2017 Sec 1 Green Book

Sagi L, Eviatar E, Gottlieb P, Gavriel H. Quantitative evaluation of facial growth in children after unilateral ESS for subperiosteal orbital abscess drainage. Int J Pediatr Otorhinolaryngol . 2015; 79(5):690-693. EBM level 4.....................................................92-95 Summary : Possible interference with facial growth has long been considered a possible complication of pediatric endoscopic sinus surgery (ESS) since animal studies in piglets done in the 1990s demonstrated fairly dramatic effects. Subsequent human studies have failed to confirm that hypothetical concern, and this study adds to the body of evidence supporting the safety of ESS by adding the unique study design of patients undergoing unilateral surgery for subperiosteal orbital abscess, enabling them to serve as their own control. Wald ER, Applegate KE, Bordley C, et al. Clinical practice guideline for the diagnosis and management of acute bacterial sinusitis in children aged 1 to 18 years. Pediatrics . 2013; 132(1):e262-e280. EBM level 1.......................................................................................96-114 Summary : Continuing the theme of credible best-practice guidelines, this updated guideline is critical for providers who treat children with acute bacterial sinusitis. Changes in this revision include the addition of a clinical presentation designated as “worsening course,” an option to either treat immediately or observe children with persistent symptoms for 3 days before treating, and a review of evidence indicating that imaging is not necessary in children with uncomplicated acute bacterial sinusitis. Otology Bergevin A, Zick CD, McVicar SB, Park AH. Cost-benefit analysis of targeted hearing directed early testing for congenital cytomegalovirus infection. Int J Pediatr Otorhinolaryngol . 2015; 79(12):2090-2093. EBM level 5...........................................115-118 Summary : The authors present a cost-benefit analysis of early cytomegalovirus (CMV) detection in Utah. They calculate the estimated costs of the early CMV detection program in place in Utah, and compare that to the costs incurred by society in untreated hearing loss due to CMV. They conclude that if antiviral therapies are used to mitigate hearing loss for one infant per year, then the public savings offset the costs of the screening program and antiviral therapy. Duval M, Grimmer JF, Meier J, et al. The effect of age on pediatric tympanoplasty outcomes: a comparison of preschool and older children. Int J Pediatr Otorhinolaryngol . 2015; 79(3):336-341. EBM level 4................................................................................119-124 Summary : T his retrospective case series looks at the rate of residual perforation following tympanoplasty in children in three different age groups (ages 2 to 4, 5 to 7, and 8 to 13 years). They found that on multivariate analysis, preschool-aged children had a 5× increased incidence of perforation when compared to the oldest children. This was mostly attributed to reperforation from eustachian tube dysfunction or acute otitis media after initial successful healing.

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