Pediatric ENT Infections

Description

The book provides a comprehensive and up-to-date overview of pediatric ENT infections. It brings together the experience of authors from more than 30 countries  and aims to provide a broader  understanding of the prevention and treatment of infectious diseases in children, that will likely lead to improve their health  globally. In addition to new infections like COVID-19, the work reviews the latest treatments modalities. The list of topics ranges from basic to very advanced and the book will be therefore an invaluable resource for ENT and pediatrics trainees and students, as well as for experienced practitioners in these fields. Preface Contents Contributors Part I: General Overview 1: Immunological Responses to Infection 1.1 Introduction 1.2 Bacterial Infections and Immunity 1.2.1 Bloodstream Infections 1.2.2 Encapsulated Bacteria 1.3 Viral Infections and Immunity 1.4 Fungal Infections and Immunity 1.5 Protozoal Infections and Immunity 1.6 Helminths and Immunity References 2: Pathophysiology of Pediatric Ear, Nose, and Throat Infections 2.1 Introduction 2.2 Acute Pharyngitis 2.2.1 Viral Pharyngitis 2.2.2 Bacterial Pharyngitis 2.3 Acute Rhinosinusitis 2.4 Acute Otitis Media 2.4.1 Anatomy 2.4.2 Infectious Causes 2.4.2.1 Viruses 2.4.2.2 Bacteria 2.4.2.3 Environment References 3: Laboratory Diagnosis for Paediatric Ear, Nose and Throat Infections 3.1 Introduction 3.2 Specimen Collection 3.3 Direct Microscopic Examination 3.4 Culture Methods 3.5 Antigen Detection Assays 3.6 Direct Fluorescent Antibody Tests 3.7 Serology 3.8 Molecular Tests References 4: Imaging of Pediatric Ear, Nose, and Throat Infections 4.1 Sinonasal Infections 4.2 Imaging Considerations 4.2.1 Acute Sinusitis 4.2.2 Chronic Sinusitis 4.2.3 Allergic Sinusitis 4.2.4 Fungal Sinusitis 4.2.5 Complications of Rhinosinusitis 4.2.5.1 Imaging 4.2.5.2 Orbital Complications 4.2.5.3 Preseptal (Periorbital) Cellulitis 4.2.5.4 Postseptal (Orbital) Cellulitis 4.2.5.5 Subperiosteal Abscess 4.2.5.6 Cavernous Sinus Thrombosis 4.2.5.7 Extra- and Intracranial Complications 4.2.5.8 Pott’s Puffy Tumor 4.2.5.9 Intracranial Complications 4.2.6 Ear Infections 4.2.6.1 Imaging 4.2.6.2 External Otitis and Necrotizing Otitis Externa 4.2.6.3 Acute Otitis Media 4.2.6.4 Mastoiditis 4.2.7 Complications of Acute Otomastoiditis 4.2.7.1 Coalescent Mastoiditis 4.2.7.2 Subperiosteal Abscess 4.2.7.3 Petrous Apicitis and Skull Base Involvement 4.2.7.4 Labyrinthitis 4.2.7.5 Intracranial Complications 4.2.8 Neck Infections 4.2.8.1 Imaging 4.2.8.2 Cervical Adenitis 4.2.8.3 Tonsillitis and Tonsillar/Peritonsillar Abscess 4.2.8.4 Retropharyngeal Phlegmon and Retropharyngeal Abscess References 5: Recurrent Respiratory Infections in Childhood: The Importance of Local Microbiota Modulation 5.1 Introduction 5.2 Conclusion References 6: Role of Allergy in ENT Infections 6.1 Introduction to Atopic Diseases 6.1.1 Allergic Rhinitis 6.1.2 Unified Airway Concept 6.2 Role of Allergy in Pediatric Otitis Media 6.3 Role of Allergy in Pediatric Rhinosinusitis 6.3.1 Allergy and Pediatric Acute Rhinosinusitis, Upper Respiratory Tract Infections 6.3.2 Allergy and Pediatric Chronic Rhinosinusitis 6.4 Role of Allergy in Pediatric and Adult Laryngitis 6.5 Conclusions and Future Needs References 7: Ear, Nose, and Throat Infections in Immunocompromised Children 7.1 Introduction 7.2 Primary Immunodeficiencies 7.3 Humoral Immunodeficiencies 7.3.1 Transient Hypogammaglobulinemia (THI) of the Infant 7.3.2 Common Variable Immune Deficiency (CVID) 7.3.3 X-Linked Agammaglobulinemia (XLA) 7.3.4 Selective IgA Deficiency (IgAD) 7.3.5 IgG Subclass Deficiency 7.3.6 Hyper-IgM Syndrome (HIgM) 7.4 Lack of Components 7.5 Phagocytosis Disorders 7.5.1 Myeloperoxidase Deficiency (MPO) 7.5.2 Chronic Granulomatous Disease (CGD) 7.5.3 Chediak-Higashi Disease (CHD) 7.5.4 Hyper-IgE Syndrome (HIgES) 7.6 Cellular Disorders 7.6.1 Di George Syndrome 7.6.2 Chronic Mucocutaneous Candidiasis (CMC) 7.6.3 T-Helper-1 Cytokine Signal Impairment 7.7 Primary Combined Immunodeficiencies 7.7.1 Severe Combined Immunodeficiency (SCID) 7.7.2 Wiscott-Aldrich Syndrome 7.8 Secondary Immunodeficiencies 7.8.1 Human immunodeficiency virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) 7.8.2 Secondary Immune Deficiencies Non-HIV Infection References 8: Immunization for Prevention of Ear, Nose, and Throat Infections in Children 8.1 Introduction 8.2 Measles, Mumps, Rubella, and Varicella Infections and Vaccines 8.2.1 Measles, Mumps, Rubella, and Varicella Infections 8.2.2 Measles, Mumps, Rubella, and Varicella Vaccines 8.3 Vaccination to Prevent Acute Otitis Media 8.4 Pneumococcal Vaccines 8.5 Haemophilus influenzae Type B Conjugate Vaccines 8.6 Pertussis Vaccines 8.7 Diphtheria Vaccines 8.8 Influenza Vaccines 8.9 Immunization to Prevent RSV Infection 8.10 Immunization Recommendations for Cochlear Implant Patients 8.10.1 Pneumococcal Vaccines 8.10.2 Haemophilus influenzae Type B Conjugate Vaccines 8.10.3 Influenza Vaccines References 9: The Role of Surgery in Protection and Treatment of Ear, Nose and Throat Infections 9.1 Introduction 9.2 Tonsillectomy 9.2.1 Structure and Function of the Tonsils 9.2.2 Effects of Tonsillitis and Tonsillectomy on Immunity 9.3 Adenoidectomy 9.3.1 Epidemiology and Incidence 9.3.2 Assessment for Adenoid Hypertrophy 9.3.3 Assessment for Adenoid Hypertrophy 9.3.4 Adenoidectomy for Chronic Rhinosinusitis in Children 9.4 Conclusion References 10: Communication with the Infected Child 10.1 Introduction 10.2 Infectious Diseases in Children 10.3 Communication with Parents 10.4 Communication with Children 10.4.1 Implications on Communication (Birth to 6 Years) 10.4.2 Implications of Communication for Middle Years (from 7 to 10 Years Old) 10.4.3 Implications for Communication in Early Adolescent Years (11 Through 14 Years) References Part II: Symptoms and Signs 11: Fever: Pathogenesis and Treatment 11.1 Introduction 11.2 Definition of Fever 11.2.1 Hyperthermia 11.3 Pathogenesis 11.4 Aetiology 11.4.1 Neonates 11.4.2 Young Infants 11.4.3 Children Aged Between 3 Months and 3 Years 11.5 History and Examination in Children 11.5.1 Neonates 11.5.2 Prenatal History 11.5.3 Household Contacts 11.5.4 Review of Systems and Physical Examination 11.5.5 History and Examination in Young Infants 11.5.5.1 Past Medical History and Household Contacts 11.5.5.2 Review of Systems and Physical Examination 11.5.6 History and Examination in Children Aged Between 3 Months and 3 Years 11.5.6.1 History of Presenting Complaint 11.5.6.2 Past Medical History 11.5.6.3 Family History 11.5.6.4 Social History and Household Contacts 11.5.6.5 Review of Systems and Physical Examination 11.6 Differential Diagnosis [18] 11.7 Diagnostic Studies 11.7.1 Urine and Stool Studies 11.7.2 Pulmonary Studies 11.8 Treatment 11.8.1 Antipyretic Agents 11.8.1.1 Indications 11.8.1.2 Paracetamol 11.8.1.3 Ibuprofen 11.8.2 External Cooling References 12: Headache in Children 12.1 Introduction 12.2 Temporal Pattern of Headaches 12.3 History and Clinical Examination 12.4 Diagnostic Procedures 12.4.1 Neuroimaging 12.4.2 Laboratory Investigations 12.4.3 Lumbar Puncture 12.4.4 Electroencephalography 12.5 Clinical Features 12.5.1 Migraine 12.5.2 Tension-Type Headache 12.5.3 Trigeminal Autonomic Cephalalgias 12.5.4 Secondary Headaches 12.6 Treatment 12.6.1 Secondary Headaches 12.6.2 Primary Headaches 12.7 Conclusion References 13: Otalgia: Pathogenesis, Diagnosis, and Treatment 13.1 Introduction 13.2 Pathophysiology 13.3 Epidemiology 13.4 Causes 13.4.1 The Primary Causes of Otalgia 13.4.2 Secondary Causes of Otalgia 13.5 Diagnosis 13.5.1 Background 13.5.2 Examination 13.5.3 Examination Tests 13.6 Treatment References 14: Otorrhea: Pathogenesis, Diagnosis, and Treatment 14.1 Introduction 14.2 Etiopathogenesis 14.2.1 Otorrhea of the Tympanostomy Tube 14.2.2 Foreign Body 14.2.3 Otitis Externa 14.2.4 Acute Otitis Media 14.2.5 Chronic Otitis Media 14.2.6 Trauma to the External Ear Canal 14.2.7 Polyps 14.2.8 Spontaneous Cerebral Spinal Fluid Otorrhea 14.3 Diagnosis 14.3.1 History 14.3.2 Examination 14.3.3 Culture of Ear Drainage 14.3.4 Testing for Cerebrospinal Fluid Otorrhea 14.3.5 Imaging 14.4 Treatment References 15: Hearing Loss 15.1 Aetiology 15.1.1 Genetic Causes 15.1.2 Prenatal Causes 15.1.3 Perinatal Causes 15.1.4 Postnatal Causes 15.1.5 Unknown Causes 15.2 Epidemiology 15.2.1 Age- and Sex-Related Demographics 15.3 High-Risk Criteria for Hearing Loss in Neonates and Infants 15.4 Indications for Auditory Assessment and Findings 15.5 Types of Auditory Impairment 15.6 Tests for Hearing Loss 15.6.1 Auditory Brainstem Response (ABR) and Brainstem Auditory Evoked Response (BAER) Testing 15.6.2 Otoacoustic Emission (OAE) Testing 15.6.3 Audiometry 15.7 Screening Programme for Neonatal Hearing Loss 15.7.1 Prevalence of Hearing Loss 15.7.2 Risk Factors 15.7.3 Early Identification and Intervention 15.7.4 Methods of Screening 15.7.5 Otoacoustic Emissions 15.7.6 Diagnostic Auditory Brainstem Response References 16: Vertigo and Dizziness in Children 16.1 Introduction 16.2 Definitions 16.3 Dizziness with Vertigo 16.4 Aetiology 16.4.1 Central Nervous System Infection 16.4.2 Intracranial Tumour or Abscess 16.4.3 Drug Overdose and Other Poisons 16.4.4 Otitis Media 16.4.5 Migraine Syndromes 16.4.6 Vestibular Neuritis 16.4.7 Benign Paroxysmal Vertigo of Childhood (BPVC) 16.4.7.1 Pathophysiology 16.4.7.2 Diagnosis 16.4.7.3 Treatment 16.4.8 Motion Sickness 16.4.9 Meniere’s Disease 16.4.10 Perilymphatic Fistula 16.5 Dizziness Without Vertigo (Pseudovertigo) References 17: Nasal Obstruction in Childhood 17.1 Introduction 17.2 Deviation of the Septum 17.2.1 Pathophysiology 17.3 Nasal Polyps 17.3.1 Pathophysiology 17.3.2 Aetiology 17.4 Prognosis 17.5 Pharmacological Management 17.5.1 Corticosteroids 17.6 Allergic Rhinitis 17.7 Investigations 17.7.1 Radiological investigations 17.7.2 Procedures 17.7.3 Therapy 17.7.4 Drug Treatment 17.7.5 Non-pharmacological Treatment References 18: Rhinorrhea: Pathogenesis, Diagnosis, and Treatment 18.1 Introduction 18.2 Etiology of the Rhinorrhea 18.2.1 Allergic Rhinitis (AR) 18.2.1.1 Diagnosis 18.2.1.2 Treatment Pharmacotherapy Nonpharmacotherapy Surgical Option 18.2.2 Chronic Non-allergic Rhinitis (NAR) 18.2.2.1 Pathogenesis 18.2.2.2 Diagnosis 18.2.2.3 Treatment 18.2.3 Sinusitis 18.2.3.1 Pathogenesis 18.2.3.2 Classification Acute Sinusitis (AS) Recurrent AS Subacute Sinusitis Chronic Sinusitis 18.2.3.3 Etiology 18.2.3.4 Diagnosis Examination Testing and Imaging 18.2.3.5 Treatment 18.3 Nasal Foreign Body (NFBs) 18.4 Diagnosis and Treatment of Rhinorrhea 18.4.1 Diagnosis 18.4.2 Treatment References 19: Dysphonia 19.1 Introduction 19.2 Definition 19.3 Vocal Cord Nodules 19.4 Acute Laryngitis 19.4.1 Causes 19.4.1.1 Signs and Symptoms of Acute Laryngitis 19.5 Vocal Cord Polyps/Vocal Cord Cysts 19.6 Recurring Papillomatosis 19.7 Gastro-oesophageal Reflux Disease (GORD) 19.7.1 Signs and Symptoms 19.7.2 Diagnosis 19.7.3 Procedures 19.7.4 Imaging Studies 19.7.5 (Electro)Physiological Studies 19.8 Management 19.8.1 Non-pharmacological Treatment 19.8.2 Drug Treatment 19.8.3 Surgery 19.9 Vocal Cord Paralysis References 20: Sore Throat 20.1 Introduction 20.2 Definition 20.3 Epidemiology and Risk Factors 20.4 Etiology 20.5 Clinical Findings 20.6 Diagnosis 20.6.1 Laboratory Evaluation 20.6.1.1 Throat Swabs 20.6.1.2 Throat Culture 20.6.1.3 Other Laboratory Tests 20.7 Treatment 20.7.1 Symptomatic Treatment 20.7.2 Antimicrobial Treatment References 21: Tonsillar Hypertrophy in Childhood 21.1 Introduction 21.2 Symptoms and Findings 21.3 Classification 21.4 Diagnosis and Clinical Importance References 22: Cervical Lymphadenopathy in Children 22.1 Introduction 22.2 Anamnesis 22.3 Clinical Examination 22.4 Infections 22.5 Immunological Diseases 22.6 Metabolic Diseases 22.7 Neoplastic Diseases 22.8 Laboratory Investigations 22.9 Imaging 22.10 Histological Examination 22.11 Etiological Differentiation in Pediatric Cervical Lymphadenopathy 22.12 Treatment of Common Bacterial Lymphadenitis 22.13 Conclusion References 23: Halitosis in Children Secondary to ENT Infections 23.1 Introduction 23.2 Aetiology 23.2.1 Intraoral Causes 23.2.2 Extraoral Causes 23.3 Distinguishing Between Halitosis of Intra-oral and Extra-oral Origin 23.4 ENT Infections and Halitosis 23.4.1 Tonsillitis 23.4.2 Gingivitis and Inadequate Mouth Hygiene 23.4.3 Sinus Infection 23.4.4 Nasal Foreign Body 23.4.5 Mouth Breathing 23.4.6 Malocclusion 23.4.7 Poor-Quality Dental Fillings and Dentures 23.5 Assessment of Halitosis 23.5.1 Direct Methods Used to Detect Halitosis 23.5.1.1 Organoleptic Detection 23.5.1.2 Gas Chromatographic Analysis 23.5.1.3 Portable Monitoring of Sulphides 23.5.2 Indirect Methods Used to Detect Halitosis 23.5.2.1 Benzoyl-DL-Arginine-Alpha-Naphthylamide (BANA) 23.5.2.2 Ammonia Monitoring 23.5.2.3 Ninhydrin Technique 23.5.2.4 Salivary Incubation Test 23.5.2.5 Quantification of Beta-Galactosidase Activity 23.5.2.6 Polymerase Chain Reaction 23.6 Conclusion References 24: Facial Paralysis in Children 24.1 Introduction 24.2 Etiology and Epidemiology 24.2.1 Idiopathic (Bell’s Palsy) 24.2.2 Congenital Causes 24.2.3 Melkersson-Rosenthal Syndrome 24.2.4 Moebius Syndrome 24.2.5 Albers-Schönberg Disease (Osteopetrosis) 24.2.6 Goldenhar Syndrome 24.2.7 Hereditary Congenital Facial Paresis 24.2.8 Infectious Causes 24.2.8.1 Herpes Simplex Virus (HSV) 24.2.8.2 Ramsay Hunt Syndrome 24.2.8.3 Lyme Disease 24.2.8.4 Human Immunodeficiency Virus (HIV) Infection 24.2.8.5 Facial Paralysis from Bacterial Infection 24.2.8.6 Cat Scratch Disease 24.2.9 Neoplastic Causes 24.2.10 Other Conditions 24.3 Diagnosis 24.3.1 History and Physical Examination 24.3.2 Laboratory Testing 24.3.3 Topographic Tests 24.3.4 Audiological Evaluation 24.3.5 Lumbar Puncture 24.3.6 Electrodiagnostic Studies 24.3.7 Imaging 24.4 Treatment 24.4.1 Drug Therapy 24.4.2 Surgery 24.5 Prognosis References 25: Snoring in Children 25.1 Introduction 25.2 Obstructive Sleep-Disordered Breathing and Clinical Entities 25.3 Epidemiology of Snoring in Children 25.4 Etiology of Snoring in Children 25.5 Pathogenesis and Mechanisms of Snoring 25.6 Evaluation of the Snoring Children 25.7 Diagnostic Approach to Snoring 25.8 Treatment of Snoring 25.8.1 Non-surgical Treatment Options 25.8.1.1 Corticosteroids/Leukotriene Receptor Antagonists 25.8.2 Weight Management 25.8.3 Continuous Positive Airway Pressure (CPAP) References 26: Dysphagia in Children 26.1 Introduction 26.2 Dysphagia in Children 26.3 The Physiology of Healthy Deglutition 26.3.1 Mouth (Oral) Stage 26.3.2 Pharyngeal Stage 26.3.3 Oesophageal Stage 26.4 Stomatitis 26.5 Infectious Pharyngitis 26.6 Quinsy 26.7 Epiglottitis 26.8 Retropharyngeal Abscess 26.9 Diphtheria 26.10 Stevens-Johnson Syndrome 26.11 Tetanus 26.12 Cornelia de Lange Syndrome (CdLS) References 27: Cough in Children 27.1 Introduction 27.2 Pathophysiology 27.3 Definition of Cough 27.3.1 Acute Cough 27.3.1.1 Diagnostic Evaluation of Acute Cough 27.3.2 Subacute Cough 27.3.3 Chronic Cough 27.3.3.1 Specific Cough 27.3.3.2 Nonspecific Cough 27.3.3.3 Wet-Moist-Productive Cough and Dry Cough 27.4 Common Etiologies of Chronic Cough 27.4.1 Asthma 27.4.2 Upper Airways Disorders 27.4.3 Gastroesophageal Reflux Disease and Laryngopharyngeal Reflux 27.4.4 Airway Lesions 27.4.5 Recurrent Respiratory Tract Infections and Postinfectious Cough 27.4.6 Protracted Bacterial Bronchitis 27.4.7 Bronchiectasis 27.4.8 Primary Ciliary Dyskinesia 27.4.9 Cystic Fibrosis 27.4.10 Foreign Body Aspiration 27.4.11 Environmental Pulmonary Toxins 27.4.12 Psychogenic Cough 27.4.13 Drug-Induced Cough 27.4.14 Cardiac Causes 27.4.15 Otogenic Causes: Stimulation of Arnold Nerve 27.4.16 Thoracic Tumors 27.5 Diagnostic Evaluation of Chronic Cough 27.6 Treatment 27.6.1 Treatment of Nonspecific Cough 27.6.1.1 Watchful Observation 27.6.1.2 Drugs Used for Cough Over the Counter Cough Medications Asthma Treatment Antibiotics Gastroesophageal Reflux Treatment Treatments for Nasal Symptoms 27.7 Conclusion References 28: Chronic Cough in Children 28.1 Introduction 28.2 Epidemiology 28.3 Differences Between Chronic Cough in Children and in Adults 28.4 Initial Assessment of a Chronic Cough in Children 28.5 Phenotypes of Chronic Cough in Children 28.5.1 Postnasal Drip Syndrome/Upper Airways Cough Syndrome 28.5.2 Cough in Asthma 28.5.3 Gastro-oesophageal Reflux Disease (GORD) and Cough in Children 28.5.4 Post-viral Cough 28.5.5 Productive (Moist or Wet) Cough 28.5.6 “Habitual” Cough 28.5.7 Irritant Cough 28.6 Treatment References 29: Wheezing in Children 29.1 Introduction 29.2 Aetiology 29.2.1 Infection 29.2.2 Foreign Body (FB) Aspiration 29.2.3 Structural Causes 29.2.4 Functional (Nonstructural) Causes 29.3 Evaluation and Differential Diagnosis 29.4 Physical Examination 29.5 Imaging 29.6 Laboratory Investigations of Value in Establishing a Differential Diagnosis 29.6.1 Sputum Staining and Culture 29.6.2 Sweat Chloride Test 29.6.3 Endoscopy 29.7 Treatment References 30: Persistent Wheezing in Children 30.1 Introduction 30.2 Etiology 30.2.1 Abnormalities of the Tracheobronchial Tree 30.2.2 Mediastinal Masses 30.2.3 Retained Foreign Body Aspiration 30.2.4 Cardiovascular Disease 30.2.5 Asthma 30.2.6 Aspiration Syndromes 30.2.7 Swallowing Disorders 30.2.8 Bronchopulmonary Dysplasia 30.2.9 Vocal Cord Dysfunction (VCD) 30.2.10 Bronchiolitis Obliterans 30.2.11 Cystic Fibrosis (CF) 30.2.12 Primary Ciliary Dyskinesia (PCD) 30.2.13 Primary Immunodeficiencies 30.3 Evaluation of a Child with Persistent/Recurrent Wheezing 30.4 Conclusion References Part III: Infections 31: Pediatric Otitis Externa 31.1 Introduction 31.2 Anatomy 31.3 Pathogenesis and Definition 31.4 Epidemiology 31.5 Etiology-Predisposing Factors 31.6 Microbiology 31.7 Diagnosis and Staging 31.8 Differential Diagnosis 31.9 Medical Treatment 31.9.1 Pain Management 31.9.2 Topical Therapy 31.9.3 Topical Therapy in Nonintact Tympanic Membrane 31.9.4 Systemic Antimicrobials 31.10 Surgical Treatment References 32: Otitis Media in Infants 32.1 Introduction 32.2 Risk Factors 32.2.1 Race and Ethnicity 32.2.2 Respiratory Infections and Exposure to Other Children 32.2.3 Lack of Breastfeeding 32.2.4 Exposure to Passive Smoke and Pollutants 32.2.5 Genetics 32.2.6 Prenatal and Perinatal Factors 32.2.7 Laterality 32.2.8 Atopy and Allergic Disease 32.2.9 Pacifier Use 32.3 Microbiology 32.4 Diagnosis 32.4.1 History 32.4.2 Otoscopic Examination and Tympanometry 32.4.3 Acoustic Reflectometry 32.5 Antibiotic Therapy 32.6 Conclusion References 33: Acute Otitis Media 33.1 Introduction 33.2 Pathophysiology 33.2.1 Microbiology 33.2.1.1 Viral Origin 33.2.1.2 Bacterial Origin 33.2.2 Risk Factors 33.2.2.1 Age, Gender, and Daycare Attendance 33.2.2.2 Immune System and Anatomy 33.2.2.3 Allergy and Gastroesophageal Reflux Disease 33.2.2.4 Genetics 33.2.2.5 Feeding and Exposure to Smoking 33.3 Clinical Manifestations of AOM and Examinations 33.4 Treatment 33.5 Complications 33.6 Prevention References 34: Mastoiditis 34.1 Introduction 34.2 Pathogenesis 34.3 Signs and Symptoms 34.4 Microbiology 34.5 Diagnosis 34.6 Complications 34.6.1 Infratemporal (Extracranial) Complications 34.6.1.1 Labyrinthitis 34.6.1.2 Petrositis 34.6.1.3 Facial Paresis/Paralysis 34.6.2 Intracranial (Extratemporal) Complications 34.6.2.1 Extradural Abscess 34.6.2.2 Meningitis 34.6.2.3 Subdural Abscess 34.6.2.4 Brain Abscess 34.6.2.5 Lateral Sinus Thrombophlebitis 34.6.2.6 Otitic Hydrocephalus 34.7 Follow-Up and Treatment 34.8 Subacute (Masked) Mastoiditis 34.9 Mastoiditis in Patients with Cochlear Implant References 35: Labyrinthitis 35.1 Introduction 35.2 Anatomy 35.3 Viral and Bacterial Pathogens Responsible for Labyrinthitis 35.4 Classification 35.4.1 Viral Labyrinthitis 35.4.2 Bacterial Labyrinthitis 35.4.3 Suppurative Labyrinthitis 35.4.4 Serous Labyrinthitis 35.4.5 Autoimmune Labyrinthitis 35.5 Prognosis 35.6 Diagnosis 35.6.1 History 35.6.2 Physical Examination 35.6.3 Imaging Studies 35.6.3.1 CT Scanning 35.6.3.2 Magnetic Resonance Imaging (MRI) 35.6.3.3 Audiological Test 35.6.3.4 Vestibular Testing 35.7 Treatment 35.7.1 Viral Labyrinthitis 35.7.2 Bacterial Labyrinthitis 35.7.3 Surgical Care References 36: Common Cold in Children 36.1 Introduction 36.2 Definition 36.3 Pathogenesis 36.4 Aetiology 36.5 Epidemiology 36.6 Symptoms 36.7 Diagnosis 36.8 Treatment 36.8.1 Antiviral Treatment 36.8.2 Symptomatic Therapy References 37: Rhinitis in Children 37.1 Introduction 37.2 Principal Causes of Rhinitis 37.3 Symptoms of Rhinitis 37.4 Specific Disorders Producing Rhinitis 37.4.1 Allergic Rhinitis 37.4.1.1 Epidemiology 37.4.1.2 Physical Findings 37.4.1.3 Diagnostic Tests Cutaneous Prick Testing Total Serum IgE Total Circulating Eosinophils Nasal Provocation (Allergen Challenge) Testing 37.4.1.4 Treatment Pharmacotherapy Immunotherapy 37.4.2 Non-allergic Rhinitis 37.4.2.1 Rhinitis Due to Infection 37.4.2.2 Vasomotor Rhinitis 37.4.2.3 Occupational Rhinitis 37.4.2.4 Hormone-Related Rhinitis 37.4.2.5 Medication-Related Rhinitis 37.4.2.6 Gustatory Rhinitis 37.4.2.7 Non-allergic Rhinitis with Eosinophilia Syndrome (NARES) 37.4.2.8 Treatment Anticholinergics Intranasal Steroids Antihistamines Sympathomimetic Agents Prescribing for Children References 38: Acute Rhinosinusitis in Children 38.1 Introduction 38.2 Pathophysiology 38.3 Causes 38.4 Signs and Symptoms of Acute Sinusitis 38.5 Diagnosis 38.5.1 History 38.5.2 Physical Examination 38.6 Treatment 38.6.1 Antibiotics 38.6.1.1 Irrigation 38.6.1.2 Decongestants and Antihistamines 38.6.1.3 Immunotherapy 38.6.1.4 Optimization of Associated Medical Conditions References 39: Pediatric Chronic Rhinosinusitis 39.1 Introduction 39.2 Definition and Classification 39.3 Pathophysiology and Microbiology 39.4 Diagnostic Methods 39.5 Treatment 39.6 Medical Treatment 39.7 Surgical Treatment 39.7.1 Adenotomy/Adenoidectomy (AT) 39.7.2 Adenoidectomy and Antral Lavage 39.7.3 Functional Endoscopic Sinus Surgery 39.8 Conclusion References 40: Complications of Rhinosinusitis 40.1 Introduction 40.2 Preseptal Cellulitis 40.2.1 Orbital Septum 40.2.2 Aetiology 40.2.3 Risk Factors 40.2.4 Clinical Presentation 40.2.5 Physical Examination 40.2.6 Staging [21] 40.2.7 Treatment 40.3 Orbital Cellulitis 40.3.1 Anatomy 40.3.2 Aetiology 40.3.3 Traumatic Causes 40.3.4 Bacterial Causes 40.3.5 Fungal Causes 40.3.6 Prognosis 40.3.7 Physical Examination 40.3.8 Treatment 40.4 Intracranial Complications 40.4.1 Cavernous Sinus Thrombosis References 41: Nasal and Paranasal Sinus Infections in Children with Cystic Fibrosis 41.1 Introduction 41.2 Sinonasal Manifestations in Cystic Fibrosis 41.3 Clinical Evaluation 41.4 Physical Assessment 41.5 Diagnosis 41.5.1 CT Imaging 41.5.2 Nitric Oxide 41.6 Treatment 41.6.1 Nasal Douching 41.6.2 Antimicrobial Pharmacotherapy 41.6.3 Corticosteroids 41.6.4 Other Therapies 41.6.5 Surgery 41.6.6 Gene Therapy References 42: Oral Candidiasis in Infants and Children 42.1 Introduction 42.2 Pathophysiology 42.2.1 Chronic Mucocutaneous Candidiasis (CMC) 42.3 Risk Factors 42.4 Aetiology 42.5 Differential Diagnosis 42.6 Diagnosis 42.6.1 History 42.6.2 Physical Examination 42.6.2.1 Differentiation Between Oral Candidiasis and Tongue Coating 42.6.2.2 Acute Pseudomembranous Candidiasis (Thrush) 42.6.2.3 Chronic Hyperplastic Candidiasis 42.6.2.4 Acute Atrophic (Erythematous) Candidiasis 42.6.2.5 Chronic Atrophic Candidiasis (Denture Stomatitis) 42.6.2.6 Angular Stomatitis (perlèche, Angular Cheilitis) 42.6.2.7 Median Rhomboid Glossitis (Glossal Central Papillary Atrophy) 42.6.3 Tests 42.6.4 Histological Appearances 42.7 Medical Treatment 42.7.1 Pharmacotherapy 42.7.2 Nystatin (Mycostatin, Nilstat, Nystex) 42.7.3 Amphotericin B Deoxycholate (Fungizone Oral Suspension) 42.7.4 Clotrimazole (Mycelex Troches) 42.7.5 Miconazole Oral (Daktar) 42.7.6 Gentian Violet 42.7.7 Fluconazole (Diflucan) 42.8 Complications References 43: Parotitis in Children 43.1 Introduction 43.2 Suppurative Parotitis 43.2.1 Suppurative Parotitis: Pathogenesis 43.2.2 Suppurative Parotitis: Clinical Manifestations 43.2.3 Suppurative Parotitis: Diagnosis 43.2.4 Suppurative Parotitis: Treatment 43.2.5 Suppurative Parotitis: Complications 43.3 Nonsuppurative Parotitis 43.3.1 Juvenile Recurrent Parotitis 43.3.2 Chronic Recurrent Parotitis 43.3.3 Nonsuppurative Parotitis: Miscellaneous Causes 43.4 Mumps and Other Viral Causes of Acute Parotitis 43.4.1 Mumps: Epidemiology 43.4.2 Mumps: Clinical Manifestations 43.4.3 Mumps: Complications 43.4.3.1 Orchitis and Epididymitis 43.4.3.2 Oophoritis 43.4.3.3 Mumps: Neurologic Complications 43.4.3.4 Mumps: Sensorineural Hearing Loss 43.4.3.5 Mumps: Pancreatitis 43.4.3.6 Mumps: Cardiac Involvement 43.4.3.7 Mumps: Other Complications 43.4.4 Mumps: Diagnosis 43.4.5 Mumps: Treatment 43.4.6 Mumps: Prevention References 44: Acute Tonsillopharyngitis in Children 44.1 Introduction 44.2 Aetiology 44.3 Epidemiology 44.4 Symptoms 44.5 Diagnosis 44.5.1 Examination 44.5.2 Investigations 44.6 Treatment 44.6.1 Medical Treatment 44.6.1.1 Timing of Therapy 44.6.1.2 Antibiotics for Group A Streptococcus 44.6.2 Surgery 44.6.2.1 Tonsillectomy Indications References 45: Chronic Tonsillopharyngitis 45.1 Introduction 45.2 Epidemiology 45.3 Pathophysiology 45.4 Biofilms 45.5 Recurrent and Chronic Tonsillitis 45.6 Physical Examination 45.7 Treatment 45.7.1 Tonsillectomy References 46: Peritonsillar Abscess in Children 46.1 Introduction 46.2 Clinical Presentation 46.3 Diagnosis 46.4 Treatment and Complications 46.4.1 Medical Treatment 46.4.2 Surgical Treatment 46.4.3 Complications References 47: Retropharyngeal and Parapharyngeal Abscesses in Children 47.1 Introduction 47.1.1 Retropharyngeal Space 47.1.2 Parapharyngeal Space 47.2 Etiology 47.2.1 Microbiology 47.3 History and Examination Findings 47.3.1 Retropharyngeal Infection 47.3.2 Parapharyngeal Infection 47.4 Laboratory Tests 47.5 Imaging Techniques 47.5.1 Conventional X-Rays 47.5.2 Computed Tomography 47.5.3 Ultrasonography 47.5.4 Magnetic Resonance Imaging 47.6 Treatment 47.6.1 Medical Treatment 47.6.2 Surgical Treatment: Indications, Predictive Factors, Preoperative Assessment, and Methods 47.7 Complications References 48: Uvulitis in Children 48.1 Introduction 48.2 Epidemiology 48.3 Etiology 48.4 Pathogenesis 48.5 Clinical Manifestations 48.6 Diagnosis 48.7 Differential Diagnosis 48.8 Treatment References 49: Epiglottitis (Supraglottitis) 49.1 Introduction 49.2 Epidemiology 49.3 Etiology 49.4 Clinical Course 49.5 Diagnosis 49.6 Differential Diagnosis 49.7 Complications 49.8 Treatment References 50: Laryngitis, Laryngotracheitis (Croup), and Bacterial Tracheitis in Children 50.1 Introduction 50.2 Laryngitis 50.3 Laryngotracheitis (Croup) 50.3.1 Epidemiology 50.3.2 Etiology 50.3.3 Clinical Features and Diagnosis 50.3.4 Differential Diagnosis 50.3.5 Complications 50.3.6 Treatment 50.3.6.1 Nebulized Epinephrine 50.3.6.2 Corticosteroids 50.3.6.3 Other Treatment Modalities 50.4 Bacterial Tracheitis 50.4.1 Epidemiology 50.4.2 Clinical Manifestation 50.4.3 Diagnosis 50.4.4 Treatment References 51: HPV-Related Recurrent Respiratory Papillomatosis in Childhood 51.1 Introduction 51.2 Microbiology 51.3 Background 51.4 HPV Infection of the Larynx in Neonates and Children 51.5 Effective Methods by Which the Uptake of HPV Vaccination in Adolescents Can Be Increased 51.6 Treatment 51.6.1 Surgical 51.6.2 Adjuvant Treatments 51.7 Future Perspectives References 52: Odontogenic İnfections in Children 52.1 Introduction 52.2 Clinical Manifestations of Odontogenic Infections in Children 52.3 Clinical Presentation of Odontogenic Infections Varies by Location 52.4 Microbiology and Treatment Principles 52.5 Management of Odontogenic Infections in Children 52.6 Special Conditions 52.6.1 Ludwig’s Angina 52.6.2 The Periapical Infection 52.6.3 Pericoronitis 52.6.4 Dental Abscess 52.6.5 Facial Cellulitis 52.7 Complications of Odontogenic Infections 52.8 Conclusions References 53: Neck Infections in Children 53.1 Introduction 53.2 Suppurative Cervical Adenitis in Children 53.2.1 Acute Viral Lymphadenitis 53.2.2 Acute Bacterial Lymphadenitis 53.2.3 Mycobacterial Lymphadenitis 53.2.4 Cat Scratch Disease 53.2.5 Other Infections 53.3 Peritonsillar Cellulitis and Abscess 53.4 Paediatric Retropharyngeal Infections 53.5 Parapharyngeal Abscess 53.6 Other Cervical Infections 53.6.1 Suppurative Thyroiditis 53.6.2 Infected Embryological Remnant Cysts 53.6.3 Infections Following Bites, Injury, Radiation Exposure or Operative Injury References 54: Infections of Congenital Neck Masses 54.1 Introduction 54.2 Cysts of the Thyroglossal Duct 54.2.1 Management by Surgery 54.3 Branchial Cleft Cysts 54.3.1 Specific Features of Cysts from Each Level 54.3.1.1 First Branchial Cleft Cyst 54.3.1.2 Second Branchial Cleft Cyst 54.3.1.3 Third Branchial Cleft Cyst 54.3.1.4 Fourth Branchial Cleft Cyst 54.3.2 Evaluation and Treatment 54.4 Dermoid Cyst 54.4.1 Aetiology and Epidemiology 54.4.2 Pathophysiology 54.4.3 Evaluation and Treatment 54.5 Macrocystic Lymphatic Malformations References Part IV: Miscellaneous 55: Pediatric Ear, Nose, and Throat Field Infectious Disease Emergencies 55.1 Introduction 55.2 Acute Pharyngitis 55.2.1 Definition and Etiology 55.3 Viral Pharyngitis 55.3.1 Definition and Etiology 55.3.2 Treatment 55.3.3 Helpful Measures 55.3.4 Analgesia 55.3.5 Complications 55.4 Bacterial Pharyngitis 55.4.1 Definition and Etiology 55.4.2 Diagnosis 55.4.3 Treatment 55.4.4 Complications 55.5 Uvulitis 55.5.1 Definition and Etiology 55.5.2 Diagnosis 55.5.3 Treatment 55.6 Epiglottitis 55.6.1 Definition and Etiology 55.6.2 Diagnosis 55.6.3 Treatment 55.7 Peritonsillar Abscess 55.7.1 Definition and Etiology 55.7.2 Diagnosis 55.7.3 Treatment 55.7.4 Complications 55.8 Retropharyngeal Abscess 55.8.1 Definition and Etiology 55.8.2 Diagnosis 55.8.3 Treatment 55.8.4 Complications 55.9 Ear Infections 55.9.1 Acute Otitis Media 55.9.2 Diagnosis 55.9.3 Tympanic Membrane Findings 55.9.4 Other Findings 55.9.5 Treatment 55.10 Nasal Infections 55.11 Acute Bacterial Rhinosinusitis (ABRS) 55.11.1 Diagnosis 55.12 Complicated ABRS 55.12.1 Treatment 55.12.2 Complications References 56: Oropharyngeal Manifestations of Common Viral Exanthems and Systemic Infectious Diseases in Children 56.1 Introduction 56.2 Measles 56.3 Rubella 56.4 Mumps 56.5 Roseola Infantum 56.6 Herpes Simplex Virus (HSV) Infections 56.7 Varicella (Chickenpox) 56.8 Epstein-Barr Virus (EBV) Infection 56.9 Non-poliovirus Enteroviral Infections 56.10 Human Papillomavirus (HPV) Infections 56.11 Human Immunodeficiency Virus (HIV) Infection 56.12 Conclusion References 57: Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis Syndrome (PFAPA Syndrome) 57.1 Introduction 57.2 Epidemiology 57.3 Etiopathogenesis 57.4 Clinical Signs 57.5 Diagnostic Criteria 57.6 Diagnosis 57.7 Differential Diagnosis 57.8 Adults PFAPA 57.9 Treatment 57.10 Prognosis References 58: Preseptal Cellulitis and Other Facial Skin Infections in Children 58.1 Introduction 58.2 Preseptal (Periorbital) Cellulitis 58.2.1 Post-traumatic Preseptal Cellulitis 58.2.2 Nontraumatic Preseptal Cellulitis 58.2.3 Treatment of Preseptal Cellulitis 58.3 Other Facial Skin Infections 58.3.1 Impetigo 58.3.1.1 Nonbullous Impetigo 58.3.1.2 Bullous Impetigo 58.3.2 Folliculitis 58.3.3 Furuncles and Carbuncles 58.3.4 Erysipelas 58.3.5 Facial Cellulitis 58.3.6 Necrotizing Fasciitis 58.3.7 Molluscum Contagiosum 58.3.8 Herpes Simplex Virus Infections 58.3.9 Varicella-Zoster Virus (VZV) Infections 58.3.10 Tinea Faciei 58.3.11 Seborrheic Dermatitis 58.3.12 Tuberculosis of the Skin 58.4 Conclusion References 59: Tuberculosis in the Ear, Nose, and Throat Field in Children 59.1 Introduction 59.2 Tuberculous Lymphadenitis 59.3 Tuberculosis of the Ear and Mastoids 59.4 Laryngeal Tuberculosis 59.5 Tuberculosis of the Nasopharynx and Paranasal Sinuses 59.6 Tuberculosis of the Oral Cavity 59.7 Tuberculosis of the Salivary Glands 59.8 Tuberculosis of the Thyroid Gland 59.9 Conclusion References 60: Cervical Lymphadenitis due to Nontuberculous Mycobacterial Infection in Children 60.1 Introduction 60.2 Microbiology and Epidemiology 60.3 Pathogenesis 60.4 Clinical Features 60.5 Radiographic Features 60.6 Laboratory Features 60.7 Diagnosis 60.8 Differential Diagnosis 60.9 Management 60.10 Conclusion References 61: Influenza in Children 61.1 Introduction 61.2 Etiology 61.3 Pathogenesis 61.4 Epidemiology 61.5 Clinical Features 61.6 Diagnosis 61.7 Treatment 61.8 Influenza Vaccines References 62: Pertussis in Children 62.1 Introduction 62.2 Etiology 62.3 Epidemiology 62.4 Pathogenesis 62.5 Clinical Manifestations 62.6 Complications 62.7 Differential Diagnosis 62.8 Diagnosis and Laboratory Findings 62.9 Treatment 62.10 Prognosis 62.11 Prevention and Control 62.12 Conclusion References 63: Diphtheria in Children 63.1 Introduction 63.2 Pathogen 63.3 Epidemiology 63.4 Pathogenesis and Pathology 63.5 Clinical Manifestations 63.5.1 Nasal Diphtheria 63.5.2 Pharyngeal and Tonsillar Diphtheria 63.5.3 Pharyngeal and Laryngeal Diphtheria 63.6 Diagnosis 63.7 Differential Diagnosis 63.8 Prevention 63.9 Treatment 63.10 Prognosis References 64: Oropharyngeal Tularemia in Children 64.1 Introduction 64.2 Etiology and Epidemiology 64.3 Clinical Manifestations 64.4 Differential Diagnosis 64.5 Laboratory Findings and Diagnosis 64.6 Treatment and Prognosis 64.7 Prevention 64.8 Conclusion References 65: Cervicofacial Actinomycosis in Children 65.1 Introduction 65.2 Microbiology 65.3 Epidemiology 65.4 Pathogenesis 65.5 Clinical Manifestations 65.6 Diagnosis 65.6.1 Gram and Acid-Fast Stains 65.6.2 Culture 65.6.3 Histopathology 65.6.4 Monoclonal Antibody Staining, Molecular Techniques, and Serology 65.6.5 Imaging 65.7 Differential Diagnosis 65.8 Treatment 65.8.1 Medical Therapy 65.8.2 Surgical Treatment 65.9 Prevention References 66: Cervicofacial Nocardiosis in Children 66.1 Introduction 66.2 Etiology 66.3 Epidemiology 66.4 Pathogenesis 66.5 Clinical Manifestations 66.6 Diagnosis and Laboratory Tests 66.7 Management 66.7.1 Antimicrobial Treatment 66.7.2 Treatment of Cervicofacial Nocardiosis 66.7.3 Treatment of Mycetoma 66.7.4 Treatment of Disseminated Disease and Nocardiosis in Immunosuppressed Patients 66.7.5 Surgical Management 66.8 Prognosis and Prevention References 67: Anthrax in the Ear, Nose, and Throat Area in Children 67.1 Introduction 67.2 Etiology 67.3 Epidemiology 67.4 Pathogenesis 67.5 Clinical Presentation 67.5.1 Cutaneous Anthrax 67.5.2 Oropharyngeal Anthrax 67.5.3 Gastrointestinal Anthrax 67.5.4 Inhalational Anthrax 67.5.5 Injection Anthrax 67.6 Laboratory Diagnosis 67.7 Treatment 67.8 Prognosis 67.9 Infection Control in Hospital Settings 67.10 Prevention 67.10.1 Vaccine References 68: COVID19 Pandemic and Children 68.1 Introduction 68.2 Epidemiology 68.3 Etiology and Pathogenesis 68.4 Clinical Characteristics 68.5 Diagnosis and Diagnostic Tests 68.6 Treatment 68.7 Prognosis 68.8 Conclusion References 69: Ophthalmological Perspective on Pediatric Ear, Nose, and Throat Infections 69.1 Introduction 69.2 Ophthalmological Evaluation 69.2.1 Evaluation of Vision 69.2.2 External Examinations (Palpebrae, Orbit, Periorbita, Lacrimal Apparatus) 69.2.3 Ocular Motility and Ocular Alignment 69.2.4 Cornea and Conjunctivae 69.2.5 Pupils 69.2.6 Ophthalmoscopic Examination of the Posterior Segment 69.2.7 Examination of the Cranial Nerves Associated with Orbital Structures [31, 32] 69.3 Ophthalmological Manifestations of Infectious Sinonasal Diseases 69.3.1 Bacterial Paranasal Sinusitis 69.3.2 Orbital Complications 69.3.3 Intracranial Complications 69.4 Other Ophthalmological Signs/Complications Secondary to Acute Bacterial Rhinosinusitis 69.4.1 Other Infectious Sinonasal Diseases 69.5 Ophthalmological Manifestations of Infectious Diseases of the Ear and Related Structures 69.5.1 Otitis Media and Facial Paralysis 69.5.2 Infectious Causes of Pediatric Facial Paralysis Other than Otitis Media 69.5.3 Other Ophthalmological Manifestations Associated with Otitis Media 69.6 Ophthalmological Manifestations of Oral Cavity, Pharynx, Upper Airway, and Neck Infections 69.6.1 Pharyngoconjunctival Fever 69.6.2 Parinaud’s Oculoglandular Syndrome 69.6.3 Other Viral Diseases that Manifest with Conjunctivitis and Lymphadenopathy 69.6.4 Leptospirosis 69.6.5 Chlamydia Trachomatis Infection References 70: Foreign Bodies in Children as a Cause of Infection Seen in ENT Practice 70.1 Introduction 70.2 Foreign Bodies in the Nose 70.2.1 Diagnosis 70.2.2 Treatment 70.3 Foreign Bodies in the Ear Canal 70.4 Foreign Body Aspiration in Children 70.5 Conclusion References 71: Infections After Cochlear Implantation 71.1 Introduction 71.2 Acute Otitis Media 71.3 Mastoiditis 71.4 Chronic Suppurative Otitis Media and Cholesteatom 71.5 Meningitis 71.6 Wound Site Infection (Biofilm) 71.7 Biofilm 71.8 Conclusion References 72: Travel-Related Paediatric ENT Infections 72.1 Introduction 72.2 Malaria 72.2.1 Clinical Manifestations 72.2.2 Management 72.3 Leishmaniasis 72.4 HIV Infection and Paediatric ENT 72.4.1 ENT Manifestations of HIV in Children 72.4.2 Ear Problems 72.5 High Altitude Sickness Amongst Children 72.5.1 Clinical Manifestations 72.5.2 Diagnosis and Treatment 72.5.3 Prevention and Prophylactic Drug Treatment 72.5.3.1 Diagnosis 72.5.3.2 Treatment 72.6 Epistaxis and Rhinitis 72.7 Respiratory Tract Infections and Nasal Obstruction 72.8 High Altitude Periodic Breathing of Sleep References 73: Tracheotomy in Children 73.1 Introduction 73.2 History of Pediatric Tracheotomy 73.3 Indications, Technique, and Complications of Pediatric Tracheotomy 73.4 Postoperative Care of Pediatric Tracheotomy 73.5 Conclusion References 74: Gastroesophageal Reflux and Respiratory Diseases in Children 74.1 Introduction 74.2 GER Evaluation in Children with Respiratory Disorders 74.3 GERD and Respiratory Symptoms/Disorders 74.4 GERD and Apnea 74.5 Treatment of GER-Related Respiratory Symptoms/Disorders 74.6 Conclusion References 75: Obstructive Sleep Apnea in Children: ENT Perspective 75.1 Introduction 75.2 Epidemiology 75.3 Etiology and Pathogenesis 75.4 Clinical Findings 75.4.1 Nighttime Symptoms 75.4.2 Daytime Symptoms 75.4.3 History 75.4.4 Clinical Examination 75.5 Imaging 75.6 Pulse Oximeter 75.7 PSG 75.8 Treatment 75.8.1 Nonsurgical Treatment 75.8.2 Surgical Treatment References 76: Neurobehavioral Consequences of Obstructive Sleep Apnea Syndrome in Children 76.1 Introduction 76.2 Neuropathogenesis of OSAS 76.3 Excessive Daytime Sleepiness 76.4 Neurobehavioral Consequences of OSAS 76.5 Effects of OSAS Treatment on Morbidity from Central Nervous System 76.6 Conclusion References Part V: Lower Airway Diseases Related to Pediatric Ear, Nose, and Throat Infections 77: Acute Bronchiolitis in Children 77.1 Introduction 77.2 Epidemiology 77.3 Risk Factors 77.4 Pathogenesis 77.5 Etiology 77.6 Diagnosis 77.6.1 History and Physical Examination 77.6.2 Diagnostic Tests 77.7 Management: Non-Pharmacological 77.7.1 Respiratory Support 77.7.1.1 Monitoring and Supplemental Oxygen 77.7.1.2 High-Flow Nasal Cannula (HFNC) and Continuous Positive Airway Pressure (CPAP) 77.7.2 Nutrition and Hydration 77.7.3 Nasal Suction 77.7.4 Chest Physiotherapy 77.8 Management: Pharmacological 77.8.1 Bronchodilators 77.8.2 Hypertonic Saline 77.8.3 Corticosteroids 77.8.4 Antibiotics 77.9 Prognosis 77.10 Prevention 77.11 Conclusion References 78: Acute Bronchitis and Protracted Bacterial Bronchitis in Children 78.1 Acute Bronchitis 78.1.1 Introduction 78.1.2 Diagnosis 78.1.3 Treatment of Acute Bronchitis 78.2 Protracted Bacterial Bronchitis (PBB) 78.2.1 Introduction 78.2.2 Definitions 78.2.3 Treatment of Protracted Bacterial Bronchitis References 79: Pneumonia in Children 79.1 Introduction 79.2 Aetiology 79.2.1 Viral–Bacterial Interaction 79.3 Diagnosis 79.4 Treatment 79.4.1 Outpatient Management 79.4.2 Inpatient Management 79.4.2.1 Prevention References 80: Diagnosis of Asthma in Children 80.1 Introduction 80.2 Evaluation and Diagnosis 80.2.1 Confirming the Diagnosis of Asthma 80.3 Conclusion References 81: Treatment of Asthma in Children 81.1 Introduction 81.2 Pharmacological Treatment 81.2.1 Inhaled Corticosteroids 81.2.2 Long-Acting Bronchodilators 81.2.3 Long-Acting Muscarinic Antagonists 81.2.4 Leukotriene Modifying Agents 81.2.5 Theophylline 81.2.6 Biologic Agents 81.3 Allergen Immunotherapy 81.4 Environmental Control 81.5 Psychosocial Factors 81.6 Physical Activity and Diet 81.7 Treatment of Acute Asthma Exacerbation in Children 81.7.1 Treatment at Home 81.7.2 Management in Office or Emergency Service 81.7.3 Management in Hospital References 82: Infections of Cervicothoracic Cystic Hygroma and Other Congenital Malformations in Children 82.1 Introduction 82.2 Embryologic Mechanism 82.3 Clinical Features and Diagnosis 82.4 Treatment Modalities 82.4.1 Infections of Cervicothoracic Cystic Hygroma 82.5 Thyroglossal Duct Cyst 82.5.1 Embryologic Mechanism 82.5.2 Clinical Features and Diagnosis 82.5.3 Treatment Modalities 82.5.4 Infections of Thyroglossal Ductus Cyst 82.6 Branchial Cleft Cysts/Sinuses/Fistulae 82.6.1 Embryologic Mechanism 82.6.2 Clinical Features, Diagnosis, and Treatment 82.6.3 First Branchial Cleft Anomalies 82.6.4 Second Branchial Cleft Anomalies 82.6.5 Third and Fourth Branchial Cleft Anomalies 82.6.6 Infections of Branchial Anomalies 82.7 Cervical Teratoma/Dermoid Cysts 82.7.1 Clinical Features and Diagnosis 82.7.2 Treatment Modalities 82.7.3 Infections of Cervical Teratoma and Dermoid Cysts 82.8 Thymic Anomalies/Cyst 82.8.1 Clinical Features and Diagnosis 82.8.2 Treatment Modalities 82.8.3 Infections References Part VI: Treatment Strategies 83: Principles of Appropriate Antimicrobial Therapy and Antibacterial Agents for Pediatric Ear, Nose, and Throat Infections 83.1 Introduction 83.2 Pharmacokinetics and Pharmacodynamics of Antimicrobial Drugs 83.3 Classification of Antibacterial Agents 83.3.1 Form of Action 83.3.2 Source of Antibacterial Agents 83.3.3 Spectrum of Activity 83.3.4 Chemical Structure 83.3.4.1 Beta-Lactams 83.3.4.2 Aminoglycosides 83.3.4.3 Macrolides 83.3.4.4 Lincosamides 83.3.4.5 Quinolones and Fluoroquinolones 83.3.4.6 Nitroimidazoles 83.3.4.7 Oxazolidinones 83.3.4.8 Streptogramins 83.3.4.9 Sulfonamides 83.3.4.10 Tetracyclines 83.3.4.11 Glycylcyclines 83.3.4.12 Polymyxins 83.3.5 Mode of Action 83.3.5.1 Cell Wall Inhibitors 83.3.5.2 Protein Synthesis Inhibitors 83.3.5.3 Nucleic Acid Synthesis Inhibitors 83.4 The Principles of Antimicrobial Therapy 83.4.1 Identification of the Etiologic Agent and Determination of Antimicrobial Susceptibility 83.4.2 Route of Administration 83.4.3 Adverse Effects 83.4.4 Resistance 83.5 Antibacterial Agents and for Pediatric Ear, Nose, and Throat Infections 83.5.1 Acute Tonsillopharyngitis 83.5.2 Acute Bacterial Sinusitis 83.5.3 Acute Otitis Media 83.6 Conclusion References 84: Antiviral Agents for Pediatric Ear, Nose, and Throat Infections 84.1 Introduction 84.2 Antiviral Treatment in Influenza 84.2.1 Oseltamivir 84.2.2 Zanamivir 84.2.3 Laninamivir 84.2.4 Peramivir 84.2.5 Baloxavir Marboxil 84.3 Antiviral Treatment in COVID-19 84.4 Conclusion References 85: Antifungal Agents for Pediatric Ear, Nose, and Throat Infections 85.1 Introduction 85.2 Polyenes 85.2.1 Amphotericin B 85.2.2 Nystatin 85.3 Pyrimidine Analogues 85.3.1 Flucytosine 85.4 Antifungal Triazoles 85.4.1 Fluconazole 85.4.2 Voriconazole 85.4.3 Itraconazole 85.4.4 Posaconazole 85.5 Echinocandins 85.5.1 Caspofungin 85.5.2 Micafungin 85.5.3 Anidulafungin 85.6 Conclusion References 86: Symptomatic Agents for Pediatric Ear, Nose, and Throat Infections 86.1 Introduction 86.2 Antipyretics and Pain Relievers 86.3 Decongestants, Antihistamines, and Antitussives 86.4 Naso-Occlusion Relievers 86.5 Other Therapies References 87: Immunomodulating Agents for Pediatric Ear, Nose, and Throat Infections 87.1 Introduction 87.2 Echinacea 87.3 Bacterial Derived Immunomodulators 87.3.1 OM-85 BV 87.4 Pidotimod 87.5 Pelargonium Extracts 87.6 Beta-Glucan 87.7 Propolis 87.8 Conclusion References 88: Nutritional Management of Pediatric ENT Infections 88.1 Introduction 88.2 The Link Between ENT Infections and Nutrition 88.3 Specific Nutritional Considerations Related with ENT Infections 88.3.1 Breastfeeding 88.3.2 Cow’s Milk 88.4 Food Allergies 88.5 Integration of Nutrition While Caring for ENT-Infected Children 88.5.1 Nutritional Assessment 88.5.2 The Energy and Nutrient Needs of Children 88.5.3 Energy 88.5.3.1 Carbohydrates 88.5.3.2 Lipids 88.5.3.3 Protein 88.5.3.4 Vitamins and Minerals 88.6 Mediterranean Diet 88.7 DASH Diet 88.8 Postoperative Tonsillectomy Diet 88.9 Enteral Nutrition 88.10 Parenteral Nutrition 88.11 Conclusions References 89: Probiotic Use in Pediatric Ear, Nose, and Throat Infections Practice 89.1 Introduction 89.2 Respiratory Tract Infections 89.3 Acute Otitis Media References 90: Supportive Agents for Pediatric Otolaryngological Infections 90.1 Introduction 90.2 Zinc and Vitamins 90.3 Probiotics 90.4 Honey and Beehive Products 90.5 Herbal Medicine 90.6 Immunomodulators References 91: Management of Pediatric Trauma: ENT View 91.1 Introduction 91.2 Management of Pediatric Ear Trauma 91.3 Management of Pediatric Nasal Trauma 91.4 Management of Pediatric Throat Trauma 91.5 Conclusion References 92: Management of Pediatric Trauma: General View 92.1 Introduction 92.2 Thoracic Trauma 92.2.1 Thoracic Traumatic Lesions and Treatment 92.3 Abdominal Traumas 92.3.1 Solid Organ Injuries in Blunt Abdominal Trauma 92.3.1.1 Liver Injuries 92.3.1.2 Spleen Injuries 92.3.1.3 Pancreatic Injuries 92.3.1.4 Renal Injury 92.3.2 Hollow Abdominal Organ Injuries in Blunt and Penetrant Traumas 92.3.2.1 Gastrointestinal System Injuries 92.3.2.2 Urinary Bladder References