Eosinophilic Esophagitis: Serious But Misunderstood

As management, the child swallowed fluticasone. He was re-evaluated three months later and found to have minimal distal esophageal inflammation and less subglottic inflammation, and the subglottic stenosis had improved to grade 2. He then had single-stage laryngotracheal reconstruction surgery with anterior and posterior costal cartilage grafts, which were nice and routine, good result, Dr. Rutter reported.

Is Routine Testing Warranted?

A study at Cincinnati Children’s Hospital found that it might be well worth it to routinely test for eosinophilic esophagitis, considering the high cost of failed surgery in cases where it wasn’t discovered.

The study looked at how many EGDs had to be done in that child population to find one child with the disease, what further tests had to be done after the disease was found, and the cost to treat one case of the disease.

It also looked the cost of surgical failure, including how many untreated patients failed to decannulate, how many additional surgeries were necessary to achieve decannulation, and the average cost of repeated surgeries.

The study found that the average cost of intervention to detect the disease early, before surgery, was $27,555, whereas the cost of failed surgeries, and the subsequent cost of further surgeries that resulted, amounted to an average cost of failure of $142,263.

The panelists said that otolaryngologists would be well served to sharpen their knowledge and openness to the possibility of eosinophilic esophagitis in their patients.

Dr. Thompson said, It does require knowledge, awareness, and a high index of suspicion.

News & Notes

FDA Advises Against use of Certain Zicam Products

The US Food and Drug Administration recently advised consumers to stop using three over-the-counter products marketed as cold remedies by Zicam, because they are associated with the loss of sense of smell.

The products are: Zicam Cold Remedy Nasal Gel, Zicam Cold Remedy Nasal Swabs, and Zicam Cold Remedy Swabs, Kids Size.

The FDA has received more than 130 reports of loss of sense of smell associated with the use of these three Zicam products. In these reports, many people who experienced a loss of smell said the condition occurred with the first dose; others reported a loss of smell after multiple uses of the product.

We are concerned that consumers may unknowingly use a product that could cause serious harm, said Janet Woodcock, MD, Director of the FDA’s Center for Drug Evaluation and Research. The loss of smell, for example, can limit the ability to detect the smell of gas or smoke or other signs of danger in the environment.