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266

International consensus statement on rhinosinusitis

TABLE V-8 Evidence for the definition of pediatric rhinosinusitis Study Year LOE Study Design Study Groups

Clinical Endpoint Symptoms Allergy testing and

Conclusions

Ilhan 224

Nasal obstruction was the most common symptoms (90%), followed by nasal drainage (48% to 62%) and cough (40%). Cough followed by rhinorrhea were the most common symptoms in both groups and the prevalence of these symptoms did not differ between groups. Subjects with abnormal sinus radiographs had more frequent cough, sore throat, and postnasal drainage than those with normal radiographs. Serum studies did not differ based on radiographic inflammation.

2012

4

Case series

50 children with PCRS

serum studies testing

Poachanukoon 223

2012

4

Case series

103 children with RS for < 4weeks (PARS). 51 children with RS for > 8weeks (PCRS) 70 children with chronic

Main symptoms Examination findings Treatment details

Rachelefsky 225

History and physical exam Sinus radiographs CBC, Ig, ESR

1978

4

Case series

respiratory symptoms

Defintion of Pediatric Acute Rhinosinusitis Sinonasal inflammation for less than 12 weeks in children with 2 or more of the following symp toms: – nasal obstruction. – discolored nasal discharge. –cough.

Cough as a Presenting Symptom in Pediatric Chronic Rhinosinusitis Aggregate Grade of Evidence: C (Level 4: 3 studies; Table V-8).

VI General Concepts of Rhinosinusitis VI.A Societal Burden of Rhinosinusitis VI.A.1 Direct Costs of Rhinosinusitis Rhinosinusitis (both acute and chronic forms) affects approximately 12% to 15.2% of the adult population in the United States, annually. 9,87 This prevalence exceeds that of other common respiratory conditions such as hay fever (8.9%), acute asthma (3.8%) and chronic bronchitis (4.8%). 87 The direct costs of managing acute and chronic RS are thought to exceed USD$11 billion per year. 88 These figures, however, do not distinguish between acute and chronic forms of RS and further stratification is presented below. Furthermore, how we define “cost” vs “charges” has been difficult to extrapolate from the current literature as cost has been loosely defined as the difference between the true costs and published costs from a payer perspec tive which are actually “charges” from the perspective of healthcare systems.

Definition of Pediatric Chronic Rhinosinusi tis Sinonasal inflammation for 12 or more weeks in children with 2 or more of the following symp toms: – nasal obstruction. – nasal discharge. – facial pain/pressure. –cough. The diagnosis of PCRS requires either nasal obstruc tion or nasal discharge to be present as well as endoscopic or radiologic confirmation of sinonasal inflammation.