IAPO Interamerican Association of Pediatric Otorhinolaryngology XII IAPO Manual of Pediatric Otorhinolaryngology Editors TANIA SIH ALBERTO CHINSKI ROLAND EAVEY RICARDO GODINHO Coordinator TANIA SIH Copyright © 2013 Interamerican Association of Pediatric Otorhinolaryngology (IAPO) This book contains information obtained from authentic and highly regarded sources. A wide variety of references or recommended readings are listed. The editors cannot assume responsibility for the validity of all materials or for the consequences of their use. No part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the editor/coordinator. Tania Sih 306 Mato Grosso Street, suite 1510 São Paulo, SP 01239-040 Brazil Fax: (55-11) 2114-6512 E-mail: [email protected] Alberto Chinski Charcas, 2777- 1A 1425 Buenos Aires Argentina Fax: (54-11) 4821-1272 E-mail: [email protected] Roland D. Eavey Bill Wilkerson Center 1215, 21st Ave. South. Medical Center East South Tower, suite 6310 Nashville, TN 37232 FAX : (615) 936-0704 E-mail: [email protected] Ricardo Godinho Rua Dr. Chassim, 208 Sete Lagoas, MG 35700-018 Brazil Fax: (55-31) 3772-2121 E-mail: [email protected] THE DEPOSIT ESTABLISHED IN BRAZIL Graphic Project: Larissa Zimbres De Carvalho ISBN International Standard Book Number: 978-85-60209-03-3 (Hardcover) Published in 2013 by Editora e Gráfica Vida & Consciência Rua Agostinho Gomes, 2312 São Paulo, SP, 04206-001, Brazil Phone: (55-11) 3577 3201 E-mail: [email protected] IAPO´s Board of Directors Ellen Friedman (USA) Officers 2012-2014 Elsa C. Marin (Cuba) Federico Murillo (Costa Rica) PRESIDENT Fred Kozak (Canada) Fernando Silva (Ecuador) Hugo Rodriguez (Argentina) PAST PRESIDENTS Jack Paradise (USA) Sylvan Stool (deceased) (USA) Jorge Astocondor (Peru) Alberto Chinski (Argentina) Liliana Palma (Uruguay) Tania Sih (Brazil) Moacyr Saffer (Brazil) Roland Eavey (USA) Oscar O. Terraza Calderon (Guatemala) Teolinda Morales (Venezuela) Peggy Kelley (USA) James Reilly (USA) Ricardo Godinho (Brazil) PRESIDENT ELECT Ricardo de Hoyos (Mexico) Margaretha Casselbrant (USA) Robert J. Ruben (USA) VICE PRESIDENT Robin Cotton (USA) Frida Sanabria (Colombia) Ximena Fonseca (Chile) SECRETARY Tania Sih (Brazil) INTERNET SERVICES ADJUNCT SECRETARY IAPO´s Web Site: www.iapo.org.br (for the Board) Ricardo Godinho (Brazil) Vera Santos (Brazil) E-mail: [email protected] TREASURER Marcelo Silber (Brazil) OFFICE OF THE SECRETARY DELEGATES Tania Sih Amarilis Meléndez (Panama) 306 Mato Grosso Street, suite 1510 Andrés Sibbald (Argentina) São Paulo, SP Augusto Peñaranda (Colombia) 01239-040 Brazil Cecilia Jové (Bolivia) Phones: (55-11) 2114-6510/2114-6511 Cesar Franco (Paraguay) Fax: (55-11) 2114-6512 Edgar Perdomo (San Salvador) E-mail: [email protected] Foreword It gives me great pleasure to share one of my favorite books in pediatric otolaryngology with you. This 12th edition of the IAPO Manual of Pediatric Otolaryngology, like numbers 1 to 11, offers an overview of what is new and important to both clinicians and researchers in our specialty. Dr. Tania Sih, with her incredible mix of dedication, charm, and intellect, has been a driving force and true leader in pediatric otolaryngology both nationally and internationally for more than two decades. For this book, she has tapped into her large network, and brought together contributions from experts from various disciplines from all over the world. With her team of co-editors Drs. Roland Eavey, Alberto Chinski and Ricardo Godinho she has put together this quality publication that is distributed free of charge worldwide in several languages. As such it provides a priceless educational service to pediatric otolaryngologists, and, most importantly, the families and children they serve. Please enjoy the text and share the knowledge and inspiration it brings to you. Anne G. M. Schilder, MD, PhD President, European Society of Pediatric ORL (ESPO) Professor of Pediatric Otorhinolaryngology University Medical Center Utrecht NIHR Research Professor and Director ENT Clinical Trials Programme University College London Introduction I As President of the Interamerican Association of Pediatric Otolaryngology (IAPO), I have the honor and privilege of thanking you for your interest and support of IAPO’s mission to improve all of our children’s’ health and well being. The Head & Neck region of every child possesses the unique facial features and beauty that creates their identity to parents, family members and friends. Equally important, all communication between parent and infant starts with the baby’s first cry and continues to expand their interactions by words from their mouth and listening attentively with their ears. Starting with a baby’s first breath, their young bodies can only grow if their nose and tracheal passages are without obstruction so that oxygen can easily enter their lungs. All health care providers who are responsible for maintaining the integrity of the ears, nose, throat and respiratory tree are challenged to provide the best wisdom and interventions to safely guide the children under our care to maximize their potential for learning throughout their school years as they grow into adult life. The 12th IAPO Manual is dedicated to assisting all of us to do what is best for all of the infants and children that are under our care. Dr. Tania Sih and her esteemed colleagues have led the path forward to provide this textbook to you since the inception of IAPO. The knowledge and information within this book is the summation of current diagnosis and treatment for virtually all ear, nose and throat disorders in children from many of the world wide leaders in this field. Please read this text with interest and keep it near your clinical practice for quick reference. Share with interested students and colleagues. Go forward to help all of the children become healthy, trusting adults and lead our world to new and happy days. We have all dedicated our lives to help you provide the best of care in your practice. Fernando Silva, MD President, IAPO 2012- 2014 Otolaryngologist Guayaquil, Ecuador Introduction II The XIIth IAPO´s Manual on Pediatric ENT happens because I am lucky enough to have so many friends in the Pediatric ENT community around the globe. In 2012 and 2013, being a speaker in over 15 Medical meetings outside Brazil, in five continents, I have witnessed many excellent presentations. I invited the speakers to contribute to our Manual. Almost never I had a negative reply! Thanks to that, IAPO does a true “scientific community service”, due to the fact that the Manuals cannot be sold. They should be given (free of costs) to the members of our Organization - IAPO. Later on, they are displayed in our website (www.iapo.org.br), and our “virtual Pediatric ENT Library” in three languages (Spanish, English and Portuguese) is the most extensive of its kind! We have so may hits from all over the world! If someone related to medical care, reads our Manuals, for sure will help with updated subjects to treat better their children. When someone says “a state of the art” it means excellence! I think that this particular Manual is a true commitment to give you, the reader, the most updated and broad knowledge in the area. Over 70 physicians from 18 countries contributed to this Manual. We always divide our Manuals in 5 Sections: a) General considerations; b) Mouth- Head & Neck) Nose & Sinus; d) Ear and e) Hearing & Communication disorders. So, other than specific subjects covering Pediatric ENT we consider that Section A (General Considerations) is also important to broaden the horizons outside ear, nose and throat, as Medical general culture. This is relevant for us to help us in a more holistic approach and management of our little patients. Not too much time left in our busy life, so it is easier and convenient to have new, updated and interesting informations in one book. Enjoy the reading! Tania Sih, MD, PhD IAPO´s General Secretary International Federation of ORL Societies (IFOS) Chair of the Standing Committee of Pediatrics Professor, Medical School, University of São Paulo São Paulo, Brazil List of Contributors As they appear in the text • Adriaan N Bosschaart, MD, Social Pediatrician, Dutch Asthmacentre, Davos, Switzerland. • Ann Hermansson, MD, Associate Professor, Department of ENT, University Hospital Lund, Sweden. • Thea van Zeben-van der A. MD, Social Pediatrician, Department of Pediatrics, Maastricht University MC, The Netherlands. • Deepa Bhargava, MD, MBBS, M.S, Department of Surgery ENT Division College of Medicine and Health Sciences, Sultan Qaboos University. Hospital, Muscat, Sultanate of Oman. • Kamlesh Bhargava, MD, MRCGP (INT), Department of Family and Community Medicine, College of Medicine and Health Sciences, Sultan Qaboos University Hospital, Sultanate of Oman. • Itzhak Brook, MD, MSc, Professor of Pediatrics Georgetown University School of Medicine, Washington DC, USA. • Wei-Chung Hsu, MD, PhD, Department of Otolaryngology, National Taiwan University Hospital, Sleep Center, National Taiwan University Hospital, Taipei, Taiwan. • Kun-Tai Kang, MD, Department of Otolaryngology, National Taiwan University Hospital, Sleep Center,. Department of Otolaryngology, Taipei Hospital, Department of Health, New Taipei City, Taiwan. • Pin-Lin Lee,