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2016 ; 3
(3
): 268-281
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Pediatric Rhinosinusitis
#MMPMID28042527
Badr DT
; Gaffin JM
; Phipatanakul W
Curr Treat Options Allergy
2016[Sep]; 3
(3
): 268-281
PMID28042527
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Rhinosinusitis, is defined as an inflammation of the paranasal and nasal sinus
mucosae. Chronic rhinosinusitis (CRS)is a common problem in the pediatric age
group and the diagnosis and treatment are challenging due to the chronicity and
similarity of symptoms with allergic rhinitis and adenoid hypertrophy. Although
it is less common than acute rhinosinusitis, CRS is becoming more frequent and
significantly affects the quality of life in children and can substantially
impair daily function. CRS is characterized by sinus symptoms lasting more than 3
months despite medical therapy. Many factors are involved in the pathogenesis of
this disease and include a primary insult with a virus followed bybacterial
infection and mucosal inflammation, along with predisposition to allergies. The
standard treatment of pediatricacute bacterial rhinosinusitis (ABRS) is nasal
irrigation and antibiotic use. Medical treatment of pediatric CRS includes
avoidance of allergens in allergic patients (environmental or food) and therapy
with nasal irrigation, nasal corticosteroids sprays, nasal decongestants, and
antibiotics directed at the most common sinonasalorganisms
(Haemophilusinfluenzae, Streptococcus pneumoniae, and Moraxella catarrhalis).
Surgical therapy is rarely needed after appropriate medical therapy. Referral to
an otolaryngologist and allergy specialist is recommended in case of failure of
medical treatment.
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