2017 Sec 1 Green Book

Fordham MT, Rock AN, Bandarkar A, et al. Transcervical ultrasonography in the diagnosis

of pediatric peritonsillar abscess.

Laryngoscope

. 2015; 125(12):2799-2804. EBM

level 4..................................................................................................................................62-67

Summary

: This study is a prospective evaluation of the predictive utility of transcervical

ultrasonography in identifying peritonsillar abscesses in children. The sensitivity and

specificity of transcervical ultrasound when compared to clinical outcomes were 100% and

76.5%, respectively. There was a significant association between negative ultrasonography

and successful medical management. Potential advantages of ultrasonography compared to

CT are cost reduction, avoidance of unnecessary radiation exposure, avoidance of undue

sedation, and real-time imaging.

Garetz SL, Mitchell RB, Parker PD, et al. Quality of life and obstructive sleep apnea

symptoms after pediatric adenotonsillectomy.

Pediatrics

. 2015; 135(2):e477-e486. EBM

level 1..................................................................................................................................68-77

Summary

: Data from the Childhood Adenotonsillectomy Trial (CHAT), a randomized

controlled trial of adenotonsillectomy versus watchful waiting for mild obstructive sleep

apnea, were evaluated to compare improvements in disease-specific and global quality of life

between groups. Greater improvements in most quality-of-life and symptom severity

measurements were found in the adenotonsillectomy group using the Pediatric Quality of Life

Inventory, the Obstructive Sleep Apnea-18 (OSA-18), the Sleep-Related Breathing Subscale

of the Pediatric Sleep Questionnaire (PSQ-22), and the modified Epworth Sleepiness Scale.

Results were not influenced by obesity or baseline sleep study indices, but some of the

symptom measures were influenced by race.

Prosser JD, Shott SR, Rodriguez O, et al. Polysomnographic outcomes following lingual

tonsillectomy for persistent obstructive sleep apnea in Down syndrome.

Laryngoscope

2017; 127(2):520-524. EBM level 4..................................................................................78-82

Summary

: This is a retrospective review of polysomnography outcomes after lingual

tonsillectomy in children with Down syndrome with residual obstructive sleep apnea

following adenotonsillectomy. There were significant improvements in change scores for

apnea-hypopnea index (AHI), obstructive AHI, apnea index, hypopnea index, and oxygen

saturation nadir, but not in time with CO

>50 mm Hg. The AHI was <5 events/hour in

61.9% of patients and ≤1 in 19% of patients. The study suggests that children with Down

syndrome and persistent obstructive sleep apnea after adenotonsillectomy should be

evaluated for lingual tonsil hypertrophy.

IV.

Rhinology

Garin A, Thierry B, Leboulanger N, et al. Pediatric sinogenic epidural and subdural

empyema: the role of endoscopic sinus surgery.

Int J Pediatr Otorhinolaryngol

. 2015;

79(10):1752-1760. EBM level 4........................................................................................83-91

Summary

: Controversy exists as to whether minimally invasive endoscopic approaches are

sufficient to treat serious suppurative intracranial complications of pediatric sinusitis. This

study supports an important role for endoscopic sinus surgery in these cases and a role as sole

surgical intervention for small epidural empyema.