These results did not demonstrate an effect of FESS on progression of lung disease in patients with CF, but further research is needed because low statistical power has made some of the negative findings inconclusive.

Dysplasia is a rare event in pediatric recurrent respiratory papillomatosis, and there does not appear to be an association between the use of cidofovir and dysplastic changes.

utaneous vascular anomalies, such as hemangiomas of infancy (HOIs), are prevalent in 5% to 10% of children and are the most common tumors of infancy. 1 Approximately 20% of these vascular anomalies result in pain, bleeding, ulceration, infection, or functional impairment with vision, feeding, or breathing necessitating medical or surgical treatment. 2 Complications from these lesions include painful ulceration, infection, bleeding, and occlusion or obstruction of vital structures such as the eyes, nose, mouth, and auditory canal. 3 Facial lesions especially can cause great cosmetic disfigurement and psychosocial morbidity, affecting the child and the parent. Fifty percent of vascular lesions are still present when the child starts primary school. Although involution can be complete in up to 50% of children by the start of school, 15% to 40% of children are left with permanent skin changes, 4 including pigment alteration, telangiectasia, atrophy, and fibrofatty residuum. 5 Port-wine stains are benign congenital vascular anomalies that are localized in the dermis and affect 0.3% to 0.5% of infants. 6 In contrast to HOIs, port-wine stains do not spontaneously involute. These lesions are characterized by an abnormal dermal plexus of layers of dilated blood vessels that increase in size with age. 7 Although port-wine stains can occur anywhere in the body, about 83% are seen in the head and IMPORTANCE Although facial vascular malformations are often treated by facial plastic surgeons, no reliable validated assessment tool exists for surgeons to assess results. OBJECTIVES To use our assessment tool to analyze results from pulsed-dye laser therapy used for pediatric facial vascular malformations, and to determine interrater reliability of our assessment tool in a standard clinical environment without the use of professional photography. DESIGN A blinded retrospective review of pediatric patients who underwent pulsed-dye laser therapy for treatment of hemangiomas of infancy (HOIs) and port-wine stains. Three pediatric otolaryngologists and facial plastic surgeons independently rated all of the pictures using our assessment tool. SETTING Tertiary care pediatric hospital. RESULTS Pulsed-dye laser therapy was performed in 22 patients, 17 with HOIs and 5 with port-wine stains. Patients with HOIs treated only by pulsed-dye laser showed, on average, a 50% to 75% improvement in color, 1% to 24%, improvement in thickness, and 1% to 24% improvement in size of the lesion. Eight patients with HOIs underwent surgery after laser therapy, and of these, 100% saw improvement in color, thickness, and size. Port-wine stains showed a 1% to 24% improvement in color and no improvement in thickness or size. Interrater reliability for questions 1 to 6 was 0.92, 0.92, 0.93, 0.91, 0.70, and 0.10, respectively. CONCLUSIONS AND RELEVANCE Currently, no standardized or validated methods exist to evaluate results from intervention of pediatric facial HOIs and port-wine stains. Our assessment tool is reliable to assess patients with HOIs and port-wine ...

No abstract

Otolaryngology-Head and Neck Surgery 145(2S) ORAL PRESENTATIONS complications were recorded. The primary outcome measure was anterior-posterior (AP) diameter at 3 months. Results: Mucosal grafting technique was performed during 19 Draf III procedures from August 2008 to November 2010. Seventeen patients (average age 54 years) were available for endoscopic measurement at 3 months with an average postoperative follow-up of 13.5 months (4-24). Reasons for the procedure included tumor (n = 9), frontal ostium stenosis (n = 7), and trauma (n = 1). Fourteen patients (83%) had complete mucosal graft viability. Average intraoperative AP diameter was 12.3 mm. All patients maintained a patent combined frontal sinus ostium for the duration of follow-up with an average diameter of 10.9 mm at 3 months and no closure >25% of intraoperative size. Conclusion: Cicatricial stenosis and osteoneogenesis are common following the Draf III procedure in up to 50% of individuals. The present study demonstrated that the mucosal grafting technique decreases Draf III stenosis when compared with historical series and should be considered a routine strategy for preventing postoperative closure.