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Pediatric non-nasopharyngeal head and neck squamous cell carcinoma: Analysis of the Surveillance, Epidemiology, and End Results (SEER) program with review of the literature 小儿非鼻咽部头颈部鳞状细胞癌:监测、流行病学和最终结果 (SEER) 计划分析及文献综述。
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-10-15 DOI: 10.1016/j.ijporl.2024.112135
Sara E. Bressler , Adele K. Evans

Background

Despite its prevalence in adults, head and neck squamous cell carcinoma (HNSCC) is considered a rare entity in pediatrics where lymphomas, neural tumors, and soft tissue sarcomas predominate in the head and neck. Given the association of squamous cell carcinoma with the human papillomavirus, a risk factor that may be present from birth, and the difficulties in staging this disease for prognostication in children, it is important to revisit nationally collected data for prevalence and outcomes assessments.

Objective

To examine a publicly available national database to describe the incidence, pathology, treatment, and survival of pediatric HNSCC. To review the available literature regarding management, outcomes, and risk factors for this disease process.

Methods

The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) tumor database was queried to identify pediatric subjects ages 0 to 19 diagnosed HNSCC between 1973 and 2019.

Results

Two-hundred ninety-two cases were identified. Subjects were 62.7 % male (n = 183) and the average age was 15.4 years (range 2–19, median 16). Subjects were 65.8 % white (n = 192), 22.9 % black (n = 67), 8.9 % Asian/Pacific Islander (n = 26), 1 % American Indian (n = 3), and 1.4 % unknown (n = 4). The most common primary sites were nasopharynx (45.9 %), oral cavity (30.5 %), larynx (8.6 %), salivary gland (4.1 %), nasal cavity & paranasal sinus (3.4 %), and lip (2.7 %). There was no statistically significant difference between primary subsite and age, race, histologic grade, or extent of disease. The 5-year overall survival was 83.6 %.

Discussion

Head and neck squamous cell carcinoma is more likely to present in older children and is more prevalent in White populations. The nasopharynx is the most common subsite involved, which differs from adult populations in which non-nasopharyngeal subsites including the larynx, oral cavity, and oropharynx are most frequently affected.

Conclusion

Head and neck squamous cell carcinoma is rare in pediatric patients but should not be overlooked by physicians in the differential diagnosis, particularly in teenagers. Further study is needed to determine whether this represents a unique entity or can be staged and treated according to adult guidelines.
背景:尽管头颈部鳞状细胞癌(HNSCC)在成人中很常见,但在淋巴瘤、神经肿瘤和软组织肉瘤在头颈部占主导地位的儿科中却被认为是罕见病。鉴于鳞状细胞癌与人类乳头状瘤病毒(一种可能从出生时就存在的危险因素)的关联性,以及对这种疾病进行分期以预测儿童预后的困难性,重新审视全国收集的数据以评估患病率和预后非常重要:研究一个公开的国家数据库,以描述小儿 HNSCC 的发病率、病理、治疗和存活率。回顾有关该疾病过程的管理、结果和风险因素的现有文献:方法:查询美国国家癌症研究所(National Cancer Institute)的监测、流行病学和最终结果(SEER)肿瘤数据库,以确定1973年至2019年期间确诊为HNSCC的0至19岁小儿受试者:结果:共发现 222 例病例。受试者中 62.7% 为男性(n = 183),平均年龄为 15.4 岁(2-19 岁不等,中位数为 16 岁)。受试者中 65.8% 为白人(n = 192),22.9% 为黑人(n = 67),8.9% 为亚洲/太平洋岛民(n = 26),1% 为美洲印第安人(n = 3),1.4% 不详(n = 4)。最常见的原发部位是鼻咽(45.9%)、口腔(30.5%)、喉(8.6%)、唾液腺(4.1%)、鼻腔和副鼻窦(3.4%)以及嘴唇(2.7%)。原发部位与年龄、种族、组织学分级或病变范围之间的差异无统计学意义。5年总生存率为83.6%:讨论:头颈部鳞状细胞癌更可能出现在年龄较大的儿童身上,而且在白人中发病率更高。鼻咽部是最常受累的部位,这与成人中包括喉、口腔和口咽在内的非鼻咽部位最常受累的情况不同:头颈部鳞状细胞癌在儿童患者中较为罕见,但医生在鉴别诊断时不应忽视,尤其是青少年患者。还需要进一步研究,以确定该病是一种独特的疾病,还是可以按照成人指南进行分期和治疗。
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引用次数: 0
Glottic widening procedures (GWPs) to avoid tracheostomy in infants’ bilateral vocal cord paralysis: A systematic review and meta-analysis 声门扩大术(GWP)可避免对双侧声带麻痹的婴儿实施气管切开术:系统回顾与荟萃分析
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-10-15 DOI: 10.1016/j.ijporl.2024.112133
Talal Al-Khatib , Leenah Turkistani , Shahad Hani Abdu , Rana A. Alahmadi , Muhnnad A. AlGhamdi , Nadeem Butt

Objective

This systematic review and meta-analysis evaluated the efficacy of various glottic widening procedures (GWPs) in avoiding tracheostomy in infants with bilateral vocal cord paralysis (BVCP).

Methods

A systematic literature search was conducted in PubMed, Scopus, Web of Science, and Cochrane Library from inception to July 2023, without any timeframe limitations. Studies reporting GWPs (Endoscopic anterior-posterior cricoid split, Botox injection, suture lateralization, and other procedures including laser posterior cordotomy/arytenoidectomy) in infants with BVCP were included. Meta-analysis was performed to assess tracheostomy avoidance and secondary outcomes including voice, swallowing, and resolution of airway symptoms.

Results

Thirteen studies with 100 patients were included. The mean age was 51.6 days. The etiology of BVCP was idiopathic (83 %), neurologic (10 %), and acquired (7 %). The GWP interventions were successful in 88 % of patients, with only 12 % requiring tracheostomy after surgery. The pooled proportion for avoiding tracheostomy was 0.88 (95 % CI 0.82–0.94) across interventions, with no significant differences between techniques. Among patients who avoided tracheostomy, 64 % had normal voice, 86 % tolerated oral feeding, 77 % had airway symptom resolution, and 70 % had recovery of vocal cord mobility.

Conclusion

GWPs prevent a majority of infants with BVCP from undergoing tracheostomy, without permanent alterations to laryngeal function. All interventions were comparable in efficacy. Further research with larger sample sizes is warranted.
方法 在 PubMed、Scopus、Web of Science 和 Cochrane Library 中进行了系统性文献检索,检索时间从开始到 2023 年 7 月,没有任何时间限制。纳入了对 BVCP 婴儿进行 GWPs(内窥镜前后环状切口、肉毒杆菌毒素注射、缝合侧切术和其他手术,包括激光后脐带切除术/耳廓切除术)治疗的研究。对避免气管造口术以及语音、吞咽和气道症状缓解等次要结果进行了 Meta 分析。平均年龄为 51.6 天。BVCP 的病因有特发性(83%)、神经性(10%)和获得性(7%)。88% 的患者成功实施了 GWP 干预术,只有 12% 的患者术后需要进行气管造口术。在所有干预措施中,避免气管切开术的总比例为 0.88(95 % CI 0.82-0.94),不同技术之间没有显著差异。在避免气管切开术的患者中,64%的患者嗓音正常,86%的患者可耐受口服喂养,77%的患者气道症状缓解,70%的患者声带活动度恢复。所有干预措施的疗效相当。有必要进行样本量更大的进一步研究。
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引用次数: 0
Evaluation of VOR function with vHIT in unilateral pediatric cochlear implant users 用 vHIT 评估单侧小儿人工耳蜗使用者的 VOR 功能
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-10-11 DOI: 10.1016/j.ijporl.2024.112132
A.A. Aygun , B.C. Cinar , L. Sennaroglu

Objective

The changes in the inner ear affect both the cochlea and the vestibule and these effects are observed after cochlear implantation surgery. The aim of the current study is to evaluate the effect of unilateral cochlear implant use on vestibulo-ocular reflex (VOR) in children.

Methods

In the current study, 29 cochlear implanted children, aged 7–18 years, were include as the study group and 32 children, in the same age range, were included with normal-hearing as the control group. vHIT was used to evaluate VOR and the results of unilateral CI users were compared with the control group. The study group was evaluated in two different situations: cochlear implant sound processor on (CI-ON) and cochlear implant sound processor off (CI-OFF). The data obtained in the evaluations were compared between the implanted ear and the non-implanted ear between the CI-ON and CI-OFF states within the study group and between the study group and the control group.

Results

When the CI-ON and CI-OFF conditions in the study group were compared, no significant difference was found (p > 0.05). Similarly, no significant difference was found between the implanted ear and the non-implanted ear (p > 0.05). Also, there was no significant difference in the comparisons between the study group and the control group (p > 0.05).

Conclusion

vHIT is a functional test method that can be used in children to test vestibular function after cochlear implant. vHIT is a comfortable test to use after cochlear implantation to demonstrate the functionality of the vestibular system. And it provides consistent results regardless of whether the speech processor is on or off.
目标 内耳的变化会影响耳蜗和前庭,人工耳蜗植入手术后也会观察到这些影响。本研究旨在评估单侧人工耳蜗植入对儿童前庭-眼反射(VOR)的影响。方法在本研究中,研究组包括 29 名 7-18 岁人工耳蜗植入儿童,对照组包括 32 名听力正常的同龄儿童。研究组在两种不同情况下进行评估:人工耳蜗声音处理器开启(CI-ON)和人工耳蜗声音处理器关闭(CI-OFF)。对评估中获得的数据,在研究组内的 CI-ON 和 CI-OFF 状态下,在植入耳和非植入耳之间进行比较,并在研究组和对照组之间进行比较。结果当比较研究组的 CI-ON 和 CI-OFF 状态时,没有发现显著差异(p >0.05)。同样,植入耳和未植入耳之间也没有发现明显差异(p > 0.05)。结论vHIT是一种功能测试方法,可用于儿童人工耳蜗植入后的前庭功能测试。而且无论语言处理器是否开启,它都能提供一致的结果。
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引用次数: 0
The impact of maturation sutures on false passage formation in pediatric tracheostomy 成熟缝合对小儿气管切开术假通道形成的影响
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-10-10 DOI: 10.1016/j.ijporl.2024.112130
Yasmine Madan , Jennifer M. Siu , Meghan E. Tepsich , Nicole K. McKinnon , Jackie Chiang , Evan J. Propst , Nikolaus E. Wolter

Introduction

False passage (FP) after tracheostomy is an infrequent but potentially life-threatening complication. The practice of tracheal stomal maturation at the time of tracheostomy is variable amongst surgeons in pediatric patients, and it remains unknown whether or not maturation sutures decrease the risk of FP. Our objective was to evaluate the impact of maturation sutures on the incidence of FP after pediatric tracheostomy.

Materials and methods

A retrospective review of children who underwent tracheostomy (2001–2024) was performed. Records were reviewed for demographics and procedural details including use of maturation sutures. Outcomes included incidence of FP, time to FP and associated complications resulting from FP.

Results

One-hundred and twenty-five children met study criteria [median (IQR) age 0.5 (0.2–3.2) years]. Fifty-five children (44.0 %) received maturation sutures, with 31 (56.4 %) of these being four-point sutures, 10 (18.2 %) being two-point sutures (70 % of which were placed inferiorly), and 14 (25.5 %) being unrecorded. Four out of 125 (3.2 %) patients developed FP at a median (IQR) of 12.8 (4.6–13.5) days following tracheostomy insertion, and they all occurred within the first two tracheostomy changes. None of the patients who developed FP had maturation sutures. Of the four children who developed FP, three (75 %) had no further complications, and one (25 %) developed subcutaneous emphysema and pneumomediastinum. No deaths associated with FP were identified.

Conclusion

This large single institution study evaluating the relationship between maturation sutures and FP in children undergoing tracheostomy suggests that maturation sutures may help prevent FP; however, ongoing work is required to validate these findings and guide clinical practice.

Level of evidence

3.
导言:气管切开术后的假通道(FP)是一种不常见但可能危及生命的并发症。儿科外科医生在气管造口术时进行气管造口成熟的做法不尽相同,而成熟缝合是否能降低FP的风险仍是未知数。我们的目的是评估成熟缝合对小儿气管切开术后 FP 发生率的影响。对记录中的人口统计学和手术细节(包括成熟缝合的使用)进行了审查。结果125名儿童符合研究标准[中位(IQR)年龄为0.5(0.2-3.2)岁]。55名儿童(44.0%)接受了成熟缝合,其中31名(56.4%)为四点缝合,10名(18.2%)为两点缝合(其中70%为下端缝合),14名(25.5%)未记录。125名患者中有4名(3.2%)在气管造口插入后12.8(4.6-13.5)天出现FP,且均发生在气管造口的头两次更换中。所有出现 FP 的患者均未进行成熟缝合。在出现FP的四名患儿中,三名(75%)未再出现并发症,一名(25%)出现皮下气肿和气胸。结论这项大型单机构研究评估了气管造口术患儿的成熟缝合与FP之间的关系,结果表明成熟缝合可能有助于预防FP;然而,还需要继续开展工作,以验证这些发现并指导临床实践。
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引用次数: 0
Rates of tracheostomy in patients with complex skeletal dysplasia: A 32-year institutional experience 复杂骨骼发育不良患者的气管切开率:32 年的机构经验
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-10-09 DOI: 10.1016/j.ijporl.2024.112129
Seth C. Eckhardt , Clare M. Richardson , Klane K. White , Sanjay R. Parikh , Juliana Bonilla-Velez , John P. Dahl

Objective

Respiratory failure secondary to multilevel airway compromise may present complex airway challenges in patients with specific skeletal dysplasia diagnoses. This study sought to identify and characterize subgroups of skeletal dysplasia diagnoses that more frequently undergo operative airway evaluations and tracheostomy placement.

Methods

Retrospective electronic medical record review of pediatric patients with an ICD-10 associated skeletal dysplasia diagnosis and CPT-specified airway intervention at a tertiary pediatric hospital from 1990 to 2022. Patients without a defined skeletal dysplasia diagnosis, subjects with craniosynostosis syndromes, and those with limited clinical data were excluded. Collected variables included demographics, age at diagnosis, comorbidities, operative procedures, and airway interventions. Descriptive statistical analysis was utilized to evaluate data distribution.

Results

From the initial population of 313 patients, 41 subjects were confirmed to have clinical features and/or genetic testing consistent with a skeletal dysplasia diagnosis. A tracheostomy was placed in 19/41 subjects and these patients’ records were further analyzed. Skeletal dysplasia groups with more frequent tracheostomy placement included Filamins and related disorders, Sulfation disorders, and Chondrodysplasia punctata. In the patients with a tracheostomy, skeletal dysplasia was diagnosed at a median age of 0.3 years (IQR 4.8 years), and tracheostomy was initiated at a median age of 1.8 years (IQR 2.2 years). Only four of these patients were successfully decannulated, and two subjects are deceased.

Conclusion

Over 32 years, nearly half of the skeletal dysplasia patients who underwent airway interventions eventually had a tracheostomy placed. Respiratory insufficiency and complex airway management challenges are common manifestations of skeletal dysplasia.
目的多层次气道损伤导致的呼吸衰竭可能会给特定骨骼发育不良患者带来复杂的气道挑战。方法回顾性电子病历,对一家三级儿科医院 1990 年至 2022 年期间患有 ICD-10 相关骨骼发育不良诊断和 CPT 指定气道干预的儿科患者进行回顾性分析。没有明确骨骼发育不良诊断的患者、颅骨发育不良综合征患者和临床数据有限的患者被排除在外。收集的变量包括人口统计学、诊断时的年龄、合并症、手术过程和气道干预。结果在最初的 313 例患者中,有 41 例患者的临床特征和/或基因检测结果与骨骼发育不良的诊断一致。对其中 19/41 例患者实施了气管造口术,并对这些患者的病历进行了进一步分析。气管造口术实施频率较高的骨骼发育不良组别包括菲拉明氏症及相关疾病、硫化紊乱和点状软骨发育不良。在实施气管造口术的患者中,骨骼发育不良的诊断年龄中位数为 0.3 岁(IQR 4.8 岁),气管造口术的实施年龄中位数为 1.8 岁(IQR 2.2 岁)。结论在 32 年的时间里,近一半接受气道干预的骨骼发育不良患者最终接受了气管造口术。呼吸功能不全和复杂的气道管理难题是骨骼发育不良的常见表现。
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引用次数: 0
Comparing sinonasal quality of life in pediatric nasal obstruction: Inferior turbinate cauterization vs turbinoplasty – A pilot study 比较小儿鼻阻塞患者的鼻窦生活质量:下鼻甲烧灼术与鼻甲成形术--一项试点研究
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-10-09 DOI: 10.1016/j.ijporl.2024.112127
Tayebeh Kazemi , Sara S. Nabavizadeh , Reza Kaboodkhani , Ali Faramarzi , Erfan Sadeghi , Akram Rahmanipour

Objective

The objective of this study is to evaluate and compare the impacts of inferior turbinate monopolar submucosal cauterization and microdebrider-assisted inferior turbinoplasty on the sinonasal quality of life in pediatric patients with chronic nasal obstruction.

Study design

A pilot randomized controlled trial.

Setting

Tertiary hospital.

Methods

This pilot clinical trial enrolled pediatric patients, all of whom had persistent inferior nasal turbinate hypertrophy. They were assigned to undergo either inferior turbinate monopolar submucosal cauterization or microdebrider-assisted turbinoplasty. The procedures were conducted under general anesthesia for both groups. Patient-reported sinonasal symptoms were assessed using the SNOT-22 questionnaire at baseline and during follow-ups.

Results

The study enrolled 52 pediatric participants aged 4–14 years for turbinate reduction, ending with 40 after follow-up losses. Nineteen underwent cauterization, and 21 had turbinoplasty. Both groups showed significant SNOT-22 score improvements at 1, 3, and 6 months post-surgery, though the turbinoplasty group had initially greater improvements. No significant differences were found in postoperative complications, except a higher malodor sensation incidence at one week in the cauterization group.

Conclusion

In conclusion, both monopolar submucosal cautery and microdebrider-assisted turbinoplasty improved sinonasal quality of life in pediatric patients. Monopolar cautery was associated with more early postoperative malodor but may offer potential cost-effectiveness and simplicity. Further research is needed to validate these findings and refine surgical approaches.
本研究的目的是评估和比较下鼻甲单极黏膜下烧灼术和微剥离器辅助下鼻甲成形术对慢性鼻阻塞儿科患者鼻窦生活质量的影响。他们被分配接受下鼻甲单极粘膜下烧灼术或微剥离器辅助鼻甲成形术。两组手术均在全身麻醉下进行。在基线和随访期间,使用 SNOT-22 问卷对患者报告的鼻窦症状进行了评估。其中 19 人接受了烧灼术,21 人接受了鼻甲整形术。两组患者在术后 1、3 和 6 个月的 SNOT-22 评分均有明显改善,但鼻甲成形术组最初的改善幅度更大。结论:单极粘膜下烧灼术和微电刀辅助鼻甲成形术都能改善儿童患者的鼻窦生活质量。单极烧灼术与更多的术后早期恶臭有关,但可能具有潜在的成本效益和简便性。要验证这些发现并改进手术方法,还需要进一步的研究。
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引用次数: 0
Auditory processing abilities of children with congenital blindness 先天性失明儿童的听觉处理能力
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-10-09 DOI: 10.1016/j.ijporl.2024.112126
Isha Dhondekar, C.S. Vanaja

Background

Children with visual challenges rely on their hearing ability to accomplish daily tasks more efficiently. Many investigations show changes in the auditory pathway in children and adults with early blindness. It can be hypothesized that the auditory processing abilities of children with congenital blindness will be superior to those of typically developing children without any visual challenges.

Purpose

The current study was designed to compare some of the auditory processing abilities of children with congenital blindness and typically developing children who do not have any visual challenges. Specifically, the study compared the perception of speech in noise, temporal patterning ability, binaural integration ability as well as auditory memory and sequencing abilities of children in two groups.

Research design

It was a prospective cross-sectional study comparing two groups.

Study sample

A total of 160 children, 80 typically developing children without any visual challenges (reference group) and 80 children with congenital blindness, in the age range of 7–11 years, participated in the study.

Data collection and analysis

Pitch pattern test (PPT), perception of speech perception in noise test in Marathi (PSIN-M), dichotic digit test in Marathi (DDT-M), and auditory memory and sequencing test in Marathi (AMST-M) were administered. Independent sample T test and Mann Whitney U test were used to compare the performance of the two groups on these tests.

Results

Children with congenital blindness showed significantly better scores on PPT, PSIN-M, and DDT-M as compared to children in the reference group in all the age groups. A clear trend was not observed on DDT-M.

Conclusion

It can be concluded that children with congenital blindness have better auditory processing, auditory memory, and sequencing abilities compared to typically developing children without any visual challenges.
背景有视觉障碍的儿童依靠听觉能力更高效地完成日常任务。许多调查显示,早期失明儿童和成人的听觉通路发生了变化。本研究旨在比较先天性失明儿童和没有视觉障碍的发育正常儿童的听觉处理能力。具体来说,本研究比较了两组儿童对噪音中语音的感知能力、时间模式能力、双耳整合能力以及听觉记忆和排序能力。数据收集与分析进行了音调模式测试(PPT)、马拉地语噪音语音感知测试(PSIN-M)、马拉地语二分法测试(DDT-M)以及马拉地语听觉记忆和排序测试(AMST-M)。结果与参照组儿童相比,先天性失明儿童在所有年龄组的 PPT、PSIN-M 和 DDT-M 测试中的得分都明显高于参照组儿童。结论先天性失明儿童的听觉处理能力、听觉记忆能力和排序能力均优于发育正常且无任何视觉障碍的儿童。
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引用次数: 0
Comparison of postoperative bleeding in pediatric tonsillectomy versus tonsillotomy 小儿扁桃体切除术与扁桃体切开术术后出血量的比较。
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-10-08 DOI: 10.1016/j.ijporl.2024.112125
Zofnat Asulin, Ohad Cohen, Boaz Forer, Jean-Yves Sichel, Pierre Attal , Chanan Shaul

Objective

Tonsillar surgery is a common intervention for pediatric obstructive sleep apnea and recurrent tonsillitis. This study compared postoperative bleeding incidence and severity following tonsillotomy and tonsillectomy at a single medical center.

Study design

A retrospective cohort study on 1984 pediatric patients (1–18 years old) who underwent surgery during 2004–2011 and 2019–2022. Tonsillectomy was performed during 2004–2011, while tonsillotomy was preferred for obstructive sleep apnea during 2019–2022. Tonsillectomy was performed using cold steel technique with complete removal of tonsillar tissue, while tonsillotomy was conducted using mono- or bipolar diathermy, preserving minimal tissue on the tonsillar capsule.

Setting

Shaare-Zedek Medical Center, Faculty of Medicine, Hebrew University.

Methods

Outcome measures included postoperative bleeding incidence and severity, surgery duration, hospitalization length, and readmission.

Results

Tonsillotomy was conducted on 958 (48.3 %) patients, and tonsillectomy was performed on 1026 (51.7 %) patients. Obstructive sleep apnea was the only indication in 1553 (78.3 %) patients. Overall bleeding rate was lower following tonsillotomy (3.9 %) than tonsillectomy (9.5 %) (p < 0.001). Significantly more patients required surgical bleeding control post-tonsillectomy than post-tonsillotomy: 39 (3.7 %) vs. 5 (0.5 %), respectively (p < 0.001). Tonsillectomy resulted in higher readmission rates (11.8 % vs 6.1 %, p < 0.001), more blood transfusions (3 vs. 0), and higher postoperative hemoglobin diminution (1.57 ± 2 vs. 0.94 ± 1 g/dL, p = 0.035). The duration of the surgery was shorter for tonsillotomy (24.7 vs 26.5 min, p = 0.012). Tonsillectomy sustained higher bleeding rates for obstructive sleep apnea patients (7.0 % vs 3.9 %, p = 0.006). For recurrent tonsillitis patients, bleeding rates did not vary between year groups. Older age and tonsillectomy were the most significant risk factors for postoperative bleeding.

Conclusion

Among children undergoing tonsillar surgery for obstructive sleep apnea, tonsillotomy was associated with a safer postoperative bleeding profile, reduced bleeding severity, and fewer readmissions compared to tonsillectomy.
目的:扁桃体手术是治疗小儿阻塞性睡眠呼吸暂停和复发性扁桃体炎的常见方法。本研究比较了一家医疗中心的扁桃体切开术和扁桃体切除术术后出血的发生率和严重程度:一项回顾性队列研究,对象为 2004-2011 年和 2019-2022 年期间接受手术的 1984 名儿科患者(1-18 岁)。2004-2011年期间进行了扁桃体切除术,2019-2022年期间因阻塞性睡眠呼吸暂停首选扁桃体切开术。扁桃体切除术采用冷钢技术,完全切除扁桃体组织,而扁桃体切开术则采用单极或双极透热疗法,保留扁桃体囊上的最小组织:地点:希伯来大学医学院Shaare-Zedek医疗中心:方法:结果测量包括术后出血发生率和严重程度、手术时间、住院时间和再入院情况:958例(48.3%)患者进行了扁桃体切开术,1026例(51.7%)患者进行了扁桃体切除术。阻塞性睡眠呼吸暂停是 1553 例(78.3%)患者的唯一适应症。扁桃体切开术后的总体出血率(3.9%)低于扁桃体切除术(9.5%)(P 结论:扁桃体切开术后的总体出血率(3.9%)低于扁桃体切除术(9.5%):在因阻塞性睡眠呼吸暂停而接受扁桃体手术的儿童中,与扁桃体切除术相比,扁桃体切除术的术后出血情况更安全,出血严重程度更低,再住院率更低。
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引用次数: 0
A review of the importance of top-down processing assessment in auditory processing disorder 回顾自上而下处理过程评估在听觉处理障碍中的重要性。
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-10-06 DOI: 10.1016/j.ijporl.2024.112128
Bahareh Khavarghazalani , Zahra Hosseini Dastgerdi , Morteza Hamidi Nahrani , Maryam Emadi

Introduction

Auditory perception process is a transient phenomenon, which enables the person to make the relationship between events and auditory factor by working memory and obtain the sequence of auditory features and be able differentiate the auditory sources by using these component. In auditory processing, the basis formed by bottom – up process (data – driven). This pathway is dependent on the central auditory integration and also on acoustic signal input and interpreting auditory information is involved top-down process (concept – driven), which this pathway is dependent on central higher resource such as perception, attention, working memory and its span. The purpose of this study was to address information about top-down processing and auditory processing disorder.

Materials and methods

A review of the latest literature on (central) auditory processing disorders and top-down processing was performed using PUBMED, EBSCO, SCIENCE DIRECT, ASHA, GOOGLE SCHOLAR, THIEME, PROQUEST data sources.

Conclusion

Deficit in cognitive processing of auditory information in children cause difficulty in processing auditory information and outbreak auditory processing disorder symptoms. Cognitive evaluation (especially working memory) in this subject is important as bottom-up processing evaluation.
导言听觉感知过程是一种瞬时现象,它能使人通过工作记忆建立事件与听觉因素之间的关系,获得听觉特征序列,并能利用这些成分区分听觉来源。在听觉处理过程中,由下而上的过程(数据驱动)形成了基础。这一途径依赖于中央听觉整合和声音信号输入,而解释听觉信息则涉及自上而下的过程(概念驱动),这一途径依赖于中央高级资源,如感知、注意力、工作记忆及其跨度。本研究的目的是探讨有关自上而下加工和听觉加工障碍的信息:使用 PUBMED、EBSCO、SCIENCE DIRECT、ASHA、GOOGLE SCHOLAR、THIEME、PROQUEST 等数据源,对有关(中枢)听觉加工障碍和自上而下加工的最新文献进行了综述:结论:儿童听觉信息认知处理方面的缺陷会导致听觉信息处理困难并爆发听觉处理障碍症状。对这一主题进行认知评估(尤其是工作记忆)作为自下而上的处理评估非常重要。
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引用次数: 0
Application of enhanced recovery after surgery based on multiphase optimization strategy in the nursing management of children with snoring disease day surgery 基于多阶段优化策略的术后强化恢复在鼾症患儿日间手术护理管理中的应用。
IF 1.2 4区 医学 Q3 OTORHINOLARYNGOLOGY Pub Date : 2024-10-05 DOI: 10.1016/j.ijporl.2024.112123
Zhi Ling Wang , Yu Ling Shen , Ting Wu, Hui Ni, Ya Qin Zhou, Wen Juan Wang
<div><h3>Aims and objectives</h3><div>This study aimed to investigate the effectiveness of applying a multiphase optimization strategy (MOST) to enhance recovery after surgery (ERAS) protocols within the nursing management of children undergoing day surgery for snoring disease.</div></div><div><h3>Background</h3><div>While MOST has been applied to behavioral intervention research in smoking cessation, AIDS management, and weight loss by international scholars, its application in constructing nursing intervention projects remains relatively unexplored<strong>.</strong></div></div><div><h3>Design</h3><div>Using convenience sampling, randomised controlled trial.</div></div><div><h3>Methods</h3><div>A convenience sampling method was employed. The study recruited 200 preschool children diagnosed with snoring who underwent day surgery at a specific hospital between January 2023 and January 2024. The participants were divided into two groups: a control group receiving standard nursing care and an experimental group receiving MOST-guided, integrated high-quality nursing plans specifically designed for children with snoring undergoing day surgery, adhering to established ERAS guidelines.</div></div><div><h3>Results</h3><div>Children in the experimental group exhibited significantly lower anxiety levels compared to the control group, both in the preoperative waiting area and upon returning to the ward (<em>p</em> < 0.01). While the quality of discharge teaching scale (QDTS) scores did not reveal a statistically significant difference between the groups (<em>p</em> > 0.01), the content of discharge instructions and the perceived effectiveness and skill of nurse guidance differed significantly between the control and experimental groups(<em>p</em> < 0.01). Notably, the experimental group experienced a demonstrably lower incidence of thirst, hunger, crying, aspiration, pain, and conversion of day ward to routine hospitalization mode compared to the control group (all <em>p</em> < 0.01). There was no significant difference in the incidence of postoperative nausea and vomiting between the groups after rehydration (<em>p</em> > 0.01).</div></div><div><h3>Conclusions</h3><div>The implementation of ERAS protocols enhanced by MOST within the nursing management of children with snoring undergoing day surgery demonstrates significant efficacy. This approach can effectively reduce preoperative anxiety in children, improve the quality of discharge guidance provided to parents, and demonstrably decrease the occurrence of postoperative thirst, hunger, crying, aspiration, pain, and the need for unplanned hospitalization transitions within 6 h after surgery.</div></div><div><h3>Relevance to clinical practice</h3><div>It is necessary to provide fast rehabilitation nursing for children with snoring during daytime operation. Nurses should adopt the theory of fast rehabilitation based on multi-stage optimization strategy to promote children's fast rehabilitation
目的和目标:本研究旨在探讨在对鼾症日间手术患儿的护理管理中,应用多阶段优化策略(MOST)加强术后恢复(ERAS)方案的有效性:背景:虽然国际学者已将多阶段优化策略应用于戒烟、艾滋病管理和减肥等行为干预研究,但其在构建护理干预项目中的应用仍相对欠缺:方法:采用方便抽样法、随机对照试验法:方法:采用便利抽样法。研究招募了 200 名被诊断为打鼾的学龄前儿童,他们于 2023 年 1 月至 2024 年 1 月期间在一家特定医院接受了日间手术。参与者被分为两组:对照组接受标准护理,实验组接受 MOST 指导下的综合优质护理计划,该计划专为接受日间手术的打鼾患儿设计,并遵循 ERAS 既定指导方针:与对照组相比,实验组患儿在术前等候区和返回病房时的焦虑程度明显降低(P 0.01),对照组和实验组患儿对出院指导的内容、护士指导的效果和技巧的感知存在显著差异(P 0.01):结论:在对接受日间手术的打鼾患儿进行护理管理的过程中,实施经MOST强化的ERAS方案效果显著。该方法可有效降低患儿术前焦虑,提高对家长的出院指导质量,明显降低术后口渴、饥饿、哭闹、吸入、疼痛的发生率,减少术后6 h内非计划住院转院的需求:为日间手术打鼾患儿提供快速康复护理很有必要。护理人员应采用基于多阶段优化策略的快速康复理论,促进患儿术后快速康复。
{"title":"Application of enhanced recovery after surgery based on multiphase optimization strategy in the nursing management of children with snoring disease day surgery","authors":"Zhi Ling Wang ,&nbsp;Yu Ling Shen ,&nbsp;Ting Wu,&nbsp;Hui Ni,&nbsp;Ya Qin Zhou,&nbsp;Wen Juan Wang","doi":"10.1016/j.ijporl.2024.112123","DOIUrl":"10.1016/j.ijporl.2024.112123","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Aims and objectives&lt;/h3&gt;&lt;div&gt;This study aimed to investigate the effectiveness of applying a multiphase optimization strategy (MOST) to enhance recovery after surgery (ERAS) protocols within the nursing management of children undergoing day surgery for snoring disease.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;While MOST has been applied to behavioral intervention research in smoking cessation, AIDS management, and weight loss by international scholars, its application in constructing nursing intervention projects remains relatively unexplored&lt;strong&gt;.&lt;/strong&gt;&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Using convenience sampling, randomised controlled trial.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A convenience sampling method was employed. The study recruited 200 preschool children diagnosed with snoring who underwent day surgery at a specific hospital between January 2023 and January 2024. The participants were divided into two groups: a control group receiving standard nursing care and an experimental group receiving MOST-guided, integrated high-quality nursing plans specifically designed for children with snoring undergoing day surgery, adhering to established ERAS guidelines.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Children in the experimental group exhibited significantly lower anxiety levels compared to the control group, both in the preoperative waiting area and upon returning to the ward (&lt;em&gt;p&lt;/em&gt; &lt; 0.01). While the quality of discharge teaching scale (QDTS) scores did not reveal a statistically significant difference between the groups (&lt;em&gt;p&lt;/em&gt; &gt; 0.01), the content of discharge instructions and the perceived effectiveness and skill of nurse guidance differed significantly between the control and experimental groups(&lt;em&gt;p&lt;/em&gt; &lt; 0.01). Notably, the experimental group experienced a demonstrably lower incidence of thirst, hunger, crying, aspiration, pain, and conversion of day ward to routine hospitalization mode compared to the control group (all &lt;em&gt;p&lt;/em&gt; &lt; 0.01). There was no significant difference in the incidence of postoperative nausea and vomiting between the groups after rehydration (&lt;em&gt;p&lt;/em&gt; &gt; 0.01).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The implementation of ERAS protocols enhanced by MOST within the nursing management of children with snoring undergoing day surgery demonstrates significant efficacy. This approach can effectively reduce preoperative anxiety in children, improve the quality of discharge guidance provided to parents, and demonstrably decrease the occurrence of postoperative thirst, hunger, crying, aspiration, pain, and the need for unplanned hospitalization transitions within 6 h after surgery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Relevance to clinical practice&lt;/h3&gt;&lt;div&gt;It is necessary to provide fast rehabilitation nursing for children with snoring during daytime operation. Nurses should adopt the theory of fast rehabilitation based on multi-stage optimization strategy to promote children's fast rehabilitation","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112123"},"PeriodicalIF":1.2,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380816","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
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International journal of pediatric otorhinolaryngology
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