{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:04:01Z","timestamp":1790053441924,"version":"4.0.1"},"reference-count":37,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100024209","name":"Japan Otological Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100024209","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the impact of the COVID\u201019 pandemic on pediatric surgery for otitis media with effusion (OME) in Japan, comparing the general population with high\u2010risk groups (Down syndrome and cleft palate) to differentiate between environmental and anatomical drivers of surgical demand.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study used the Japanese Diagnosis Procedure Combination database (April 2013 to March 2023). Children &lt;\u200918\u2009years undergoing tympanostomy tube insertion or myringotomy were included. Interrupted time\u2010series (ITS) analysis was employed to estimate immediate \u201clevel shifts\u201d and pandemic\u2010period \u201ctrend changes,\u201d effectively accounting for 10\u2010year pre\u2010existing secular trends to isolate the pandemic's impact.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 22,748 surgical cases, no significant pre\u2010pandemic trend (+0.05 surgeries\/month) was observed, followed by a significant immediate level shift (\u2212107.55 surgeries\/month) and a non\u2010significant slope change (0.95 surgeries\/month). In contrast, immediate level shifts in the Down syndrome and cleft palate groups were not statistically significant, indicating relatively preserved surgical volume. Concomitant adenoidectomy and tonsillectomy decreased significantly from 38.8% to 29.7% and 23.2% to 16.9%, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While OME surgical volume for the general population plummeted, likely due to reduced community\u2010acquired respiratory infections, it remained resilient in high\u2010risk children. These findings suggest that while environmental factors drive OME in the general population, anatomical vulnerabilities necessitate consistent surgical intervention in high\u2010risk groups even during a pandemic. This distinction provides a crucial framework for surgical prioritization in future public health crises.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70943","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:15:47Z","timestamp":1790050547000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pediatric Otitis Media With Effusion Surgical Trends During\n                    <scp>COVID<\/scp>\n                    \u201019: A Time\u2010Series Study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5214-3159","authenticated-orcid":false,"given":"Hiroshi","family":"Hidaka","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery Kansai Medical University  Hirakata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunio","family":"Tarasawa","sequence":"additional","affiliation":[{"name":"Department of Healthcare Administration and Policy Tohoku University Graduate School of Medicine and Medical IT Center, Tohoku University Hospital  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Fujimori","sequence":"additional","affiliation":[{"name":"Tohoku University  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoki","family":"Kitawaki","sequence":"additional","affiliation":[{"name":"Department of Mathematics Kansai Medical University  Hirakata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyohide","family":"Fushimi","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Informatics Institute of Science Tokyo Graduate School of Medical and Dental Sciences  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0076-6092","authenticated-orcid":false,"given":"Ryoukichi","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Gifu University Graduate School of Medicine  Gifu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuko","family":"Nakano","sequence":"additional","affiliation":[{"name":"Division of Otorhinolaryngology Chiba Children's Hospital  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruo","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery National Hospital Organization Nagasaki Medical Center  Omura Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Kamide","sequence":"additional","affiliation":[{"name":"Kamide Ear Nose and Throat Clinic  Fuji Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Jichi Medical University  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Risako","family":"Kakuta","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Tohoku Rosai Hospital  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5153-2806","authenticated-orcid":false,"given":"Kosuke","family":"Tochigi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery Dokkyo Medical University Saitama Medical Center  Koshigaya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Kasai","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Hyogo Prefectural Children's Hospital  Kobe Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruo","family":"Kuroki","sequence":"additional","affiliation":[{"name":"Pauroom Clinic for Children and Parents  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukiko","family":"Iino","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Tokyo\u2010Kita Medical Center  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitome","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Showa Medical University Graduate School of Health Sciences  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arata","family":"Horii","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Niigata University Graduate School of Medical and Dental Sciences  Niigata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Jichi Medical University  Shimotsuke Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"issue":"1","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0165-5876(95)01184-D","article-title":"Otitis Media in a Population of Black American and White American Infants, 0\u20132\u2009Years of Age","volume":"33","author":"Casselbrant M. 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