Management of Complications of Pediatric Acute Rhinosinusitis

PROGRAM DESCRIPTION: Orbital infections are common complications of acute rhinosinusitis (ARS) in children. These infections can progress intracranially which can lead to meningitis and brain abscesses. A large proportion of these patients respond well to oral or intravenous antibiotics. Depending on the severity of the infection, these patients can be treated as outpatient, while others require admission to the hospital for systemic antibiotics. Some studies have suggested benefit for concomitant use of corticosteroid. Surgical drainage is indicated when medical treatment fails. This panel seeks to gain insight to the most recent evidence-based treatment of complications of ARS with emphasis on the role of the otolaryngologists in the medical and surgical treatment decisions.

OUTCOME OBJECTIVE 1: Review the evidence-based medical treatment for complications of acute rhinosinusitis.

OUTCOME OBJECTIVE 2: Identify children with high risk factors that may fail medical treatment.

OUTCOME OBJECTIVE 3: Determine the best approaches for surgical interventions with discussion of the importance of multispecialty team approach.

BACKGROUND STATEMENT: The optimal treatment of complications of acute rhinosinusitis is not clear due to lack of high-level evidence-based studies. Timing of surgical intervention can vary depending on disease acuity. Otolaryngologists are often the leading clinicians in treatment decision making.