Practice patterns in pediatric chronic rhinosinusitis: A survey of the American Rhinologic Society.
Am J Rhinol Allergy. 2016 Nov 01;30(6):418-423
Authors: Beswick DM, Ramadan H, Baroody FM, Hwang PH
Abstract
BACKGROUND: The management of pediatric chronic rhinosinusitis (PCRS) is evolving.
OBJECTIVE: To assess current practice patterns of members of the American Rhinologic Society (ARS) in managing PCRS.
METHODS: A 27-item Web-based survey on treatment of PCRS was electronically distributed to the ARS membership.
RESULTS: The survey was completed by 67 members, 40% of whom had completed a rhinology fellowship. The most frequently used medical therapies as part of initial treatment for PCRS were nasal saline solution irrigation, (90%), topical nasal steroids (93%), oral antibiotics (52%), and oral steroids (20%). For initial surgical therapy, 90% performed adenoidectomy; in addition, 31% also performed sinus lavage, 17% performed balloon catheter dilation (BCD), and 17% performed endoscopic sinus surgery (ESS). Sixty percent performed adenoidectomy before obtaining computed tomography imaging. When initial surgical treatment failed, 85% performed traditional ESS. In patients with pansinusitis, 50% of the respondents performed frontal sinusotomy and 70% performed sphenoidotomy. BCD was not frequently used; overall, 66% never or rarely used it, 20% sometimes used it, 12% usually used it, and 3% always or almost always used BCD.
CONCLUSIONS: Most aspects of PCRS management among ARS members were aligned with published consensus statements. Adenoidectomy was almost always included as part of first-line surgical treatment but was also combined with adjunctive surgical procedures with moderate frequency. ESS was performed by a minority of rhinologists as a primary procedure for medically refractory PCRS but was favored when previous surgery failed. BCD was uncommonly used in PCRS.
PMID: 28124653 [PubMed - in process]
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