International journal of pediatric otorhinolaryngology最新文献

{"title":"Preventing unnecessary tympanostomy tube placement in children: A 5-year Update","authors":"Sofia Piperno ,&nbsp;Zachary S. Burgess ,&nbsp;Jason F. Ohlstein ,&nbsp;Yusif Hajiyev ,&nbsp;Charles A. Hughes ,&nbsp;Harold S. Pine","doi":"10.1016/j.ijporl.2025.112250","DOIUrl":"10.1016/j.ijporl.2025.112250","url":null,"abstract":"<div><h3>Objective</h3><div>In 2022 the American Academy of Otolaryngology (AAO) published updated clinical guidelines for pediatric tympanostomy tube placement. Statement 6 recommended that clinicians should not perform tympanostomy tube insertion in children with recurrent acute otitis media (rAOM) who do not have middle ear effusion (MEE) at the time of evaluation. We performed a 5-year update on a study evaluating this recommendation in our pediatric patient population.</div></div><div><h3>Study design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>University of Texas Medical Branch.</div></div><div><h3>Methods</h3><div>Retrospective chart review was performed on children aged 6 months to 12 years diagnosed with rAOM without MEE at the time of assessment. The watchful waiting group (WW) consisted of children who did not receive tympanostomy tubes, while the watchful waiting failure group (BMT) ultimately underwent myringotomy with tube placement. Common rAOM risk factors were assessed between groups.</div></div><div><h3>Results</h3><div>285 children met inclusion criteria. There was a significant difference in age between groups (WW = 2.62 ± 1.87 years, BMT = 1.79 ± 1.19 years; p &lt; 0.001). There was a 64.2 % success rate for watchful waiting. There was no significant difference in risk factors associated with rAOM between the groups.</div></div><div><h3>Conclusion</h3><div>As a 5-year update from a previous study, this study again assesses Statement 6 of the 2022 AAO tympanostomy tube guidelines. The 64.2 % watchful waiting success rate following these guidelines is consistent with the 66 % success rate found at the same institution 5 years prior. Contrary to the previous study, older children were significantly more likely to be successfully observed.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"191 ","pages":"Article 112250"},"PeriodicalIF":1.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479516","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":"Socioeconomic disparities in reconstructive pediatric microtia surgery","authors":"Kalena Liu ,&nbsp;Alex J. Gordon ,&nbsp;Danielle F. Eytan ,&nbsp;Zahrah Taufique","doi":"10.1016/j.ijporl.2025.112278","DOIUrl":"10.1016/j.ijporl.2025.112278","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the association of race/ethnicity and education status on time to intervention and the total number of interventions in pediatric patients with microtia undergoing hearing intervention and external ear reconstruction.</div></div><div><h3>Methods</h3><div>A retrospective chart review was performed in pediatric patients diagnosed with congenital ear deformities evaluated by an otolaryngologist or audiologist from January 1, 2013 to December 1, 2021 at a large surgical institution. Variables analyzed included demographics, patient conditions, time to surgery, and number of surgeries. Statistical analysis included analysis of variance, chi-squared tests, and multivariate regression.</div></div><div><h3>Results</h3><div>Disparities were identified in reconstructive microtia repair, with non-White patients having an increased number of external ear reconstructive surgeries (p = 0.004), with Black patients average 2 external ear reconstructive surgeries, Hispanic patients 1.74 surgeries, while White patients averaged 0.812 surgeries. All non-White patients also demonstrated increased total number of surgeries (1.94 Asian, 2.57 Black, 2.11 Hispanic, 3.29 Other/Unknown, vs 1.23 White, p = 0.007) and total number of interventions (2.17 Asian, 2.71 Black, 2.37 Hispanic 3.43 Other/Unknown, vs 1.56 White, p = 0.02) as compared to White patients. In multivariate regression analysis, race was a significant factor influencing the number of reconstructive and overall surgeries, while the presence of aural atresia was the strongest predictor for requiring additional hearing surgery.</div></div><div><h3>Conclusion</h3><div>An increased number of interventions and surgeries were seen amongst non-White patients with microtia. Further investigation is warranted to understand the socioeconomic factors associated with pediatric microtia surgery.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"191 ","pages":"Article 112278"},"PeriodicalIF":1.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464229","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":"Surgical and audiometric outcomes of active osseointegrated bone-conduction hearing device (Cochlear™ Osia® 2 system) placement from a tertiary paediatric centre","authors":"Mona Mozaffari,&nbsp;Nicola Guderley,&nbsp;Anita Wong,&nbsp;Sevasti Konstantinidou,&nbsp;Nikul Amin,&nbsp;Robert Nash","doi":"10.1016/j.ijporl.2025.112272","DOIUrl":"10.1016/j.ijporl.2025.112272","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the audiometric and surgical outcomes of implanted Osia<strong>®</strong> 2 bone conduction devices in a large paediatric population.</div></div><div><h3>Methods</h3><div>We conducted a retrospective electronic patient record review of patients implanted with the Cochlear<strong>™</strong> Osia<strong>®</strong> 2 system, over a two-year period. Pre-operative clinical details, audiometric data, operative details and post-operative surgical and audiological outcomes were recorded.</div></div><div><h3>Results</h3><div>66 Osia<strong>®</strong> 2 devices were implanted in 49 patients between September 2021 and September 2023 (median age: 9, range: 5–18). Patients were followed up in the ENT clinic for an average of 8.7 months. The majority of cases were primary surgery with patients using a BCHD on softband prior to surgery. Post-op pure tone audiometry and speech in noise testing showed a notable improvement post Osia (vs aided pre Osia) which was significant at 4 KHz and 0 dB speech-noise-ratio. There was one case of infection requiring explant and re-implantation with no further issues. Other post-operative complications included abnormal scarring and neuropathic pain. Subjective reports from the device users reflected high daily compliance and overall satisfaction with the device.</div></div><div><h3>Conclusion</h3><div>The Cochlear<strong>™</strong> Osia<strong>®</strong> 2 is a relatively new active, transcutaneous osseointegrated implant, which has been available to our paediatric practice since September 2021. Our experience demonstrates the device is an increasingly popular choice amongst paediatric patients and can be safely implanted in children. We advocate simultaneous bilateral implantation in children with bilateral hearing loss. We have seen limited surgical complications and overall excellent audiometric outcomes.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"190 ","pages":"Article 112272"},"PeriodicalIF":1.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437481","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":"Hearing loss in newborns with prenatal cytomegalovirus record: Analysis of the nation-based data in Türkiye","authors":"Rahşan Çinar ,&nbsp;Başak Tezel ,&nbsp;Bekir Keskinkiliç ,&nbsp;Fatih Kara ,&nbsp;Yusuf Kemal Kemaloğlu","doi":"10.1016/j.ijporl.2025.112274","DOIUrl":"10.1016/j.ijporl.2025.112274","url":null,"abstract":"<div><h3>Purpose</h3><div>Primary and non-primary prenatal maternal cytomegalovirus (CMV) infections are a common risk factor for congenital CMV (cCMV) infection, leading to sensorineural hearing loss (SNHL). In this study, we looked for the rate of SNHL in newborns with prenatal maternal CMV records in the National Newborn Hearing Screening Program (NNHSP).</div></div><div><h3>Methods</h3><div>The database between 2016 and 2019 was retrospectively analyzed for those with prenatal maternal CMV record. The controls were composed of the sex-matched newborns without prenatal maternal CMV record. In addition to hearing status at the end of NNHSP, other risk factors related to congenital hearing loss (CHL) were also analyzed in both groups.</div></div><div><h3>Results</h3><div>The study included 243 and 235 newborns with and without prenatal maternal CMV records, respectively, and of them, 222 and 213 newborns completed the whole NNHSP. While the control newborns without any risk factors disclosed no SNHL, 1.96 % of those with only prenatal maternal CMV record had SNHL. Rates of SNHL in those with risk factors were 3.33 % and 3.88 % in the prenatal maternal CMV and control groups, respectively.</div></div><div><h3>Conclusion</h3><div>With the results of this study, we can say that the CHL rate in those with prenatal maternal CMV history (1.96 %) was much higher than previously published CHL data in general population in Türkiye (0.2–0.3 %). Presence of other risk factors along with prenatal maternal CMV increased the rate of SNHL. Maternal CMV infection should be taken account during management of pregnancies as important a risk factor as other risk factors of CHL even in the societies with high maternal CMV seropositivity.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"190 ","pages":"Article 112274"},"PeriodicalIF":1.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420987","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":"Implementation of Child Life Specialists to improve outcomes in flexible endoscopic evaluation of swallowing in children","authors":"Beth Osterbauer ,&nbsp;Yvonne Adigwu ,&nbsp;Sheng Zhou ,&nbsp;Katy Peck ,&nbsp;Avital Abraham ,&nbsp;Christian Hochstim","doi":"10.1016/j.ijporl.2025.112266","DOIUrl":"10.1016/j.ijporl.2025.112266","url":null,"abstract":"<div><h3>Background</h3><div>Dysphagia and feeding difficulties are common problems in children, and Flexible Endoscopic Evaluation of Swallowing (FEES) is a modality for evaluating pharyngeal swallow function through a transnasal flexible fiberoptic laryngoscopy.</div></div><div><h3>Objective</h3><div>Due to the concerns around participation and its impact on successfully completing FEES in children, we began utilizing Child Life Specialists (CLS) for FEES procedures and a concurrent implementation research study was launched to measure the impact CLS interventions had on participation rates of children undergoing FEES.</div></div><div><h3>Methods</h3><div>A retrospective chart review was conducted, collecting patient demographics, participation rates and presence of CLS for all FEES conducted in the study period. To compare children undergoing FEES with the benefit of CLS and those without a CLS present, two by two comparisons were conducted using Student's T-test and Pearson's Chi Squared test.</div></div><div><h3>Results</h3><div>During the study period 196 children had a FEES with a median age of 2 years (range 2 weeks–17.8 years). Overall, 89 % of children cooperated with the procedure, and in children over the age of 5 years, 99 % of children cooperated. Presence of CLS did not seem to affect cooperation rates in our study.</div></div><div><h3>Conclusion</h3><div>The addition of CLS services to the FEES team did not appear to improve participation rates in the current study, however more subtle potential impacts on procedural satisfaction/comfort were not assessed. Our results point to the need for additional work to standardize protocols in pediatric FEES to ensure not only improved participation, but a comfortable patient/family experience.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"190 ","pages":"Article 112266"},"PeriodicalIF":1.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444266","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":"Effect of ice cream intake on post-tonsillectomy pain in children","authors":"Faiza Grati ,&nbsp;Mohamed Omrane ,&nbsp;Imen Zouche ,&nbsp;Sirine Ayadi ,&nbsp;Wassim Guermazi ,&nbsp;Hichem Cheikhrouhou","doi":"10.1016/j.ijporl.2025.112254","DOIUrl":"10.1016/j.ijporl.2025.112254","url":null,"abstract":"<div><h3>Aims</h3><div>We aim to evaluate the effect of ice cream intake on post tonsillectomy pain in children.</div></div><div><h3>Material and methods</h3><div>This study is a prospective, randomized, simple blinded clinical trial. Patients were randomized into two groups: no ice-cream group which received a standard analgesic protocol and the ice cream group which received the same analgesic protocol associated with an ice cream offered for the child before leaving the post anesthesia care unit (PACU). Pain was evaluated by the FLACC scale.</div></div><div><h3>Objectives</h3><div>The main objective was to compare the FLACC scales between the 2 groups at H6 post-operatively. Accessory objectives included evaluating the time to the first analgesic request and to the first oral intake as well as the occurrence of post operative complications.</div></div><div><h3>Results</h3><div>Forty-eight children were included. Better pain control was noted in the ice-cream group with significant difference in FLACC scales compared to the no ice-cream group at H6 (p = 0,031), H12 (p = 0,04), H18 (p = 0,024).</div><div>The time to first analgesic request was significantly longer in the ice-cream group (p &lt; 0,001).</div><div>The time to first oral fluid intake was significantly shorter in the ice-cream group (p = 0,043). Post operative complications were comparable between the 2 groups.</div></div><div><h3>Conclusion</h3><div>Ice cream intake proved to reduce post tonsillectomy pain and to improve the time to first oral fluid intake without increasing the incidence of post operative complications.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"192 ","pages":"Article 112254"},"PeriodicalIF":1.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576770","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":"Decision aid for pediatric sleep disordered breathing: A randomized trial","authors":"Purcell Chad ,&nbsp;Corsten Gerard ,&nbsp;Hong Paul","doi":"10.1016/j.ijporl.2025.112269","DOIUrl":"10.1016/j.ijporl.2025.112269","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to assess whether a decision aid (DA) can increase parental perceptions of shared decision making and reduce decisional conflict.</div></div><div><h3>Study design</h3><div>Prospective randomized controlled trial.</div></div><div><h3>Setting</h3><div>January 2017–June 2018 Single-Center Tertiary Pediatric Otolaryngology Practice in Halifax Nova Scotia, Canada.</div></div><div><h3>Methods</h3><div>English-speaking parents of children younger than 6 years with mild to moderate SDB were included. Parents were randomized to the intervention, with in-person consultation using the DA or the control group, without the DA. Outcomes measured were the decisional conflict scale (DCS), shared decision-making questionnaire (SDM-Q-9) and the OPTION instrument. Descriptive, parametric and non-parametric analyses were performed where appropriate. Spearman's r correlations were used to examine the relation between outcome measures.</div></div><div><h3>Results</h3><div>101 parents were included (n = 50 DA/51 control). Parents who used the DA reported lower median DCS scores (6.50 vs. 19.25; p = 0.005) and higher SDM-Q-9 scores (93.59 vs. 80.74; p = 0.035). The DCS scores were significantly negatively correlated to SDM-Q-9 scores (Spearman's r = −0.680; p &lt; 0.001). No significant differences were found in mean OPTION scores between groups. SDM-Q-9 and OPTION scores were positively correlated (Spearman's r = 0.590; p &lt; 0.010).</div></div><div><h3>Conclusion</h3><div>Parents using our DA reported lower levels of decisional conflict and greater perceived involvement in the decision-making process for their children with SDB.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"191 ","pages":"Article 112269"},"PeriodicalIF":1.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143471405","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":"Abbe-Estlander flap reconstruction in infants with extensive upper lip defects following oncosurgery: Two case reports","authors":"Wei-Liang Chen ,&nbsp;Dao-Wei Lin ,&nbsp;Zi-Xian Huang ,&nbsp;Bin Zhou ,&nbsp;Rui Chen","doi":"10.1016/j.ijporl.2025.112252","DOIUrl":"10.1016/j.ijporl.2025.112252","url":null,"abstract":"<div><h3>Background</h3><div>Surgical resection of malignant lip tumors and the reconstruction of extensive lip defects in infants pose significant challenges. We evaluated the effectiveness of the Abbe-Estlander (A-E) flap in repairing upper lip defects in infants following oncosurgery.</div></div><div><h3>Case presentation</h3><div>We present two cases of pediatric upper lip malignancies: an 18-month-old infant diagnosed with fibrosarcoma (FS) of the right upper lip (Case 1) and a 19-month-old infant diagnosed with rhabdomyosarcoma (RMS) of the left upper lip (Case 2). Both patients underwent surgical resection of the tumors followed by reconstruction of large upper lip defects using the A-E flap under general anesthesia via nasotracheal intubation. No complications were reported during the procedures. Postoperatively, neither patient received adjuvant chemotherapy. Both patients demonstrated acceptable aesthetic outcomes. Case 1 could use a straw, whereas Case 2 could breastfeed. At the 32- and 18-month follow-up, no recurrences were observed.</div></div><div><h3>Conclusion</h3><div>Surgical resection, followed by reconstruction with an A-E flap, is an effective and safe treatment for these tumors in infants. In addition, general anesthesia via nasotracheal intubation is a reliable anesthetic technique for these procedures.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"190 ","pages":"Article 112252"},"PeriodicalIF":1.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420989","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":"Investigation of feasibility of early fitting after cochlear implantation and comparison with classical fitting method","authors":"Ahmet Cansu ,&nbsp;Muzaffer Kanlıkama ,&nbsp;Hüseyin Deniz","doi":"10.1016/j.ijporl.2025.112273","DOIUrl":"10.1016/j.ijporl.2025.112273","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the feasibility of early activation of the sound processor (1 day postoperatively) after cochlear implant surgery and to compare the electrophysiological parameters with those of the classical method (activation 1 month postoperatively).</div></div><div><h3>Method</h3><div>This prospective study included 69 patients who underwent cochlear implant surgery between March 2019 and August 2022. Patients were divided into two groups: early fitting and classic fitting (control group). In the early fitting group, the sound processor was activated 1 day after surgery, whereas in the classic fitting group, it was activated 4 weeks after surgery. The study investigated whether early fitting had a negative effect on wound healing and compared electrophysiological parameters between the two groups.</div></div><div><h3>Results</h3><div>In both groups, the most common early side effects were pain, redness, and swelling. In both groups, 2 patients (5.7 %) required flap revision. The electrode impedance (EI) and most comfortable loudness level (MCL) values were lower in the early fitting group than in the classic fitting group at the initial measurements. However, no significant difference was observed in measurements after 1 month.</div></div><div><h3>Conclusion</h3><div>Early fitting of the sound processor after surgery did not adversely affect wound healing and is considered a viable approach. Although the electrode impedance and MCL values were lower in the early fitting group in the short term, similar results were obtained in the long term. Early fitting may reduce the procedure cost, particularly for patients who travel long distances to reach the treatment center.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"190 ","pages":"Article 112273"},"PeriodicalIF":1.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420988","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":"Botox injections with and without general anesthesia for pediatric sialorrhea: A cost, efficacy, and safety analysis","authors":"Michael M. Lindeborg,&nbsp;Alyssa M. Civantos,&nbsp;Michelle Florentine,&nbsp;Anna K. Meyer,&nbsp;Kristina W. Rosbe","doi":"10.1016/j.ijporl.2025.112270","DOIUrl":"10.1016/j.ijporl.2025.112270","url":null,"abstract":"<div><h3>Objective</h3><div>Ultrasound-guided salivary gland Botulinum toxin A (Botox) injections are often used in pediatric patients with refractory sialorrhea, performed with or without general anesthesia. This study aims to compare outcomes and costs between these methods.</div></div><div><h3>Study design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Tertiary children's hospital.</div></div><div><h3>Methods</h3><div>Patients with chronic sialorrhea refractory to medical therapy who underwent Botulinum toxin A injections between 2012 and 2023 under general anesthesia (n = 50; 126 injections) were compared to those performed without general anesthesia (n = 31; 116 injections). Sociodemographic factors, clinical history, and injection regimen were recorded. Available billing data from this time period was used to compare costs.</div></div><div><h3>Results</h3><div>Pediatric patients who underwent Botulinum toxin A injections without general anesthesia did not have statistically significant differences in post-injection cessation of anticholinergic medications (AOR = 0.980, [0.29, 3.29]), family-reported improvement in sialorrhea (AOR = 3.25, [0.58, 18.1]), admissions for aspiration pneumonia within the year (Coefficient = 0.260, [-0.22, 0.75]), or progression to sialorrhea surgery (AOR = 0.374, [0.07, 2.16]) compared to those performed under general anesthesia. Amongst patients who underwent repeat injections, there were no significant differences in the average number of injections (p = 0.41) or time between injections (p = 0.16). Botulinum toxin A injections performed in the outpatient setting ($1374.49) had significantly lower costs compared to injections performed under general anesthesia ($5077.13) (p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Pediatric patients undergoing Botulinum toxin A injections with and without general anesthesia have similar efficacy and quality outcomes. Exploring the advantages of Botulinum toxin A injections without general anesthesia could lead to improved access, reduced risks of general anesthesia, and reduced costs to the medical system.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"190 ","pages":"Article 112270"},"PeriodicalIF":1.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143420990","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}