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Updates in Pediatric Otolaryngology
OTOLARYNGOLOGIC CLINICS OF NORTH AMERICA (Source: Otolaryngologic clinics of North America)
Source: Otolaryngologic clinics of North America - November 10, 2022 Category: ENT & OMF Authors: ROMAINE F. JOHNSON, ELTON M. LAMBERT Source Type: research

Copyright
Elsevier (Source: Otolaryngologic clinics of North America)
Source: Otolaryngologic clinics of North America - November 10, 2022 Category: ENT & OMF Source Type: research

Contributors
SUJANA S. CHANDRASEKHAR, MD, FACS, FAAOHNS (Source: Otolaryngologic clinics of North America)
Source: Otolaryngologic clinics of North America - November 10, 2022 Category: ENT & OMF Source Type: research

Contents
Sujana S. Chandrasekhar (Source: Otolaryngologic clinics of North America)
Source: Otolaryngologic clinics of North America - November 10, 2022 Category: ENT & OMF Source Type: research

Forthcoming Issues
Unified Airway Disease (Source: Otolaryngologic clinics of North America)
Source: Otolaryngologic clinics of North America - November 10, 2022 Category: ENT & OMF Source Type: research

Aspirin-Exacerbated Respiratory Disease and the Unified Airway
Aspirin-exacerbated respiratory disease (AERD) is characterized by abnormal arachidonic acid metabolism leading to chronic rhinosinusitis with nasal polyposis (CRSwNP), asthma, and upper and/or lower respiratory symptoms after ingestion of cyclooxygenase-1 inhibiting nonsteroidal antiinflammatory drugs. Diagnosis is clinical and may involve an aspirin challenge. Inflammatory biomarkers may be useful for diagnosis and treatment monitoring. Conventional medical management for asthma and CRSwNP is often inadequate. Endoscopic sinus surgery followed by continued medical management with or without aspirin desensitization freque...
Source: Otolaryngologic clinics of North America - October 22, 2022 Category: ENT & OMF Authors: Benjamin K. Walters, John B. Hagan, Rohit Divekar, Thomas J. Willson, Janalee K. Stokken, Carlos D. Pinheiro-Neto, Erin K. O ’Brien, Garret Choby Source Type: research

Upper Airway Cough Syndrome
Upper airway cough syndrome (UACS), formerly known as postnasal drip syndrome, is one of the most common causes of chronic cough. UACS, asthma, and gastroesophageal reflux make up 90% of the cause of chronic cough. UACS is a clinical diagnosis of exclusion with no diagnostic testing or objective findings. UACS can be present with or without associated rhinitis and chronic rhinosinusitis. Treatment includes dual therapy with H1 receptor antihistamines and decongestants. Diagnosis is confirmed when therapeutic intervention results in symptom resolution. (Source: Otolaryngologic clinics of North America)
Source: Otolaryngologic clinics of North America - October 22, 2022 Category: ENT & OMF Authors: Angela M. Donaldson Source Type: research

Unified Airway Disease
Upper and lower airways diseases are very common, with population prevalence of 10% to 40%. The conditions are usually interlinked and referred to as “unified airway disease” or “the united airways.” Especially in phenotypes with more severe disease, type 2 immunologic endotype is often noted. Comorbid upper and lower airway diseases are usually caused by similar underlying immunologic response. Any patient with rhinitis or rhinosinusitis should have their lower respiratory tract evaluated. A multidisciplinary approach in the diagnosis and treatment of airway disease is advised, especially, for more severe phenotyp...
Source: Otolaryngologic clinics of North America - October 17, 2022 Category: ENT & OMF Authors: Wytske Fokkens, Sietze Reitsma Source Type: research

Sex Differences in Airway Diseases
It is evident that sex and gender differences impact pathophysiology, disease burden, and treatment outcomes for a variety of systems and major illnesses including those affecting the unified airway. Important male-female differences in unified airway disease are driven by various intrinsic and extrinsic mechanisms including anatomic, morphometric, hormonal, genetic (and epigenetic), environmental, psycho-social, and comorbidity-related factors. This review highlights current knowledge of how patient sex influences epidemiology, diagnosis, treatment, and outcomes for diseases affecting the unified airway. (Source: Otolaryn...
Source: Otolaryngologic clinics of North America - October 17, 2022 Category: ENT & OMF Authors: Mackenzie Latour, Devyani Lal, Michael T. Yim Source Type: research

Unified Airway Disease
The “unified airway” describes the concept that inflammation affects upper and lower airways by similar mechanisms; this often manifests as rhinitis, rhinosinusitis, and/or nasal polyposis in the upper airway with associated asthma or bronchial inflammation in the lower airways. The relationships be tween eosinophilic diseases of the upper and lower airways are highlighted by examining their prevalence and treatment regimens along with the synergistic effects of treatment on upper and lower airway symptoms. It is important to recognize the interrelatedness of upper and lower airway eosinophilic disease to assess and ma...
Source: Otolaryngologic clinics of North America - October 17, 2022 Category: ENT & OMF Authors: Mitesh P. Mehta, Sarah K. Wise Source Type: research

Immunoglobulin Deficiency and the Unified Airway
Primary Ig deficiencies are a heterogeneous group of disorders with widespread implications for the unified airway. Manifestations can vary greatly, with some patients being asymptomatic, whereas others suffering from acute and chronic life-threatening pathologic conditions of the upper and lower airways. Although the diagnosis of PIDs can be complex, the onus of early diagnosis and initiation of treatment will often fall on the shoulders of the otolaryngologist. (Source: Otolaryngologic clinics of North America)
Source: Otolaryngologic clinics of North America - October 17, 2022 Category: ENT & OMF Authors: Chadi A. Makary, David W. Jang, Patricia Lugar Source Type: research

Unified Airway —Cystic Fibrosis
Cystic fibrosis (CF) is a genetic disease caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. The CFTR channel is responsible for the transport of the anions (chloride and bicarbonate) across airway epithelia. Patients with CF have thick mucus, disrupted mucociliary transport, and chronic bacterial infections in the upper and lower airways. In this article, the pathophysiology of CFTR dysfunction and its impact on the united airway are reviewed as well as the treatment strategies for patients with chronic rhinosinusitis –related CF and acquired CFTR dysfunction. (Source: Otolaryngo...
Source: Otolaryngologic clinics of North America - October 17, 2022 Category: ENT & OMF Authors: Do-Yeon Cho, Jessica W. Grayson, Bradford A. Woodworth Source Type: research

Pediatric Unified Airway
This study identifies and characterizes the common manifestations of the pediatric unified airway, including pediatric chronic rhinosinusitis, adenoid disease, asthma, cystic fibrosis, and primary ciliary dyskinesia. (Source: Otolaryngologic clinics of North America)
Source: Otolaryngologic clinics of North America - October 17, 2022 Category: ENT & OMF Authors: Carly Mulinda, Nathan Yang, David A. Gudis Source Type: research

Unified Airway Disease
Concurrent chronic rhinosinusitis with nasal polyps (CRSwNP) in the upper airway, and asthma in the lower airway, often have a shared underlying pathophysiology, namely type 2 inflammation; hence, the term “unified airway disease.” The combination of CRSwNP and asthma is associated with uncontrolled disease. The range of treatment of CRSwNP includes intranasal corticosteroids, nasal saline irrigation, oral corticosteroids, antibiotics, and biologics. A combined clinical algorithm for the managemen t of the upper and lower airways in type 2 inflammation will be beneficial, especially for patients with uncontrolled disea...
Source: Otolaryngologic clinics of North America - October 17, 2022 Category: ENT & OMF Authors: Eamon Shamil, Claire Hopkins Source Type: research

Complex Head and Neck Resection, Reconstruction, and Rehabilitation in Children
Pediatric head and neck tumors are uncommon but the consequences of radical resection are extensive. These tumors, benign and malignant, are uniquely challenging because of their proximity to critical functional and neurovascular structures and intimately affect speech, swallowing, voice, breathing, hearing, and vision. In addition, the psychosocial and emotional trauma from the cosmetic and functional consequences can be enduring. Their relative rarity limits surgeon experience and requires a focused effort to develop individual and programmatic expertise. A practiced multidisciplinary team can facilitate smooth preoperat...
Source: Otolaryngologic clinics of North America - October 9, 2022 Category: ENT & OMF Authors: Amy L. Dimachkieh, Daniel C. Chelius Source Type: research