Charles M. Bower, MD, Editor

Gresham T. Richter, MD, Editor

Although rare, hearing loss is the most commonly encountered congenital malady. As a result, many states now require that one hundred percent of babies be screened for hearing loss before leaving the newborn nursery. Once identified, management of early detected hearing loss can be complicated by lack of follow-up, inconsistent and incomplete referrals, and slow progression to early intervention or amplification. The article on hearing screening will help define the role of otolaryngologists and pediatricians in terms of appropriate referrals and interventions for neonatal hearing loss. Similarly, otitis media afflicts many children and requires a systematic approach. Herein, Dr Benson and Tunkel provide comprehensive evidence-based data on the best management of acute otitis media for single episodes and recurrent disease.

Pediatric rhinosinusitis is ubiquitous and encountered by all pediatricians and otolaryngologists. The diagnosis is predominately clinical but might require imaging to help define the extent of disease for complications or perioperative planning. Management options for sinonasal disease range from observation to invasive surgery. The article by Dr Magit describes common medical strategies and options for surgical management, including endoscopic approaches, while examining uncommon causes or manifestations of pediatric sinusitis related to cystic fibrosis, immunodeficiency, and fungal allergy. The article by Dr Nolder emphasizes general medical management of infectious lymphadenopathy, but also reviews the indications for open biopsy to rule out more serious, but fortunately much less common malignant diseases. The articles on stridor and dysphagia in this issue both provide an algorithm for diagnosis and management of these frequently related conditions in the child. Both endoscopic surgical techniques and medical management are required for these disorders. A team of physicians and ancillary services may be required for more complicated cases of stridor and dysphagia. Similarly, management of cleft lip and palate remains strongly benefited by team management. The included article describes a team-based approach to cleft lip and palate as a model for pediatric diagnoses and treatment and demonstrates how enhanced quality of care can be achieved through multidisciplinary action.

Fortunately the majority of pediatric facial trauma is soft tissue injury and managed in the emergency room or primary practitioner’s office. Facial fractures in children may be more complicated and are addressed in an excellent review by Dr Boyette. The article emphasizes the variance in trauma patterns and management strategies between infants, children, and adults. An article on sialadenitis is also included in this issue to emphasize the importance of primary care management of sialadenitis through preventive immunization and conservative management strategies. Indications for referral for surgical options, including noninvasive endoscopic procedures and open surgery, are reviewed for children with more chronic disease. We complete this issue with a final article on the identification and management of behavioral problems as they relate to common otolaryngology problems, including sleep apnea, cleft lip and palate, and hearing loss. Behavioral problems are surprisingly common in these patients, but may not be adequately addressed by the otolaryngologist. A short guideline is provided to assist in appropriate referral and management strategies for behavior problems in children.

We certainly would like to thank the many authors for their excellent contributions to this special issue of Otolaryngologic Clinics of North America . We hope that this will be a highly beneficial resource for general as well as pediatric otolaryngologists that has great practical value for pediatricians, family practitioners, and others managing children.