International Journal Of Pediatric Otorhinolaryngology[JOURNAL]
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200 papers
The increasing incidence and features of grill brush wire bristle injuries in the United States: 2015-2023.
Coppola MO, Shaffer AD, Chi DH
Int J Pediatr Otorhinolaryngol · 2026 May · PMID 41825094 · Publisher ↗
BACKGROUND: Brushes with metal bristles are a common tool used to clean grills of food remnants during the cooking process. When scrubbing the grill, these metal bristles can detach from the brush. As they are difficult...
BACKGROUND: Brushes with metal bristles are a common tool used to clean grills of food remnants during the cooking process. When scrubbing the grill, these metal bristles can detach from the brush. As they are difficult to see, they sometimes adhere to the cooked food and cause aerodigestive tract injury when consumed. The epidemiology of these injuries has not been reported since 2016. METHODS: The National Electronic Injury Surveillance System (NEISS) and The Consumer Product Safety Commission's database of consumer-reported harm (saferproducts.gov) were searched from 1/1/2015-12/31/2023 using relevant codes and terms to identify relevant injury cases. The estimated incidence of these cases within the United States was calculated. RESULTS: From January 1st, 2015, until December 31st, 2023, there was a total of 85 raw cases in the NEISS database contributing to an estimated 3739 cases 95% CI [2440.43, 5038.09] in the United States over that period. In the saferproducts. gov database, there were 9 raw cases between 2015 and 2023. As established in medical literature and reverified, there were 40 raw cases and an estimated 1632 cases in the United States [95% CI [871.24, 2393.69]] from 2006 to 2014. This is a 229% increase in the incidence from 2015 to 2023. Simple linear regression was used to evaluate if the estimated NEISS cases differed significantly from 2006 to 2023. There was a linear increase in cases from 2006 to 2023 (R = 0.8295, p = 0.01). CONCLUSION: Although the dangers of wire grill brush bristles were published widely in the 2010s, awareness strategies have not decreased the estimated incidence of injury in the United States. Potential strategies to address this issue include targeted media initiatives and implementing enhanced safety measures in product packaging.
Paediatric airway inflammatory myofibroblastic tumours: a decade of lessons from a quaternary centre.
Marrable L, Asairinachan A, Farwana M … +8 more , Sutton L, Butler C, Hewitt R, Sebire N, Ike C, Muthialu N, Slater O, Nguyen T
Int J Pediatr Otorhinolaryngol · 2026 May · PMID 41818868 · Publisher ↗
OBJECTIVES: Inflammatory myofibroblastic tumours (IMTs) are rare low-grade neoplasms that can occur in the airway and can result in airway compromise and respiratory distress. There are no clear guidelines on the managem...
OBJECTIVES: Inflammatory myofibroblastic tumours (IMTs) are rare low-grade neoplasms that can occur in the airway and can result in airway compromise and respiratory distress. There are no clear guidelines on the management of airway IMT. This retrospective study discusses the management and outcomes of patients presenting with an airway IMT at our centre. METHODS: Five patients diagnosed with an IMT in the larynx, trachea or bronchi between January 2014 and November 2024 were included. Initial presentation, initial and definitive management, complications, surveillance method and recurrence rates were recorded. RESULTS: The initial treatment was endoluminal debulking for histological diagnosis. Immunohistochemistry was positive for anaplastic lymphoma kinase (ALK) in four patients. The upfront definitive treatment was open resection in two patients and endoscopic removal in one patient. Both patients with upfront non-surgical treatment failed, requiring open surgical resection. One patient was initially treated with an ALK-inhibitor and one with systemic steroids and nonsteroidal anti-inflammatory agents. Tumour surveillance was via microlaryngobronchoscopy and cross-sectional imaging. There was no tumour recurrence in the surgically treated group despite tumour present at the margins. There were no deaths in this series. CONCLUSION: Airway lesions such as IMT are rare. Our management includes a multidisciplinary approach to treatment, favouring upfront surgery tailored to the tumour location and characteristics.
Neonatal and maternal outcomes of scheduled versus unscheduled ex-utero intrapartum treatment (EXIT) procedures.
Chang AG, Curtis C, Diakow E … +4 more , Chang E, Kloosterman N, Brennan E, Clemmens C
Int J Pediatr Otorhinolaryngol · 2026 Apr · PMID 41806786 · Publisher ↗
OBJECTIVE: Ex-utero intrapartum treatment (EXIT) procedures are employed during delivery to establish a safe airway on placental support for neonates with potential airway obstruction. While EXITs are typically planned w...
OBJECTIVE: Ex-utero intrapartum treatment (EXIT) procedures are employed during delivery to establish a safe airway on placental support for neonates with potential airway obstruction. While EXITs are typically planned with a multidisciplinary team, these procedures may occur emergently due to preterm labor, late diagnosis, or delayed transfer of care. This systematic review compares outcomes of scheduled versus unscheduled/emergent EXIT procedures. DATA SOURCES: We searched PubMed, Scopus, and CINAHL in March 2025 to identify observational studies describing EXIT procedures. METHODS: Studies were included if they identified the procedure as scheduled/unscheduled and had at least one neonatal and maternal outcome of interest. We assessed quality using the Joanna Briggs Institute (JBI) checklists. Raw data were pooled and assessed with summary statistics. RESULTS: 67 articles were included for data extraction and synthesis. Primary findings were: (1) the unscheduled group had a significantly higher maternal estimated blood loss (EBL) and (2) rates of neonatal perioperative mortality were higher for the unscheduled group. Though the mortality difference was clinically significant (16% unscheduled versus 4.9% scheduled), it was not statistically significant. Furthermore, a higher percentage of patients in the unscheduled group were managed with tracheostomy (49%) as compared to the scheduled group (30%, p-value variable across imputation sets, range 0.029 - 0.076). CONCLUSION: EXIT procedures should always be carefully planned and coordinated with a multidisciplinary team. However, if necessary, unscheduled EXIT procedures can be safely performed by experienced personnel in prepared centers, though they may have a slight increase in maternal EBL.
Timing of middle ear normalization after furlow palatoplasty vs. intravelar veloplasty.
Husman T, Barba P, Chan DK … +1 more , Virbalas J
Int J Pediatr Otorhinolaryngol · 2026 Apr · PMID 41793925 · Publisher ↗
PURPOSE: To compare the impact of Furlow palatoplasty (FP) and intravelar veloplasty (IVVP) on time to middle ear normalization following cleft palate repair. METHODS: A retrospective cohort study was conducted at a sing...
PURPOSE: To compare the impact of Furlow palatoplasty (FP) and intravelar veloplasty (IVVP) on time to middle ear normalization following cleft palate repair. METHODS: A retrospective cohort study was conducted at a single tertiary care institution, including pediatric patients who underwent cleft palate repair between 2012 and 2024. Normal middle ear function was defined as type A tympanometry or a documented normal middle ear exam. Descriptive statistics, univariate and multivariate analyses, and time-to-event analyses were performed. RESULTS: 289 patients were analyzed, including 114 who underwent FP and 175 who underwent IVVP. Median age at repair was 10.0 months (IQR 10.0-12.0), and median follow-up duration was 30.0 months (IQR 13.0-53.0). Follow-up duration was significantly longer in the IVVP group (34.0 months [IQR 16.0-59.0]) compared to those who underwent FP (26.0 [IQR 11.0-43.0], p = 0.008). IVVP patients had a higher proportion of Veau III-IV clefts compared to FP (53.7% vs. 34.2%, p < 0.001). FP was associated with earlier middle-ear normalization on (HR 1.47, 95% CI 1.10-1.98, p = 0.010) and remained a significant predictor after adjusting for age, cleft severity, and the need for repeat tympanostomy tubes (HR 1.41 95% CI 1.02-1.94, p = 0.035). The median time to normalization was 31.0 months (IQR, 27-41) for FP versus 51.0 months (IQR, 42-58; p = 0.009) for IVVP. CONCLUSION: FP is associated with significantly earlier time to middle ear normalization when compared to IVVP, suggesting its potential benefit in reducing middle-ear disease.
Clinical predictors of pediatric obstructive sleep apnea: Demographic and physical factors.
Choi H, Choi Y, Park CS … +4 more , Kim SW, Kim SW, Kim BG, Lee DC
Int J Pediatr Otorhinolaryngol · 2026 Apr · PMID 41791281 · Publisher ↗
OBJECTIVE: To identify clinical predictors of obstructive sleep apnea (OSA) in pediatric patients undergoing level I polysomnography (PSG). METHODS: We retrospectively analyzed children aged ≤12 years who underwent level...
OBJECTIVE: To identify clinical predictors of obstructive sleep apnea (OSA) in pediatric patients undergoing level I polysomnography (PSG). METHODS: We retrospectively analyzed children aged ≤12 years who underwent level I PSG. Correlation analyses were performed to examine the relationships between clinical variables and PSG parameters. Multiple linear regression analysis was conducted to identify predictors of the apnea-hypopnea index (AHI), using age, sex, tonsil grade, adenoid ratio, and body mass index (BMI) percentile as candidate variables. Subgroup analysis was performed by stratifying patients into preschool-aged (<6 years) and school-aged (≥6 years) groups. RESULTS: In the total population, older age, male sex, higher tonsil grade, and higher BMI percentile were positively associated with AHI. Subgroup analysis revealed that tonsil grade was the only significant predictor of AHI in the preschool-aged group. In the school-aged group, age and BMI percentile emerged as additional predictors of AHI, whereas the influence of tonsil grade, though still significant, was reduced. CONCLUSIONS: Older age, male sex, tonsillar hypertrophy, and obesity were significant predictors of AHI in children. Tonsillar hypertrophy played a more prominent role in younger children, while the influence of age and BMI percentile increased in older children. These findings highlight the importance of age-tailored evaluation in assessing OSA risk in pediatric populations.
Evaluating speech dysfunction in patients with congenital cytomegalovirus - A multicenter retrospective study.
Cherches A, Vasireddy A, Mizelle C … +3 more , Ogunsusi M, Riska K, Raynor E
Int J Pediatr Otorhinolaryngol · 2026 Apr · PMID 41791280 · Publisher ↗
OBJECTIVE: Despite the known impact of congenital cytomegalovirus (cCMV) on hearing, implications on speech have been understudied. In the absence of hearing loss, 2% of cCMV patients may still develop speech and languag...
OBJECTIVE: Despite the known impact of congenital cytomegalovirus (cCMV) on hearing, implications on speech have been understudied. In the absence of hearing loss, 2% of cCMV patients may still develop speech and language impairment. This study will describe demographics of cCMV patients, rates of speech therapy referral, and speech dysfunction within two of North Carolina's largest health systems. STUDY DESIGN: A retrospective chart review study. SETTING: Two academic medical centers. METHODS: A multisite retrospective chart review of patients was performed to identify cCMV patients. 69 patients were identified, 20 from Duke University Medical Center and 49 from University of North Carolina Health Systems. Data obtained from medical records included patient demographics, referrals, and speech dysfunction. RESULTS: Of 69 patients, 34 (49.3%) had evidence of speech dysfunction. Most patients (44.9%) were found to have a constitutional speech delay, an umbrella term used in this study to signify that a provider or speech-language pathologist reported speech dysfunction within the medical chart. Out of all cCMV patients, 9 of the 34 (26.5%) showed evidence of speech dysfunction in the presence of normal hearing. 88.2% of patients with speech dysfunction were referred to speech therapy by an SLP, with 79.4% attending a session and 61.8% having medical chart descriptions of improved speech. CONCLUSION: This is the largest US-based study on cCMV speech outcomes, with findings suggesting a higher rate of speech dysfunction than previously reported, including a higher rate of speech delay in those without a diagnosed hearing loss. Speech therapy initiation averaged within the 1-3-year early intervention American Speech-Language-Hearing Association recommendation. Recommendations to receive early speech evaluation referrals, regardless of hearing loss, may enhance outcomes in this population.
Association between adenoid hypertrophy and facial biotype in growing Patients: A CBCT observational study.
Mero Chávez JM, Aguirre Balseca M, Freitas KMS … +1 more , Vaca Zapata ME
Int J Pediatr Otorhinolaryngol · 2026 Apr · PMID 41785820 · Publisher ↗
OBJECTIVE: This study aimed to evaluate the association between the degree of adenoid hypertrophy and facial growth patterns using cone-beam computed tomography (CBCT). METHODS: An observational descriptive study was per...
OBJECTIVE: This study aimed to evaluate the association between the degree of adenoid hypertrophy and facial growth patterns using cone-beam computed tomography (CBCT). METHODS: An observational descriptive study was performed using 150 anonymized CBCT scans (80 males, 70 females) of patients aged 6-18 years. Adenoid hypertrophy was classified by percentage of nasopharyngeal obstruction (Grades I-IV), and facial biotype was determined using the Vert Index (dolichofacial, mesofacial, brachyfacial). Age and sex distributions were analyzed using Student's t-test and chi-square tests. The relationship between hypertrophy and biotype was evaluated with independence tests and Multiple Correspondence Factorial Analysis. Statistical significance was set at p < 0.05. RESULTS: Adenoid hypertrophy was most prevalent between 9 and 14 years of age, particularly for Grades III (50-75%) and IV (>75%). Beginning at 15 years, obstruction gradually decreased, with Grades I-II predominating at age 18. No significant association was detected between hypertrophy grade and sex (p > 0.05). Dolichofacial patients were more frequently observed among those with higher obstruction grades (≥50%), whereas mesofacial and brachyfacial patterns predominated among individuals with lower obstruction grades. The association between facial biotype and hypertrophy was significant overall (p = 0.019), although only the group aged 18 years showed significant stratified association (p = 0.035). CONCLUSION: Adenoid hypertrophy was most prevalent in growing patients, decreasing progressively after mid-adolescence. Severity of hypertrophy was independent of sex. Dolichofacial characteristics were more frequently associated with moderate-to-severe obstruction, whereas lower obstruction correlated with mesofacial and brachyfacial patterns. CBCT proved to be a valuable tool in visualizing airway obstruction and identifying its craniofacial associations, supporting its use in early diagnosis and interdisciplinary treatment planning.
Idiopathic progressive facial palsy in adolescents: A distinct clinical entity in females?
Oh JW, Lee JH, Joo HA … +1 more , Kim J
Int J Pediatr Otorhinolaryngol · 2026 Apr · PMID 41785819 · Publisher ↗
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Frenulotomy - what are the clinical benefits? A review on the management of tongue-tie.
van der Heijden D, Bruijnzeel H, Schuffel IL … +1 more , Hol MLF
Int J Pediatr Otorhinolaryngol · 2026 Apr · PMID 41785818 · Publisher ↗
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Complications and factors associated with emergency department presentation for pediatric tracheostomy patients.
Trope M, Tabangin M, Hart CK … +2 more , Benscoter DT, Smith MM
Int J Pediatr Otorhinolaryngol · 2026 Apr · PMID 41785817 · Publisher ↗
OBJECTIVES: To describe the frequency of presentation to the emergency department (ED) for tracheostomy related complications within the first year after initial tracheostomy placement discharge. Secondary outcomes aimed...
OBJECTIVES: To describe the frequency of presentation to the emergency department (ED) for tracheostomy related complications within the first year after initial tracheostomy placement discharge. Secondary outcomes aimed to describe potential differences in presentation based on socioeconomic status (SES). METHODS: This was a case series with chart review. Included were ≤21 year olds who underwent tracheostomy from Jan 1, 2011 to Dec 31, 2016 and had 1 year follow up after discharge from hospital admission. Excluded were those who lived >75 miles from the hospital. Patients were split into two groups - those that visited the ED within one year of discharge with a tracheostomy related complication and those that did not. A principal components analysis was used to create an index using census data obtained by the US Census Bureau's American Community Survey 5-year data profile from 2013 to 2017. Statistical comparisons were performed using chi-square for categorical variables and Wilcoxon rank-sum test for continuous variables. RESULTS: 230 patients were included. 165 patients were seen in the ED within the first year of discharge. 86/164 had high SES (52%) and 78/164 had low SES (48%). There was no significant difference between the mean number of ED visits based on SES (high SES 1.58 visits vs low SES 1.53 visits, p = 0.85) or race. CONCLUSION: The majority of children with tracheostomies will present to the ED within 1 year of discharge for medical care. Many of these visits were due to tracheostomy related complications and does not appear to be correlated with SES or race.
Can you understand me in class? Effects of age and reverberation on speech recognition in school- age children.
Kanigalpula A, Nisha KV, Pitchaimuthu AN
Int J Pediatr Otorhinolaryngol · 2026 Apr · PMID 41759329 · Publisher ↗
PURPOSE: This study investigated how age and reverberation time affect speech recognition abilities in children across realistic classroom acoustic conditions with spatially separated noise sources. METHODS: The study co...
PURPOSE: This study investigated how age and reverberation time affect speech recognition abilities in children across realistic classroom acoustic conditions with spatially separated noise sources. METHODS: The study comprised three phases: classroom acoustic measurement, laboratory simulation, and speech recognition testing. Sixty children in the age range of 8-11.5 years participated in the study. Each child completed the Spatial Separation Sentence Test in Kannada (SSST-K) under 12 conditions (2 SNRs, 2 RTs, 3 masker locations). Scores were analysed using generalized linear mixed-effects model (GLMM) in RStudio. RESULTS: Classroom reverberation averaged 2.47 s, approximately 5-6 times above the recommended values. GLMM analysis with age as a covariate revealed significant main effects SNR, reverberation time, and noise location on speech recognition (all p ≤ 0.001). In general, children's speech recognition was better under favourable listening conditions (short RT, +10 dB SNR) and when the target and noise sources were spatially separated (much better with distractor in the right compared to left) rather than collocated. Crucially, we quantified key trade-offs: adding 1.0 s of RT cost ∼8.17 dB of SNR, whereas each additional year of age conferred an equivalent +1.79 dB SNR benefit (≈0.22 s RT). In practical terms, modest reverberation increases can negate several years of maturational gain in speech recognition. CONCLUSIONS: Excessive reverberation significantly compromises speech recognition in school-age children, with performance varying substantially by age and acoustic conditions. These findings highlight the critical need for acoustic optimization in educational environments to support positive learning outcomes.
Structured health education to improve nurses' newborn hearing screening competencies: A quasi-experimental study.
Telingai SM, Mohamed Z, Zakaria R … +2 more , Abdullah A, Mazlan R
Int J Pediatr Otorhinolaryngol · 2026 Apr · PMID 41747402 · Publisher ↗
AIM/OBJECTIVE: To determine whether nurses' knowledge and attitudes towards newborn hearing screening (NBHS) improve following a structured health education intervention (HEI). BACKGROUND: The effectiveness of NBHS relie...
AIM/OBJECTIVE: To determine whether nurses' knowledge and attitudes towards newborn hearing screening (NBHS) improve following a structured health education intervention (HEI). BACKGROUND: The effectiveness of NBHS relies heavily on nurses' preparedness. However, limited training and confidence often hinder effective parent counselling and timely referrals for infants who fail initial screening. Enhancing nurses' competence through targeted education may strengthen early hearing detection and intervention efforts. METHODS: This quasi-experimental, single-group pretest-posttest study involved 70 registered nurses from the maternity and neonatal wards of a tertiary public hospital in Malaysia attended a 120-min HEI session. Content included NBHS rationale, the '1-3-6' benchmark, risk factors, result interpretation, referral pathways, and parent-centered counselling. The session was delivered in English with bilingual (English-Malay) discussions and pamphlets for bedside use. Knowledge was assessed using a 22-item scale (General Facts; Diagnosis/Early Intervention; Risk Factors) and attitudes with a 25-item scale (cognitive, affective, behavioural) before and after the intervention. RESULTS: Post-intervention, 94% of nurses achieved the knowledge adequacy threshold compared with 3% at baseline. The greatest improvements were in identifying risk factors and understanding early diagnosis. Attitudes showed significant positive changes across all domains, with increased confidence, motivation, and readiness to counsel parents. CONCLUSIONS: A brief, low-cost HEI conducted within ward settings significantly improved nurses' NBHS knowledge and attitudes. Its practicality and adaptability make it a promising model for integration into nursing education and continuing professional development to support timely hearing screening and referral.
Assessment of cool and hot executive functions in children with bilateral cochlear implants using a computerized psychology experiment building language test battery.
Parabakan Polat A, Çakmak B
Int J Pediatr Otorhinolaryngol · 2026 Apr · PMID 41747401 · Publisher ↗
OBJECTIVE: This study aimed to evaluate cool and hot executive functions in children with congenital hearing loss using bilateral cochlear implants, using a computerized Psychology Experiment Building Language Test Batte...
OBJECTIVE: This study aimed to evaluate cool and hot executive functions in children with congenital hearing loss using bilateral cochlear implants, using a computerized Psychology Experiment Building Language Test Battery. METHODS: This causal-comparative, cross-sectional study included 19 children with cochlear implants who had participated in an early rehabilitation program and 20 typical-hearing children aged 6-15 years. Cool executive functions were evaluated using the Berg Card Sorting Test and the Tower of London Test, and hot executive functions were assessed with the Hungry Donkey task. Group differences were analyzed in terms of perseverative errors, categories completed, and correct responses on the Berg Card Sorting Test, total moves on the Tower of London Test, and net score on the Hungry Donkey Task. RESULTS: No statistically significant difference was found between groups in the Hungry Donkey Task net scores (t (37) = -1.86, p = .071). Perseverative errors (t (37) = 1.45, p = .154), categories completed (U = 167.50, p = .531), and correct responses (U = 132.00, p = .107) on the Berg Card Sorting Test were not significantly different between groups. Total moves on the Tower of London Test were also not significantly different between groups (U = 180.50, p = .792). CONCLUSIONS: Children with congenital hearing loss using bilateral cochlear implants, participating in early intervention programs, exhibited hot and cool executive functions similar to those of their typically hearing peers. Assessing cognitive processes such as executive functions is important for intervention planning, evaluation, and rehabilitation in children using cochlear implants.
An analysis of mechanism patterns in pediatric mandible fractures.
Jamil TL, Tatineni S, Paquin RL … +8 more , Wharton M, Abell B, Wershoven N, Goryachok M, Wine T, Herrmann B, Prager JD, Francom C
Int J Pediatr Otorhinolaryngol · 2026 Apr · PMID 41740203 · Publisher ↗
INTRODUCTION: The mandible is the second most fractured facial bone in children, with potentially severe consequences if not optimally treated. However, data on pediatric mandible fracture epidemiology and management, pa...
INTRODUCTION: The mandible is the second most fractured facial bone in children, with potentially severe consequences if not optimally treated. However, data on pediatric mandible fracture epidemiology and management, particularly by injury mechanism, remains limited. METHODS: A retrospective chart review was conducted between January 1, 2014, to August 1, 2024, among patients 18 years old and younger who presented with a mandible fracture to a level I pediatric trauma center. Demographic information, injury mechanism, fracture pattern, and hospital course data were analyzed. RESULTS: We identified 490 patients (median age 10 years; male-predominant). The most common mandible fracture subtypes were condyle, parasymphysis, and angle/ramus; the most common mechanisms of injury were falls from height/standing, bicycle accidents, and recreational sports. Nasal bone, unilateral orbital, unilateral temporal bone, and unilateral ZMC fractures were the most frequent concomitant facial injuries. Approximately one-third had polytrauma, and slightly more than half required hospitalization and surgical intervention. Chi-square analyses showed parasymphyseal, body, and angle/ramus fractures were more common after higher-impact mechanisms, whereas condylar and alveolar fractures were more common after lower-impact mechanisms. Polytrauma was more likely with body and angle/ramus fractures. Hospitalization was more likely with symphyseal, parasymphyseal, body, angle/ramus, and subcondylar fractures. Surgical intervention was more likely with symphyseal, parasymphyseal, body, and angle/ramus fractures and in older patients. DISCUSSION: Significant associations exist between mechanism of injury and mandible fracture location. Certain anatomic sites had higher odds of comorbid trauma, hospitalization, and surgical intervention. Understanding these patterns can guide diagnostic evaluation and management of pediatric mandible fractures.
Polysomnographic versus parent-reported predictors of executive function in children with sleep disordered breathing.
Nusraty S, Navarathna N, Novi S … +3 more , Bortfeld H, Mitchell RB, Isaiah A
Int J Pediatr Otorhinolaryngol · 2026 Apr · PMID 41719644 · Full text
OBJECTIVE:: To compare polysomnography (PSG) indices with parent-reported questionnaires in predicting executive dysfunction in children with sleep-disordered breathing (SDB). STUDY DESIGN:: Prospective observational stu...
OBJECTIVE:: To compare polysomnography (PSG) indices with parent-reported questionnaires in predicting executive dysfunction in children with sleep-disordered breathing (SDB). STUDY DESIGN:: Prospective observational study. SETTING:: Tertiary pediatric otolaryngology clinic, January-August 2025. METHODS:: Seventy-eight children aged 5–11 years referred for SDB evaluation underwent overnight PSG, caregiver-completed Obstructive Sleep Apnea-18 (OSA-18) and Pediatric Sleep Questionnaire Sleep-Related Breathing Disorder (PSQ-SRBD) scale, and executive function testing. Outcomes included inhibitory control measured by a computerized Go/No-Go (GNG) task (d′ sensitivity) and parent-reported executive dysfunction using the Behavior Rating Inventory of Executive Function, Second Edition (BRIEF-2) Global Executive Composite (GEC). Associations between predictors and outcomes were assessed using Spearman’s rank correlations. RESULTS:: The cohort (mean age, 7.8 years) was 53% male and 56% Black. PSG revealed moderate-to-severe obstructive sleep apnea (OSA) (mean apnea–hypopnea index [AHI], 12.7 events/hr; mean oxygen nadir, 86.6%). OSA-18 and PSQ-SRBD scores were significantly correlated with BRIEF-2 GEC (OSA-18 vs. GEC: = 0.61, < 0.001; PSQ-SRBD vs. GEC: = 0.62, < 0.001). In contrast, no PSG variable, including AHI or oxygen nadir, was significantly associated with BRIEF-2 or GNG outcomes. Neither PSG indices nor questionnaire scores correlated with GNG d′. CONCLUSION:: Parent-reported symptom burden, but not PSG indices, predicted executive dysfunction in children with SDB. Validated questionnaires such as the OSA-18 and PSQ-SRBD may provide practical, patient-centered tools for identifying children at risk for neurobehavioral morbidity, particularly in settings where PSG access is limited.
The effect of exposure to air pollutants during pregnancy on infant otitis media and hearing loss.
Hong TU, Oh MK, Son WJ … +2 more , Park SY, Kim WJ
Int J Pediatr Otorhinolaryngol · 2026 Apr · PMID 41719643 · Publisher ↗
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Vestibular dysfunction in children undergoing cochlear implantation: Prevalence and postoperative changes.
Dittmer AL, Lund A, Frederiksen TW … +1 more , Devantier L
Int J Pediatr Otorhinolaryngol · 2026 Apr · PMID 41707632 · Publisher ↗
OBJECTIVE: To determine the prevalence of vestibular dysfunction in children with sensorineural hearing loss (SNHL) undergoing cochlear implantation (CI), and to assess postoperative changes in vestibular function in the...
OBJECTIVE: To determine the prevalence of vestibular dysfunction in children with sensorineural hearing loss (SNHL) undergoing cochlear implantation (CI), and to assess postoperative changes in vestibular function in the implanted ear. METHODS: This retrospective study included all children with SNHL who underwent CI at Aarhus University Hospital between 2020 and 2024 and received preoperative vestibular testing. Vestibular assessment comprised video head impulse testing (vHIT/HIT) and cervical vestibular evoked myogenic potentials (cVEMP). Paired pre- and postoperative data were available for a subset of children, in whom within-subject changes were analysed using McNemar's test. RESULTS: A total of 171 children completed preoperative vestibular testing. Preoperatively, 26.9% showed abnormalities on at least one vestibular modality, with otolith dysfunction on cVEMP being most frequent (31.2%). Paired pre- and postoperative assessments were available for 47 children. In the implanted ear, vestibular dysfunction increased from 8.5% preoperatively to 25.5% postoperatively. Otolith function deteriorated in 21.9% (9/41) of children with available cVEMP data (p = 0.0156), whereas semicircular canal changes on vHIT/HIT were infrequent and not statistically significant. Postoperative findings in the non-implanted ear were sparse and showed no systematic pattern. CONCLUSION: Vestibular dysfunction is common among children with SNHL prior to cochlear implantation. In the subgroup with paired data, CI was associated with a significant postoperative decline in otolith function, while semicircular canal responses remained largely stable. These findings highlight the importance of implementing systematic vestibular assessment in both the preoperative and postoperative CI work-up to support surgical planning and early rehabilitation.
Hematologic indices in pediatric sleep-disordered breathing: a retrospective case-control study.
Carvalho RT, de Sousa FA, Almeida JC … +4 more , de Magalhães MF, Rios M, Coutinho MB, Santos M
Int J Pediatr Otorhinolaryngol · 2026 Apr · PMID 41690158 · Publisher ↗
INTRODUCTION: Pediatric obstructive sleep-disordered breathing (OSDB), commonly caused by adenotonsillar hypertrophy, ranges from primary snoring to obstructive sleep apnea syndrome (OSAS) and is a frequent reason for pe...
INTRODUCTION: Pediatric obstructive sleep-disordered breathing (OSDB), commonly caused by adenotonsillar hypertrophy, ranges from primary snoring to obstructive sleep apnea syndrome (OSAS) and is a frequent reason for pediatric otolaryngology referral. OSDB leads to intermittent hypoxia, oxidative stress, systemic inflammation, and may activate the coagulation cascade, contributing to metabolic, cardiovascular, and neurocognitive complications. While these effects are more well-documented in adults, pediatric studies also report associations with obesity, insulin resistance, behavioral issues, and cognitive impairments. Diagnosis remains challenging due to the resource demands of polysomnography, prompting interest in alternative tools, including hematological biomarkers. In adults, markers like neutrophil-to-lymphocyte (N/L) and platelet-to-lymphocyte (P/L) ratios, as well as mean platelet volume (MPV), have shown promise; however, data in pediatric population are scarce. OBJECTIVES: To compare hematological parameters in children with OSDB to those without OSDB. METHODS: We retrospectively analyzed data from children who were indicated for primary otorhinolaryngology surgery between January and May 2024. Pre-operative hematological data from children with OSDB (cases) were compared to those without OSDB (controls). RESULTS: 166 patients (75 females, 91 males; mean age 5.4 ± 2.4 years; mean weight 22.3 ± 10.2 kg) were included. 85 children (51.2%) had OSDB. No significant differences were found between groups regarding age, sex, or weight (p > 0.05). Children with OSDB had significantly higher neutrophil-to-lymphocyte ratios (N/L ratio) (OSDB: 1.71 ± 1.02 vs. controls: 1.40 ± 0.67, p = 0.026) and platelet counts (OSDB: 328,152.94 ± 69,961.30 vs. controls: 302,876.54 ± 74,327.38, p = 0.025). No significant differences were encountered regarding neutrophil count (OSDB: 4260.59 ± 1755.87 vs controls: 3736.05 ± 1717.90, p = 0.054), total leukocyte count (OSDB: 8275.88 ± 1957.93, controls: 7624.57 ± 2351.98, p = 0.054) platelet-to-lymphocyte ratio (OSDB: 127.62 ± 49.50 vs controls: 114.17 ± 38.01, p = 0.052) and other hematological data, including coagulability state (p > 0.05 for prothrombin time, INR and APTT). CONCLUSIONS: OSDB in children is associated with significantly increased N/L ratio and platelet count, suggesting a potential systemic inflammatory response. Further research is needed to determine the clinical significance of these findings.
Spatial release from masking and localization among pediatric cochlear implant users.
Sahana P, Manjula P
Int J Pediatr Otorhinolaryngol · 2026 Apr · PMID 41679201 · Publisher ↗
AIM & OBJECTIVES: This study aimed to assess spatial hearing abilities in children using bimodal hearing devices. (1) comparing spatial release from masking (SRM) in monaural and bimodal conditions; (2) comparing horizon...
AIM & OBJECTIVES: This study aimed to assess spatial hearing abilities in children using bimodal hearing devices. (1) comparing spatial release from masking (SRM) in monaural and bimodal conditions; (2) comparing horizontal localization error across conditions; and (3) examining the correlation between SRM and localization error. METHOD: A cross-sectional, repeated-measures design was used with 43 Kannada-speaking children (aged 4-10 years) with bilateral severe-to-profound hearing loss, fitted with a cochlear implant (CI) in one ear and a hearing aid (HA) in the other. Spatial hearing was assessed using phonemically balanced word lists in noise (SRM task) and white noise bursts from eight loudspeakers (localization task). SRM was calculated as the difference in speech identification scores (SIS) between collocated and spatially separated speech-noise conditions. Localization was measured using root mean square (RMS) error. RESULTS: SRM was significantly higher in the bimodal condition (M = 3.09) than monaural (M = 1.23), t (42) = 3.15, p < 0.001, d = 0.49. Localization accuracy also improved with bimodal hearing (M = 82.27° vs. 105.88°), F (1,42) = 100.79, p < 0.001, η = 0.706. A significant negative correlation (r = -0.518, p < 0.001) was found between SRM and localization error. CONCLUSIONS: Bimodal hearing significantly enhances spatial hearing in children, improving both speech-in-noise perception and localization. The correlation between SRM and localization suggests shared spatial processing mechanisms. These findings support the clinical importance of bimodal device use, especially in settings where bilateral implantation is not feasible, and highlight the need for individualized auditory management.
Determinants influencing variability in outcomes of prelingual cochlear implantation.
Ahmed ME, Aly E, Mostafa E
Int J Pediatr Otorhinolaryngol · 2026 Apr · PMID 41679200 · Publisher ↗
OBJECTIVE: To identify factors affecting cochlear implantation (CI) outcomes in pre-lingual deaf children, focusing on language development. METHOD: A cross-sectional study of 106 pre-lingual deaf children who received u...
OBJECTIVE: To identify factors affecting cochlear implantation (CI) outcomes in pre-lingual deaf children, focusing on language development. METHOD: A cross-sectional study of 106 pre-lingual deaf children who received unilateral CI was conducted to analyse factors influencing their language and speech outcomes. RESULTS: The average age of participating children was 83 ± 31.6 months; 53.8% were male, and 36.8% attended regular school programs. Most parents had higher education (64.2% of fathers, 55.7% of mothers), and 58.5% belonged to a low socioeconomic level. Hearing loss diagnosis was delayed: 37.7% were diagnosed at 6-12 months, 24.5% at 12-24 months, with an average auditory deprivation of 18.6 ± 13.3 months. Average CI age was 41.9 ± 14.2 months; 40.1% had consanguineous parents. Language outcomes were positively associated with speech after hearing aid use and negatively with longer auditory deprivation. Parent education, socioeconomic status, age of deafness, and family history were not significantly linked to language improvement. Children undergoing ≥3 years of post-implant rehabilitation showed greater language development than those with ≤3 years. CONCLUSION: CI leads to a statistically significant improvement in language quotient over time, and key factors affecting outcomes include prior speech after hearing aid use, length of auditory deprivation, and ongoing CI usage. The study highlights the need for culturally adapted parental counselling protocols and increased awareness through comprehensive information.
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