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

Characterization of hearing loss in pediatric patients with osteogenesis imperfecta 小儿成骨不全症患者听力损失的特征

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2024-07-06 DOI: 10.1016/j.ijporl.2024.112027

Chelsea Cleveland, Jamil Hayden, Tekin Baglam, Todd Otteson

Introduction

Osteogenesis imperfecta (OI) is a common heritable disorder affecting type 1 collagen. The sequelae of OI vary, but hearing loss is a significant complication with 46–58 % of patients having some degree of hearing loss. Previous studies have suggested patients with OI may have conductive, sensorineural, or mixed hearing loss. Majority of these studies focus on the adult population.

Objectives

Identify a relationship between OI and hearing loss in the pediatric population.

Methods

The TriNetx Analytics Network, a federated health research network that aggregates the de-identified electronic health record data of over 78 million patients across the United States, was queried for patients 18 years old or younger with a diagnosis of OI. Patients in this group with diagnosis of sensorineural, conductive, or mixed hearing loss were recorded. Patients with diagnoses of congenital cytomegalovirus, congenital inner ear malformations, and noise-induced hearing loss were excluded from analysis.

Results

Out of 3256 patients 18 years old or younger with OI, 10.07 % (95 % CI: 9.06–11.16) had a history of any form of hearing loss, 5.71 % (95 % CI: 4.94–6.57) had conductive hearing loss, 3.01 % (95 % CI: 2.45–3.66) had sensorineural hearing loss, and 1.35 % (95 % CI: 0.98–1.81) had mixed hearing loss. Relative risks for diagnosis of any type of hearing loss, conductive hearing loss, sensorineural hearing loss, and mixed hearing loss were calculated: 5.90 (95 % CI 5.32–6.53), 5.08 (95 % CI 4.42–5.84), 6.18 (95 % CI 5.09–7.51), and 13.86 (95 % CI 10.33–18.59) respectively.

Discussion

This study is the largest to date that describes a relationship between OI and conductive, sensorineural, and mixed hearing loss. Pediatric patients with OI are almost five times as likely to have any type of hearing loss. There was a significant increased risk in each subgroup, but conductive hearing loss was the most common for hearing loss in children with OI. The highest risk subtype when compared to controls was mixed hearing loss.

导言成骨不全症（OI）是一种影响 1 型胶原蛋白的常见遗传性疾病。成骨不全症的后遗症多种多样，但听力损失是一种重要的并发症，46%-58%的患者会出现不同程度的听力损失。以往的研究表明，OI 患者可能患有传导性、感音神经性或混合性听力损失。这些研究主要集中在成人人群中。方法在 TriNetx Analytics Network（一个联合健康研究网络，汇集了全美 7800 多万名患者的去标识化电子健康记录数据）中查询了 18 岁或以下诊断为 OI 的患者。这组患者中被诊断为感音神经性听力损失、传导性听力损失或混合性听力损失的患者被记录在案。结果在 3256 名 18 岁及以下的 OI 患者中，10.07%（95% CI：9.06-11.16）有 OI 病史。在 3256 名 18 岁及以下的 OI 患者中，10.07%（95% CI：9.06-11.16）有任何形式的听力损失病史，5.71%（95% CI：4.94-6.57）有传导性听力损失，3.01%（95% CI：2.45-3.66）有感音神经性听力损失，1.35%（95% CI：0.98-1.81）有混合性听力损失。计算了诊断出任何类型听力损失、传导性听力损失、感音神经性听力损失和混合性听力损失的相对风险：本研究是迄今为止描述 OI 与传导性听力损失、感音神经性听力损失和混合性听力损失之间关系的最大规模研究。患有 OI 的小儿患者出现任何类型听力损失的几率几乎是 OI 患者的五倍。每个亚组的风险都明显增加，但传导性听力损失是患有开放性损伤的儿童中最常见的听力损失。与对照组相比，风险最高的亚型是混合性听力损失。

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引用次数: 0

Clinical protocol using calcium and calcitriol after paediatric total thyroidectomy decreases postoperative hypocalcaemia and inpatient blood tests 小儿甲状腺全切除术后使用钙和钙三醇的临床方案可降低术后低钙血症和住院血液化验率

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2024-07-01 DOI: 10.1016/j.ijporl.2024.112021

Kung-Ting Kao , Margaret Zacharin , Stephen Farrell , Peter Simm

Introduction

Postoperative hypocalcaemia is common after thyroidectomy. This study aimed to evaluate whether a standardised post-thyroidectomy protocol using prophylactic calcium and calcitriol reduces hypocalcaemia incidence after total thyroidectomy in children and adolescents.

Methods

A cohort children and adolescents ≤18 years of age undergoing total thyroidectomy between January 2016 and October 2022 in one institution were retrospectively identified and divided into pre-protocol and post-protocol groups. The primary outcome measure was hypocalcaemia (total serum calcium of <2.0 mmol/L; ionised serum calcium of 0.9 mmol/L). Secondary outcome measures were the occurrence of hypercalcaemia (serum Calcium >2.7 mmol/L; ionised calcium >1.31 mmol/L), length of hospitalisation and number of postoperative blood tests.

Results

There were 22 patients in each group (mean age 11.8; SD 4.3 years, female 36 %). The rate of hypocalcaemia was significantly higher in the pre-protocol group than the post-protocol group (54 % vs 13.6 %, p = 0.010). Patients in the pre-protocol group had more inpatient blood tests (mean 5.4; SD 3.2) than the post-protocol group (mean 3.3; SD 1.8, p = 0.011), although the total postoperative blood test count was similar between the groups. Six (13.6 %) patients developed hypercalcaemia. The rate of hypercalcaemia was similar between groups (pre-protocol 2, 9.1 %; post-protocol 4, 18.1 %; p = 0.664). Length of hospitalisation was similar between groups.

Conclusion

Our standardized protocol decreased hypocalcemia and inpatient blood tests after total thyroidectomy in children. Future research should explore if incorporating preoperative calcium and calcitriol treatment, along with intraoperative PTH levels for risk management, can further reduce hypocalcemia rates in paediatric patients.

导言：甲状腺切除术后低钙血症很常见。本研究旨在评估使用预防性钙剂和降钙素三醇的标准化甲状腺切除术后方案是否能降低儿童和青少年甲状腺全切除术后低钙血症的发生率。方法回顾性地确定了2016年1月至2022年10月期间在一家机构接受甲状腺全切除术的18岁以下儿童和青少年队列，并将其分为方案前组和方案后组。主要结局指标为低钙血症（血清总钙为<2.0 mmol/L；离子化血清钙为0.9 mmol/L）。次要结果指标为高钙血症的发生率（血清钙<2.7 mmol/L；离子化钙<1.31 mmol/L）、住院时间和术后验血次数。方案前组的低钙血症发生率明显高于方案后组（54% vs 13.6%，P = 0.010）。协议前组患者的住院血液检测次数（平均 5.4 次；标准差 3.2 次）多于协议后组（平均 3.3 次；标准差 1.8 次，p = 0.011），但两组患者的术后血液检测总次数相似。六名患者（13.6%）出现了高钙血症。两组的高钙血症发生率相似（协议前 2 例，9.1%；协议后 4 例，18.1%；p = 0.664）。结论我们的标准化方案减少了儿童甲状腺全切除术后的低钙血症和住院血液检查。未来的研究应探讨术前钙剂和降钙素三醇治疗以及术中PTH水平风险管理是否能进一步降低儿科患者的低钙血症发生率。

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引用次数: 0

Risk of otitis media in offspring following maternal prenatal stress exposure 母体产前受到压力后，后代患中耳炎的风险。

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2024-07-01 DOI: 10.1016/j.ijporl.2024.112022

Monique Robinson , David Burgner , Ashleigh Lin , Peter Jacoby , Robert Eikelboom , Shyan Vijayasekaran , Christopher G. Brennan-Jones

Objectives

There is limited but consistent evidence that suggests prenatal factors, including maternal stress, may contribute to susceptibility for otitis media. We aimed to determine the effect of multiple life stress events during pregnancy on risk of acute and recurrent otitis media in offspring at three and five years of age.

Methods

Exposure data on stressful life events were collected from pregnant women in a longitudinal prospective pregnancy cohort study, at 18 and 34 weeks’ gestation. We used longitudinal regression models stratified by offspring sex to examine associations between the number, type and timing of maternal prenatal stress events and the likelihood of any OM in addition to recurrent OM infection at age three and five years, adjusting for pre-specified prenatal sociodemographic and environmental confounders.

Results

Each additional stressful life event in pregnancy was associated with increased risk of any OM at both ages (3 years: OR = 1.07, 95%CI = 1.02, 1.12; 5 years: OR = 1.07, 95%CI = 1.02, 1.12), with larger effect sizes for recurrent otitis media (3 years: OR = 1.11, 95%CI = 1.05, 1.17; 5 years: OR = 1.09, 95%CI = 1.04, 1.14). Risk of offspring otitis media did not differ with timing of stress nor by offspring sex. Specific types of stress (pregnancy and relationship problems, issues with other children) were each associated with increased risk of recurrent OM at age three and five years.

Conclusions

We observed a dose-response relationship between maternal stressful life events in pregnancy and the risk for offspring otitis media in the preschool years, most marked for recurrent otitis media.

目的：有限但一致的证据表明，包括母亲压力在内的产前因素可能会导致中耳炎的易感性。我们旨在确定孕期多种生活压力事件对3岁和5岁后代患急性和复发性中耳炎风险的影响：在一项纵向前瞻性妊娠队列研究中，我们收集了孕妇在妊娠 18 周和 34 周时的生活压力事件暴露数据。我们使用按后代性别分层的纵向回归模型来研究母体产前压力事件的数量、类型和时间与三岁和五岁时除复发性 OM 感染之外的任何 OM 感染可能性之间的关系，并对产前社会人口和环境混杂因素进行了调整：结果发现：妊娠期每增加一次生活压力事件，都会增加两岁时罹患任何OM的风险（3岁时，OR = 1.07，95%≥0.05）：3岁：OR = 1.07，95%CI = 1.02，1.12；5岁：OR = 1.07，95%CI = 1.02，1.12：3岁：OR = 1.07，95%CI = 1.02，1.12；5岁：OR = 1.07，95%CI = 1.02，1.12），复发性中耳炎的影响更大（3岁：OR = 1.11，95%CI = 1.02，1.12）：OR=1.11，95%CI=1.05，1.17；5 年：OR=1.09，95%CI=1.04，1.14）。后代患中耳炎的风险与压力发生的时间和后代的性别无关。特定类型的压力（怀孕和人际关系问题、与其他孩子的问题）分别与三岁和五岁时中耳炎复发风险的增加有关：我们观察到，母亲怀孕期间的生活压力事件与后代学龄前期患中耳炎的风险之间存在剂量反应关系，其中以复发性中耳炎最为明显。

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引用次数: 0

A retrospective analysis of factors affecting speech production in school-aged children with cleft palate (+- cleft lip) 对影响腭裂（+-唇裂）学龄儿童语言能力的因素进行回顾性分析。

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2024-07-01 DOI: 10.1016/j.ijporl.2024.112029

Hedieh Hashemi Hosseinabad , Yixun Xing , Monica Kemp

Objective

The present investigation examined how factors such as cleft type, age of primary palatal surgery, diagnosed syndromes, hearing problems, and malocclusions could predict persistent speech difficulties and the need for speech services in school-aged children with cleft palate.

Methods

Participants included 100 school-aged children with cleft palate. Americleft speech protocol was used to assess the perceptual aspects of speech production. The logistic regression was performed to evaluate the impact of independent variables (IV) on the dependent variables (DV): intelligibility, posterior oral CSCs, audible nasal emission, hypernasality, anterior oral CSCs, and speech therapy required.

Results

Sixty-five percent of the children were enrolled in (or had received) speech therapy. The logistic regression model shows a good fit to the data for the need for speech therapy (Hosmer and Lemeshow's $χ^{2} (8) = 9.647, p = . 291$ ). No IVs were found to have a significant impact on the need for speech therapy. A diagnosed syndrome was associated with poorer intelligibility (Pulkstenis-Robinson's $χ^{2} (11) = 7.120, p = . 789$ ). Children with diagnosed syndromes have about six times the odds of a higher hypernasality rating (Odds Ratio = 5.703) than others. The cleft type was significantly associated with audible nasal emission ( $Fisher ’ s exact p = . 006$ ). At the same time, malocclusion had a significant association with anterior oral CSCs ( $Fisher ’ s exact p = . 005$ ).

Conclusions

According to the latest data in the Cleft Registry and Audit Network Annual Report for the UK, the majority of children with cleft palate attain typical speech by age five. However, it is crucial to delve into the factors that may influence the continuation of speech disorders beyond this age. This understanding is vital for formulating intervention strategies aimed at mitigating the long-term effects of speech disorders as individuals grow older.

调查目的本研究探讨了腭裂类型、初次腭裂手术年龄、诊断出的综合症、听力问题和咬合不正等因素如何预测学龄腭裂儿童的持续性语言障碍和对语言服务的需求：参与者包括 100 名学龄腭裂儿童。方法：受试者包括 100 名学龄腭裂儿童，采用 Americleft 言语协议评估言语生成的感知方面。采用逻辑回归法评估自变量（IV）对因变量（DV）的影响，因变量包括：清晰度、口腔后部CSCs、可闻鼻音、鼻音过重、口腔前部CSCs和所需言语治疗：结果：65%的儿童参加了（或接受了）言语治疗。逻辑回归模型显示，语言治疗需求与数据拟合良好（Hosmer 和 Lemeshow's χ2(8)=9.647,p=.291 ）。没有发现任何 IV 对言语治疗需求有显著影响。已确诊的综合症与较差的智能相关（Pulkstenis-Robinson's χ2(11)=7.120,p=.789 ）。患有已确诊综合症的儿童的低鼻音评分是其他儿童的六倍（Odds Ratio = 5.703）。裂隙类型与可闻鼻音有明显相关性（Fisher's sexactp=.006）。同时，错颌畸形与口腔前部 CSCs 有显著相关性（Fisher'sexactp=.005）：根据英国腭裂登记和审计网络年度报告的最新数据，大多数腭裂儿童在五岁前都能获得典型的语言能力。然而，深入研究可能影响儿童在五岁后继续出现言语障碍的因素至关重要。了解这些因素对于制定干预策略至关重要，这些策略旨在减轻言语障碍在儿童长大后造成的长期影响。

{"title":"A retrospective analysis of factors affecting speech production in school-aged children with cleft palate (+- cleft lip)","authors":"Hedieh Hashemi Hosseinabad , Yixun Xing , Monica Kemp","doi":"10.1016/j.ijporl.2024.112029","DOIUrl":"10.1016/j.ijporl.2024.112029","url":null,"abstract":"<div><h3>Objective</h3><p>The present investigation examined how factors such as cleft type, age of primary palatal surgery, diagnosed syndromes, hearing problems, and malocclusions could predict persistent speech difficulties and the need for speech services in school-aged children with cleft palate.</p></div><div><h3>Methods</h3><p>Participants included 100 school-aged children with cleft palate. Americleft speech protocol was used to assess the perceptual aspects of speech production. The logistic regression was performed to evaluate the impact of independent variables (IV) on the dependent variables (DV): intelligibility, posterior oral CSCs, audible nasal emission, hypernasality, anterior oral CSCs, and speech therapy required.</p></div><div><h3>Results</h3><p>Sixty-five percent of the children were enrolled in (or had received) speech therapy. The logistic regression model shows a good fit to the data for the need for speech therapy (Hosmer and Lemeshow's <span><math><mrow><msup><mi>χ</mi><mn>2</mn></msup><mrow><mo>(</mo><mn>8</mn><mo>)</mo></mrow><mo>=</mo><mn>9.647</mn><mo>,</mo><mi>p</mi><mo>=</mo><mo>.</mo><mn>291</mn></mrow></math></span>). No IVs were found to have a significant impact on the need for speech therapy. A diagnosed syndrome was associated with poorer intelligibility (Pulkstenis-Robinson's <span><math><mrow><msup><mi>χ</mi><mn>2</mn></msup><mrow><mo>(</mo><mn>11</mn><mo>)</mo></mrow><mo>=</mo><mn>7.120</mn><mo>,</mo><mi>p</mi><mo>=</mo><mo>.</mo><mn>789</mn></mrow></math></span>). Children with diagnosed syndromes have about six times the odds of a higher hypernasality rating (Odds Ratio = 5.703) than others. The cleft type was significantly associated with audible nasal emission (<span><math><mrow><mtext>Fisher</mtext><mo>’</mo><mi>s</mi><mspace></mspace><mtext>exact</mtext><mspace></mspace><mi>p</mi><mo>=</mo><mo>.</mo><mn>006</mn></mrow></math></span>). At the same time, malocclusion had a significant association with anterior oral CSCs (<span><math><mrow><mtext>Fisher</mtext><mo>’</mo><mi>s</mi><mspace></mspace><mtext>exact</mtext><mspace></mspace><mi>p</mi><mo>=</mo><mo>.</mo><mn>005</mn></mrow></math></span>).</p></div><div><h3>Conclusions</h3><p>According to the latest data in the Cleft Registry and Audit Network Annual Report for the UK, the majority of children with cleft palate attain typical speech by age five. However, it is crucial to delve into the factors that may influence the continuation of speech disorders beyond this age. This understanding is vital for formulating intervention strategies aimed at mitigating the long-term effects of speech disorders as individuals grow older.</p></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141554756","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

Lexical tone recognition in multi-talker babbles and steady-state noise by Mandarin-speaking children with unilateral cochlear implants or bimodal hearing 单侧人工耳蜗或双模态听力的普通话儿童在多语者咿呀声和稳态噪声中的词汇音调识别。

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2024-07-01 DOI: 10.1016/j.ijporl.2024.112020

Chao Meng , Qianqian Guo , Jing Lyu , Abigail Jaquish , Xueqing Chen , Li Xu

Background and objectives

Lexical tone presents challenges to cochlear implant (CI) users especially in noise conditions. Bimodal hearing utilizes residual acoustic hearing in the contralateral side and may offer benefits for tone recognition in noise. The purpose of the present study was to evaluate tone recognition in both steady-state noise and multi-talker babbles by the prelingually-deafened, Mandarin-speaking children with unilateral CIs or bimodal hearing.

Methods

Fifty-three prelingually-deafened, Mandarin-speaking children who received CIs participated in this study. Twenty-two of them were unilateral CI users and 31 wore a hearing aid (HA) in the contralateral ear (i.e., bimodal hearing). All subjects were tested for Mandarin tone recognition in quiet and in two types of maskers: speech-spectrum-shaped noise (SSN) and two-talker babbles (TTB) at four signal-to-noise ratios (−6, 0, +6, and +12 dB).

Results

While no differences existed in tone recognition in quiet between the two groups, the Bimodal group outperformed the Unilateral CI group under noise conditions. The differences between the two groups were significant at SNRs of 0, +6, and +12 dB in the SSN conditions (all p < 0.05), and at SNRs of +6 and +12 dB of TTB conditions (both p < 0.01), but not significant at other conditions (p > 0.05). The TTB exerted a greater masking effect than the SSN for tone recognition in the Unilateral CI group as well as in the Bimodal group at all SNRs tested (all p < 0.05). Among demographic or audiometric variables, only age at implantation showed a weak but significant correlation with the mean tone recognition performance under the SSN conditions (r = −0.276, p = 0.045). However, when Bonferroni correction was applied to the correlation analysis results, the weak correlation became not significant.

Conclusion

Prelingually-deafened children with CIs face challenges in tone perception in noisy environments, especially when the noise is fluctuating in amplitude such as the multi-talker babbles. Wearing a HA on the contralateral side when residual hearing permits is beneficial for tone recognition in noise.

背景和目的：词汇音对人工耳蜗（CI）使用者来说是一项挑战，尤其是在噪音条件下。双模态听力利用对侧的残余听力，可为噪声中的音调识别带来益处。本研究旨在评估使用单侧人工耳蜗或双模听力的语前聋普通话儿童在稳态噪声和多语者咿呀声中的音调识别能力：53名接受了CI的舌聋儿童参加了这项研究。其中 22 名是单侧 CI 使用者，31 名在对侧耳佩戴助听器（即双模听力）。所有受试者都在安静环境和两种掩蔽物（语谱噪声（SSN）和双语咿呀声（TTB））中接受了普通话音调识别测试，信噪比分别为 -6、0、+6 和 +12dB：虽然两组在安静环境下的音调识别能力没有差异，但在噪音条件下，双模态组的表现优于单侧 CI 组。在 SSN 条件下，信噪比为 0、+6 和 +12 dB 时，两组之间的差异显著（均为 p 0.05）。在所有测试的信噪比条件下，TTB 对单侧 CI 组和双模组的音调识别产生的掩蔽效应均大于 SSN（所有 p 均为 0.05）：带 CI 的舌前失聪儿童在嘈杂环境中的音调感知能力面临挑战，尤其是当噪音振幅波动较大时，如多语种咿呀学语。在残余听力允许的情况下，在对侧佩戴助听器有利于在噪声中识别音调。

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引用次数: 0

Epidemiological assessment of non-tuberculous mycobacterial cervicofacial lymphadenitis: A PHIS database study 非结核分枝杆菌颈面部淋巴结炎的流行病学评估：PHIS 数据库研究。

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2024-07-01 DOI: 10.1016/j.ijporl.2024.112019

David Hoying , Sindhoosha Malay , Matthew Gropler , Todd Otteson

Objective

Cervicofacial lymphadenitis caused by non-tubercular mycobacterial (NTM) infections has the highest infection rate in children. Our objective was to assess patient demographics, treatment methods, and the impact of weather and geography on the incidence of disease in patients with NTM cervicofacial lymphadenitis.

Methods

The Pediatric Health Information System (PHIS) database was queried for data on all patients diagnosed with concurrent cervicofacial lymphadenopathy and NTM infection from 2004 to 2022. We assessed the association between weather patterns and NTM cervicofacial lymphadenitis by collecting monthly weather data from the NOAA National Center for Environmental Information. Incidence rates were calculated by dividing the number of cases by the total hospital discharges during the study period.

Results

Among 47 PHIS hospitals, there were 992 diagnoses of NTM cervicofacial lymphadenitis. The average age at diagnosis was 2 [IQR, 2–4], with 59 % female. Drainage of skin abscesses or lesions was performed for 93 (9.4 %) patients, while 15 (1.5 %) had an excisional procedure of the CPT codes assessed. The most common antibiotics utilized were cephalosporins (28 %), macrolides (27 %), and rifampin (12 %). The most common treatment method was surgery with antibiotics (37 %) followed by no treatment at all (35 %), surgery alone (17 %), and antibiotics alone (10 %). Of the 28 states included in the analysis, Washington (IR: 3.5) and Nebraska (IR: 3.3) had the highest incidence rates (IR) of NTM cervical lymphadenitis. The cases were relatively equally distributed across the different weather seasons within each U.S. geographic region. However, the overall average wind speed was weakly associated with increasing the risk of diagnosis when utilizing a mixed effect zero-inflated negative binomial model (Incidence Ratio: 1.07, 95 % CI: (1.01–1.14), p = 0.035).

Conclusions

Our results indicate that the most common treatment method utilized in patients within our cohort with NTM cervicofacial lymphadenitis was the concurrent use of surgery and antibiotics. Our results also indicate there may be variation in the incidence rate among different states, but additional studies are needed as our cohort only included approximately 50 % of states within the U.S.

目的：由非结核分枝杆菌（NTM）感染引起的颈面部淋巴结炎在儿童中感染率最高。我们的目的是评估 NTM 颈面部淋巴结炎患者的人口统计学特征、治疗方法以及天气和地理位置对发病率的影响：我们从儿科健康信息系统（PHIS）数据库中查询了 2004 年至 2022 年期间所有确诊同时患有颈面部淋巴结病和 NTM 感染的患者数据。我们从诺阿国家环境信息中心（NOAA National Center for Environmental Information）收集了每月的天气数据，评估了天气模式与 NTM 颈面部淋巴结炎之间的关联。研究期间的病例数除以医院出院总人数，计算出发病率：结果：在 47 家 PHIS 医院中，共有 992 例 NTM 颈面部淋巴结炎诊断病例。确诊时的平均年龄为 2 岁 [IQR，2-4 岁]，59% 为女性。93名患者（9.4%）进行了皮肤脓肿或病变引流，15名患者（1.5%）进行了 CPT 编码评估的切除术。最常用的抗生素是头孢菌素类（28%）、大环内酯类（27%）和利福平（12%）。最常见的治疗方法是手术加抗生素（37%），其次是完全不治疗（35%）、单纯手术（17%）和单纯抗生素（10%）。在纳入分析的 28 个州中，华盛顿州（IR：3.5）和内布拉斯加州（IR：3.3）的非淋巴结核颈淋巴结炎发病率（IR）最高。病例在美国各地理区域内不同气候季节的分布相对平均。然而，在使用混合效应零膨胀负二项模型时，总体平均风速与确诊风险的增加关系不大（发病率比：1.07，95 % CI：(1.01-1.14)，p = 0.035）：我们的研究结果表明，在我们的队列中，NTM 颈面部淋巴结炎患者最常用的治疗方法是同时使用手术和抗生素。我们的研究结果还表明，不同州的发病率可能存在差异，但由于我们的队列只包括美国约 50% 的州，因此还需要进行更多的研究。

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引用次数: 0

Consensus on intake questionnaire data elements in the development of an aerodigestive registry 在建立消化系统登记册过程中就摄入量问卷数据要素达成共识

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2024-07-01 DOI: 10.1016/j.ijporl.2024.112016

Ryan Ruiz , Christopher Wootten , Karthik Balakrishnan , Richard Paul Boesch , Jeremy Prager , Rachel Rosen , Douglas Sidell , Alessandro de Alarcon , Eric H. Chiou , Michael J. Rutter , Joseph Piccione , Aerodigestive Research Collaborative

Objective

To define the essential elements of the intake questionnaire that will be a part of a larger multicenter registry for aerodigestive patients.

Methods

A modified Delphi method was utilized to obtain consensus on the data elements that should warrant inclusion in the final research database. Patient questionnaires from the eight participating institutions were reviewed and individual elements were aggregated into 14 categories.

Results

A total of 198 initial elements were voted on for inclusion. The categories included demographics, respiratory symptoms, gastrointestinal symptoms, ear nose and throat symptoms, feeding, birth history, medical history, surgical history, family history, social history, medications prior to evaluation, devices used prior to evaluation, prior diagnostic evaluations, and prior evaluation by aerodigestive team members. 83 of the 198 elements met consensus for inclusion in the final registry for an inclusion rate of 41.9 %. Three separate rounds of ranking were required to obtain consensus.

Conclusion

The aerodigestive registry is an important initiative that will help foster research and help guide future management. The intake questionnaire of the registry is a critical component of this project, and the consensus obtained during this study should help create a streamlined and efficient registry that will help all aerodigestive patients on a national level.

方法采用改良德尔菲法，就应纳入最终研究数据库的数据元素达成共识。对来自八家参与机构的患者问卷进行了审核，并将单个要素汇总为 14 个类别。这些类别包括人口统计学、呼吸道症状、胃肠道症状、耳鼻喉症状、喂养、出生史、病史、手术史、家族史、社会史、评估前的用药、评估前使用的设备、之前的诊断评估以及之前由气道消化团队成员进行的评估。在 198 项内容中，有 83 项符合纳入最终登记册的共识，纳入率为 41.9%。结论气道消化系统登记册是一项重要举措，有助于促进研究并指导未来的管理。登记处的接收问卷是该项目的重要组成部分，本研究中达成的共识应有助于创建一个精简高效的登记处，在全国范围内帮助所有气道消化道患者。

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引用次数: 0

A qualitative analysis of pediatric otolaryngology fellowship websites 对儿科耳鼻喉科研究员网站的定性分析。

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2024-07-01 DOI: 10.1016/j.ijporl.2024.112026

Micah K. Harris , Nathan Lu , Anthony Tang , Natasha Mayer , Elizabeth B. McCarty , Amanda Stapleton , Noel Jabbour

Objective

To evaluate the availability and breadth of information provided by program-created pediatric otolaryngology fellowship websites as well as the American Society of Pediatric Otolaryngology (ASPO) program directory.

Methods

Program-created pediatric otolaryngology fellowship websites and the ASPO directory were evaluated for 16 key criteria deemed to be relevant to fellowship applicants.

Results

All 36 ACGME-accredited pediatric otolaryngology fellowship programs had websites that were readily available by Google search, and the ASPO program directory contained direct links to 17 (47.2 %) program-created websites. On average, program-created websites fulfilled 6.9 (43.1 %, range 1–11) and the ASPO directory fulfilled 6.9 (43.1 %, range 3–11) of the 16 key criteria. When utilizing both resources, the average increased to 8.3 (51.2 %) - criteria included program description (94.4 %), location description (30.4 %), fellowship director contact information (94.4 %), program coordinator contact information (72.2 %), teaching responsibilities (68.6 %), call responsibilities/schedule (41.7 %), operative volume (80 %), breadth of surgical exposure (94.4 %), research opportunities (72.2 %), research expectations (63.9 %), current fellow(s) (42.9 %), post-fellowship placement (28.6 %), fellow clinic (28.6 %), medical missions/outreach (20 %), and resident coverage (36.1 %).

Conclusion

Pediatric otolaryngology fellowship websites as well as program-specific data sheets from ASPO lack many key criteria that would otherwise be valuable to applicants. Inclusion of these criteria could help applicants make a more well-informed decision when applying into pediatric otolaryngology fellowship.

目的评估由项目创建的小儿耳鼻喉科奖学金网站以及美国小儿耳鼻喉科学会（ASPO）项目目录所提供信息的可用性和广度：方法：根据与奖学金申请者相关的16项关键标准，对项目创建的小儿耳鼻喉科奖学金网站和ASPO目录进行评估：所有36个经ACGME认证的小儿耳鼻喉科奖学金项目的网站都可以通过谷歌搜索找到，ASPO项目目录包含17个（47.2%）项目创建网站的直接链接。在 16 项关键标准中，项目创建的网站平均满足 6.9 项（43.1%，范围 1-11），ASPO 目录满足 6.9 项（43.1%，范围 3-11）。当同时使用这两种资源时，平均值增加到 8.3 (51.2 %) - 标准包括项目描述 (94.4%)、地点描述 (30.4%)、研究金主任联系信息 (94.4%)、项目协调员联系信息 (72.2%)、教学职责 (68.6%)、呼叫职责/时间表 (41.7%)、手术量 (41.7%)。7 %）、手术量（80 %）、手术接触面的广度（94.4 %）、研究机会（72.2 %）、研究期望（63.9 %）、现任研究员（42.9 %）、研究员后安置（28.6 %）、研究员诊所（28.6 %）、医疗任务/外联（20 %）和住院医师覆盖率（36.1 %）：小儿耳鼻喉科奖学金网站以及ASPO提供的具体项目数据表中缺少许多对申请者有价值的关键标准。纳入这些标准可帮助申请人在申请小儿耳鼻喉科奖学金时做出更明智的决定。

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引用次数: 0

The use of hearing tests to assess otitis media with effusion in children with Down syndrome 使用听力测试评估唐氏综合征患儿的中耳炎伴渗出。

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2024-07-01 DOI: 10.1016/j.ijporl.2024.112018

Mackenzie O'Donnell , Nasrin Sultana , Nasreen Talib , Jason May , Michael Slogic

Background

Down syndrome is associated with an increased risk for otitis media with effusion (OME), a childhood condition in which fluid accumulates in the middle ear, potentially leading to hearing loss. The American Academy of Pediatrics Down syndrome guidelines and the American Academy of Otolaryngology – Head and Neck Surgery OME guidelines recommend hearing testing to assess the hearing status of children with Down syndrome diagnosed with OME.

Methods

Through an Institutional Review Board approved retrospective chart review at Children's Mercy, this project assessed how clinical factors affect the frequency in which children with Down syndrome receive hearing testing after diagnosis of OME. The study included data from all children with Down syndrome between 1 and 8 years old diagnosed with OME in the Down syndrome, general pediatrics, and otolaryngology clinics between 2018 and 2020. Demographics and clinical factors, including clinic setting, were collected.

Results

Of the 124 patients identified, 91.1 % were diagnosed with OME in the otolaryngology clinic and 33.1 % received hearing testing. While most diagnoses occurred in the otolaryngology clinic, a higher proportion of hearing testing at the time of diagnosis occurred in the Down syndrome clinic. This could be explained by the fact that the Down syndrome clinic is a multidisciplinary clinic, where yearly visits include hearing screening. Bivariate analysis using chi-square or Fisher's tests showed that clinic setting had a significant association (p-value <0.001) with hearing testing. However, logistic regression depicted all clinical factors had an insignificant effect on hearing testing at 5 % significance.

Conclusion

While results indicate hearing testing is largely not performed to assess OME early in otolaryngology clinics, they may be used to assess intervention efficacy post-diagnosis. Results point to the importance of Down syndrome clinics in early diagnosis of hearing loss leading to timely referrals to otolaryngology clinics which diagnose and manage OME in children with Down syndrome.

背景：唐氏综合征与中耳积液性中耳炎（OME）风险增加有关，OME是一种中耳积液的儿童疾病，可能导致听力损失。美国儿科学会唐氏综合征指南和美国耳鼻咽喉-头颈外科OME指南建议进行听力测试，以评估确诊患有OME的唐氏综合征患儿的听力状况：本项目通过儿童慈善机构审查委员会批准的一项回顾性病历审查，评估了临床因素如何影响唐氏综合征患儿在确诊 OME 后接受听力测试的频率。研究纳入了2018年至2020年期间在唐氏综合征、普通儿科和耳鼻喉科门诊确诊为OME的所有1至8岁唐氏综合征患儿的数据。结果：在已确认的 124 名患者中，91.1% 在耳鼻喉科诊所确诊为 OME，33.1% 接受了听力测试。虽然大多数诊断在耳鼻喉科诊所进行，但唐氏综合症诊所在诊断时进行听力测试的比例较高。这可能是因为唐氏综合症诊所是一个多学科诊所，每年的就诊都包括听力筛查。使用卡方检验或费雪检验进行的双变量分析表明，门诊环境与听力筛查有显著关联（P 值结论）：虽然结果表明，耳鼻喉科诊所大多不进行听力测试以评估早期 OME，但它们可用于评估诊断后的干预效果。结果表明，唐氏综合征诊所在早期诊断听力损失方面非常重要，这有助于及时转诊到耳鼻喉科诊所，由耳鼻喉科诊所诊断和治疗唐氏综合征儿童的OME。

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引用次数: 0

Children's Tinnitus Questionnaire – A novel tool for assessing the impact of tinnitus on a child's everyday life 儿童耳鸣问卷 - 用于评估耳鸣对儿童日常生活影响的新型工具。

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2024-07-01 DOI: 10.1016/j.ijporl.2024.112024

Danuta Raj-Koziak , Elżbieta Gos , Marek Porowski , Piotr Henryk Skarzynski , Henryk Skarzynski

Objective

Self-report instruments are commonly used in tinnitus clinics, but they are presently available only for adults. There is a lack of a validated multi-item instrument to capture tinnitus-related problems in children and their impact on everyday life. This study has developed and validated a specifically child-centered questionnaire to assess the impact of tinnitus.

Methods

Development of the tool consisted of several stages. Following a pilot study on 12 children with tinnitus, a validation study was done on a further 192 children with tinnitus aged between 11 and 14 years. The children had an audiological examination, completed a Visual Analogue Scale (VAS) and the newly framed questionnaire.

Results

The development and validation process resulted in the new 11-item Children's Tinnitus Questionnaire (CTQ). It includes items concerning the impact of tinnitus on functional, cognitive, emotional and social domains. The validity of the new tool has been established by finding significant correlations between it and VAS loudness (r = 0.42), VAS annoyance (r = 0.67), and VAS coping (r = −0.41). Validity has also been confirmed by measuring differences in CTQ scores and 4 groups of children having graded incidences of tinnitus. The internal consistency assessed with Cronbach's alpha was high (α = 0.82).

Conclusion

The Children's Tinnitus Questionnaire (CTQ) is the first fully validated multi-item instrument designed specifically for children. The tool has the potential to become a valuable new instrument for use in clinical practice and research; it might be useful for assessing the impact of tinnitus on those children who find that the condition creates problems in their everyday life.

目的：自我报告工具是耳鸣诊所常用的工具，但目前仅适用于成人。目前还缺乏一种经过验证的多项目工具来记录儿童耳鸣相关问题及其对日常生活的影响。本研究开发并验证了一份专门以儿童为中心的问卷，用于评估耳鸣的影响：该工具的开发分为几个阶段。在对 12 名耳鸣儿童进行试点研究后，又对 192 名年龄在 11 至 14 岁之间的耳鸣儿童进行了验证研究。这些儿童接受了听力检查，填写了视觉模拟量表（VAS）和新编制的问卷：结果：经过开发和验证，新的儿童耳鸣问卷（CTQ）共 11 个项目。它包括耳鸣对功能、认知、情感和社交领域影响的相关项目。新工具与 VAS 响度（r = 0.42）、VAS 烦扰（r = 0.67）和 VAS 应对（r = -0.41）之间的显著相关性证明了新工具的有效性。通过测量 CTQ 分数的差异和 4 组儿童耳鸣发生率的分级，也证实了其有效性。用 Cronbach's alpha 评估的内部一致性很高（α = 0.82）：儿童耳鸣问卷（CTQ）是首个经过全面验证的专为儿童设计的多项目工具。该工具有可能成为临床实践和研究中使用的一种有价值的新工具；它可能有助于评估耳鸣对那些发现耳鸣对其日常生活造成困扰的儿童的影响。

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引用次数: 0