Diagnosis and follow-up of ultrasonographical sinus changes in children

Revonta, Matti; Suonpää, Jouko

doi:10.1016/0165-5876(82)90042-8

Cited by 28 publications

(12 citation statements)

References 7 publications

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“…One study 16 found good correlation between ultrasonographic findings and retrieval of fluid on aspiration: 68 of 72 sinuses with ultrasonographic abnormalities yielded fluid on aspiration, but aspiration was not attempted in any control group without ultrasonographic abnormalities. Cultures of the aspirate from 59 sinuses yielded microbial pathogens in less than half the cases (26/59).…”

Section: Concordance Of Diagnostic Methodsmentioning

confidence: 99%

“…In addition, 2 of the randomized, controlled trials on therapeutic measures provided data on percentage of abnormal radiographs among children with a clinical diagnosis of sinusitis 12,15 ; a third trial 16 addressed the presence of aspiration fluid in the setting of abnormal ultrasonography without any symptoms being present. Thus, a total of 8 studies qualified for considerations pertaining to diagnostic concordance.…”

Section: Concordance Of Diagnostic Methodsmentioning

confidence: 99%

“…[15][16][17] The age range of the remaining 9 trials extended to as young as 9 to 20 years (younger than 12 years in 7 of them), but no separate data on the pediatric population were provided and the majority of the enrolled patients were presumably adults (upper age limit: 62 years to undefined).…”

Section: Retrieved Reportsmentioning

confidence: 99%

“…16 The other 2 trials addressed, in a double-blind fashion, the efficacy of steroid or combination agents (nasal spray budenoside 15 and a combination of nasal oxymetazoline in addition to oral liquid brompheniramine and phenylpropanolamine, 17 respectively) against placebo.…”

Section: Efficacy Of Ancillary Measuresmentioning

confidence: 99%

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Technical Report: Evidence for the Diagnosis and Treatment of Acute Uncomplicated Sinusitis in Children: A Systematic Overview

Ioannidis

Lau

2001

Pediatrics

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ABSTRACT.Objective. To evaluate and analyze the existing evidence for the diagnosis and treatment of acute uncomplicated sinusitis in children.Design. A systematic overview and meta-analysis considered all pertinent studies with at least 10 children younger than 18 years with acute symptoms of <30 days and without serious complications.Outcomes. Clinical improvement rates for intervention studies of antibiotics or ancillary measures; concordance of diagnostic tests (expressed as likelihood ratios).Results. Of 1857 citations originally reviewed, we identified 21 qualifying studies, compared with 450 reports on complications of acute sinusitis and 233 nonsystematic reviews of the subject. The qualifying studies included 5 randomized, controlled trials and 8 case series on antibiotic therapy, 3 randomized, controlled trials on ancillary treatments, and 8 studies with information on diagnostic tests (including 3 therapeutic trials). Definitions and inclusion criteria were heterogeneous across studies. The pooled clinical improvement rate with antibiotics was 88% (177/202) in randomized, controlled trials and 92% (318/345) in nonrandomized studies; the improvement rates on no antibiotics were 60% and 80%, respectively. Improvement rates were significantly higher in nonrandomized studies (Mantel-Haenszel odds ratio: 1.79; 95% CI: 1.05-3.04, stratified for use of antibiotics). Data on ancillary measures were sparse and heterogeneous. In studies comparing clinical findings with plain film radiography, the pooled rate of abnormal radiographic findings against a clinical diagnosis of sinusitis was 73% (596/814; range: 55% to 96% between studies). There was poor concordance between clinical criteria, plain radiographs, ultrasonography, computed tomography, and fluid on aspiration in all available paired assessments (all positive likelihood ratios were <4 and all negative likelihood ratios were >0.2).Conclusions. Good, high-quality evidence for acute uncomplicated sinusitis in children is limited. Diagnostic modalities show poor concordance, and treatment options are based on inadequate data. More evidence is needed for defining the optimal treatment and diagnostic methods for this common condition.

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Section: Concordance Of Diagnostic Methodsmentioning

confidence: 99%

Section: Concordance Of Diagnostic Methodsmentioning

confidence: 99%

Section: Retrieved Reportsmentioning

confidence: 99%

Section: Efficacy Of Ancillary Measuresmentioning

confidence: 99%

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Technical Report: Evidence for the Diagnosis and Treatment of Acute Uncomplicated Sinusitis in Children: A Systematic Overview

Ioannidis

Lau

2001

Pediatrics

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“…The 2001 technical report cited 1 study that demonstrated good concordance between ultrasonographic findings and retrieval of fluid on sinus aspiration. 24 On the basis of that study, ultrasonographic findings (either mucosal thickening of ≥5 mm or fluid in at least 1 maxillary sinus) were used as entry criteria in the study by Kristo et al 9 In that study, children also underwent occipitomental radiography, and the film results were defined as positive for sinusitis if there was mucosal thickening of at least 4 mm, an air-fluid level, or total opacification of at least 1 maxillary sinus. Eightynine percent of children in the treatment group and 92% of those in the placebo group met this criterion, suggesting good concordance between plain films and ultrasonography.…”

Section: Imaging Studiesmentioning

confidence: 99%

Evidence for the Diagnosis and Treatment of Acute Uncomplicated Sinusitis in Children: A Systematic Review

Smith¹

2013

Pediatrics

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In 2001, the American Academy of Pediatrics published clinical practice guidelines for the management of acute bacterial sinusitis (ABS) in children. The technical report accompanying those guidelines included 21 studies that assessed the diagnosis and management of ABS in children. This update to that report incorporates studies of pediatric ABS that have been performed since 2001. Overall, 17 randomized controlled trials of the treatment of sinusitis in children were identified and analyzed. Four randomized, double-blind, placebo-controlled trials of antimicrobial therapy have been published. The results of these studies varied, likely due to differences in inclusion and exclusion criteria. Because of this heterogeneity, formal meta-analyses were not performed. However, qualitative analysis of these studies suggests that children with greater severity of illness at presentation are more likely to benefit from antimicrobial therapy. An additional 5 trials compared different antimicrobial therapies but did not include placebo groups. Six trials assessed a variety of ancillary treatments for ABS in children, and 3 focused on subacute sinusitis. Although the number of pediatric trials has increased since 2001, there are still limited data to guide the diagnosis and management of ABS in children. Diagnostic and treatment guidelines focusing on severity of illness at the time of presentation have the potential to identify those children most likely to benefit from antimicrobial therapy and at the same time minimize unnecessary use of antibiotics.

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Diagnosis and Medical Management of Recurrent and Chronic Sinusitis in Children

Siegel¹

1996

Diseases of the Sinuses

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Diagnosis and follow-up of ultrasonographical sinus changes in children

Cited by 28 publications

References 7 publications

Technical Report: Evidence for the Diagnosis and Treatment of Acute Uncomplicated Sinusitis in Children: A Systematic Overview

Technical Report: Evidence for the Diagnosis and Treatment of Acute Uncomplicated Sinusitis in Children: A Systematic Overview

Evidence for the Diagnosis and Treatment of Acute Uncomplicated Sinusitis in Children: A Systematic Review

Diagnosis and Medical Management of Recurrent and Chronic Sinusitis in Children

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