International Journal Of Pediatric Otorhinolaryngology[JOURNAL]
Sun
200 papers
Perioperative nursing based on the rapid rehabilitation concept reduces pain, accelerates recovery, and improves quality of life in children undergoing adenoidectomy.
Li Y, Wu J, Zhang Z … +2 more , Sun Y, Li N
Int J Pediatr Otorhinolaryngol · 2026 Jul · PMID 42229112 · Publisher ↗
BACKGROUND: The rapid rehabilitation concept is widely adopted in adult surgery but remains underexplored in pediatric otolaryngology. This study evaluated enhanced perioperative nursing based on this concept in children...
BACKGROUND: The rapid rehabilitation concept is widely adopted in adult surgery but remains underexplored in pediatric otolaryngology. This study evaluated enhanced perioperative nursing based on this concept in children undergoing endoscopic adenoidectomy. METHODS: In this prospective quasi-experimental study, 102 children (aged 1 to 12 years) undergoing endoscopic adenoidectomy were allocated to an observation group (OG, n = 51) receiving enhanced perioperative nursing (preoperative psychological preparation and carbohydrate loading, intraoperative normothermia, postoperative multimodal analgesia, early nutrition, and graded mobilization) or a control group (CG, n = 51) receiving routine care. The primary outcome was pain at postoperative day 3 (FLACC scale). Secondary outcomes included hospital stay, symptom resolution, quality of life (OSA-18), complications, and parental satisfaction. RESULTS: The OG had significantly lower FLACC pain scores at day 3 (median 2.0 vs. 4.0; p < 0.001; r = 0.62) and shorter hospital stay (4.2 vs. 5.8 days; p < 0.001; d = 1.33). Resolution of nasal congestion, rhinorrhea, nasal flaring, and sleep snoring was significantly faster (all p < 0.001; d = 1.05 to 1.29). At 3 months, OSA-18 scores were lower across all five dimensions (all p < 0.001; d = 0.87 to 1.07). Complication rates were lower (2.0% vs. 13.7%; p = 0.028), with higher compliance (96.1% vs. 84.3%; p = 0.046) and parental satisfaction (98.0% vs. 82.4%; p = 0.007). CONCLUSION: Perioperative nursing based on the rapid rehabilitation concept improved pain control, accelerated recovery, enhanced quality of life, and increased compliance and parental satisfaction in children undergoing adenoidectomy.
Exploring one aspect of family-centered practice: Readability of written documents to support parental understanding and decision-making regarding cochlear implants.
Dettman S, Wong R, Lettieri S … +2 more , Courtenay D, Leigh J
Int J Pediatr Otorhinolaryngol · 2026 Jul · PMID 42229111 · Publisher ↗
PURPOSE: This exploratory study examined whether CI medical file documents met family-centered criteria for accessibility and readability, that is, could the average parent understand these documents? METHODS: The access...
PURPOSE: This exploratory study examined whether CI medical file documents met family-centered criteria for accessibility and readability, that is, could the average parent understand these documents? METHODS: The accessibility and readability of written documents used in one cochlear implant (CI) program were studied using two approaches. First, clinicians were asked to recall and rank their most complex cases. Files were reviewed for seven of the most complex cases. All tailored written documents relating to each child's CI candidacy, expectations, meetings, and counselling that had been shared with parents were reviewed. Second, five iterations of the generic CI surgical consent and information form from the same CI program were gathered. All documents were subjected to two readability scales: Flesch-Kincaid Grade Level and Fry's Readability Graph. RESULTS: Of the 58 tailored documents in files that considered candidacy/expectations, 27 were shared with parents (45.8%). The mean Flesch-Kincaid Grade Level for these 27 documents was 12.4 (range 11.2 - 13.0; SD 0.64) and the mean Fry Score was 13.6 (range 12.0 - 15.7; SD 1.24). The mean Flesch-Kincaid score for the generic CI surgical consent and information forms from 2000 to 2017 was 11.8 (range 10.9 - 12.9; SD 0.66) and the mean Fry Score was 14.4 (range 13 - 16; SD 1.02). CONCLUSIONS: Readability levels for both the tailored candidacy/expectations documents and the generic CI surgical consent and information forms were higher than average adult reading levels and did not meet recommended readability targets for patient education material. CI programs should plan to share all counselling/expectation documents with parents and could apply simple readability formulae to improve family-centered engagement, empowerment and understanding.
Tracheitis after pediatric tracheostomy: A NSQIP analysis.
Larson J, Lavin J, Rowland M … +1 more , Hazkani I
Int J Pediatr Otorhinolaryngol · 2026 Jul · PMID 42215001 · Publisher ↗
INTRODUCTION: Tracheostomy-associated tracheitis is a common postoperative complication in children, yet its early incidence and risk factors remain poorly defined. OBJECTIVE: To identify predictors and outcomes of trach...
INTRODUCTION: Tracheostomy-associated tracheitis is a common postoperative complication in children, yet its early incidence and risk factors remain poorly defined. OBJECTIVE: To identify predictors and outcomes of tracheitis within 30 days following pediatric tracheostomy. METHODS: The NSQIP-P database (2019-2023) was queried for children undergoing tracheostomy. Postoperative tracheitis within 30 days was defined by new positive tracheal cultures and antibiotic treatment. Associations with demographic and clinical variables were assessed using Poisson regression with robust variance to estimate adjusted risk ratios, with propensity score weighting and stratified analyses used to evaluate the impact of baseline illness severity. RESULTS: Among 5,784 tracheostomies, 652 (11.3%) developed tracheitis at a mean of 11 ± 8 days postoperatively. Preoperative steroid use (excluding a single dose), nutritional support, cardiac comorbidities, and unplanned postoperative intubation were associated with increased risk in unadjusted analyses. Associations for steroid use, nutritional support, and cardiac comorbidities persisted in ASA-stratified analyses and exposure-specific propensity score-weighted models. Age, gestational age, ASA classification, and chronic lung disease were not independently associated. Patients with tracheitis had higher rates of pneumonia (11.5% vs 4.6%) and sepsis (20.7% vs 4.3%), as well as longer hospital stays (all p < 0.001). CONCLUSIONS: Tracheitis occurred in 11% of children within 30 days of tracheostomy and was associated with increased odds of pneumonia, sepsis, and longer hospital stay. Associations with preoperative factors were partly explained by baseline illness severity but persisted within comparable severity groups. Early identification of high-risk patients may inform targeted prevention and quality improvement efforts.
Parapharyngeal sialoblastoma: Systematic literature review.
Wirth L, Ewert I, Kumar R … +1 more , Levi E
Int J Pediatr Otorhinolaryngol · 2026 Jul · PMID 42215000 · Publisher ↗
A 2-year-old female presented with an enlarging right parotid mass that was reported as a sialoblastoma on initial incisional biopsy. She underwent subsequent total parotidectomy and infratemporal fossa clearance with ad...
A 2-year-old female presented with an enlarging right parotid mass that was reported as a sialoblastoma on initial incisional biopsy. She underwent subsequent total parotidectomy and infratemporal fossa clearance with adjuvant chemotherapy. At 5-year follow-up, she is disease-free having undergone costochondral TMJ reconstruction and facial nerve reanimation. Sialoblastoma is a rare salivary gland tumour typically presenting in early childhood. This study aims to review the available literature on sialoblastomas to inform contemporary practice. A systematic review was performed to identify articles describing cases of sialoblastoma for extraction of data regarding presentation, investigation, management and outcomes. Sixty-six articles describing 92 cases were included. Age at initial presentation ranged from birth to 83 years with 70.3% of patients aged one year or younger with no sex predilection. Tumours were most commonly in the parotid region followed by submandibular region. Imaging features are generally benign due to a lack of infiltrative borders. Surgery is the usual first line treatment. Eleven patients had metastasis, and six had synchronous hepatoblastoma. Patients were followed for an average of 4.4 years with seven reported deaths and 23 recurrences on average 18.1 months after initial treatment. Sialoblastoma should be considered as a differential diagnosis in infants or toddlers presenting with a salivary gland mass. Tissue diagnosis should be established prior to complete onocologic resection with adjuvant chemotherapy if indicated. Additionally, patients should be screened for synchronous hepatoblastoma due to high rate of synchronicity. Close oncosurveillance is recommended due to high recurrence.
Common Otolaryngologic Clinical Manifestations and Symptoms of Langerhans Cell Histiocytosis and Evaluation of Treatment Regimens in Pediatric Patients: A Systematic Review and Meta-Analysis.
Zhang K, Dweydari M, Alshaikh A … +4 more , Banerjee S, Balaji S, Zhu C, Harley E
Int J Pediatr Otorhinolaryngol · 2026 Jul · PMID 42214999 · Publisher ↗
Langerhans Cell Histiocytosis (LCH) is a rare clonal disorder that frequently involves the head and neck in pediatric patients, often presenting with nonspecific otolaryngologic symptoms that can delay diagnosis. This sy...
Langerhans Cell Histiocytosis (LCH) is a rare clonal disorder that frequently involves the head and neck in pediatric patients, often presenting with nonspecific otolaryngologic symptoms that can delay diagnosis. This systematic review and meta-analysis aimed to characterize the otolaryngologic manifestations of pediatric LCH and evaluate current treatment strategies and clinical outcomes. A comprehensive search of Ovid MEDLINE, Embase, Cochrane CENTRAL, and Web of Science was conducted through June 2025. Studies were included if they involved patients under 18 years of age with head and neck manifestations of LCH and reported treatment modalities and outcomes. Twenty studies comprising 885 pediatric patients met inclusion criteria. The most common head and neck manifestation was skull involvement (48.8%, 95% CI: 38.1%-59.8%), with temporal bone lesions frequently reported. Otologic involvement occurred in 36.8% (95% CI: 21.8%-54.8%) of patients, and otorrhea was the most common presenting symptom (22.8%, 95% CI: 10.6%-42.6%). These findings highlight the potential for LCH to mimic chronic or refractory ear infections. Systemic chemotherapy was the most commonly utilized treatment modality. Overall remission was achieved in 55.2% (95% CI: 36.8%-72.2%), while recurrence occurred in 20% of patients and mortality attributable to LCH was 11.5%. Pediatric LCH frequently presents with nonspecific otologic complaints, particularly persistent otorrhea, warranting heightened clinical suspicion in refractory cases. Although many patients achieve remission, recurrence and mortality remain significant, warranting further investigation into effective treatment protocols.
Lesion location and surgical outcomes in pediatric frontonasal and orbital dermoid cysts: A systematic review.
Gierlotka A, Bielecki I
Int J Pediatr Otorhinolaryngol · 2026 Jul · PMID 42214998 · Publisher ↗
OBJECTIVE: This systematic review aimed to answer the clinically relevant question of whether lesion location (midline versus periorbital) is associated with differences in risk of intracranial extension, operative strat...
OBJECTIVE: This systematic review aimed to answer the clinically relevant question of whether lesion location (midline versus periorbital) is associated with differences in risk of intracranial extension, operative strategy, and recurrence in pediatric frontonasal and orbital dermoid cysts. DATA SOURCES: MEDLINE, Embase, Cochrane Library, and ScienceDirect were searched for studies published between 2000 and 2025. REVIEW METHODS: Eligible studies included pediatric patients with histopathologically confirmed dermoid cysts involving the frontonasal or periorbital regions. Data on demographics, lesion location, intracranial extension, surgical approach, and recurrence were extracted and synthesized. RESULTS: 39 studies encompassing 766 pediatric patients were included. Patients were divided into three groups: Type I (37.9%) - lateral dermoids (eyebrow/orbital); Type II (42%) - midline superficial dermoids without a sinus tract; and Type III (20.1%) - midline dermoids with a sinus tract, with or without intracranial extension. Intracranial extension was identified in 68 of 766 patients. Almost all cases occurred in children with midline lesions; only two patients with orbital dermoid cysts had intracranial extension. Recurrence occurred in 29 of 763 evaluable patients. CONCLUSIONS: This systematic review demonstrates that lesion location is the key determinant of clinical behavior in pediatric frontonasal and orbital dermoid cysts. Lateral periorbital lesions are typically superficial and associated with a low risk of complications, whereas midline lesions carry a significantly higher risk of sinus tract formation, intracranial extension, and postoperative recurrence. The choice of surgical approach should be individualized based on lesion location, depth, and extension, balancing adequate exposure with optimal cosmetic and functional outcomes.
Click and chirp evoked auditory brainstem responses in infants whose mothers had COVID-19 during pregnancy.
Veeranna SA, Marx CG
Int J Pediatr Otorhinolaryngol · 2026 Jul · PMID 42208271 · Publisher ↗
AIM: Recent studies have reported that COVID-19 and its complications during pregnancy are not a risk for hearing loss. However, there is limited research on examining auditory brainstem response (ABR) latencies in infan...
AIM: Recent studies have reported that COVID-19 and its complications during pregnancy are not a risk for hearing loss. However, there is limited research on examining auditory brainstem response (ABR) latencies in infants whose mothers had COVID-19 during pregnancy. Hence, in this study, ABRs were recorded using condensation and rarefaction click polarities, as well as for CE-Chirp® stimuli, in infants whose mothers had COVID-19 during pregnancy and those whose mothers did not. METHODS: In total, 27 infants whose mothers had COVID-19 during pregnancy and 32 infants whose mothers did not report COVID-19 during pregnancy participated in this study. Distortion product otoacoustic emissions (DPOAEs) were recorded. ABRs (at 70 dB nHL) for the click stimulus were recorded using condensation and rarefaction polarities. Whereas the ABRs for the CE-Chirp® stimuli were recorded only for rarefaction polarity. Absolute peak latencies (I, III, and V), I-V interpeak intervals, peak-to-peak amplitudes (I and V), and amplitude ratios (V/I) were examined. RESULTS: DPOAEs were similar between groups. ABR analyses showed no differences in peak I latencies between groups, but absolute latencies of peak III and V and I-V interpeak intervals for both condensation and rarefaction click polarities were significantly different between groups. Peak I amplitudes for both click polarities were similar between groups, but peak V amplitudes were significantly smaller in infants of mothers with COVID-19 during pregnancy. Peak I latencies of CE-Chirp® evoked ABRs were similar between groups, but latencies of III and V and I-V interpeak intervals were significantly prolonged in infants of mothers with COVID-19 during pregnancy, compared to those without. CONCLUSION: ABRs were atypical, regardless of the stimulus polarities or type in infants whose mothers had COVID-19 during pregnancy. Along with threshold assessment, the audiologist should prioritize evaluating ABRs recorded at higher intensity levels.
Post-tonsillectomy hemorrhage following ketorolac in children: A 2010-2024 national database analysis.
Hamdi O, Wershoven N, Hill M … +3 more , Janosy N, Friedman N, Gitomer SA
Int J Pediatr Otorhinolaryngol · 2026 Jul · PMID 42202390 · Publisher ↗
OBJECTIVE: To determine whether ketorolac improves clinical outcomes without increasing the risk of a primary post-tonsillectomy hemorrhage. We hypothesized that early administration of ketorolac following a tonsillectom...
OBJECTIVE: To determine whether ketorolac improves clinical outcomes without increasing the risk of a primary post-tonsillectomy hemorrhage. We hypothesized that early administration of ketorolac following a tonsillectomy would be associated with decreased health care utilization without increasing the risk of a primary post-tonsillectomy hemorrhage. METHODS: We performed a retrospective cohort study using a national administrative claims dataset of pediatric tonsillectomies performed between 2010 and 2024. Children younger than 19 years undergoing tonsillectomy with or without adenoidectomy were included; those with bleeding disorders were excluded. Exposure was defined as ketorolac administration within 24 h postoperatively. Primary outcomes were PTH within 14 days and return to the operating room within 48 h. Secondary outcomes included time-to-hemorrhage using Kaplan-Meier analysis, hemorrhage hazard via Cox proportional hazards modeling, ED utilization, and total 14-day episode-of-care cost. RESULTS: Among 1,958,742 pediatric tonsillectomies, 2208 (0.11%) patients received ketorolac. PTH occurred in 1.90% of ketorolac recipients compared to 1.02% without ketorolac (P < .0001). Return to the operating room within 48 h occurred in 0.72% vs. 0.12% (P < .0001). Kaplan-Meier analysis demonstrated significantly earlier bleeding among ketorolac recipients (log-rank P = .00003). Cox modeling demonstrated increased hazard of hemorrhage among ketorolac recipients (HR 1.88; 95% CI, 1.39-2.55; P < .005). ED utilization within 14 days was significantly higher among ketorolac recipients. Mean 14-day cost was $1743 among ketorolac recipients and $1350 among non-recipients (+29%). CONCLUSION: Immediate postoperative ketorolac use was associated with increased and earlier PTH, greater early ED utilization, and higher short-term healthcare cost. These findingscontribute important contemporary evidence regarding the association between ketorolac use and hemorrhage-related outcomes following pediatric tonsillectomy.
A qualitative analysis of the experiences of pioneering females in pediatric otolaryngology.
Scholes MA, Don DM, Chan KH
Int J Pediatr Otorhinolaryngol · 2026 Jul · PMID 42202389 · Publisher ↗
OBJECTIVES: This qualitative study of women leaders in pediatric otolaryngology explores challenges and obstacles they have faced because of their gender. Their advice for current and current female pediatric otolaryngol...
OBJECTIVES: This qualitative study of women leaders in pediatric otolaryngology explores challenges and obstacles they have faced because of their gender. Their advice for current and current female pediatric otolaryngologists was also examined. METHODS: A semi-structured interview format of identified early women leaders in pediatric otolaryngology was created to gather subjective data from chosen respondents. An opt-in survey was used that consisted of six, two-part questions developed via Delphi methodology and consensus. Respondent answers to the survey questions were analyzed manually using grounded theory techniques in qualitative analysis. RESULTS: Nine female pediatric otolaryngologists were ultimately interviewed, and their responses showed common themes including mentorship, discrimination, devaluation, and the use of coping mechanisms. Themes on advice for current and future female pediatric otolaryngologists included self-care, perseverance and adaptability. Importantly, active discrimination was noted to still exist. CONCLUSIONS: Qualitative analysis uncovered common themes experienced by female pediatric otolaryngologists when examining how gender affected their career paths. The themes and advice for other women in pediatric otolaryngology provide important knowledge and perspective that can be used to address ongoing discrimination and bias. LEVEL OF EVIDENCE: 5 (Qualitative Analysis).
Association between autoimmune disease and obstructive sleep apnea in a pediatric population.
Sorrentino JM, Franz BS, Varavenkataraman G … +3 more , Han T, Piccillo EM, Carr MM
Int J Pediatr Otorhinolaryngol · 2026 Jul · PMID 42172808 · Publisher ↗
OBJECTIVE: Autoimmune diseases (AD) and Obstructive Sleep Apnea (OSA) both involve systemic inflammation, though their relationship is unclear. This study evaluates the association between AD and OSA, identifies specific...
OBJECTIVE: Autoimmune diseases (AD) and Obstructive Sleep Apnea (OSA) both involve systemic inflammation, though their relationship is unclear. This study evaluates the association between AD and OSA, identifies specific associated ADs, and examines tonsillectomy rates and post-tonsillectomy bleeding in pediatric patients with and without AD. METHODS: This retrospective analysis used the TriNetX United States Collaborative Network database, focusing on pediatric patients aged 2-17 years with outpatient visits. After identifying over 7.3 million patients, children with 18 specific ADs were matched 1:1 by age, sex, race, and ethnicity with non-AD controls. The primary analysis assessed the odds of having OSA in patients with and without AD. Additionally, we examined the rates of tonsillectomy and the likelihood of post-tonsillectomy bleeding in OSA patients with and without AD. RESULTS: 160,517 patients with AD were matched with 160,517 patients without AD. Mean age is 4.2 years and mostly female (81,157, 50.6%). AD patients were significantly more likely to have OSA (OR = 2.283 ± 0.08, p < .0001). Strongest associations were found with necrotizing vasculopathy (OR = 3.571 ± 0.87), connective tissue disease (OR = 3.103 ± 0.30), multiple sclerosis (OR = 3.037 ± 1.07), systemic lupus erythematosus (OR = 2.644 ± 0.83), rheumatoid arthritis (OR = 2.406 ± 0.68), and ulcerative colitis (OR = 2.377 ± 0.45) (p < .001 for all). OSA patients with AD were less likely to undergo tonsillectomy (3752 (39.7%) vs. 3975 (42.0%), OR = 0.91 ± 0.05, p = .001) but faced a higher post-tonsillectomy bleeding risk (232(5.7%) vs. 177(4.4%), OR = 1.33 ± 0.24, p = .005). CONCLUSION: Children with AD are more likely to have OSA than children without AD, emphasizing the need for careful management, especially when surgical options are considered.
Corrigendum to "Long term effectiveness of Solo+ TTD: A single step tympanostomy tube (TT) delivery device" [Int. J. Pediatr. Otorhinolaryngol. 198, (November 2025), 112567].
McCormick ME, Preciado DA, Chun RH … +14 more , Reilly BK, Shay SG, Link R, Peterson K, Behzadpour HK, Baumgartner I, Anderson S, Jansen K, Daniel M, Kane E, Theriault T, Zetzer E, Davis L, Kerschner JE
Int J Pediatr Otorhinolaryngol · 2026 May · PMID 42150963 · Publisher ↗
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Predicting and preventing tracheostomy risk in pediatrics: Development and pilot testing of a focused assessment tool.
Brooks R, Chen P, Johnson R … +10 more , Chorney S, Sewell A, Smith C, Whitney C, Hogan C, Ganwerker E, Kou YF, Wang C, Abu L, Walker D
Int J Pediatr Otorhinolaryngol · 2026 Jul · PMID 42143906 · Publisher ↗
BACKGROUND: Tracheostomy dependent patients are at risk for adverse events such as accidental decannulation, potentially causing serious harm, prolonging hospital stays, and increasing medical care costs. However, standa...
BACKGROUND: Tracheostomy dependent patients are at risk for adverse events such as accidental decannulation, potentially causing serious harm, prolonging hospital stays, and increasing medical care costs. However, standardized tools for risk identification do not exist. PURPOSE: This study aimed to develop and evaluate the Children's Health Decannulation Risk Assessment Tool (CH-DRAT), a focused assessment instrument designed to reduce the risk of accidental decannulation in pediatric hospitalized patients. METHODS: Following instrument development, content validation and inter rater reliability assessment, a pilot study was conducted to assess the CH-DRAT's psychometric properties. Predictive validity was examined using clinical outcomes, while sensitivity, specificity, and reliability were evaluated through statistical analysis of pilot data. RESULTS: The CHDRAT demonstrated predictive validity and strong sensitivity and specificity. During the study period there was a statistically significant 37% reduction in accidental decannulation rates compared to the year before. CONCLUSION: Findings suggest that CHDRAT is a reliable and valid instrument for assessing accidental decannulation risk in pediatric patients, with potential to improve clinical decision-making and patient outcomes.
Newborn hearing screening in infants at risk of hearing loss: diagnostic outcomes, false-negative results, and the role of surveillance.
Lund A, Nielsen CK, Jensen RB … +3 more , Thuesen M, Madsen A, Devantier L
Int J Pediatr Otorhinolaryngol · 2026 Jul · PMID 42143905 · Publisher ↗
BACKGROUND: Newborn hearing screening programmes aim to identify hearing loss early; however, infants with recognised risk factors may have different screening outcomes, including false-negative results. This study evalu...
BACKGROUND: Newborn hearing screening programmes aim to identify hearing loss early; however, infants with recognised risk factors may have different screening outcomes, including false-negative results. This study evaluates screening outcomes, diagnostic yield, and false-negative rates among at-risk infants. DESIGN: This retrospective observational study included infants screened in the Central Denmark Region between 2019 and 2023 using automated auditory brainstem response (AABR) and transient evoked otoacoustic emissions (TEOAE), followed by structured audiological surveillance. Among 72,335 screened infants, 1206 at-risk infants were referred to the Department of Audiology, Aarhus University Hospital, Denmark, and included in the analysis. RESULTS: At the initial audiological assessment, 1086 infants (90.1%) were discharged with normal hearing, whereas 120 (9.9%) had persistent abnormal findings and underwent further evaluation. Permanent hearing loss was diagnosed in 46 infants (3.8% of referred infants; diagnostic yield 54.7%), including 41 with sensorineural hearing loss and five with auditory neuropathy spectrum disorder. False-negative results occurred in both modalities but were more frequent for AABR than for OAE-based testing (26.6% vs. 6.9%, p < 0.001). Several infants with hearing loss initially passed screening and were identified only through repeat testing or surveillance. CONCLUSIONS: At-risk infants with persistent abnormal screening findings represent a subgroup with a high probability of permanent hearing loss. False-negative screening results highlight the importance of continued surveillance beyond the newborn period.
Pediatric laryngeal lymphoma: A systematic review of clinical presentation, management, and outcomes.
Boot M, Niles N, Lee J
Int J Pediatr Otorhinolaryngol · 2026 Jul · PMID 42143904 · Publisher ↗
AIM: Pediatric laryngeal lymphoma is a rare malignancy, with limited guidance available to inform diagnosis and management. This systematic review aims to synthesize published cases to characterize epidemiology, clinical...
AIM: Pediatric laryngeal lymphoma is a rare malignancy, with limited guidance available to inform diagnosis and management. This systematic review aims to synthesize published cases to characterize epidemiology, clinical presentation, diagnostic approaches, treatment strategies, and outcomes in children with primary or secondary laryngeal lymphoma. METHODOLOGY: This review was conducted in accordance with PRISMA guidelines. PubMed, Medline, and Embase searches were performed using the terms "larynx" OR "laryngeal" AND "lymphoma." Studies reporting pediatric patients (≤18 years) with histologically confirmed lymphoma involving the larynx were included. Exclusion criteria comprised reviews without new cases, non-lymphoma diagnoses, non-laryngeal involvement, adult cases, insufficient outcome data and animal studies. Data extracted included demographics, clinical features, investigations, lymphoma subtype, management, and outcomes. RESULTS: A total of 1196 studies were reviewed, with 17 meeting the inclusion criteria for final analysis. Eighteen patients were identified (median age 13 years; 66.7% male). Non-Hodgkin lymphomas accounted for 94.4% of cases, predominantly B-cell subtypes. The supraglottis was the most frequently affected subsite (50.0%). Disease was localised in two thirds of cases. Diffuse disease was more common in patients with B symptoms or immunodeficiency and was associated with significantly higher mortality (66.7%). Chemotherapy was the primary treatment modality, with radiotherapy or combined chemoradiotherapy used in selected cases. Surgical intervention was limited to biopsy or airway stabilization. Overall, 50.0% of patients achieved durable remission, while 38.9% died during follow-up. Locoregional recurrence occurred in 16.7% of cases, exclusively in patients with initially diffuse or transglottic disease. CONCLUSION: Pediatric laryngeal lymphoma requires a high index of clinical suspicion due to its rarity and variable presentation. Outcomes are generally favorable for localized disease, while diffuse involvement and immunodeficiency predict poorer prognosis. Early endoscopic evaluation, accurate histopathological diagnosis, multidisciplinary management, and long-term surveillance are essential to optimize outcomes.
A three-dimensional printed laryngoscope holding helmet for continuous laryngoscopy during exercise in a pediatric exercise induced laryngeal obstruction clinic.
Richardson CM, Clements AC, Friedman SD … +5 more , Le H, Siu J, Vernon MM, Parikh SR, Johnson KE
Int J Pediatr Otorhinolaryngol · 2026 Jul · PMID 42139797 · Publisher ↗
INTRODUCTION: Continuous laryngoscopy during exercise (CLE) is increasingly used to diagnose exercise induced laryngeal obstruction (EILO). One barrier to widespread implementation is reliable fixation of the flexible la...
INTRODUCTION: Continuous laryngoscopy during exercise (CLE) is increasingly used to diagnose exercise induced laryngeal obstruction (EILO). One barrier to widespread implementation is reliable fixation of the flexible laryngoscope during exercise. This study describes the development and validation of an adjustable, low-cost helmet constructed from commercially available and 3D-printed components to facilitate CLE in a pediatric EILO clinic. MATERIALS AND METHODS: An adjustable CLE helmet was developed using 3D-printed and commercially available materials. Eight otolaryngologists at a tertiary pediatric hospital performed initial testing for fit and function validation. The helmet was then implemented in a multidisciplinary pediatric clinic for patients with suspected EILO. RESULTS: Otolaryngologists completed surveys after a simulation session with the helmet. Using a 5-point Likert scale, they rated the helmet "easy to use" with "good realism" (median 4, IQR 4-5), and "complete comfort" using it in practice after simulation (median 5, IQR 4-5). The helmet was successfully used during CLE in 27 patients (ages 12-20 years, mean 15.9) without complication or readjustment during CLE. Mean exam duration was 26.9 ± 9.3 min. EILO was diagnosed in 96% (n = 26) of patients, with Maat scores of Grade I in 4 (15%), Grade II in 14 (54%), and Grade III in 8 (31%). Biofeedback therapy was used for EILO management during CLE. CONCLUSION: This data demonstrates face validity and clinical utility of an adjustable, 3D-printed helmet for CLE in a pediatric EILO clinic. This open-source solution may reduce technical barriers and expand access to CLE for EILO evaluation and management.
A five-year longitudinal analysis of discussion topics in online multidisciplinary collaboration for children with hearing loss in rural Japan.
Kanno T, Kaneshiro S, Nakanishi H … +3 more , Kobayashi Y, Tsushima Y, Sato H
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42134030 · Publisher ↗
OBJECTIVES: Sustaining multidisciplinary collaboration is crucial yet challenging in rural areas characterized by geographical challenges. This study assessed an online multidisciplinary conference (MDC) system in Iwate,...
OBJECTIVES: Sustaining multidisciplinary collaboration is crucial yet challenging in rural areas characterized by geographical challenges. This study assessed an online multidisciplinary conference (MDC) system in Iwate, Japan, with the objective of supporting a shift from reactive care toward a more proactive support model for the long-term development of children with hearing loss. METHODS: A retrospective analysis was conducted on 315 discussion topics from 46 online MDCs (2020-2025). The topics were categorized based on age and hearing level. A questionnaire survey was administered to 20 professionals to evaluate the system's impact. RESULTS: A significant shift in support needs was identified. While placement support was predominant for younger children, the proportion of cases involving profound hearing loss reached 76% (26/34 cases) in the high school group, with topics increasingly focusing on psychosocial issues, including psychosomatic symptoms. Conversely, MDCs facilitated early-stage clinical optimizations, such as increasing daily cochlear implant wear time in an infant, suggesting the potential effectiveness of proactive, multidisciplinary intervention. CONCLUSION: The "Iwate model" may support a transition from reactive medical care to a proactive support model by identifying latent risks before they manifest as school refusal or psychosomatic symptoms. By integrating multidisciplinary data from infancy, the system may facilitate the early visualization of latent risks. This longitudinal monitoring not only addresses immediate maladaptation but also establishes a foundation for fostering future self-advocacy and ensuring broad social participation by individuals with hearing loss.
Pediatric Lemierre's syndrome: A systematic review.
Aldawsari L, Alzohari J, Khashab R … +4 more , Yamani M, Taher A, Alqahtani MB, Althubaiti A
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42127655 · Publisher ↗
INTRODUCTION: Lemierre syndrome (LS) is a condition characterized by septic thrombophlebitis of the internal jugular vein. Prompt diagnosis and appropriate management are crucial to achieve a good prognosis. Controversy...
INTRODUCTION: Lemierre syndrome (LS) is a condition characterized by septic thrombophlebitis of the internal jugular vein. Prompt diagnosis and appropriate management are crucial to achieve a good prognosis. Controversy remains regarding the management of this condition in children. The aim of this study is to provide physicians with an update regarding the clinical presentation, management, and prognosis of LS in children. METHODS: This systematic review was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Search performed using PubMed and Google Scholar databases targeting pediatric patients (<18 years old) with LS and included the following terms: Lemierre's Syndrome, thrombophlebitis, Internal jugular vein thrombosis, pediatric, and F.necrophorum. RESULTS: 423 studies were identified, and 53 studies reporting 143 individual cases that met the diagnostic criteria of LS were included; the mean age was 15.2 years (SD ± 3.6). Fever was the most common presenting symptom in 92% of patients, and F. necrophorum was the predominantly identified organism in 78.3% of patients. Computed tomography (CT) imaging was utilized in 89.5% of cases, and was most useful for detecting thrombosis of the internal jugular vein and septic emboli. Antibiotics were administered to all patients. Anticoagulation therapy was used in 62.2% of cases. 6% of patients required surgical intervention. Long-term complications were reported in 4.2% of patients. The mortality rate was 1.4%. CONCLUSION: Early diagnosis and medical management in suspected cases of LS appear to prevent complications resulting from this syndrome. Interdisciplinary collaboration will be essential to achieve this and improve patient outcomes.
An artificial intelligence classifier as a screening tool to rule out otitis media in children.
Nuuttila S, Vallin A, Klockars T … +4 more , Ruohola A, Laine M, Ivaska LE, Tähtinen PA
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42114455 · Publisher ↗
OBJECTIVE: Acute otitis media is the most common bacterial infection among children and a significant global health burden. Despite its high incidence, diagnostic accuracy is poor. The objective of this study was to eval...
OBJECTIVE: Acute otitis media is the most common bacterial infection among children and a significant global health burden. Despite its high incidence, diagnostic accuracy is poor. The objective of this study was to evaluate whether an artificial intelligence classifier can rule out otitis media in children based on a tympanic membrane image. METHODS: Artificial intelligence analysis of tympanic membrane images was carried out on images gathered as part of a randomized double-blind study. 793 tympanic membrane images were analyzed with an AI classifier. Images were obtained from children aged 6 to 35 months participating in a trial investigating the efficacy of amoxicillin-clavulanate for acute otitis media. The primary outcome was the sensitivity, specificity and accuracy of the classifier. RESULTS: All four variants of the artificial intelligence classifier showed excellent sensitivity for an abnormal ear (96% to 100%), and areas under the curves were respectively high (0.83-0.92). After a change in image normalization due to an initially poor image quality, the performance of the best variant improved to a specificity of 73%, and sensitivity remained high (92%). CONCLUSIONS: Our study suggests that an artificial intelligence classifier at a primary level can rule out otitis media in children. This may eliminate the need for a physician's visit in the great majority of suspected acute otitis media cases in children with healthy ears. Further research in a parent-led setting is needed to measure the real-world impact of automatic classifiers.
Mixed hearing loss in children: Etiology, management, and audiological outcomes.
Aldè M, Rasom C, Zanon LS … +4 more , Pignataro L, Zanetti D, Marchisio P, Valdez TA
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42114454 · Publisher ↗
OBJECTIVES: Mixed hearing loss (MHL), defined as the coexistence of conductive and sensorineural components, remains insufficiently characterized in the pediatric population. This study aimed to investigate the etiology,...
OBJECTIVES: Mixed hearing loss (MHL), defined as the coexistence of conductive and sensorineural components, remains insufficiently characterized in the pediatric population. This study aimed to investigate the etiology, audiological characteristics, management strategies, and 1-year hearing outcomes in children with MHL. METHODS: The medical charts of children aged 5-12 years with HL referred to a tertiary-level audiologic center between January 1, 2017, and August 31, 2025, were reviewed. The study specifically included children with MHL, and demographic, clinical, audiological (baseline and 1-year follow-up), radiological, and genetic data were analyzed. RESULTS: Of 5618 first visits for pediatric HL, 129 children (mean age: 88.3 ± 26.0 months; 53.5% male) met the inclusion criteria. Pathogenic genetic variants were identified in 50 children (38.8%), with most cases (88.0%) associated with syndromic conditions, primarily Branchio-Oto-Renal, CHARGE, Down, and Pendred syndromes. Children with syndromic MHL showed a significantly higher prevalence of otologic malformations (72.7% vs. 40.0%, P < 0.001) and chronic or recurrent otitis media (84.1% vs. 23.5%, P < 0.001). Treatment of MHL included hearing devices in 57.4% of cases and middle ear surgery in 34.9%. The mean pure-tone average (PTA-4) improved significantly from 60.3 ± 19.3 dB HL at baseline to 54.6 ± 25.8 dB HL at the 1-year follow-up (P < 0.001). CONCLUSION: This study is the first to focus exclusively on pediatric MHL and demonstrates that MHL is a highly heterogeneous condition frequently associated with genetic syndromes. Long-term audiological follow-up and a personalized therapeutic approach are essential for the optimal management of children with MHL.
Timing and risk factors for peristomal granulation in pediatric tracheostomy patients.
Takada N, Okuda H, Yamada N … +4 more , Yanagida M, Yamada H, Mikami T, Ogawa T
Int J Pediatr Otorhinolaryngol · 2026 Jun · PMID 42097004 · Publisher ↗
BACKGROUND: Peristomal granulation occurs more frequently in pediatric than adult tracheostomy patients and may complicate postoperative airway management. Establishing a tracheal stoma resistant to granulation is theref...
BACKGROUND: Peristomal granulation occurs more frequently in pediatric than adult tracheostomy patients and may complicate postoperative airway management. Establishing a tracheal stoma resistant to granulation is therefore critical. This study evaluated differences in the incidence and timing of peristomal granulation according to tracheostomy technique, identified additional risk factors, and assessed long-term outcomes. METHODS: This retrospective cohort study included 42 pediatric patients who underwent tracheostomy at our institution between January 2015 and February 2025. All patients were younger than 12 months at surgery and were followed for at least one month postoperatively. Tracheostomy techniques included the conventional method, Starplasty, and the Björk flap method. RESULTS: Peristomal granulation developed in 17 patients (40%). The incidence did not differ significantly among techniques: conventional (42%), Starplasty (40%), and Björk flap (38%). However, the onset of granulation occurred significantly later in the Björk flap group compared with the other two techniques (p = .0218). This association remained significant after adjustment for inflammation-related confounding factors. Regarding long-term outcomes, 3 patients were successfully decannulated, 11 achieved oral intake, and 28 required ongoing home care. CONCLUSIONS: Although the incidence of peristomal granulation was similar among tracheostomy techniques, the Björk flap method was associated with a significantly delayed onset of granulation. Given the importance of early postoperative stoma stabilization, the Björk flap method may offer a safer tracheostomy approach in pediatric patients by reducing the risk of early complications.
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