Adenotonsillectomy is first-line treatment for pediatric obstructive sleep apnea (OSA), yet residual disease persists in a notable subset of children. Traditional preoperative assessments reflect patient characteristics rather than airway anatomy, while prior cone-beam CT (CBCT) studies required extra research-only scans. We evaluated whether postoperative CBCT-measured upper-airway volume distinguishes complete OSA resolution from residual disease, and assessed age-related postoperative soft-tissue remodeling. This single-center retrospective STROBE-compliant cohort enrolled 238 children aged 3–10 years with PSG-confirmed OSA who underwent coblation adenotonsillectomy, with clinically indicated pre- and 3-month postoperative CBCT. Postoperative OAHI <1 defined complete resolution, and OAHI ≥5 defined residual OSA. ROC and multivariable logistic regression analyses were performed. Mean OAHI decreased from 16.8 to 5.4 events/h (*p*<0.001). Complete resolution was achieved in 63.4% patients. The optimal postoperative airway volume cutoff was 10.5 cm³ (AUC=0.89). Postoperative volume <10.5 cm³, adenoid regrowth, high preoperative OAHI, younger age (3.0–3.9 years), and tongue-base hypertrophy were independent predictors of residual OSA. Postoperative upper-airway volume of 10.5 cm³ effectively stratifies residual OSA risk. Young age independently predicts persistent disease, likely due to incomplete soft tissue remodeling. This CBCT-based stratification uses clinically acquired imaging without extra radiation exposure.
OBJECTIVE To explore the joint evaluation value of canal paresis (CP), directional preponderance (DP), and fixation index (FI) in caloric tests for assessing peripheral and central vestibular damage in vestibular migraine (VM). METHODS Clinical data of 126 VM patients completing caloric tests were retrospectively analyzed and divided into attack and interictal groups. Additionally, 100 healthy individuals were included as controls. Differences in core caloric test parameters (CP, DP, FI) among the groups were compared in terms of both means and abnormal/positive rates. RESULTS The means and abnormal/positive rates of CP, DP, and FI in the VM attack group (37.3%, 41.3%, and 31.0%, respectively) were significantly higher than those in the interictal group (13.5%, 22.2%, and 8.0%, respectively) (all p < 0.05). Furthermore, the interictal group's mean indicators were significantly higher than those of the healthy controls (all p < 0.001), while the healthy controls had a 0% abnormal/positive rate. CONCLUSION Joint analysis of CP, DP, and FI has important laboratory reference value for evaluating vestibular function in VM. Vestibular abnormalities in both attack and interictal periods reflect pathological characteristics involving both peripheral and central pathways. The caloric test is an effective clinical tool for the dynamic evaluation of vestibular function in VM, rather than a standalone diagnostic instrument.
BACKGROUND Olfactory dysfunction substantially affects olfaction-related quality of life, daily functioning, safety, and well-being, yet a validated, comprehensive, Hebrew, olfaction-specific patient-reported outcome measure is unavailable. OBJECTIVES To translate, culturally adapt, and validate the Hebrew version of the Questionnaire of Olfactory Disorders (He-QOD). METHODS This prospective cross-sectional study included 90 patients with OD and 48 healthy controls. Participants completed the He-QOD, Sniffin' Sticks threshold-discrimination-identification (TDI) testing, and a Hebrew-adapted University of Pennsylvania Smell Identification Test (UPSIT). Thirty-three participants underwent retesting after at least 4 weeks. Internal consistency, test-retest reliability, known-group validity, convergent validity, and discriminative ability were evaluated. RESULTS The total He-QOD had excellent internal consistency (Cronbach's alpha = 0.931) and test-retest reliability (intraclass correlation coefficient = 0.971). Patients had higher total and domain scores than controls (all p < 0.001). Total He-QOD score correlated inversely with TDI (ρ = -0.57, p < 0.001) and UPSIT scores (ρ = -0.56, p < 0.001). Areas under receiver operating characteristic curves ranged from 0.833 to 0.846. CONCLUSION The He-QOD is a reliable and valid tool for assessing the patient-reported burden of OD among Hebrew-speaking populations. Its association with two psychophysical assessments supports its use alongside objective testing in clinical and research settings.
