Brietzke Scott E, Shin Jennifer J, Choi Sukgi, Lee Jivianne T, Parikh Sanjay R, Pena Maria, Prager Jeremy D, Ramadan Hassan, Veling Maria, Corrigan Maureen, Rosenfeld Richard M
Walter Reed National Military Medical Center, Bethesda, Maryland, USA
Harvard Medical School, Boston, Massachusetts, USA.
Otolaryngol Head Neck Surg. 2014 Oct;151(4):542-53. doi: 10.1177/0194599814549302.
To develop a clinical consensus statement on the optimal diagnosis and management of pediatric chronic rhinosinusitis (PCRS).
A representative 9-member panel of otolaryngologists with no relevant conflicts of interest was assembled to consider opportunities to optimize the diagnosis and management of PCRS. A working definition of PCRS and the scope of pertinent otolaryngologic practice were first established. Patients of ages 6 months to 18 years without craniofacial syndromes or immunodeficiency were defined as the targeted population of interest. A modified Delphi method was then used to distill expert opinion into clinical statements that met a standardized definition of consensus.
After 2 iterative Delphi method surveys, 22 statements met the standardized definition of consensus while 12 statements did not. Four statements were omitted due to redundancy. The clinical statements were grouped into 4 categories for presentation and discussion: (1) definition and diagnosis of PCRS, (2) medical treatment of PCRS, (3) adenoiditis/adenoidectomy, and (4) endoscopic sinus surgery (ESS)/turbinoplasty.
Expert panel consensus may provide helpful information for the otolaryngologist in the diagnosis and management of PCRS in uncomplicated pediatric patients.
制定关于小儿慢性鼻-鼻窦炎（PCRS）最佳诊断和管理的临床共识声明。
组建了一个由9名无相关利益冲突的耳鼻喉科医生组成的代表性小组，以探讨优化PCRS诊断和管理的机会。首先确定了PCRS的工作定义和相关耳鼻喉科实践的范围。年龄在6个月至18岁之间、无颅面综合征或免疫缺陷的患者被定义为目标人群。然后采用改良的德尔菲法将专家意见提炼为符合共识标准化定义的临床声明。
经过两轮德尔菲法调查，22项声明符合共识的标准化定义，12项声明不符合。由于冗余，4项声明被省略。临床声明分为4类进行展示和讨论：（1）PCRS的定义和诊断，（2）PCRS的药物治疗，（3）腺样体炎/腺样体切除术，以及（4）鼻内镜鼻窦手术（ESS）/鼻甲成形术。
专家小组共识可为耳鼻喉科医生诊断和管理无并发症的小儿PCRS患者提供有用信息。
