Pediatric Rhinosinusitis

What are the symptoms of chronic rhinosinusitis in children?

Which organisms are involved in acute bacterial rhinosinusitis? Describe the possible complications of acute bacterial rhinosinusitis.

How are newborns screened for cystic fibrosis? Describe how the sweat test is performed and its role in the diagnosis of cystic fibrosis.

What are the most common symptoms of cystic fibrosis?

What is the cystic fibrosis transmembrane conductance regulator (CFTR)? Discuss the mechanisms by which a mutation in CFTR can promote chronic rhinosinusitis.

What bacteria typically are found in the sinuses of cystic fibrosis patients? Does the type of bacteria found relate to the age of the patient?

What is ciliary dyskinesia? What is Kartagener’s syndrome?

List risk factors for the development of chronic rhinosinusitis in the pediatric population. Describe the most common pediatric immunodeficiencies which can lead to recurrent bacterial rhinosinusitis.

Discuss the utility of plain radiography versus computer tomography versus magnetic resonance imaging in the diagnosis of chronic rhinosinusitis. What percentage of children with an upper respiratory tract infection in the previous 2 weeks will have mucosal abnormalities in their sinuses on sinus CT?

When should you consider treating a child with acute bacterial rhinosinusitis? What antibiotics are recommended as first line treatment in children with acute rhinosinusitis? What antibiotics are typically recommended if the first line treatment fails?

What is the initial recommended surgical procedure for children with chronic pediatric rhinosinusitis? What is the efficacy of this procedure?

Will sinus surgery in the pediatric population alter facial growth?

Discuss the role of maxillary antral lavage, and windows in pediatric rhinosinusitis.

Discuss why classic sinus surgery may fail in patients with cystic fibrosis.

Do antibiotics prevent the complications of acute bacterial rhinosinusitis?

Reference(s):

Keith, T., Saxena, S., Murray, J., & Sharland, M. (2010). Risk-benefit analysis of restricting antimicrobial prescribing in children: what  do we really know? Current Opinion in Infectious Diseases, 23(3), 242–248.

Discuss the known efficacy of decongestants, antihistamines and nasal irrigation in children with clinically diagnosed acute sinusitis.

Reference(s):

Shaikh, N., & Wald, E. R. (2014). Decongestants, antihistamines and nasal irrigation for acute sinusitis in children. The Cochrane Database of Systematic Reviews, (10), CD007909.

When is functional endoscopic sinus surgery indicated in non-CF and CF pediatric patients?

Reference(s):

Rizzi, M. D., & Kazahaya, K. (2014). Pediatric chronic rhinosinusitis: when should we operate? Current Opinion in Otolaryngology & Head and Neck Surgery, 22(1), 27–33.

What is the nasal nitric oxide measurement and how does it relate to pediatric sinusitis?

Reference(s):

Manna, A., Montella, S., Maniscalco, M., Maglione, M., & Santamaria, F. (2015). Clinical application of nasal nitric oxide measurement in pediatric airway diseases. Pediatric Pulmonology, 50(1), 85–99.

Discuss management of patients after a complication from pediatric acute sinusitis.

Reference(s):

Patel, R. G., Daramola, O. O., Linn, D., Flanary, V. A., & Chun, R. H. (2014). Do you need to operate following recovery from complications of pediatric acute sinusitis? International Journal of Pediatric Otorhinolaryngology, 78(6), 923–925.

Discuss the role of balloon dilation in pediatric sinus surgery.

Reference(s):

Ference, E. H., Schroeder, J. W. J., Qureshi, H., Conley, D., Chandra, R. K., Tan, B. K., & Shintani Smith, S. (2014). Current utilization of balloon dilation versus endoscopic techniques in pediatric sinus surgery. Otolaryngology–Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 151(5), 852–860.

How have vaccinations impacted the complication rate of pediatric rhinosinusitis?

Reference(s):

Capra, G., Liming, B., Boseley, M. E., & Brigger, M. T. (2015). Trends in orbital complications of pediatric rhinosinusitis in the United States. JAMA Otolaryngology– Head & Neck Surgery, 141(1), 12–17.