-M), and auditory memory and sequencing test in Marathi (AMST-M) were administered. Independent sample T test and Mann Whitney <em>U</em> test were used to compare the performance of the two groups on these tests.</div></div><div><h3>Results</h3><div>Children with congenital blindness showed significantly better scores on PPT, PSIN-M, and DDT-M as compared to children in the reference group in all the age groups. A clear trend was not observed on DDT-M.</div></div><div><h3>Conclusion</h3><div>It can be concluded that children with congenital blindness have better auditory processing, auditory memory, and sequencing abilities compared to typically developing children without any visual challenges.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112126"},"PeriodicalIF":1.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442853","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 postoperative bleeding in pediatric tonsillectomy versus tonsillotomy","authors":"Zofnat Asulin,&nbsp;Ohad Cohen,&nbsp;Boaz Forer,&nbsp;Jean-Yves Sichel,&nbsp;Pierre Attal ,&nbsp;Chanan Shaul","doi":"10.1016/j.ijporl.2024.112125","DOIUrl":"10.1016/j.ijporl.2024.112125","url":null,"abstract":"<div><h3>Objective</h3><div>Tonsillar surgery is a common intervention for pediatric obstructive sleep apnea and recurrent tonsillitis. This study compared postoperative bleeding incidence and severity following tonsillotomy and tonsillectomy at a single medical center.</div></div><div><h3>Study design</h3><div>A retrospective cohort study on 1984 pediatric patients (1–18 years old) who underwent surgery during 2004–2011 and 2019–2022. Tonsillectomy was performed during 2004–2011, while tonsillotomy was preferred for obstructive sleep apnea during 2019–2022. Tonsillectomy was performed using cold steel technique with complete removal of tonsillar tissue, while tonsillotomy was conducted using mono- or bipolar diathermy, preserving minimal tissue on the tonsillar capsule.</div></div><div><h3>Setting</h3><div>Shaare-Zedek Medical Center, Faculty of Medicine, Hebrew University.</div></div><div><h3>Methods</h3><div>Outcome measures included postoperative bleeding incidence and severity, surgery duration, hospitalization length, and readmission.</div></div><div><h3>Results</h3><div>Tonsillotomy was conducted on 958 (48.3 %) patients, and tonsillectomy was performed on 1026 (51.7 %) patients. Obstructive sleep apnea was the only indication in 1553 (78.3 %) patients. Overall bleeding rate was lower following tonsillotomy (3.9 %) than tonsillectomy (9.5 %) (p &lt; 0.001). Significantly more patients required surgical bleeding control post-tonsillectomy than post-tonsillotomy: 39 (3.7 %) vs. 5 (0.5 %), respectively (p &lt; 0.001). Tonsillectomy resulted in higher readmission rates (11.8 % vs 6.1 %, p &lt; 0.001), more blood transfusions (3 vs. 0), and higher postoperative hemoglobin diminution (1.57 ± 2 vs. 0.94 ± 1 g/dL, p = 0.035). The duration of the surgery was shorter for tonsillotomy (24.7 vs 26.5 min, p = 0.012). Tonsillectomy sustained higher bleeding rates for obstructive sleep apnea patients (7.0 % vs 3.9 %, p = 0.006). For recurrent tonsillitis patients, bleeding rates did not vary between year groups. Older age and tonsillectomy were the most significant risk factors for postoperative bleeding.</div></div><div><h3>Conclusion</h3><div>Among children undergoing tonsillar surgery for obstructive sleep apnea, tonsillotomy was associated with a safer postoperative bleeding profile, reduced bleeding severity, and fewer readmissions compared to tonsillectomy.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112125"},"PeriodicalIF":1.2,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400257","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":"A review of the importance of top-down processing assessment in auditory processing disorder","authors":"Bahareh Khavarghazalani ,&nbsp;Zahra Hosseini Dastgerdi ,&nbsp;Morteza Hamidi Nahrani ,&nbsp;Maryam Emadi","doi":"10.1016/j.ijporl.2024.112128","DOIUrl":"10.1016/j.ijporl.2024.112128","url":null,"abstract":"<div><h3>Introduction</h3><div>Auditory perception process is a transient phenomenon, which enables the person to make the relationship between events and auditory factor by working memory and obtain the sequence of auditory features and be able differentiate the auditory sources by using these component. In auditory processing, the basis formed by bottom – up process (data – driven). This pathway is dependent on the central auditory integration and also on acoustic signal input and interpreting auditory information is involved top-down process (concept – driven), which this pathway is dependent on central higher resource such as perception, attention, working memory and its span. The purpose of this study was to address information about top-down processing and auditory processing disorder.</div></div><div><h3>Materials and methods</h3><div>A review of the latest literature on (central) auditory processing disorders and top-down processing was performed using PUBMED, EBSCO, SCIENCE DIRECT, ASHA, GOOGLE SCHOLAR, THIEME, PROQUEST data sources.</div></div><div><h3>Conclusion</h3><div>Deficit in cognitive processing of auditory information in children cause difficulty in processing auditory information and outbreak auditory processing disorder symptoms. Cognitive evaluation (especially working memory) in this subject is important as bottom-up processing evaluation.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112128"},"PeriodicalIF":1.2,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396962","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}