Literature Review: A Roundup of Important Recent Studies

Bottom line: Obesity appeared to contribute to differences in internalizing behaviors, but not in externalized behaviors; poor correlation between OSA severity, quality of life and behavior underscore the importance of treating OSA regardless of severity.

Citation: Tripuraneni M, Paruthi S, Armbrecht ES, Mitchell RB. Obstructive sleep apnea in children. Laryngoscope. 2013;123:1289-1293.

—Reviewed by Amy Eckner

Many Otolaryngologists Dissatisfied with Current Sinus CT Results

How satisfied are otolaryngologists with paranasal sinus computed tomography (PSCT), and how effective is it?

Background: PSCT is an important aid in the diagnosis of chronic rhinosinusitis because of the excellent osseous detail it provides, including extent and characterization of the disease, location of surgically relevant anatomic structure and critical anatomic variations. Although standardized reporting templates exist for many pathology and radiology investigations, standardized PSCT reporting has failed to gain acceptance among otolaryngology communities.

Study design: A national voluntary online survey of practicing otolaryngologists in Canada (14 percent response rate) and a randomized retrospective review of PSCT reporting from two major centers between December 1, 2009 and December 1, 2011.

Setting: A national survey of all Canadian otolaryngologists was conducted in September 2011; Alberta Health Services—Calgary Zone and the Ottawa Hospital.

Synopsis: Seventy-five percent of all survey respondents indicated that current PSCT reporting did little for clinical assessments, with 67 percent wanting more clinically relevant information on CRS disease staging and sinonasal anatomic variations, as well as information addressing high-risk areas encountered during endoscopic sinus surgery.

PSCT scan results were separated into groups based on radiologist training and experience: head and neck radiologists (at least two years of neuroradiology fellowship training, including detailed head and neck training); neuroradiologists (at least two years of neuroradiology fellowship training, with less than 50 percent of that time spent interpreting non-neuro head and neck imaging studies); and other radiologists (did not fulfill the criteria for either of the other two groups). A list of seven critical and 11 noncritical items were examined in the PSCTs; three independent reviewers reviewed each PSCT report. Reporting of both critical and noncritical items was inconsistent and highly variable, and variation depended on the training and experience of the radiologist. The most consistently reported items were optic nerve anatomy, internal carotid artery anatomy and lamina papyracea integrity. The least consistently reported items were anterior ethmoid artery location, ethmoid skull base integrity and the presence of a sphenoethmoidal (Onodi) cell.