International journal of pediatric otorhinolaryngology最新文献

英文中文

Wideband absorbance measurements in cochlear implant recipients: Insights into the Transcranial Veria Technique 人工耳蜗受者的宽带吸光度测量：经颅Veria技术的见解。

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2026-01-13 DOI: 10.1016/j.ijporl.2026.112727

Nerale Maraiah Mamatha , Raghunath Bansode Rohit , Karuppannan Arunraj

Purpose

Cochlear implantation (CI) significantly improves hearing in individuals with severe to profound sensorineural hearing loss. However, variations in surgical techniques may affect middle and inner ear mechanics. This study explores the effect of transcranial transcanal wall-Veria technique for CI on middle ear mechanics, measured using wideband absorbance (WBA).

Methods

Ten children (4–7 years) who underwent CI using the transcranial Transcanal wall-Veria technique were compared to age- and gender-matched controls with normal-hearing children. Tympanometric measures such as static compliance, tympanometric peak pressure, Ear canal volume, resonance frequency, and wideband absorbance at peak and ambient pressure were measured.

Results

Conventional 226 Hz Tympanometric measures were similar for both CI and Normal hearing groups, showing no significant differences (p > 0.05) between the groups. However, WBA measurements revealed significant changes (p < 0.05) in absorbance across frequencies, particularly at higher frequencies (2000–8000 Hz). The WBA pattern was different, with two maximum absorbance for normal-hearing children, whereas single maxima around 2000 Hz for CI group. Further, WBA at peak pressure differed from ambient pressure in both groups at low and mid-frequencies, with significant differences (p < 0.05) observed only in CI group. These results suggest that the Veria technique causes alterations in middle ear mechanics, specifically in the high-frequency regions.

Conclusions

This study highlights the utility of WBA in detecting subtle, frequency-specific changes in ear mechanics following the Veria CI technique, which may remain undetected by conventional tympanometry. Although functional auditory outcomes such as aided thresholds, speech perception scores, and eSRT were not correlated in this study,the findings underscore the importance of WBA as an advanced diagnostic tools in assessing the impact of surgical techniques on ear function post-CI.

目的：人工耳蜗植入术（CI）可显著改善重度至重度感音神经性听力损失患者的听力。然而，手术技术的变化可能会影响中耳和内耳的力学。本研究探讨了经颅经扫描wall-Veria技术对中耳力学的影响，采用宽带吸光度（WBA）测量。方法：10名4-7岁的儿童使用经颅经scanal wall-Veria技术接受CI，并与年龄和性别匹配的正常听力儿童进行比较。测量了静顺应性、峰值压力、耳道容积、共振频率、峰值压力和环境压力下的宽带吸光度等鼓室测量指标。结果：CI组与正常听力组常规226 Hz鼓室测量值相似，组间无显著差异（p < 0.05）。结论：本研究强调了WBA在检测Veria CI技术后耳力学中细微的频率特异性变化方面的实用性，这可能是传统鼓室测量法无法检测到的。虽然在本研究中，辅助阈值、语音感知评分和eSRT等功能性听觉结果并不相关，但研究结果强调了WBA作为评估手术技术对ci后耳功能影响的先进诊断工具的重要性。

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引用次数: 0

Prevalence of vestibular pathology in patients with congenital inner ear malformation 先天性内耳畸形患者前庭病变的患病率

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2026-01-13 DOI: 10.1016/j.ijporl.2026.112723

Gillian Michaelson , Chelsea Cleveland , Daniel Karasik , Todd Otteson

引用次数: 0

Postoperative complications following tonsillectomy in children with Ehlers-Danlos Syndrome Ehlers-Danlos综合征患儿扁桃体切除术后的并发症。

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2026-01-12 DOI: 10.1016/j.ijporl.2026.112719

Murilo de Santana Hager , Mary Youssef , Gaayathri Varavenkataraman , Nicole Favre , Michele M. Carr

引用次数: 0

Adenoidectomy with tympanostomy or with myringotomy alone: A systematic review of pediatric randomized controlled trials 腺样体切除联合鼓室切开术或单独鼓膜切开术：一项儿科随机对照试验的系统综述

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2026-01-12 DOI: 10.1016/j.ijporl.2026.112718

Ebraheem Albazee , Noof Albannai , Hajar Alismail , Yasmeen Alazemi , Munawer Alsaeed , Esraa Alhammadi , Abrar Awadh , Abdullah Alabdullah , Mariam AlRaish , Ahmad Alawadhi , Ghezlan Aldawas , Mohmmad Alkaak , Dhoha Ismaeel

Background

Otitis media with effusion (OME) is a leading cause of acquired conductive hearing loss in children. When performing an adenoidectomy for OME, surgeons must decide whether to supplement the procedure with a simple myringotomy or a myringotomy with tympanostomy tube (TT) insertion. While TT offers extended middle ear ventilation, it carries a risk of long-term complications. This systematic review of randomized controlled trials (RCTs) aimed to compare the efficacy and safety of these two approaches.

Methods

A comprehensive search of PubMed, Scopus, CENTRAL, and Web of Science was conducted for RCTs up to August 2025. Eligible RCTs were assessed for quality using the risk of bias (RoB)-2 tool. The primary outcomes were hearing improvement and resolution of effusion. Secondary outcomes included OME recurrence and postoperative complications.

Results

Eleven RCTs involving 955 pediatric patients were included. The addition of TT consistently resulted in superior short-term outcomes, with significantly better hearing levels and faster resolution of middle ear effusion within the first 3–6 months. However, these advantages were not sustained, and no significant differences in hearing or effusion rates were observed at 12-month follow-ups. In contrast, the TT group experienced a significantly higher incidence of long-term complications, including otorrhea, tympanosclerosis, and persistent tympanic membrane perforation.

Conclusion

Adding a TT to adenoidectomy provides a transient benefit in hearing and effusion resolution but significantly increases the risk of long-term tympanic membrane complications. Adenoidectomy with myringotomy alone appears to be a safer and equally effective long-term strategy for managing pediatric OME.

背景：渗出性中耳炎是儿童获得性传导性听力损失的主要原因。当对OME进行腺样体切除术时，外科医生必须决定是否辅以简单的鼓膜切开术或鼓膜切开术并插入鼓膜造瘘管（TT）。虽然TT提供了延长的中耳通气，但它有长期并发症的风险。本系统综述随机对照试验（rct）旨在比较这两种方法的疗效和安全性。方法对截至2025年8月的随机对照试验进行PubMed、Scopus、CENTRAL、Web of Science的综合检索。使用风险偏倚(RoB)-2工具评估符合条件的随机对照试验的质量。主要结果是听力改善和积液的消除。次要结果包括OME复发和术后并发症。结果纳入6项随机对照试验，共955例儿科患者。TT治疗的短期效果一直很好，在最初的3-6个月内，患者的听力水平明显提高，中耳积液的清除速度也更快。然而，这些优势并没有持续，在12个月的随访中没有观察到听力或积液率的显著差异。相比之下，TT组的长期并发症发生率明显更高，包括耳漏、鼓膜硬化和持续性鼓膜穿孔。结论在腺样体切除术中加入TT对听力和积液解决有短暂的好处，但明显增加了长期鼓膜并发症的风险。腺样体切除术联合鼓膜切开术似乎是治疗小儿OME的一种更安全、同样有效的长期策略。

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引用次数: 0

Molecular markers of pediatric cholesteatoma: A gene expression comparison with adult tissue 儿童胆脂瘤的分子标记：与成人组织的基因表达比较

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2026-01-12 DOI: 10.1016/j.ijporl.2026.112721

Mack J. Tempero , Peter Kfoury , Michael Seipp , Kelly Otsuka , Matthew A. Firpo , Sarah Al Nemer , Albert H. Park

Objective

This study aims to compare gene expression levels in pediatric versus adult cholesteatoma using bulk RNA sequencing.

Study design

Retrospective analysis of prospectively collected human tissue.

Setting

Tertiary medical center.

Methods

RNA sequencing was performed on 3 pediatric and 3 adult cholesteatoma tissue samples and differentially expressed genes were identified. Gene set enrichment analysis (GSEA) was performed to identify mechanistic pathways and differential cellular reprogramming.

Results

Bulk RNA sequencing of 3 pediatric and 3 adult cholesteatoma tissue samples identified 20,298 genes. Differential gene expression analysis revealed 14 genes: 6 downregulated in and 8 upregulated in pediatric cholesteatoma compared to adult tissue. The GSEA revealed 3 gene sets upregulated in pediatric samples compared to adults relevant in cholesteatoma literature: Tumor Necrosis Factor (TNF-α), Transforming Growth Factor Beta (TGF-β, and the Epithelial-Mesenchymal Transition (EMT).

Conclusion

Pediatric cholesteatoma has distinct gene expression and pathway enrichment compared to adult disease, involving inflammation and fibrosis. This study highlights the complex inflammatory process seen in pediatric cholesteatoma and suggests molecular markers that could serve as potential therapeutic targets for treatment.

目的：本研究旨在通过大规模RNA测序比较儿童和成人胆脂瘤的基因表达水平。研究设计对前瞻性收集的人体组织进行回顾性分析。三级医疗中心。方法对3例儿童和3例成人胆脂瘤组织样本进行srna测序，鉴定差异表达基因。基因集富集分析（GSEA）用于鉴定机制途径和差异细胞重编程。结果3份儿童和3份成人胆脂瘤组织样本的大量RNA测序鉴定出20,298个基因。差异基因表达分析显示14个基因：与成人组织相比，儿童胆脂瘤中6个基因下调，8个基因上调。GSEA显示，与成人文献中与胆脂瘤相关的3个基因组在儿童样本中上调：肿瘤坏死因子（TNF-α）、转化生长因子β (TGF-β)和上皮-间质转化（EMT）。结论与成人疾病相比，儿童胆脂瘤具有不同的基因表达和通路富集，涉及炎症和纤维化。这项研究强调了儿童胆脂瘤中复杂的炎症过程，并提出了可能作为潜在治疗靶点的分子标记。

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引用次数: 0

ADHEAR in infants with Down syndrome and minimal hearing loss ADHEAR在患有唐氏综合症和轻度听力损失的婴儿中的应用。

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2026-01-11 DOI: 10.1016/j.ijporl.2026.112722

Evette A. Ronner , Nicole Kim , Michael Cheung , Heidi Leonard , Julie Arenberg , Michael S. Cohen

引用次数: 0

Enhancing paediatric endoscopic airway training with a high-fidelity 3D-printed simulator 增强儿科内镜气道训练与高保真3d打印模拟器

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2026-01-11 DOI: 10.1016/j.ijporl.2026.112716

Victoria Carswell , Wisha Gul , Thushitha Kunanandam

Objectives

To develop and validate a high-fidelity, low-cost paediatric airway simulation model for endoscopic procedures, replicating a range of laryngeal pathologies. The study assessed the model's face, content, and construct validity and evaluated its educational value for airway surgery training.

Methods

A prospective, multicentre validation study was conducted across three international paediatric otolaryngology courses. Eighty otolaryngologists of varying seniority completed a 19-item Likert questionnaire assessing face and content validity for laryngomalacia, subglottic stenosis and laryngeal cyst models. A subgroup of registrars undertook repeated supraglottoplasty practice to assess construct validity through performance scores and completion time.

Results

All 80 participants completed validation surveys. Mean face and content validity scores exceeded 4/5 across all models, indicating strong anatomical fidelity and educational value. The simulator was rated highly for improving endoscopic technique (mean content score 4.79 ± 0.41). In the construct validity subgroup, supraglottoplasty completion time improved by 7.54m (t = 3.55, p = 0.01) with skill scores increasing by +1.25 points (t = −3.56, p = 0.01). Junior trainees showed greater improvement than seniors. Participants provided favourable qualitative feedback on realism and instrument handling.

Conclusions

This modular, 3D-printed paediatric airway simulator demonstrates face, content and construct validity, with reproducible educational benefits across an international cohort. Its low cost, modularity and interchangeable inserts supports scalable adoption in training programmes. Future work should assess transferability of skills to clinical practice and optimise tissue fidelity for improved haptic realism.

目的：开发和验证一种高保真、低成本的儿科气道模拟模型，用于内镜手术，复制一系列喉部病变。本研究评估了模型的外观、内容和结构效度，并评价了其对气道外科培训的教育价值。方法在三个国际儿科耳鼻喉科课程中进行了一项前瞻性、多中心验证研究。80名不同资历的耳鼻喉科医生完成了一份19项李克特问卷，评估喉软化症、声门下狭窄和喉囊肿模型的面部和内容效度。一组注册者进行了重复的喉上成形术练习，通过表现分数和完成时间来评估结构的有效性。结果80名参与者均完成了验证性问卷调查。所有模型的平均面部和内容效度得分均超过4/5分，显示出较强的解剖逼真度和教育价值。该模拟器对内镜技术的改进评价较高（平均内容评分4.79±0.41）。在构念效度亚组，喉上成形术完成时间提高了7.54m (t = 3.55, p = 0.01)，技能得分提高了+1.25分（t = - 3.56, p = 0.01）。初级学员比高年级学员表现出更大的进步。与会者对现实主义和仪器处理提供了有利的定性反馈。这个模块化的3d打印儿科气道模拟器展示了面部、内容和结构的有效性，在国际队列中具有可重复的教育效益。它的低成本，模块化和可互换的插入支持可扩展的培训计划采用。未来的工作应评估技能转移到临床实践和优化组织保真度，以提高触觉真实感。

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引用次数: 0

Recurrent post-tonsillectomy bleeding in pediatric patients 小儿扁桃体切除术后复发性出血。

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2026-01-11 DOI: 10.1016/j.ijporl.2026.112720

Kathleen R. Billings , Sydney J. Sachse , Saied Ghadersohi , Achilles A. Kanaris , Rachel L. Schappacher , Rachel D. Yoon , Alexander J. Szymczak , Inbal Hazkani

Objective

Post-tonsillectomy hemorrhage is a common risk after tonsillectomy. The goal of this study is to analyze the rate of recurrent PTH (R-PTH), and to determine potential risk factors for recurrent bleeding.

Methods

Retrospective cohort study of patients <18 years of age evaluated at a tertiary care pediatric hospital for PTH. Risk factors for patients with R-PTH episodes were evaluated, when compared to patients with a single bleeding episode. An assessment of healthcare utilization in those with R-PTH was performed.

Results

Among 18,819 tonsillectomies performed in the study period, 382 (2.0 %) had a PTH. Of these, 42 patients (11.0 %) experienced R-PTH: 35 patients (9.2 %) with two bleeding episodes, and 7 patients (1.8 %) with three. Patients with R-PTH were male (n = 26, 61.9 %), Hispanic/Latino (n = 19, 45.2 %), and English-speaking (n = 33, 78.6 %). The overall risk of R-PTH following tonsillectomy was 0.2 %, and the relative risk of R-PTH after an initial PTH was 5.4 times. None of the factors analyzed were found to have a significant association with R-PTH, although a greater proportion of patients with R-PTH were found to have a history of chronic tonsillitis (21.4 % vs 14.4 %). Healthcare utilization, an aggregate measurement of primary care, otolaryngology, telemedicine, and emergency department visits unrelated to PTH, was significantly higher in R-PTH patients (2.5 vs. 1.8 occurrences, p = 0.023).

Conclusions

The rate of R-PTH was small (0.2 %), although those patients with an initial PTH had a relative risk of 5.4 for a R-PTH episode. No clear risk factors for R-PTH were identified. Increased healthcare utilization was noted in those with R-PTH.

Level of evidence

目的：扁桃体切除术后出血是扁桃体切除术后常见的危险。本研究的目的是分析甲状旁腺激素（R-PTH）的复发率，并确定出血复发的潜在危险因素。方法：回顾性队列研究患者结果：在研究期间18,819例扁桃体切除术中，382例（2.0%）有PTH。其中，42例患者（11.0%）经历了甲状旁腺激素：35例患者（9.2%）有两次出血发作，7例患者（1.8%）有三次出血发作。R-PTH患者为男性（n = 26，占61.9%）、西班牙裔/拉丁裔（n = 19，占45.2%）和英语患者（n = 33，占78.6%）。扁桃体切除术后R-PTH的总风险为0.2%，而初始PTH后R-PTH的相对风险为5.4倍。虽然有较大比例的R-PTH患者有慢性扁桃体炎病史（21.4% vs 14.4%），但分析的所有因素均未发现与R-PTH有显著关联。与甲状旁腺激素无关的初级保健、耳鼻喉科、远程医疗和急诊科就诊的综合测量结果显示，r -甲状旁腺激素患者的医疗利用率明显更高（2.5比1.8,p = 0.023）。结论：尽管初始PTH患者发生R-PTH发作的相对风险为5.4，但R-PTH的发生率很小（0.2%）。没有明确的促甲状旁腺激素的危险因素。在有促性甲状旁腺激素的患者中，医疗保健利用率增加。证据等级：4；

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引用次数: 0

Interdisciplinary approach: The importance of dysphagia diagnostics in pediatric patients 跨学科方法：儿科患者吞咽困难诊断的重要性

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2026-01-11 DOI: 10.1016/j.ijporl.2026.112724

Fabian Kraus, Wafaa Shehata-Dieler, Rudolf Hagen, Stephan Hackenberg

Pediatric dysphagia represents a complex and multifactorial clinical challenge with potentially profound implications for development, nutritional status, pulmonary health, and overall quality of life. In infants and children, the early identification of swallowing difficulties is critical due to their impact on growth trajectories, neurodevelopment, and the psychosocial well-being of both the child and caregivers. This comprehensive article examines the importance of a systematic, interdisciplinary diagnostic approach in evaluating pediatric dysphagia in a university hospital. Based on a ten-year retrospective cohort study involving 223 pediatric patients aged one month to sixteen years, we investigate how the integration of clinical history, physical examination, and state-of-the-art instrumental techniques - such as flexible endoscopic evaluation of swallowing (FEES) - within a collaborative, multi-specialist framework can enhance diagnostic precision. Findings underscore the necessity of individualized, developmentally sensitive diagnostic pathways involving phoniatricions, ENT specialists, pediatricians, speech-language pathologists, radiologists and nutrition experts.

小儿吞咽困难是一种复杂的多因素临床挑战，对发育、营养状况、肺部健康和整体生活质量具有潜在的深远影响。在婴儿和儿童中，吞咽困难的早期识别是至关重要的，因为它们对儿童和照顾者的生长轨迹、神经发育和社会心理健康都有影响。这篇综合性的文章探讨了在大学医院评估儿童吞咽困难的一个系统的、跨学科的诊断方法的重要性。基于一项为期10年的回顾性队列研究，涉及223名1个月至16岁的儿童患者，我们研究了如何将临床病史、体格检查和最先进的仪器技术（如柔性内窥镜吞咽评估（FEES））整合在一个协作的多专家框架内，以提高诊断精度。研究结果强调了个体化的、对发育敏感的诊断途径的必要性，这些诊断途径包括发音专家、耳鼻喉科专家、儿科医生、语言病理学家、放射科医生和营养专家。

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引用次数: 0

Early detection of congenital cytomegalovirus – universal screening in the neonatal ICU 先天性巨细胞病毒的早期检测——新生儿重症监护病房的普遍筛查。

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology

Pub Date : 2026-01-10 DOI: 10.1016/j.ijporl.2026.112712

Avani Vasireddy , Monica Ogunsusi , Rick Pittman , Kristin Weimer , Eileen Raynor

引用次数: 0

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