Beswick Daniel M, Messner Anna H, Hwang Peter H
1 Stanford University School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Stanford, California, USA.
Ann Otol Rhinol Laryngol. 2017 Sep;126(9):634-639. doi: 10.1177/0003489417719717. Epub 2017 Aug 2.
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).
Comparison of surveys.
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.
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.
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.
比较美国鼻科学会(ARS)成员与美国儿科学会耳鼻咽喉科分会(ASPO)成员对小儿慢性鼻窦炎(PCRS)的治疗方法。
调查比较。
2016年9月至10月,对ASPO成员进行了两次基于网络的调查。将数据与2016年3月至4月ARS成员先前公布的数据进行比较。
ASPO的调查完成率为22%。ARS成员在初始治疗(P = 0.025)和最大程度药物治疗(P = 0.001)中更倾向于使用口服类固醇。ASPO成员在计算机断层扫描(CT)前更常进行腺样体切除术(P < 0.001)。两组均普遍将腺样体切除术作为初始手术治疗的一部分(90%对94%,P = 0.316),而ASPO成员更频繁地单独进行腺样体切除术(70%对43%,P = 0.001)。如果初始手术治疗失败,两组均普遍进行鼻内镜鼻窦手术(ESS;81%对88%,P = 0.56),手术范围相似,包括额窦(P≥0.207)和蝶窦(P≥0.304)手术。
两组对小儿慢性鼻窦炎的治疗方法相似,但存在差异,包括口服类固醇的使用、CT与腺样体切除术的相对顺序以及与腺样体切除术同时进行的手术。如果先前的手术治疗失败,两组均普遍进行ESS,手术范围相似。两组的治疗方法在很大程度上与已发表的共识声明一致。