International journal of pediatric otorhinolaryngology最新文献_第10页

A Retrospective Study Distinguishing between Hyperacusis and Misophonia in children with Auditory Processing Disorder (APD) 区分听觉处理障碍（APD）儿童听力过强和失音的回顾性研究

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2024-09-21 DOI: 10.1016/j.ijporl.2024.112119

Ansar Ahmmed, Sabarinath Vijayakumar

Objectives

Decreased sound tolerance (DST) is common in children with auditory processing disorder (APD). This study aimed to differentiate between hyperacusis and misophonia in children with APD.

Design

A retrospective study evaluating outcomes of structured history and co-morbidity following Research Domain Criteria (RDoC) frame-work. Misophonia was considered as oversensitivity to eating/chewing sounds and hyperacusis as oversensitivity to other sounds.

Study sample

Two hundred and seventy-nine children (160 males; 119 females), 6-16 year-olds with NVIQ ≥80, diagnosed with APD between January 2021 and December 2022.

Results

One hundred and forty-three out of 279 children with APD had DST, of which 107 had hyperacusis (without misophonia) and 36 had misophonia. Misophonia co-existed with hyperacusis in 35 children (97 %), and in one child misophonia occurred without hyperacusis. Misophonia was prevalent in older children, in females, and those with tinnitus. Fear and being upset were predominant emotional responses in hyperacusis (without misophonia) while disgust and verbal abuse were prevalent in misophonia (with or without hyperacusis). Compared to children without DST, the hyperacusis (without misophonia) and misophonia (with or without hyperacusis) groups had significant higher prevalence of ADHD, anxiety, and language impairment. Educational difficulties were similar in APD irrespective of the presence or absence of DST. Despite higher tinnitus prevalence in misophonia (with or without hyperacusis) along with similar co-morbidities and educational difficulties in both hyperacusis (without misophonia) and misophonia (with or without hyperacusis), the misophonia (with or without hyperacusis) group surprisingly had less support at school which was reflected in fewer Education, Health and Care Plan (EHCP).

Conclusions

In APD misophonia mostly co-exists with hyperacusis, with differences in emotional responses, tinnitus prevalence, and gender distribution when compared to hyperacusis (without misophonia). Increase in awareness about misophonia is needed, as children with misophonia may have unidentified needs. Larger scale prospective study is required to clarify if misophonia evolves from hyperacusis, and to explore the factors underlying ‘misophonia with hyperacusis’ and ‘misophonia without hyperacusis’. For clarity, DST studies need to specify if hyperacusis or misophonia co-existed when referring to hyperacusis or misophonia.

目标听觉处理障碍（APD）儿童普遍存在声音耐受性降低（DST）的情况。本研究旨在区分听觉处理障碍儿童中的过度听力障碍和失音。研究样本2021年1月至2022年12月期间被诊断为APD的6至16岁儿童（160名男性；119名女性），NVIQ≥80。结果279名APD儿童中有143名患有DST，其中107名患有听力障碍（无失音），36名患有失音。有 35 名儿童（97%）患有听力障碍，其中有一名儿童患有听力障碍，但没有听力障碍。失音症主要发生在年龄较大的儿童、女性和有耳鸣的儿童身上。恐惧和不安是听力障碍儿童的主要情绪反应（不伴有失音），而厌恶和辱骂则是失音儿童的主要情绪反应（伴有或不伴有听力障碍）。与没有听力障碍的儿童相比，听力障碍过重（无听力障碍）组和听力障碍过轻（有或无听力障碍）组的多动症、焦虑症和语言障碍发病率明显更高。无论是否存在 DST，APD 患者在教育方面遇到的困难相似。尽管听力障碍（伴有或不伴有听力亢进）患者的耳鸣发生率较高，而且听力亢进（不伴有听力障碍）和听力障碍（伴有或不伴有听力亢进）患者的合并疾病和教育困难相似，但令人惊讶的是，听力障碍（伴有或不伴有听力亢进）组患者在学校获得的支持较少，这反映在较少的教育、健康和护理计划（EHCP）中。结论在自闭症患者中，失音症大多与听力障碍同时存在，与听力障碍（无失音症）相比，在情绪反应、耳鸣发生率和性别分布方面存在差异。需要提高对误听症的认识，因为患有误听症的儿童可能有一些未被发现的需求。需要进行更大规模的前瞻性研究，以明确失音症是否由听力障碍演变而来，并探讨 "伴有听力障碍的失音症 "和 "不伴有听力障碍的失音症 "的基本因素。为明确起见，DST 研究在提及听力过高或听力障碍时，需要说明是听力过高还是听力障碍同时存在。

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引用次数: 0

The AMSA® manosonic nebulizer for ENT disease among children in Poland 用于治疗波兰儿童耳鼻喉疾病的 AMSA® manosonic 雾化吸入器

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2024-09-20 DOI: 10.1016/j.ijporl.2024.112113

Magdalena Beata Skarżyńska , Elżbieta Gos , Milaine Dominici Sanfins , Patryk Hartwich , Piotr Henryk Skarżyński , Agata Szkiełkowska

<div><h3>Introduction</h3><div>The AMSA® manosonic nebulizer uses acoustic vibration and a flow of air to create an aerosol from a solution or suspension of a drug. The aerosol created this way is claimed to have enhanced penetration and drug delivery. It is administered under short-term overpressure, meaning that the aerosol is able to penetrate into the middle ear through the Eustachian tube (ET).</div></div><div><h3>Purpose</h3><div>of the study: The aim of this study is to identify the active substances used in AMSA® manosonic nebulization for treating common ENT diseases in children aged 2–17 years and to evaluate the overall effectiveness of AMSA® manosonic nebulization in this context. Assessments were done by comparing conditions before and after nebulization using the following tests: (1) Eustachian tube function test, (2) tympanometry, and (3) otoscopy.</div></div><div><h3>Material and methods</h3><div>This study was a retrospective study with ethics committee consent. 129 children, comprising 56 girls and 73 boys. They were aged between 2 and 17 years, with a mean age of 6.9 years (SD = 3.0). There were 74 children up to 6 years and 55 children over 6 years of age. Children had the following conditions: (1) chronic otitis media with effusion, OME (n = 86), (2) Eustachian tube dysfunction, ETD (n = 34) (3) Other conditions (e.g. cholesteatoma, retraction pocket), (n = 9). Combination of medicines administered in this study was: Budesonide + ambroxol (with or without NaCl), Budesonide (with or without NaCl), Budesonide + N-acetylcysteine (with or without NaCl), Budesonide + hyaluronic acid, Budesonide + ambroxol (with hyaluronic acid), Ambroxol (with or without NaCl).</div></div><div><h3>Results</h3><div>The number of nebulizations ordered was between 1 and 20 treatments, but most commonly, pa-tients were given a nebulization series of 10 treatments. This was the case for 80.6 % of the patients. Most patients with OME and ETD had 10 treatments ordered (79 % and 79.5 %, respectively), while all patients with other conditions had 10 treatments. Analysis of the tympanometry results was done in terms of the number of affected ears (not by individual). There were 210 ears with complete tympanometry (both pre and post), including 142 ears with OME, 54 with ETD, and 14 others. Statistically significant changes (improvements) after AMSA nebulizations were found for statistic compliance and middle ear pressure. Otoscopy assessments were done in all ears. The results were abnormal in 155 ears (73.8 %) and normal in 55 ears (26.2 %). After AMSA nebulizations, the number of abnormal results decreased to 117 ears (55.7 %) and normal results were found in 93 ears (44.7 %).</div></div><div><h3>Conclusion</h3><div>Use of the AMSA manosonic nebulizer appears to be an effective way of improving chronic medical conditions in children – such as chronic otitis media with effusion and Eustachian tube defect – but only if patient compliance can be achieved. Th

简介 AMSA® manosonic 雾化器利用声波振动和气流将药物溶液或悬浮液制成气溶胶。据称，以这种方式产生的气溶胶具有更强的渗透性和给药性。它是在短期超压的情况下给药的，这意味着气雾剂能够通过咽鼓管（ET）渗入中耳：本研究旨在确定 AMSA® manosonic 雾化疗法中用于治疗 2-17 岁儿童常见耳鼻喉疾病的活性物质，并评估 AMSA® manosonic 雾化疗法在这方面的总体效果。通过比较雾化前后的情况，使用以下测试进行评估：(1) 咽鼓管功能测试；(2) 鼓室测量法；(3) 耳镜检查。129 名儿童中包括 56 名女孩和 73 名男孩。他们的年龄在 2 到 17 岁之间，平均年龄为 6.9 岁（SD = 3.0）。其中 6 岁以下儿童 74 名，6 岁以上儿童 55 名。儿童患有以下疾病：（1）慢性中耳炎伴流脓（OME，n = 86）；（2）咽鼓管功能障碍（ETD，n = 34）；（3）其他疾病（如胆脂瘤、回缩袋）（n = 9）。本研究中的联合用药为布地奈德+氨溴索（含或不含氯化钠）、布地奈德（含或不含氯化钠）、布地奈德+N-乙酰半胱氨酸（含或不含氯化钠）、布地奈德+透明质酸、布地奈德+氨溴索（含透明质酸）、氨溴索（含或不含氯化钠）。80.6%的患者都是这种情况。大多数 OME 和 ETD 患者都接受了 10 次治疗（分别为 79% 和 79.5%），而所有其他疾病患者都接受了 10 次治疗。对鼓室测量结果的分析是按受影响耳朵的数量进行的（而不是按个人）。共有 210 只耳朵进行了完整的鼓室测量（包括治疗前和治疗后），其中包括 142 只患有 OME 的耳朵、54 只患有 ETD 的耳朵和 14 只其他耳朵。经AMSA雾化治疗后，统计顺应性和中耳压力均有明显改善。对所有耳朵进行了耳镜检查。结果显示，155 只耳朵（73.8%）异常，55 只耳朵（26.2%）正常。结论使用 AMSA 人工渗液雾化器似乎是改善儿童慢性疾病（如慢性中耳炎伴渗液和咽鼓管缺损）的有效方法，但前提是患者必须遵从医嘱。最常用的活性物质是布地奈德，与是否使用额外的分泌物/褐质溶解剂无关。

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引用次数: 0

Pediatric parathyroid carcinoma and hyperparathyroidism-jaw tumor syndrome: A case report and literature review 小儿甲状旁腺癌和甲状旁腺功能亢进-颌骨肿瘤综合征：病例报告和文献综述

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2024-09-18 DOI: 10.1016/j.ijporl.2024.112116

Harrison M. Thompson , Mikayla G. Hubbard , Sarah A. Ackah , Alden Dewey , Erika Zevin , Erik A. Imel , Boaz Kamazyn , Monali Lipman , Adeyinka O. Akinsanya , L. Daniel Wurtz , Diane W. Chen

引用次数: 0

A multicentre observational study of paediatric head and neck abscesses 儿科头颈部脓肿多中心观察研究

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2024-09-17 DOI: 10.1016/j.ijporl.2024.112117

Timothy Davies , Anne Markey , Noor Janjua , Jacquline Chan , Kate Stephenson , Heather Newport , Thushita Kunanandam , Christine English , Jaya Nichani , Kade Harbert , Eishaan Bhargava , Miran Pankhania , Ayla Tabaksert , Steven Powell , Emily Davis , Richard Brown , Rhodri Costello , Jack Sandeman , Sarah O'Donnell , Mary Consunji , Madhankumar Krishnan

Introduction

In winter of 2022/3 paediatric ENT surgeons across the UK observed that the incidence of severe abscesses in the head and neck and associated complications was higher than seen in previous years. We aimed to collate and evaluate data from across the UK to establish if this was a true rise in cases, and to describe the factors associated.

Methods

A multicentre retrospective data collection was undertaken from 13 units across the UK. Patients admitted between September 2022–February 2023 with a head and neck abscess including sinogenic, otogenic, deep and superficial neck abscesses were included. Demographic, disease specific, management and outcome data were collected. Hospital episode statistic data were also requested and analysed to allow for comparison with previous 10 years of head and neck abscesses.

Results

262 patients with abscesses of the head and neck were admitted during the study period, 100 between September and November and 163 between December and February. Mastoid abscesses were the most common abscess across both groups. The rate of group A streptococcus + culture results rose significantly from 12 % in autumn group to 30 % in winter (p = 0.02). The rate of intracranial complications rose from 10 % to 18 % (p = 0.11) and the rate of venous thrombosis rose over the same timeframe from 3 % to 14 % (p = 0.01).

Discussion

This study demonstrated a statistically significant rise in the rate of group A streptococcus associated abscesses when comparing Autumn and Winter 2022/2023. Over the same timeframe a statistically significant rise in the proportion of patients with venous thromboses associated with H&N abscesses was noted. Interestingly, despite perceived national consensus regarding a spike in abscess incidence, the number of abscesses seen in winter 2022/2023 was in keeping with expected rates of paediatric H&N abscesses, based on pre covid year-on-year rise in incidence.

导言2022年3月的冬天，英国各地的儿童耳鼻喉外科医生发现，头颈部严重脓肿和相关并发症的发病率比往年要高。我们旨在整理和评估英国各地的数据，以确定病例数是否真的增加，并描述相关因素。研究纳入了2022年9月至2023年2月期间收治的头颈部脓肿患者，包括窦源性、耳源性、深层和浅层颈部脓肿。收集了人口统计学、特定疾病、管理和结果数据。研究期间共收治了262名头颈部脓肿患者，其中100名是在9月至11月期间收治的，163名是在12月至次年2月期间收治的。乳突脓肿是两组中最常见的脓肿。A组链球菌+培养结果的比例从秋季组的12%显著上升到冬季组的30%（p = 0.02）。颅内并发症的发生率从 10% 上升到 18%（p = 0.11），静脉血栓的发生率在同一时间范围内从 3% 上升到 14%（p = 0.01）。讨论这项研究表明，与 2022/2023 年秋季和冬季相比，A 组链球菌相关脓肿的发生率有明显的统计学上升。在同一时间段内，与 H&N 脓肿相关的静脉血栓患者比例也出现了统计学意义上的显著上升。有趣的是，尽管全国一致认为脓毒症发病率会激增，但根据发病率的同比增长趋势，2022/2023 年冬季的脓毒症数量与儿科 H&N 脓毒症的预期发病率相符。

{"title":"A multicentre observational study of paediatric head and neck abscesses","authors":"Timothy Davies , Anne Markey , Noor Janjua , Jacquline Chan , Kate Stephenson , Heather Newport , Thushita Kunanandam , Christine English , Jaya Nichani , Kade Harbert , Eishaan Bhargava , Miran Pankhania , Ayla Tabaksert , Steven Powell , Emily Davis , Richard Brown , Rhodri Costello , Jack Sandeman , Sarah O'Donnell , Mary Consunji , Madhankumar Krishnan","doi":"10.1016/j.ijporl.2024.112117","DOIUrl":"10.1016/j.ijporl.2024.112117","url":null,"abstract":"<div><h3>Introduction</h3><div>In winter of 2022/3 paediatric ENT surgeons across the UK observed that the incidence of severe abscesses in the head and neck and associated complications was higher than seen in previous years. We aimed to collate and evaluate data from across the UK to establish if this was a true rise in cases, and to describe the factors associated.</div></div><div><h3>Methods</h3><div>A multicentre retrospective data collection was undertaken from 13 units across the UK. Patients admitted between September 2022–February 2023 with a head and neck abscess including sinogenic, otogenic, deep and superficial neck abscesses were included. Demographic, disease specific, management and outcome data were collected. Hospital episode statistic data were also requested and analysed to allow for comparison with previous 10 years of head and neck abscesses.</div></div><div><h3>Results</h3><div>262 patients with abscesses of the head and neck were admitted during the study period, 100 between September and November and 163 between December and February. Mastoid abscesses were the most common abscess across both groups. The rate of <em>group A streptococcus</em> + culture results rose significantly from 12 % in autumn group to 30 % in winter (p = 0.02). The rate of intracranial complications rose from 10 % to 18 % (p = 0.11) and the rate of venous thrombosis rose over the same timeframe from 3 % to 14 % (p = 0.01).</div></div><div><h3>Discussion</h3><div>This study demonstrated a statistically significant rise in the rate of group A streptococcus associated abscesses when comparing Autumn and Winter 2022/2023. Over the same timeframe a statistically significant rise in the proportion of patients with venous thromboses associated with H&N abscesses was noted. Interestingly, despite perceived national consensus regarding a spike in abscess incidence, the number of abscesses seen in winter 2022/2023 was in keeping with expected rates of paediatric H&N abscesses, based on pre covid year-on-year rise in incidence.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112117"},"PeriodicalIF":1.2,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357580","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}

引用次数: 0

Dysphagia is a strong predictor of revision supraglottoplasty in pediatric laryngomalacia 吞咽困难是预测小儿喉头畸形喉上成形术翻修的一个重要因素

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2024-09-17 DOI: 10.1016/j.ijporl.2024.112115

Amy Callaghan , Hamdy El-Hakim , Amanda R. Adsett , Daniela M. Isaac , Andre Isaac

Background

There is growing research on the association between swallowing dysfunction and laryngomalacia. Supraglottoplasty is the surgical intervention used to treat laryngomalacia, however a portion of patients who undergo this procedure will require a revision surgery. Predictive risk factors for revision supraglottoplasty in patients with laryngomalacia are not well understood, and previous studies failed to evaluate swallowing systematically.

Hypothesis

We predict a significant association between swallowing dysfunction and revision supraglottoplasty for patients with laryngomalacia.

Methods

This was a retrospective cohort study of consecutive patients between 2013 and 2023 at a tertiary pediatric care centre (Stollery Children's Hospital). All patients had an endoscopic diagnosis of laryngomalacia by a staff otolaryngologist and at minimum a systematic clinical swallowing assessment by a speech language pathologist, with an instrumental assessment as needed. Patients with genetic or neurological comorbidities, lack of follow up information, or age of >3 years were excluded. Clinical and instrumental swallow data, demographic information, surgical outcomes and revision surgeries were documented and collected. Univariate analysis was done to determine associations between variables and revision supraglottoplasty. Binary logistic regression was done to determine independent predictors of revision supraglottoplasty.

Results

214 patients met the inclusion criteria and were analyzed in the study. 24 patients (11 %) required revision supraglottoplasty. 118 out of the 214 patients (55 %) had an instrumental assessment completed (FEES or VFSS). Of those, 92 (78 %) had abnormal findings on instrumental assessments. Univariate analysis showed Type 2 laryngomalacia (P = 0.017), presence of aspiration (P=<0.001), presence of cyanosis (P = 0.002) and abnormal findings on an instrumental assessment (P = 0.013) to be significantly associated with the need for revision supraglottoplasty. Binary regression analysis showed aspiration (OR = 5.6 {2.087–14.889}, P=<0.001) and cyanosis (OR = 5.3 {1.852–15.181}, P = 0.002) to be the only independent predictors of revision supraglottoplasty.

Conclusion

Presence of aspiration is a strong predictive factor for revision supraglottoplasty in patients with laryngomalacia, when swallowing is evaluated systematically. More prospective research is needed to understand the relationship between swallowing dysfunction, laryngomalacia and surgery.

背景关于吞咽功能障碍与喉水肿之间关系的研究越来越多。声门上成形术是用于治疗喉肌无力的手术干预措施，但部分接受过该手术的患者需要进行翻修手术。我们预测吞咽功能障碍与喉上成形术翻修之间存在显著关联。方法这是一项回顾性队列研究，研究对象为一家三级儿科医疗中心（斯托莱里儿童医院）2013年至2023年间的连续患者。所有患者均经耳鼻喉科医生内镜诊断为喉发育不全，并至少由言语病理学家进行了系统的临床吞咽评估，必要时还进行了仪器评估。有遗传或神经系统合并症、缺乏随访信息或年龄小于 3 岁的患者被排除在外。记录并收集了临床和仪器吞咽数据、人口统计学信息、手术结果和翻修手术。通过单变量分析确定变量与翻修声门上成形术之间的关联。结果214名患者符合纳入标准，并在研究中进行了分析。24名患者（11%）需要进行翻修声门上成形术。214 名患者中有 118 名（55%）完成了仪器评估（FEES 或 VFSS）。其中 92 人（78%）的器械评估结果异常。单变量分析显示，2 型喉瘤（P = 0.017）、吸入（P=0.001）、发绀（P = 0.002）和器械评估结果异常（P = 0.013）与翻修声门上成形术的需求显著相关。二元回归分析显示，吸入（OR = 5.6 {2.087-14.889}, P=<0.001）和发绀（OR = 5.3 {1.852-15.181}, P=0.002）是唯一可预测喉上成形术翻修的独立因素。需要进行更多的前瞻性研究，以了解吞咽功能障碍、喉气肿和手术之间的关系。

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引用次数: 0

Does injection of botulinum toxin to salivary glands require ultrasound guidance? 唾液腺肉毒素注射是否需要超声引导？

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2024-09-17 DOI: 10.1016/j.ijporl.2024.112114

I.H. Marks , J. Ridgley Vaidya , O. Israel , P. Nixon , R. Sharma

Introduction

Injection of botulinum toxin into salivary glands is a well-established treatment for sialorrhea in children, but the absolute need for radiological guidance has not been tested.

Methods

Single-centre study in which clinicians of varying seniority attempted blind injection of salivary glands, after which their position within or outside the gland was confirmed by ultrasound guidance before the injection is administered.

Results

117 patients underwent botulinum toxin of salivary glands between November 2008 and August 2023, with 459 glands injected in total. 24 (5 %) glands were injected by medical students, 32 (7 %) by junior trainees (foundation doctors or senior house officers), 343 (75 %) by registrars or senior fellows and 36 (8 %) by consultants. 160 (68 %) of injections to the parotid gland were on target, and 74 (32 %) submandibular gland were on target (P < 0.01). No differences were detected on likelihood of success depending on seniority of practitioner, age of patient or hand dominance.

Conclusion

Ultrasound guidance ought to be recommended for injection of botulinum toxin into salivary glands regardless of the seniority of the practitioner.

方法在单中心研究中，不同资历的临床医生尝试对唾液腺进行盲注，之后在注射前通过超声引导确认其在腺体内或外的位置。结果2008年11月至2023年8月期间，117名患者接受了唾液腺肉毒素注射，共注射了459个腺体。其中 24 个（5%）腺体由医学生注射，32 个（7%）由初级受训人员（基础医生或高级住院医师）注射，343 个（75%）由注册医师或高级研究员注射，36 个（8%）由顾问注射。腮腺注射中有 160 次（68%）达到目标，颌下腺注射中有 74 次（32%）达到目标（P < 0.01）。结论：在唾液腺注射肉毒杆菌毒素时，无论医生的资历如何，都应推荐使用超声波引导。

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引用次数: 0

Evaluation of safety and effectiveness of the LISTENT LCI-20PI cochlear implant in prelingually deafened children 评估 LISTENT LCI-20PI 人工耳蜗对语前聋儿童的安全性和有效性

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2024-09-15 DOI: 10.1016/j.ijporl.2024.112109

Qiang Du , Zengjun Sun , Weijia Kong , Hao Wu , Yun Li , Chunfu Dai

Objectives

This prospective multicenter clinical trial was to evaluate the safety and effectiveness of a novel cochlear implant (CI) system, the LISTENT LCI-20PI device in prelingually deafened children (<6 years old).

Design

The LCI-20PI CI system was implanted in 70 prelingually deafened children (<6 years old). The median age (interquartile range) at implantation was 3 years old (2–4 years old). The status of the LCI-20PI devices was evaluated through CI device testing and fitting including measurement of electrically evoked compound action potential (ECAP), electrode impedances, subjective thresholds (T levels), and subjective comfort levels (C levels). The safety and effectiveness of the devices were evaluated during 1-year follow-up. The clinical trial registration number is ChiCTR2200067092.

Results

ECAPs were successfully measured in 92.8% (64/70) recipients intraoperatively and in 94.3% (66/70) recipients during device activation. Most of the impedances (99.7%) were within normal limits of 0.7–20 kOhm. The median (interquartile ranges) Meaningful Auditory Integration Scale/Infant-Toddler Meaningful Auditory Integration Scale (MAIS/IT-MAIS) was 95% (85%–97.5%) at 12-month post-activation testing. Median (interquartile range) close-set monosyllabic-word recognition score (MRS) and disyllabic-word recognition score (DRS) in children 3–6 years old at 12-month post-activation testing were 86% (77%–97%) and 90% (70%–100%), respectively.

Conclusions

The new developed LCI-20PI CI device proved safe and effective in prelingually deafened children (<6 years old) in the clinical trial. This CI system could be a cost-effective alternative for prelingually deafened children.

目的这项前瞻性多中心临床试验旨在评估新型人工耳蜗（CI）系统 LISTENT LCI-20PI 装置在语前聋儿童（6 岁）中的安全性和有效性。设计为 70 名语前聋儿童（6 岁）植入了 LCI-20PI CI 系统。植入时的中位年龄（四分位数间距）为 3 岁（2-4 岁）。LCI-20PI 装置的状态通过 CI 装置测试和装配进行评估，包括测量电诱发复合动作电位 (ECAP)、电极阻抗、主观阈值（T 级）和主观舒适度（C 级）。在为期一年的随访中，对设备的安全性和有效性进行了评估。临床试验注册号为 ChiCTR2200067092。结果92.8%（64/70）的受试者在术中成功测量了电动电势，94.3%（66/70）的受试者在设备激活时成功测量了电动电势。大多数阻抗（99.7%）在 0.7-20 千欧的正常范围内。在激活后 12 个月的测试中，有意义听觉整合量表/婴幼儿有意义听觉整合量表（MAIS/IT-MAIS）的中位数（四分位数间距）为 95%（85%-97.5%）。在激活后 12 个月的测试中，3-6 岁儿童近集单音节词识别得分（MRS）和双音节词识别得分（DRS）的中位数（四分位数间距）分别为 86% (77%-97%) 和 90% (70%-100%)。对于舌前失聪儿童来说，这种 CI 系统是一种经济有效的选择。

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引用次数: 0

Pediatric cricopharyngeal achalasia: A systematic review 小儿环咽贲门失弛缓症：系统性综述

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2024-09-14 DOI: 10.1016/j.ijporl.2024.112112

Sepideh Mohajeri , Ghedak Ansari , Daniela M. Isaac , Amanda Rae Adsett , Han Zhang , Andre Isaac

Background

Pediatric dysphagia is a commonly encountered clinical problem, with primary cricopharyngeal achalasia being a rare etiology. Management options for this condition include observation, medical and surgical management. The goal of this review paper was to summarize the current literature on the topic with respect to patient presentation, diagnosis and surgical management options.

Methods

The inclusion criteria were as follows: pediatric patients less than age 18 years, case series featuring equal to or greater than two patients, and any article that described surgical interventions pertaining to primary cricopharyngeal achalasia. Exclusion criteria included patients greater than 18 years of age, those with lower esophageal sphincter pathology (achalasia), non-English articles and case reports consisting of only one patient. A search was run on the PubMed/Medline, OVID, EMBASE, Cochrane, and Web of Science databases on November 1, 2023. The validated bias tool from the Institute of Health Economics was used for bias screening. The results were synthesized using pooled analysis and descriptive statistics.

Results

Ten case series were identified that met inclusion criteria. The most common symptoms at presentation were choking/regurgitation, aspiration and failure to thrive. The most utilized diagnostic test that identified cricopharyngeal achalasia abnormality was the video fluoroscopic swallow study. Management options are dictated by the patient's symptoms and include observation, treating concomitant co-morbidities, balloon dilation, botulinum injection, and endoscopic or open cricopharyngeal myotomies. While botulinum toxin injections are reported to be effective, they often need to be repeated and thus offer a temporizing strategy to allow the natural history of the condition to declare itself. Surgical myotomy represents a more definitive management strategy compared to balloon dilation but has associated risks.

Discussion

There are limited studies available regarding the diagnosis and management of CPA in children. The studies that are available are mainly case series, with low sample sizes and heterogeneous data. This systematic review highlights the importance of keeping this diagnosis within the differential for infants and pediatric patients with dysphagia to minimize delays in diagnosis and provides updated data on the presentation and surgical management of this condition. There was a limitation of evidence in this systematic review, including the small number of articles that were identified, and limited sample size of patients within the articles themselves. Consequently, the analysis was not amenable to a meta-analysis.

背景小儿吞咽困难是一种常见的临床问题，原发性环咽贲门失弛缓症是一种罕见的病因。治疗方法包括观察、药物治疗和手术治疗。方法纳入标准如下：年龄小于 18 岁的儿科患者，病例数大于等于两名患者，以及任何描述原发性环咽贲门失弛缓症手术干预的文章。排除标准包括年龄超过 18 岁的患者、患有下食道括约肌病变（贲门失弛缓症）的患者、非英语文章以及仅有一名患者的病例报告。2023 年 11 月 1 日在 PubMed/Medline、OVID、EMBASE、Cochrane 和 Web of Science 数据库中进行了检索。使用卫生经济研究所的有效偏倚工具进行偏倚筛选。结果确定了 10 个符合纳入标准的病例系列。发病时最常见的症状是呛咳/反胃、吸入和无法茁壮成长。发现环咽贲门失弛缓症异常最常用的诊断检查是视频透视吞咽检查。治疗方案由患者的症状决定，包括观察、治疗并发症、球囊扩张、肉毒杆菌注射、内窥镜或开放式环咽肌切开术。据报道，肉毒杆菌毒素注射虽然有效，但往往需要重复注射，因此只能暂时缓解症状，让病情自然发展。与球囊扩张术相比，手术肌切开术是一种更明确的治疗策略，但也存在相关风险。现有的研究主要是病例系列，样本量少，数据不统一。这篇系统性综述强调了将这一诊断纳入婴儿和吞咽困难儿科患者鉴别诊断的重要性，以尽量减少诊断延误，并提供了有关这一病症的表现和手术治疗的最新数据。本系统性综述的证据存在局限性，包括发现的文章数量较少，文章本身的患者样本量有限。因此，无法进行荟萃分析。

{"title":"Pediatric cricopharyngeal achalasia: A systematic review","authors":"Sepideh Mohajeri , Ghedak Ansari , Daniela M. Isaac , Amanda Rae Adsett , Han Zhang , Andre Isaac","doi":"10.1016/j.ijporl.2024.112112","DOIUrl":"10.1016/j.ijporl.2024.112112","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric dysphagia is a commonly encountered clinical problem, with primary cricopharyngeal achalasia being a rare etiology. Management options for this condition include observation, medical and surgical management. The goal of this review paper was to summarize the current literature on the topic with respect to patient presentation, diagnosis and surgical management options.</div></div><div><h3>Methods</h3><div>The inclusion criteria were as follows: pediatric patients less than age 18 years, case series featuring equal to or greater than two patients, and any article that described surgical interventions pertaining to primary cricopharyngeal achalasia. Exclusion criteria included patients greater than 18 years of age, those with lower esophageal sphincter pathology (achalasia), non-English articles and case reports consisting of only one patient. A search was run on the PubMed/Medline, OVID, EMBASE, Cochrane, and Web of Science databases on November 1, 2023. The validated bias tool from the Institute of Health Economics was used for bias screening. The results were synthesized using pooled analysis and descriptive statistics.</div></div><div><h3>Results</h3><div>Ten case series were identified that met inclusion criteria. The most common symptoms at presentation were choking/regurgitation, aspiration and failure to thrive. The most utilized diagnostic test that identified cricopharyngeal achalasia abnormality was the video fluoroscopic swallow study. Management options are dictated by the patient's symptoms and include observation, treating concomitant co-morbidities, balloon dilation, botulinum injection, and endoscopic or open cricopharyngeal myotomies. While botulinum toxin injections are reported to be effective, they often need to be repeated and thus offer a temporizing strategy to allow the natural history of the condition to declare itself. Surgical myotomy represents a more definitive management strategy compared to balloon dilation but has associated risks.</div></div><div><h3>Discussion</h3><div>There are limited studies available regarding the diagnosis and management of CPA in children. The studies that are available are mainly case series, with low sample sizes and heterogeneous data. This systematic review highlights the importance of keeping this diagnosis within the differential for infants and pediatric patients with dysphagia to minimize delays in diagnosis and provides updated data on the presentation and surgical management of this condition. There was a limitation of evidence in this systematic review, including the small number of articles that were identified, and limited sample size of patients within the articles themselves. Consequently, the analysis was not amenable to a meta-analysis.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112112"},"PeriodicalIF":1.2,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357579","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}

引用次数: 0

Prevalence of concha bullosa in a pediatric population 儿科牛皮癣的发病率

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2024-09-13 DOI: 10.1016/j.ijporl.2024.112108

Jessie G. Jiang , Sarah A. Gitomer , Suhong Tong , Brian W. Herrmann , Ilana Neuberger , David M. Mirsky

Objective

Existing literature on the prevalence of middle turbinate pneumatization, or concha bullosa (CB), in the pediatric population is limited. CB is an anatomic variant important to identify prior to sinonasal surgery and is often associated with congenital nasal septal deviation (SD). This paper aims to describe the prevalence of CB in the pediatric population on head imaging.

Methods

A retrospective chart review was performed for 695 children undergoing CT head for trauma from 2021 to 2022. Nearly equal numbers of males and females were evaluated, with at least 19–20 per year from 0.5 to 18 years. Patients with significant facial fractures, sinusitis, craniofacial syndromes, prior sinus surgery, and sinonasal masses were excluded. Two pediatric neuroradiologists evaluated the CTs. CB was defined as aeration >50 % of the vertical height of the middle turbinate.

Results

In this study, 384 patients were included. The prevalence of CB was 153 (39.8 %), which was significantly higher in children >4 years (p < 0.0001). Lamellar type CB was the most common, present in 160 out of 768 middle turbinates assessed (20.8 %). SD occurred in 60 (39.2 %) patients with CB and was more commonly contralateral to the CB.

Conclusions

The prevalence of CB in the pediatric population is at the lower range of what is reported in the adult literature. The most common type of CB in patients is lamellar. Similar to previous studies, there is an association between CB and contralateral SD. Finally, there is a positive correlation between the severity of CB and the severity of SD.

目的有关中鼻甲气化或牛皮癣（CB）在儿科人群中发病率的现有文献很有限。中鼻甲积气是鼻窦手术前需要鉴别的一种解剖变异，通常与先天性鼻中隔偏曲（SD）有关。本文旨在描述 CB 在儿童头部成像中的患病率。方法对 2021 年至 2022 年期间因外伤接受头部 CT 检查的 695 名儿童进行了回顾性病历审查。接受评估的男性和女性人数几乎相等，从0.5岁到18岁，每年至少有19-20名儿童接受评估。有明显面部骨折、鼻窦炎、颅面综合征、曾接受鼻窦手术和鼻窦肿块的患者被排除在外。两名儿科神经放射专家对 CT 进行了评估。CB定义为中鼻甲垂直高度的50%。CB的发病率为153例（39.8%），4岁儿童的发病率明显更高（p <0.0001）。瓣膜型 CB 最常见，在评估的 768 个中鼻甲中有 160 个（20.8%）。60名（39.2%）CB 患者出现 SD，且多发生在 CB 的对侧。患者中最常见的 CB 类型是片状。与之前的研究相似，CB 与对侧 SD 存在关联。最后，CB 的严重程度与 SD 的严重程度呈正相关。

{"title":"Prevalence of concha bullosa in a pediatric population","authors":"Jessie G. Jiang , Sarah A. Gitomer , Suhong Tong , Brian W. Herrmann , Ilana Neuberger , David M. Mirsky","doi":"10.1016/j.ijporl.2024.112108","DOIUrl":"10.1016/j.ijporl.2024.112108","url":null,"abstract":"<div><h3>Objective</h3><p>Existing literature on the prevalence of middle turbinate pneumatization, or concha bullosa (CB), in the pediatric population is limited. CB is an anatomic variant important to identify prior to sinonasal surgery and is often associated with congenital nasal septal deviation (SD). This paper aims to describe the prevalence of CB in the pediatric population on head imaging.</p></div><div><h3>Methods</h3><p>A retrospective chart review was performed for 695 children undergoing CT head for trauma from 2021 to 2022. Nearly equal numbers of males and females were evaluated, with at least 19–20 per year from 0.5 to 18 years. Patients with significant facial fractures, sinusitis, craniofacial syndromes, prior sinus surgery, and sinonasal masses were excluded. Two pediatric neuroradiologists evaluated the CTs. CB was defined as aeration >50 % of the vertical height of the middle turbinate.</p></div><div><h3>Results</h3><p>In this study, 384 patients were included. The prevalence of CB was 153 (39.8 %), which was significantly higher in children >4 years (p < 0.0001). Lamellar type CB was the most common, present in 160 out of 768 middle turbinates assessed (20.8 %). SD occurred in 60 (39.2 %) patients with CB and was more commonly contralateral to the CB.</p></div><div><h3>Conclusions</h3><p>The prevalence of CB in the pediatric population is at the lower range of what is reported in the adult literature. The most common type of CB in patients is lamellar. Similar to previous studies, there is an association between CB and contralateral SD. Finally, there is a positive correlation between the severity of CB and the severity of SD.</p></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112108"},"PeriodicalIF":1.2,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142233834","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}

引用次数: 0

Study on the complications after implantation of different types of metal stents in rabbit trachea 关于在兔气管中植入不同类型金属支架后并发症的研究

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2024-09-13 DOI: 10.1016/j.ijporl.2024.112111

Zhenyu Yang , Ziyi Liu , Jie Zhang , Xiaoxiao Li , Daxiong Zeng , Chuanyong Mu , Junhong Jiang

Objective

To observe the complications and inflammatory responses caused by the different types of metal stents in the trachea of rabbits.

Method

79 rabbits were randomly divided into 4 groups and were implanted with the customized nickel-titanium alloy metal stents(fully covered metal stent: group A, bare metal stent: group B, segmented covered metal stent: group C and control group: group D). The complications (tracheal deformation, granulation tissue hyperplasia, scar hyperplasia and secretion retention) of different types of metal stents were compared by observing the anatomical and pathological specimens of dead rabbits; And the expression of inflammatory factors of different types of metal stents were compared by detecting the tissue of tracheas of dead rabbits.

Results

(1)There were significant differences in the above four complications among groups A, B and C(p < 0.01). The incidences of tracheal deformation, scar hyperplasia and secretion retention in group A were significantly higher than that in group B(p < 0.0167), however, the incidence of granulation tissue hyperplasia in group A was significantly lower than that in group B(p < 0.0167). The incidence of scar hyperplasia in group A was significantly lower than that in group C(p < 0.0167) and there were no significant differences in other complications between these two groups(p > 0.0167). The incidences of tracheal deformation, scar hyperplasia and secretion retention in group B were significantly lower than that in group C(p < 0.0167), however, the incidence of granulation tissue hyperplasia in group B was significantly higher than that in group C(p < 0.0167). (2)The concentration of IL-1β in group A was higher than that in group B (p < 0.05 and foldchange>1.2).

Conclusion

(1)There are significant differences in complications between the fully covered metal stent, bare metal stent and segmented covered metal stent; the incidences of complications between the segmented covered metal stent and fully covered metal stent are similar. (2)Changes in different inflammatory factors can be observed between the fully covered and bare metal stent.

方法将79只家兔随机分为4组，分别植入定制的镍钛合金金属支架（全覆盖金属支架A组、裸金属支架B组、分段覆盖金属支架C组和对照组D组）。通过观察死亡家兔的解剖和病理标本，比较不同类型金属支架的并发症（气管变形、肉芽组织增生、瘢痕增生和分泌物潴留）；通过检测死亡家兔的气管组织，比较不同类型金属支架的炎症因子表达。A组气管变形、瘢痕增生和分泌物滞留的发生率明显高于B组（P＜0.0167），但A组肉芽组织增生的发生率明显低于B组（P＜0.0167）。A 组瘢痕增生的发生率明显低于 C 组（p < 0.0167），两组在其他并发症方面无明显差异（p > 0.0167）。B组气管变形、瘢痕增生和分泌物潴留的发生率明显低于C组（p < 0.0167），但B组肉芽组织增生的发生率明显高于C组（p < 0.0167）。(结论 (1)全覆盖金属支架、裸金属支架和分段覆盖金属支架的并发症有显著差异；分段覆盖金属支架和全覆盖金属支架的并发症发生率相似。(2)全覆盖金属支架和裸金属支架之间可以观察到不同炎症因子的变化。

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引用次数: 0