International Journal Of Pediatric Otorhinolaryngology[JOURNAL]
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200 papers
Postoperative complications after injection laryngoplasty for minor laryngeal clefts.
Tamani Z, Mercier E, Bergeron M
Int J Pediatr Otorhinolaryngol · 2026 Jul · PMID 42402231 · Publisher ↗
OBJECTIVE: To describe the incidence, clinical presentation, and management of postoperative complications following injection laryngoplasty for minor laryngeal clefts and to assess their impact on postoperative dysphagi...
OBJECTIVE: To describe the incidence, clinical presentation, and management of postoperative complications following injection laryngoplasty for minor laryngeal clefts and to assess their impact on postoperative dysphagia evolution. METHODS: A unicentric retrospective case-control study of pediatric patients who underwent injection laryngoplasty for minor laryngeal clefts (hyaluronic acid-based injectable or sodium carboxymethylcellulose) between January 2018 and October 2025 in a tertiary pediatric center was conducted. Demographics, comorbidities, intraoperative variables, postoperative dysphagia outcomes, and Penetration-Aspiration Scale scores were analyzed. Ordinal logistic regression was used to evaluate the overall dysphagia trajectory. RESULTS: Among 48 patients, 10 (20.8%) developed postoperative complications. Case and control groups were comparable in age, sex, weight percentiles, gestational age and most comorbidities. Operative duration, injected volume, and intraoperative antibiotic use were similar (all p > 0.2). Swallowing outcomes (resolution, improvement, persistence, or worsening) did not differ between groups. Ordinal logistic regression showed no association between complications and the dysphagia trajectory (Odds ratio, OR 5.1, p = 0.2). PAS severity categories were also similar (p = 0.8). Patients with hyaluronic acid appeared to have more complications (26.5%) compared to methylcellulose (7.1%), despite not reaching statistical significance. CONCLUSION: Despite a higher-than-expected complication rate, postoperative inflammatory or infectious complications were not linked to worse swallowing function or higher PAS scores. These findings inform risk-benefit discussions and support informed shared decision-making with families regarding minor cleft treatment options.
Tranexamic acid and beyond: A systematic review of pediatric post-tonsillectomy hemorrhage protocols and introduction of a universal management guideline.
Casey C, MaGowan N, Rocker J … +1 more , Patel N
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42398383 · Publisher ↗
INTRODUCTION: Tonsillectomy is one of the most common procedures performed in children. A well-known complication of tonsillectomy is post-tonsillectomy hemorrhage (PTH). PTH is a very serious complication due to the pot...
INTRODUCTION: Tonsillectomy is one of the most common procedures performed in children. A well-known complication of tonsillectomy is post-tonsillectomy hemorrhage (PTH). PTH is a very serious complication due to the potential for airway compromise and severe bleeding. Most hospital protocols call for observation in scenarios where there is no active bleeding and return to operating room in situations where bleeding is not controlled. In recent years, the use of tranexamic acid (TXA), an antifibrinolytic agent, has been incorporated into the management of post-tonsillectomy bleeds, through nebulization and/or intravenously (IV). The goal of this study is to systematically review publicly available hospital protocols for the management of pediatric PTH, with particular focus on the incorporation of nebulized and/or IV TXA, and to introduce a universally applicable protocol for PTH management. METHODS: A systematic review of publicly available hospital protocols for pediatric PTH was conducted in accordance with PRISMA guidelines. The Children's Hospital Association (CHA) database was used to identify protocols that were publicly available, written in English, and specific to pediatric PTH management. The protocols were analyzed for key management domains including specialist consultation and use and dosing of nebulized and IV TXA. RESULTS: Through this systematic review, we identified 12 publicly available hospital PTH protocols, all developed at quaternary or near-quaternary centers. Of these protocols, 83% of protocols outline when to use nebulized TXA, whereas 67% of protocols outline when to use IV TXA and in total 67% include the use of both IV and nebulized TXA. Nebulized TXA was most consistently recommended for active bleeding, with IV TXA reserved for active or higher-volume bleeding. Our guideline recommends nebulized TXA for all PTH patients, with IV TXA for all active bleeding and on a case by case basis for controlled bleeding. CONCLUSION: This study reveals 12 publicly available pediatric PTH hospital protocols, 67% of which included the use of nebulized and IV TXA. Our guideline combines key practical management guidelines for PTH, including when to consult services like Interventional Radiology and PICU, and is designed for applicability beyond tertiary referral centers, providing a practical framework for frontline providers across a range of clinical settings.
Percutaneous contralateral vocal fold lateralization in pediatric bilateral vocal fold paralysis.
Avelino MAG, Bernardes MND, Ferri LA … +4 more , de Matos Moraes ME, de Castro Filho CG, Ribeiro TE, Coutinho MAC
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42398382 · Publisher ↗
OBJECTIVE: To describe a percutaneous contralateral vocal fold lateralization as an endoscopic technical modification procedure originally described by Lichtenberger for the management of pediatric bilateral vocal fold p...
OBJECTIVE: To describe a percutaneous contralateral vocal fold lateralization as an endoscopic technical modification procedure originally described by Lichtenberger for the management of pediatric bilateral vocal fold paralysis (BVFP), employing readily available materials, and to evaluate clinical outcomes in a public tertiary referral center. METHODS: This longitudinal observational case series included nine pediatric patients diagnosed with BVFP who had previously undergone tracheostomy and were managed at a tertiary university hospital in Central-West Brazil. Endoscopic vocal fold lateralization was performed using a 16-gauge peripheral intravenous catheter (Abocath®) as a substitute for the conventional Lichtenberger endo-extralaryngeal needle carrier. All procedures were conducted under general anesthesia with suspension laryngoscopy and endoscopic guidance. Postoperative primary outcome included respiratory status following decannulation over a minimum follow-up of six months, and secondary outcomes: phonatory quality, swallowing function, evidence of aspiration and other complications. RESULTS: The mean age at surgery was 4 years. The predominant etiology was idiopathic (7 cases), one neurologic and other cardiac causes. All patients achieved successful decannulation (100%). Transient postoperative dysphonia was observed in all cases. No major complications, including aspiration pneumonia or lower airway infections, were documented. Two patients required revision surgery, one with contralateral and other ipsilateral lateralization. Adequate glottic airway patency was achieved in all cases, with preservation of swallowing function and satisfactory phonatory outcomes. CONCLUSION: The proposed adaptation of the Lichtenberger vocal fold lateralization technique using a 16-gauge intravenous catheter is a safe, effective, and reproducible alternative for pediatric patients with BVFP. This low-cost modification facilitates successful decannulation while preserving laryngeal function, representing a valuable strategy in resource-limited settings and supporting vocal fold lateralization as a first-line surgical option in tracheostomized children with BVFP.
Outcomes of single-stage excision in infected preauricular sinus: a retrospective cohort study.
Nicholson OA, Levi E
Int J Pediatr Otorhinolaryngol · 2026 Jul · PMID 42391915 · Publisher ↗
BACKGROUND: Preauricular sinus is a common congenital malformation that can become infected. The traditional treatment paradigm has been to settle any infection followed by delayed second-stage excision. This has been th...
BACKGROUND: Preauricular sinus is a common congenital malformation that can become infected. The traditional treatment paradigm has been to settle any infection followed by delayed second-stage excision. This has been thought to achieve better post-operative outcomes and lower risk of recurrence. More recently, however, there have been studies reporting similar outcomes with emergency single-stage 'hot' excision. There are also few microbiological studies; hence, there is need to elucidate the bacteriology in an Australian population. METHOD: A 10-year retrospective review of preauricular sinuses treated with surgery by the Otolaryngology department at the Royal Children's Hospital, Melbourne. RESULTS: Seventy-six sinuses were treated with surgical excision. 70.7% of sinuses had been previously infected. Elective excision occurred in 85.5%, while the remaining 14.5% underwent single-stage excision. 36.8% of sinuses were actively infected at the time of excision even though they may have been elective cases. There were two cases of sinus recurrence in elective cases. There was no significant difference in recurrence rates with regards to previous infections, management of infections, active infection at the time of excision nor elective versus emergency single-stage excision. The most common microorganisms were anaerobes, staphylococcus aureus, and upper respiratory tract flora. Multiple organisms were implicated in 77.6% of cases. CONCLUSION: Traditionally, the treatment paradigm of infected preauricular sinuses has been to settle the infection followed by delayed second-stage excision. This study demonstrates that single-stage excision of actively infected sinuses is a safe and viable treatment option. We suggest the addition of anti-anaerobic antimicrobials in the treatment of infection.
Therapy changes in the treatment of subglottic laryngitis: A 30-year experience in Croatia.
Penezic A, Kelava I, Ivkic B … +3 more , Knez L, Geber G, Baudoin T
Int J Pediatr Otorhinolaryngol · 2026 May · PMID 42391914 · Publisher ↗
BACKGROUND: Croup (viral laryngotracheitis, also referred to in some settings as subglottic laryngitis) can cause acute upper-airway obstruction and requires prompt management to prevent respiratory compromise. This stud...
BACKGROUND: Croup (viral laryngotracheitis, also referred to in some settings as subglottic laryngitis) can cause acute upper-airway obstruction and requires prompt management to prevent respiratory compromise. This study evaluated long-term changes in reported croup management in Croatia. METHODS: Questionnaires were distributed to pediatricians and otolaryngologists in multiple Croatian hospitals in 1993, 2003, 2013, and 2023. A standardized clinical vignette of a 2-year-old child with mild-to-moderate croup was used for the core longitudinal comparisons. Categorical variables are reported as n (%) by specialty and survey year. The primary endpoint was the proportion of respondents selecting nebulized racemic epinephrine for the index vignette; other therapies and management choices were secondary endpoints. Trends over time were assessed using the Cochran-Armitage test and interpreted as exploratory. RESULTS: Over the 30-year period, the most notable change was the widespread adoption of nebulized racemic epinephrine (otolaryngologists: 3.3% in 1993 to 93.9% in 2023; pediatricians: 17.2% to 86.7%). Use of humidification showed a non-linear pattern, with an initial decline followed by a partial resurgence in both specialties. In contrast, use of antibiotics and antihistamines declined substantially in both groups. Corticosteroids, given systemically or by inhalation, remained a mainstay of treatment throughout the study period. CONCLUSION: Over three decades, reported management of croup in Croatia moved closer to contemporary evidence-based practice, particularly through adoption of nebulized epinephrine and reduced use of antibiotics and antihistamines.
Regional barriers and innovative solutions in the medical rehabilitation of children with cochlear implants in Uzbekistan: A telemonitored home-based versus center-based comparative study.
Kodirova FU, Safieva M, Sharofutdinova R … +3 more , Turgunboev SF, Berdiyorov K, Tuymurodov D
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42372483 · Publisher ↗
The purpose of this study was to compare an innovative home-based rehabilitation model supported by telemonitoring with conventional center-based rehabilitation for children with cochlear implants in Uzbekistan facing re...
The purpose of this study was to compare an innovative home-based rehabilitation model supported by telemonitoring with conventional center-based rehabilitation for children with cochlear implants in Uzbekistan facing regional access barriers. A prospective comparative pre-post intervention study was conducted over 12 weeks among 50 children aged 5-12 years with cochlear implants (control n = 20; intervention n = 30). Outcome measures included the Pediatric Balance Scale (PBS), Timed Up and Go (TUG) test, auditory-speech skill ratings across three domains (non-speech sound discrimination, speech sound discrimination, and sentence recognition), and a parent questionnaire assessing the home educational environment (n = 30). The results showed that the intervention group achieved greater functional improvement than the control group, with higher PBS at week 12 (42.5 ± 6.4 vs 37.8 ± 6.9; p = 0.020) and lower TUG time (9.1 ± 1.5 s vs 10.1 ± 1.7 s; p = 0.039). Improvements in auditory-speech skill distributions were observed in both groups, reflected by reductions in low-performance categories and increases in moderate and high-performance categories. However, between-group differences in auditory-speech outcomes were not statistically significant at baseline or week 12 (all p > 0.05). Parent questionnaire findings indicated inconsistent home-based support, including limited dedicated home learning space and difficulties understanding speech in public settings. These findings suggest that caregiver-supported home practice combined with telemonitoring may improve rehabilitation continuity and functional outcomes, particularly balance and mobility performance, in regions with limited access to specialized services. The impact of this study was to provide practical evidence that a hybrid home-plus-telemonitoring approach may strengthen functional rehabilitation outcomes and improve service accessibility for children with cochlear implants in access-limited settings in Uzbekistan.
Long-term quality of life outcomes after tympanostomy tube by surgical indication.
Kim MS, Sharma P, Irace A … +1 more , Dedhia K
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42365706 · Publisher ↗
OBJECTIVE: To compare longitudinal quality of life (QOL) outcomes among pediatric patients undergoing tympanostomy tube placement (TTP) for recurrent acute otitis media alone (rAOM), both rAOM and other indication(s), an...
OBJECTIVE: To compare longitudinal quality of life (QOL) outcomes among pediatric patients undergoing tympanostomy tube placement (TTP) for recurrent acute otitis media alone (rAOM), both rAOM and other indication(s), and other indication(s) alone, using the Otitis Media-6 (OM-6) questionnaire. METHODS: We conducted a retrospective cohort study of children aged 0-6 years who underwent TTP at a tertiary pediatric center between January 2020 and August 2024. Inclusion required completion of both preoperative and postoperative OM-6 surveys. The primary outcome was change in total OM-6 score over time, assessed at 0-2, 2-6, 6-12, 12-18, and 18-24 months postoperatively. Analysis used inverse probability weighting and linear mixed-effects regression (LMER) adjusted for sociodemographic and clinical covariates. RESULTS: Among 7800 subjects, 4511 (57.8%) underwent surgery for rAOM alone, 2462 (31.6%) for mixed indications, and 827 (10.6%) for other indications alone. At baseline, children in the rAOM and mixed groups had significantly worse QOL than those with other indications alone. Across all follow-up intervals, children with rAOM or mixed indications demonstrated significantly greater improvement in total OM-6 scores compared with other-indication alone. Domain-specific analyses showed greater improvement in caregiver concerns, activity limitations, emotional distress, and physical suffering among children with rAOM, whereas hearing-related improvement was greatest in the other-indication groups. CONCLUSION: TTP resulted in sustained long-term QOL improvements across all indication groups. Despite worse baseline scores in the rAOM group, this group had proportionally greater improvement in total OM-6 scores, leading to similar long-term total OM-6 scores across indications.
Prevalence of high risk for obstructive sleep apnea and its impact on quality of life in children with overweight and obesity.
Suriyasathaporn J, Tanphaichitr A, Densupsoontorn N … +6 more , Saengpanit P, Ungkanont K, Banhiran W, Vathanophas V, Wannarong T, Gozal D
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42364422 · Publisher ↗
STUDY OBJECTIVES: To determine the prevalence of high risk for obstructive sleep apnea (OSA) in children with overweight and obesity and evaluate its impact on quality of life. METHODS: We conducted a cross-sectional stu...
STUDY OBJECTIVES: To determine the prevalence of high risk for obstructive sleep apnea (OSA) in children with overweight and obesity and evaluate its impact on quality of life. METHODS: We conducted a cross-sectional study of children aged 2-12 years diagnosed with overweight or obesity according to World Health Organization body mass index-for-age z-scores (BMIz). OSA risk and quality of life were assessed using the Thai version of the Pediatric Obstructive Sleep Apnea Screening Tool (POSAST) and the OSA-18 questionnaire, respectively. Physical examination included standardized tonsillar assessment using the Brodsky grading scale. Logistic regression models adjusted for potential confounders were applied in the data analyses. RESULTS: Among 68 children with overweight and obesity, the prevalence of high OSA risk was 41.2% based on POSAST criteria. Tonsillar hypertrophy was the strongest predictor of high OSA risk (adjusted OR: 10.92, 95% CI: 3.04-39.15, p < 0.001). Twenty-one percent of children experienced moderate to severe quality-of-life impairment. High OSA risk (adjusted OR: 14.59, 95% CI: 1.94-109.86, p = 0.009) and attention-deficit hyperactivity disorder (adjusted OR: 11.84, 95% CI: 1.52-92.14, p = 0.02) were independently associated with diminished quality of life after controlling for age, sex, and obesity severity. CONCLUSIONS: High OSA risk is prevalent among Thai children with overweight and obesity and significantly impairs their quality of life. Tonsillar hypertrophy represents a major treatable risk factor. These findings underscore the need for systematic OSA screening in pediatric obesity clinics and integration of quality-of-life assessments into routine clinical practice.
National trends in pediatric concurrent inferior turbinate reduction with tonsillectomy and adenoidectomy.
Naranjo C, Ceremsak J, O'Brien KJ … +2 more , Whigham AS, Belcher RH
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42348979 · Publisher ↗
OBJECTIVE: To examine the national trends in tonsillectomy and adenoidectomy (TA) with concurrent inferior turbinate reduction (ITR) over a 10-year period. METHODS: Retrospective analysis of a one percent random sample f...
OBJECTIVE: To examine the national trends in tonsillectomy and adenoidectomy (TA) with concurrent inferior turbinate reduction (ITR) over a 10-year period. METHODS: Retrospective analysis of a one percent random sample from the Merative MarketScan Commercial Claims and Encounters (CCAE) database from 2015 through 2024. Pediatric patients (<18 years) with an outpatient claim for TA or TA with concurrent ITR were included. The primary outcome included the annual rate of concurrent ITR. Secondary outcomes included the annual rates of concurrent ITR stratified by patient age group, associated preoperative nasal diagnoses, turbinate procedure type, postoperative bleeding complications and readmission rates. RESULTS: Of 11,174 TA procedures, 586 (5.2%) included a concurrent ITR. The annual rate of these paired procedures remained stable across the study period, with a transient increase during the COVID-19 pandemic (range 4.5-8.3%, Cochran-Armitage p = 0.43). Concurrent ITR increased significantly with patient age (X = 123.8, p < 0.0001), with adolescents (13-17 years) at four times the rate of young children (0-3 years) (10.7% vs 2.6%). Submucous resection was performed in 304 of 586 cases (52%). Concurrent ITR was not independently associated with increased risk of postoperative hemorrhage (OR 1.29, 95% CI 0.67-2.27, p = 0.41) or 30-day readmission (OR 0.64, 95% CI 0.16-1.74, p = 0.46). CONCLUSION: Concurrent ITR is performed in approximately 1 in 20 pediatric TAs at a stable overall rate over the past decade. Utilization is higher in older patients, submucous resection is most performed, postoperative bleeding complications and 30-day readmissions are rare.
Language outcomes following pediatric cochlear implantation: Associations with clinical, socioeconomic, and rehabilitation factors.
Tutar M, Ray T, Parchure S … +4 more , Escobar P, Johnson A, Nunez C, Pritchett C
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42330611 · Publisher ↗
OBJECTIVE: Language outcomes after pediatric cochlear implantation vary widely and are not fully explained by established clinical factors such as age at implantation and neurodevelopmental comorbidities. This study exam...
OBJECTIVE: Language outcomes after pediatric cochlear implantation vary widely and are not fully explained by established clinical factors such as age at implantation and neurodevelopmental comorbidities. This study examined the associations between selected clinical, socioeconomic, and appointment-related factors and receptive and expressive language outcomes following cochlear implantation. METHODS: We conducted a retrospective cohort study of children with congenital bilateral severe-to-profound sensorineural hearing loss who underwent cochlear implantation, received post implantation Auditory Verbal Therapy and completed post-implant language assessments using the Preschool Language Scale, Fifth Edition. Receptive and expressive language age-equivalent scores were analyzed over two years after activation (n = 36). A subset of children with at least two post-implant language assessments available (n = 17) was included in secondary analyses estimating language development rates. Associations between language outcomes and first-year post-activation appointment measures, clinical factors, and socioeconomic variables were evaluated using nonparametric tests and linear regression. RESULTS: Post-activation appointment count emerged as the factor most consistently associated with language outcomes. Higher appointment attendance was associated with higher receptive and expressive language scores beginning approximately one year after activation and persisting through later hearing-age intervals. Neurodevelopmental diagnosis was associated with lower receptive and expressive language scores at hearing age 4. In longitudinal analyses, appointment volume remained significantly associated with expressive language development rate after adjustment for available covariates. Receptive language outcomes demonstrated greater variability across hearing ages, and no variables were significantly associated with receptive language development rate. CONCLUSIONS: Higher appointment attendance was consistently associated with more favorable language outcomes following pediatric cochlear implantation. Whether this association reflects increased rehabilitation exposure, broader family and social factors, or a combination of these influences remains uncertain.
Cesarean section and maternal atopy increase the risk of allergic rhinitis in offspring: a case-control study.
Liu Z, Zeng Y, Zhao R … +5 more , Xiang Z, Li J, Gong X, Liu M, Dong Y
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42322725 · Publisher ↗
OBJECTIVE: To assess the interaction between cesarean section (CS) and maternal history of allergic diseases (MHAD) in influencing the risk of allergic rhinitis in the offspring. METHODS: A case-control study was conduct...
OBJECTIVE: To assess the interaction between cesarean section (CS) and maternal history of allergic diseases (MHAD) in influencing the risk of allergic rhinitis in the offspring. METHODS: A case-control study was conducted with a 1:1 frequency matching by sex. A total of 239 children diagnosed with AR were enrolled in the case group, and 239 children without a history of AR served as the control group. Logistic regression models were used to analyze the association between maternal CS, MHAD, and the risk of AR in offspring. Interaction effects were evaluated using both the multiplicative and additive models. RESULTS: The CS (50.7%) and MHAD (36.8%) rates in the case group were significantly higher than those in the control group (35.1% and 27.6%, respectively). Logistic regression analysis revealed that maternal CS (OR = 1.916, 95%CI:1.322-2.778, P < 0.001) and MHAD (OR = 1.585, 95%CI:1.071-2.344, P = 0.021) were independent risk factors for AR in offspring. Furthermore, a significant multiplicative interaction was observed between maternal CS and MHAD (OR = 3.472, 95% CI:1.497-8.053, P = 0.004), with the combined effect increasing the risk by 5.619 times. CONCLUSION: Maternal CS and MHAD synergistically increase the risk of AR in children. These findings underscore the importance of considering both maternal CS and MHAD when developing public health strategies and preventive interventions to reduce the incidence of AR in the offspring.
Outcomes of pediatric prophylactic thyroidectomy in MEN2: A systematic review.
Lee I, Pierre Z, Naranjo C … +5 more , Sharma R, Thompson DK, Bartz S, Lopez ME, Belcher RH
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42322724 · Publisher ↗
Abstract loading — click title to view on PubMed.
Comparative study of the post-helical crus approach for excision of classic preauricular sinuses.
Zhang H, Gao Y, Dou X
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42322723 · Publisher ↗
BACKGROUND: The standard Pre-helical Crus Approach (Pre-HCA) for preauricular sinus excision often leaves a visible scar. OBJECTIVE: To investigate the feasibility of the Post-helical Crus Approach (Po-HCA) for the excis...
BACKGROUND: The standard Pre-helical Crus Approach (Pre-HCA) for preauricular sinus excision often leaves a visible scar. OBJECTIVE: To investigate the feasibility of the Post-helical Crus Approach (Po-HCA) for the excision of classic preauricular sinuses in pediatric patients. METHODS: The differences between Po-HCA and the Pre-HCA were analyzed regarding total incision length, sinus incision length, operative time, postoperative wound infection rate, and recurrence rate. RESULTS: The Po-HCA achieved a significantly shorter sinus incision length (0.2 ± 0.004) compared to the Pre-HC (2.02 ± 0.09) (P < 0.05). No statistically significant differences were observed between the two groups in total incision length, operative time, postoperative wound infection rate, or recurrence rate (all P > 0.05). CONCLUSION: The Po-HCA technique offers a safe and effective alternative for excising classic preauricular sinuses in the non-infected stage, with the advantage of a minimal visible scar (0.2) compared to conventional approaches.
Corrigendum to "The effects of maturation on auditory brainstem response latencies and amplitudes using CE-Chirp® LS stimulus in a pediatric population" [Int. J. Pediatr. Otorhinolaryngol. 201 (2026) 112711].
Kaynakoğlu B, Sendesen İ, Sendesen E
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42321087 · Publisher ↗
Abstract loading — click title to view on PubMed.
Use of palliative care services in NICU patients undergoing tracheostomy: Enhancing decision-making and care with an underutilized discipline.
Alperin K, Said M, Espinel AG … +3 more , Lloyd AM, Behzadpour HK, Bauman NM
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42320446 · Publisher ↗
INTRODUCTION: Palliative care provides a proactive, family-centered approach for infants with life-threatening conditions. We examined the frequency of palliative care consultations among NICU tracheostomy patients and t...
INTRODUCTION: Palliative care provides a proactive, family-centered approach for infants with life-threatening conditions. We examined the frequency of palliative care consultations among NICU tracheostomy patients and their associated demographics, hypothesizing that it is mainly used for high-risk infants but could benefit a broader group. METHODS: Charts of all NICU patients who underwent tracheostomy between 1/1/2012-12/31/2020 at a tertiary care NICU were reviewed for demographics, comorbidities, and palliative care consults. Outcomes were compared for preoperative consult vs. no-consult groups using chi-square and fisher's exact tests, with significance set at p < 0.05. RESULTS: Among 171 infants, 13.5% received perioperative palliative care consults. Sex did not differ, but race did (p < 0.001), with African-American/Black infants predominating. Infants receiving palliative care consults had greater gestational age (36.7 vs 32.5 weeks, p = 0.02), more neurologic indications (43.5% vs 17.5%, p = 0.01), and fewer cardiac (21.9% vs 57.1%, p = 0.002) and pulmonary comorbidities (34.8% vs 59.1%, p = 0.04). Median rates of perioperative consults were higher in the consulted group (15 vs 13, p = 0.04). No differences were seen in rates of discharge on a ventilator (95.6% vs 80.5%, p = 0.1), 1-year decannulation (0% vs 3.4%, p = 1), or mortality (4.4% vs 12.2%, p = 0.5). At 5 years, palliative care patients were less likely to be decannulated (4.35% vs 35.81%, p = 0.001), with no differences in mortality (47.83% vs 32.43%, p = 0.2). CONCLUSIONS: Palliative care was underutilized in NICU tracheostomy patients. Consults were more frequent in neurologic cases and less common in cardiac, pulmonary, or anatomic obstruction, despite similarly complex post-discharge courses. Expanding palliative care access in this population could improve family-centered decision-making, coordination, and long-term planning.
Mandibular distraction osteogenesis in Robin sequence: identifying the optimal timing: A systematic review.
Tabchi Y, Bentahar O
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42320445 · Publisher ↗
Abstract loading — click title to view on PubMed.
How acceptable is high-intensity speech intervention for children with a cleft palate? A qualitative study.
Alighieri C, Van Lierde K
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42314520 · Publisher ↗
PURPOSE: This study investigated the retrospective acceptability of high-intensive (10 1-hr speech intervention sessions divided over 2 weeks) versus low-intensive (10 1-hr speech intervention sessions divided over 10 we...
PURPOSE: This study investigated the retrospective acceptability of high-intensive (10 1-hr speech intervention sessions divided over 2 weeks) versus low-intensive (10 1-hr speech intervention sessions divided over 10 weeks) speech intervention from the perspective of children with a cleft palate using the theoretical framework of acceptability (TFA). METHODS: Eleven children (aged 6 to 12 years) with a cleft palate who either received high-intensive speech intervention (n = 6) or low-intensive intervention (n = 5) were recruited. Child-friendly, participatory-based, semi-structured interviews were conducted to investigate children's experiences with speech intervention dosage. The TFA was used to analyse the data deductively. RESULTS: Children shared varied experiences of high- versus low-intensive speech intervention. In terms of affective attitude, some children felt happy attending frequent sessions because their speech could "get better faster," while others described feeling tired. Children linked more sessions with quicker progress. Despite the burden of more frequent appointments, several noted they were "less likely to quit" because the total intervention time was shorter. Some children understood why they were doing the exercises, while others did not know about the purpose of speech intervention. Some children felt that frequent practice made intervention feel more important. CONCLUSIONS: Speech intervention planning should consider not only clinical effectiveness but also how acceptable the approach is from the child's perspective. It is important to align intervention intensity with children's emotional responses and daily lives. A flexible approach that balances intensity with individual child preferences may support better adherence and long-term success.
Allergic rhinitis in children in relation to sleep breathing disorders: a meta-analysis.
Li Q, Zhong Q, Kong X … +7 more , Bai S, Cai J, Yang X, Tai X, Li Z, Liu J, Liu T
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42302637 · Publisher ↗
INTRODUCTION: To investigate the relationship between allergic rhinitis (AR) and sleep-disordered breathing (SDB) in the pediatric population. METHODS: We searched PubMed, Embase, Web of Science, and the Cochrane Library...
INTRODUCTION: To investigate the relationship between allergic rhinitis (AR) and sleep-disordered breathing (SDB) in the pediatric population. METHODS: We searched PubMed, Embase, Web of Science, and the Cochrane Library from databases' inception to November 10, 2022, and included studies that reported results in AR children with SDB or habitual snoring (HS). The pooled prevalence of HS and SDB and odds ratio (OR) with 95% confidence intervals (CIs) was calculated for each analysis of the outcome using the random-effects model. RESULTS: A total of 17 studies involving 32,907 children were included. The pooled prevalence of HS was 0.04 (95% CI: 0.02-0.07; I = 98%, p < 0.0001). The overall OR for AR in the HS group compared with the non-HS group was 2.24 (95% CI: 1.66-3.02; z = 5.28, p < 0.0001; I = 34%, p = 0.1972). For the comparison between SDB and non-SDB groups, the OR was 1.49 (95% CI: 1.12-1.98; z = 2.77, p = 0.0056; I = 77%, p < 0.0001) (test for subgroup differences: p = 0.0540). Additionally, the pooled OR for AR in OSA versus non-OSA was 1.23 (95% CI: 1.04-1.46; z = 2.40, p = 0.0164; I = 46%, p = 0.0738). CONCLUSIONS: This updated meta-analysis suggest a positive association between AR and SDB in children.
Predicting abnormal auditory brainstem response outcomes using risk factors.
Leno M, Sharghi S, Wei JL
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42296693 · Publisher ↗
BACKGROUND: Auditory brainstem response (ABR) testing diagnoses hearing loss in children unable to complete behavioral audiometry. ABR evaluations have been scheduled for 60-min operating room (OR) blocks regardless of h...
BACKGROUND: Auditory brainstem response (ABR) testing diagnoses hearing loss in children unable to complete behavioral audiometry. ABR evaluations have been scheduled for 60-min operating room (OR) blocks regardless of hearing loss risk, resulting in poor utilization and prolonged wait times. At Akron Children's Hospital, wait times averaged 82 days. However, 63% of cases demonstrated normal hearing and were completed in under 60 min. No validated tool predicts abnormal ABR results prior to scheduling. A predictive model based on clinical risk factors could optimize OR block utilization and improve access. METHODS: We conducted a retrospective study of 239 children who underwent sedated ABR testing between February 2024 and September 2025. Risk factors collected from electronic health records included autism, cardiac diagnosis, congenital CMV, hyperbilirubinemia, neurologic diagnoses, trauma, universal newborn hearing screening (UNHS) referral, family history of hearing loss, parental speech/hearing concern, NICU stay, prematurity, and syndrome diagnosis. Candidate models were compared using stratified 4-fold cross-validation; logistic regression was selected as the primary model and evaluated using discrimination, calibration, and clinical utility. RESULTS: The model demonstrated moderate discrimination (AUC ≈ 0.68). UNHS referral and syndrome diagnosis showed increased abnormal ABR risk. Autism diagnosis was associated with decreased risk. At a 35% risk threshold, the model identified 53% of abnormal cases with 75% specificity and 49% positive predictive value. CONCLUSIONS: A pre-test risk stratification model can moderately discriminate children at higher risk for abnormal ABR, with potential to improve OR block utilization, patient access, and workflow efficiency.
Diagnostic accuracy of bone-conducted cervical vestibular- evoked myogenic potentials in early infancy: a prospective cohort study.
Karpeta N, Verrecchia L, Duan M
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42296692 · Publisher ↗
BACKGROUND/OBJECTIVES: Vestibular function assessment in infants is demanding. To develop age-appropriate methods for vestibular investigation early in infancy and in newborns we studied whether Bone-Conducted cervical V...
BACKGROUND/OBJECTIVES: Vestibular function assessment in infants is demanding. To develop age-appropriate methods for vestibular investigation early in infancy and in newborns we studied whether Bone-Conducted cervical Vestibular-Evoked Myogenic Potentials (BCcVEMP) is an accurate method. We also outlined BCcVEMP wave values in early infancy and compared them with values obtained at one year of age in the same cohort. MATERIALS AND METHODS: A total of 53 infants and newborn were included in the study (median age 6.4 weeks, IQR 8.29). Referrals were made to a university-affiliated audiology and neurotology department due to perinatal risk factors for inner ear impairment. The study was conducted between January 2021 and March 2023. We tested BCcVEMP in all participants within a few weeks after birth. The same group was tested again at approximately one year of age with the same protocol. We assessed each ear independently and recorded responses in the number of ears. We calculated and compared BCcVEMP wave latencies and amplitudes between the two test trials. RESULTS: We identified vestibular responses in 72.6% of the tested ears (n = 77 ears) during the newborn and early infancy testing and in 94% (n = 92 ears) during the one-year follow up. There was a 75% chance of a response in the first test among the infants with a positive predictive value of 94.5%.Wave reproducibility (WR) was significantly higher at follow-up, while P13, N23 and P13-N23 were significantly shorter than at early in infancy testing; no statistically significant difference was observed in the P13-N13 scaled amplitude ratio between the two time points. CONCLUSIONS: Our findings support the use of BCcVEMP as an accurate method to confirm vestibular function early in infancy and it can be used for vestibular assessment beside the hearing screening; the test should only be repeated in those cases with a failed outcome.
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