P232
Otolaryngology–Head and Neck Surgery 147(2S)
Pediatric Otolaryngology
IgE in Infants with Laryngomalacia:
Risk for Asthma
POSTERS
Mahmoud F. Abdel-Aziz, MD (presenter)
Objective: To evaluate a possible predictive value for develop-
ing asthma later on in infants with laryngomalacia by measur-
ing specific immunoglobulin E (IgE) antibodies to food and/
or inhalant allergens.
Method: Sixty-four children having congenital laryngeal stri-
dor “laryngomalacia” before 18 months of age were followed
prospectively until early school age. Serum levels of food and
inhalant allergen-specific IgE antibodies were determined at
presentation, using the CAP system IgE FEIA (Pharmacia,
Uppsala, Sweden). At 6 to 8 years, the children were evaluated
for asthma and allergic manifestations.
Results: Asthma was present in 24 (37.5%) children at school
age. Food-specific IgE antibodies of ≥ 0.35 kU/L were found
in 27 (42%) infants, but only specific IgE to wheat and to egg
white at the level of  ≥ 0.35 kU/L were significantly associated
with later asthma. In regard to specific IgE to the mixture of
food allergens, the cutoff level of ≥ 0.70 proved to be signifi-
cant. Inhalant allergen-specific IgE of ≥ 0.35 kU/L was found
in 16 cases (25%) and was significantly predictive of asthma.
Conclusion: Presence of specific IgE of ≥ 0.35 kU/L to wheat, egg
white, or inhalant allergens are predictive of later childhood
asthma. Consequently, detection of those specific IgE antibodies
in those infants may facilitate the early diagnosis of asthma, espe-
cially in cases with no clinically evident atopic manifestations.
Pediatric Otolaryngology
Immunity in Children with Chronic
Tonsillitis
Lucian Danilov, MD (presenter); Svetlana Diacova;
Ion Ababii; Mihail Maniuc; Tatiana Vinogradova;
Polina Ababii
Objective: 1) To explore some aspects of systemic immunity
reactions in chronic tonsillitis. 2) To compare systemic immu-
nity reactions in chronic tonsillitis in children and adults.
Method: Prospective study design in 2011. Subjects: 24 children
and 13 adults with chronic tonsillitis. Setting: Otolaryngology
department, Moldova. Outcome measures: C reactive protein,
antistreptolysin O, absolute and relative amount of B lympho-
cytes, immunoglobulins–A, M, G, circulatory immune com-
plexes, interleukins IL-4, IL-8, IL-1β in blood serum.
Results: Interleukin-8 is 6.5 times higher in children than in
adults (P = .047), interleukin-1β is 17.4 times higher (P =
.045). Level of serum IgA in adults is higher than in children
(P = .038), antistreptolysin–O titre is 1.4 times higher.
Conclusion: Study of interleukin-1β and interleukin-8 is useful in
understunding the etiopathogenetic mechanism of chronic
tonsillitis in children. Nonspecific immune factors play an
important role in immune response in chronic tonsillitis in
children, while in adults the main role is held by specific
immune response.
Pediatric Otolaryngology
Impact of ASA and Body Mass Index
in Pediatric Tonsillectomy
Corrie Roehm, MD (presenter); Jeffrey Marino;
Jessica Weiss; James Naples; Tulio A. Valdez, MD
Objective: To identify the impact of body mass index and ASA
classification on complications, PICU stay and length of hos-
pitalization following tonsillectomy.
Method: Retrospective chart review of all tonsillectomies per-
formed from July 2008 to December 2009 at a tertiary pediat-
ric institution, including BMI, length of stay, length of
intubation, ASA status, hemorrhage, and PICU stay.
Results: A total of 677 patients were identified, with complete
data in 607, 4.4% underweight, 49% normal, 45% overweight
or obese. No significance difference between BMI categories
for hospitalization, length of intubation or postoperative hem-
orrhage, or between ASA for hemorrhage or length of intuba-
tion. BMI normal to obese (P = .0006) and overweight to
obese patients (P = .0253) showed significant difference in
PICU stay. ASA classification showed significant difference
in length of hospitalization in ASA 1 and 2 (P < .001), 2 and 3
(P = .0002), and 1 and 3 (P = .0002), and in PICU stay between
ASA 1 and 3 (P < .0001), 1 and 2 (P = .0095) and 2 and 3 (P
< .0001).
Conclusion: Overweight and obese patients are a significant
percentage of patients undergoing tonsillectomies in this
country. Patients with higher ASA status (2 and 3) show higher
use of PICU resources and longer hospitalizations, and
patients of overweight and obese categories require PICU care
more often than patients with normal weight.
Pediatric Otolaryngology
Impact of Tonsillectomy Clinical
Practice Guidelines
Dhave Setabutr, MD (presenter); Eelam Adil; Irina
Chaikhoutdinov; Michele M. Carr
Objective: To evaluate the effect of the recently published pedi-
atric tonsillectomy and polysomnography clinical guidelines
on current practice patterns.
Method: An anonymous 15-question survey was sent to mem-
bers of the American Academy of Otolaryngology–Head and
Neck Surgery regarding their awareness of the Clinical
Practice Guideline: Tonsillectomy in Children and Clinical
Practice Guideline: Polysomnography for Sleep-Disordered
Breathing Prior to Tonsillectomy in Children and whether or
not they have changed their practice as a result.