title: Practice patterns in pediatric chronic rhinosinusitis: A survey of the American Rhinologic Society.
abstract: BACKGROUND
  The management of pediatric chronic rhinosinusitis (PCRS) is evolving.
  
  
  OBJECTIVE
  To assess current practice patterns of members of the American Rhinologic Society (ARS) in managing PCRS.
  
  
  METHODS
  A 27-item Web-based survey on treatment of PCRS was electronically distributed to the ARS membership.
  
  
  RESULTS
  The survey was completed by 67 members, 40% of whom had completed a rhinology fellowship. The most frequently used medical therapies as part of initial treatment for PCRS were nasal saline solution irrigation, (90%), topical nasal steroids (93%), oral antibiotics (52%), and oral steroids (20%). For initial surgical therapy, 90% performed adenoidectomy; in addition, 31% also performed sinus lavage, 17% performed balloon catheter dilation (BCD), and 17% performed endoscopic sinus surgery (ESS). Sixty percent performed adenoidectomy before obtaining computed tomography imaging. When initial surgical treatment failed, 85% performed traditional ESS. In patients with pansinusitis, 50% of the respondents performed frontal sinusotomy and 70% performed sphenoidotomy. BCD was not frequently used; overall, 66% never or rarely used it, 20% sometimes used it, 12% usually used it, and 3% always or almost always used BCD.
  
  
  CONCLUSIONS
  Most aspects of PCRS management among ARS members were aligned with published consensus statements. Adenoidectomy was almost always included as part of first-line surgical treatment but was also combined with adjunctive surgical procedures with moderate frequency. ESS was performed by a minority of rhinologists as a primary procedure for medically refractory PCRS but was favored when previous surgery failed. BCD was uncommonly used in PCRS.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Beswick
authors.forename: Hassan
authors.initials: H
authors.lastname: Ramadan
authors.forename: Fuad M
authors.initials: FM
authors.lastname: Baroody
authors.forename: Peter H
authors.initials: PH
authors.lastname: Hwang
mesh_terms: D000233:Adenoidectomy; D000305:Adrenal Cortex Hormones; D002648:Child; D002908:Chronic Disease; D019468:Disease Management; D004724:Endoscopy; D006801:Humans; D000072220:Otolaryngologists; D010372:Pediatrics; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012220:Rhinitis / Q000453:epidemiology* / Q000628:therapy; D012852:Sinusitis / Q000453:epidemiology* / Q000628:therapy; D012955:Societies, Medical; D011795:Surveys and Questionnaires
chemical_list: D000305:Adrenal Cortex Hormones