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

Read more by and about Dr. Rande Lazar:

• Dr. Rande Lazar‘s Memphis Ear Nose and Throat Blog
• Dr. Rande Lazar‘s Functional Endoscopic Sinus Surgery Blog
• Facebook for Dr. Rande Lazar
• Twitter for Dr. Rande Lazar
• LinkedIn for Dr. Rande Lazar

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.