BACKGROUND: Recurrent respiratory papillomatosis (RRP) is a chronic, HPV-induced disease characterized by the growth of benign, wart-like lesions within the upper aerodigestive tract, most commonly affecting the larynx....BACKGROUND: Recurrent respiratory papillomatosis (RRP) is a chronic, HPV-induced disease characterized by the growth of benign, wart-like lesions within the upper aerodigestive tract, most commonly affecting the larynx. These lesions can lead to progressive voice changes and, in more severe cases, upper airway obstruction. Clinical evaluation, including flexible nasoendoscopic examination and symptom assessment, remains central to diagnosing and monitoring disease progression. However, due to the recurrent nature of RRP and the need for repeated surgical intervention, there is growing interest in identifying objective, non-invasive adjuncts to complement clinical evaluation and aid in disease monitoring. AIM: To determine whether peak expiratory flow rate (PEFR) monitoring can serve as an effective adjunct for disease monitoring in RRP. To prove this, we aimed to demonstrate that post-operative PEFR values reflect expected clinical improvement when compared to pre-operative measurements, and that pre-operative PEFR correlates with disease severity when matched with intraoperative Derkay score. METHODS: 38 patients were enrolled between July 2021 and September 2022. Each patient had PEFR readings recorded at each visit. Patients requiring surgical intervention, pre-operative and post-operative PEFR were recorded and Derkay scored intraoperatively (n = 30). RESULTS: Whilst the study size is small, the findings of this study do suggest that PEFR significantly improved post operatively, p value < 0.001, 95% CI; and PEFR correlated with disease severity showing an inversely proportional relationship between pre operative PEFR and intraoperative Derkay score, a medium correlation was observed between PEFR and disease severity (r = -.0.309, P > 0.05) CONCLUSION: PEFR significantly improved in post-operative readings, indicating physiologic confirmation of the clinical observation that surgical debulking of respiratory papilloma causing upper airway obstruction results in functional improvements in airflow. PEFR correlates with disease severity, low PEFR correlated with higher Derkay scores.
Sarıoğlu SC, Cengi̇z DU, Buğra E
… +2 more, Mazooğlu B, Avşar A
Int J Pediatr Otorhinolaryngol
· 2026 Mar · PMID 41653779
·
Publisher ↗
BACKGROUND: Subjective Visual Vertical (SVV) and Subjective Visual Horizontal (SVH) tests are useful tests to identify central vestibular tone imbalances. AIM: To determine the normal values of the Subjective Visual Vert...BACKGROUND: Subjective Visual Vertical (SVV) and Subjective Visual Horizontal (SVH) tests are useful tests to identify central vestibular tone imbalances. AIM: To determine the normal values of the Subjective Visual Vertical/Subjective Visual Horizontal (SVV/SVH) test in the pediatric group. The normative data were intended to be used as reference values in the vestibular evaluation of patients presenting with balance disorders and complaints of dizziness. MATERIALS AND METHODS: The study included 60 individuals between the ages of 8 and 18. All participants underwent static and dynamic SVV and SVH testing using the Virtualis Virtual Reality device, based on a test-retest protocol with six different initial tilt angles (10°, -10°, 20°, -20°, 30°, -30°). Deviation angles were analyzed. RESULTS: Across all tilt angles, the mean deviation angle ranged from 1.93° to 2.44° for the static SVV test and from 1.73° to 2.31° for the static SVH test. For the dynamic SVV test, the mean deviation angle ranged from 10.47° to 11.42°, while in the dynamic SVH test, it ranged from 7.3° to 8.85° across all tilt angles. CONCLUSION: As a result of this study, normative values for static and dynamic SVV and SVH tests using the Virtualis Virtual Reality Device were established for use in vestibular assessment in the pediatric population. The study contributes to the current literature by providing updated data, addressing the limited number of studies on static and dynamic SVV and SVH tests in pediatric populations.
Nicolas V, Raccah M, Perrinet M
… +5 more, Betolaud FX, Petroff N, Jbyeh S, Teissier N, Bois E
Int J Pediatr Otorhinolaryngol
· 2026 Mar · PMID 41643500
·
Publisher ↗
INTRODUCTION: Depending on the habits of the implanting center, the time interval between the surgical procedure and the activation of a cochlear implant varies greatly. Traditionally, the activation occurs several weeks...INTRODUCTION: Depending on the habits of the implanting center, the time interval between the surgical procedure and the activation of a cochlear implant varies greatly. Traditionally, the activation occurs several weeks after surgery, particularly in pediatric population. If recent improvements have concern surgical procedures and peri-operative care, early fitting constitutes the next optimization in cochlear implant management; for the past 5 years, we have introduced early fitting with Day 1 activation in the Robert Debré pediatric hospital. This study aims to evaluate the satisfaction of parents regarding early activation of their child's cochlear implant. MATERIALS AND METHODS: Pediatric patients who underwent an early activation of their cochlear implant between 2021 and 2024 in Robert Debré Hospital were included in the study. A satisfaction questionnaire was handed out to the parents and collected. The questionnaire encompassed informations received before implantation and during the hospital stay, and their feelings regarding early activation, and after hospital discharge. RESULTS: 68 parents of patients completed the questionnaire: 73.5 % were activated on day 1 of surgery. 60.3 % considered that early activation has not been painful for their child. 53 % of the parents identified a reaction to an auditory stimulus in their child during activation. 44 % were satisfied with the clinical pharmacologist's visit. 92.3 % were satisfied with the early activation procedure, and 97 % with returning home with an activated cochlear implant. They felt well informed before and after the surgery. No major complication was reported amongst our patients. CONCLUSION: Parents are satisfied with their child's early activation of the cochlear implant and felt relieved to go home with an activated processor and early data on the proper functioning of the implant.
Park RK, Hu K, Fullerton ZH
… +3 more, Lee MC, Khosla RK, Balakrishnan K
Int J Pediatr Otorhinolaryngol
· 2026 Mar · PMID 41637834
·
Publisher ↗
PURPOSE: This study aimed to evaluate the incidence of tracheal cartilaginous sleeve (TCS) among syndromic craniosynostosis patients, as well as describe their genetic profiles, associated co-morbidities, and operative o...PURPOSE: This study aimed to evaluate the incidence of tracheal cartilaginous sleeve (TCS) among syndromic craniosynostosis patients, as well as describe their genetic profiles, associated co-morbidities, and operative outcomes. METHODS: We performed a retrospective analysis of syndromic craniosynostosis patients (Apert, Crouzon, and Pfeiffer) at a single tertiary academic center between January 1, 2002, and February 1, 2024. RESULTS: 39 patients with syndromic craniosynostosis were identified, with 17 patients (17/39, 43.6%) undergoing airway evaluation. 1 patient (1/17, 5.9%) was diagnosed with TCS, but 5 patients (5/17, 29.4%) had other airway abnormalities, all reflecting abnormalities of the airway wall or some type of airway stenosis. 28 patients (28/39, 73.7%) presented with a diagnosis of OSA, and 7 patients (7/39, 17.9%) of patients presented with choanal anomaly (atresia or stenosis). 32 patients (32/39, 82.1%) had genetic sequencing information available, with the most common mutations affecting p.P253R within the FGFR2 gene in 7 patients. No patients in our cohort presented with a p.W290 mutation and 7 patients presented with a p.C342 mutation, of which 4 patients had the p.C342Y mutation. CONCLUSION: The true prevalence of TCS may be likely lower than prior reports, which may aid with alleviating some familial anxiety and provide additional context and data for medical counseling and decision-making. Nonetheless, all patients should be strongly recommended to undergo airway evaluation given the risks associated with TCS, the high prevalence of structural airway anomalies, and the overall low risk of airway evaluation.
Forli F, Capobianco S, Palazzo L
… +3 more, Bruschini L, Berrettini S, Lazzerini F
Int J Pediatr Otorhinolaryngol
· 2026 Mar · PMID 41637833
·
Publisher ↗
OBJECTIVES: To evaluate the long-term outcomes of infants with a "refer" result on transient evoked otoacoustic emissions (TEOAE) but a subsequent bilateral "pass" on the automated auditory brainstem response (AABR) at n...OBJECTIVES: To evaluate the long-term outcomes of infants with a "refer" result on transient evoked otoacoustic emissions (TEOAE) but a subsequent bilateral "pass" on the automated auditory brainstem response (AABR) at neonatal screening, with the goal of determining the risk of permanent hearing loss and potential functional consequences during childhood of this profile. METHODS: We retrospectively analyzed infants born between 2011 and 2019 at Pisa University Hospital (Italy) who failed TEOAE but passed bilateral AABR. Long-term follow-up was conducted ≥5 years after screening using a structured telephone questionnaire on functional outcomes (speech therapy, language delay, school difficulties, formal diagnosis of hearing loss). Children with positive responses were recalled for in-person audiological testing. RESULTS: Among 16,574 screened newborns, 74 (0.45 %) showed a TEOAE "refer" but bilateral AABR "pass". Long-term data were obtained for 63 children (85.1 %), with a mean follow-up age of 9.2 years (median 10, range 5-12). Of the 25 children who reported at least one functional difficulty and underwent in-person audiological reassessment, three (4.7 % of the total cohort) showed conductive hearing loss, while all others had normal pure-tone thresholds (≤20 dB HL bilaterally). The conductive losses were associated with otitis media with effusion and underlying conditions such as Down syndrome or cleft palate. Despite these findings, 25 children (39.7 %) were reported to have functional difficulties, including need for speech therapy, language delay, or school problems. CONCLUSIONS: This is the first study to report long-term (>5 years) outcomes in children with a TEOAE "refer"/bilateral AABR "pass" profile. In this cohort, no cases of permanent hearing loss were identified. However, the relatively high prevalence of functional difficulties highlights the importance of pediatric surveillance to ensure timely recognition of developmental issues.
Int J Pediatr Otorhinolaryngol
· 2026 Mar · PMID 41628587
·
Publisher ↗
OBJECTIVE: Developmental dyslexia is a neurodevelopmental disorder primarily characterized by phonological and reading difficulties. This study aimed to investigate temporal auditory processing and dichotic listening per...OBJECTIVE: Developmental dyslexia is a neurodevelopmental disorder primarily characterized by phonological and reading difficulties. This study aimed to investigate temporal auditory processing and dichotic listening performance in children with developmental dyslexia and to explore their potential contribution to reading-related difficulties. METHODS: Sixty children aged 8-13 years participated in the study, including 30 children diagnosed with developmental dyslexia and 30 age-matched typically developing peers. Central auditory processing was assessed using the Staggered Spondaic Word (SSW) test for dichotic listening and the Frequency Pattern Test (FPT), Duration Pattern Test (DPT), and Random Gap Detection Test (RGDT) for temporal auditory processing. RESULTS: Children with developmental dyslexia demonstrated significantly poorer performance than controls across all temporal and dichotic auditory processing measures (p < 0.05). In the SSW test, the greatest performance difference was observed in the left competing condition. Temporal processing deficits were evident in frequency discrimination, duration pattern recognition, and gap detection tasks. CONCLUSION: Children with developmental dyslexia exhibit weaknesses in temporal and dichotic auditory processing tasks. Given the linguistic demands inherent in some dichotic measures, these findings likely reflect an interaction between auditory and language-related processing rather than isolated auditory pathway dysfunction. Incorporating central auditory processing assessment into multidisciplinary dyslexia evaluations may contribute to more targeted diagnostic and intervention approaches.
deFaria FT, Preciado P, Pershad AR
… +9 more, Moscoso-Morales R, Di Bono G, Shahine A, Kavuri A, Wills T, Behzadpour HK, Pestieau S, Preciado DA, Vazquez-Colon C
Int J Pediatr Otorhinolaryngol
· 2026 Mar · PMID 41621230
·
Publisher ↗
Gökay NY, Baş B, Demi̇rtaş Yilmaz B
… +1 more, Yücel E
Int J Pediatr Otorhinolaryngol
· 2026 Mar · PMID 41619522
·
Publisher ↗
PURPOSE: This study aimed to analyze and compare the sensory profiles and language skills of children with auditory brainstem implants (ABI) and cochlear implants (CI) over one year. METHOD: This prospective comparative...PURPOSE: This study aimed to analyze and compare the sensory profiles and language skills of children with auditory brainstem implants (ABI) and cochlear implants (CI) over one year. METHOD: This prospective comparative study included 24 children aged 6-8 years and 11 months, consisting of 12 bimodal CI-ABI users and 12 bilateral CI users. All children received scheduled auditory rehabilitation and audiological follow-ups. Sensory profiles were assessed using the Sensory Profile scale, while school-age language skills were evaluated using the Test of Language Development-Primary: Fourth Edition. The language and sensory profile scores of the children from one year prior and later to the study were compared. Additionally, the progress levels of the groups within one year were compared. RESULTS: Both children with CI and ABI demonstrated significant improvements in verbal language skills (e.g., sentence repetition, p < 0.001), registration, sensory seeking, sensory input processing, low endurance, and fine motor skills over the year. However, children with CI showed significantly greater progress in verbal language composite scores (p = 0.015) and subskills such as registration and fine motor skills (p < 0.05) compared to the ABI group. Multivariate analysis further revealed that hearing loss etiology and implantation mode were significant factors influencing developmental outcomes. CONCLUSION: Hearing implants not only enhance language skills but also facilitate progress in children's sensory profile sub-skills. A holistic approach that evaluates hearing, language, and overall development is recommended for hearing-impaired children.
Int J Pediatr Otorhinolaryngol
· 2026 Mar · PMID 41619521
·
Publisher ↗
OBJECTIVES: Chronic otitis media with effusion (COME) and recurrent acute otitis media (rAOM) pose significant burdens on pediatric patients and their families. These conditions disproportionately affect marginalized pop...OBJECTIVES: Chronic otitis media with effusion (COME) and recurrent acute otitis media (rAOM) pose significant burdens on pediatric patients and their families. These conditions disproportionately affect marginalized populations, such as Indigenous communities in Canada, where higher incidence rates and reduced access to care are well documented. This study aims to better understand the sequelae of rAOM/COME following tympanostomy tube (TT) insertion in Indigenous pediatric patients living in northern Quebec. METHODS: A retrospective matched cohort study was conducted on children who underwent TT insertion. Indigenous patients were matched 1:2 by age and gender with non-Indigenous controls. Data collected included comorbidities, TT indications, surgical history, cancellation rates, otolaryngology and audiology assessments (pre- and post-operative), operative notes, and follow-up documentation. RESULTS: A total of 240 patients (80 Indigenous and 160 non-Indigenous) were analyzed. Baseline characteristics, surgical wait times (p = 0.18), and time to first follow-up (p = 0.33) were similar. At first follow-up (mean 5.4-5.9 months), Indigenous children were more likely to have tympanic membrane perforation (6.2 % vs. 1.3 %, p = 0.04). Tube extrusion was observed in 23.8 % of Indigenous children versus 15 % of non-Indigenous children (p = 0.054). Among Indigenous patients, Inuit children had a significantly higher extrusion rate (50 %) compared to First Nations children (23.3 %) (p = 0.04). CONCLUSION: While access to care appears equitable post-referral, Indigenous children-particularly Inuit-exhibit higher rates of tympanic membrane perforation and possible early tube extrusion. These differences underscore the need for tailored approaches and further investigation into population-specific pathophysiology.
Allen M, Reeves C, Torres-Small S
… +4 more, Yawn RJ, Macdonald CB, Smith SH, Richard C
Int J Pediatr Otorhinolaryngol
· 2026 Mar · PMID 41581250
·
Publisher ↗
OBJECTIVE: This study aims to comprehensively assess the timing and accessibility of cochlear implantation, patterns of its utilization, and the associated outcomes related to quality of life (QoL), in children diagnosed...OBJECTIVE: This study aims to comprehensively assess the timing and accessibility of cochlear implantation, patterns of its utilization, and the associated outcomes related to quality of life (QoL), in children diagnosed with autism spectrum disorder (ASD). STUDY DESIGN: Retrospective case-control review, and cross-sectional hearing-related QoL survey. SETTING: Tertiary children's hospital. METHODS: This investigation employed a retrospective case-control design, complemented by a cross-sectional hearing-related QoL survey using the HEAR-QL questionnaires. Outcomes were compared between two populations of pediatric cochlear implant recipients: one group with a preoperative diagnosis of ASD and a control group of neurotypical peers. A review of 413 patient records from 2000 to 2022 identified 22 eligible patients with ASD and matched controls. Of these, 16 participants from the ASD group and 16 controls completed the prospective quality-of-life surveys. RESULTS: The time between the definitive diagnosis of profound sensorineural hearing loss and the cochlear implantation evaluation was longer for patients with ASD. However, no other significant differences in care delays were observed between ASD children and controls, including time to CI qualification, and implantation. Nevertheless, children with ASD aged 2-6 years showed poorer outcomes in social interaction (p = 0.02) and new social situations (p = 0.02 and 0.04). Despite these behavioral differences, no significant disparity in hearing-related QoL-related communication outcomes was observed. CONCLUSION: The study shows that cochlear implant benefit children with ASD, with expected challenges not affecting overall success. It underscores the importance of individualized approaches to address delays in CI evaluation, communication, and social interaction challenges. These insights can help guide care teams, parents and educators in setting realistic expectations following cochlear implantation.
Jarmund AH, Tollefsen SE, Sakshaug BC
… +2 more, Honarmandi Y, Torp SH
Int J Pediatr Otorhinolaryngol
· 2026 Mar · PMID 41581249
·
Publisher ↗
BACKGROUND: Children occasionally adhere their tongues to cold metal surfaces during winter ("tundra tongue"), but little is known about the epidemiology and outcomes of these cases. OBJECTIVES: To explore the following...BACKGROUND: Children occasionally adhere their tongues to cold metal surfaces during winter ("tundra tongue"), but little is known about the epidemiology and outcomes of these cases. OBJECTIVES: To explore the following questions: who experiences tundra tongue, under which circumstances does it occur, and what are the outcomes? METHODS: We conducted a scoping review to identify case reports published in historical newspapers from Norway, Sweden and Denmark using national library databases. Epidemiological data were charted manually from newspaper items describing literal frozen tongues. RESULTS: Among 17,009 unique search hits, 856 reports of 113 different cases were identified. Almost all cases (96 %) involved children, median age 5.25 years, and the majority were boys (63 %). Tongues were most often frozen to railings (40 %). Ambient temperature was reported in 18 cases with a median of -16.5 °C. Outcomes ranged from discomfort to potential amputation of tongue tissue, with 20 (18 %) cases involving a doctor or a hospital. Severe injuries were reported in several cases through three distinct mechanisms: (1) the direct effect of cold on tissue, (2) detachment injuries, and (3) the consequences of immobility. CONCLUSION: Children, and especially boys, in wintertime, are vulnerable to tundra tongue. Most cases had no or mild consequences but severe injuries were also described in multiple cases. Hence, parents, health care professionals and policymakers should not underestimate the potential harm of tundra tongue.
Li J, Guo M, Yu W
… +6 more, Ma L, Zhang Q, Wang Q, Yang X, He H, Liu W
Int J Pediatr Otorhinolaryngol
· 2026 Mar · PMID 41564508
·
Publisher ↗
BACKGROUND: This study aimed to characterize the Variant profile of the 4 common deafness-causing genes and evaluated the genotype-phenotype correlation of GJB2 c.109G > A variants in a neonatal cohort, providing insight...BACKGROUND: This study aimed to characterize the Variant profile of the 4 common deafness-causing genes and evaluated the genotype-phenotype correlation of GJB2 c.109G > A variants in a neonatal cohort, providing insights for early diagnosis of congenital hearing loss. METHODS: A total of 47,729 newborns in Shenzhen underwent integrated deafness gene screening (23 common pathogenic variants across GJB2, SLC26A4, MT-RNR1, and GJB3) and two-stage audiometric assessments from January 2022 to November 2024. Participants were stratified into three groups based on GJB2 c.109G > A genotypes: homozygous (Group A, n = 487), compound heterozygous (Group B, n = 87), and heterozygous carriers (Group C, n = 8055). Hearing function was evaluated via otoacoustic emissions (OAE) at 48 h postpartum, with non-passing cases receiving follow-up OAE and auditory brainstem response (ABR) testing at 42 days. RESULTS: Deafness-associated Variant were detected in 21.56 % (10,291/47,729) of neonates, with GJB2 exhibiting the highest carrier frequency (20.25 %), followed by SLC26A4 (1.44 %), MT-RNR1 (0.28 %), and GJB3 (0.18 %). The GJB2 c.109G > A locus dominated the variant landscape, with a carrier rate of 18.12 % (n = 8649) and an minor allele frequency of 9.57 %. The overall pass rates for the two-stage audiological assessments differed significantly across the groups: 63.66 % (Group A), 70.11 % (Group B), and 98.92 % (Group C). Bilateral hearing impairment predominated in Groups A and B. CONCLUSION: The GJB2 c.109G > A Variant represents the most prevalent pathogenic variant in Shenzhen neonates, and the infants carrying deafness-causing genotypes of this variant presents relatively high hearing screening pass rate. Integrated genetic and audiometric screening could enhance early identification of high-risk infants.
Int J Pediatr Otorhinolaryngol
· 2026 Mar · PMID 41558172
·
Publisher ↗
PURPOSE: Cochlear implantation (CI) significantly improves hearing in individuals with severe to profound sensorineural hearing loss. However, variations in surgical techniques may affect middle and inner ear mechanics....PURPOSE: Cochlear implantation (CI) significantly improves hearing in individuals with severe to profound sensorineural hearing loss. However, variations in surgical techniques may affect middle and inner ear mechanics. This study explores the effect of transcranial transcanal wall-Veria technique for CI on middle ear mechanics, measured using wideband absorbance (WBA). METHODS: Ten children (4-7 years) who underwent CI using the transcranial Transcanal wall-Veria technique were compared to age- and gender-matched controls with normal-hearing children. Tympanometric measures such as static compliance, tympanometric peak pressure, Ear canal volume, resonance frequency, and wideband absorbance at peak and ambient pressure were measured. RESULTS: Conventional 226 Hz Tympanometric measures were similar for both CI and Normal hearing groups, showing no significant differences (p > 0.05) between the groups. However, WBA measurements revealed significant changes (p < 0.05) in absorbance across frequencies, particularly at higher frequencies (2000-8000 Hz). The WBA pattern was different, with two maximum absorbance for normal-hearing children, whereas single maxima around 2000 Hz for CI group. Further, WBA at peak pressure differed from ambient pressure in both groups at low and mid-frequencies, with significant differences (p < 0.05) observed only in CI group. These results suggest that the Veria technique causes alterations in middle ear mechanics, specifically in the high-frequency regions. CONCLUSIONS: This study highlights the utility of WBA in detecting subtle, frequency-specific changes in ear mechanics following the Veria CI technique, which may remain undetected by conventional tympanometry. Although functional auditory outcomes such as aided thresholds, speech perception scores, and eSRT were not correlated in this study,the findings underscore the importance of WBA as an advanced diagnostic tools in assessing the impact of surgical techniques on ear function post-CI.
Kerschner JE, Daley RA, Link R
… +27 more, Jones RM, Peterson KJ, Chun RH, Flanary VA, Gorelik M, Keppel KL, Maksimoski M, Malloy M, Martin TJ, McCormick ME, Robey TC, Ansari S, Matoska GM, Rupcich CA, Saunderson ML, Shay SG, Sulman C, Erbe C, Thompson JK, Khampang P, Yan K, Simpson PM, Ho A, Monroy GL, Spillman DR, Aksamitiene E, Boppart SA
Int J Pediatr Otorhinolaryngol
· 2026 Mar · PMID 41547297
·
Full text
OBJECTIVE: To identify the ability of optical coherence tomography (OCT) to assist in the diagnosis and treatment of patients presenting to a primary care provider with signs and symptoms suggesting acute otitis media (A...OBJECTIVE: To identify the ability of optical coherence tomography (OCT) to assist in the diagnosis and treatment of patients presenting to a primary care provider with signs and symptoms suggesting acute otitis media (AOM). DESIGN-SETTING-PARTICIPANTS: An NIH-funded clinical trial was conducted and enrolled 75 children between 1 and under 7 years of age. Children presented with complaints of ear pain or suspected ear infection from their caregiver history to primary care clinics associated with an academic children's hospital. These patients upon presentation were eligible to enroll in the trial. Following a complete history and physical exam, including pneumatic otoscopy (PO), patients were provided with a diagnosis and treatment plan. Diagnoses included: AOM, middle ear effusion without AOM, or no evidence of otitis media with a clear middle ear space. Following this, OCT was performed, and the diagnosis and treatment plan was reassessed using this data. RESULTS: The diagnosis and/or treatment plan changed for 15.3 % of patients following the use of OCT compared with the initial use of PO. The greatest influence was seen in the patient group with MEE without AOM, with 36 % (5/14) of these patients having their diagnosis and/or treatment plan changed after OCT was employed. CONCLUSIONS: OCT provides an additional adjunct for primary care providers to enhance visualization of the tympanic membrane and middle ear space. This data, in our clinical trial, resulted in enhanced clinical decision making, in particular for patients with MEE who were not diagnosed with AOM on PO. TRIAL REGISTRATION INFORMATION: Coherent Optical Detection of Middle Ear Disease (OCTII). CLINICALTRIALS: gov ID number: NCT05353569.