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  1. AU="Kubba, Haytham"
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  1. Article ; Online: Spontaneous abscess of the nasal septum in children: a 10-year series.

    Drake, Ivy / Wilkinson, Sophie / Kubba, Haytham

    The Journal of laryngology and otology

    2024  , Page(s) 1–3

    Abstract: Background: This paper reports a 10-year series of spontaneous nasal septal abscesses in immune-competent children, with suggestions for optimal management.: Methods: A retrospective case note review was conducted of children undergoing an operation ... ...

    Abstract Background: This paper reports a 10-year series of spontaneous nasal septal abscesses in immune-competent children, with suggestions for optimal management.
    Methods: A retrospective case note review was conducted of children undergoing an operation for incision and drainage of nasal septal abscesses between 2013 and 2023.
    Results: Six children were identified via electronic hospital records during the 10-year review period, five with a spontaneous abscess. The children were aged 10-14 years. All were immunocompetent and none had active sinus infection. The most common presenting features were nasal swelling, facial swelling, headache, nasal congestion and fever. The most common bacterial isolate was
    Conclusion: To our knowledge, this is the first series of spontaneous nasal septal abscesses in immunocompetent children. The high prevalence of
    Language English
    Publishing date 2024-02-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 218299-3
    ISSN 1748-5460 ; 0022-2151
    ISSN (online) 1748-5460
    ISSN 0022-2151
    DOI 10.1017/S0022215124000276
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  2. Article ; Online: Managing recurrent nosebleeds in children: a retrospective review of 718 children attending a nurse-led epistaxis clinic.

    Drake, Ivy / Fountain, Hazel / Kubba, Haytham

    The Journal of laryngology and otology

    2024  Volume 138, Issue 4, Page(s) 431–435

    Abstract: Objective: This review assessed the effectiveness of the nurse-led children's epistaxis clinic in streamlining patient care and avoiding unnecessary general anaesthesia.: Methods: A retrospective case note review was conducted of children attending ... ...

    Abstract Objective: This review assessed the effectiveness of the nurse-led children's epistaxis clinic in streamlining patient care and avoiding unnecessary general anaesthesia.
    Methods: A retrospective case note review was conducted of children attending the nurse-led epistaxis clinic between 2019 and 2021.
    Results: A total of 718 children were seen over three years. Twelve (1.7 per cent) had a known coagulopathy. Of the children, 590 (82 per cent) had visible vessels and 29 (4 per cent) had mucosal crusting. Silver nitrate cautery was attempted under topical anaesthesia in 481 children, with 463 (96 per cent) successful cauterisations. Fifteen (3 per cent) were cauterised under general anaesthesia. Of the children, 706 (99 per cent) were prescribed nasal antiseptic preparations; this was the sole treatment for 58 (8 per cent). Blood investigations were requested for eight children (1 per cent) and haematology referral for three (0.4 per cent).
    Conclusion: This is the largest published series of children's nosebleeds. Given the short-lived benefit from cautery, it is suggested that general anaesthesia should not be offered routinely. However, improved haematology referral criteria are required to increase underlying diagnosis.
    MeSH term(s) Child ; Humans ; Chlorhexidine ; Epistaxis/surgery ; Epistaxis/diagnosis ; Retrospective Studies ; Neomycin ; Nurse's Role ; Cautery
    Chemical Substances Chlorhexidine (R4KO0DY52L) ; Neomycin (I16QD7X297)
    Language English
    Publishing date 2024-01-15
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 218299-3
    ISSN 1748-5460 ; 0022-2151
    ISSN (online) 1748-5460
    ISSN 0022-2151
    DOI 10.1017/S0022215124000069
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  3. Article ; Online: The impact of intranasal corticosteroids in a prospective cohort of children with sleep disordered breathing.

    Rowe, Katherine Sylvia / Pinczower, Gideon David / Nixon, Gillian Michelle / Kubba, Haytham

    International journal of pediatric otorhinolaryngology

    2024  Volume 178, Page(s) 111899

    Abstract: Introduction: Sleep disordered breathing (SDB) is common in children and the most common reason for adenotonsillectomy. This large observational cohort study from a specialist outpatient clinic describes the impact of intranasal steroids (INS) on ... ...

    Abstract Introduction: Sleep disordered breathing (SDB) is common in children and the most common reason for adenotonsillectomy. This large observational cohort study from a specialist outpatient clinic describes the impact of intranasal steroids (INS) on symptom improvement and the need for surgery.
    Method: Observational cohort study of 568 children assessing the impact of INS using the OSA-5 questionnaire with clinical and surgical outcome measures.
    Results: The mean OSA-5 score at first visit was 7.78. Symptoms were persistent for a median 9 months (range 2-72). 51% underwent a trial of INS with 56% reporting symptomatic improvement. The mean score decreased from 8.2 to 5.5 (p < 0.0001) in those prescribed INS. They had a significantly higher symptom load (p < 0.01), turbinate size (p < 0.005) and history of atopy (p < 0.01) than the non-trial group. The rate of surgery in the non-trial group was 56% compared with 38% in those who had INS (p < 0.001). With increasing symptom burden, the reported improvement with INS and comparative reduction in surgery increased. Baseline OSA-5 scores were predictive of rates of surgery. Atopic status or age did not influence response to INS.
    Conclusion: The mean score at first visit and the median duration of symptoms indicated significant persistent symptoms in this cohort. The use of INS improved symptoms of SDB in 56%. The need for surgery in the group that received INS was 38% compared with 56% in those not trialling INS, despite the non-trial group having significantly less symptoms and signs. Symptomatic improvement was not influenced by age or atopic status.
    MeSH term(s) Child ; Humans ; Prospective Studies ; Sleep Apnea Syndromes/drug therapy ; Sleep Apnea Syndromes/surgery ; Adenoidectomy ; Tonsillectomy ; Surveys and Questionnaires ; Adrenal Cortex Hormones/therapeutic use ; Sleep Apnea, Obstructive/drug therapy ; Sleep Apnea, Obstructive/surgery
    Chemical Substances Adrenal Cortex Hormones
    Language English
    Publishing date 2024-02-20
    Publishing country Ireland
    Document type Observational Study ; Journal Article
    ZDB-ID 754501-0
    ISSN 1872-8464 ; 0165-5876
    ISSN (online) 1872-8464
    ISSN 0165-5876
    DOI 10.1016/j.ijporl.2024.111899
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  4. Article ; Online: Prevalence of thyroid gland tissue in midline neck dermoid cysts in children and a proposed new 'thyroglossal entrainment' hypothesis for their formation.

    Barbour, Amy / Penman, Dawn / Kubba, Haytham

    The Journal of laryngology and otology

    2023  Volume 138, Issue 4, Page(s) 448–450

    Abstract: Background: Thyroglossal duct cysts and dermoid cysts both commonly present as midline neck lumps in children. They are treated as separate entities with different embryological origins. There are isolated reports of thyroid gland tissue in a dermoid ... ...

    Abstract Background: Thyroglossal duct cysts and dermoid cysts both commonly present as midline neck lumps in children. They are treated as separate entities with different embryological origins. There are isolated reports of thyroid gland tissue in a dermoid cyst, concurrent thyroglossal and dermoid cysts, and cysts with mixed histology. It is not known if these are rare or common.
    Methods: All children undergoing excision of a congenital midline neck cyst between January 2017 and December 2022 were identified. Histopathology slides were reviewed in detail.
    Results: In 53 children, there were 26 thyroglossal duct cysts, 24 dermoids, 1 lymph node and 2 with no diagnostic material identified. Five dermoids (28 per cent) had associated thyroid gland tissue, and 1 (4 per cent) had hybrid histology with keratinising and respiratory epithelium. Infection occurred in 17 per cent of dermoids prior to excision and 8 per cent of dermoids recurred after excision.
    Conclusion: Hybrid histology, infection and recurrence are all common in midline neck dermoids. A new theory for their embryological origin is proposed, with the suggestion that some may need more extensive surgery.
    MeSH term(s) Child ; Humans ; Dermoid Cyst/epidemiology ; Dermoid Cyst/surgery ; Dermoid Cyst/pathology ; Thyroid Gland/surgery ; Thyroid Gland/pathology ; Thyroglossal Cyst/epidemiology ; Thyroglossal Cyst/surgery ; Thyroglossal Cyst/diagnosis ; Prevalence ; Neck/surgery ; Neck/pathology
    Language English
    Publishing date 2023-10-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 218299-3
    ISSN 1748-5460 ; 0022-2151
    ISSN (online) 1748-5460
    ISSN 0022-2151
    DOI 10.1017/S0022215123001792
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  5. Article ; Online: How common are ear, nose and throat disorders in children with Noonan syndrome and other RASopathies?

    Madej, Olga / Kiff, Rebecka / Kubba, Haytham

    International journal of pediatric otorhinolaryngology

    2023  Volume 166, Page(s) 111480

    Abstract: Introduction: Noonan syndrome and related conditions (RASopathies) are known to be associated with abnormalities in many organ systems. It is our impression that few otolaryngologists are familiar with the manifestations of these syndromes and we ... ...

    Abstract Introduction: Noonan syndrome and related conditions (RASopathies) are known to be associated with abnormalities in many organ systems. It is our impression that few otolaryngologists are familiar with the manifestations of these syndromes and we therefore reviewed our hospital's patient cohort to identify the prevalence of ear, nose and throat disorders in these children.
    Methods: We cross-referenced various hospital department databases (otolaryngology, audiology, cardiology, haematology and genetics) to try to identify as many children with Noonan and other RASopathies as possible. We then performed a retrospective review of electronic patient records.
    Results: We identified 67 children with Noonan, Costello, LEOPARD and other RASopathy syndromes. Around half have been seen in otolaryngology and audiology clinics. Otitis media with effusion requiring ventilation tubes occurred in 4% of children. 10% have suffered recurrent acute otitis media. 9% have a sensorineural hearing loss. 7% have undergone adenotonsillectomy for obstructive sleep apnoea. Airway anomalies and head and neck malformations occur but are rare.
    Discussion: Children with Noonan and other RASopathies present commonly to otolaryngology and audiology clinics. The prevalence of sensorineural hearing loss is high and audiological screening is likely to be worthwhile. Surgeons should be aware that complications of surgery are common and can be very severe, especially in those with cardiac anomalies.
    MeSH term(s) Humans ; Male ; Female ; Child ; Noonan Syndrome/diagnosis ; Pharyngeal Diseases/epidemiology ; Hearing Loss, Sudden/epidemiology ; Costello Syndrome ; Nose Diseases/epidemiology ; Sinusitis ; Tonsillitis ; LEOPARD Syndrome
    Language English
    Publishing date 2023-02-06
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 754501-0
    ISSN 1872-8464 ; 0165-5876
    ISSN (online) 1872-8464
    ISSN 0165-5876
    DOI 10.1016/j.ijporl.2023.111480
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  6. Article ; Online: What is the annual risk of infection in congenital midline neck cysts in children? Thyroglossal duct cysts versus dermoid cysts.

    Barbour, Amy Edith / Penman, Dawn / Kubba, Haytham

    International journal of pediatric otorhinolaryngology

    2023  Volume 176, Page(s) 111842

    Abstract: Introduction: Midline neck lumps in children are mostly found to be thyroglossal duct cysts or dermoid cysts. Thyroglossal duct cysts often have an associated sinus tract which may connect all the way to the foramen caecum on the tongue, while dermoids ... ...

    Abstract Introduction: Midline neck lumps in children are mostly found to be thyroglossal duct cysts or dermoid cysts. Thyroglossal duct cysts often have an associated sinus tract which may connect all the way to the foramen caecum on the tongue, while dermoids have no such connection. This study aims to estimate the annual infection risk for midline neck cysts based on our patient series, and to see if this differs between thyroglossal duct cysts and dermoid cysts.
    Methods: All children seen at the Royal Hospital for Children, Glasgow who underwent surgical excision of a midline neck cyst between 1
    Results: We identified 53 children (29 male, 24 female) aged 1-16 years (median 4) at the time of surgical excision. There were 26 thyroglossal and 24 dermoid cysts, plus 2 with indeterminate histology and 1 lymph node. Of the 24 dermoids, 4 suffered infection prior to surgery (17%), and 2 of these recurred after surgery (8%). Of the 26 thyroglossal cysts, 16 suffered infection prior to surgery (62%) and 5 of these recurred (19%). 78% of thyroglossal and dermoid cysts had at least 1 episode of infection by age 10 years.
    Discussion: In a child with a congenital midline neck cyst that has never been infected, deferring surgery for a year comes with a 7.8% risk that the cyst will get infected.
    MeSH term(s) Child ; Humans ; Male ; Female ; Thyroglossal Cyst/surgery ; Thyroglossal Cyst/pathology ; Dermoid Cyst/complications ; Dermoid Cyst/surgery ; Dermoid Cyst/pathology ; Neoplasm Recurrence, Local ; Neck/surgery ; Neck/pathology ; Fistula/surgery
    Language English
    Publishing date 2023-12-30
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 754501-0
    ISSN 1872-8464 ; 0165-5876
    ISSN (online) 1872-8464
    ISSN 0165-5876
    DOI 10.1016/j.ijporl.2023.111842
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  7. Article ; Online: External peri-stomal skin granulations in paediatric tracheostomy: Incidence, outcomes and a proposed treatment algorithm.

    Kawar, Luai / Clark, Emma / Kubba, Haytham

    International journal of pediatric otorhinolaryngology

    2023  Volume 176, Page(s) 111821

    Abstract: Background: External peri-stomal skin granulations after tracheostomy in children are common and may interfere with routine tube changes. This study is the first attempt to describe the incidence and outcomes, along with a proposed treatment algorithm.!# ...

    Abstract Background: External peri-stomal skin granulations after tracheostomy in children are common and may interfere with routine tube changes. This study is the first attempt to describe the incidence and outcomes, along with a proposed treatment algorithm.
    Methods: A retrospective review of all inpatient children with a tracheostomy between January 2020 and May 2022 at the Royal Hospital for Children (RHC) in Glasgow. The presence of external peri-stomal granulation, date of onset and resolution, recurrence and treatment modalities were noted. All tracheostomy tubes used during the study period were made of silicone.
    Results: A total of 50 episodes of peri-stomal granulation were identified in 27 children (52 %). Median age at the end of the study period was 4.3 years, with younger children experiencing more frequent granulation. 3 episodes interfered with tracheostomy tube changes. Time to resolution of the granulation was significantly longer with topical steroid/antimicrobial ointment monotherapy, but recurrence was less common when this was used a first treatment modality.
    Conclusion: Non-invasive measures such as topical anti-microbials should be used in the first instance when managing external stoma-site granulations. More invasive measures, such as silver nitrate cautery and surgical excision, should be considered if the granulation tissue is not improving or when it poses a risk to safe tube changes.
    MeSH term(s) Humans ; Child ; Child, Preschool ; Tracheostomy/adverse effects ; Incidence ; Granulation Tissue ; Retrospective Studies
    Language English
    Publishing date 2023-12-16
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 754501-0
    ISSN 1872-8464 ; 0165-5876
    ISSN (online) 1872-8464
    ISSN 0165-5876
    DOI 10.1016/j.ijporl.2023.111821
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  8. Article ; Online: Retrospective observational study analysing the trends in ventilation tube insertion in children in Scotland between 2001 and 2018.

    Wescott, Robert A / Downie, Laura S / Kubba, Haytham

    Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery

    2023  Volume 49, Issue 2, Page(s) 199–206

    Abstract: Objectives: Otitis media with effusion (OME) is common, affecting up to 90% of children. Around 25% will have a persistent effusion with conductive hearing loss which can impact their development. Ventilation tubes (VTs) can improve their hearing in the ...

    Abstract Objectives: Otitis media with effusion (OME) is common, affecting up to 90% of children. Around 25% will have a persistent effusion with conductive hearing loss which can impact their development. Ventilation tubes (VTs) can improve their hearing in the short term. This study aims to analyse the trends in VT insertion rates across Scotland.
    Design: Retrospective observational study.
    Setting: All mainland Scottish health boards.
    Participants: All children aged 0-16 who underwent a VT insertion procedure from 2001 to 2018 were included.
    Main outcome measures: Data were provided by the Scottish Public Health Observatory, using Scottish Morbidity Records. Mid-year population estimates were obtained from the National Records Office of Scotland. Socioeconomic deprivation was estimated based on area of residence using the Scottish Index of Multiple Deprivation. VT insertion rates were calculated and trends analysed.
    Results: A total of 35 878 VT procedures were performed in total with a mean rate of 2.02 per 1000 children per year. The highest insertion rates were observed in children aged 4-6. VT insertion rates reduced during the study period (R = -0.729, p = .001). Variability in VT insertion rates between health boards reduced. There was a significant association between socioeconomic deprivation and VT insertion rate, with the most deprived children having the highest rate (p < .001).
    Conclusions: VT insertion rates and the variability between Scottish health boards have reduced over the past two decades, suggesting a more equitable system. Our data intimates that the decision to perform VT insertion is based upon disease prevalence rather than clinician preference.
    MeSH term(s) Child ; Humans ; Hearing ; Otitis Media with Effusion/epidemiology ; Otitis Media with Effusion/surgery ; Hearing Loss, Conductive/surgery ; Retrospective Studies ; Middle Ear Ventilation/methods ; Scotland/epidemiology
    Language English
    Publishing date 2023-11-14
    Publishing country England
    Document type Observational Study ; Journal Article
    ZDB-ID 2205891-6
    ISSN 1749-4486 ; 1749-4478 ; 0307-7772 ; 1365-2273
    ISSN (online) 1749-4486
    ISSN 1749-4478 ; 0307-7772 ; 1365-2273
    DOI 10.1111/coa.14112
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  9. Article ; Online: Long-term Airway Outcomes and Interventions in Children With Oesophageal Atresia With Tracheoesophageal Fistula: A 20-year Single Centre Observational Study.

    Davis, Sandra E / Davis, Carl / Patel, Neil / Kubba, Haytham / Clement, W Andrew

    Journal of pediatric surgery

    2024  Volume 59, Issue 6, Page(s) 1066–1071

    Abstract: Background: Airway anomalies, symptoms and interventions are commonly reported in children with oesophageal atresia with tracheoesophageal fistula (OA/TOF). The purpose of this study was to assess the incidence of these airway pathologies and those ... ...

    Abstract Background: Airway anomalies, symptoms and interventions are commonly reported in children with oesophageal atresia with tracheoesophageal fistula (OA/TOF). The purpose of this study was to assess the incidence of these airway pathologies and those requiring interventions in the long-term.
    Methods: A retrospective case note review of all patients admitted to the Neonatal Unit at the Royal Hospital for Children, Glasgow between January 2000 and December 2015 diagnosed with OA/TOF. Included patients had a minimum of 5 years follow-up.
    Results: 121 patients were identified. 118 proceeded to OA/TOF repair. 115 patients had long-term follow-up data. Ninety-five (83%) children had one or more airway symptom recorded. Thirty-six (31%) neonates underwent airway endoscopy at the time of their initial OA/TOF repair. Forty-six (40%) children underwent airway endoscopy at a later date due to airway symptoms. Airway pathologies identified included airway malacia, thirty-two (28%), subglottic stenosis, eleven (10%), tracheal pouch, twenty-five (22%), laryngeal cleft, seven (6%) and recurrent fistula, five (4%). Airway interventions included endoscopic division of tracheal pouch, ten (9%), tracheostomy, seven (6%), aortopexy, six (5%), repair of recurrent fistula, five (4%), endoscopic repair of laryngeal cleft, three (3%) and four (3%) required open airway reconstruction for subglottic stenosis. One child (1%) remains tracheostomy dependent.
    Conclusions: Long-term airway pathologies are common in children with OA/TOF. Many of these are remediable with surgical intervention. Clinicians should be cognisant of this and refer to Airway Services appropriately.
    MeSH term(s) Humans ; Tracheoesophageal Fistula/surgery ; Tracheoesophageal Fistula/complications ; Esophageal Atresia/surgery ; Esophageal Atresia/complications ; Retrospective Studies ; Infant, Newborn ; Male ; Female ; Follow-Up Studies ; Infant ; Treatment Outcome ; Child, Preschool ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Laryngostenosis/surgery ; Recurrence ; Larynx/abnormalities ; Larynx/surgery ; Congenital Abnormalities
    Language English
    Publishing date 2024-02-10
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 80165-3
    ISSN 1531-5037 ; 0022-3468
    ISSN (online) 1531-5037
    ISSN 0022-3468
    DOI 10.1016/j.jpedsurg.2024.02.005
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  10. Article ; Online: Complication rates for paediatric tonsillectomy based on Scottish national data 2000-2018.

    Moen, Christy / Downie, Laura S / Kubba, Haytham

    Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery

    2022  Volume 47, Issue 3, Page(s) 500–503

    MeSH term(s) Child ; Humans ; Postoperative Hemorrhage/etiology ; Retrospective Studies ; Scotland/epidemiology ; Tonsillectomy/adverse effects ; Tonsillitis/complications ; Tonsillitis/epidemiology ; Tonsillitis/surgery
    Language English
    Publishing date 2022-03-22
    Publishing country England
    Document type Journal Article
    ZDB-ID 2205891-6
    ISSN 1749-4486 ; 1749-4478 ; 0307-7772 ; 1365-2273
    ISSN (online) 1749-4486
    ISSN 1749-4478 ; 0307-7772 ; 1365-2273
    DOI 10.1111/coa.13928
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