Pediatric Chronic Rhinosinusitis Management in Rhinologists and Pediatric Otolaryngologists

Ann Otol Rhinol Laryngol. 2017 Sep;126(9):634-639. doi: 10.1177/0003489417719717. Epub 2017 Aug 2.

Abstract

Objective: To compare the management of pediatric chronic rhinosinusitis (PCRS) between members of the American Rhinologic Society (ARS) and the American Society of Pediatric Otolaryngology (ASPO).

Study design: Comparison of surveys.

Methods: A web-based survey was distributed to ASPO membership twice in September-October 2016. Data were compared to previously published data from ARS membership in March-April 2016.

Results: ASPO survey completion rate was 22%. ARS members were more likely to employ oral steroids in initial ( P = .025) and maximal medical management ( P = .001). ASPO members more commonly performed adenoidectomy before computed tomography (CT) ( P < .001). Both groups commonly included adenoidectomy as part of initial surgical management (90% vs 94%, P = .316), while ASPO members more frequently performed adenoidectomy alone (70% vs 43%, P = .001). If initial surgical treatment failed, both groups commonly performed endoscopic sinus surgery (ESS; 81% vs 88%, P = .56) with a similar extent including frontal ( P ≥ .207) and sphenoid ( P ≥ .304) surgery.

Conclusions: Pediatric chronic rhinosinusitis management is similar between groups, yet there are differences including oral steroid use, relative order of CT versus adenoidectomy, and performing concomitant procedures with adenoidectomy. Both groups commonly perform ESS with similar surgical extent if prior surgical treatment fails. Management by both groups is largely in agreement with published consensus statements.

Keywords: chronic; management; pediatric; rhinosinusitis; survey.

Publication types

  • Comparative Study

MeSH terms

  • Adenoidectomy / methods
  • Adenoidectomy / statistics & numerical data
  • Administration, Oral
  • Anti-Bacterial Agents / therapeutic use*
  • Child
  • Chronic Disease
  • Disease Management
  • Endoscopy
  • Glucocorticoids / therapeutic use*
  • Histamine Antagonists / therapeutic use*
  • Humans
  • Nasal Sprays
  • Otolaryngologists*
  • Otolaryngology
  • Otorhinolaryngologic Surgical Procedures / methods*
  • Otorhinolaryngologic Surgical Procedures / statistics & numerical data
  • Pediatricians*
  • Pediatrics
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'
  • Rhinitis / diagnostic imaging
  • Rhinitis / therapy*
  • Sinusitis / diagnostic imaging
  • Sinusitis / therapy*
  • Societies, Medical
  • Surveys and Questionnaires
  • Tomography, X-Ray Computed

Substances

  • Anti-Bacterial Agents
  • Glucocorticoids
  • Histamine Antagonists
  • Nasal Sprays