To evaluate the 2-year post-operative outcomes of pediatric patients with chronic rhinosinusitis (CRS) treated with balloon catheter sinuplasty (BCS) and ethmoidectomy compared to functional endoscopic sinus surgery (FESS). Two-group, retrospective cohort study of 28 children with CRS was performed. Of these 28 participants, 15 were treated with traditional FESS (53.6 %) and 13 (46.4 %) underwent traditional ethmoidectomy with balloon sinuplasty. Pre-operative and 2-year postoperative total symptom scores and medications were compared. To examine the potential long-term differences in surgical outcomes and surgical procedure on symptom outcome, one-tailed Chi square analyses were employed. The mean age of the children examined was 9.3 (SD = SD = 4.1; range 3-18) and 61.9 % were male. Pre-operative symptomatology, medication and Lund Mackay scores were evaluated for both groups and no significant differences were identified. Overall, 73.3 % of children that underwent traditional FESS and 76.9 % of those who had BCS with ethmoidectomy reported significant long-term improvement in at least one of their pre-operative sinus complaints. Our data suggests that both BCS with ethmoidectomy and traditional FESS are effective treatment options for uncomplicated CRS and result in long-term alleviation of core sinus complaints, as well as decreased sinus related medication use. Larger prospective studies are needed to further evaluate these procedures.

This is the largest patient series to date of AIIA patients evaluated with flexible laryngoscopy. Physicians should be aware of certain risk factors that will require a higher acuity level of care, including (1) presentation within 4 hours of symptom onset, (2) symptoms such as drooling and respiratory distress, (3) and involvement of the tongue, soft palate, and larynx.

Objectives: (1) Identify high-risk symptoms and anatomical regions involved in Angiotensin Converting-Enzyme Inhibitor-Induced Angioedema (AIIA) that may affect admission and placement, hospital length of stay, need for airway intervention, and clinical improvement versus deterioration. (2) Describe a clinical algorithm for the management and treatment of AIIA that would dictate placement of patients (ICU, general medical floor, observation unit, or discharge home), medical therapy, and the need for airway intervention (intubation or tracheostomy). Methods: A retrospective chart review of adult patients presenting to the emergency department (ED) at Detroit Medical Center diagnosed with AIIA from July 2010 to July 2013. Patients were followed from initial presentation until discharge. Descriptive statistics (frequency, means, and standard deviations) were calculated for all predictor, outcome, and control variables. Results: A total of 302 patients who were diagnosed with AIIA in the ED were evaluated with flexible laryngoscopy by an otolaryngologist. A total of 94% of patients were African American, with a slight female predominance of 63%. The most frequent presenting sign was lip swelling (62%). Angioedema confined to the lips was a negative predictor for airway intervention ( P < .01). Also, patients with isolated lip swelling were less likely to have progression of symptoms ( P < .05), and were less likely to require ICU monitoring ( P < .05). Conclusion: This is the largest patient series to date of AIIA. Using the information from this study, a clinical algorithm was developed that details management of AIIA based on presenting signs and anatomic location, with otolaryngologists playing a vital role in the decision making process.