Pub Date : 2024-10-05DOI: 10.1016/j.ijporl.2024.112122
Daniel Peñaranda , Riley Hue Vo , Tania Sih , Graciela Gonzalez Franco , Tulio A. Valdez
Objective
To assess the real-world application of legislative measures and regulations governing newborn hearing testing in Latin America.
Methods
An online survey was sent to the Interamerican Association of Pediatric Otorhinolaryngology (IAPO) network to investigate neonatal hearing screening practices. Twelve questions were asked about legislation, implementation, and barriers to neonatal hearing screening.
Results
A total of 89 pediatric otolaryngologists representing 20 Latin American nations participated in this survey. The majority of respondents (64 %) indicated the existence of neonatal hearing laws within their respective countries and correctly named the specific legislation. However, it is noteworthy that over half (58 %) of pediatric ear, nose, and throat specialists reported that these laws are not consistently put into practice in their daily clinical routines. Respondents from five countries disclosed that neonatal hearing screening is not conducted within the first month of an infant’s life.
Conclusions
While the majority of Latin American nations have established legislation concerning neonatal hearing screening, its application in clinical practice is lacking due to economic obstacles. Marked disparities across Latin America persist for neonatal hearing screening. Our study provides key insights and recommendations aimed at addressing these issues, including the need for stronger legislative enforcement, increased funding, improved infrastructure, targeted professional training, and expanded public education to strengthen this vital aspect of healthcare in Latin America.
{"title":"Advancing neonatal hearing screening in Latin America: Insights from pediatric otolaryngologists","authors":"Daniel Peñaranda , Riley Hue Vo , Tania Sih , Graciela Gonzalez Franco , Tulio A. Valdez","doi":"10.1016/j.ijporl.2024.112122","DOIUrl":"10.1016/j.ijporl.2024.112122","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the real-world application of legislative measures and regulations governing newborn hearing testing in Latin America.</div></div><div><h3>Methods</h3><div>An online survey was sent to the Interamerican Association of Pediatric Otorhinolaryngology (IAPO) network to investigate neonatal hearing screening practices. Twelve questions were asked about legislation, implementation, and barriers to neonatal hearing screening.</div></div><div><h3>Results</h3><div>A total of 89 pediatric otolaryngologists representing 20 Latin American nations participated in this survey. The majority of respondents (64 %) indicated the existence of neonatal hearing laws within their respective countries and correctly named the specific legislation. However, it is noteworthy that over half (58 %) of pediatric ear, nose, and throat specialists reported that these laws are not consistently put into practice in their daily clinical routines. Respondents from five countries disclosed that neonatal hearing screening is not conducted within the first month of an infant’s life.</div></div><div><h3>Conclusions</h3><div>While the majority of Latin American nations have established legislation concerning neonatal hearing screening, its application in clinical practice is lacking due to economic obstacles. Marked disparities across Latin America persist for neonatal hearing screening. Our study provides key insights and recommendations aimed at addressing these issues, including the need for stronger legislative enforcement, increased funding, improved infrastructure, targeted professional training, and expanded public education to strengthen this vital aspect of healthcare in Latin America.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112122"},"PeriodicalIF":1.2,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406383","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}
Pub Date : 2024-09-29DOI: 10.1016/j.ijporl.2024.112124
Alexandra E. Tunkel , Anisa Benbourenane , Hengameh K. Behzadpour , Md Sohel Rana , Tracey Ambrose , Eve Kronzek , Diego A. Preciado , Brian K. Reilly
Objective
Auditory brainstem response (ABR) testing is the gold standard for diagnosis of hearing loss in children who cannot complete behavioral audiometry. Testing under general anesthesia is often recommended when natural sleep ABR and/or behavioral audiometry are unsuccessful. This study aims to determine which demographic and patient factors serve as barriers to receiving this diagnostic testing.
Methods
A retrospective chart review from an internal database of patients who underwent ABR testing under anesthesia from 2017 to 2023 was completed. Patient demographics, clinical diagnoses, dates of initial recommendation, and dates of testing were recorded.
Results
A total of 395 patients met inclusion criteria, with a median time from initial evaluation to successful ABR under anesthesia of 5.1 months (range 0.1–209 months). This time was significantly higher in patients with public insurance compared to private insurance and in patients with the following medical complexities: cardiac disease, developmental delay, neurologic disease, eye disease, and genetic syndromes not associated with hearing loss. The interval was significantly shorter in patients with abnormal ear anatomy.
Conclusion
Patient factors, such as insurance type and certain medical diagnoses, may lead to delayed ABR testing under anesthesia and thus delayed diagnosis and management of hearing loss. This has implications for the timely care and treatment of children with hearing loss.
目的：听性脑干反应（ABR）测试是诊断无法完成行为测听的儿童听力损失的金标准。当自然睡眠 ABR 和/或行为测听不成功时，通常建议在全身麻醉下进行测试。本研究旨在确定哪些人口统计学因素和患者因素是接受这种诊断测试的障碍：从内部数据库中对 2017 年至 2023 年期间在麻醉状态下接受 ABR 测试的患者进行回顾性病历审查。结果：共有 395 名患者符合纳入条件：共有 395 名患者符合纳入标准，从初步评估到麻醉下成功 ABR 的中位时间为 5.1 个月（范围为 0.1-209 个月）。与参加私人保险的患者相比，参加公共保险的患者所需的时间明显更长，患有以下复杂疾病的患者所需的时间也明显更长：心脏病、发育迟缓、神经系统疾病、眼部疾病以及与听力损失无关的遗传综合征。在耳部解剖异常的患者中，间隔时间明显更短：结论：患者因素（如保险类型和某些医疗诊断）可能会导致麻醉下 ABR 测试延迟，从而延误听力损失的诊断和治疗。这对及时护理和治疗听力损失儿童具有重要意义。
{"title":"Barriers to auditory brainstem response testing under anesthesia","authors":"Alexandra E. Tunkel , Anisa Benbourenane , Hengameh K. Behzadpour , Md Sohel Rana , Tracey Ambrose , Eve Kronzek , Diego A. Preciado , Brian K. Reilly","doi":"10.1016/j.ijporl.2024.112124","DOIUrl":"10.1016/j.ijporl.2024.112124","url":null,"abstract":"<div><h3>Objective</h3><div>Auditory brainstem response (ABR) testing is the gold standard for diagnosis of hearing loss in children who cannot complete behavioral audiometry. Testing under general anesthesia is often recommended when natural sleep ABR and/or behavioral audiometry are unsuccessful. This study aims to determine which demographic and patient factors serve as barriers to receiving this diagnostic testing.</div></div><div><h3>Methods</h3><div>A retrospective chart review from an internal database of patients who underwent ABR testing under anesthesia from 2017 to 2023 was completed. Patient demographics, clinical diagnoses, dates of initial recommendation, and dates of testing were recorded.</div></div><div><h3>Results</h3><div>A total of 395 patients met inclusion criteria, with a median time from initial evaluation to successful ABR under anesthesia of 5.1 months (range 0.1–209 months). This time was significantly higher in patients with public insurance compared to private insurance and in patients with the following medical complexities: cardiac disease, developmental delay, neurologic disease, eye disease, and genetic syndromes not associated with hearing loss. The interval was significantly shorter in patients with abnormal ear anatomy.</div></div><div><h3>Conclusion</h3><div>Patient factors, such as insurance type and certain medical diagnoses, may lead to delayed ABR testing under anesthesia and thus delayed diagnosis and management of hearing loss. This has implications for the timely care and treatment of children with hearing loss.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112124"},"PeriodicalIF":1.2,"publicationDate":"2024-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375453","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}
Pub Date : 2024-09-27DOI: 10.1016/j.ijporl.2024.112121
Taylor Loth , Rebecca Compton , Zahrah Taufique , Andrew Redmann , Brianne Barnett Roby
Objectives
To analyze the language of letters of recommendation for pediatric otolaryngology fellowship for possible gender and/or racial bias. To refine methodology for future investigation of gender and language within letters of recommendation for pediatric otolaryngology fellowship.
Methods
Practicing pediatric otolaryngologists were recruited as survey participants. A total of 10 letters of recommendation were screened to represent an equal number of applicants who identify as male and female and an equal number of applicants who identify as White and applicants who identify as Black, Indigenous, or a Person of Color. Names, pronouns, location, and other identifying information were removed from the letters. Survey participants were asked to read each letter and categorize the applicant's gender and race as well as that of the letter writer. The letters were also subject to analysis by WordStat linguistic software.
Results
A total of 35 pediatric otolaryngologists participated in the survey. Participants assigned gender of the applicant correctly in 43 % of letters and gender of the letter writer correctly in 53 % of letters. Race of the applicant was judged correctly in 65 % of letters. Participants indicated words such as caring, hard-working, and prepared led them to assume the applicant was female, which was corroborated by linguistic analysis. No such words were identified as predictive of race.
Conclusion
This pilot study suggests that while there are certain linguistic associations with gender among applications to pediatric otolaryngology fellowship, they may not impact biases held by the reader. This is relevant given a recent rise in the number of female applicants to this subspecialty and ongoing unfilled fellowship positions. Future studies are needed to determine if such associations exist and ultimately affect match potential and success within the field. These studies will require analysis of more letters and with more survey respondents, along with a higher in-depth linguistic analysis.
Lay summary
This pilot study aims to evaluate letters of recommendation for pediatric otolaryngology fellowship applications for gender bias with the goal of outlining future studies. There were certain words associated with a given gender, which could impact applicants’ potential to match.
{"title":"Linguistic analysis of letters of recommendation for pediatric otolaryngology: A pilot study","authors":"Taylor Loth , Rebecca Compton , Zahrah Taufique , Andrew Redmann , Brianne Barnett Roby","doi":"10.1016/j.ijporl.2024.112121","DOIUrl":"10.1016/j.ijporl.2024.112121","url":null,"abstract":"<div><h3>Objectives</h3><div>To analyze the language of letters of recommendation for pediatric otolaryngology fellowship for possible gender and/or racial bias. To refine methodology for future investigation of gender and language within letters of recommendation for pediatric otolaryngology fellowship.</div></div><div><h3>Methods</h3><div>Practicing pediatric otolaryngologists were recruited as survey participants. A total of 10 letters of recommendation were screened to represent an equal number of applicants who identify as male and female and an equal number of applicants who identify as White and applicants who identify as Black, Indigenous, or a Person of Color. Names, pronouns, location, and other identifying information were removed from the letters. Survey participants were asked to read each letter and categorize the applicant's gender and race as well as that of the letter writer. The letters were also subject to analysis by WordStat linguistic software.</div></div><div><h3>Results</h3><div>A total of 35 pediatric otolaryngologists participated in the survey. Participants assigned gender of the applicant correctly in 43 % of letters and gender of the letter writer correctly in 53 % of letters. Race of the applicant was judged correctly in 65 % of letters. Participants indicated words such as caring, hard-working, and prepared led them to assume the applicant was female, which was corroborated by linguistic analysis. No such words were identified as predictive of race.</div></div><div><h3>Conclusion</h3><div>This pilot study suggests that while there are certain linguistic associations with gender among applications to pediatric otolaryngology fellowship, they may not impact biases held by the reader. This is relevant given a recent rise in the number of female applicants to this subspecialty and ongoing unfilled fellowship positions. Future studies are needed to determine if such associations exist and ultimately affect match potential and success within the field. These studies will require analysis of more letters and with more survey respondents, along with a higher in-depth linguistic analysis.</div></div><div><h3>Lay summary</h3><div>This pilot study aims to evaluate letters of recommendation for pediatric otolaryngology fellowship applications for gender bias with the goal of outlining future studies. There were certain words associated with a given gender, which could impact applicants’ potential to match.</div></div><div><h3>Level of evidence</h3><div>NA.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112121"},"PeriodicalIF":1.2,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377921","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}
Pub Date : 2024-09-25DOI: 10.1016/j.ijporl.2024.112118
Michael D. Puricelli
Objective
To characterize medical complexity and advanced interventions necessary to treat pediatric patients with chronic ear disease.
Methods
A retrospective case review of children who received surgery for chronic otitis media, cholesteatoma, or tympanic membrane perforation at a tertiary children's hospital from 2020 to 2024 was performed. The frequency and type of medical complexities as well as distribution and success of advanced otologic interventions were recorded.
Results
Operations were performed on 80 ears. Forty-five percent were in medically complex patients. Twenty-five percent had a syndrome, 13 % had American Society for Anesthesiologists Severity Class 3 or more, and 38 % attended multi-disciplinary programs. Advanced audiology testing protocols were utilized in 53 % of patients, and multiple children received complex sleep and airway operations. Advanced surgical techniques were required in 58 %. Post-operatively, an intact tympanic membrane was achieved in 95 % of operated ears (p < 0.01). Residual and recurrent cholesteatoma were each present in 5 % of cases, with mean follow-up of 11.6 months. Otorrhea reduced from 64 % of patients pre-operatively to 2 % post-operatively (p < 0.01), including cessation in all individuals who reported social/bullying issues related to ear drainage/odor. Unrestricted water exposure was achieved in 99 % of individuals (p < 0.01). Patients showed a mean improvement after surgery of 7.6 dB, as measured by the change in air-bone gap (p < 0.05). Conclusions: Comprehensive treatment of otologic conditions included care that was holistic of all medical needs, integrated with other services, developmentally appropriate, encompassing of non-otologic procedures, technically advanced, effective, and functionally-focused. Surgical teams should endeavor together to provide this combination of services.
{"title":"Comprehensive management of chronic ear disease: Consecutive patient analysis at a tertiary children's hospital","authors":"Michael D. Puricelli","doi":"10.1016/j.ijporl.2024.112118","DOIUrl":"10.1016/j.ijporl.2024.112118","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize medical complexity and advanced interventions necessary to treat pediatric patients with chronic ear disease.</div></div><div><h3>Methods</h3><div>A retrospective case review of children who received surgery for chronic otitis media, cholesteatoma, or tympanic membrane perforation at a tertiary children's hospital from 2020 to 2024 was performed. The frequency and type of medical complexities as well as distribution and success of advanced otologic interventions were recorded.</div></div><div><h3>Results</h3><div>Operations were performed on 80 ears. Forty-five percent were in medically complex patients. Twenty-five percent had a syndrome, 13 % had American Society for Anesthesiologists Severity Class 3 or more, and 38 % attended multi-disciplinary programs. Advanced audiology testing protocols were utilized in 53 % of patients, and multiple children received complex sleep and airway operations. Advanced surgical techniques were required in 58 %. Post-operatively, an intact tympanic membrane was achieved in 95 % of operated ears (p < 0.01). Residual and recurrent cholesteatoma were each present in 5 % of cases, with mean follow-up of 11.6 months. Otorrhea reduced from 64 % of patients pre-operatively to 2 % post-operatively (p < 0.01), including cessation in all individuals who reported social/bullying issues related to ear drainage/odor. Unrestricted water exposure was achieved in 99 % of individuals (p < 0.01). Patients showed a mean improvement after surgery of 7.6 dB, as measured by the change in air-bone gap (p < 0.05). <strong>Conclusions</strong>: Comprehensive treatment of otologic conditions included care that was holistic of all medical needs, integrated with other services, developmentally appropriate, encompassing of non-otologic procedures, technically advanced, effective, and functionally-focused. Surgical teams should endeavor together to provide this combination of services.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112118"},"PeriodicalIF":1.2,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365217","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}
The aim of this study was to measure tonsils and adenoid vegetations, investigate the modified Mallampati score, determine BMI according to body mass and corresponding percentile, and compare these data with the results of the Pediatric Sleep Questionnaire (PSQ). The subjects were children aged 2 to 18 who were indicated for adenotonsillectomy at the Clinic for Otorhinolaryngology and Head and Neck Surgery. A doctor specialist conducted the clinical examinations. According to the PSQ, 75 subjects were divided into two groups: those at high risk and those at low risk for developing obstructive sleep apnea (OSA). The PSQ results showed that 45 subjects (60 %) were at high risk for OSA, and these subjects had significantly lower weight and BMI. Although a higher number of subjects had grade 4 tonsils and grade 3 and 4 adenoids, this distribution was not statistically significant. There was no statistically significant difference in the distribution of the modified Mallampati score when compared with the PSQ results. Lower body mass and BMI were statistically significant risk factors for OSA, while the size of the tonsils and adenoids, as well as the modified Mallampati score, did not show any statistically significant difference in comparison with the PSQ results.
{"title":"Correlations between clinical parameters and PSQ in children with suspected OSA","authors":"Laura Jelušić , Hrvoje Vidić , Andrijana Včeva , Željko Zubčić , Hrvoje Mihalj , Zlatko Kljajić , Ivan Abičić , Kristina Kralik , Tihana Mendeš","doi":"10.1016/j.ijporl.2024.112120","DOIUrl":"10.1016/j.ijporl.2024.112120","url":null,"abstract":"<div><div>The aim of this study was to measure tonsils and adenoid vegetations, investigate the modified Mallampati score, determine BMI according to body mass and corresponding percentile, and compare these data with the results of the Pediatric Sleep Questionnaire (PSQ). The subjects were children aged 2 to 18 who were indicated for adenotonsillectomy at the Clinic for Otorhinolaryngology and Head and Neck Surgery. A doctor specialist conducted the clinical examinations. According to the PSQ, 75 subjects were divided into two groups: those at high risk and those at low risk for developing obstructive sleep apnea (OSA). The PSQ results showed that 45 subjects (60 %) were at high risk for OSA, and these subjects had significantly lower weight and BMI. Although a higher number of subjects had grade 4 tonsils and grade 3 and 4 adenoids, this distribution was not statistically significant. There was no statistically significant difference in the distribution of the modified Mallampati score when compared with the PSQ results. Lower body mass and BMI were statistically significant risk factors for OSA, while the size of the tonsils and adenoids, as well as the modified Mallampati score, did not show any statistically significant difference in comparison with the PSQ results.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112120"},"PeriodicalIF":1.2,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371799","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}
Pub Date : 2024-09-21DOI: 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.
{"title":"A Retrospective Study Distinguishing between Hyperacusis and Misophonia in children with Auditory Processing Disorder (APD)","authors":"Ansar Ahmmed, Sabarinath Vijayakumar","doi":"10.1016/j.ijporl.2024.112119","DOIUrl":"10.1016/j.ijporl.2024.112119","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Design</h3><div>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.</div></div><div><h3>Study sample</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112119"},"PeriodicalIF":1.2,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142327034","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}
Pub Date : 2024-09-20DOI: 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
{"title":"The AMSA® manosonic nebulizer for ENT disease among children in Poland","authors":"Magdalena Beata Skarżyńska , Elżbieta Gos , Milaine Dominici Sanfins , Patryk Hartwich , Piotr Henryk Skarżyński , Agata Szkiełkowska","doi":"10.1016/j.ijporl.2024.112113","DOIUrl":"10.1016/j.ijporl.2024.112113","url":null,"abstract":"<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","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112113"},"PeriodicalIF":1.2,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142319883","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}
Pub Date : 2024-09-18DOI: 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
{"title":"Pediatric parathyroid carcinoma and hyperparathyroidism-jaw tumor syndrome: A case report and literature review","authors":"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","doi":"10.1016/j.ijporl.2024.112116","DOIUrl":"10.1016/j.ijporl.2024.112116","url":null,"abstract":"","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112116"},"PeriodicalIF":1.2,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371800","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}
Pub Date : 2024-09-17DOI: 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.
{"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}
Pub Date : 2024-09-17DOI: 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.
{"title":"Dysphagia is a strong predictor of revision supraglottoplasty in pediatric laryngomalacia","authors":"Amy Callaghan , Hamdy El-Hakim , Amanda R. Adsett , Daniela M. Isaac , Andre Isaac","doi":"10.1016/j.ijporl.2024.112115","DOIUrl":"10.1016/j.ijporl.2024.112115","url":null,"abstract":"<div><h3>Background</h3><p>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.</p></div><div><h3>Hypothesis</h3><p>We predict a significant association between swallowing dysfunction and revision supraglottoplasty for patients with laryngomalacia.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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.</p></div><div><h3>Conclusion</h3><p>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.</p></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"186 ","pages":"Article 112115"},"PeriodicalIF":1.2,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0165587624002696/pdfft?md5=c5694037aea7c67be7a9f896b9cb098b&pid=1-s2.0-S0165587624002696-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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