American Journal of Otolaryngology最新文献

{"title":"The impact of race and ethnicity on cochlear implant outcomes","authors":"Grant Primer,&nbsp;Russell A. Whitehead,&nbsp;Joshua D. Sevier,&nbsp;Elias Michaelides","doi":"10.1016/j.amjoto.2026.104874","DOIUrl":"10.1016/j.amjoto.2026.104874","url":null,"abstract":"<div><h3>Objectives</h3><div>Racial and ethnic disparities in healthcare access and outcomes are well documented, yet their influence on cochlear implant (CI) performance remains underexplored. This study evaluated whether race or ethnicity is associated with post-implant speech recognition outcomes.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted of adult CI recipients at a single tertiary academic center (2012–2024). Demographic variables, including race, ethnicity, and sex, were analyzed alongside speech recognition outcomes: AzBio sentence, Consonant-Nucleus-Consonant (CNC) phoneme, and CNC word scores. Patients were grouped as White vs. non-White and Hispanic/Latino vs. non-Hispanic/Latino. Between-group differences were assessed using independent <em>t</em>-tests and Wilcoxon rank-sum tests. Multivariable linear regression models adjusted for age, sex, body mass index, tobacco and substance use, number of follow-ups, and duration of hearing loss.</div></div><div><h3>Results</h3><div>Among patients with complete data (<em>n</em> = 115 in total; <em>n</em> = 110 AzBio; <em>n</em> = 60 CNC), no significant differences were observed in post-implant speech recognition improvement between White and non-White patients for AzBio (<em>p</em> = 0.758), CNC phonemes (<em>p</em> = 0.228), or CNC words (<em>p</em> = 0.309). Additionally, there were no significant differences between Hispanic/Latino and non-Hispanic/Latino groups for AzBio (<em>p</em> = 0.653), CNC phonemes (<em>p</em> = 0.873), or CNC words (<em>p</em> = 0.751). Multivariable linear regression revealed no significant associations between race or ethnicity and any speech recognition outcome.</div></div><div><h3>Conclusion</h3><div>Race and ethnicity were not significantly associated with post-implant speech recognition outcomes. While this may indicate equitable CI performance across demographic groups, this study was limited by a smaller sample size and other possible unmeasured variables. Future studies should incorporate larger cohorts and more granular social determinants of health to better characterize potential disparities in post-implant performance.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 4","pages":"Article 104874"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350225","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":"Managing post-extubation dysphagia after prolonged intubation: A systematic review of Speech-Language Pathology (SLP) approaches","authors":"David Sánchez Fernández,&nbsp;Cosimo Galletti,&nbsp;Luca Fiorillo,&nbsp;Cosimo Galletti,&nbsp;Javier Flores Fraile","doi":"10.1016/j.amjoto.2026.104887","DOIUrl":"10.1016/j.amjoto.2026.104887","url":null,"abstract":"<div><h3>Introduction</h3><div>Speech-Language Pathology encompasses the assessment, diagnosis, prevention, and treatment of disorders affecting speech, language, voice, hearing, and swallowing. Among these, dysphagia management is crucial, as safe and efficient swallowing depends on the coordinated action of neuromuscular and anatomical structures within the oropharyngeal, laryngeal, and esophageal systems. Disruption of this coordination, particularly after prolonged intubation, can lead to aspiration, malnutrition, and reduced quality of life.</div></div><div><h3>Objective</h3><div>To review the literature on swallowing disorders following prolonged intubation, identify associated risk factors, and describe the main Speech-Language Patathology (SLP) assessment and intervention strategies.</div></div><div><h3>Methods</h3><div>A systematic review was conducted on swallowing disorders after prolonged endotracheal intubation using PubMed, BVS, and Cochrane databases. Following PRISMA 2020 guidelines, 266 articles were identified, of which 16 met the inclusion criteria. Risk of bias was assessed with the ROBINS-I and Newcastle–Ottawa (NOS) scales.</div></div><div><h3>Results</h3><div>Most studies showed low risk of bias and moderate methodological quality. Prolonged intubation was consistently associated with dysphagia. Key risk factors included advanced age, neurological conditions, tracheostomy, inflammation, pneumonia, poor functional status, and extended ICU (Intensive care unit) or hospital stays.</div></div><div><h3>Conclusions</h3><div>Dysphagia after prolonged intubation results from multifactorial influences that compromise the swallowing mechanism. Early assessment and targeted Speech-Language Pathology significantly improve swallowing safety, accelerate recovery, and enhance patients' quality of life. These findings highlight the essential role of Speech-Language Pathology (SLP) in post-extubation care and the importance of standardized assessment and rehabilitation protocols.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 4","pages":"Article 104887"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387090","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":"A novel autoinflation device for persistent pediatric otitis media with effusion: A prospective single-arm cohort study","authors":"Nanki Hura,&nbsp;Maria-Jose Soto,&nbsp;Zarna Lalwani,&nbsp;Intan Oldakowska,&nbsp;Matthew Oldakowski,&nbsp;Paul Bumbak,&nbsp;Peter L. Santa Maria","doi":"10.1016/j.amjoto.2026.104862","DOIUrl":"10.1016/j.amjoto.2026.104862","url":null,"abstract":"<div><h3>Background</h3><div>Autoinflation is a non-surgical option for pediatric otitis media with effusion (OME), but existing devices are limited to children ≥4 years and lack objective adherence confirmation. EarFlo® is a novel prototype autoinflation device designed for younger children with built-in objective treatment detection.</div></div><div><h3>Design</h3><div>Prospective single-arm cohort study.</div></div><div><h3>Setting</h3><div>Single pediatric otolaryngology practice, Western Australia.</div></div><div><h3>Participants</h3><div>Children aged 1–12 years with persistent OME after ≥3 months of watchful waiting, assessed for tympanostomy tube placement.</div></div><div><h3>Intervention</h3><div>Four weeks of twice-daily home use of EarFlo® (10 successful treatments per session), followed by 8 weeks of observation without device use.</div></div><div><h3>Primary outcomes</h3><div>Within-patient serial tympanometric and audiometric changes over 12 weeks.</div></div><div><h3>Results</h3><div>18 participants completed the study (median age 6 years, range 2–11; 22% &lt; 4 years). Objectively measured adherence was 99% (median). Mean pure tone average (PTA) in ears with baseline hearing loss improved by 12.9 dB HL (95% CI: 7.8 to 17.9) at 2 weeks and 9.7 dB HL (95% CI: 3.7 to 15.7) at 4 weeks in adjusted analyses. Tympanometric improvement was observed in 91% of ears during active device use; 35% (95% CI: [19.7% to 53.5%]) exhibited sustained improvement at final follow-up. 89% of participants (16/18) were not recommended for tympanostomy tube surgery during the observed follow-up period. No adverse events were recorded.</div></div><div><h3>Conclusions</h3><div>In children with persistent OME meeting criteria for surgical intervention, EarFlo® demonstrated high objective adherence, no adverse events, and clinically meaningful within-patient tympanometric and audiometric improvements. These findings support further evaluation in randomized controlled trials.</div><div>This trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR12621000949886; registered 15 April 2024, prior to first enrollment in May 2024).</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 4","pages":"Article 104862"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257033","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":"Comment on “Modified ultrasound-guided polidocanol sclerotherapy is an effective treatment for thyroid cystic-solid nodules: A single-center retrospective study”","authors":"Kotina Shridevi,&nbsp;Megha Doiphode,&nbsp;Rakhi Mishra,&nbsp;Archana Dhyani","doi":"10.1016/j.amjoto.2026.104875","DOIUrl":"10.1016/j.amjoto.2026.104875","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 4","pages":"Article 104875"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403227","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":"Outcomes of pediatric tracheostomy with a standardized surgical technique: A retrospective single-center analysis","authors":"Utku Kubilay,&nbsp;Fatih Durak,&nbsp;Hüseyin Berk Yaramış,&nbsp;Emine Pinar Kulluoglu,&nbsp;Gokcen Ozcifci,&nbsp;Inci Çisem Burhan,&nbsp;Abdullah Dalgıç","doi":"10.1016/j.amjoto.2026.104881","DOIUrl":"10.1016/j.amjoto.2026.104881","url":null,"abstract":"<div><h3>Objective</h3><div>Pediatric tracheostomy is a life-saving procedure for children requiring prolonged mechanical ventilation or airway protection. This study evaluated clinical outcomes, postoperative respiratory changes, and complications in pediatric tracheostomy cases performed using a structured institutional surgical and postoperative management framework.</div></div><div><h3>Methods</h3><div>This retrospective single-center cohort included 43 pediatric patients (0–18 years) who underwent tracheostomy at a tertiary care hospital in İzmir, Türkiye, between October 2023 and September 2025. Demographics, tracheostomy indications, complications, ventilatory parameters, decannulation outcomes, and mortality were analyzed. Positive end-expiratory pressure (PEEP), peak inspiratory pressure (PIP), and fraction of inspired oxygen (FiO₂) were recorded preoperatively and at postoperative 24 h, 72 h, and day 7 while patients remained on invasive mechanical ventilation. Longitudinal changes were analyzed using linear mixed-effects models.</div></div><div><h3>Results</h3><div>Median age was 12 months (IQR 4–90), and 51.2% of patients were male. The most common indications were neuromuscular disease (51.2%) and chronic respiratory failure (37.2%) and upper airway obstruction or malformation (11.6%). No major intraoperative complications occurred. Early and late postoperative complications were observed in 14.0% and 30.2% of patients, respectively, most commonly cannula-related events. Mixed-effects modeling demonstrated significant longitudinal improvement in ventilatory parameters. Mean PEEP decreased from 6.30 to 5.07 cmH₂O, PIP from 17.51 to 14.12 cmH₂O, and FiO₂ from 34.30% to 26.65% by postoperative day 7 (all <em>p</em> &lt; 0.001). Overall, 3 patients (7.0%) were successfully decannulated. Among the remaining tracheostomy-dependent patients, 15/29 (51.7%) achieved spontaneous breathing without invasive mechanical ventilation.</div></div><div><h3>Conclusion</h3><div>Pediatric tracheostomy performed within a structured multidisciplinary framework was intraoperatively safe and associated with significant early improvement in ventilatory parameters. These findings support the feasibility of protocol-based perioperative management and may help inform future prospective comparative studies.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 4","pages":"Article 104881"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403261","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":"Associations and trends in recency of hearing tests in the United States","authors":"Roy W. Qu,&nbsp;Haley R. Kowalski,&nbsp;Jonathan Raskin,&nbsp;Helen Xu,&nbsp;Baishakhi Choudhury","doi":"10.1016/j.amjoto.2026.104873","DOIUrl":"10.1016/j.amjoto.2026.104873","url":null,"abstract":"<div><h3>Objective</h3><div>To identify associations and trends in recency of hearing test in aggregate and race-specific fashion.</div></div><div><h3>Methods</h3><div>Adults (&gt;20 years) in the United States participating in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2012, 2015–2016, and 2017–2020.</div></div><div><h3>Results</h3><div>10,751 participants with 9130 audiograms, were included for analysis. Less severe HL (<em>p</em> = 0.005), better self-perceived hearing (<em>p</em> &lt; 0.001), and shorter time in the United States (p &lt; 0.001) were associated with a longer interval since their last hearing test. On multivariable analysis, only Asians had a longer time since their last hearing tested compared to whites (OR = 1.62, <em>p</em> = 0.005). Better self-perceived hearing was associated with a longer time since the last hearing test in Blacks (<em>p</em> = 0.019) and Hispanics (<em>p</em> = 0.006), while HL severity was not (Black, <em>p</em> = 0.203; Hispanic, <em>p</em> = 0.872). Speaking mostly a non-English language (OR 1.39, <em>p</em> = 0.006) was associated with a longer interval for Asians, while speaking mostly Spanish at home was not for Hispanics (OR 1.29, <em>p</em> = 0.128). Compared to 2011–2012 rates, all races (<em>p</em> &lt; 0.001) had increased rates of recent hearing tests by 2017–2020 except for Blacks (<em>p</em> = 0.664).</div></div><div><h3>Conclusions</h3><div>Despite adjustments for HL, the time since last hearing test differed by race. Addressing factors associated with recency of hearing tests, such as discordance between objective and self-perceived HL and language barriers, may improve identification of HL in racial minorities.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 4","pages":"Article 104873"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148325445","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":"Clinical factors associated with surgical intervention and outcomes in pediatric laryngomalacia: A five-year tertiary care study from Eastern India","authors":"Partha Pratim Halder,&nbsp;Parinita Ranjit,&nbsp;Barnali Ghosh Das,&nbsp;Pallavi Agarwal","doi":"10.1016/j.amjoto.2026.104868","DOIUrl":"10.1016/j.amjoto.2026.104868","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate clinical characteristics, associated comorbidities, management strategies, and factors associated with surgical intervention in children with laryngomalacia managed at a tertiary pediatric airway referral center in Eastern India.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included children aged 0–60 months diagnosed with laryngomalacia between January 2019 and December 2024 at Institute of Child Health. Diagnosis was confirmed by flexible nasopharyngolaryngoscopy. Clinical features, disease severity, feeding dysfunction, gastroesophageal reflux disease (GERD), synchronous airway lesions (SALs), management details, and outcomes were analyzed. Additional variables were extracted from institutional records following peer-review recommendations to improve methodological reporting. Factors associated with surgical intervention were evaluated using univariate analysis and exploratory multivariable analysis where statistically feasible.</div></div><div><h3>Results</h3><div>A total of 68 children were included (male:female ratio 1.9:1). Median age at symptom onset was 2.5 months (IQR 1.5–4.0 months), and median age at diagnosis was 5 months (IQR 3–7 months). Feeding difficulty occurred in 47.1%, aspiration in 17.6%, failure to thrive in 22.1%, GERD in 30.9%, and SALs in 26.5%. Most children (82.4%) were successfully managed conservatively, while 17.6% required Supraglottoplasty. Fifty-nine children (86.8%) completed at least 12 months follow-up. Complete resolution of stridor occurred in 48/59 children (81.4%), and surgical success was observed in 10/12 children (83.3%). Feeding dysfunction and SALs were significantly associated with surgical intervention.</div></div><div><h3>Conclusions</h3><div>Most children with laryngomalacia improve with conservative management. However, feeding dysfunction and synchronous airway lesions may identify children at higher risk of requiring surgery. Early multidisciplinary airway evaluation may improve outcomes.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 4","pages":"Article 104868"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148282994","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":"Letter to the editor regarding “Development of a novel self-assessment tool following endoscopic sinus surgery in the management of chronic rhinosinusitis”","authors":"Ali Omidvari,&nbsp;Mahsa Sepahvand","doi":"10.1016/j.amjoto.2026.104870","DOIUrl":"10.1016/j.amjoto.2026.104870","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 4","pages":"Article 104870"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148381452","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":"Multifunctional xylitol-HA hydrogel for chronic rhinosinusitis management","authors":"Jibin Huang,&nbsp;Jiayan Wang,&nbsp;Wei Wang,&nbsp;Ming Xu","doi":"10.1016/j.amjoto.2026.104878","DOIUrl":"10.1016/j.amjoto.2026.104878","url":null,"abstract":"<div><h3>Purpose</h3><div>Chronic rhinosinusitis (CRS) often recurs after surgery due to biofilms and inflammation, as current therapies have poor mucosal retention and limited biofilm penetration. We developed a natural hydrogel combining xylitol and hyaluronic acid (HA) to enhance drug delivery and antibiofilm efficacy.</div></div><div><h3>Methods</h3><div>A hydrogel of xylitol (5% <em>w</em>/<em>v</em>) and HA (0.1% w/v), with or without mometasone furoate (MF, 0.2 mg/mL), was formulated. Mucoadhesion was tested in mice. Biocompatibility, anti-inflammatory effects (IL-6, IL-8, TNF-α, FOXJ1), and ciliary toxicity were evaluated in LPS-stimulated human nasal epithelial cells (HNEpCs). Antibiofilm activity against <em>S. aureus</em>, <em>P. aeruginosa</em>, and <em>S. pneumoniae</em> was assessed via MIC/MBC, crystal violet staining, and SEM. Virulence gene expression (<em>fnbA</em>, <em>fnbB</em>, <em>clfB</em>, <em>sarA</em>, <em>agrA</em>) was analyzed during HNEpC-<em>S. aureus</em> co-culture.</div></div><div><h3>Results</h3><div>The xylitol-HA hydrogel showed prolonged nasal retention (up to 12 h). MF incorporation further improved mucoadhesion. The xylitol-HA-MF formulation was biocompatible, significantly reduced IL-6, IL-8, and TNF-α, and partially restored LPS-suppressed FOXJ1 expression (<em>p</em> &lt; 0.01). MF addition provided synergistic bactericidal activity (MBC: 32–64 μg/mL) and reduced pre-formed biofilm biomass (<em>p</em> &lt; 0.05). It also downregulated <em>S. aureus</em> adhesion genes and global regulators (<em>p</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>A natural xylitol-based hydrogel with MF offers prolonged mucosal retention, potent anti-inflammatory effects, and synergistic antibiofilm activity by targeting bacterial virulence, presenting a promising strategy for postoperative CRS management.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 4","pages":"Article 104878"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403267","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":"Risk factors for residual obstructive sleep apnea after adenotonsillectomy in children: A single-center retrospective cohort study","authors":"Jianbin Zhang,&nbsp;Yufeng Zhang,&nbsp;He Li","doi":"10.1016/j.amjoto.2026.104859","DOIUrl":"10.1016/j.amjoto.2026.104859","url":null,"abstract":"<div><h3>Objective</h3><div>Adenotonsillectomy (T&amp;A) is the first-line treatment for pediatric obstructive sleep apnea (OSA). However, a significant proportion of children, particularly those with specific phenotypes, exhibit residual OSA postoperatively. Identifying preoperative risk factors for residual disease is crucial for managing parental expectations and planning postoperative care.</div></div><div><h3>Methods</h3><div>This single-center retrospective study included children (aged 3–14 years) who underwent T&amp;A for OSA between January 2018 and December 2024. All patients had complete preoperative and postoperative (6–12 months) polysomnography (PSG) data. Residual OSA was defined as a postoperative obstructive apnea-hypopnea index (AHI) ≥ 2 events/h. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors.</div></div><div><h3>Results</h3><div>A total of 642 children were included. The overall prevalence of residual OSA was 26.8% (172/642). The multivariate analysis identified three independent risk factors: obesity (BMI ≥ 95th percentile) [Odds Ratio (OR) 3.12, 95% CI 1.85–5.26], severe baseline AHI (OR 1.08 per unit increase, 95% CI 1.05–1.11), and concurrent asthma (OR 1.95, 95% CI 1.12–3.40). The multivariate risk assessment demonstrated good discrimination with an area under the curve (AUC) of 0.82 (95% CI 0.78–0.86).</div></div><div><h3>Conclusion</h3><div>Residual OSA is common after T&amp;A, affecting approximately one-quarter of the pediatric population. Obesity, disease severity, and comorbid asthma are robust risk factors of incomplete resolution. Preoperative counseling and planned postoperative PSG surveillance are essential for these high-risk groups.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 4","pages":"Article 104859"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148325426","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}