Background: Thyroid gland malignancy is rare in pediatrics (0.7% of tumors); only 1.8% are observed in patients < 20 yrs with a higher prevalence recorded in females and adolescents. Risk factors include genetic syndromes - MEN disorders, autoimmune disease and ionizing radiation exposure. Radiotherapy is also linked with increased risk of secondary thyroid cancers. The present study describes the clinical features and surgical outcomes of primary and secondary thyroid tumors. Methods: Institutional data was collected on pediatric patients with thyroid cancer during 2000 - 2020 from 8 International Surgical Oncology centers. Statistical analysis was performed using GraphPad Prism. Results: Of 255 cases of thyroid cancer, only 13 (5.1%) were secondary tumors. Primary thyroid malignancies were more likely to be multifocal in origin (odds ratio [OR] 1.993, 95% confidence interval [CI] 0.7466-5.132, p 0.2323), had bilateral glandular location (OR 2.847, 95% CI 0.6835-12.68, p 0.2648) and proved metastatic at 1st diagnosis (OR 1.259, 95% CI 0.3267-5.696 p>0.999). Secondary tumors showed a higher incidence of disease relapse (OR 1.556, 95% CI 0.4579-5.57, p 0.4525) and surgical morbidity (OR 2.042, 95% CI 0.7917-5.221, p 0.1614) including hypoparathyroidism and recurrent laryngeal nerve injury. Overall survival (OS) was 99% at 1 year and 97% after 10 years. No EFS differences were evident with primary vs. secondary tumors (Chi square 0.7307, p 0.39026). Conclusions: This multicenter study demonstrates excellent survival for pediatric thyroid malignancy. Secondary tumors exhibit greater disease relapse (15.8% vs 10.5%) and a higher incidence of surgical related complications (36.8% vs 22.2%).

Objectives: The aim of the study was to identify factors that could influence the repair of eardrum perforation using cartilage graft (or cartilage tympanoplasty) in children. Methods: A cohort of children operated on between January 1998 and December 2012 was reviewed. We have studied the repair rate of the eardrum (anatomical result) and the hearing level with audiometric tests (functional result) at 1 year and 3 years after surgery. These results were correlated with size or location of the perforation, status of the contralateral ear, gender, allergies, cleft palate, craniofacial anomalies, expertise of the surgeon (junior, senior) and perioperative observations (mucosa, glue, etc.). Results: 1240 tympanoplasties were selected from the database, of which 139 ears (127 patients) could be analysed (perforation without concurrent disease, authorisation from patients obtained and sufficient information reported). Mean age at surgery was 9.6 years ± 2.6 (range 4-16). At one year, 129/139 (93%) tympanic membranes were closed and 112/139 (81%) were satisfactory (no residual perforation, nor retraction, cholesteatoma, myringitis or OME). Air-bone gap was < 20 dB in 102/127 ears (80%). At 3 years, the eardrum was closed in 64/66 (97%) ears (reperforation in one case) and 82% were satisfactory. Myringitis occurred in 5% and 9% of cases at one- and three-year follow-up. Surgery before the age of 8 years was the only risk factor of a non-satisfactory result at one-year follow-up (p = 0.024). Conclusions: Long-term results were satisfactory; the only risk factor was surgery before eight years of age. In the child, long-term yearly follow-up is necessary after tympanic perforation.