Working towards consensus in the management of pediatric chronic rhinosinusitis in cystic fibrosis
| Autor: | Bethany L. Bartley, Lael M. Yonker, M. Shannon Fracchia, Frank W. Virgin, Asitha D. L. Jayawardena, Christopher J. Hartnick, Allen Lapey |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Consensus Cystic Fibrosis Population Disease Cystic fibrosis Pediatrics 03 medical and health sciences Otolaryngology 0302 clinical medicine 030225 pediatrics Internal medicine Surveys and Questionnaires Otolaryngologists otorhinolaryngologic diseases medicine Pulmonary Medicine Humans Pediatricians Practice Patterns Physicians' Sinusitis 030223 otorhinolaryngology education Child Pulmonologists Rhinitis Response rate (survey) education.field_of_study business.industry General Medicine medicine.disease Anti-Bacterial Agents Regimen Pulmonology Cross-Sectional Studies Otorhinolaryngology Pediatrics Perinatology and Child Health Chronic Disease Nasal Lavage Female business |
| Zdroj: | International journal of pediatric otorhinolaryngology. 135 |
| ISSN: | 1872-8464 |
| Popis: | Objective The prevalence of chronic rhinosinusitis (CRS), defined by mucosal thickening on imaging, approaches 100% in the cystic fibrosis (CF) population. CRS is associated with significant morbidity in CF, including its ability to trigger pulmonary exacerbations. CRS in CF is typically managed by pediatricians, otolaryngologists and pulmonologists. This survey evaluates the variance in practice patterns of CRS in CF amongst specialists. Methods This is a cross-sectional, electronic survey in which maximum variation purposive sampling was used by a multi-disciplinary group of pediatric, otolaryngology and pulmonology providers in order to select a survey population with expertise in CRS in CF patients. The survey was distributed to 381 practitioners from September to October 2019. Results 175 participants responded (45% response rate). Ten (of 54) statements achieved 75% consensus agreement. Consensus statements included: The decision to pursue surgical intervention for CRS in CF is a multi-disciplinary approach (94%; n = 146); maximal medical management should include nasal saline irrigation (93%; n = 142), topical steroids (75%; n = 117), maximal medical management should not include intravenous steroids (79%; n = 122); image guidance in surgery is necessary for all surgery involving the frontal sinuses (77%; n = 43), and all revision surgery(80%, n = 45); the appropriate setting for sinus surgery in a CF patient varies depending on patient presentation (89%; n = 133); post-operative regimen should include nasal saline (93%; n = 137); but does depend on the severity of disease discovered intra-operatively (84%; n = 124); post-operative antibiotics should be guided by intra-operative culture data (82%; n = 121). Conclusions There is a great deal of variation amongst specialists in the treatment of CRS in CF, however 10 statements met consensus criteria and should be considered when forming clinical care guidelines in this population. |
| Databáze: | OpenAIRE |
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