The Pediatric Sinus Staging System: A Computed Tomography-Based Approach to Grading Pediatric Sinus Disease

被引:4
作者
Melder, Katie [1 ]
Shaffer, Amber [2 ]
Govil, Nandini [3 ]
Stapleton, Amanda [2 ]
机构
[1] Univ Pittsburgh, Dept Otolaryngol, Med Ctr, Pittsburgh, PA 15260 USA
[2] Univ Pittsburgh, Childrens Hosp Pittsburgh, Div Pediat Otolaryngol, Med Ctr, Pittsburgh, PA 15213 USA
[3] Emory Univ, Dept Pediat Otolaryngol, Atlanta, GA 30322 USA
基金
美国国家卫生研究院;
关键词
Pediatric sinus staging system; CHRONIC RHINOSINUSITIS; CHILDREN;
D O I
10.1002/lary.28752
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Objectives/Hypothesis Pediatric chronic rhinosinusitis (CRS) is a prevalent disease with few objective measurements available to predict which patients will require surgical intervention. The Lund-Mackay (LM) score for computed tomography (CT) scans is one objective data point available for the adult population; however, a dedicated scoring system in the pediatric population has not been popularized. We present a Pediatric Sinus Staging System (PSSS) that considers both opacification and the varying developmental stages of each sinus. Study Design Retrospective chart review. Methods We analyzed CT scans of pediatric patients with a diagnosis of CRS. Both LM and PSSS scores were calculated for each scan. Groups were formed based on treatment outcomes and included patients who were treated successfully with medical therapy and/or adenoidectomy (med/adenoid), patients who required functional endoscopic sinus surgery (FESS), and patients who required revision FESS. Results Overall, 76 patient scans were reviewed. PSSS values were significantly less than LM for the control group (P = .001) and significantly higher for patients with cystic fibrosis (P = .027) and with CRS with polyps (P = .001). The ideal cutoff for PSSS to distinguish between med/adenoid and single FESS treatment with a sensitivity 90.6% and specificity of 50.0% was >= 2. Conclusions The PSSS gives a more descriptive score by accounting for the opacification and pneumatization of each sinus. Our current results show similar values between PSSS and LM scores, which suggests internal validity. In addition, a PSSS score of >= 2 may help physicians better counsel families on the likelihood of requiring FESS. Further investigation is needed to fully validate the PSSS. Level of Evidence 3b Laryngoscope, 2020
引用
收藏
页码:E642 / E648
页数:7
相关论文
共 18 条
  • [1] Paranasal sinus development in children: A magnetic resonance imaging analysis
    Adibelli, Zehra Hilal
    Songu, Murat
    Adibelli, Hamit
    [J]. AMERICAN JOURNAL OF RHINOLOGY & ALLERGY, 2011, 25 (01) : 30 - 35
  • [2] The relationship between anatomical variations of the sino-nasal region and chronic sinusitis, extension in children
    Al-Qudah, Mohannad
    [J]. INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY, 2008, 72 (06) : 817 - 821
  • [3] The diagnostic accuracy of computed tomography in pediatric chronic rhinosinusitis
    Bhattacharyya, N
    Jones, DT
    Hill, M
    Shapiro, NL
    [J]. ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY, 2004, 130 (09) : 1029 - 1032
  • [4] Clinical Consensus Statement: Pediatric Chronic Rhinosinusitis
    Brietzke, Scott E.
    Shin, Jennifer J.
    Choi, Sukgi
    Lee, Jivianne T.
    Parikh, Sanjay R.
    Pena, Maria
    Prager, Jeremy D.
    Ramadan, Hassan
    Veling, Maria
    Corrigan, Maureen
    Rosenfeld, Richard M.
    [J]. OTOLARYNGOLOGY-HEAD AND NECK SURGERY, 2014, 151 (04) : 542 - 553
  • [5] Functional burden and limitations in children with chronic sinusitis
    Cheng, Brian T.
    Smith, Stephanie S.
    Fishbein, Anna B.
    [J]. PEDIATRIC ALLERGY AND IMMUNOLOGY, 2020, 31 (01) : 103 - 105
  • [6] Computer-assisted staging of chronic rhinosinusitis correlates with symptoms
    Garneau, Jonathan
    Ramirez, Michael
    Armato, Samuel G., III
    Sensakovic, William F.
    Ford, Megan K.
    Poon, Colin S.
    Ginat, Daniel T.
    Starkey, Adam
    Baroody, Fuad M.
    Pinto, Jayant M.
    [J]. INTERNATIONAL FORUM OF ALLERGY & RHINOLOGY, 2015, 5 (07) : 637 - 642
  • [7] The Burden and Visit Prevalence of Pediatric Chronic Rhinosinusitis
    Gilani, Sapideh
    Shin, Jennifer J.
    [J]. OTOLARYNGOLOGY-HEAD AND NECK SURGERY, 2017, 157 (06) : 1048 - 1052
  • [8] Incidental paranasal sinus imaging abnormalities and the normal Lund score in children
    Hill, M
    Bhattacharyya, N
    Hall, TR
    Lufkin, R
    Shapiro, NL
    [J]. OTOLARYNGOLOGY-HEAD AND NECK SURGERY, 2004, 130 (02) : 171 - 175
  • [9] Quality of life for children with persistent sinonasal symptoms
    Kay, DJ
    Rosenfeld, RM
    [J]. OTOLARYNGOLOGY-HEAD AND NECK SURGERY, 2003, 128 (01) : 17 - 26
  • [10] Treatment of chronic rhinosinusitis with high-dose oral terbinafine: A double blind, placebo-controlled study
    Kennedy, DW
    Kuhn, FA
    Hamilos, DL
    Zinreich, SJ
    Butler, D
    Warsi, G
    Pfister, PJ
    Tavakkol, A
    [J]. LARYNGOSCOPE, 2005, 115 (10) : 1793 - 1799