共 18 条
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