International journal of pediatric otorhinolaryngology最新文献

{"title":"Artificial intelligence classification of pediatric middle ear effusion using consumer-grade otoscopes","authors":"Sruthi Surapaneni ,&nbsp;Nikhil Rangarajan ,&nbsp;Kyle Davis ,&nbsp;Katherine Pletcher ,&nbsp;Jeffrey Flowers ,&nbsp;Graham Strub ,&nbsp;Abby Nolder ,&nbsp;Deanne King ,&nbsp;Alexander P. Marston ,&nbsp;Mark Vecchiotti ,&nbsp;Kristan Alfonso ,&nbsp;Sean Evans ,&nbsp;Anita Deshpande ,&nbsp;Kara Prickett ,&nbsp;April Landry ,&nbsp;Steven Goudy ,&nbsp;Nandini Govil ,&nbsp;Anna Messner ,&nbsp;Gresham Richter ,&nbsp;Andrew R. Scott ,&nbsp;Courtney A. Hill","doi":"10.1016/j.ijporl.2025.112655","DOIUrl":"10.1016/j.ijporl.2025.112655","url":null,"abstract":"<div><h3>Introduction</h3><div>Early and accurate diagnosis of middle ear effusion in primary care settings enables timely intervention, improving long-term patient outcomes while preventing overtreatment with antibiotics. Diagnosis requires assessment of tympanic membrane mobility, but this is hampered by access to and inexperience with pneumatic otoscopy or tympanometry. This research aims to train an artificial intelligence algorithm, using tympanic membrane images captured with consumer-grade otoscopes, to accurately predict the presence or absence of pediatric middle ear effusions.</div></div><div><h3>Methods</h3><div>Using an over-the-counter digital otoscope, tympanic membrane images were obtained from patients aged 6 months to 6 years old undergoing tympanostomy tube placement at 4 different institutions. The images were labeled according to the middle ear findings identified by pediatric otolaryngologists during myringotomy. A deep learning neural network was trained to classify tympanic membrane images as “Effusion” or “No Effusion”.</div></div><div><h3>Results</h3><div>From 219 patients, 537 tympanic membrane images were obtained. Serous, mucoid or purulent effusion were represented in 263 images and 273 images demonstrated no effusion. The trained model achieved a classification accuracy of 92.1 %, a sensitivity of 90.3 %, and specificity of 93.8 %.</div></div><div><h3>Discussion</h3><div>This model has a balanced sensitivity and specificity comparable to or surpassing pneumatic otoscopy (94 % sensitivity, 80 % specificity) and tympanometry (90–94 % sensitivity, 50–75 % specificity). With current barriers to using the diagnostic tools recommended in clinical guidelines, it is evident that an inexpensive, objective diagnostic aid is needed for the primary care setting. This model's performance demonstrates the first step toward an accessible tool for primary care providers.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"200 ","pages":"Article 112655"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145668334","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":"Conservative treatment of mastoiditis without the need for imaging: A 20-year follow-up study","authors":"Ayalon Hadar ,&nbsp;Yehuda Schwarz ,&nbsp;Sharon Ovnat Tamir ,&nbsp;Adiel Cohen ,&nbsp;Chanan Shaul ,&nbsp;Jean-Yves Sichel ,&nbsp;Pierre Attal","doi":"10.1016/j.ijporl.2025.112675","DOIUrl":"10.1016/j.ijporl.2025.112675","url":null,"abstract":"","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"200 ","pages":"Article 112675"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145723401","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":"Factors associated with misophonia in children","authors":"Katelin R. Keenehan ,&nbsp;Erin M. Gawel ,&nbsp;Amanda G. Baanante ,&nbsp;Gaayathri Varavenkataraman ,&nbsp;Alexis Rondinelli ,&nbsp;Ellen Piccillo ,&nbsp;Michele M. Carr","doi":"10.1016/j.ijporl.2025.112681","DOIUrl":"10.1016/j.ijporl.2025.112681","url":null,"abstract":"","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"200 ","pages":"Article 112681"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145734476","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":"Sialendoscopy-assisted corticosteroid irrigation in Juvenile recurrent parotitis: Clinical outcomes, sonographic assessment, and diagnostic delay","authors":"Luca J. Merlo,&nbsp;Gunther Pabst","doi":"10.1016/j.ijporl.2025.112686","DOIUrl":"10.1016/j.ijporl.2025.112686","url":null,"abstract":"","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"200 ","pages":"Article 112686"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145787237","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":"Provision of a preparatory information video for parents prior to an infant's diagnostic audiological assessment: a randomised controlled trial","authors":"Alison Jagger ,&nbsp;Jane Sheehan ,&nbsp;Kate L. Francis ,&nbsp;Melinda Barker ,&nbsp;Felicity Hood ,&nbsp;Valerie Sung ,&nbsp;Zeffie Poulakis","doi":"10.1016/j.ijporl.2025.112679","DOIUrl":"10.1016/j.ijporl.2025.112679","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the impact of a preparatory information video on parent knowledge and anxiety. The video was viewed prior to infant diagnostic audiology, following referral from a universal newborn hearing screening program.</div></div><div><h3>Methods</h3><div>Randomised controlled trial comparing the provision of an information video in addition to usual care (intervention) versus usual care only. Parents of infants who were referred to audiology by the Victorian Infant Hearing Screening Program between February and December 2024 were assessed for eligibility. Parent knowledge and preparedness about infant audiological testing was measured using a study designed questionnaire (score range 0–9) and anxiety was assessed using a standardised measure. Mean differences were compared between the groups. Number of appointments required to reach a complete diagnosis was also measured and parent feedback regarding usefulness of the video was sought.</div></div><div><h3>Results</h3><div>The intervention group scored 2.1 (95 % confidence interval 1.6–2.6) points higher on total knowledge score compared to the usual care group. Analysis of knowledge questionnaire items at an individual level showed the proportion of correct responses was up to 48 % higher in the intervention group. No difference in anxiety scores or the number of appointments required to reach a complete diagnosis was observed. More than 94 % of participants would recommend the video to other parents.</div></div><div><h3>Conclusion</h3><div>Routine provision of preparatory video information prior to infant diagnostic audiology is recommended. In addition to usual care, video information embedded within clinical services can improve parent knowledge and preparedness, and support parent health literacy.</div><div>Trial ID ACTRN12623000886684.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"200 ","pages":"Article 112679"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145819144","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 preoperative infection severity on surgical outcomes in branchial cleft anomalies: A retrospectie cohort study","authors":"Jiajun Chen,&nbsp;Huijiao Xu,&nbsp;Bing Xu,&nbsp;Meng Xia,&nbsp;Li Yang,&nbsp;Feifan Chen,&nbsp;Kunpeng Li,&nbsp;Wenying Liu,&nbsp;Fang Hou","doi":"10.1016/j.ijporl.2025.112684","DOIUrl":"10.1016/j.ijporl.2025.112684","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the association between preoperative infection severity and surgical outcomes in patients undergoing excision for branchial cleft anomalies (BCAs).</div></div><div><h3>Study design</h3><div>A single-center, retrospective cohort study of patients with BCAs who underwent surgical excision at Sichuan Provincial People's Hospital between August 2014 and October 2023.</div></div><div><h3>Methods</h3><div>Patients were categorized into non-infected (n = 58), mildly infected (n = 169), and severely infected (n = 107) groups using a preoperative infection grading system. Data collected included demographics, clinical presentation, surgical duration, intraoperative blood loss, preoperative infection-control period, postoperative hospitalization, duration of postoperative antibiotic therapy, recurrence, infection, and other complications. Conduct appropriate statistical analyses on the above data.</div></div><div><h3>Results</h3><div>Age and sex distributions were similar among groups, while significant differences were observed in morphology, origin, and laterality. Non-infected and mildly infected cases were predominantly cystic, whereas severely infected cases had higher proportions of fistulae and sinuses. Preoperative infection-control periods differed significantly (P &lt; 0.001), with longer durations in severely infected patients. Surgery duration, intraoperative blood loss, postoperative hospital stay, and duration of postoperative antibiotics increased with infection severity (all P &lt; 0.01). No recurrence or postoperative infection occurred in the non-infected group. Mildly infected patients had low recurrence (2 %) and infection rates (4 %), while severely infected patients showed higher recurrence (8 %) and infection rates (18 %). Most events occurred within the first postoperative year.</div></div><div><h3>Conclusion</h3><div>Preoperative infection severity in BCAs significantly affects surgical complexity, postoperative recurrence, and infection. Careful infection control prior to surgery is crucial, particularly for severely infected cases, to optimize outcomes and minimize complications.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"200 ","pages":"Article 112684"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774527","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 Grisel Syndrome: early interdisciplinary treatment needed to prevent severe upper cervical deformity - Experience from a high-volume spine center and systematic review of existing literature","authors":"Vincent J. Heck ,&nbsp;Peer Eysel ,&nbsp;Tobias Prasse ,&nbsp;Max J. Scheyerer ,&nbsp;Katrin Eysel-Gosepath","doi":"10.1016/j.ijporl.2025.112656","DOIUrl":"10.1016/j.ijporl.2025.112656","url":null,"abstract":"<div><h3>Purpose</h3><div>Grisel Syndrome (GS) describes a rare, non-traumatic atlantoaxial rotatory subluxation in children typically associated with upper respiratory tract infection, or otorhinolaryngological surgery. The aim of this study was to systematically review the literature regarding interdisciplinary treatment approaches, consequences of delayed or misdiagnosed GS, and upper cervical deformities resulting from misdiagnosed GS. Additionally, we share our institutional experience with this pathology.</div></div><div><h3>Methods</h3><div>We queried our institutional database for patients suffering from GS which were treated in our department between 2001 and 2024. A systematic literature search was conducted using Medline and the Cochrane Library, following PRISMA guidelines.</div></div><div><h3>Results</h3><div>Our database revealed three patients with GS. One patient with misdiagnosed of GS presented with rigid occipital rotation, ultimately progressing to occipito-atlantoaxial rotatory dislocation (OAARD). Two patients were early diagnosed and successfully treated with halo vest immobilization. The systematic literature review identified 13 cases of OAARD across 12 reports. Etiologies included upper respiratory infections, otorhinolaryngological surgery, juvenile idiopathic arthritis, and minor trauma. The average time to diagnosis of OAARD was 5.9 months (0.5–18 months). The treatment involved occipito-atlantal fusion (43 %), atlantoaxial fusion with halo vest (29 %), or traction followed by halo vest (21 %).</div></div><div><h3>Conclusion</h3><div>GS and OAARD are underrecognized and often diagnosed late, causing irreversible deformity and permanent loss of upper cervical spine mobility. Painful torticollis following upper respiratory tract infection, otorhinolaryngological surgery, or minor trauma should be treated as GS until proven otherwise. Early recognition and interdisciplinary treatment are crucial to prevent progression and avoid invasive surgical interventions.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"200 ","pages":"Article 112656"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617529","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":"Longitudinal impact of the coronavirus disease pandemic on pediatric adenoidectomy volume and referrals in Japan: A 6-year retrospective study","authors":"Makoto Ogawa ,&nbsp;Takeshi Maruta ,&nbsp;Takefumi Kamakura ,&nbsp;Yusuke Otami ,&nbsp;Takato Sudo ,&nbsp;Hiroto Fujita ,&nbsp;Nozomi Fujisawa ,&nbsp;Shusuke Okamoto ,&nbsp;Maki Yamashita ,&nbsp;Suzuyo Okazaki ,&nbsp;Kiyohito Hosokawa ,&nbsp;Yasuo Mishiro","doi":"10.1016/j.ijporl.2025.112654","DOIUrl":"10.1016/j.ijporl.2025.112654","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the impact of the coronavirus disease (COVID-19) pandemic and public health measures, including emergency declarations and reclassification of COVID-19, on pediatric adenoidectomy (Ad) volume and referrals diagnosed with adenoidal hypertrophy (AH) accompanied by obstructive sleep apnea (OSA) and/or otitis media with effusion (OME) in Japan.</div></div><div><h3>Methods</h3><div>Monthly case volumes from January 2019 to December 2024 were analyzed at a regional tertiary hospital. Trends were assessed for pediatric Ad, new referrals, general anesthesia surgeries (all departments and ENT), and regional COVID-19 cases. Ad cases were classified according to the presence of concomitant tonsillectomy (T) or tympanostomy tube insertion (TTI); referrals based on the presence of OSA or OME symptoms. The annual age trends were also evaluated.</div></div><div><h3>Results</h3><div>General anesthesia surgeries across the hospital and in the adult ENT department declined temporarily during the emergency declarations but rapidly recovered afterward, whereas those in the pediatric ENT department remained below the baseline even after each declaration. Notably, Ad volumes showed no apparent post-declaration recoveries and remained suppressed until 2023, except for a transient increase in summer 2021, followed by a sharp rebound after the COVID-19 reclassification. In 2024, the volumes of Ad with concurrent T and referrals for AH with OSA or OME symptoms both exceeded the pre-pandemic baseline. Surgical age declined during the pandemic, while referral age remained stable until 2023. Both ages increased in 2024.</div></div><div><h3>Conclusion</h3><div>The total Ad volume—especially Ad with concurrent T—and referrals for AH with OSA symptoms showed an abrupt decline immediately after the pandemic onset, followed by a sharp recovery exceeding pre-pandemic levels. These findings suggest that public health crises can disrupt elective care for chronic pediatric conditions and that the post-pandemic surge reflects behavioral changes and pent-up demand as well as possible epidemiological alterations in tonsillar tissue dynamics.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"200 ","pages":"Article 112654"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145617530","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":"Virtual reality to create positive and timely awareness of hearing loss in middle- and secondary school","authors":"Signe Wischmann ,&nbsp;Lærke Hammer ,&nbsp;Lone Jantzen ,&nbsp;Tanja Pihl Sandager ,&nbsp;Nete Rudbeck Kamper ,&nbsp;Signe Toftgaard Henriksen ,&nbsp;Ali Adjorlu ,&nbsp;Stefania Serafin ,&nbsp;Per Cayé-Thomasen ,&nbsp;Lone Percy-Smith","doi":"10.1016/j.ijporl.2025.112660","DOIUrl":"10.1016/j.ijporl.2025.112660","url":null,"abstract":"<div><div>Patient education empowers patients to control their own health and care. Taking responsibility of own hearing is important for children with hearing loss to navigate effectively in noisy environments at school. However, children must never stand alone with this responsibility. Raising positive awareness about hearing might enhance teachers' and classmates’ understanding of hearing loss, making them more competent in supporting children with hearing loss to achieve the best possible listening conditions.</div><div>In this study we explored how to create positive and timely awareness of hearing loss in middle- and secondary school. We developed a playful virtual reality game about the hearing sense and tested a setup that was suitable for group-use in classrooms. A total of 538 pupils between 10 and 16 years of age, including 26 children with hearing loss, participated in the study. Pupils, teachers and speech and language pathologists from the schools evaluated the game positively, and test before and after intervention showed a significant effect of learning. However, our study also highlighted that some children experience symptoms of cybersickness that shall not be ignored. Furthermore, implementing virtual reality in mainstream schools may present challenges in terms of economic costs and limited teacher resources.</div><div>Educational gaming certainly has the potential to support learning in schools, but future studies must investigate if virtual reality or other digital platforms are the best solution.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"200 ","pages":"Article 112660"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648584","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 use of intralesional & systemic bevacizumab in severe recurrent respiratory papillomatosis: A case report","authors":"Róisín Kay ,&nbsp;Hannah Griffiths ,&nbsp;Mihiar Atfeh","doi":"10.1016/j.ijporl.2025.112683","DOIUrl":"10.1016/j.ijporl.2025.112683","url":null,"abstract":"<div><h3>Introduction</h3><div>Recurrent respiratory papillomatosis (RRP) can represent a significant clinical challenge in the world of paediatric airway disease. The disease's severity and progression may vary and therefore necessitate a constantly evolving and evidence-based approach. The most recently pioneered arm of managing RRP is the use of VEGF monoclonal antibody, bevacizumab. This is a challenging case of aggressive paediatric RRP that has required the use of all available treatment modalities.</div></div><div><h3>The patient</h3><div>A 10-year-old girl, with significant medical and neurological history, was diagnosed with aggressive airway-obstructing RRP at 2 years of age. Over the years, she has undergone various RRP treatments, which have failed to control her disease progression.</div></div><div><h3>The primary diagnoses interventions and outcomes</h3><div>Following failure of traditional management adjuncts, and due to the increasing frequency and need for surgical debridement, an evidence-based decision was made to administer bevacizumab. This was administered locally, and resulted in temporary improvement. Therefore, systemic bevacizumab was eventually sought with excellent outcomes within the first year.</div></div><div><h3>Conclusion</h3><div>Aggressive RRP, particularly in the presence of other comorbidities, presented a management dilemma in this case. The aggressive nature of the disease necessitated out-of-box thinking, seeking evidence from the literature, and a consultation with national experts on the application of alternative treatment options such as intralesional and, subsequently, systemic bevacizumab. The latter has so far produced a yearlong excellent control of the condition. The article discusses suggestions for multicentre research into this treatment modality, and for the standardisation its administration protocols in adults and children.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"200 ","pages":"Article 112683"},"PeriodicalIF":1.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145810063","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}