Optimizing the Management of the Main Acute Infections in Pediatric ORL: Tonsillitis, Sinusitis, Otitis media

Valuing tonsillitis manifestations in schoolchildren in Rio de Janeiro

Objective:

To evaluate the importance attributed to tonsillitis by guardians and their level of knowledge about the disease, correlating their management with their schooling and socioeconomic profiles.

Methods:

A quantitative, descriptive and observational cross-sectional study involving students aged 5 to 17 years from state-owned and private schools. A questionnaire was applied on management of tonsillitis and knowledge about rheumatic fever, addressing demographic and socioeconomic data.

Results:

A total of 323 students were included, predominantly females (61.3%), from state-owned schools (77.1%), with a mean age of 9.7±0.3 years. Among the guardians, 48.6% completed high school. Among the students 75.2% had at least one episode of odynophagia in the previous 12 months. Considering the previous 2 years, 89.8% reported this symptom. There was no collection of bacteriological specimens in 67.8%, and in 83% if taking into account only the last episode, despite the search for medical care in most cases (92.6%). The use of anti-inflammatory drugs was very frequent (43.0% “always” and 42.4% “sometimes”). Among the guardians, 81.7% denied being aware of the relation between rheumatic fever and inappropriate treatment of odynophagia; 85.8% said they wished they had received more information.

Conclusion:

Although it is quite common in schoolchildren, tonsillitis is neglected by many guardians and health professionals, and the ignorance of its relation with rheumatic fever is practically universal, which may contribute to its high prevalence.

Pediatric otorhinolaryngology emergencies at the Jos University Teaching Hospital: Study of frequency, management, and outcomes

Background:

Studies from Nigeria on pediatric otorhinolaryngology (ORL) emergencies are rare in literature with most focusing on emergencies involving individual systems.

Objective:

The aim of this study is to determine the prevalence of all ORL emergencies among children in our region to provide a baseline data for future health planning.

Patients and Methods:

This is a 1-year retrospective cross-sectional study of patients aged 16 years and below presenting to the Accident and Emergency Department of the Jos University Teaching Hospital, Jos, Nigeria.

Results:

A total of 203 otolaryngology emergencies were attended of which 129 (63.5%) were pediatric emergencies. Records of 87 patients were retrievable with age range 2 months to 15 years (mean 3.44 years; standard deviation ± 3.35). There were 55 males and 32 females with a male to female ratio of 1.7:1. The majority of cases were aged under 5 years (64; 73.6%). Acute tonsillitis accounted for 32 (36.7%) cases with 6 (6.9%) having peritonsillar abscesses. Acute pharyngitis accounted for 11 (12.6%) presentations followed closely by foreign bodies (FBs) in the ear with 10 (11.5%) presentations. FB in the throat occurred in 4 (4.6%) patients who had removal under general anesthesia. Three (3.4%) cases of maxillofacial injuries occurred as a result of insurgent terror attacks and 3.4% presented following corrosive substance ingestion. Conservative management was commenced in 76 (87.4%) patients, 23 (26.4%) had surgery with 68 (78.2%) admitted and discharged, 18 (20.7%) treated as outpatients, and 1 (1.1%) died on admission. Otolaryngologists attended most (95.4%) patients.

Conclusion:

Pediatric ORL emergencies are common in our region involving a wide range of pathologies. Expansion is required in the ORL training of the emergency room physician to enhance emergency services.