International journal of pediatric otorhinolaryngology最新文献

{"title":"Laryngomalacia: Not just an infant disease","authors":"Leon Joseph ,&nbsp;Shmuel Goldberg ,&nbsp;Shlomo Cohen ,&nbsp;Gabrielle Aschkenasy ,&nbsp;Elie Picard","doi":"10.1016/j.ijporl.2025.112291","DOIUrl":"10.1016/j.ijporl.2025.112291","url":null,"abstract":"<div><h3>Aim</h3><div>Laryngomalacia is the most common congenital anomaly of the larynx and is regarded as a process that resolves by the age of two years. The aim of the current study was to assess the prevalence of laryngomalacia beyond the age of 2 years, to describe its clinical characteristics and to identify risk factors.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed all bronchoscopies performed over a 3 year period. We compared the prevalence of laryngomalacia between children younger and older than 2 years of age. We also compared the presenting symptoms and co-morbidities between the two age groups.</div></div><div><h3>Results</h3><div>Laryngomalacia was diagnosed in 167 (27 %) out of 618 pediatric bronchoscopies. Among the patients with laryngomalacia, 125 (75 %) were less than 2 years old and 42 (25 %) were more than 2 years old. Older children with laryngomalacia were more likely to present with snoring than stridor (44 % vs 24 %) and had more co-morbidities (48 % vs 22 %) than the younger group.</div></div><div><h3>Conclusions</h3><div>Laryngomalacia is not rare in children older than 2 years of age. Co-morbidities are reported frequently in these children. Snoring is a more common symptom in this age group. Further complementary prospective studies are necessary to confirm our observations.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"191 ","pages":"Article 112291"},"PeriodicalIF":1.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549918","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":"Primary vs. secondary closure of tracheocutaneous fistulas: A prospective cohort study","authors":"Alisa Timashpolsky ,&nbsp;Luv Javia ,&nbsp;Ian Jacobs ,&nbsp;Conor Devine ,&nbsp;Terri Giordano ,&nbsp;Karen B. Zur ,&nbsp;Ryan Borek ,&nbsp;Steven Sobol","doi":"10.1016/j.ijporl.2025.112293","DOIUrl":"10.1016/j.ijporl.2025.112293","url":null,"abstract":"<div><h3>Objective</h3><div>To prospectively compare outcomes and complications of the two most common techniques for closure of tracheocutaneous fistulas (TCFs): surgical excision of the tract with primary closure (PC), and de-epithelialization with healing by secondary intention (SI).</div></div><div><h3>Study design</h3><div>Prospective cohort study.</div></div><div><h3>Setting</h3><div>Tertiary academic center.</div></div><div><h3>Methods</h3><div>All patients who underwent closure of a TCF between 5/1/2022 and 5/30/2023 were eligible for inclusion in the study. Data was prospectively collected and included demographics, tracheostomy history, intraoperative data (including fistula size and closure technique), postoperative recovery and any complications.</div></div><div><h3>Results</h3><div>There were 15 patients who underwent PC, and 10 patients who underwent closure by SI. Both cohorts were premature and had tracheostomies for at least 2 years prior to decannulation. The length of time from decannulation to closure was longer in the primary vs secondary group (p = .01). The operative time was significantly longer in the PC group (p = .002) and the PC group experienced a significantly higher number of postoperative respiratory complications (p = .05) during their postoperative admission. The average TCF size was larger in the SI group compared to the PC group (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>This prospective study demonstrated fewer postoperative respiratory complications for SI closure of TCFs compared to PC.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"191 ","pages":"Article 112293"},"PeriodicalIF":1.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549919","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":"Platinum-induced ototoxicity in pediatric patients with solid tumors: Younger and male children are more susceptible","authors":"Jie Bai ,&nbsp;Yao Song ,&nbsp;Xuetong Wang ,&nbsp;Zhihan Lin ,&nbsp;Yi Zhou ,&nbsp;Xin Jin ,&nbsp;Ying Li ,&nbsp;Zhipeng Zheng ,&nbsp;Xueyao Wang ,&nbsp;Jifeng Shi ,&nbsp;Haihong Liu","doi":"10.1016/j.ijporl.2025.112292","DOIUrl":"10.1016/j.ijporl.2025.112292","url":null,"abstract":"<div><div>The purpose of this study was to explore prevalence and risk factors of platinum drug-induced ototoxicity, delineate the severity of ototoxicity, and quantify the cumulative dose of platinum-based drugs, in China. This retrospective study involved 108 pediatric solid tumor patients who underwent platinum-containing chemotherapy. We utilized logistics regression to identify risk factors. A threshold for the cumulative dose of platinum-drugs was determined by ROC (receiver operating characteristic curve). The hearing thresholds across sex and age groups were examined. Overall, 37.04 % of patients had ototoxicity as measured audiometrically. The prevalence of males (46.43 %, p = .036) was higher than that of females. The cumulative dose of cisplatin was the most significant risk factor for ototoxicity (p = .002, OR = 1.29, per 100 mg/mm²). The cut-off value for the cisplatin cumulative dose was 220 mg/m². Another risk factor is male (p = .037, OR = 2.54). The hearing thresholds at 8 kHz were higher in males (61.81 ± 15.05 dB HL; p = .042)than in females. The group of patients≤3 years old showed more pronounced ototoxicity at 6 kHz [66.00 ± 9.37 dB HL]and 8 kHz [70.00 (65.00,80.00)dB HL] than the older group (4–6 years)at 6 kHz and 8 kHz. Ototoxicity in pediatric patients with platinum-containing chemotherapy is ubiquitous in China, which is influenced by cumulative dose of drugs, sex and age. The threshold of cumulative dose deserves attention.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112292"},"PeriodicalIF":1.2,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682541","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 speech abilities and quality of life of Malaysian school-aged children with cleft lip and palate","authors":"Hui Hui Lim ,&nbsp;Tim Bressmann ,&nbsp;Alyssa Jun Pang ,&nbsp;Badrulzaman Abdul Hamid ,&nbsp;Hasherah Mohd Ibrahim","doi":"10.1016/j.ijporl.2025.112282","DOIUrl":"10.1016/j.ijporl.2025.112282","url":null,"abstract":"<div><h3>Purposes</h3><div>The study investigated the relationship between speech outcomes and quality of life (QoL) among Malay-speaking school-aged children with CLP.</div></div><div><h3>Methodology</h3><div>Forty-nine children with CLP (age range 7–11 years) completed an online or in-person speech assessment and filled in the CLEFT-Q (Malay Version) questionnaire, which assessed QoL. An experienced SLP rated the nasality and speech intelligibility of the patients’ speech samples.</div></div><div><h3>Results</h3><div>Based on the auditory-perceptual ratings, 63.3 % of the children had normal resonance, and 71.5 % had normal or near-normal speech intelligibility. The appearance of “teeth'' was rated as the poorest feature by all participants (52.71), while “psychological function” was rated as the best outcome (83.49). Weak correlations were found between speech intelligibility and speech distress (r = −0.450, p &lt; 0.001), speech intelligibility and speech function (r = −0.370, p &lt; 0.05), hypernasality and speech distress (r = −0.474, p &lt; 0.001), and hypernasality and speech function (r = −0.308, p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Many children with CLP still presented with speech difficulties at school age and facial appearance dissatisfaction in the present study. However, the children's self-awareness of their speech difficulties did not negatively affect non-speech-related aspects of their QoL.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"191 ","pages":"Article 112282"},"PeriodicalIF":1.2,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509339","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":"Screening of pediatric obstructive sleep apnea using video monitoring","authors":"Konomi Ikeda ,&nbsp;Shintaro Chiba","doi":"10.1016/j.ijporl.2025.112281","DOIUrl":"10.1016/j.ijporl.2025.112281","url":null,"abstract":"<div><h3>Introduction</h3><div>According to International classification of sleep disorder (ICSD-3), overnight polysomnography (PSG) is the gold standard examination for the diagnosis of pediatric obstructive sleep apnea (OSA). However, most of the patients in Japan are not able to access the specialized sleep medical facilities for PSG due to less availability and cost issues. Purpose of this study is to examine whether combination of video monitoring items and other clinical examinations can reliably predict the severity of pediatric OSA compared with PSG.</div></div><div><h3>Methods</h3><div>The study subjects were children diagnosed with sleep related breathing disorder (SRBD) who attended the Department of Otorhinolaryngology at Ota General Hospital between 2012 and 2019. A total of 175 cases were included in this individual retrospective-cohort study, consisting of 122 boys and 53 girls, with ages from 3 to 12 years (median: 8.00). Clinical data included the children's medical history, physical examinations, imaging cephalograms, rhinomanometry, and PSG with video monitoring performed by sleep technicians for all patients. Multiple linear regression analyses were performed to identify independent predictors significantly related to the severity of OSA (AHI: apnea hypopnea index, 5/h and 10/h).</div></div><div><h3>Results</h3><div>For AHI greater than 5/h, the independent predictors were nocturnal oximetry (PSG-ODI 3 % &gt; 3/h), total nasal resistance, tonsil size, one video monitoring item, and the total video monitoring score. The accuracy of this predictive statistic model was 88.0 % (sensitivity 78.3 %, specificity 93.0 %). For AHI greater than 10/h, the independent predictors included facial axis of cephalogram, nocturnal oximetry (PSG-ODI 3 % &gt; 5/h), and BMI &lt;15, along with video monitoring parameters such as whole-night inspiratory noise (loud) and chest retraction. The sensitivity of this model was 88.7 %, specificity was 84.1 %, and accuracy was 86.9 %, which is much higher than the accuracy of the model without video monitoring score.</div></div><div><h3>Conclusions</h3><div>Instead of relying solely on PSG, the combination of video monitoring score and multiple clinical examinations could provide a reliable diagnostic approach for pediatric OSA. These results will support the establishment of more efficient diagnostic strategies for both patients and physicians.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"191 ","pages":"Article 112281"},"PeriodicalIF":1.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529325","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":"Outcomes of stretching exercises after lingual frenotomy in infants: A prospective, interventional study","authors":"Jessa E. Miller ,&nbsp;Hye Rhyn Chung ,&nbsp;Camryn R. Marshall ,&nbsp;Holly M. Wilhalme ,&nbsp;Alisha N. West","doi":"10.1016/j.ijporl.2025.112280","DOIUrl":"10.1016/j.ijporl.2025.112280","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the safety and efficacy of stretching exercises after frenotomy for ankyloglossia.</div></div><div><h3>Study design</h3><div>Prospective cohort study.</div></div><div><h3>Setting</h3><div>Single academic tertiary care hospital.</div></div><div><h3>Methods</h3><div>Subjects with ankyloglossia were enrolled from 4/5/2021–4/5/2023. All patients underwent in-office frenotomy using scissors. Patients enrolled from 4/5/2021–10/5/2021 and 4/6/2022–4/5/2023 were assigned to the stretching group; those enrolled from 10/6/2021–4/5/2022 were assigned to the non-stretching group. Caregivers of patients in the stretching group were instructed on how to perform stretching exercises. All patients returned to clinic after one month for evaluation. Chart review was performed and demographic and outcomes data were collected.</div></div><div><h3>Results</h3><div>Eighty-eight patients were included. There were 25 patients in the non-stretching group and 63 in the stretching group; however, only 36 were adherent to stretching exercises and 27 were non-adherent. The average age of participants was 50.0 ± 45.5 days; 59.0 % were male. Preoperatively, all but one patient had breastfeeding difficulties. For the stretching adherent, stretching non-adherent, and non-stretching groups, there were persistent feeding difficulties present in 0 % (n = 0), 14.8 % (n = 4), and 16 % (n = 4), respectively (p = 0.024). Recurrent ankyloglossia was present in 5.6 % (n = 2), 40.7 % (n = 11), and 16 % (n = 4) of patients in the stretching adherent, stretching non-adherent, and non-stretching groups, respectively (p = 0.003). A revision procedure was required in 5.6 % (n = 2), 37.0 % (n = 10), and 32 % (n = 8) of those in the stretching adherent, stretching non-adherent, and non-stretching groups, respectively (0.005).</div></div><div><h3>Conclusion</h3><div>Stretching exercises improved patient-reported feeding difficulties, the development of recurrent frenulum, scarring, and need for revision procedure. Postoperative regimen adherence may be challenging for caregivers.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"191 ","pages":"Article 112280"},"PeriodicalIF":1.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143487904","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":"Intracapsular tonsillectomy improves children's postoperative behavior measures","authors":"Ephraim Rinot ,&nbsp;Netanel Eisenbach ,&nbsp;Igor Yakubovich ,&nbsp;Ahmad Bader ,&nbsp;Abeer Dabbah Miari ,&nbsp;Samah Khalil ,&nbsp;Rania Faris ,&nbsp;Eyal Sela ,&nbsp;Maayan Gruber","doi":"10.1016/j.ijporl.2025.112279","DOIUrl":"10.1016/j.ijporl.2025.112279","url":null,"abstract":"<div><h3>Background</h3><div>Tonsillectomy represents one of the most frequently performed surgical interventions in pediatric otolaryngology (Bohr and Shermetaro, 2023) [1]. The selection of surgical technique plays a crucial role in determining multiple aspects of postoperative recovery, including pain management, healing trajectory, and behavioral adaptation (Karam et al., 2022; Lin et al., 2024). This investigation sought to evaluate the differential impacts of coblation intracapsular tonsillectomy (CIT) versus traditional cold dissection total tonsillectomy (TT) on postoperative behavioral patterns in pediatric patients.</div></div><div><h3>Objective</h3><div>This study aimed to conduct a comprehensive comparison of postoperative behavioral outcomes between pediatric patients undergoing CIT versus TT procedures.</div></div><div><h3>Methods</h3><div>The investigation prospectively enrolled 163 pediatric patients, aged 2–15 years, scheduled for tonsillectomy. Subjects underwent either CIT or TT procedures according to standardized protocols. Postoperative assessment utilized two validated instruments: the Parental Postoperative Pain Management (PPPM) questionnaire and the Wong-Baker Faces Pain Scale. Parents completed these assessments daily from postoperative day (POD) 1 through 7.</div></div><div><h3>Results</h3><div>Analysis revealed consistently superior behavioral outcomes in the CIT group compared to the TT cohort. Initial evaluations on POD 1 demonstrated advantages for the CIT technique across all measured parameters, with two reaching statistical significance. By POD 7, the behavioral differences between groups had become more pronounced, with seven parameters showing statistically significant advantages in the CIT group. Composite behavioral scores similarly demonstrated significant superiority in the CIT cohort.</div></div><div><h3>Conclusions</h3><div>The postoperative period following tonsillectomy presents substantial challenges for pediatric patients and their families, characterized by notable behavioral modifications. Our findings demonstrate that CIT procedures are associated with markedly improved behavioral outcomes compared to conventional TT approaches. These results provide compelling evidence supporting the preferential use of CIT when considering the behavioral impact of tonsillectomy in pediatric populations. This data contributes valuable insights to inform surgical decision-making in pediatric tonsillectomy cases.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"191 ","pages":"Article 112279"},"PeriodicalIF":1.2,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474492","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":"Transforming pediatric ENT documentation: Efficiency, accuracy, and adoption of speech recognition technology (Speaknosis)","authors":"Cristóbal Langdon,&nbsp;Oliver Haag,&nbsp;Melisa Vigliano,&nbsp;Maurizio Levorato,&nbsp;Johan Leon-Ulate,&nbsp;Marti Adroher","doi":"10.1016/j.ijporl.2025.112275","DOIUrl":"10.1016/j.ijporl.2025.112275","url":null,"abstract":"<div><h3>Introduction</h3><div>Efficient and accurate medical documentation ensures patient safety, continuity of care, and clinician satisfaction. Speech recognition technology has emerged as a promising alternative to traditional documentation methods, potentially reducing administrative burden and improving workflow efficiency. However, concerns about accuracy, consistency, and clinical adoption remain significant barriers to its integration into medical practice.</div></div><div><h3>Objective</h3><div>This study evaluates the impact of AI-powered speech recognition technology (Speaknosis) on medical documentation in pediatric ENT settings, focusing on its efficiency, accuracy, and acceptance among clinicians. The research also explores the tool's potential to enhance clinical data interpretation and decision-making.</div></div><div><h3>Methods</h3><div>Ten pediatric ENT physicians participated in 375 AI interactions, and a quasi-experimental design was employed. Speaknosis-generated documentation was assessed for semantic relevance (BERTScore), quality (PDQI-9), and clinician satisfaction using a 5-point Likert scale. Human interventions were analyzed for error correction and alignment with professional standards. Statistical analysis of quantitative data and thematic evaluation of qualitative feedback were conducted.</div></div><div><h3>Results</h3><div>The AI system achieved a high average BERTS score (96.50 %), with notable instances of inaccuracies requiring human intervention, including omission of clinical findings, redundant content, and formatting issues. The PDQI-9 mean score was 38.34, indicating overall high-quality documentation, with strengths in organization (mean = 5.0) and internal consistency (mean = 4.83). However, comprehensiveness (mean = 3.99) and timeliness (mean = 4.00) exhibited variability. Clinician satisfaction averaged 4.64, with higher satisfaction rates correlated to interactions with superior documentation quality and duration.</div></div><div><h3>Conclusion</h3><div>Speaknosis has the potential to improve documentation efficiency and accuracy and alleviate clinician burden. However, challenges in addressing error variability and comprehensiveness highlight the need for ongoing algorithm refinement and human oversight. This study emphasizes the transformative role of AI in healthcare documentation, contingent on robust validation and strategic implementation.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"191 ","pages":"Article 112275"},"PeriodicalIF":1.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464152","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":"Global tonsillectomy practice patterns – A survey study of pediatric otolaryngologists","authors":"Gina M. Spencer ,&nbsp;Claire A. Wilson ,&nbsp;Jacob Davidson ,&nbsp;Julie E. Strychowsky ,&nbsp;Claire M. Lawlor ,&nbsp;Hannah Burns ,&nbsp;Eishaan K. Bhargava ,&nbsp;James Fowler ,&nbsp;M. Elise Graham","doi":"10.1016/j.ijporl.2025.112276","DOIUrl":"10.1016/j.ijporl.2025.112276","url":null,"abstract":"<div><h3>Objective</h3><div>There is variation in surgical techniques and postoperative management of tonsillectomy globally. Our objective was to consolidate international similarities and differences in tonsillectomy management by pediatric otolaryngologists.</div></div><div><h3>Methods</h3><div>This cross-sectional survey study was conducted from April 4 to May 16, 2024. It involved a 55-item questionnaire distributed online to an international sample of pediatric otolaryngologists via an international WhatsApp group comprising pediatric otolaryngologists from various countries. The study achieved responses from 132 out of 293 invited pediatric otolaryngologists (45.1 % response rate). Participants were from 22 countries. Eligibility included proficiency in English and currently practicing pediatric otolaryngology.</div></div><div><h3>Results</h3><div>Among respondents, the majority primarily performed extracapsular tonsillectomy (44.7 %), followed by those who used both intracapsular and extracapsular tonsillectomy equally (34.8 %), and those who predominantly performed intracapsular tonsillectomy (20.5 %). Ideal patient candidates for extracapsular tonsillectomy included those with recurrent tonsillitis (70.5 %), recurrent peritonsillar abscesses (67.4 %), and obstructive sleep apnea (46.2 %). Ideal candidates for intracapsular tonsillectomy were those with obstructive sleep apnea (50.0 %) and bleeding disorders (38.6 %). Intracapsular tonsillectomy adoption was notably high in this cohort, with 68.8 % of European respondents favoring intracapsular tonsillectomy. Postoperative pain management varied, with 76.5 % of respondents using acetaminophen, 77.3 % using ibuprofen, and 28.8 % prescribing opioids, primarily oxycodone (48.6 %). Access to polysomnography was reported by 84.0 % of respondents. Common indications for inpatient admission included age under three (75.8 %), medical comorbidity (71.2 %), and severe sleep apnea (59.1 %).</div></div><div><h3>Conclusion</h3><div>This study highlights the increasing adoption of intracapsular tonsillectomy and the need for comprehensive guidelines addressing the observed global variability in practices.</div></div><div><h3>Level of evidence</h3><div>4.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"191 ","pages":"Article 112276"},"PeriodicalIF":1.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of acute and chronic facial palsy in children and adolescents: Prognostic factors for the outcomes","authors":"Chang Ho Hong ,&nbsp;Gerd Fabian Volk ,&nbsp;Orlando Guntinas-Lichius","doi":"10.1016/j.ijporl.2025.112277","DOIUrl":"10.1016/j.ijporl.2025.112277","url":null,"abstract":"<div><h3>Introduction</h3><div>Pediatric facial palsy is a rare disease. There is a lack of data on the outcome of peripheral acute facial palsy (AFP) or chronic facial palsy (CFP) in children and adolescents after treatment and on the prognostic factors.</div></div><div><h3>Methods</h3><div>A retrospective study was conducted in a university facial nerve center. Clinical data was analyzed for their impact on probability of recovery or functional improvement using univariable and multivariable statistics.</div></div><div><h3>Results</h3><div>84 F P patients (range: 0–18 years, 35 % AFP, 17.9 % flaccid CFP; 29.8 % synkinetic CFP) treated 2003–2021 were included. All AFP received intravenous prednisolone therapy (PT). 56 % of patients with synkinetic CFP were treated with electromyography biofeedback facial training (EBFT). Facial nerve reconstruction (FNR) was the most common treatment (40 %) for flaccid CFP. 82.8 % of AFP fully recovered. Synkinetic CFP showed improvement in 60 %. 26.7 % of flaccid CFP patients showed improved facial mobility. AFP patients with a Stennert Index (SI) &gt; 6 (p = 0.024), House Brackmann scale (HB) &gt; III (p = 0.034), or PT started more than 96 h after onset had worse outcomes. CFP patients with SI motor function &gt;4 (p = 0.002), total SI &gt; 6 (p = 0.015), HB &gt; III (p = 0.002), or ipsilateral loss of the stapedius reflex (p = 0.021) had a lower probability of improvement.</div></div><div><h3>Conclusions</h3><div>PT should ideally begin within 96 h after the onset of AFP in children to maximize recovery chances. The severity of FP is a key prognostic factor for recovery. Like adults, children with synkinetic CFP benefit from EBFT. Guideline-based therapies for adults seem to be also effective for children and adolescents.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"190 ","pages":"Article 112277"},"PeriodicalIF":1.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}