Pediatric Rhinosinusitis

The volume provides a comprehensive, uptodate and exhaustive review of pediatric rhinosinusitis for clinicians, surgeons, researchers, advanced care providers as well as emergency personnel. It provides information regarding pathophysiology of sinusitis, and how to distinguish between the differential diagnoses of a child with a runny nose. It also utilizes current evidencebased guidelines and consensus statements to clarify this condition to the physician and discusses available medical and surgical treatment. Authored by clinicians with longtime expertise with this disease, Pediatric Rhinosinusitis also reviews definitions, burden of disease, microbiology and pathophysiology of the disease; role of adenoids, allergy and asthma as comorbid conditions; comprehensive medical management; and the role of topical treatment. It also covers the latest advancements in new treatments such as drugeluting stents; comprehensive surgical management; and complications of rhinosinusitis. It will be a valuable resource for otolaryngologists, surgeons, residents, medical students and advanced practice providers for years to come.

Pediatric Rhinosinusitis Hassan H Ramadan Fuad M Baroody  Editors 123 Pediatric Rhinosinusitis Hassan H Ramadan  •  Fuad M Baroody Editors Pediatric Rhinosinusitis Editors Hassan H Ramadan Department of Otolaryngology West Virginia University School of Medicine Morgantown, WV USA Fuad M Baroody Section of Otolaryngology–Head and Neck Surgery The University of Chicago Medicine and The Comer Children’s Hospital Chicago, IL USA ISBN 978-3-030-22890-3    ISBN 978-3-030-22891-0 (eBook) https://doi.org/10.1007/978-3-030-22891-0 © Springer Nature Switzerland AG 2020 This work is subject to copyright All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed The use of general descriptive names, registered names, trademarks, service marks, etc in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Contents Part I Definitions and Basics 1 Definitions and Clinical Signs and Symptoms��������������������������������������    3 Andrea Shogan and Fuad M Baroody 2 Burden and Health Impact of Pediatric Rhinosinusitis ����������������������    9 Aimee A Kennedy and Mark E Gerber 3 Pathogenesis of Pediatric Rhinosinusitis������������������������������������������������   17 Lyuba Gitman and Maria Peña 4 Imaging in Pediatric Rhinosinusitis ������������������������������������������������������   41 Phillip R Purnell, Abdul Rahman Tarabishy, and Johnathan E Castaño 5 Microbiology of Pediatric Sinusitis��������������������������������������������������������   57 Phillip R Purnell and Michele M Carr Part II Sinusitis and Other Pediatric Issues 6 The Role of Adenoids in Pediatric Sinusitis������������������������������������������   73 Max April and Sara C Gallant 7 Allergy and Sinusitis��������������������������������������������������������������������������������   85 Sidrah M Ahmad and Ahmad R Sedaghat 8 Rhinosinusitis and Asthma in Children ������������������������������������������������   95 Ahmad Salaheddine Naja, Ahmad R Sedaghat, and Wanda Phipatanakul 9 Chronic Rhinosinusitis in Children with Cystic Fibrosis��������������������  107 Nour Akil and Austin S Rose 10 Sinusitis and Immunodeficiency in Children����������������������������������������  129 Randa Barazi and Zeina Korban v vi Contents 11 Pediatric Rhinosinusitis and Gastroesophageal Reflux������������������������  139 Lauren Sowa and Fuad M Baroody 12 Pediatric Sinusitis and Adenoiditis��������������������������������������������������������  149 Angela M Donaldson Part III Medical Treatment of Rhinosinusitis 13 Antibiotics: Intranasal and Systemic for Treatment of Sinusitis in Children����������������������������������������������������������������������������  159 Zachariah K Chandy, Elisabeth H Ference, and Jivianne T Lee 14 Saline Irrigation in Pediatric Rhinosinusitis ����������������������������������������  171 Friederike S Luetzenberg and Julie L Wei 15 Medical Treatment of Pediatric Rhinosinusitis: Focus on Intranasal and Systemic Corticosteroids������������������������������  189 Fuad M Baroody Part IV Surgical Treatment of Rhinosinusitis 16 Adenoidectomy and Sinus Lavage����������������������������������������������������������  203 Habib G Zalzal, Chadi A Makary, and Hassan H Ramadan 17 Balloon Sinuplasty in Children��������������������������������������������������������������  211 Elisabeth H Ference and Hassan H Ramadan 18 Endoscopic Sinus Surgery for Pediatric Patients����������������������������������  227 Judd H Fastenberg, Michael S Weinstock, and John P Bent 19 Septoplasty and Turbinate Reduction in Children ������������������������������  241 Christian P Soneru, Charles A Riley, and David A Gudis 20 Postoperative Management of Pediatric Sinusitis��������������������������������  253 Jason R Rudman, Douglas M Nguyen, Mikhaylo Szczupak, and Ramzi T Younis 21 Failure of Surgical Treatment in Children with Chronic Rhinosinusitis��������������������������������������������������������������������  267 Anne S Lowery and Frank W Virgin Part V Complications 22 Pediatric Intracranial Complications from Sinusitis����������������������������  279 Osama Hamdi, Connor M Smith, Caitlin E Fiorillo, and Diego Preciado Index������������������������������������������������������������������������������������������������������������������  291 Contributors Sidrah  M.  Ahmad, MD  Department of Surgery, Division of Otolaryngology, Stony Brook University Hospital, Stony Brook University School of Medicine, Stony Brook, NY, USA Nour  Akil, MD  Division of Pediatric Pulmonary, University of North Carolina School of Medicine, Chapel Hill, NC, USA Max  April, MD  Department of Otolaryngology–Head and Neck Surgery, NYU Langone Medical Center, New York, NY, USA Randa  Barazi, MD  Department of Otolaryngology Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon Fuad M. Baroody, MD  Section of Otolaryngology–Head and Neck Surgery and Department of Pediatrics, The University of Chicago Medicine and The Comer Children’s Hospital, Chicago, IL, USA John  P.  Bent, MD  Department of Otolaryngology–Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA Department of Otolaryngology, Children’s Hospital at Montefiore, Bronx, NY, USA Michele  M.  Carr, DDS, MD, PhD  Department of Otolaryngology–Head and Neck Surgery, West Virginia University School of Medicine, Morgantown, WV, USA Johnathan  E.  Castaño, MD  Department of Otolaryngology–Head and Neck Surgery, West Virginia University School of Medicine, Morgantown, WV, USA Zachariah K. Chandy, MD  Department of Head and Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA vii viii Contributors Angela M. Donaldson, MD  Department of Otorhinolaryngology Head and Neck Surgery, Mayo Clinic Jacksonville, Jacksonville, FL, USA Judd  H.  Fastenberg, MD  Department of Otorhinolaryngology–Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA Elisabeth  H.  Ference, MD, MPH  Rick and Tina Caruso Department of Otolaryngology–Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA Caitlin  E.  Fiorillo, MD  Department of Pediatric Otolaryngology, Children’s National Medical Center, Children’s National Health System, Washington, DC, USA Sara  C.  Gallant, MD  Department of Otolaryngology–Head and Neck Surgery, NYU Langone Medical Center, New York, NY, USA Mark  E.  Gerber, MD  Otolaryngology, Head and Neck Surgery, Phoenix Children’s Hospital, Phoenix, AZ, USA Lyuba  Gitman, MD  Division of Otolaryngology, Children’s National Medical Center, and the Department of Otolaryngology, George Washington University, Washington, DC, USA David A. Gudis, MD  Department of Otolaryngology - Head and Neck Surgery, Columbia University Irving Medical Center, New York, NY, USA Osama  Hamdi, BS  Division of Pediatric Otolaryngology, Children’s National Health System, Washington, DC, USA Aimee  A.  Kennedy, MD  Otolaryngology, Head and Neck Surgery, Children’s Hospital Medical Center, Cincinnati, OH, USA Zeina R. Korban, MD  Department of Otolaryngology Head and Neck Surgery, American University of Beirut Medical Center, Beirut, Lebanon Jivianne T. Lee, MD, FACS  Department of Head and Neck Surgery, University of California Los Angeles Medical Center and David Geffen School of Medicine at the University of California Los Angeles, Los Angeles, CA, USA Anne S. Lowery, BA  Vanderbilt University School of Medicine, Nashville, TN, USA Surgical Outcomes Center for Kids, Vanderbilt University Medical Center, Nashville, TN, USA Friederike S. Luetzenberg, BS  University of Central Florida College of Medicine, Orlando, FL, USA Contributors ix Chadi A. Makary, MD  Department of Otolaryngology–Head and Neck Surgery, West Virginia University School of Medicine, Morgantown, WV, USA Ahmad Salaheddine Naja, MD  Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon Douglas  M.  Nguyen, BS  Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, FL, USA Maria Peña, MD, FACS, FAAP  Division of Otolaryngology, Children’s National Medical Center, and the Department of Otolaryngology, George Washington University, Washington, DC, USA Wanda  Phipatanakul, MD, MS  Department of Pediatrics, Harvard Medical School, Boston, MA, USA Division of Allergy and Immunology, Boston Children’s Hospital, Boston, MA, USA Diego  Preciado, MD, PhD  Department of Pediatric Otolaryngology, Children’s National Health System, The George Washington University School of Medicine, Washington, DC, USA Phillip  R.  Purnell, MD, PhD  Department of Otolaryngology–Head and Neck Surgery, West Virginia University School of Medicine, Morgantown, WV, USA Hassan  H.  Ramadan, MD  Department of Otolaryngology, West Virginia University, School of Medicine, Morgantown, WV, USA Charles Alexander Riley, MD  Department of Otolaryngology - Head and Neck Surgery, Columbia University Irving Medical Center, New York, NY, USA Austin  S.  Rose, MD, FARS  Department of Otolaryngology–Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA Jason R. Rudman, MD  Department of Otolaryngology–Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, FL, USA Ahmad R. Sedaghat, MD, PhD  Department of Otolaryngology–Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA Andrea  Shogan, MD  Section of Otolaryngology–Head and Neck Surgery, The University of Chicago Medicine and The Comer Children’s Hospital, Chicago, IL, USA Connor M. Smith, BA  Division of Pediatric Otolaryngology, Children’s National Health System, Washington, DC, USA Christian  P.  Soneru, MD  Department of Otolaryngology - Head and Neck Surgery, Columbia University Irving Medical Center, New York, NY, USA x Contributors Lauren  Sowa, MD  Section of Otolaryngology–Head and Neck Surgery, The University of Chicago Medicine and The Comer Children’s Hospital, Chicago, IL, USA Mikhaylo  Szczupak, MD  Department of Otolaryngology–Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, FL, USA Abdul  Rahman  Tarabishy, MD  Department of Radiology, Department of Interventional Neuroradiology, West Virginia University School of Medicine, Morgantown, WV, USA Frank  W.  Virgin, MD  Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA Surgical Outcomes Center for Kids, Vanderbilt University Medical Center, Nashville, TN, USA Julie  L.  Wei, MD  Pediatric Otolaryngology/Audiology, Department of Surgery, Nemours Children’s Hospital, Orlando, FL, USA Otolaryngology-Head Neck Surgery, University of Central Florida College of Medicine, Orlando, FL, USA Michael  S.  Weinstock, MD  Department of Otolaryngology–Head and Neck Surgery, Montefiore Medical Center, Albert Einstein Medical School, Bronx, NY, USA Ramzi T. Younis, MD, FACS, FAAP  Department of Otolaryngology–Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, FL, USA Habib  G.  Zalzal, MD  Department of Otolaryngology–Head and Neck Surgery, West Virginia University School of Medicine, Morgantown, WV, USA 22  Pediatric Intracranial Complications from Sinusitis 285 Fig 22.6  A 14-year-old male presented with 24 hours of headache followed by left periorbital edema T2-weighted MRI demonstrated acute left maxillary, ethmoid, and frontal sinusitis with a frontal subperiosteal abscess or “Pott’s puffy tumor.” He was taken to OR for incision and drainage of abscess and endoscopic sinus surgery Fig 22.7  A 7-year-old presented with meningitic signs and fever after 2 weeks of upper respiratory tract symptoms She was found to have acute right sinusitis with a left frontotemporal subdural empyema, secondary encephalitis, and cavernous sinus thrombosis It is to be noted that those with subdural abscesses that were managed without craniotomy had small, focal collections and showed rapid clinical improvement with parenteral antibiotics Parenteral antibiotics were administered to all children with suspected intracranial complications of sinusitis A combination of a penicillin or vancomycin, metronidazole, and a third-generation cephalosporin is chosen because of the ability to 286 O Hamdi et al penetrate into inflamed central nervous system tissue and adequate empiric broad-­ spectrum coverage Therapy was adjusted as culture and sensitivity results became available Parenteral antibiotics are typically continued for a period of 4–8 weeks Patients with intracranial abscesses are also treated with intravenous phenytoin Since our report in 1995, ESS has become a readily available, useful tool in the surgical management of children with acute and chronic sinusitis Its precise therapeutic role, however, in the management of children with intracranial complications from sinusitis is perhaps less defined Some propose that aggressive use of ESS should be instituted in nearly all patients with intracranial complications from sinusitis and that its use can result in improved overall outcomes [20] In our previous series, we highlighted the importance of frontal sinus cranialization and exenteration as a “single-stage” procedure at the time of neurosurgical craniotomy if the frontal sinus was found to be the infectious source and the posterior table was deficient [3] In general, studies of surgical management for intracranial complications of sinusitis are limited by relatively small patient samples and the fact that outcomes are for the most part favorable; therefore, statistical analyses need to be interpreted with caution Given the lack of a randomized protocol, and selection of surgical treatment modality employed based upon patient characteristics, one cannot draw any conclusions on whether early or aggressive ESS or frontal sinus trephination make a substantial impact in the rate of favorable outcomes in these patients The only way to prove this definitively is with a strictly defined prospective, randomized protocol comparing those undergoing ESS or trephination at the time of craniotomy vs those undergoing only craniotomy Such a study has yet to be performed  hanging Nature of Complications Since the Advent C of the Prevnar Vaccine In a recent report, we compared 49 patients with OC and/or SPOA/OA in the pre-­ PCV7 era with 59 patients from the post-PCV7 era We found that although PCV7 vaccination eliminated S pneumoniae as an etiologic pathogen in acute sinusitis complications in our series, there was a parallel and significant increase in S aureus, including an increase in the prevalence of MRSA associated with orbital infections related to acute sinusitis Seeing that there has been an increased incidence of orbital infections from MRSA pathogens and given that patients with OC and SPOA/OA have a significantly increased risk of morbidity if they are not treated aggressively in a timely manner, it is prudent to treat patients with these infections with broad-spectrum antibiotics that cover MRSA until specific culture information becomes available [30] No studies have been done to date noting the effect of the PCV13 vaccine on acute sinusitis patients However, both Olarte L et al [31] and Lindstrand et al [32] assessed the impact of PCV13 on chronic sinusitis in children Olarte observed 91 cases of chronic sinusitis with positive cultures for S pneumonia, and 61 (67%) isolates were non-PCV13 serotypes Despite a decrease in S pneumoniae isolation 22  Pediatric Intracranial Complications from Sinusitis 287 in children with chronic sinusitis in the post PCV13 era, there was a significant increase in isolation of the anaerobic organism, Prevotella spp (P  =  0.02) [31] Lindstrand et al found a 66% lower risk of hospitalization for sinusitis following PCV7 and PCV13 vaccination in children