Dr. Rande Lazar is an Otolaryngologist based in Memphis, TN. He is the founder of Otolaryngology Consultants, an ear, nose, and throat practice in the city. Although his primary focus is children, he treats adult patients for ear, nose, and throat disorders as well. Dr. Rande Lazar has a vast array of experience in many areas of otolaryngology, including treatment for most ear, nose and throat infections, as well as sleep disorders. He is also experienced in pediatric hearing and larynx (voice box) problems, as well as many other problems affecting the head and neck. Dr. Lazar is an experienced surgeon for both pediatric and adult sleep and sinus disorders.

Dr. Rande Lazar is the founder of the Memphis-based pediatric ear, nose and throat practice, Otolaryngology Consultants.

Article Abstract:

Infections of the paranasal sinuses can be complicated by septic thrombosis of the cavernous venous sinuses. After standard antibiotic treatment, fewer than 50% of the patients recover completely, and the mortality rate is approximately 30%. We chose to treat this potentially catastrophic complication with functional endonasal sinus surgery in addition to standard antibiotic therapy.

Read the full article as a PDF here: Cavernous Sinus Thrombosis: Successful Treatment using Functional Endonasal Sinus Surgery

If you have any questions about ear, nose and throat disorders, please contact Otolaryngology Consultants of Memphis.

Memphis Otolaryngologist Dr. Rande Lazar primarily focuses in pediatric ear, nose and throat disorders, including ear infections, throat infections, tonsil infections, sinus infections and sleep disorders. Dr. Lazar has special expertise in adult and pediatric sleep and snoring disorders and surgery, as well as adult and pediatric sinus disorders. Hi experience crosses a wide range of disorders of the ear, nose, throat, sinus and respiratory systems, as well as other head and neck systems. He also focuses in children’s disorders of the larynx (voicebox), and hearing problems.

Dr. Rande Lazar is the founder of the Memphis-based pediatric ear, nose and throat practice, Otolaryngology Consultants.

Article Abstract:

Subperiosteal abscess is a serious orbital complication of sinusitis that occurs predominantly in children. Infection may spread to the orbital site through a preexisting defect in the lamina papyracea or by means of a thrombophlebitic process. Although the traditional approach to treating a subperiosteal abscess has been drainage through an external incision, we treated this serious complication with functional endonasal sinus surgery. Ten pediatric patients with clinical and CT evidence of orbital subperiosteal abscess underwent endoscopic surgery at LeBonheur Children’s Hospital in Memphis, Tenn., between 3 and 12 years of age at the time of surgery. Despite 2 to 4 days of intravenous antibiotic therapy, their signs and symptoms progressed, and axial and coronal CT scans demonstrated orbital subperiosteal abscess. Seven patients had bilateral ethmoid and maxillary sinusitis, and the remaining three patients had unilateral ethmoiditis. Opthalmologic assessments were performed for all patients immediately after hospital admission. The patients were started on regimens of high-dose intravenous cefuroxime sodium to subdue infections and pediatric decongestant nasal spray to facilitate drainage. All 10 patients with the confirmed diagnosis of subperiosteal abscess were treated with endoscopic surgery to drain the site of infection. All 10 patients improved significantly 12 to 24 hours after surgery and were discharged from the hospital to their homes 48 to 72 hours after surgery. Patients were continued on a regimen of broad-spectrum oral antibiotics and beclomethasone nasal spray for 2 weeks beyond the final examination. Follow-up endoscopic examinations were performed under general anesthesia in the operating room 2 to 3 weeks after surgery. No complications or adverse sequelae occurred. Our study appears to confirm that endoscopic drainage of subperiosteal abscess offers the patient an alternative to incisional surgery. The endoscopic approach prevents an external scar without increasing morbidity or length of hospitalization.

Read the full article as a PDF here: Endoscopic Drainage of Subperiosteal Abscess in Children: A Pilot Study

If you have any questions about ear, nose and throat disorders, please contact Otolaryngology Consultants of Memphis.

Dr. Rande Lazar is an Otolaryngologist and founder of Otolaryngology Consultants, an ear, nose, and throat practice located in Memphis, TN. Dr. Lazar is a specialist, with a primary focus in pediatrics. He has a vast amount of experience treating sinus infections, respiratory infections, tonsil infections, ear infections, throat infections, sleep disorders, and many other areas of otolaryngology. Dr. Lazar routinely performs surgery for both adult and pediatric patients. Alongside his years of expertise in respiratory disorders, sleep disorders, and sinus disorders, Dr. Lazar also treats a wide range of head and neck problems, including pediatric larynx (voice box) and hearing problems.

Rande Lazar, MD is available at his Memphis-based pediatric ear, nose and throat practice, Otolaryngology Consultants. Contact him if you have any concerns or issues he can help you with.

Article Abstract:

Evaluating the extent of chronic sinusitis in children is critical in management of the disease and determination of the need for surgery. High-resolution computed tomography can demonstrate disease that is not shown on routine x-ray films. It can also delineate pathologic variations and demonstrate inaccessible anatomic structures. We compared plain radiographs, CT scans, and intraoperative findings for 300 pediatric patients with chronic or recurrent sinusitis. Despite an imperfect record in demonstration of sinus disease in all of our patients, computed tomography was unquestionably better than plain radiography in diagnosis of chronic sinusitis and evaluation of the need for surgery. Despite its superior performance, CT should not be used exclusively to diagnose disease or propose surgery. These determinations must be made on the basis of a combination of the patient’s symptoms, physical examination findings, and CT results.

Read the full article as a PDF here: Comparison of plain radiographs, coronal CT, and intraoperative findings in children with chronic sinusitis

If you have any questions about ear, nose and throat disorders, please contact Otolaryngology Consultants of Memphis.

Dr. Rande Lazar is the founder of Otolaryngology Consultants, an ear, nose and throat practice located in Memphis, TN. Dr. Lazar is an experienced Memphis-based Otolaryngologist and surgeon who specializes in pediatric ear infections, throat infections, tonsil infections, sinus infections and sleep disorders. He treats children’s larynx (voice box) and hearing disorders. Dr. Rande Lazar has many years of experience in pediatric and adult sleep and snoring disorders, respiratory disorders, and a vast range of other head and neck problems.

Please contact Rande Lazar, MD at Otolaryngology Consultants if you have a child with chronic sinusitis or with other symptoms of concern.

Article Abstract:

Chronic sinusitis and recurrent acute sinusitis are relatively common clinical disorders in children. Chronic sinusitis describes signs and symptoms of sinusitis that persist longer than 3 months despite optimal medical therapy. In recurrent acute sinusitis, sufficient change has occurred in the anatomic structure of the infundibulum or in the efficacy of the mucociliary system to predispose the patient to recurrent bouts of sinusitis. In addition to the immediate discomfort of a about of sinusitis, the disease may exacerbate other conditions, such as asthma and otitis media, or lead to suppurative complications, such as orbital abscess or cavernous sinus thrombosis.

During the last decade, opinions have changed about the pathogenesis and treatment of chronic sinusitis. It had long been accepted that chronic sinusitis originated in the maxillary sinus and that removal of diseased mucosa by means of a Caldwell-Luc procedure or aeration of the sinus by antrostomy would reinstate the normal sinonasal condition. These concepts and practices were challenged by Messerklinger, who made it clear that the origin of sinusitis is the ostiomeatal complex. This region, which includes the uncinate process, the bulla ethmoidalis, the hiatus semilunaris, and the infundibulum, forms the dominant drainage system of the anterior ethmoid, frontal, and maxillary sinuses.

The development of the rod-lens telescope and other effective instrumentation has enabled otolaryngologists to address disease in the ostiomeatal complex endoscopically. In 1989, Gross and Lazar described the successful use of functional endonasal sinus surgery (FESS) in treating children. Since then, its use and efficacy have been reported by many physicians, and the indications for the procedures have greatly expanded. In addition to treating chronic sinusitis, FESS is now used for the treatment of orbital complications such as subperiosteal abscesses, for dacryocystorhinostomy creation, for the repair of limited cranial defects, and for the removal of benign lesions.

This review delineates the current ideas about the development of the sinuses, the pathophysiology of sinusitis, and the treatment of chronic rhinosinusitis.

Read the full article as a PDF here: Sinusitis in Children: Current Management

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Dr. Rande Lazar is an Otolaryngologist located in Memphis, TN and also the founder of Otolaryngology Consultants, an ear, nose, and throat practice based out of the Memphis area. Dr. Rande Lazar has a wide array of experience in many areas of otolaryngology, including treatment for sinus infections, respiratory infections, tonsil infections, ear infections, throat infections, and sleep disorders. Though his primary focus is children, he treats adults for ear, nose, and throat disorders as well. He is also experienced in pediatric hearing and larynx (voice box) problems, as well as many other problems affecting the head and neck. Dr. Lazar is an experienced surgeon for both pediatric and adult sleep and sinus disorders.

You can also find Dr. Rande Lazar his practice’s website, Otolaryngology Consultants of Memphis.

Abstract:

Sinusitis has become the number one chronic illness for all age groups in the U.S. It has surpassed arthritis and hypertension as reported by the National Center for Disease Statistics. Although its exact incidence in children is not known, it is a common disease entity in the pediatric age group.

The etiological factors predisposing to sinusitis are multiple. They range from local anatomic variations to major systemic abnormalities. Diagnosis may be based on clinical manifestations or may require advanced radiographic studies. The majority of cases respond to conventional medical treatment. Surgical intervention is entertained only after optimal medical therapy fails.

Functional Endonasal Sinus Surgery (FESS) is a relatively new surgical procedure that was introduced in the mid 1980’s in the U.S. It is proving to be an effective treatment for chronic and/or recurrent sinusitis in children who have failed maximal medical therapy. FESS is a functional rather than an ablative or exentrative procedure. The diseased tissues are removed under direct visualization and the physiologic mucociliary clearance is restored.

This course is intended to familiarize the otolaryngologist and residents-in-training with the embryology, anatomy and pathophysiology of pediatric sinusitis. Systemic diseases such as allergy, asthma and immunodeficiency as they relate to sinusitis in children are discussed. The important role of pediatric FESS, its indications, the techniques, the results and the complications will be dealt with extensively.
View the full article in PDF format here: The Medical and Surgical Management of Sinusitis in Children

Dr. Rande Lazar makes his internet home at Otolaryngology Consultants of Memphis.

Dr. Rande Lazar is a Memphis Otolaryngologist with a primary focus in pediatric ear, nose and throat disorders, including ear infections, throat infections, tonsil infections, sinus infections and sleep disorders. Dr. Rande Lazar has special expertise in adult and pediatric sleep and snoring disorders and surgery, as well as adult and pediatric sinus disorders. Dr. Rande Lazar is experienced in a wide range of disorders of the ear, nose, throat, sinus, respiratory system and the other head and neck systems, as well as children’s disorders of the larynx (voicebox), and hearing problems.

Learn more about Dr. Rande Lazar at Otolaryngology Consultants of Memphis.

Abstract:

A medial subperiosteal abscess (SPA) of the orbit is the most common serious complication of sinusitis in children. The distinction between SPA and the more benign pre-septal disease is difficult to make especially in a young child in whom an opthalmological evaluation is often difficult. Computerized tomography (CT) is the investigation of choice in making this distinction. Subperiosteal inflammatory disease of the orbit is initially treated with intravenous antibiotic therapy with surgery reserved for those patients who do not respond to medical treatment and in whom a medial SPA is confirmed by CT. Conventionally, the abscess is drained via an external incision and an ethmoidectomy is performed at the same time. More recently, successful drainage of SPA’s has been accomplished endoscopically via a intranasal approach with less morbidity and superior cosmesis. We present a 5 year experience of 24 patients with CT scans suggestive of medial SPA who underwent endoscopic exploration of the medial subperiosteal orbital space. We discuss the current management of medial subperiosteal disease of the orbit in children and include a review of the literature. Also included is a clinical staging system which aids the management of orbital complications of sinusitis.

View the full article in PDF format here:

Management of medial subperiosteal abscess of the orbit in children–a 5 year experience

Read more by and about Dr. Rande Lazar and Otolaryngology Consultants of Memphis.