September 2019 HSC Section 1 Congenital and Pediatric Problems

Newton L, Kotowski A, Grinker M, Chun R. Diagnosis and management of pediatric sinusitis: a survey of primary care, otolaryngology and urgent care providers. Int J Pediatr Otorhinolaryngol . 2018; 108:163-167. EBM level 2.............................................................................................133-137 Summary : This article provides a prospective comparison between physician groups in the adherence to previously published rhinosinusitis guidelines. It identifies some of the areas where the guidelines are followed and where current practice deviates from the guidelines overall or within the subgroups. This highlights potential areas for improvement, such as use of adjunctive therapies, proper length of antibiotic usage, and proper antibiotic choice. Otology Knutsson J, Priwin C, Hessén-Söderman AC, et al. A randomized study of four different types of tympanostomy ventilation tubes – full-term follow-up. Int J Pediatr Otorhinolaryngol . 2018; 107:140-144. EBM level 1.......................................................................................................138-142 Summary : The authors compared the impact of different types of ventilation tubes (material and shape) on time to extrusion, otorrhea, occlusion, need for tube removal, and perforation risk. Four hundred children between 1 to 10 years of age were randomized to receive a different tube in each ear, and were followed every 3 months until 6 months following extrusion of both tubes. They concluded that long tubes are less prone to early extrusion, while silicone tubes render a longer time until the first infection. Liming BJ, Carter J, Cheng A, et al. International Pediatric Otolaryngology Group (IPOG) consensus recommendations: hearing loss in the pediatric patient. Int J Pediatr Otorhinolaryngol . 2016; 90:251-258. EBM level 5...............................................................................................143-150 Summary : Senior author Richard Smith, MD. This article provides consensus recommendations of an international group of pediatric otolaryngologists regarding the identification and workup of the child with hearing loss. They make recommendations and present algorithms for newborn screening and initial workup, auditory neuropathy spectrum disorder, sensorineural hearing loss, and conductive or mixed hearing loss. Yankey H, Isaacson G. Efficacy of topical 2% mupirocin ointment for treatment of tympanostomy tube otorrhea caused by community-acquired methicillin resistant Staphylococcus aureus . Int J Pediatr Otorhinolaryngol . 2018; 109:36-39. EBM level 3.....................................................151-154 Summary : The authors performed a case-control study in which children with MRSA tympanostomy tube otorrhea were treated with systemic antibiotics with or without fluoroquinolone drops (prior to 2014) vs the addition of a single application of topical mupirocin (after 2014). They treated a total of 29 children (37 ears), and compared the recurrence of MRSA and non-MRSA otorrhea between the groups, as well as the incidence of sensorineural hearing loss.

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