2017 Sec 1 Green Book

Huyett P, Monaco SE, Choi SS, Simons JP. Utility of fine-needle aspiration biopsy in the evaluation of pediatric head and neck masses. Otolaryngol Head Neck Surg . 2016; 154(5):928-935. EBM level 4........................................................................................190-197 Summary : This article evaluates the use of fine-needle aspiration biopsy (FNAB) to assess head and neck masses in the pediatric population. A total of 257 consecutive patients underwent FNAB in the interventional radiology suite, operating room, clinic, or ward from 2007-2014. Most common diagnoses were reactive lymphadenopathy (38.5%), benign thyroid colloid nodule (12.1%), malignancy (8.2%), and atypical mycobacterial infection (5.8%). FNAB yielded an overall sensitivity of 94.6% and specificity of 97.7%. Complication rate was 2.1%. Most patients required sedation or anesthesia for the FNAB procedure. Negative FNAB can be utilized to provide reassurance to avoid unnecessary surgery with its associated morbidity and cost. Léauté-Labrèze C, Hoeger P, Mazereeuw-Hautier J, et al. A randomized, controlled trial of oral propranolol in infantile hemangioma. N Engl J Med . 2015; 372(8):735-746. EBM level 1..............................................................................................................................198-209 Summary : This article summarizes the results of a randomized controlled trial on the use of propranolol to treat complicated infantile hemangioma. A total of 460 patients were randomized to receive placebo or one of four propranolol dosing regimens (1 or 3 mg/kg/day for 3 or 6 months). The regimen of 3 mg/kg/day for 6 months was found to be the most effective dosing regimen, with 60% of patients having complete or near-complete resolution of hemangioma vs. 4% in the placebo group. Adverse events were more common in the propranolol-treated groups (90%) compared to the placebo group (76%).