International journal of pediatric otorhinolaryngology最新文献

{"title":"Genotypes and clinical phenotypes of pediatric patients with NOG variants: Middle ear surgical outcomes from a Tertiary Center in South Korea","authors":"Sang-Yoon Han ,&nbsp;Sung Ho Cho ,&nbsp;Sung Ho Jung ,&nbsp;Myeongsin Kang ,&nbsp;Myung-Whan Suh ,&nbsp;Moo Kyun Park ,&nbsp;Jun Ho Lee ,&nbsp;Sang-Yeon Lee","doi":"10.1016/j.ijporl.2025.112230","DOIUrl":"10.1016/j.ijporl.2025.112230","url":null,"abstract":"<div><h3>Objective</h3><div>Although <em>NOG</em> variants are linked to congenital stapes fixation and conductive hearing loss (CHL), little is known about middle ear surgery outcomes and the characteristics of accompanying inner ear anomalies. We explored auditory phenotypes in patients with <em>NOG</em> variants, with a focus on the outcomes of middle ear surgery.</div></div><div><h3>Methods</h3><div>This study included 11 patients from five unrelated Korean families harboring <em>NOG</em> variants. Genomic investigations were conducted using whole-exome sequencing and whole-genome sequencing. The clinical phenotypes, including pre- and postoperative audiological profiles, radiological abnormalities, and other comorbidities, were analyzed.</div></div><div><h3>Results</h3><div>The average age at genetic testing was 8.2 years (range, 0–13 years). Two previously reported <em>NOG</em> variants (c.509C &gt; T:p.Pro170Leu and c.252dup:p.Glu85ArgfsTer97) and three novel <em>NOG</em> variants, including the c.187G &gt; T: p.Glu63Ter and two cryptic large deletion within the 17q22.2 region, were identified. All patients exhibited non-progressive CHL. Inner ear anomalies were documented in two patients, with variations such as cochlea and vestibular dysplasia. In this study, seven ears of four patients underwent stapedotomy, resulting in a significantly reduced air-bone gap of 10.18 ± 1.48 dB (<em>P</em> = 0.016), with sustained improvement. Conversely, patients carrying p.Pro170Leu variant, which is associated with poor outcomes for middle ear surgery, were excluded from surgical consideration.</div></div><div><h3>Conclusion</h3><div>We expanded the spectrum of genotypes and auditory phenotypes associated with <em>NOG</em> variants. Surgical intervention for CHL underlying <em>NOG</em> variants elicits favorable outcomes. However, clinicians should consider the potential for poor prognosis in certain <em>NOG</em> variants. Collectively, identifying <em>NOG</em> variants could guide the treatment strategies to improve CHL.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"189 ","pages":"Article 112230"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005406","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}

{"title":"Aspirated foreign bodies in children: 10-Years experience in a single tertiary centre in New Zealand","authors":"Jae Hyun Jeong ,&nbsp;Jeyasakthy Saniasiaya ,&nbsp;Craig McCaffer","doi":"10.1016/j.ijporl.2025.112234","DOIUrl":"10.1016/j.ijporl.2025.112234","url":null,"abstract":"<div><h3>Objective</h3><div>Aspirated foreign bodies (FB) are potentially life-threatening conditions which can be challenging to diagnose in children. The previous similar study from our hospital, published in 2014, created a guideline suggesting when to proceed to laryngobronchoscopy (LB) in suspected FB aspiration with over 99 % sensitivity. The grading system included the presence or absence of acute history, positive examination, and/or radiological findings, including witnessed choking, dysphonia, stridor, wheezing, or reduced air entry on examination or abnormal radiological findings. The current study reviewed a further 10 years and 5 months of data to re-evaluate the ongoing diagnostic usefulness of the three positive findings in children with suspicion of aspirated FB.</div></div><div><h3>Methods</h3><div>We undertook a retrospective review of all LB performed at our institution for suspected acute FB aspiration from August 2013 to January 2023. We analysed patient characteristics, clinical examination, radiological findings, and outcomes.</div></div><div><h3>Results</h3><div>We found a total of 100 children under the age of 16 years who underwent LB for suspected FB aspiration. The mean age of our study population was 2.6 years. The population demographics were similar to the results from the previous study from our institution, with Māori and Pasifika children having the highest probability of finding a FB on LB. Male children presenting for suspected FB aspiration are 1.39 times more likely than female children to have a foreign body at LB (p = 0.04). Overall, having two or more positive findings had a sensitivity of 100 %. History or examination alone are more sensitive (both 95.6 %) but less specific (12.5 % and 31.3 %, respectively). Abnormal radiology alone was more specific (75.0) but less sensitive (77.9 %). The most common site of FB was the right bronchial tree (45.6 %), followed by the left (39.7 %). 95 % of FB were organic, and 54 % were nuts. The negative bronchoscopy rate was 32 %.</div></div><div><h3>Conclusion</h3><div>Two or more positive indicators in history, examination and radiological findings continue to be highly sensitive predictors for the presence of an aspirated foreign body in our paediatric population. We recommend a future large-scale multicentre study to confirm how applicable these findings would be to a broader cohort of patients.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"189 ","pages":"Article 112234"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005382","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}

{"title":"Analysis of the therapeutic effect of EarWell ear orthotics on elderly children with congenital ear deformities within 98 days","authors":"Jie OuYang,&nbsp;Xiaoqin Wang","doi":"10.1016/j.ijporl.2025.112236","DOIUrl":"10.1016/j.ijporl.2025.112236","url":null,"abstract":"<div><h3>Objective</h3><div>To observe the efficacy of EarWell ear orthotics in treating congenital ear deformities in older children (≥7 weeks) within 98 days.</div></div><div><h3>Method</h3><div>A retrospective study was conducted on 58 infants (69 ears) aged 7–14 weeks after birth. Divided into three groups: A (7–9 weeks old, 26 ears), B (10–12 weeks old, 23 ears), and C (13–14 weeks old, 20 ears). Analyze the differences in treatment time, effective rate, six-month recurrence rate, and incidence of complications among three age groups.</div></div><div><h3>Result</h3><div>Age group A had the shortest treatment time (25.13 ± 3.28d) and the highest effective rate (84.61 %), while age group C had the longest treatment time (48.35 ± 7.64d) and the lowest effective rate (60.00 %), with statistically significant differences (p &lt; 0.05); The six-month recurrence rate and incidence of complications in the A age group were lower than the other two groups, and the difference was statistically significant (p &lt; 0.05); The recurrence cases in the three age groups are mainly concentrated in the cup ear and the prominent ear.</div></div><div><h3>Conclusion</h3><div>EarWell ear orthotics can still be chosen for morphological correction of congenital ear deformities in children aged 7–14 weeks. However, the effectiveness of treatment may be affected by the age of treatment and the type of malformation. The older the age of treatment, the lower the effectiveness of orthosis treatment, the longer the treatment time, and the higher the probability of complications. Cup ears and prominent ear over 7 weeks old have a higher recurrence rate after treatment, and it is recommended to correct them as soon as possible.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"189 ","pages":"Article 112236"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023401","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}

{"title":"Comparative analysis of small-incision and traditional techniques in costal cartilage harvesting: Outcomes on thoracic deformities and scar appearance","authors":"Jiajun Zhi ,&nbsp;Yicheng Liu ,&nbsp;Xiaochen Sun,&nbsp;Jingwei Feng,&nbsp;Guanwen Ding,&nbsp;Bo Pan,&nbsp;Chuan Li","doi":"10.1016/j.ijporl.2025.112235","DOIUrl":"10.1016/j.ijporl.2025.112235","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to compare the postoperative thoracic deformity and scar aesthetic outcomes of auricular reconstruction between the conventional large-incision technique and small-incision technique with perichondrium preservation for costal cartilage harvesting.</div></div><div><h3>Methods</h3><div>A retrospective analysis was performed on 134 patients who underwent auricular reconstruction using tissue expanders and autologous costal cartilage harvested from the right chest wall between January 2021 and September 2023. Patients were divided into two groups according to the harvesting technique: the traditional large-incision group (n = 64) and the small-incision group with perichondrium preservation (n = 70). Preoperative and postoperative chest CT scans were reviewed for thoracic deformities by measurements of the modified Haller Index (mHI) and modified correction index (mCI). Thoracic scar dimensions were measured in postoperative follow-up.</div></div><div><h3>Results</h3><div>In the conventional group, significant difference were observed between the left and right hemithorax in anterior-posterior diameter, maximum transverse diameter, cross-sectional area, and mHI values (p &lt; 0.05), showing thoracic deformities. In contrast, within the small-incision group, there were no significant differences between hemithoraces. Additionally, postoperative thoracic scars were significantly smaller in the small-incision group, with shorter scar length (5.63 ± 1.33 cm vs. 11.44 ± 1.31 cm) and width (1.41 ± 0.55 cm vs. 3.75 ± 1.54 cm; p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The small-incision technique with perichondrium preservation significantly reduces postoperative thoracic deformities and results in smaller, less conspicuous scars compared to the traditional large-incision method. This approach minimizes disruption to the chest wall structure and reduces donor-site morbidity, offering improved patient outcomes.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"189 ","pages":"Article 112235"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028784","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}

{"title":"Indications for tracheostomy placement in pediatric patients with cerebral palsy","authors":"Elizabeth Fisher ,&nbsp;Taher Valika","doi":"10.1016/j.ijporl.2025.112226","DOIUrl":"10.1016/j.ijporl.2025.112226","url":null,"abstract":"<div><h3>Background</h3><div>Cerebral palsy (CP) is the most common neuromuscular disorder in children, and children with CP are at increased risk of respiratory distress potentially requiring tracheostomy placement. Previous studies have characterized indications for tracheostomy in neurologically compromised children, however no studies focus specifically on children with CP. The purpose of this study was to identify the indications for tracheostomy placement, sites of airway obstruction, and rate of decannulation in children with CP.</div></div><div><h3>Methods</h3><div>We conducted a single-center retrospective chart review of all patients who presented with cerebral palsy and required tracheostomy at our center between 2005 and 2023. Patients were categorized according to primary indication for tracheostomy placement. The most common sites of airway obstruction in the cohort were recorded. The date of decannulation was recorded for those patients who had undergone decannulation.</div></div><div><h3>Results</h3><div>933 patients with tracheostomies were identified, of whom 169 (18 %) had CP and 122 met inclusion criteria. The median age at tracheostomy placement was 1.69 (IQR 0.539–6.609) years. The most common indications for tracheostomy placement were: prolonged intubation or BiPAP dependence (81 %), airway obstruction/hypotonia (13 %), and aspiration/recurrent respiratory infection (6 %). At the time of tracheostomy placement: 38 % of patients had a single site of upper airway obstruction, while 27 % had multi-level obstruction. The most common sites of upper airway obstruction were the supraglottis (23.0 %), tongue base (12 %), and the tonsils/pharyngeal wall (8 %). 24 % of patients had tracheobronchomalacia, and 16 % had subglottic stenosis. Among all patients, 4 of 122 (3 %) were ultimately decannulated.</div></div><div><h3>Conclusions</h3><div>Patients in our cohort most often received tracheostomy after failure of less invasive ventilation therapies. Tracheostomy placement occurred at a young age. Patients presented with a variety of sites of airway obstruction. Decannulation rate in this cohort was low. Further work is needed to confirm indications for tracheostomy placement and decannulation rate in this population.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"189 ","pages":"Article 112226"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965037","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}

{"title":"Parental anxiety and catastrophizing in pediatric tonsillectomy pain control: A multivariate analysis","authors":"Ben B. Levy ,&nbsp;Jennifer M. Siu ,&nbsp;Brittany N. Rosenbloom ,&nbsp;Melanie Noel ,&nbsp;Tanya Chen ,&nbsp;Nikolaus E. Wolter","doi":"10.1016/j.ijporl.2025.112244","DOIUrl":"10.1016/j.ijporl.2025.112244","url":null,"abstract":"<div><h3>Objective</h3><div>Parental anxiety and/or catastrophizing may bias the interpretation of children's pain and administration of analgesia post-tonsillectomy. We aimed to determine whether high levels of parental anxiety and/or catastrophizing impact child pain intensity interpretation and administration of analgesia.</div></div><div><h3>Methods</h3><div>Child-parent dyads were recruited from a tertiary care institution between July 2017–December 2019. Preoperative parental anxiety and catastrophizing were assessed using self-report measures. Postoperative data on child and parent pain intensity, as well as analgesia use, were collected up to 2 weeks post-surgery. Multivariable logistic regression models were created to assess predictors of postoperative child pain intensity and analgesia use.</div></div><div><h3>Results</h3><div>Our cohort included 234 child-parent dyads. Median child age was 5 years (IQR, 4–6), and 9.0 % of children (n = 21) had a medical comorbidity. Both child- and parent-reported pain intensity were highest on postoperative day 2 (3.65 [SD = 3.08] and 3.67 [SD = 2.51], respectively). Parental catastrophizing did not predict analgesia use at home, although a minimal significant decrease in the odds of analgesia administration was observed on postoperative day 7 (OR 0.932, <em>p</em> = 0.017). Maximal parental anxiety did not predict higher odds of increased child postoperative pain intensity on any postoperative day.</div></div><div><h3>Conclusion</h3><div>Parental catastrophizing prior to tonsillectomy has minimal predictive value for analgesia use postoperatively. Children may be successfully advocating for their own pain control as parental anxiety and catastrophizing do not appear to be unduly influencing analgesia administration. Future studies should explore the impact of parental anxiety on vulnerable pediatric populations who may be unable to self-advocate for pain management.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"190 ","pages":"Article 112244"},"PeriodicalIF":1.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255666","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}

{"title":"Pneumococcal revaccination in pediatric patients with sinusitis","authors":"William G. Cohen ,&nbsp;Chau Phung ,&nbsp;Dominick Rich ,&nbsp;Fengling Hu ,&nbsp;Jana Bradley ,&nbsp;Mark D. Rizzi ,&nbsp;Adva Buzi","doi":"10.1016/j.ijporl.2025.112242","DOIUrl":"10.1016/j.ijporl.2025.112242","url":null,"abstract":"<div><h3>Objectives</h3><div>In pediatric patients with sinusitis and suspected low pneumococcal antibody titers, we aimed to determine the association between a pneumococcal polysaccharide vaccine booster dose (PPSV23) and healthcare utilization.</div></div><div><h3>Methods</h3><div>Pediatric patients with a diagnosis of sinusitis, a PPSV23 booster dose, and pre-vaccine anti-pneumococcal antibody titers (age 2–16) were abstracted from the medical records system. Sinusitis-related healthcare encounters and antibiotic prescriptions were measured for 2 years before and after PPSV23 vaccination. A mixed effects negative binomial regression was utilized to compare pre and post-vaccine healthcare utilization while accounting for age and sex.</div></div><div><h3>Results</h3><div>A total of 233 patients were included in the study analysis. Mean age at pre-vaccination titer was 7.99 years (±3.83), 47 (20.2 %) were immunocompromised, and nearly all patients received the complete childhood pneumococcal vaccine series. When comparing pre and post-vaccination periods, encounters decreased from an average of 2.70 (95 % CI: [2.29, 3.10]) to 1.23 (95 % CI: [1.00, 1.46]). Antibiotic prescriptions decreased from 2.58 (95 % CI: [2.17, 2.98]) to 1.18 (95 % CI: [0.93, 1.42]). Mixed effects modeling demonstrated the number of encounters after vaccination decreased 51.1 % as compared to before vaccination (95 % CI: [42.9, 58.2], p &lt; 0.001) and the number of antibiotic prescriptions decreased 51.3 % (95 % CI: [42.9 %, 58.6 %], p &lt; 0.001). Among immunocompromised patients, encounters were decreased by 46.9 % (95 % CI: [26.2 %, 62.1 %], p &lt; 0.001) and antibiotic prescriptions by 49.2 % (95 % CI: [28.5 %, 64.2 %], p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>PPSV23 booster vaccination was associated with a significant decrease in sinusitis-related healthcare encounters and antibiotic use among pediatric patients, including those who are immunocompromised.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"190 ","pages":"Article 112242"},"PeriodicalIF":1.2,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255668","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}

{"title":"Acute mastoiditis: 30 years review in a tertiary hospital","authors":"Aida Veiga-Alonso ,&nbsp;Natalia Roldán-Pascual ,&nbsp;Rosa María Pérez-Mora ,&nbsp;Beatriz Jiménez-Montero ,&nbsp;María Jesús Cabero-Pérez ,&nbsp;Carmelo Morales-Angulo","doi":"10.1016/j.ijporl.2024.112204","DOIUrl":"10.1016/j.ijporl.2024.112204","url":null,"abstract":"<div><h3>Objective</h3><div>Acute mastoiditis, the most common complication of acute otitis media, is approached in our study, focused on children from the Autonomous Community of Cantabria, Spain. The aim is to analyze its clinical-epidemiological characteristics and propose diagnostic and treatment recommendations.</div></div><div><h3>Study design/setting</h3><div>We conducted a 30-year retrospective study on patients under 18 years of age diagnosed with acute mastoiditis in Cantabria.</div></div><div><h3>Methods</h3><div>We analysed epidemiological data, clinical presentation, causes, treatment, and follow-up.</div></div><div><h3>Results</h3><div>We included 111 patients, 60.4 % of which were under 2 years old. The average incidence was 3.9/100,000 children per year. Streptococcus pneumoniae was the most common microorganism. Third-generation cephalosporins and amoxicillin-clavulanic acid were the most frequently used antibiotics. 19 % of patients underwent temporal bone CT scans. Twenty-nine children required surgical intervention, primarily myringotomy and mastoidectomy. Only 5.4 % developed retroauricular abscesses. During follow-up, 32 % experienced new acute otitis media cases.</div></div><div><h3>Conclusions</h3><div>The incidence of acute mastoiditis in Cantabria is similar to that of other developed countries. Imaging studies are reserved for cases with poor progression. Conservative management with antibiotics is suitable for many patients, with surgery reserved for poor responders. Complications are rare in our setting.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"188 ","pages":"Article 112204"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872028","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}

{"title":"Pediatric cochlear implantation in otitis media with effusion: Are ventilation tubes truly necessary?","authors":"Erim Pamuk,&nbsp;Ergin Eroğlu,&nbsp;Levent Sennaroğlu","doi":"10.1016/j.ijporl.2024.112203","DOIUrl":"10.1016/j.ijporl.2024.112203","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to evaluate the clinical findings of our cochlear implant (CI) patients with otitis media with effusion (OME) and CI patients treated with ventilation tube (VT) for OME.</div></div><div><h3>Methods</h3><div>The medical records of patients who underwent CI surgery at Hacettepe University, Department of Otorhinolaryngology, between November 1997 and March 2023 were reviewed. Patients who had OME or VT in the implanted ear at the time of surgery were included in the study. Perioperative findings, complication status, revision status, and reasons for revision were recorded.</div></div><div><h3>Results</h3><div>A total of 2945 ears were operated for cochlear implantation during this period. Of these cases, 169 (5.7 %) had OME and 55 (1.86 %) had VT at time of surgery (180 patients). There were no significant differences between the two groups regarding demographic parameters and follow-up time. None of the investigated parameters showed any significant differences between the two groups, except for revision status. The revision rate was significantly higher in the OME group than that in the VT group (10.65 % vs. null, p = 0.008). The total non-OME and non-VT patient cohort had a significantly lower revision rates than the OME group (5.29 % vs. 10.65 %, p = 0.003).</div></div><div><h3>Conclusion</h3><div>There is no significant difference in surgical difficulty and perioperative complications after CI between patients with VT and those with OME. The relationship between a higher rate of revision and OME in CI patients, and the optimal timing and necessity of VT insertion prior to CI surgery, should be further investigated.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"188 ","pages":"Article 112203"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872030","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}

{"title":"Long-term outcomes of pediatric temporal bone fractures with hearing loss: Results of a multinational database analysis","authors":"Jason L. Steele ,&nbsp;Heather J. Smith ,&nbsp;Samira Takkoush ,&nbsp;Jumah G. Ahmad ,&nbsp;Zachary D. Urdang ,&nbsp;Neil S. Patel ,&nbsp;Richard K. Gurgel ,&nbsp;Mana Espahbodi","doi":"10.1016/j.ijporl.2024.112186","DOIUrl":"10.1016/j.ijporl.2024.112186","url":null,"abstract":"<div><h3>Introduction</h3><div>Pediatric temporal bone fractures (TBFs) can result in adverse outcomes including meningitis, significant sensorineural hearing loss requiring cochlear implantation (CI), facial nerve weakness, cerebrospinal fluid (CSF) leak, and labyrinthitis. The objective of this study is to determine the risks of these outcomes for TBFs with hearing loss.</div></div><div><h3>Methods</h3><div>Using the multinational TriNetX database, a retrospective cohort study was performed of patients less than 18 years old with diagnostic codes for <em>other fracture of base of skull</em> and <em>hearing loss</em> to serve as an approximation of TBF. This classification excluded all TBFs without hearing loss. An age- and sex-matched control cohort was selected without the above-mentioned diagnostic codes. More than 95 % of patient data used is from 2006-present, with an average of 12–14 years of data per health care organization. Measured outcomes included meningitis, CI, facial nerve disorders (including facial nerve weakness, lagophthalmos, and eyelid weight placement for lagophthalmos), CSF leak and labyrinthitis after TBF. Risk ratios were calculated after 1:1 propensity-score matching (PSM) for age and sex.</div></div><div><h3>Results</h3><div>TriNetX identified 2739 pediatric patients (mean age of 7.61 ± 4.39 years) with TBF and an age- and sex-matched cohort of 2739 pediatric patients without TBF (mean age of 7.58 ± 4.37 years). Those with TBF had a greater risk of developing meningitis (RR: 2.90, 95 % CI: 1.42–5.94) and facial nerve disorders (RR: 13.44, 95 % CI: 8.83–20.45) at any time than those without TBF. Matched results were not available for labyrinthitis, CI or CSF leak, as there were multiple instances in the Pediatric TBF cohort versus zero instances in the Control cohort. Results prior to PSM demonstrated an increased risk for labyrinthitis (RR: 43.12, 95 % CI: 23.17–80.27), CI (RR: 21.61, 95 % CI: 13.03–35.84) and CSF leak (89.08, 95 % CI: 67.71–117.20) in the pediatric TBF cohort compared with the cohort without TBF.</div></div><div><h3>Discussion</h3><div>Pediatric patients who sustain TBF with hearing loss are at increased risk of subsequent meningitis and facial nerve disorders and may also be at increased risk of labyrinthitis, CSF leak, and undergoing CI.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"188 ","pages":"Article 112186"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894345","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}