Dr. Rande Lazar is an ear, nose, and throat specialist, with a primary focus in pediatrics. He is a Memphis-based Otolaryngologist and founder of Otolaryngology Consultants, an ear, nose, and throat practice located in Memphis, TN.  He has a wide range of experience treating sinus infections, respiratory infections, tonsil infections, ear infections, throat infections, sleep disorders, and many other areas of otolaryngology. Dr. Rande Lazar regularly performs surgery for both adult and pediatric sleep and sinus disorders. Alongside his years of expertise in respiratory disorders, sleep disorders, and sinus disorders, Dr. Lazar also treats a many patients with head and neck problems, including pediatric larynx (voice box) and hearing problems.

Article Abstract:

Functional endonasal sinus surgery (FESS) is becoming the procedure of choice for the surgical treatment of chronic and recurrent sinusitis in adults and children. Retrospective analysis of the charts of 513 adult and 260 pediatric patients who underwent FESS after failing to respond to optimal medical treatment revealed an improvement rate of approximately 80% for both age groups. Although high response rates and low complication rates were found for both groups, there were significant differences in indications, preoperative evaluation, operative technique, and methods of postoperative follow-up for children.

Read the full article as a PDF here: Functional Endonasal Sinus Surgery in Adults and Children

Dr. Rande Lazar is the founder of the Memphis-based pediatric ear, nose and throat practice, Otolaryngology Consultants.

Dr. Rande Lazar is the founder of Otolaryngology Consultants, an ear, nose and throat practice located in Memphis, TN. He is an experienced Memphis-based Otolaryngologist and surgeon who specializes in pediatric ear infections, throat infections, tonsil infections, sinus infections and sleep disorders. Dr. Lazar also treats children’s larynx (voice box) and hearing disorders. Along with these, Dr. Rande Lazar also has many years of experience in pediatric and adult sleep and snoring disorders, respiratory disorders, and a vast range of other head and neck problems.

Article Abstract:

Sinusitis is commonly seen in pediatrics. It is a dynamic, multifactorial process whose symptoms are variable. Upper respiratory tract infections and allergy are the major predisposing causes of sinusitis. Most patients respond to medical treatment. Surgery is generally indicated when optimal conservative management fails.

Functional endonasal sinus surgery (FESS) using endoscopes can form the mainstay of surgical therapy for pediatric patients with chronic/recurrent sinusitis. It is a surgical approach that can potentially restore the physiologic function of the paranasal sinuses. Although it was only introduced 5 years ago by Kennedy, it is becoming a popular surgical treatment for sinus disease in the United States. Most past reports have addressed its use in the adult population.

In children, we believe that FESS may be a curative and safe procedure. Gross et al. were the first to report on its use in the pediatric age group. They reported their experience with a series of 57 patients. The diagnosis of sinusitis in children may be difficult. The child is frequently unable to communicate many of the characteristic symptoms of sinusitis. Additionally, radiographic findings may be confusing. Ostensibly normal children may have abnormal findings on plain radiographs.

With the introduction of a wide variety of chemotherapeutic agents and new technologies, our therapeutic choices have become very broad. Accurate diagnosis and appropriate decisions can be made when a thorough understanding of the pathophysiologic mechanism of the disease entity is known.

Read the full article as a PDF here: Functional Endonasal Sinus Surgery in the Pediatric Age Group

Dr. Rande Lazar is the founder of the Memphis-based pediatric ear, nose and throat practice, Otolaryngology Consultants.

Dr. Rande Lazar is an Otolaryngologist located in Memphis, TN and also the founder of Otolaryngology Consultants, an ear, nose, and throat practice based out of the city. Though his primary focus is children, he treats adult patients for ear, nose, and throat disorders as well. Dr. Rande Lazar has a wide range of expertise in many areas of otolaryngology, including treatment for sinus infections, respiratory infections, tonsil infections, ear infections, throat infections, and sleep disorders. He is experienced in pediatric hearing and larynx (voice box) problems, as well as many other problems affecting the head and neck. Dr. Lazar is also a skilled surgeon for both pediatric and adult sleep and sinus disorders.

Article Abstract:

Toxic shock syndrome (TSS) is a serious multisystem disease that was first described in 1978 by Todd. It occurs most often in menstruating women using superabsorbent tampons. The exact pathogenesis is not well understood, but it is felt to be due to the effects of an enterotoxin produced by certain strains of Staphyloccus aureus. The reported incidence of TSS following endonasal sinus surgery in which minimal packing was used is 16/100,000. The nasal surgeon should be aware of this rare and possibly fatal entity, as TSS may occur following any nasal/sinus surgery, even where packing is minimal and of short duration and when the patient is receiving antibiotic therapy.

View the full article in PDF format: Toxic Shock Syndrome Following Functional Endonasal Sinus Surgery: A Case Report

Dr. Rande Lazar is the founder of the Memphis-based pediatric ear, nose and throat practice, Otolaryngology Consultants.

Dr. Rande Lazar is a Memphis Otolaryngologist with a primary focus in pediatric ear, nose and throat disorders, including ear infections, throat infections, tonsil infections, sinus infections and sleep disorders. Dr. Rande Lazar has special expertise in adult and pediatric sleep and snoring disorders and surgery, as well as adult and pediatric sinus disorders. Dr. Rande Lazar is experienced in a wide range of disorders of the ear, nose, throat, sinus, respiratory system and the other head and neck systems, as well as children’s disorders of the larynx (voicebox), and hearing problems.

Dr. Rande Lazar is the founder of the Memphis-based pediatric ear, nose and throat practice, Otolaryngology Consultants.

Article Abstract:

Revision functional endonasal sinus surgery (FESS) is recommended for patients whose symptoms of chronic or recurrent sinusitis persist despite primary FESS, long-term maximal medical therapy, and no sign of other abnormalities as demonstrated by computed tomography. After analyzing the charts of 673 patients who underwent primary FESS, we reviewed the 63 cases of revision surgery performed between 1986 and 1989. This retrospective analysis presents the management and outcome of 16 children (<16 years) and 47 adults who had revision FESS. The overall success rate of revision FESS was 78%, with no major complications, reflecting the improved management of sinus disease offered by this procedure.

View the full article in PDF format: Revision Functional Endonasal Sinus Surgery

If you have any questions about ear, nose and throat disorders, please contact Otolaryngology Consultants of Memphis.

Dr. Rande Lazar is a Memphis-based Otolaryngologist and founder of Otolaryngology Consultants, an ear, nose, and throat practice located in Memphis, TN. Dr. Lazar is an ear, nose, and throat specialist, with a primary focus in pediatrics. He has a vast amount of experience treating sinus infections, respiratory infections, tonsil infections, ear infections, throat infections, sleep disorders, and many other areas of otolaryngology. Dr. Rande Lazar routinely performs surgery for both adult and pediatric sleep and sinus disorders. Alongside his years of expertise in respiratory disorders, sleep disorders, and sinus disorders, Dr. Lazar also treats a wide range of head and neck problems, including pediatric larynx (voice box) and hearing problems.

Abstract:

Pediatric functional endonasal sinus surgery (FESS) requires significant surgical training and proficiency. Although the technique is essentially the same as for adults, children need different tactics in each step of the treatment. Preoperative assessment of children relies on the clinical manifestations and the findings of computer tomography scans of the sinuses. Because office nasal endoscopy is not well tolerated by children, the procedure must be done under general anesthesia. The intraoperative approach depends on obtaining adequate vasoconstriction and the surgeon’s understanding of varied pediatric anatomy. Careful follow-up, including medical therapy and a nasal endoscopic examination under general anesthesia, is necessary to ensure a good outcome.

Read the full article as a PDF: Pediatric Functional Endonasal Sinus Surgery: Preoperative Evaluation, Surgical Technique, and Postoperative Care

Dr. Rande Lazar is the founder of the Memphis-based pediatric ear, nose and throat practice, Otolaryngology Consultants.

Dr. Rande Lazar is the founder of Otolaryngology Consultants, an ear, nose and throat practice located in Memphis, TN, and is also an experienced Memphis-based Otolaryngologist and surgeon himself. Dr. Lazar specializes in pediatric ear infections, throat infections, tonsil infections, sinus infections and sleep disorders. He also treats children’s larynx (voice box) and hearing disorders. Along with these, Dr. Rande Lazar also has many years of experience in pediatric and adult sleep and snoring disorders, respiratory disorders, and a vast range of other head and neck problems.

Article Abstract:

Functional endonasal sinus surgery (FESS) is widely used in the treatment of chronic sinusitis in adults and children. Although success rates of 80% to 93% have been reported, no criteria for success or improvement have been suggested. Standardized measures are needed to assess the outcome of FESS and to compare the results obtained by different surgical teams and for various patient groups. After reviewing the charts of 500 pediatric patients who underwent FESS between July 1987 and June 1992, the authors of this study formalized criteria for assessing the outcome of surgery.

Read the full article as a PDF: Criteria for Success in Pediatric Functional Endonasal Sinus Surgery

Dr. Rande Lazar is the founder of the Memphis-based pediatric ear, nose and throat practice, Otolaryngology Consultants.

Dr. Rande Lazar is an Otolaryngologist located in Memphis, TN and also the founder of Otolaryngology Consultants, an ear, nose, and throat practice based out of Memphis. Though his primary focus is children, he treats adult patients for ear, nose, and throat disorders as well. Dr. Rande Lazar has a wide array of experience in many areas of otolaryngology, including treatment for sinus infections, respiratory infections, tonsil infections, ear infections, throat infections, and sleep disorders. He is also experienced in pediatric hearing and larynx (voice box) problems, as well as many other problems affecting the head and neck. Dr. Lazar is also an experienced surgeon for both pediatric and adult sleep and sinus disorders.

Article Abstract:

Toxic shock syndrome (TSS) is an uncommon, severe, multisystem illness that may follow any surgical procedure. It usually occurs in the immediate postoperative period and is manifested by the sudden onset of high fever and a variety of other signs and symptoms. The reported incidence of TSS after nasal surgery is 16 cases per 100,000 patients. We report five unusual cases of delayed TSS that occurred after functional endonasal sinus surgery in which no packing was used. Toxic shock syndrome developed in three children and two adults 5 days to 5 weeks postoperatively.  All patients were treated successfully with no sequelae. The pathophysiologic features, clinical manifestations, and treatment of TSS are described in detail.

Read the entire article as a PDF: Delayed Toxic Shock Syndrome After Functional Endonasal Sinus Surgery

If you have any questions about ear, nose and throat disorders, please contact Otolaryngology Consultants of Memphis.

Dr. Rande Lazar, a Memphis Otolaryngologist with a primary focus in pediatric ear, nose and throat disorders, including ear infections, throat infections, tonsil infections, sinus infections and sleep disorders, is the founder of Otolaryngology Consultants. Dr. Rande Lazar has special expertise in adult and pediatric sleep and snoring disorders and surgery, as well as adult and pediatric sinus disorders. Dr. Rande Lazar is skilled in a wide range of disorders of the ear, nose, throat, sinus, respiratory system and the other head and neck systems, as well as children’s disorders of the larynx (voicebox), and hearing problems.

Dr. Rande Lazar can be contacted at Otolaryngology Consultants.

Abstract:

Functional endoscopic sinus surgery (FESS) has become the surgical procedure of choice for the treatment of chronic sinusitis that is refractory to medical treatment. It has become routine to perform endoscopy in children under general anesthesia 2 to 3 weeks after FESS to facilitate examination and cleaning of the operative site. We compared the clinical outcome of 50 children who underwent FESS without a second-look endoscopy with 50 children who underwent a routine second look. Patients with systemic disease (cystic fibrosis, immotile ciliary syndrome, immunoglobulin deficiency) or undergoing a revision procedure were excluded from the study. The results show that the postoperative improvement in nasal obstruction, nasal drainage, and chronic cough was the same for both groups. We conclude that in the vast majority of children without systemic disease and not undergoing a revision procedure, a second endoscopic procedure may not offer any apparent advantage.

View the full article in PDF format: Pediatric Functional Endoscopic Sinus Surgery: Is a Second Look Necessary?

Learn more about Dr. Rande Lazar at Otolaryngology Consultants of Memphis.