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Dedhia K, Maltenfort M, Elden L, Horn D, Magnusen B, Pattisapu P, Pritchett CV, Wine T, Utidjian L, Forrest CB. Multi-institutional Assessment of Otitis Media Epidemiology Using Real-world Data. Int J Pediatr Otorhinolaryngol 2024; 179:111921. [PMID: 38582054 DOI: 10.1016/j.ijporl.2024.111921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/12/2024] [Accepted: 03/12/2024] [Indexed: 04/08/2024]
Abstract
OBJECTIVES To determine rates and risk factors of pediatric otitis media (OM) using real-world electronic health record (PEDSnet) data from January 2009 through May 2021. STUDY DESIGN Retrospective cohort study. SETTING Seven pediatric academic health systems that participate in PEDSnet. METHODS Children <6 months-old at time of first outpatient, Emergency Department, or inpatient visit were included and followed longitudinally. A time-to-event analysis was performed using a Cox proportional hazards model to estimate hazard ratios for OM incidence based on sociodemographic factors and specific health conditions. RESULTS The PEDSnet cohort included 910,265 children, 54.3% male, mean age (months) 1.3 [standard deviation (SD) 1.6] and mean follow up (years) 4.3 (SD 3.2). By age 3 years, 39.6% of children had evidence of one OM episode. OM rates decreased following pneumococcal-13 vaccination (PCV-13) and the COVID-19 pandemic. Along with young age, non-Hispanic Black/African American or Hispanic race/ethnicity, public insurance, higher family income, and male sex had higher incidence rates. Health conditions that increased OM risk included cleft palate [adjusted hazard ratio (aHR) 4.0 [95% confidence interval (CI) 3.9-4.2], primary ciliary dyskinesia [aHR 2.5 (95% CI 1.8-3.5)], trisomy 21 [aHR 2.0 (95% CI 1.9-2.1)], atopic dermatitis [aHR 1.4 (95% CI 1.4-1.4)], and gastroesophageal reflux [aHR1.5 (95% CI 1.5-1.5)]. CONCLUSIONS Approximately 20% of children by age 1 and 40% of children by age 3 years will have experienced an OM episode. OM rates decreased after PCV-13 and COVID-19. Children with abnormal ciliary function or craniofacial conditions, specifically cleft palate, carry the highest risk of OM.
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Affiliation(s)
- Kavita Dedhia
- The Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA.
| | - Mitch Maltenfort
- Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Wilmington, DE, USA
| | - Lisa Elden
- The Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA
| | - David Horn
- Otolaryngology Head and Neck Surgery, Seattle Children's Hospital, Seattle, WA, USA
| | - Brianna Magnusen
- Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Prasanth Pattisapu
- General Otolaryngology, Nationwide Children's Hospital, Columbus, OH, USA
| | - Cedric V Pritchett
- Pediatric Otolaryngology Head & Neck Surgery, Nemours Children's Health, Orlando, FL, USA
| | - Todd Wine
- Otolaryngology Head and Neck Surgery, Children's Hospital Colorado, Aurora, CO, USA
| | - Levon Utidjian
- Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Wilmington, DE, USA
| | - Christopher B Forrest
- The Children's Hospital of Philadelphia and University of Pennsylvania, Philadelphia, PA, USA; Applied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Wilmington, DE, USA
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Gisselsson-Solen M, Gunasekera H, Hall A, Homoe P, Kong K, Sih T, Rupa V, Morris P. Panel 1: Epidemiology and global health, including child development, sequelae and complications. Int J Pediatr Otorhinolaryngol 2024; 178:111861. [PMID: 38340606 DOI: 10.1016/j.ijporl.2024.111861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 12/19/2023] [Accepted: 01/09/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE To summarise the published research evidence on the epidemiology of otitis media, including the risk factors and sequelae associated with this condition. DATA SOURCES Medline (PubMed), Embase, and the Cochrane Library covering the period from 2019 to June 1st, 2023. REVIEW METHODS We conducted a broad search strategy using otitis [Medical Subject Heading] combined with text words to identify relevant articles on the prevalence, incidence, risk factors, complications, and sequelae for acute otitis media, otitis media with effusion, and chronic suppurative otitis media. At least one review author independently screened titles and abstracts of the retrieved records for each condition to determine whether the research study was eligible for inclusion. Any discrepancies were resolved by reviewing the full text followed by discussion with a second review author. Studies with more than 100 participants were prioritised. RESULTS Over 2,000 papers on otitis media (OM) have been published since 2019. Our review has highlighted around 100 of these publications. While the amount of otitis media research on the Medline database published each year has not increased, there has been an increase in epidemiological studies using routinely collected data and systematic review methodology. Most of the large incidence studies have addressed acute otitis media (AOM) in children. Several studies have described a decrease in incidence of AOM after the introduction of conjugate PCV vaccines. Similarly, a decrease was noted when rates of coronavirus disease of 2019 (COVID-19) were high and there were major public health efforts to reduce the spread of infection. There have been new studies on OM in adults and OM prevalence in a broader range of countries and population subgroups. CONCLUSION Overall, the rates of severe and/or suppurative OM appeared to be decreasing. However, there is substantial heterogeneity between populations. While better use of available data is informative, it can be difficult to predict rates of severe disease without accurate examination findings. Most memorably, the COVID-19 pandemic had an enormous impact on the research and clinical services for otitis media for most of the period under review. IMPLICATIONS FOR PRACTICE The use of routinely collected data for epidemiological studies will lead to greater variability in the definitions and diagnostic criteria used. The impact of new vaccines will continue to be important. Some of the lessons learned during the COVID-19 pandemic concerning behaviours that reduce spread of respiratory viruses can hopefully be used to decrease the burden of otitis media in the future. There are still many countries in the world where the burden of otitis media is not well described. In countries where otitis media has been studied over many years, new potential risk factors continue to be identified. In addition, a better understanding of the disease in specific subgroups has been achieved.
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Affiliation(s)
- Marie Gisselsson-Solen
- Department of Otorhinolaryngology, Head and Neck Surgery, Lund University Hospital, Lund, Sweden.
| | - Hasantha Gunasekera
- Children's Hospital Westmead Clinical School, University of Sydney, Australia
| | | | - Preben Homoe
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zeeland University Hospital, Koege, Denmark
| | - Kelvin Kong
- School of Medicine and Public Health, Newcastle, Australia
| | - Tania Sih
- Medical School University of Sao Paolo, Brazil
| | | | - Peter Morris
- Menzies School of Health Research Charles Darwin University Darwin, Australia
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Shi D, Zhao H, Chen G, Jin X, Wu Z, Wang J, Chen J. The effects of treating GERD on the outcomes of otitis media with effusion: A systematic review and meta-analysis. Am J Otolaryngol 2024; 45:104061. [PMID: 37806281 DOI: 10.1016/j.amjoto.2023.104061] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 09/12/2023] [Accepted: 09/20/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVE Gastroesophageal reflux disease (GERD) may cause otitis media with effusion (OME). However, whether treating GERD can benefit patients with OME has not been well studied. METHODS We systematically searched PubMed, Embase, Cochrane Library, and Wanfang databases. The search period was from the establishment of the databases until December 31, 2022. Clinical studies related to GERD treatment on the outcomes of OME were included. Two reviewers independently conducted literature screening and data extraction according to the inclusion and exclusion criteria. To evaluate the quality of the included studies, we used the NOS assessment tool and the RevMan 5.4. Subgroup analysis was conducted to reduce the risk of heterogeneity, and Egger and Begg funnel plots were used to evaluate publication bias. Meta-analysis was performed using Stata14.0 and Review Manager 5.4 software. RESULTS Finally, 21,744 patients from 16 studies were included. The results showed that the rate of GERD in OME patients was 0.56 (95 % confidence interval (CI): 0.33, 0.79), while it was 0.04 (95 % CI: 0.03, 0.05) in the adult GERD population. The combined risk ratio (RR) of OME in patients with versus without GERD was 1.58 (95 % CI: 1.35, 1.85; p < 0.01). The efficacy rate of GERD treatment in OME patients was 0.59 (95 % CI: 0.44, 0.74), especially for those with chronic OME (0.64, 95 % CI: 0.36, 0.92). Compared to the control group, treatment with GERD improved the symptoms and efficacy of OME (OR = 1.65; 95 % CI: 0.95, 2.85; p > 0.05). The hearing loss cure rate was 0.70 (95 % CI: 0.57, 0.82). CONCLUSION GERD has been suggested to be a high-risk factor for OME. Treatment of GERD can improve the symptoms of OME. However, further studies are required to verify these findings.
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Affiliation(s)
- Dike Shi
- Department of Gastroenterology Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310000, China.
| | - Hanxin Zhao
- Department of Endocrinology and Metabolism, Zhejiang University Affiliated Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310000, China.
| | - Guofeng Chen
- Department of Gastroenterology Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310000, China.
| | - Xiaoli Jin
- Department of Gastroenterology Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310000, China.
| | - Zhiwei Wu
- Department of Gastroenterology Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310000, China.
| | - Jun Wang
- Department of Gastroenterology Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310000, China.
| | - Jian Chen
- Department of Gastroenterology Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310000, China.
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Nokso-Koivisto J, Ehrlich GD, Enoksson F, Komatsu K, Mason K, Melhus Å, Patel JA, Vijayasekaran S, Ryan A. Otitis media: Interactions between host and environment, immune and inflammatory responses. Int J Pediatr Otorhinolaryngol 2024; 176:111798. [PMID: 38041988 DOI: 10.1016/j.ijporl.2023.111798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 11/12/2023] [Accepted: 11/19/2023] [Indexed: 12/04/2023]
Abstract
OBJECTIVE To review and highlight progress in otitis media (OM) research in the areas of immunology, inflammation, environmental influences and host-pathogen responses from 2019 to 2023. Opportunities for innovative future research were also identified. DATA SOURCES PubMed database of the National Library of Medicine. REVIEW METHODS Key topics were assigned to each panel member for detailed review. Search of the literature was from June 2019 until February 2023. Draft reviews were collated, circulated, and discussed among panel members at the 22nd International Symposium on Recent Advances in Otitis Media in June 2023. The final manuscript was prepared and approved by all the panel members. CONCLUSIONS Important advances were identified in: environmental influences that enhance OM susceptibility; polymicrobial middle ear (ME) infections; the role of adaptive immunity defects in otitis-proneness; additional genes linked to OM; leukocyte contributions to OM pathogenesis and recovery; and novel interventions in OM based on host responses to infection. Innovative areas of research included: identification of novel bacterial genes and pathways important for OM persistence, bacterial adaptations and evolution that enhance chronicity; animal and human ME gene expression, including at the single-cell level; and Sars-CoV-2 infection of the ME and Eustachian tube.
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Affiliation(s)
- Johanna Nokso-Koivisto
- Department of Otorhinolaryngology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
| | - Garth D Ehrlich
- Department of Microbiology and Immunology and Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, PA, USA
| | | | - Kensei Komatsu
- Center for Inflammation, Immunity & Infection, Institute for Biomedical Sciences, Georgia State University, Atlanta, GA, USA
| | - Kevin Mason
- The Research Institute at Nationwide Children's Hospital, Infectious Diseases Institute, The Ohio State University School of Medicine, Columbus, OH, USA
| | - Åsa Melhus
- Department of Medical Sciences, Section of Clinical Bacteriology, Uppsala University, Uppsala, Sweden
| | - Janak A Patel
- Department of Infection Control & Healthcare Epidemiology and Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, USA
| | - Shiyan Vijayasekaran
- Perth ENT Centre, Perth Children's Hospital, University of Western Australia, Perth, Australia
| | - Allen Ryan
- Department of Surgery, Division of Otolaryngology, University of California San Diego, San Diego, CA, USA
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Wang X, Xu J, Feng G, Gao Z, Sun W. Proteomic Study of Middle Ear Effusion and Its Clinical Application for Otitis Media with Effusion. Infect Drug Resist 2023; 16:5923-5940. [PMID: 37700801 PMCID: PMC10494926 DOI: 10.2147/idr.s424475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 08/31/2023] [Indexed: 09/14/2023] Open
Abstract
Background Proteins found in middle ear effusion play crucial roles in the physiological and pathological processes of otitis media with effusion (OME), influencing the etiology and clinical characteristics of this disease. The qualitative and quantitative composition of these proteins depending on the underlying pathogenesis of middle ear effusion. Understanding their physiological and pathological functions is of great importance. Methods We collected samples from 19 volunteers diagnosed with OME. After offline separation using high-pH reversed-phase liquid chromatography (RPLC), the pooled sample was subjected to LC-MS/MS analysis to obtain a comprehensive profile of the OME proteome. Functional analysis was performed using Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Ingenuity Pathway Analysis (IPA) annotations. Data-independent acquisition (DIA) technology was utilized to analyze samples and fix whether the OME proteome could replicate the pathophysiological features associated with this disease. We conducted a differential proteomic analysis between patients with simple OME and patients who had received radiotherapy. The radiotherapy-reduced group was further divided into two subgroups: nasopharyngeal carcinoma (NPC) and other types of carcinoma. Parallel reaction monitoring (PRM) technology was used for validation of 36 differentially expressed proteins (DEPs). Results A number of 732 proteins were identified in the OME proteome database. Among them, 527 proteins were quantified using peak intensity-based semi-quantification (iBAQ), covering a wide dynamic range of approximately 8 orders of magnitude. Based on the functional analysis, we proposed a hypothetical mechanism of OME. Conclusion This study managed to put up an inclusive analysis of the OME proteome, establishing the first human OME proteome database. We focused on differential proteomic analysis among different groups to gain a more comprehensive concept of the OME proteome and search for meaningful biomarkers.
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Affiliation(s)
- Xi Wang
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Jiyu Xu
- Institute of Basic Medical Sciences, School of Basic Medicine, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, People’s Republic of China
| | - Guodong Feng
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Zhiqiang Gao
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Wei Sun
- Institute of Basic Medical Sciences, School of Basic Medicine, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, People’s Republic of China
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Lupu VV, Beşer ÖF, Gurzu S, Stefanescu G, Starcea IM, Adam Raileanu A, Popp A, Lupu A. Pediatric Gastroenterology Research. Life (Basel) 2023; 13:1810. [PMID: 37763214 PMCID: PMC10532566 DOI: 10.3390/life13091810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/09/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
For several decades, before the 19th century, pediatric pathology was considered to be an annex of adult pathology and treated as a secondary matter in medical practice [...].
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Affiliation(s)
- Vasile Valeriu Lupu
- Department of Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ömer Faruk Beşer
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Cerrahpasa Medical Faculty, Istanbul University Cerrahpasa, Istanbul 34776, Turkey
| | - Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540012 Targu Mures, Romania
| | - Gabriela Stefanescu
- Department of Gastroenterology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Iuliana Magdalena Starcea
- Department of Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Anca Adam Raileanu
- Department of Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alina Popp
- Department of Pediatrics, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Ancuta Lupu
- Department of Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
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Andreeva IG, Mamleev RN, Marapov DI, Nesterov OV. The influence of nasal and oropharyngeal mucosal dysbiosis on the condition of the middle ear in children with congenital cleft palate. ROSSIYSKIY VESTNIK PERINATOLOGII I PEDIATRII (RUSSIAN BULLETIN OF PERINATOLOGY AND PEDIATRICS) 2022. [DOI: 10.21508/1027-4065-2022-67-5-158-162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Disturbance of the microbiocenosis of the nasal cavity and oropharynx in children with congenital cleft palate presents serious therapeutic difficulties. Pathobionts colonizing the upper respiratory tract and chronic adenoiditis pose a threat of acute purulent otitis media and chronic otitis media with effusion. The authors studied nasal and oropharyngeal mucosal dysbiosis in patients before elective uranoplasty and the effect of dysbiotic manifestations on the condition of the middle ear in the postoperative period. The results of microbiological examination of 80 swabs from the nasal cavity and oropharynx in patients with congenital cleft palate were analyzed. Among the culture-positive results in patients in clinical and laboratory remission of ENT-infections dysbiosis of 2–3 degrees prevails, the presence of bacterial-bacterial and bacterial-fungal associations is often noted, the predominance of gram-negative microflora is noted. There was an increase in the frequency of perforations of the tympanic membrane in the presence of bacterial and fungal associations, the appearance of retraction pockets in the presence of gram-negative microflora, the relationship between grade 3 dysbiosis and the appearance of purulent otitis media after uranoplasty were revealed.Conclusion. Disturbance of microbiocenosis in patients with congenital cleft palate before uranoplasty requires the inclusion of a microbiological study in the preoperative preparation schedule and a personalized approach to perioperative antibiotic prophylaxis.
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Affiliation(s)
| | - R. N. Mamleev
- Children’s Republican Clinical Hospital;
Kazan State Medical University
| | | | - O. V. Nesterov
- Kazan State Medical Academy, Branch Campus of the Medical Academy of Continuous Professional Education
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Thomas AT, Waite J, Williams CA, Kirk J, Oliver C, Richards C. Phenotypic characteristics and variability in CHARGE syndrome: a PRISMA compliant systematic review and meta-analysis. J Neurodev Disord 2022; 14:49. [PMID: 36045324 PMCID: PMC9429597 DOI: 10.1186/s11689-022-09459-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 08/15/2022] [Indexed: 12/01/2022] Open
Abstract
Background CHARGE syndrome (OMIM #214800) is a phenotypically complex genetic condition characterised by multi-system, multi-sensory impairments. Behavioural, psychological, cognitive and sleep difficulties are not well delineated and are likely associated with biopsychosocial factors. Methods This meta-analysis investigated the prevalence of clinical features, physical characteristics and conditions, behavioural, psychological, cognitive and sleep characteristics in CHARGE syndrome, and statistically evaluated directional associations between these characteristics. Pooled prevalence estimates were calculated using reliable, prespecified quality weighting criteria, and meta-regression was conducted to identify associations between characteristics. Results Of the 42 eligible studies, data could be extracted for 1675 participants. Prevalence estimates were highest for developmental delay (84%), intellectual disability (64%), aggressive behaviour (48%), self-injurious behaviour (44%) and sleep difficulties (45%). Meta-regression indicated significant associations between intellectual disability and choanal atresia, intellectual disability and inner ear anomalies, sleep difficulties and growth deficiency, and sleep difficulties and gross motor difficulties. Conclusions Our comprehensive review of clinical features, behavioural, psychological, cognitive and physical characteristics, conditions and comorbidities in CHARGE syndrome provides an empirically based foundation to further research and practice. Supplementary Information The online version contains supplementary material available at 10.1186/s11689-022-09459-5.
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Affiliation(s)
- Andrea T Thomas
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK. .,Cerebra Network for Neurodevelopmental Disorders, Birmingham, UK.
| | - Jane Waite
- Cerebra Network for Neurodevelopmental Disorders, Birmingham, UK.,Aston University, Birmingham, UK
| | - Caitlin A Williams
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry, UK
| | - Jeremy Kirk
- Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Chris Oliver
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
| | - Caroline Richards
- School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK.,Cerebra Network for Neurodevelopmental Disorders, Birmingham, UK
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Abstract
Acute otitis media (AOM) is an acute infection of the middle ear and, depending on the age of the child, the certainty of diagnosis, and the severity of symptoms, should be either observed closely or treated (with high-dose amoxicillin, if not allergic). Host-related risk factors such as age, sex, cleft palate, or genetic predisposition or environmental risk factors such as seasonality, day care attendance, or tobacco smoke exposure may contribute to recurrent AOM (RAOM) episodes. Tympanostomy tubes are recommended in children with RAOM and an abnormal ear examination at the time of the clinic evaluation.
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Affiliation(s)
- Todd Otteson
- Pediatric Otolaryngology, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Suite 4500, Cleveland, OH 44106, USA.
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Jung Y, Cho A, Yang S, Jeon Y, Bae SH. Patients Requiring Gastrostomy Tube Insertion After Total Laryngectomy Have a Higher Incidence of Otitis Media. J Audiol Otol 2021; 26:31-35. [PMID: 34963275 PMCID: PMC8755433 DOI: 10.7874/jao.2021.00549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/24/2021] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives Some reports propose an increased risk of otitis media and hearing impairment after total laryngectomy. However, the incidence of otitis media following laryngectomy and the mechanism remain unclear. This study aimed to identify the incidence and risk factors of otitis media after total laryngectomy. Subjects and Methods This retrospective cohort study assessed 77 patients who underwent total laryngectomy from 2010 to 2020 in a tertiary referral center. Serial imaging studies (computed tomography [CT], magnetic resonance imaging, and positron emission tomography-CT) were used to assess otitis media. Results The study enrolled 58 patients (mean age, 67.0±7.7 years; male, 56 [96.6%]); nine (15.5%) underwent a gastrostomy tube (four preoperatively and five postoperatively). Otitis media was confirmed in seven (12.1%) patients. Gastrostomy tube insertion was the only significant risk factor for otitis media (p=0.012). Of the nine patients who underwent gastrostomy tube insertion, four developed otitis media; all four had the procedure after laryngectomy. Conclusions This study found an increased incidence of otitis media after total laryngectomy. Swallowing difficulties likely contribute to otitis media as it occurred more frequently in patients requiring postoperative gastrostomy tube insertion.
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Affiliation(s)
- Youngrak Jung
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Ara Cho
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Seungjoon Yang
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Yutae Jeon
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Seong Hoon Bae
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
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