Long-Term Follow-Up for Children Treated With Surgical Intervention for Chronic Rhinosinusitis

Lusk, Rodney P.; Bothwell, Marcella; Piccirillo, Jay F.

doi:10.1097/01.mlg.0000244387.11129.a0

Cited by 35 publications

(23 citation statements)

References 78 publications

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“…The results of FESS due to CRS in children have been shown in several studies [18,21,24,38]. Most of the reported outcomes are based on the levels of symptomatic relief and do not include objective measures such as nasal endoscopy or CT scans.…”

Section: Discussionmentioning

confidence: 96%

“…FESS is unlike to be successful in children below the age of three [45]. But Lusk et al reported a 10-year retrospective study, which proved superiority (p > 0.001) of FESS in the age of 2-5 years over medical treatment in parenteral assessment of improvement [38]. Efficiency of FESS has been found to be reduced if a child is exposed to tobacco smoke [44].…”

Section: Discussionmentioning

confidence: 96%

See 1 more Smart Citation

Functional endoscopic sinus surgery—A retrospective analysis of 115 children and adolescents with chronic rhinosinusitis

Siedek

Stelter

Betz

et al. 2009

International Journal of Pediatric Otorhinolaryngology

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 96%

Functional endoscopic sinus surgery—A retrospective analysis of 115 children and adolescents with chronic rhinosinusitis

Siedek

Stelter

Betz

et al. 2009

International Journal of Pediatric Otorhinolaryngology

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“…Conjunctive consolidation has been used to develop grading systems for lung cancer, 30 head and neck cancer, 31, 32 obstructive sleep apnea, 25 and rhinosinusitis. 33 , and is particularly useful for combining independent indices into a composite measure. Based on the conjunctive consolidation approach, neuroimaging information did not alter outcome predictions for patients with favorable clinical presentations.…”

Section: Discussionmentioning

confidence: 99%

The Chiari Severity Index

et al. 2015

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Background To develop evidence-based treatment guidelines for Chiari Malformation Type 1 (CM-1), preoperative prognostic indices capable of stratifying patients for comparative trials are needed. Objective To develop a preoperative Chiari Severity Index (CSI) integrating the clinical and neuroimaging features most predictive of long-term patient-defined improvement in quality of life (QOL) after CM-1 surgery. Methods We recorded preoperative clinical (e.g. headaches, myelopathic symptoms) and neuroimaging (e.g. syrinx size, tonsillar descent) characteristics. Brief follow-up surveys were administered to assess overall patient-defined improvement in QOL. We used sequential sequestration to develop clinical and neuroimaging grading systems and conjunctive consolidation to integrate these indices to form the CSI. We evaluated statistical significance using the Cochran-Armitage test and discrimination using the c-statistic. Results Our sample included 158 patients. Sequential sequestration identified headache characteristics and myelopathic symptoms as the most impactful clinical parameters, producing a clinical grading system with improvement rates ranging from 81% (grade 1) to 58% (grade 3) (p=0.01). Based on sequential sequestration, the neuroimaging grading system included only the presence (55% improvement) or absence (74% improvement) of a syrinx ≥ 6 mm (p=0.049). Integrating the clinical and neuroimaging indices, improvement rates for the CSI ranged from 83% (grade 1) to 45% (grade 3) (p=0.002). The combined CSI had moderately better discrimination (c=0.66) than the clinical (c=0.62) or neuroimaging (c=0.58) systems alone. Conclusion Integrating clinical and neuroimaging characteristics, the CSI is a novel tool that predicts patient-defined improvement following CM-1 surgery. The CSI may aid preoperative counseling and stratify patients in comparative effectiveness trials.

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“…The surgical drainage of the abscess was afforded with FESS. This transnasal endoscopic technique provided a quick and safe drainage of the paranasal sinuses, orbita, anterior skull base avoiding facial scars as well as hastening the post-operative recovery period [11,12]. Rahbar et al found that orbital subperiosteal abscess in children can be successfully and safely managed by a transnasal endoscopic approach in selected patients [6].…”

Section: Discussionmentioning

confidence: 99%

Rapidly progressing subperiosteal orbital abscess: an unexpected complication of a group-A streptococcal pharyngitis in a healthy young patient

et al. 2012

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IntroductionComplications associated to group-A streptococcal pharyingitis include non-suppurative complications such as acute rheumatic fever and glomerulonephritis and suppurative complications such as peritonsillar or retropharyngeal abscess, sinusitis, mastoiditis, otitis media, meningitis, brain abscess, or thrombosis of the intracranial venous sinuses.Case presentationWe described a case of a 15-year-old patient with a history of acute pharyngodinia early followed by improvise fever and a progressive formation of a diffuse orbital edema, corneal hyperaemia, diplopia and severe decrease of visual acuity.The patient was surgically treated with functional endoscopic sinus surgery (FESS) after the response of a maxillofacial computed tomography scans that showed a pansinusitis complicated by a left orbital cellulites. Numerous colonies of Streptococcus pyogenes were found in the samples of pus and an antibiotic therapy with meropenem was initiated on the basis of the sensitivity test to antibiotics. The patient was finally discharged with diagnosis of left orbital cellulites with periorbital abscess, endophtalmitis and acute pansinusitis as a consequence of streptococcal pharyngitis.ConclusionThe case highlights the possible unusual complication of a group-A streptococcal pharyingitis in a immunocompetent child and the needing of a prompt surgical and medical approach toward the maxillofacial complications associated to the infection.

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Long-Term Follow-Up for Children Treated With Surgical Intervention for Chronic Rhinosinusitis

Cited by 35 publications

References 78 publications

Functional endoscopic sinus surgery—A retrospective analysis of 115 children and adolescents with chronic rhinosinusitis

Functional endoscopic sinus surgery—A retrospective analysis of 115 children and adolescents with chronic rhinosinusitis

The Chiari Severity Index

Rapidly progressing subperiosteal orbital abscess: an unexpected complication of a group-A streptococcal pharyngitis in a healthy young patient

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