Anne S Lowery1, Jean-Nicolas Gallant1, Bradford A Woodworth2, Rebekah F Brown3, Gregory S Sawicki4, Chevis N Shannon5, Frank W Virgin6. 1. Vanderbilt University School of Medicine, Nashville, TN, USA; Surgical Outcomes Center for Kids, Vanderbilt University Medical Center, Nashville, TN, USA. 2. Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, AL, USA. 3. Division of Pediatric Allergy, Immunology and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA. 4. Division of Pulmonary and Respiratory Diseases, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA. 5. Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, TN, USA; Surgical Outcomes Center for Kids, Vanderbilt University Medical Center, Nashville, TN, USA. 6. Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA; Surgical Outcomes Center for Kids, Vanderbilt University Medical Center, Nashville, TN, USA. Electronic address: frank.w.virgin@vumc.org.
Abstract
OBJECTIVES: Children with cystic fibrosis (CF) have a high incidence of chronic rhinosinusitis (CRS); however, no clinical care guidelines currently exist for the management of CRS in these patients. As a result, there is variation in the treatment of CRS in children, especially when it comes to the frequency of surgery for nasal polyposis. METHODS: A 28-question survey was sent to pediatric otolaryngologists (POs) and pulmonologists (PPs) who care for pediatric CF patients. Questions assessed the level of agreement that practitioners had with various approaches to CRS care in pediatric CF patients. RESULTS: Responses from 114 POs and 50 PPs were included in our final analysis. Each group demonstrated significantly different approaches to the medical and surgical management of CRS in pediatric CF patients. POs prefer multi-modal approach while PPs prefer single-modal approaches. With respect to medical management, PPs incline towards IV antibiotics while POs tend toward oral steroids. CONCLUSION: POs and PPs strongly agree that CRS has an impact on overall disease state and quality of life of pediatric CF patients. However, POs and PPs significantly differ in their approach to treating CRS, demonstrating a potential need for clinical care guidelines for the management these common sequelae of CF.
OBJECTIVES:Children with cystic fibrosis (CF) have a high incidence of chronic rhinosinusitis (CRS); however, no clinical care guidelines currently exist for the management of CRS in these patients. As a result, there is variation in the treatment of CRS in children, especially when it comes to the frequency of surgery for nasal polyposis. METHODS: A 28-question survey was sent to pediatric otolaryngologists (POs) and pulmonologists (PPs) who care for pediatric CF patients. Questions assessed the level of agreement that practitioners had with various approaches to CRS care in pediatric CF patients. RESULTS: Responses from 114 POs and 50 PPs were included in our final analysis. Each group demonstrated significantly different approaches to the medical and surgical management of CRS in pediatric CF patients. POs prefer multi-modal approach while PPs prefer single-modal approaches. With respect to medical management, PPs incline towards IV antibiotics while POs tend toward oral steroids. CONCLUSION:POs and PPs strongly agree that CRS has an impact on overall disease state and quality of life of pediatric CF patients. However, POs and PPs significantly differ in their approach to treating CRS, demonstrating a potential need for clinical care guidelines for the management these common sequelae of CF.
Authors: Do-Yeon Cho; Shaoyan Zhang; Daniel F Skinner; Dong Jin Lim; Catherine Banks; Jessica W Grayson; Guillermo J Tearney; Steven M Rowe; Bradford A Woodworth Journal: Int Forum Allergy Rhinol Date: 2021-10-26 Impact factor: 5.426