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
2
>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.