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P160: Bacteriology of Recurrent Tonsillitis
Scientific Posters—Wednesday
P160 Bacteriology of Recurrent Tonsillitis Andre Luiz Lopes Sampaio, MD, PhD (presenter); Mercedes Fabiana Araujo, MD; Carlos Oliveira OBJECTIVES: Evaluate the most common bacteria recovered from the tonsils core of children submitted to tonsillectomy with the diagnosis of recurrent tonsillitis and the its antibiotic susceptibility. METHODS: Between May 2005 and April 2006, 52 children from 2,9 to 12,11 years of age were evaluated at the Brası´lia University Hospital. The features observed were age, sex, frequency of tonsillitis and time of disease, last antibiotic used and the time between last infection and operation, history of pharyngeal or tonsil abscess, previous culture, antibiotics prophylaxis, tonsils size, detection of acute infection during the operation, and transoperatory antibiotic use. The cultures were grown from fragments of tonsil core obtained after tonsil resection. RESULTS: Fifty percent were male, with median age of 6.1 years. Only 5,8% of patients were operated in consequence of tonsil hypertrophy; the last group had chronic tonsillitis. Fortyeight percent of the cultures were negative, Staphylococcus aureus were found in 32,7% of the cultures, Brahamella catarrhalis in 9,6%, Haemophilus influenzae in 7,7%, Corynebacterium sp in 3,8% and Streptococcus pyogenes in 1,9%. All staphylococcus isolated were penicillin resistant. CONCLUSIONS: The high prevalence of staphylococcus observed by the authors confirms previous reports, and the
knowledge of the resistance to penicillin by a significantly elevated number of the strains could reorient antibiotic choice in recurrent tonsillitis.
P161 Phosphorylcholine-Coated Ventilation Tube Study Jennifer Luz (presenter); Greg R Licameli, MD; Margaret A Kenna, MD, MPH; Patrick R Johnston, MMath (Statistics); Dwight T Jones, MD OBJECTIVES: 1. Determine if a Phosphorylcholine antibacterial coating (PC) on standard ventilation tubes (VT) will reduce the incidence of post-tube placement complications. 2. Analyze the incidence of VT tube complications: otorrhea, premature extrusion, VT lumen obstruction, granulation tissue, and persistent tympanic membrane perforations. METHODS: A prospective cohort aged 1-3 years received bilateral VT for otitis media with effusion between July 2002 and February 2004 at a tertiary care pediatric hospital; 73 children were randomized to receive a PC-coated VT in one ear and an uncoated VT in the other. Otologic examinations at prescribed intervals over two years postoperatively ascertained the status of sequelae. RESULTS: Outcomes analyzed were otorrhea, premature extrusion, VT lumen obstruction, granulation tissue, and persistent tympanic membrane perforations. The data did not reveal a statistical difference in the incidence of any of these sequelae between standard and PC-coated ventilation tubes (p ⬎ .05) during the 24-month follow-up period. Results after 13 months of follow-up may have been affected by patients lost to follow-up and therefore a smaller sample size as the study continued. CONCLUSIONS: There was no statistical difference in the incidence of complications after PC-coated VT and standard VT insertion. The study concludes Phosphorylcholine-coated ventilation tubes do not reduce the rate of complications in comparison with uncoated ventilation tubes.
P162 Etiology and Outcome of Pediatric Facial Nerve Palsy Melanie Duval (presenter); Mamatha Bhat, MD; Anthony Abela, MD; Sam J Daniel, MD OBJECTIVES: Characterize the demographics, etiologies, treatment and outcome of children presenting with facial nerve palsy at two tertiary care pediatric hospitals. METHODS: In a retrospective chart review, children aged 0 to 18 years old admitted for facial nerve palsy between April 1989 and April 2005 were identified and pertinent information was recorded from their medical records. The facial nerve
SCIENTIFIC POSTERS
maxillary sinus irrigation followed by long-term double oral antibiotic therapy for the treatment of CRS in pediatric patients refractory to oral antibiotic therapy. METHODS: A retrospective review of the medical records of 23 patients who received treatment looking at the following: age, presenting signs and symptoms and their duration, medical and social history, maxillary sinus culture and sensitivity results, postoperative antibiotic treatment regimen and duration, whether resolution was achieved, length of follow-up, surgical and antibiotic-related complications and compliance with follow-up and therapy. RESULTS: Of patients without a documented immunodefiency, 18/19 (95%) had complete resolution of symptoms. Overall, clinical resolution was achieved in 18 of 23 (78%) patients. Long-term resolution was maintained in 13/15 (87%) of patients who resolved. No treatment-related complications were reported, and no patients in the study required FESS. CONCLUSIONS: A stepwise protocol that includes concurrent adenoidectomy and bilateral maxillary sinus irrigation followed by long-term double oral antibiotic therapy is effective for the treatment of pediatric CRS refractory to oral antibiotic therapy. Patients with immunodeficiency may require long-term IV therapy to achieve symptom resolution.
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P160 Bacteriology of Recurrent Tonsillitis Andre Luiz Lopes Sampaio, MD, PhD (presenter); Mercedes Fabiana Araujo, MD; Carlos Oliveira OBJECTIVES: Evaluate the most common bacteria recovered from the tonsils core of children submitted to tonsillectomy with the diagnosis of recurrent tonsillitis and the its antibiotic susceptibility. METHODS: Between May 2005 and April 2006, 52 children from 2,9 to 12,11 years of age were evaluated at the Brası´lia University Hospital. The features observed were age, sex, frequency of tonsillitis and time of disease, last antibiotic used and the time between last infection and operation, history of pharyngeal or tonsil abscess, previous culture, antibiotics prophylaxis, tonsils size, detection of acute infection during the operation, and transoperatory antibiotic use. The cultures were grown from fragments of tonsil core obtained after tonsil resection. RESULTS: Fifty percent were male, with median age of 6.1 years. Only 5,8% of patients were operated in consequence of tonsil hypertrophy; the last group had chronic tonsillitis. Fortyeight percent of the cultures were negative, Staphylococcus aureus were found in 32,7% of the cultures, Brahamella catarrhalis in 9,6%, Haemophilus influenzae in 7,7%, Corynebacterium sp in 3,8% and Streptococcus pyogenes in 1,9%. All staphylococcus isolated were penicillin resistant. CONCLUSIONS: The high prevalence of staphylococcus observed by the authors confirms previous reports, and the
knowledge of the resistance to penicillin by a significantly elevated number of the strains could reorient antibiotic choice in recurrent tonsillitis.
P161 Phosphorylcholine-Coated Ventilation Tube Study Jennifer Luz (presenter); Greg R Licameli, MD; Margaret A Kenna, MD, MPH; Patrick R Johnston, MMath (Statistics); Dwight T Jones, MD OBJECTIVES: 1. Determine if a Phosphorylcholine antibacterial coating (PC) on standard ventilation tubes (VT) will reduce the incidence of post-tube placement complications. 2. Analyze the incidence of VT tube complications: otorrhea, premature extrusion, VT lumen obstruction, granulation tissue, and persistent tympanic membrane perforations. METHODS: A prospective cohort aged 1-3 years received bilateral VT for otitis media with effusion between July 2002 and February 2004 at a tertiary care pediatric hospital; 73 children were randomized to receive a PC-coated VT in one ear and an uncoated VT in the other. Otologic examinations at prescribed intervals over two years postoperatively ascertained the status of sequelae. RESULTS: Outcomes analyzed were otorrhea, premature extrusion, VT lumen obstruction, granulation tissue, and persistent tympanic membrane perforations. The data did not reveal a statistical difference in the incidence of any of these sequelae between standard and PC-coated ventilation tubes (p ⬎ .05) during the 24-month follow-up period. Results after 13 months of follow-up may have been affected by patients lost to follow-up and therefore a smaller sample size as the study continued. CONCLUSIONS: There was no statistical difference in the incidence of complications after PC-coated VT and standard VT insertion. The study concludes Phosphorylcholine-coated ventilation tubes do not reduce the rate of complications in comparison with uncoated ventilation tubes.
P162 Etiology and Outcome of Pediatric Facial Nerve Palsy Melanie Duval (presenter); Mamatha Bhat, MD; Anthony Abela, MD; Sam J Daniel, MD OBJECTIVES: Characterize the demographics, etiologies, treatment and outcome of children presenting with facial nerve palsy at two tertiary care pediatric hospitals. METHODS: In a retrospective chart review, children aged 0 to 18 years old admitted for facial nerve palsy between April 1989 and April 2005 were identified and pertinent information was recorded from their medical records. The facial nerve
SCIENTIFIC POSTERS
maxillary sinus irrigation followed by long-term double oral antibiotic therapy for the treatment of CRS in pediatric patients refractory to oral antibiotic therapy. METHODS: A retrospective review of the medical records of 23 patients who received treatment looking at the following: age, presenting signs and symptoms and their duration, medical and social history, maxillary sinus culture and sensitivity results, postoperative antibiotic treatment regimen and duration, whether resolution was achieved, length of follow-up, surgical and antibiotic-related complications and compliance with follow-up and therapy. RESULTS: Of patients without a documented immunodefiency, 18/19 (95%) had complete resolution of symptoms. Overall, clinical resolution was achieved in 18 of 23 (78%) patients. Long-term resolution was maintained in 13/15 (87%) of patients who resolved. No treatment-related complications were reported, and no patients in the study required FESS. CONCLUSIONS: A stepwise protocol that includes concurrent adenoidectomy and bilateral maxillary sinus irrigation followed by long-term double oral antibiotic therapy is effective for the treatment of pediatric CRS refractory to oral antibiotic therapy. Patients with immunodeficiency may require long-term IV therapy to achieve symptom resolution.
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