Abstract
The term SCUAD (severe chronic upper airway disease) has been previously introduced to describe cases with upper airway disorders and symptoms not adequately controlled despite correct diagnosis and management. It has been so far applied mainly in adults and no specific focus has been given on the pediatric population. When the term SCUAD is considered for children specifically, a series of issues may arise. These issues involve accurate definition, epidemiology, clinical characteristics, pathophysiology, and socioeconomic implications. These issues seem to clearly differentiate adult from pediatric SCUAD. We attempt to shed light on these issues in an effort to provide directions for future guideline development and research. In this context, P-SCUAD (pediatric severe chronic upper airway disease) is hereby introduced.
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Bousquet J, Khaltaev N, Cruz AA, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) 2008 update (in collaboration with the World Health Organization, GA(2)LEN and AllerGen). Allergy. 2008;63 Suppl 86:8–160.
Fokkens WJ, Lund VJ, Mullol J, et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. Rhinol Suppl. 2012;23:1–298.
Prokopakis EP, Hellings PW, Velegrakis GA, Kawauchi H. From ancient Greek medicine to EP3OS. Rhinology. 2010;48(3):265–72.
Bousquet J, Bachert C, Canonica GW, et al. Unmet needs in severe chronic upper airway disease (SCUAD). J Allergy Clin Immunol. 2009;124:428–33. Keynote publication introducing the term SCUAD in the literature.
Prokopakis E, Vlastos IM, Ferguson BJ, et al. SCUAD and chronic rhinosinusitis. Reinforcing hypothesis driven research in difficult cases. Rhinology. 2014;52:3–8.
Karatzanis A, Kalogjera L, Scadding G, et al. Severe chronic upper airway disease (SCUAD) in children. Definition issues and requirements. Int J Pediatr Otorhinolaryngol. 2015;79(7):965–8. First study to address the need for specific focus on children with regard to SCUAD.
Hardjojo A, Shek LPC, van Bever HPS, et al. Rhinitis in children less than 6 years of age: current knowledge and challenges. Asia Pac Allergy. 2011;1:115–22.
Papadopoulos NG, Bernstein JA, Demoly P, et al. Phenotypes and endotypes of rhinitis and their impact on management: a PRACTALL report. Allergy. 2015;70:474–94.
Ibañez MD, Valero A, Montoro J, et al. Analysis of comorbidities and therapeutic approach for allergic rhinitis in a pediatric population in Spain. Pediatr Allergy Immunol. 2013;24:678–84.
Di Cara G, Carelli A, Latini A, et al. Severity of allergic rhinitis and asthma development in children. WAO J. 2015;8:13–5.
Montoro J, Del Cuvillo A, Mullol J, et al. Validation of the modified allergic rhinitis and its impact on asthma (ARIA) severity classification in allergic rhinitis children: the PEDRIAL study. Allergy. 2012;67:1437–42.
Izquierdo A, Valero A, Mullol J. Comparative analysis of allergic rhinitis in children and adults. Curr Allergy Asthma Rep. 2013;13:142–51.
Veling MC. The role of allergy in pediatric rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg. 2013;21:271–6.
Settipana RA. Rhinitis: a dose of epidemiological reality. Allergy Asthma Proc. 2003;24:147–54.
Civelek E, Yavuz ST, Boz AB, et al. Epidemiology and burden of rhinitis and rhinoconjunctivitis in 9- to 11-year-old children. Am J Rhinol Allergy. 2010;24(5):364–70.
Blaiss MS. Allergic rhinitis: direct and indirect costs. Allergy Asthma Proc. 2010;31(5):375–80.
Hellings PW, Prokopakis EP. Global airway disease beyond allergy. Curr Allergy Asthma Rep. 2010;10(2):143–9.
Roberts G, Xatzipsalti M, Borrego LM, Custovic A, Halken S, Hellings PW, et al. Paediatric rhinitis: position paper of the European Academy of Allergy and Clinical Immunology. Allergy. 2013;68(9):1102–16.
Sami AS, Scadding GK. Rhinosinusitis in secondary school children-part 2: main project analysis of MSNOT-20 Young Persons Questionnaire (MSYPQ). Rhinology. 2014;52(3):225–30.
Jones NS. Current concepts in the management of paediatric rhinosinusitis. J Laryngol Otol. 1999;113(1):1–9.
Clement PA et al. Management of rhinosinusitis in children: consensus meeting, Brussels, Belgium, September 13, 1996. Arch Otolaryngol Head Neck Surg. 1998;124(1):31–4.
Kay DJ, Rosenfeld RM. Quality of life for children with persistent sinonasal symptoms. Otolaryngol Head Neck Surg. 2003;128(1):17–26.
Gordts F, Clement PA, Destryker A, et al. Prevalence of sinusitis signs on MRI in a non-ENT paediatric population. Rhinology. 1997;35(4):154–7.
Chang AB, Newman RG, Carlin JB, et al. Subjective scoring of cough in children: parent-completed vs child-completed diary cards vs an objective method. Eur Respir J. 1998;11(2):462–6.
Georgalas C, Vlastos I, Picavet V, et al. Is chronic rhinosinusitis related to allergic rhinitis in adults and children? Applying epidemiological guidelines for causation. Allergy. 2014;69(7):828–33.
Prokopakis E, Vlastos I, Pant H, Ferguson BJ. Chronic rhinosinusitis: observation or treatment. Curr Opin Allergy Clin Immunol. 2013;13(1):31–6.
Eun YG, Park DC, Kim SG, et al. Immunoglobulins and transcription factors in adenoids of children with otitis media with effusion and chronic rhinosinusitis. Int J Pediatr Otorhinolaryngol. 2009;73(10):1412–6.
Elwany S, El-Dine AN, El-Medany A, et al. Relationship between bacteriology of the adenoid core and middle meatus in children with sinusitis. J Laryngol Otol. 2011;125(3):279–81.
Shin KS, Cho SH, Kim KR, et al. The role of adenoids in pediatric rhinosinusitis. Int J Pediatr Otorhinolaryngol. 2008;72(11):1643–50.
Otten FW, Van Aarem A, Grote JJ. Long term follow up of chronic therapy resistant purulent rhinitis in children. Clin Otolaryngol. 1992;17:32–2.
Tosca MA, Cosentino C, Pallestrini E, et al. Improvement of clinical and immunopathologic parameters in asthmatic children treated for concomitant chronic rhinosinusitis. Ann Allergy Asthma Immunol. 2003;91(1):71–8.
Georgalas C, Cornet M, Adriaensen G, et al. Evidence-based surgery for chronic rhinosinusitis with and without nasal polyps. Curr Allergy Asthma Rep. 2014;14(4):427.
Shields BJ, Palermo TM, Powers JD, et al. Predictors of a child's ability to use a visual analogue scale. Child Care Health Dev. 2003;29(4):281–90.
Chambers CT, Johnston C. Developmental differences in children's use of rating scales. J Pediatr Psychol. 2002;27(1):27–36.
Terrell AM, Ramadan HH. Correlation between SN-5 and computed tomography 2009;119(7):1394–8.
Brozec J, Bousquet J, Baena-Cagnani CE, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol. 2010;126(3):466–76.
Izquierdo A, Valero AL, Mullol J. Comparative analysis of allergic rhinitis in children and adults. Curr Allergy Asthma Rep. 2013;13(2):142–51.
Sejima T, Holtappels G, Kikuchi H, et al. Cytokine profiles in Japanese patients with chronic rhinosinusitis. Allergol Int. 2012;61(1):115–22.
Zhang N, Liu S, Lin P, Li X, et al. Remodeling and inflammation in Chinese versus white patients with chronic rhinosinusitis. J Allergy Clin Immunol. 2010;125(2):507.
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Drs. Prokopakis, Kalogjera, and Karatzanis declare that they have no conflicts of interest.
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Prokopakis, E.P., Kalogjera, L. & Karatzanis, A.D. Pediatric Severe Chronic Upper Airway Disease (P-SCUAD). Curr Allergy Asthma Rep 15, 68 (2015). https://doi.org/10.1007/s11882-015-0570-9
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DOI: https://doi.org/10.1007/s11882-015-0570-9