Search

Objective: We assessed patterns in the national incidence of pediatric acute sinusitis and associated complications surrounding the initial COVID‐19 lockdown. Study Design: Retrospective National Database review. Setting: The Pediatric Health Information System. Methods: Acute sinusitis and associated complication incidence data from 2015 to 2022 were queried. Three time periods of T1, T2, and T3 were defined as: pre‐COVID‐19 baseline, initial pandemic, and postpandemic. Statistical analysis included Wilcoxon rank sum tests, multivariable logistic regressions, and autoregressive integrated moving averages (ARIMA) to assess differences between the observed complication rates in T2 and T3 and the expected incidence rates in these time periods as estimated from T1 data. Results: We identified 2535 acute sinusitis admissions across 42 centers. The incidence differed between T1 (31.5 cases/month), T2 (15.8 cases/month), and T3 (29 cases/month). Children aged 10 to 14 years had the highest acute sinusitis incidence rate (32.5%) compared to other ages in T2. At T1, acute sinusitis and associated complication rates followed parallel seasonal patterns. Although sinusitis incidence decreased during T2, complications increased significantly during T2 and T3 compared to T1 (37.4% and 39% vs 27.5%, P <.001). In the ARIMA model, the ratio of the observed to expected incidence (95% confidence interval) of complications was 1.09 (0.69, 2.60) in T2 and 1.14 (0.73, 2.62) in T3. Conclusion: We report the simultaneous decrease in acute sinusitis incidence and an increase in associated complications during and after the initial COVID‐19 pandemic compared to the prepandemic baseline, reflecting changing patterns in viral infection due to the pandemic. [ABSTRACT FROM AUTHOR]

Objective: Odontogenic sinusitis (ODS) can cause infectious orbital, intracranial, and osseous complications. Diagnosis and management of complicated ODS have not been discussed in recent sinusitis guidelines. The purpose of this systematic review was to describe epidemiological and clinical features, as well as management strategies of complicated ODS. Data Sources: PubMed, EMBASE, and Cochrane Library. Review Methods: A systematic review was performed to describe various features of complicated ODS. All complicated ODS studies were included in qualitative analysis, but studies were only included in quantitative analysis if they reported specific patient-level data. Results: Of 1126 studies identified, 75 studies with 110 complicated ODS cases were included in qualitative analysis, and 47 studies with 62 orbital and intracranial complications were included in quantitative analyses. About 70% of complicated ODS cases were orbital complications. Only 23% of complicated ODS studies were published in otolaryngology journals. Regarding ODS-related orbital and intracranial complications, about 80% occurred in adults, and 75% were male. Complicated ODS occurred most commonly from apical periodontitis of maxillary molars. There were no relationships between sinusitis extent and orbital or intracranial complications. High rates of anaerobic and α-hemolytic streptococcal bacteria were identified in complicated ODS. Management generally included systemic antibiotics covering aerobic and anaerobic bacteria, and surgical interventions were generally performed to address both the complications (orbital and/or intracranial) and possible infectious sources (dentition and sinuses). Conclusion: ODS should be considered in all patients with infectious extrasinus complications. Multidisciplinary management between otolaryngologists, dental specialists, ophthalmologists, and neurosurgeons should be considered to optimize outcomes. [ABSTRACT FROM AUTHOR]

Background: Sinusitis complications are potentially lethal conditions that generally require extensive treatment and thus place a significant burden on the health-care system. The purpose of this study was to assess the impact of surgery on hospital utilization associated with treatment of sinusitis complications. Methods: Retrospective cohort study using a national hospital database. The 2012 to 2013 National Inpatient Sample was queried for adult patients with sinusitis and complications. Patients were grouped based upon the presence or absence of sinus procedures. Patient demographics and health status, hospital characteristics, length of stay (LOS), and charges were determined. Results: Of 1645 patients with sinusitis and associated complications, 232 (14%) underwent sinus procedures. These patients had higher LOS (8.0 ± 7.3 days vs 4.3 ± 5.2 days; P <.001) and charges (US$96 107 ± 108 089 vs US$30 661 ± 47 138; P <.001) than nonprocedure patients. Increased time to procedure in one operation patients (n = 209) of more than 2 days increased total LOS (11.4 ± 9.3 days vs 6.2 ± 5.5 days; P <.001) and charges (US$120 306 ± 112 748 vs US$76 923 ± 81 185; P =.005). Patients with multiple sinus procedures (n = 23) versus one had increased LOS and charges, despite no time difference from admission to first procedure (P =.35). On regression analysis, sinus procedure patients had excess LOS of 0.827 days and charges of US$36 949. Conclusion: Although often necessary, sinus procedures lead to increased LOS and charges. As prolonged time to sinus procedure and revision operations also increase charges, shorter trials of medical therapy and earlier surgical intervention may improve outcomes and reduce costs. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Kartal Training & Research Hospital / Kartal Egitim ve Arastirma Hastanesi Tip Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article discusses a study on the efficacy of transorbital neuroendoscopic surgery (TONES) for the management of sinogenic complications involving the frontal sinus, orbit and anterior cranial fossa in a prospective series of 13 patients presented with these symptoms. Results demonstrated the safety and efficacy of TONES in the management of sinogenic complications and the procedure's use as a primary surgical modality or in multiportal combination with endonasal approaches.

Objectives: We sought to determine whether the bacteria in complicated rhinosinusitis were the typical acute rhinosinusitis triad of Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. We also compared the difference in yield between infection sites and blood cultures. Methods: We performed a retrospective review of all patients who had required surgical intervention for rhinosinusitis complications over 7 years at a tertiary care pediatric hospital. Results: There were a total of 28 patients during the review period. Twenty-five organisms were isolated from 21 patients, of which Streptococcus viridans formed 44% of the isolates (11 of the 25). The typical triad of bacteria only formed 20% of the isolates (5 of the 25), and none of these bacteria were found in the group with intracranial complications. Infection site cultures had a superior yield compared to blood cultures (p < .001). Ninety-six percent of the bacteria were sensitive to a combination of amoxicillin-clavulanate and cloxacillin. Conclusions: In distinction to the typical bacteria of acute rhinosinusitis, S viridans is the leading cause of rhinosinusitis complications. It is not merely a commensal organism of the upper respiratory tract. [ABSTRACT FROM AUTHOR]

Describes a case of Pott's puffy tumor in a pediatric patient with sinusitis. Medical history of the subject; Complications of paranasal sinus disease; Diseases associated with Pott's puffy tumor.