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You Make the Call: What is Diagnosis, Treatment of ENT Cases? :

September 15, 2017

Editor's note: The 2017 AAP National Conference & Exhibition will take place from Sept. 16-19 in Chicago.

A 5-year-old with a history of recurrent ear infections, drainage and tympanostomy tubes comes into clinic. He has developed pain, drainage and infection in the right ear. Is this a routine middle ear infection that can be treated with antibiotics, or is there anything in the history and physical exam that would suggest the child should be referred to an otolaryngologist?

Next, you see a 2-month-old with noisy breathing. Are the history and exam findings consistent with laryngomalacia or other airway pathology? Is it safe to manage the infant as an outpatient, or should she be seen urgently in the emergency department?

These are the types of cases that will be presented during “ENT Potpourri: You Make the Diagnosis.” The session will be held from 4:00-5:30 pm Saturday (A1142) in McCormick Place, W196 C and again from 2:00-3:30 pm Sunday (A2129) in McCormick Place, W196 A.

“Each case will have a point to it,” said Jeffrey Rastatter, MD, FAAP, a member of the AAP Section on Otolaryngology-Head and Neck Surgery (SOOHNS). “Sometimes that point might be making a diagnosis, but sometimes that point might be choosing a particular treatment or making the appropriate next-step decision, whether follow-up in a clinic vs. referral to the emergency room vs. prompt referral to specialist within a week.”

Dr. Rastatter will be joined by Cristina Baldassari, MD, FACS, FAAP, a member of the SOOHNS Executive Committee and associate professor in the Department of Otolaryngology at Eastern Virginia Medical School/The Children's Hospital of the King's Daughters.

After presenting each case, the pair will pose a question to attendees, who will be able to weigh in using an audience response system. Based on their responses, Drs. Rastatter and Baldassari will lead a discussion on key findings in the history, physical exam or workup that would lead to a diagnosis or management strategy. Discussions will include best practice guidelines, such as indications for ear tubes and tonsillectomy, from the AAP and the American Academy of Otolaryngology-Head and Neck Surgery.

Dr. Rastatter said he solicited ideas for cases from his partners at Ann & Robert H. Lurie Children’s Hospital of Chicago to ensure they cover a broad range of ENT topics of interest to pediatricians.

They also may discuss some controversial topics such as indications for frenulectomy and lip clipping, which people have strong opinions about, said Dr. Rastatter, associate professor of otolaryngology-head and neck surgery at Northwestern University Feinberg School of Medicine.

“We’re not going to totally resolve the controversy on that day,” he said “but we can try and hit on what information is out there that is best evidence at the current time.”

For more coverage of the AAP National Conference & Exhibition visit and follow AAPNews on Twitter and Facebook.

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