Pediatric ENT Infections

Preface
Contents
Contributors
Part I: General Overview
1: Immunological Responses to Infection
1.1 Introduction
1.2 Bacterial Infections and Immunity
1.2.1 Bloodstream Infections
1.2.2 Encapsulated Bacteria
1.3 Viral Infections and Immunity
1.4 Fungal Infections and Immunity
1.5 Protozoal Infections and Immunity
1.6 Helminths and Immunity
References
2: Pathophysiology of Pediatric Ear, Nose, and Throat Infections
2.1 Introduction
2.2 Acute Pharyngitis
2.2.1 Viral Pharyngitis
2.2.2 Bacterial Pharyngitis
2.3 Acute Rhinosinusitis
2.4 Acute Otitis Media
2.4.1 Anatomy
2.4.2 Infectious Causes
2.4.2.1 Viruses
2.4.2.2 Bacteria
2.4.2.3 Environment
References
3: Laboratory Diagnosis for Paediatric Ear, Nose and Throat Infections
3.1 Introduction
3.2 Specimen Collection
3.3 Direct Microscopic Examination
3.4 Culture Methods
3.5 Antigen Detection Assays
3.6 Direct Fluorescent Antibody Tests
3.7 Serology
3.8 Molecular Tests
References
4: Imaging of Pediatric Ear, Nose, and Throat Infections
4.1 Sinonasal Infections
4.2 Imaging Considerations
4.2.1 Acute Sinusitis
4.2.2 Chronic Sinusitis
4.2.3 Allergic Sinusitis
4.2.4 Fungal Sinusitis
4.2.5 Complications of Rhinosinusitis
4.2.5.1 Imaging
4.2.5.2 Orbital Complications
4.2.5.3 Preseptal (Periorbital) Cellulitis
4.2.5.4 Postseptal (Orbital) Cellulitis
4.2.5.5 Subperiosteal Abscess
4.2.5.6 Cavernous Sinus Thrombosis
4.2.5.7 Extra- and Intracranial Complications
4.2.5.8 Pott’s Puffy Tumor
4.2.5.9 Intracranial Complications
4.2.6 Ear Infections
4.2.6.1 Imaging
4.2.6.2 External Otitis and Necrotizing Otitis Externa
4.2.6.3 Acute Otitis Media
4.2.6.4 Mastoiditis
4.2.7 Complications of Acute Otomastoiditis
4.2.7.1 Coalescent Mastoiditis
4.2.7.2 Subperiosteal Abscess
4.2.7.3 Petrous Apicitis and Skull Base Involvement
4.2.7.4 Labyrinthitis
4.2.7.5 Intracranial Complications
4.2.8 Neck Infections
4.2.8.1 Imaging
4.2.8.2 Cervical Adenitis
4.2.8.3 Tonsillitis and Tonsillar/Peritonsillar Abscess
4.2.8.4 Retropharyngeal Phlegmon and Retropharyngeal Abscess
References
5: Recurrent Respiratory Infections in Childhood: The Importance of Local Microbiota Modulation
5.1 Introduction
5.2 Conclusion
References
6: Role of Allergy in ENT Infections
6.1 Introduction to Atopic Diseases
6.1.1 Allergic Rhinitis
6.1.2 Unified Airway Concept
6.2 Role of Allergy in Pediatric Otitis Media
6.3 Role of Allergy in Pediatric Rhinosinusitis
6.3.1 Allergy and Pediatric Acute Rhinosinusitis, Upper Respiratory Tract Infections
6.3.2 Allergy and Pediatric Chronic Rhinosinusitis
6.4 Role of Allergy in Pediatric and Adult Laryngitis
6.5 Conclusions and Future Needs
References
7: Ear, Nose, and Throat Infections in Immunocompromised Children
7.1 Introduction
7.2 Primary Immunodeficiencies
7.3 Humoral Immunodeficiencies
7.3.1 Transient Hypogammaglobulinemia (THI) of the Infant
7.3.2 Common Variable Immune Deficiency (CVID)
7.3.3 X-Linked Agammaglobulinemia (XLA)
7.3.4 Selective IgA Deficiency (IgAD)
7.3.5 IgG Subclass Deficiency
7.3.6 Hyper-IgM Syndrome (HIgM)
7.4 Lack of Components
7.5 Phagocytosis Disorders
7.5.1 Myeloperoxidase Deficiency (MPO)
7.5.2 Chronic Granulomatous Disease (CGD)
7.5.3 Chediak-Higashi Disease (CHD)
7.5.4 Hyper-IgE Syndrome (HIgES)
7.6 Cellular Disorders
7.6.1 Di George Syndrome
7.6.2 Chronic Mucocutaneous Candidiasis (CMC)
7.6.3 T-Helper-1 Cytokine Signal Impairment
7.7 Primary Combined Immunodeficiencies
7.7.1 Severe Combined Immunodeficiency (SCID)
7.7.2 Wiscott-Aldrich Syndrome
7.8 Secondary Immunodeficiencies
7.8.1 Human immunodeficiency virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS)
7.8.2 Secondary Immune Deficiencies Non-HIV Infection
References
8: Immunization for Prevention of Ear, Nose, and Throat Infections in Children
8.1 Introduction
8.2 Measles, Mumps, Rubella, and Varicella Infections and Vaccines
8.2.1 Measles, Mumps, Rubella, and Varicella Infections
8.2.2 Measles, Mumps, Rubella, and Varicella Vaccines
8.3 Vaccination to Prevent Acute Otitis Media
8.4 Pneumococcal Vaccines
8.5 Haemophilus influenzae Type B Conjugate Vaccines
8.6 Pertussis Vaccines
8.7 Diphtheria Vaccines
8.8 Influenza Vaccines
8.9 Immunization to Prevent RSV Infection
8.10 Immunization Recommendations for Cochlear Implant Patients
8.10.1 Pneumococcal Vaccines
8.10.2 Haemophilus influenzae Type B Conjugate Vaccines
8.10.3 Influenza Vaccines
References
9: The Role of Surgery in Protection and Treatment of Ear, Nose and Throat Infections
9.1 Introduction
9.2 Tonsillectomy
9.2.1 Structure and Function of the Tonsils
9.2.2 Effects of Tonsillitis and Tonsillectomy on Immunity
9.3 Adenoidectomy
9.3.1 Epidemiology and Incidence
9.3.2 Assessment for Adenoid Hypertrophy
9.3.3 Assessment for Adenoid Hypertrophy
9.3.4 Adenoidectomy for Chronic Rhinosinusitis in Children
9.4 Conclusion
References
10: Communication with the Infected Child
10.1 Introduction
10.2 Infectious Diseases in Children
10.3 Communication with Parents
10.4 Communication with Children
10.4.1 Implications on Communication (Birth to 6 Years)
10.4.2 Implications of Communication for Middle Years (from 7 to 10 Years Old)
10.4.3 Implications for Communication in Early Adolescent Years (11 Through 14 Years)
References
Part II: Symptoms and Signs
11: Fever: Pathogenesis and Treatment
11.1 Introduction
11.2 Definition of Fever
11.2.1 Hyperthermia
11.3 Pathogenesis
11.4 Aetiology
11.4.1 Neonates
11.4.2 Young Infants
11.4.3 Children Aged Between 3 Months and 3 Years
11.5 History and Examination in Children
11.5.1 Neonates
11.5.2 Prenatal History
11.5.3 Household Contacts
11.5.4 Review of Systems and Physical Examination
11.5.5 History and Examination in Young Infants
11.5.5.1 Past Medical History and Household Contacts
11.5.5.2 Review of Systems and Physical Examination
11.5.6 History and Examination in Children Aged Between 3 Months and 3 Years
11.5.6.1 History of Presenting Complaint
11.5.6.2 Past Medical History
11.5.6.3 Family History
11.5.6.4 Social History and Household Contacts
11.5.6.5 Review of Systems and Physical Examination
11.6 Differential Diagnosis [18]
11.7 Diagnostic Studies
11.7.1 Urine and Stool Studies
11.7.2 Pulmonary Studies
11.8 Treatment
11.8.1 Antipyretic Agents
11.8.1.1 Indications
11.8.1.2 Paracetamol
11.8.1.3 Ibuprofen
11.8.2 External Cooling
References
12: Headache in Children
12.1 Introduction
12.2 Temporal Pattern of Headaches
12.3 History and Clinical Examination
12.4 Diagnostic Procedures
12.4.1 Neuroimaging
12.4.2 Laboratory Investigations
12.4.3 Lumbar Puncture
12.4.4 Electroencephalography
12.5 Clinical Features
12.5.1 Migraine
12.5.2 Tension-Type Headache
12.5.3 Trigeminal Autonomic Cephalalgias
12.5.4 Secondary Headaches
12.6 Treatment
12.6.1 Secondary Headaches
12.6.2 Primary Headaches
12.7 Conclusion
References
13: Otalgia: Pathogenesis, Diagnosis, and Treatment
13.1 Introduction
13.2 Pathophysiology
13.3 Epidemiology
13.4 Causes
13.4.1 The Primary Causes of Otalgia
13.4.2 Secondary Causes of Otalgia
13.5 Diagnosis
13.5.1 Background
13.5.2 Examination
13.5.3 Examination Tests
13.6 Treatment
References
14: Otorrhea: Pathogenesis, Diagnosis, and Treatment
14.1 Introduction
14.2 Etiopathogenesis
14.2.1 Otorrhea of the Tympanostomy Tube
14.2.2 Foreign Body
14.2.3 Otitis Externa
14.2.4 Acute Otitis Media
14.2.5 Chronic Otitis Media
14.2.6 Trauma to the External Ear Canal
14.2.7 Polyps
14.2.8 Spontaneous Cerebral Spinal Fluid Otorrhea
14.3 Diagnosis
14.3.1 History
14.3.2 Examination
14.3.3 Culture of Ear Drainage
14.3.4 Testing for Cerebrospinal Fluid Otorrhea
14.3.5 Imaging
14.4 Treatment
References
15: Hearing Loss
15.1 Aetiology
15.1.1 Genetic Causes
15.1.2 Prenatal Causes
15.1.3 Perinatal Causes
15.1.4 Postnatal Causes
15.1.5 Unknown Causes
15.2 Epidemiology
15.2.1 Age- and Sex-Related Demographics
15.3 High-Risk Criteria for Hearing Loss in Neonates and Infants
15.4 Indications for Auditory Assessment and Findings
15.5 Types of Auditory Impairment
15.6 Tests for Hearing Loss
15.6.1 Auditory Brainstem Response (ABR) and Brainstem Auditory Evoked Response (BAER) Testing
15.6.2 Otoacoustic Emission (OAE) Testing
15.6.3 Audiometry
15.7 Screening Programme for Neonatal Hearing Loss
15.7.1 Prevalence of Hearing Loss
15.7.2 Risk Factors
15.7.3 Early Identification and Intervention
15.7.4 Methods of Screening
15.7.5 Otoacoustic Emissions
15.7.6 Diagnostic Auditory Brainstem Response
References
16: Vertigo and Dizziness in Children
16.1 Introduction
16.2 Definitions
16.3 Dizziness with Vertigo
16.4 Aetiology
16.4.1 Central Nervous System Infection
16.4.2 Intracranial Tumour or Abscess
16.4.3 Drug Overdose and Other Poisons
16.4.4 Otitis Media
16.4.5 Migraine Syndromes
16.4.6 Vestibular Neuritis
16.4.7 Benign Paroxysmal Vertigo of Childhood (BPVC)
16.4.7.1 Pathophysiology
16.4.7.2 Diagnosis
16.4.7.3 Treatment
16.4.8 Motion Sickness
16.4.9 Meniere’s Disease
16.4.10 Perilymphatic Fistula
16.5 Dizziness Without Vertigo (Pseudovertigo)
References
17: Nasal Obstruction in Childhood
17.1 Introduction
17.2 Deviation of the Septum
17.2.1 Pathophysiology
17.3 Nasal Polyps
17.3.1 Pathophysiology
17.3.2 Aetiology
17.4 Prognosis
17.5 Pharmacological Management
17.5.1 Corticosteroids
17.6 Allergic Rhinitis
17.7 Investigations
17.7.1 Radiological investigations
17.7.2 Procedures
17.7.3 Therapy
17.7.4 Drug Treatment
17.7.5 Non-pharmacological Treatment
References
18: Rhinorrhea: Pathogenesis, Diagnosis, and Treatment
18.1 Introduction
18.2 Etiology of the Rhinorrhea
18.2.1 Allergic Rhinitis (AR)
18.2.1.1 Diagnosis
18.2.1.2 Treatment
Pharmacotherapy
Nonpharmacotherapy
Surgical Option
18.2.2 Chronic Non-allergic Rhinitis (NAR)
18.2.2.1 Pathogenesis
18.2.2.2 Diagnosis
18.2.2.3 Treatment
18.2.3 Sinusitis
18.2.3.1 Pathogenesis
18.2.3.2 Classification
Acute Sinusitis (AS)
Recurrent AS
Subacute Sinusitis
Chronic Sinusitis
18.2.3.3 Etiology
18.2.3.4 Diagnosis
Examination
Testing and Imaging
18.2.3.5 Treatment
18.3 Nasal Foreign Body (NFBs)
18.4 Diagnosis and Treatment of Rhinorrhea
18.4.1 Diagnosis
18.4.2 Treatment
References
19: Dysphonia
19.1 Introduction
19.2 Definition
19.3 Vocal Cord Nodules
19.4 Acute Laryngitis
19.4.1 Causes
19.4.1.1 Signs and Symptoms of Acute Laryngitis
19.5 Vocal Cord Polyps/Vocal Cord Cysts
19.6 Recurring Papillomatosis
19.7 Gastro-oesophageal Reflux Disease (GORD)
19.7.1 Signs and Symptoms
19.7.2 Diagnosis
19.7.3 Procedures
19.7.4 Imaging Studies
19.7.5 (Electro)Physiological Studies
19.8 Management
19.8.1 Non-pharmacological Treatment
19.8.2 Drug Treatment
19.8.3 Surgery
19.9 Vocal Cord Paralysis
References
20: Sore Throat
20.1 Introduction
20.2 Definition
20.3 Epidemiology and Risk Factors
20.4 Etiology
20.5 Clinical Findings
20.6 Diagnosis
20.6.1 Laboratory Evaluation
20.6.1.1 Throat Swabs
20.6.1.2 Throat Culture
20.6.1.3 Other Laboratory Tests
20.7 Treatment
20.7.1 Symptomatic Treatment
20.7.2 Antimicrobial Treatment
References
21: Tonsillar Hypertrophy in Childhood
21.1 Introduction
21.2 Symptoms and Findings
21.3 Classification
21.4 Diagnosis and Clinical Importance
References
22: Cervical Lymphadenopathy in Children
22.1 Introduction
22.2 Anamnesis
22.3 Clinical Examination
22.4 Infections
22.5 Immunological Diseases
22.6 Metabolic Diseases
22.7 Neoplastic Diseases
22.8 Laboratory Investigations
22.9 Imaging
22.10 Histological Examination
22.11 Etiological Differentiation in Pediatric Cervical Lymphadenopathy
22.12 Treatment of Common Bacterial Lymphadenitis
22.13 Conclusion
References
23: Halitosis in Children Secondary to ENT Infections
23.1 Introduction
23.2 Aetiology
23.2.1 Intraoral Causes
23.2.2 Extraoral Causes
23.3 Distinguishing Between Halitosis of Intra-oral and Extra-oral Origin
23.4 ENT Infections and Halitosis
23.4.1 Tonsillitis
23.4.2 Gingivitis and Inadequate Mouth Hygiene
23.4.3 Sinus Infection
23.4.4 Nasal Foreign Body
23.4.5 Mouth Breathing
23.4.6 Malocclusion
23.4.7 Poor-Quality Dental Fillings and Dentures
23.5 Assessment of Halitosis
23.5.1 Direct Methods Used to Detect Halitosis
23.5.1.1 Organoleptic Detection
23.5.1.2 Gas Chromatographic Analysis
23.5.1.3 Portable Monitoring of Sulphides
23.5.2 Indirect Methods Used to Detect Halitosis
23.5.2.1 Benzoyl-DL-Arginine-Alpha-Naphthylamide (BANA)
23.5.2.2 Ammonia Monitoring
23.5.2.3 Ninhydrin Technique
23.5.2.4 Salivary Incubation Test
23.5.2.5 Quantification of Beta-Galactosidase Activity
23.5.2.6 Polymerase Chain Reaction
23.6 Conclusion
References
24: Facial Paralysis in Children
24.1 Introduction
24.2 Etiology and Epidemiology
24.2.1 Idiopathic (Bell’s Palsy)
24.2.2 Congenital Causes
24.2.3 Melkersson-Rosenthal Syndrome
24.2.4 Moebius Syndrome
24.2.5 Albers-Schönberg Disease (Osteopetrosis)
24.2.6 Goldenhar Syndrome
24.2.7 Hereditary Congenital Facial Paresis
24.2.8 Infectious Causes
24.2.8.1 Herpes Simplex Virus (HSV)
24.2.8.2 Ramsay Hunt Syndrome
24.2.8.3 Lyme Disease
24.2.8.4 Human Immunodeficiency Virus (HIV) Infection
24.2.8.5 Facial Paralysis from Bacterial Infection
24.2.8.6 Cat Scratch Disease
24.2.9 Neoplastic Causes
24.2.10 Other Conditions
24.3 Diagnosis
24.3.1 History and Physical Examination
24.3.2 Laboratory Testing
24.3.3 Topographic Tests
24.3.4 Audiological Evaluation
24.3.5 Lumbar Puncture
24.3.6 Electrodiagnostic Studies
24.3.7 Imaging
24.4 Treatment
24.4.1 Drug Therapy
24.4.2 Surgery
24.5 Prognosis
References
25: Snoring in Children
25.1 Introduction
25.2 Obstructive Sleep-Disordered Breathing and Clinical Entities
25.3 Epidemiology of Snoring in Children
25.4 Etiology of Snoring in Children
25.5 Pathogenesis and Mechanisms of Snoring
25.6 Evaluation of the Snoring Children
25.7 Diagnostic Approach to Snoring
25.8 Treatment of Snoring
25.8.1 Non-surgical Treatment Options
25.8.1.1 Corticosteroids/Leukotriene Receptor Antagonists
25.8.2 Weight Management
25.8.3 Continuous Positive Airway Pressure (CPAP)
References
26: Dysphagia in Children
26.1 Introduction
26.2 Dysphagia in Children
26.3 The Physiology of Healthy Deglutition
26.3.1 Mouth (Oral) Stage
26.3.2 Pharyngeal Stage
26.3.3 Oesophageal Stage
26.4 Stomatitis
26.5 Infectious Pharyngitis
26.6 Quinsy
26.7 Epiglottitis
26.8 Retropharyngeal Abscess
26.9 Diphtheria
26.10 Stevens-Johnson Syndrome
26.11 Tetanus
26.12 Cornelia de Lange Syndrome (CdLS)
References
27: Cough in Children
27.1 Introduction
27.2 Pathophysiology
27.3 Definition of Cough
27.3.1 Acute Cough
27.3.1.1 Diagnostic Evaluation of Acute Cough
27.3.2 Subacute Cough
27.3.3 Chronic Cough
27.3.3.1 Specific Cough
27.3.3.2 Nonspecific Cough
27.3.3.3 Wet-Moist-Productive Cough and Dry Cough
27.4 Common Etiologies of Chronic Cough
27.4.1 Asthma
27.4.2 Upper Airways Disorders
27.4.3 Gastroesophageal Reflux Disease and Laryngopharyngeal Reflux
27.4.4 Airway Lesions
27.4.5 Recurrent Respiratory Tract Infections and Postinfectious Cough
27.4.6 Protracted Bacterial Bronchitis
27.4.7 Bronchiectasis
27.4.8 Primary Ciliary Dyskinesia
27.4.9 Cystic Fibrosis
27.4.10 Foreign Body Aspiration
27.4.11 Environmental Pulmonary Toxins
27.4.12 Psychogenic Cough
27.4.13 Drug-Induced Cough
27.4.14 Cardiac Causes
27.4.15 Otogenic Causes: Stimulation of Arnold Nerve
27.4.16 Thoracic Tumors
27.5 Diagnostic Evaluation of Chronic Cough
27.6 Treatment
27.6.1 Treatment of Nonspecific Cough
27.6.1.1 Watchful Observation
27.6.1.2 Drugs Used for Cough
Over the Counter Cough Medications
Asthma Treatment
Antibiotics
Gastroesophageal Reflux Treatment
Treatments for Nasal Symptoms
27.7 Conclusion
References
28: Chronic Cough in Children
28.1 Introduction
28.2 Epidemiology
28.3 Differences Between Chronic Cough in Children and in Adults
28.4 Initial Assessment of a Chronic Cough in Children
28.5 Phenotypes of Chronic Cough in Children
28.5.1 Postnasal Drip Syndrome/Upper Airways Cough Syndrome
28.5.2 Cough in Asthma
28.5.3 Gastro-oesophageal Reflux Disease (GORD) and Cough in Children
28.5.4 Post-viral Cough
28.5.5 Productive (Moist or Wet) Cough
28.5.6 “Habitual” Cough
28.5.7 Irritant Cough
28.6 Treatment
References
29: Wheezing in Children
29.1 Introduction
29.2 Aetiology
29.2.1 Infection
29.2.2 Foreign Body (FB) Aspiration
29.2.3 Structural Causes
29.2.4 Functional (Nonstructural) Causes
29.3 Evaluation and Differential Diagnosis
29.4 Physical Examination
29.5 Imaging
29.6 Laboratory Investigations of Value in Establishing a Differential Diagnosis
29.6.1 Sputum Staining and Culture
29.6.2 Sweat Chloride Test
29.6.3 Endoscopy
29.7 Treatment
References
30: Persistent Wheezing in Children
30.1 Introduction
30.2 Etiology
30.2.1 Abnormalities of the Tracheobronchial Tree
30.2.2 Mediastinal Masses
30.2.3 Retained Foreign Body Aspiration
30.2.4 Cardiovascular Disease
30.2.5 Asthma
30.2.6 Aspiration Syndromes
30.2.7 Swallowing Disorders
30.2.8 Bronchopulmonary Dysplasia
30.2.9 Vocal Cord Dysfunction (VCD)
30.2.10 Bronchiolitis Obliterans
30.2.11 Cystic Fibrosis (CF)
30.2.12 Primary Ciliary Dyskinesia (PCD)
30.2.13 Primary Immunodeficiencies
30.3 Evaluation of a Child with Persistent/Recurrent Wheezing
30.4 Conclusion
References
Part III: Infections
31: Pediatric Otitis Externa
31.1 Introduction
31.2 Anatomy
31.3 Pathogenesis and Definition
31.4 Epidemiology
31.5 Etiology-Predisposing Factors
31.6 Microbiology
31.7 Diagnosis and Staging
31.8 Differential Diagnosis
31.9 Medical Treatment
31.9.1 Pain Management
31.9.2 Topical Therapy
31.9.3 Topical Therapy in Nonintact Tympanic Membrane
31.9.4 Systemic Antimicrobials
31.10 Surgical Treatment
References
32: Otitis Media in Infants
32.1 Introduction
32.2 Risk Factors
32.2.1 Race and Ethnicity
32.2.2 Respiratory Infections and Exposure to Other Children
32.2.3 Lack of Breastfeeding
32.2.4 Exposure to Passive Smoke and Pollutants
32.2.5 Genetics
32.2.6 Prenatal and Perinatal Factors
32.2.7 Laterality
32.2.8 Atopy and Allergic Disease
32.2.9 Pacifier Use
32.3 Microbiology
32.4 Diagnosis
32.4.1 History
32.4.2 Otoscopic Examination and Tympanometry
32.4.3 Acoustic Reflectometry
32.5 Antibiotic Therapy
32.6 Conclusion
References
33: Acute Otitis Media
33.1 Introduction
33.2 Pathophysiology
33.2.1 Microbiology
33.2.1.1 Viral Origin
33.2.1.2 Bacterial Origin
33.2.2 Risk Factors
33.2.2.1 Age, Gender, and Daycare Attendance
33.2.2.2 Immune System and Anatomy
33.2.2.3 Allergy and Gastroesophageal Reflux Disease
33.2.2.4 Genetics
33.2.2.5 Feeding and Exposure to Smoking
33.3 Clinical Manifestations of AOM and Examinations
33.4 Treatment
33.5 Complications
33.6 Prevention
References
34: Mastoiditis
34.1 Introduction
34.2 Pathogenesis
34.3 Signs and Symptoms
34.4 Microbiology
34.5 Diagnosis
34.6 Complications
34.6.1 Infratemporal (Extracranial) Complications
34.6.1.1 Labyrinthitis
34.6.1.2 Petrositis
34.6.1.3 Facial Paresis/Paralysis
34.6.2 Intracranial (Extratemporal) Complications
34.6.2.1 Extradural Abscess
34.6.2.2 Meningitis
34.6.2.3 Subdural Abscess
34.6.2.4 Brain Abscess
34.6.2.5 Lateral Sinus Thrombophlebitis
34.6.2.6 Otitic Hydrocephalus
34.7 Follow-Up and Treatment
34.8 Subacute (Masked) Mastoiditis
34.9 Mastoiditis in Patients with Cochlear Implant
References
35: Labyrinthitis
35.1 Introduction
35.2 Anatomy
35.3 Viral and Bacterial Pathogens Responsible for Labyrinthitis
35.4 Classification
35.4.1 Viral Labyrinthitis
35.4.2 Bacterial Labyrinthitis
35.4.3 Suppurative Labyrinthitis
35.4.4 Serous Labyrinthitis
35.4.5 Autoimmune Labyrinthitis
35.5 Prognosis
35.6 Diagnosis
35.6.1 History
35.6.2 Physical Examination
35.6.3 Imaging Studies
35.6.3.1 CT Scanning
35.6.3.2 Magnetic Resonance Imaging (MRI)
35.6.3.3 Audiological Test
35.6.3.4 Vestibular Testing
35.7 Treatment
35.7.1 Viral Labyrinthitis
35.7.2 Bacterial Labyrinthitis
35.7.3 Surgical Care
References
36: Common Cold in Children
36.1 Introduction
36.2 Definition
36.3 Pathogenesis
36.4 Aetiology
36.5 Epidemiology
36.6 Symptoms
36.7 Diagnosis
36.8 Treatment
36.8.1 Antiviral Treatment
36.8.2 Symptomatic Therapy
References
37: Rhinitis in Children
37.1 Introduction
37.2 Principal Causes of Rhinitis
37.3 Symptoms of Rhinitis
37.4 Specific Disorders Producing Rhinitis
37.4.1 Allergic Rhinitis
37.4.1.1 Epidemiology
37.4.1.2 Physical Findings
37.4.1.3 Diagnostic Tests
Cutaneous Prick Testing
Total Serum IgE
Total Circulating Eosinophils
Nasal Provocation (Allergen Challenge) Testing
37.4.1.4 Treatment
Pharmacotherapy
Immunotherapy
37.4.2 Non-allergic Rhinitis
37.4.2.1 Rhinitis Due to Infection
37.4.2.2 Vasomotor Rhinitis
37.4.2.3 Occupational Rhinitis
37.4.2.4 Hormone-Related Rhinitis
37.4.2.5 Medication-Related Rhinitis
37.4.2.6 Gustatory Rhinitis
37.4.2.7 Non-allergic Rhinitis with Eosinophilia Syndrome (NARES)
37.4.2.8 Treatment
Anticholinergics
Intranasal Steroids
Antihistamines
Sympathomimetic Agents
Prescribing for Children
References
38: Acute Rhinosinusitis in Children
38.1 Introduction
38.2 Pathophysiology
38.3 Causes
38.4 Signs and Symptoms of Acute Sinusitis
38.5 Diagnosis
38.5.1 History
38.5.2 Physical Examination
38.6 Treatment
38.6.1 Antibiotics
38.6.1.1 Irrigation
38.6.1.2 Decongestants and Antihistamines
38.6.1.3 Immunotherapy
38.6.1.4 Optimization of Associated Medical Conditions
References
39: Pediatric Chronic Rhinosinusitis
39.1 Introduction
39.2 Definition and Classification
39.3 Pathophysiology and Microbiology
39.4 Diagnostic Methods
39.5 Treatment
39.6 Medical Treatment
39.7 Surgical Treatment
39.7.1 Adenotomy/Adenoidectomy (AT)
39.7.2 Adenoidectomy and Antral Lavage
39.7.3 Functional Endoscopic Sinus Surgery
39.8 Conclusion
References
40: Complications of Rhinosinusitis
40.1 Introduction
40.2 Preseptal Cellulitis
40.2.1 Orbital Septum
40.2.2 Aetiology
40.2.3 Risk Factors
40.2.4 Clinical Presentation
40.2.5 Physical Examination
40.2.6 Staging [21]
40.2.7 Treatment
40.3 Orbital Cellulitis
40.3.1 Anatomy
40.3.2 Aetiology
40.3.3 Traumatic Causes
40.3.4 Bacterial Causes
40.3.5 Fungal Causes
40.3.6 Prognosis
40.3.7 Physical Examination
40.3.8 Treatment
40.4 Intracranial Complications
40.4.1 Cavernous Sinus Thrombosis
References
41: Nasal and Paranasal Sinus Infections in Children with Cystic Fibrosis
41.1 Introduction
41.2 Sinonasal Manifestations in Cystic Fibrosis
41.3 Clinical Evaluation
41.4 Physical Assessment
41.5 Diagnosis
41.5.1 CT Imaging
41.5.2 Nitric Oxide
41.6 Treatment
41.6.1 Nasal Douching
41.6.2 Antimicrobial Pharmacotherapy
41.6.3 Corticosteroids
41.6.4 Other Therapies
41.6.5 Surgery
41.6.6 Gene Therapy
References
42: Oral Candidiasis in Infants and Children
42.1 Introduction
42.2 Pathophysiology
42.2.1 Chronic Mucocutaneous Candidiasis (CMC)
42.3 Risk Factors
42.4 Aetiology
42.5 Differential Diagnosis
42.6 Diagnosis
42.6.1 History
42.6.2 Physical Examination
42.6.2.1 Differentiation Between Oral Candidiasis and Tongue Coating
42.6.2.2 Acute Pseudomembranous Candidiasis (Thrush)
42.6.2.3 Chronic Hyperplastic Candidiasis
42.6.2.4 Acute Atrophic (Erythematous) Candidiasis
42.6.2.5 Chronic Atrophic Candidiasis (Denture Stomatitis)
42.6.2.6 Angular Stomatitis (perlèche, Angular Cheilitis)
42.6.2.7 Median Rhomboid Glossitis (Glossal Central Papillary Atrophy)
42.6.3 Tests
42.6.4 Histological Appearances
42.7 Medical Treatment
42.7.1 Pharmacotherapy
42.7.2 Nystatin (Mycostatin, Nilstat, Nystex)
42.7.3 Amphotericin B Deoxycholate (Fungizone Oral Suspension)
42.7.4 Clotrimazole (Mycelex Troches)
42.7.5 Miconazole Oral (Daktar)
42.7.6 Gentian Violet
42.7.7 Fluconazole (Diflucan)
42.8 Complications
References
43: Parotitis in Children
43.1 Introduction
43.2 Suppurative Parotitis
43.2.1 Suppurative Parotitis: Pathogenesis
43.2.2 Suppurative Parotitis: Clinical Manifestations
43.2.3 Suppurative Parotitis: Diagnosis
43.2.4 Suppurative Parotitis: Treatment
43.2.5 Suppurative Parotitis: Complications
43.3 Nonsuppurative Parotitis
43.3.1 Juvenile Recurrent Parotitis
43.3.2 Chronic Recurrent Parotitis
43.3.3 Nonsuppurative Parotitis: Miscellaneous Causes
43.4 Mumps and Other Viral Causes of Acute Parotitis
43.4.1 Mumps: Epidemiology
43.4.2 Mumps: Clinical Manifestations
43.4.3 Mumps: Complications
43.4.3.1 Orchitis and Epididymitis
43.4.3.2 Oophoritis
43.4.3.3 Mumps: Neurologic Complications
43.4.3.4 Mumps: Sensorineural Hearing Loss
43.4.3.5 Mumps: Pancreatitis
43.4.3.6 Mumps: Cardiac Involvement
43.4.3.7 Mumps: Other Complications
43.4.4 Mumps: Diagnosis
43.4.5 Mumps: Treatment
43.4.6 Mumps: Prevention
References
44: Acute Tonsillopharyngitis in Children
44.1 Introduction
44.2 Aetiology
44.3 Epidemiology
44.4 Symptoms
44.5 Diagnosis
44.5.1 Examination
44.5.2 Investigations
44.6 Treatment
44.6.1 Medical Treatment
44.6.1.1 Timing of Therapy
44.6.1.2 Antibiotics for Group A Streptococcus
44.6.2 Surgery
44.6.2.1 Tonsillectomy Indications
References
45: Chronic Tonsillopharyngitis
45.1 Introduction
45.2 Epidemiology
45.3 Pathophysiology
45.4 Biofilms
45.5 Recurrent and Chronic Tonsillitis
45.6 Physical Examination
45.7 Treatment
45.7.1 Tonsillectomy
References
46: Peritonsillar Abscess in Children
46.1 Introduction
46.2 Clinical Presentation
46.3 Diagnosis
46.4 Treatment and Complications
46.4.1 Medical Treatment
46.4.2 Surgical Treatment
46.4.3 Complications
References
47: Retropharyngeal and Parapharyngeal Abscesses in Children
47.1 Introduction
47.1.1 Retropharyngeal Space
47.1.2 Parapharyngeal Space
47.2 Etiology
47.2.1 Microbiology
47.3 History and Examination Findings
47.3.1 Retropharyngeal Infection
47.3.2 Parapharyngeal Infection
47.4 Laboratory Tests
47.5 Imaging Techniques
47.5.1 Conventional X-Rays
47.5.2 Computed Tomography
47.5.3 Ultrasonography
47.5.4 Magnetic Resonance Imaging
47.6 Treatment
47.6.1 Medical Treatment
47.6.2 Surgical Treatment: Indications, Predictive Factors, Preoperative Assessment, and Methods
47.7 Complications
References
48: Uvulitis in Children
48.1 Introduction
48.2 Epidemiology
48.3 Etiology
48.4 Pathogenesis
48.5 Clinical Manifestations
48.6 Diagnosis
48.7 Differential Diagnosis
48.8 Treatment
References
49: Epiglottitis (Supraglottitis)
49.1 Introduction
49.2 Epidemiology
49.3 Etiology
49.4 Clinical Course
49.5 Diagnosis
49.6 Differential Diagnosis
49.7 Complications
49.8 Treatment
References
50: Laryngitis, Laryngotracheitis (Croup), and Bacterial Tracheitis in Children
50.1 Introduction
50.2 Laryngitis
50.3 Laryngotracheitis (Croup)
50.3.1 Epidemiology
50.3.2 Etiology
50.3.3 Clinical Features and Diagnosis
50.3.4 Differential Diagnosis
50.3.5 Complications
50.3.6 Treatment
50.3.6.1 Nebulized Epinephrine
50.3.6.2 Corticosteroids
50.3.6.3 Other Treatment Modalities
50.4 Bacterial Tracheitis
50.4.1 Epidemiology
50.4.2 Clinical Manifestation
50.4.3 Diagnosis
50.4.4 Treatment
References
51: HPV-Related Recurrent Respiratory Papillomatosis in Childhood
51.1 Introduction
51.2 Microbiology
51.3 Background
51.4 HPV Infection of the Larynx in Neonates and Children
51.5 Effective Methods by Which the Uptake of HPV Vaccination in Adolescents Can Be Increased
51.6 Treatment
51.6.1 Surgical
51.6.2 Adjuvant Treatments
51.7 Future Perspectives
References
52: Odontogenic İnfections in Children
52.1 Introduction
52.2 Clinical Manifestations of Odontogenic Infections in Children
52.3 Clinical Presentation of Odontogenic Infections Varies by Location
52.4 Microbiology and Treatment Principles
52.5 Management of Odontogenic Infections in Children
52.6 Special Conditions
52.6.1 Ludwig’s Angina
52.6.2 The Periapical Infection
52.6.3 Pericoronitis
52.6.4 Dental Abscess
52.6.5 Facial Cellulitis
52.7 Complications of Odontogenic Infections
52.8 Conclusions
References
53: Neck Infections in Children
53.1 Introduction
53.2 Suppurative Cervical Adenitis in Children
53.2.1 Acute Viral Lymphadenitis
53.2.2 Acute Bacterial Lymphadenitis
53.2.3 Mycobacterial Lymphadenitis
53.2.4 Cat Scratch Disease
53.2.5 Other Infections
53.3 Peritonsillar Cellulitis and Abscess
53.4 Paediatric Retropharyngeal Infections
53.5 Parapharyngeal Abscess
53.6 Other Cervical Infections
53.6.1 Suppurative Thyroiditis
53.6.2 Infected Embryological Remnant Cysts
53.6.3 Infections Following Bites, Injury, Radiation Exposure or Operative Injury
References
54: Infections of Congenital Neck Masses
54.1 Introduction
54.2 Cysts of the Thyroglossal Duct
54.2.1 Management by Surgery
54.3 Branchial Cleft Cysts
54.3.1 Specific Features of Cysts from Each Level
54.3.1.1 First Branchial Cleft Cyst
54.3.1.2 Second Branchial Cleft Cyst
54.3.1.3 Third Branchial Cleft Cyst
54.3.1.4 Fourth Branchial Cleft Cyst
54.3.2 Evaluation and Treatment
54.4 Dermoid Cyst
54.4.1 Aetiology and Epidemiology
54.4.2 Pathophysiology
54.4.3 Evaluation and Treatment
54.5 Macrocystic Lymphatic Malformations
References
Part IV: Miscellaneous
55: Pediatric Ear, Nose, and Throat Field Infectious Disease Emergencies
55.1 Introduction
55.2 Acute Pharyngitis
55.2.1 Definition and Etiology
55.3 Viral Pharyngitis
55.3.1 Definition and Etiology
55.3.2 Treatment
55.3.3 Helpful Measures
55.3.4 Analgesia
55.3.5 Complications
55.4 Bacterial Pharyngitis
55.4.1 Definition and Etiology
55.4.2 Diagnosis
55.4.3 Treatment
55.4.4 Complications
55.5 Uvulitis
55.5.1 Definition and Etiology
55.5.2 Diagnosis
55.5.3 Treatment
55.6 Epiglottitis
55.6.1 Definition and Etiology
55.6.2 Diagnosis
55.6.3 Treatment
55.7 Peritonsillar Abscess
55.7.1 Definition and Etiology
55.7.2 Diagnosis
55.7.3 Treatment
55.7.4 Complications
55.8 Retropharyngeal Abscess
55.8.1 Definition and Etiology
55.8.2 Diagnosis
55.8.3 Treatment
55.8.4 Complications
55.9 Ear Infections
55.9.1 Acute Otitis Media
55.9.2 Diagnosis
55.9.3 Tympanic Membrane Findings
55.9.4 Other Findings
55.9.5 Treatment
55.10 Nasal Infections
55.11 Acute Bacterial Rhinosinusitis (ABRS)
55.11.1 Diagnosis
55.12 Complicated ABRS
55.12.1 Treatment
55.12.2 Complications
References
56: Oropharyngeal Manifestations of Common Viral Exanthems and Systemic Infectious Diseases in Children
56.1 Introduction
56.2 Measles
56.3 Rubella
56.4 Mumps
56.5 Roseola Infantum
56.6 Herpes Simplex Virus (HSV) Infections
56.7 Varicella (Chickenpox)
56.8 Epstein-Barr Virus (EBV) Infection
56.9 Non-poliovirus Enteroviral Infections
56.10 Human Papillomavirus (HPV) Infections
56.11 Human Immunodeficiency Virus (HIV) Infection
56.12 Conclusion
References
57: Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis Syndrome (PFAPA Syndrome)
57.1 Introduction
57.2 Epidemiology
57.3 Etiopathogenesis
57.4 Clinical Signs
57.5 Diagnostic Criteria
57.6 Diagnosis
57.7 Differential Diagnosis
57.8 Adults PFAPA
57.9 Treatment
57.10 Prognosis
References
58: Preseptal Cellulitis and Other Facial Skin Infections in Children
58.1 Introduction
58.2 Preseptal (Periorbital) Cellulitis
58.2.1 Post-traumatic Preseptal Cellulitis
58.2.2 Nontraumatic Preseptal Cellulitis
58.2.3 Treatment of Preseptal Cellulitis
58.3 Other Facial Skin Infections
58.3.1 Impetigo
58.3.1.1 Nonbullous Impetigo
58.3.1.2 Bullous Impetigo
58.3.2 Folliculitis
58.3.3 Furuncles and Carbuncles
58.3.4 Erysipelas
58.3.5 Facial Cellulitis
58.3.6 Necrotizing Fasciitis
58.3.7 Molluscum Contagiosum
58.3.8 Herpes Simplex Virus Infections
58.3.9 Varicella-Zoster Virus (VZV) Infections
58.3.10 Tinea Faciei
58.3.11 Seborrheic Dermatitis
58.3.12 Tuberculosis of the Skin
58.4 Conclusion
References
59: Tuberculosis in the Ear, Nose, and Throat Field in Children
59.1 Introduction
59.2 Tuberculous Lymphadenitis
59.3 Tuberculosis of the Ear and Mastoids
59.4 Laryngeal Tuberculosis
59.5 Tuberculosis of the Nasopharynx and Paranasal Sinuses
59.6 Tuberculosis of the Oral Cavity
59.7 Tuberculosis of the Salivary Glands
59.8 Tuberculosis of the Thyroid Gland
59.9 Conclusion
References
60: Cervical Lymphadenitis due to Nontuberculous Mycobacterial Infection in Children
60.1 Introduction
60.2 Microbiology and Epidemiology
60.3 Pathogenesis
60.4 Clinical Features
60.5 Radiographic Features
60.6 Laboratory Features
60.7 Diagnosis
60.8 Differential Diagnosis
60.9 Management
60.10 Conclusion
References
61: Influenza in Children
61.1 Introduction
61.2 Etiology
61.3 Pathogenesis
61.4 Epidemiology
61.5 Clinical Features
61.6 Diagnosis
61.7 Treatment
61.8 Influenza Vaccines
References
62: Pertussis in Children
62.1 Introduction
62.2 Etiology
62.3 Epidemiology
62.4 Pathogenesis
62.5 Clinical Manifestations
62.6 Complications
62.7 Differential Diagnosis
62.8 Diagnosis and Laboratory Findings
62.9 Treatment
62.10 Prognosis
62.11 Prevention and Control
62.12 Conclusion
References
63: Diphtheria in Children
63.1 Introduction
63.2 Pathogen
63.3 Epidemiology
63.4 Pathogenesis and Pathology
63.5 Clinical Manifestations
63.5.1 Nasal Diphtheria
63.5.2 Pharyngeal and Tonsillar Diphtheria
63.5.3 Pharyngeal and Laryngeal Diphtheria
63.6 Diagnosis
63.7 Differential Diagnosis
63.8 Prevention
63.9 Treatment
63.10 Prognosis
References
64: Oropharyngeal Tularemia in Children
64.1 Introduction
64.2 Etiology and Epidemiology
64.3 Clinical Manifestations
64.4 Differential Diagnosis
64.5 Laboratory Findings and Diagnosis
64.6 Treatment and Prognosis
64.7 Prevention
64.8 Conclusion
References
65: Cervicofacial Actinomycosis in Children
65.1 Introduction
65.2 Microbiology
65.3 Epidemiology
65.4 Pathogenesis
65.5 Clinical Manifestations
65.6 Diagnosis
65.6.1 Gram and Acid-Fast Stains
65.6.2 Culture
65.6.3 Histopathology
65.6.4 Monoclonal Antibody Staining, Molecular Techniques, and Serology
65.6.5 Imaging
65.7 Differential Diagnosis
65.8 Treatment
65.8.1 Medical Therapy
65.8.2 Surgical Treatment
65.9 Prevention
References
66: Cervicofacial Nocardiosis in Children
66.1 Introduction
66.2 Etiology
66.3 Epidemiology
66.4 Pathogenesis
66.5 Clinical Manifestations
66.6 Diagnosis and Laboratory Tests
66.7 Management
66.7.1 Antimicrobial Treatment
66.7.2 Treatment of Cervicofacial Nocardiosis
66.7.3 Treatment of Mycetoma
66.7.4 Treatment of Disseminated Disease and Nocardiosis in Immunosuppressed Patients
66.7.5 Surgical Management
66.8 Prognosis and Prevention
References
67: Anthrax in the Ear, Nose, and Throat Area in Children
67.1 Introduction
67.2 Etiology
67.3 Epidemiology
67.4 Pathogenesis
67.5 Clinical Presentation
67.5.1 Cutaneous Anthrax
67.5.2 Oropharyngeal Anthrax
67.5.3 Gastrointestinal Anthrax
67.5.4 Inhalational Anthrax
67.5.5 Injection Anthrax
67.6 Laboratory Diagnosis
67.7 Treatment
67.8 Prognosis
67.9 Infection Control in Hospital Settings
67.10 Prevention
67.10.1 Vaccine
References
68: COVID19 Pandemic and Children
68.1 Introduction
68.2 Epidemiology
68.3 Etiology and Pathogenesis
68.4 Clinical Characteristics
68.5 Diagnosis and Diagnostic Tests
68.6 Treatment
68.7 Prognosis
68.8 Conclusion
References
69: Ophthalmological Perspective on Pediatric Ear, Nose, and Throat Infections
69.1 Introduction
69.2 Ophthalmological Evaluation
69.2.1 Evaluation of Vision
69.2.2 External Examinations (Palpebrae, Orbit, Periorbita, Lacrimal Apparatus)
69.2.3 Ocular Motility and Ocular Alignment
69.2.4 Cornea and Conjunctivae
69.2.5 Pupils
69.2.6 Ophthalmoscopic Examination of the Posterior Segment
69.2.7 Examination of the Cranial Nerves Associated with Orbital Structures [31, 32]
69.3 Ophthalmological Manifestations of Infectious Sinonasal Diseases
69.3.1 Bacterial Paranasal Sinusitis
69.3.2 Orbital Complications
69.3.3 Intracranial Complications
69.4 Other Ophthalmological Signs/Complications Secondary to Acute Bacterial Rhinosinusitis
69.4.1 Other Infectious Sinonasal Diseases
69.5 Ophthalmological Manifestations of Infectious Diseases of the Ear and Related Structures
69.5.1 Otitis Media and Facial Paralysis
69.5.2 Infectious Causes of Pediatric Facial Paralysis Other than Otitis Media
69.5.3 Other Ophthalmological Manifestations Associated with Otitis Media
69.6 Ophthalmological Manifestations of Oral Cavity, Pharynx, Upper Airway, and Neck Infections
69.6.1 Pharyngoconjunctival Fever
69.6.2 Parinaud’s Oculoglandular Syndrome
69.6.3 Other Viral Diseases that Manifest with Conjunctivitis and Lymphadenopathy
69.6.4 Leptospirosis
69.6.5 Chlamydia Trachomatis Infection
References
70: Foreign Bodies in Children as a Cause of Infection Seen in ENT Practice
70.1 Introduction
70.2 Foreign Bodies in the Nose
70.2.1 Diagnosis
70.2.2 Treatment
70.3 Foreign Bodies in the Ear Canal
70.4 Foreign Body Aspiration in Children
70.5 Conclusion
References
71: Infections After Cochlear Implantation
71.1 Introduction
71.2 Acute Otitis Media
71.3 Mastoiditis
71.4 Chronic Suppurative Otitis Media and Cholesteatom
71.5 Meningitis
71.6 Wound Site Infection (Biofilm)
71.7 Biofilm
71.8 Conclusion
References
72: Travel-Related Paediatric ENT Infections
72.1 Introduction
72.2 Malaria
72.2.1 Clinical Manifestations
72.2.2 Management
72.3 Leishmaniasis
72.4 HIV Infection and Paediatric ENT
72.4.1 ENT Manifestations of HIV in Children
72.4.2 Ear Problems
72.5 High Altitude Sickness Amongst Children
72.5.1 Clinical Manifestations
72.5.2 Diagnosis and Treatment
72.5.3 Prevention and Prophylactic Drug Treatment
72.5.3.1 Diagnosis
72.5.3.2 Treatment
72.6 Epistaxis and Rhinitis
72.7 Respiratory Tract Infections and Nasal Obstruction
72.8 High Altitude Periodic Breathing of Sleep
References
73: Tracheotomy in Children
73.1 Introduction
73.2 History of Pediatric Tracheotomy
73.3 Indications, Technique, and Complications of Pediatric Tracheotomy
73.4 Postoperative Care of Pediatric Tracheotomy
73.5 Conclusion
References
74: Gastroesophageal Reflux and Respiratory Diseases in Children
74.1 Introduction
74.2 GER Evaluation in Children with Respiratory Disorders
74.3 GERD and Respiratory Symptoms/Disorders
74.4 GERD and Apnea
74.5 Treatment of GER-Related Respiratory Symptoms/Disorders
74.6 Conclusion
References
75: Obstructive Sleep Apnea in Children: ENT Perspective
75.1 Introduction
75.2 Epidemiology
75.3 Etiology and Pathogenesis
75.4 Clinical Findings
75.4.1 Nighttime Symptoms
75.4.2 Daytime Symptoms
75.4.3 History
75.4.4 Clinical Examination
75.5 Imaging
75.6 Pulse Oximeter
75.7 PSG
75.8 Treatment
75.8.1 Nonsurgical Treatment
75.8.2 Surgical Treatment
References
76: Neurobehavioral Consequences of Obstructive Sleep Apnea Syndrome in Children
76.1 Introduction
76.2 Neuropathogenesis of OSAS
76.3 Excessive Daytime Sleepiness
76.4 Neurobehavioral Consequences of OSAS
76.5 Effects of OSAS Treatment on Morbidity from Central Nervous System
76.6 Conclusion
References
Part V: Lower Airway Diseases Related to Pediatric Ear, Nose, and Throat Infections
77: Acute Bronchiolitis in Children
77.1 Introduction
77.2 Epidemiology
77.3 Risk Factors
77.4 Pathogenesis
77.5 Etiology
77.6 Diagnosis
77.6.1 History and Physical Examination
77.6.2 Diagnostic Tests
77.7 Management: Non-Pharmacological
77.7.1 Respiratory Support
77.7.1.1 Monitoring and Supplemental Oxygen
77.7.1.2 High-Flow Nasal Cannula (HFNC) and Continuous Positive Airway Pressure (CPAP)
77.7.2 Nutrition and Hydration
77.7.3 Nasal Suction
77.7.4 Chest Physiotherapy
77.8 Management: Pharmacological
77.8.1 Bronchodilators
77.8.2 Hypertonic Saline
77.8.3 Corticosteroids
77.8.4 Antibiotics
77.9 Prognosis
77.10 Prevention
77.11 Conclusion
References
78: Acute Bronchitis and Protracted Bacterial Bronchitis in Children
78.1 Acute Bronchitis
78.1.1 Introduction
78.1.2 Diagnosis
78.1.3 Treatment of Acute Bronchitis
78.2 Protracted Bacterial Bronchitis (PBB)
78.2.1 Introduction
78.2.2 Definitions
78.2.3 Treatment of Protracted Bacterial Bronchitis
References
79: Pneumonia in Children
79.1 Introduction
79.2 Aetiology
79.2.1 Viral–Bacterial Interaction
79.3 Diagnosis
79.4 Treatment
79.4.1 Outpatient Management
79.4.2 Inpatient Management
79.4.2.1 Prevention
References
80: Diagnosis of Asthma in Children
80.1 Introduction
80.2 Evaluation and Diagnosis
80.2.1 Confirming the Diagnosis of Asthma
80.3 Conclusion
References
81: Treatment of Asthma in Children
81.1 Introduction
81.2 Pharmacological Treatment
81.2.1 Inhaled Corticosteroids
81.2.2 Long-Acting Bronchodilators
81.2.3 Long-Acting Muscarinic Antagonists
81.2.4 Leukotriene Modifying Agents
81.2.5 Theophylline
81.2.6 Biologic Agents
81.3 Allergen Immunotherapy
81.4 Environmental Control
81.5 Psychosocial Factors
81.6 Physical Activity and Diet
81.7 Treatment of Acute Asthma Exacerbation in Children
81.7.1 Treatment at Home
81.7.2 Management in Office or Emergency Service
81.7.3 Management in Hospital
References
82: Infections of Cervicothoracic Cystic Hygroma and Other Congenital Malformations in Children
82.1 Introduction
82.2 Embryologic Mechanism
82.3 Clinical Features and Diagnosis
82.4 Treatment Modalities
82.4.1 Infections of Cervicothoracic Cystic Hygroma
82.5 Thyroglossal Duct Cyst
82.5.1 Embryologic Mechanism
82.5.2 Clinical Features and Diagnosis
82.5.3 Treatment Modalities
82.5.4 Infections of Thyroglossal Ductus Cyst
82.6 Branchial Cleft Cysts/Sinuses/Fistulae
82.6.1 Embryologic Mechanism
82.6.2 Clinical Features, Diagnosis, and Treatment
82.6.3 First Branchial Cleft Anomalies
82.6.4 Second Branchial Cleft Anomalies
82.6.5 Third and Fourth Branchial Cleft Anomalies
82.6.6 Infections of Branchial Anomalies
82.7 Cervical Teratoma/Dermoid Cysts
82.7.1 Clinical Features and Diagnosis
82.7.2 Treatment Modalities
82.7.3 Infections of Cervical Teratoma and Dermoid Cysts
82.8 Thymic Anomalies/Cyst
82.8.1 Clinical Features and Diagnosis
82.8.2 Treatment Modalities
82.8.3 Infections
References
Part VI: Treatment Strategies
83: Principles of Appropriate Antimicrobial Therapy and Antibacterial Agents for Pediatric Ear, Nose, and Throat Infections
83.1 Introduction
83.2 Pharmacokinetics and Pharmacodynamics of Antimicrobial Drugs
83.3 Classification of Antibacterial Agents
83.3.1 Form of Action
83.3.2 Source of Antibacterial Agents
83.3.3 Spectrum of Activity
83.3.4 Chemical Structure
83.3.4.1 Beta-Lactams
83.3.4.2 Aminoglycosides
83.3.4.3 Macrolides
83.3.4.4 Lincosamides
83.3.4.5 Quinolones and Fluoroquinolones
83.3.4.6 Nitroimidazoles
83.3.4.7 Oxazolidinones
83.3.4.8 Streptogramins
83.3.4.9 Sulfonamides
83.3.4.10 Tetracyclines
83.3.4.11 Glycylcyclines
83.3.4.12 Polymyxins
83.3.5 Mode of Action
83.3.5.1 Cell Wall Inhibitors
83.3.5.2 Protein Synthesis Inhibitors
83.3.5.3 Nucleic Acid Synthesis Inhibitors
83.4 The Principles of Antimicrobial Therapy
83.4.1 Identification of the Etiologic Agent and Determination of Antimicrobial Susceptibility
83.4.2 Route of Administration
83.4.3 Adverse Effects
83.4.4 Resistance
83.5 Antibacterial Agents and for Pediatric Ear, Nose, and Throat Infections
83.5.1 Acute Tonsillopharyngitis
83.5.2 Acute Bacterial Sinusitis
83.5.3 Acute Otitis Media
83.6 Conclusion
References
84: Antiviral Agents for Pediatric Ear, Nose, and Throat Infections
84.1 Introduction
84.2 Antiviral Treatment in Influenza
84.2.1 Oseltamivir
84.2.2 Zanamivir
84.2.3 Laninamivir
84.2.4 Peramivir
84.2.5 Baloxavir Marboxil
84.3 Antiviral Treatment in COVID-19
84.4 Conclusion
References
85: Antifungal Agents for Pediatric Ear, Nose, and Throat Infections
85.1 Introduction
85.2 Polyenes
85.2.1 Amphotericin B
85.2.2 Nystatin
85.3 Pyrimidine Analogues
85.3.1 Flucytosine
85.4 Antifungal Triazoles
85.4.1 Fluconazole
85.4.2 Voriconazole
85.4.3 Itraconazole
85.4.4 Posaconazole
85.5 Echinocandins
85.5.1 Caspofungin
85.5.2 Micafungin
85.5.3 Anidulafungin
85.6 Conclusion
References
86: Symptomatic Agents for Pediatric Ear, Nose, and Throat Infections
86.1 Introduction
86.2 Antipyretics and Pain Relievers
86.3 Decongestants, Antihistamines, and Antitussives
86.4 Naso-Occlusion Relievers
86.5 Other Therapies
References
87: Immunomodulating Agents for Pediatric Ear, Nose, and Throat Infections
87.1 Introduction
87.2 Echinacea
87.3 Bacterial Derived Immunomodulators
87.3.1 OM-85 BV
87.4 Pidotimod
87.5 Pelargonium Extracts
87.6 Beta-Glucan
87.7 Propolis
87.8 Conclusion
References
88: Nutritional Management of Pediatric ENT Infections
88.1 Introduction
88.2 The Link Between ENT Infections and Nutrition
88.3 Specific Nutritional Considerations Related with ENT Infections
88.3.1 Breastfeeding
88.3.2 Cow’s Milk
88.4 Food Allergies
88.5 Integration of Nutrition While Caring for ENT-Infected Children
88.5.1 Nutritional Assessment
88.5.2 The Energy and Nutrient Needs of Children
88.5.3 Energy
88.5.3.1 Carbohydrates
88.5.3.2 Lipids
88.5.3.3 Protein
88.5.3.4 Vitamins and Minerals
88.6 Mediterranean Diet
88.7 DASH Diet
88.8 Postoperative Tonsillectomy Diet
88.9 Enteral Nutrition
88.10 Parenteral Nutrition
88.11 Conclusions
References
89: Probiotic Use in Pediatric Ear, Nose, and Throat Infections Practice
89.1 Introduction
89.2 Respiratory Tract Infections
89.3 Acute Otitis Media
References
90: Supportive Agents for Pediatric Otolaryngological Infections
90.1 Introduction
90.2 Zinc and Vitamins
90.3 Probiotics
90.4 Honey and Beehive Products
90.5 Herbal Medicine
90.6 Immunomodulators
References
91: Management of Pediatric Trauma: ENT View
91.1 Introduction
91.2 Management of Pediatric Ear Trauma
91.3 Management of Pediatric Nasal Trauma
91.4 Management of Pediatric Throat Trauma
91.5 Conclusion
References
92: Management of Pediatric Trauma: General View
92.1 Introduction
92.2 Thoracic Trauma
92.2.1 Thoracic Traumatic Lesions and Treatment
92.3 Abdominal Traumas
92.3.1 Solid Organ Injuries in Blunt Abdominal Trauma
92.3.1.1 Liver Injuries
92.3.1.2 Spleen Injuries
92.3.1.3 Pancreatic Injuries
92.3.1.4 Renal Injury
92.3.2 Hollow Abdominal Organ Injuries in Blunt and Penetrant Traumas
92.3.2.1 Gastrointestinal System Injuries
92.3.2.2 Urinary Bladder
References