Paranasal Sinus Disease in Infants and Young Children

Chronic Maxillary Sinusitis in Children

“…He agrees with Dean (1925), Cleminson (1921, Mollison and Kendall (1922) and Carmack (1931), among others, in advocating the removal of the adenoids, asserting that he has never seen a case of maxillary sinusitis in childhood in which the adenoids were not present, even when they were supposed to have been removed. This agrees with the experience of most operators, except Walker (1947) who found the tonsils more blameworthy than the adenoids, and assessed their degree of involvement by their actual size.…”

“…Dean (1925) thought diagnosis was easy, and other writers, such as Birdsall (1939) and Walker (1947), appear to rely on symptoms, signs and x-ray findings in their assumption that a child has sinusitis.…”

“…The earlier the paper, the greater appears to have been the faith in radiography. Cleminson (1921) considered radiographs valuable, while Dean (1925) stated that 'the greatest benefit to be derived from roentgen-ray examination is to tell us whether or not a given sinus is present, and, if present, whether on an anatomical basis, it has clinical signnc '. Crooks and Signy (1936) judged radiography to be 'the most sensitive of all the diagnostic tests' because it ' will show slight and transitory changes of mucous membrane'.…”

“…Conservative measures advocated for the treatment of sinusitis include change of climate to the seaside (Dean, 1925;Crooks and Signy, 1936), Proetz displacement (Birdsall, 1939;De Boissiere, 1949) and x-radiation (De Boissiere, 1949). Dietetic therapy is recommended by Dean (1925), and this should include a liberal supply of vitamin A.…”

“…>-hen does it clear up. and xshx ' The opinion of Dean (1925) and others that remoxal of the adenoids and tonsils xsill cure 80'. of cases of chronic sinusitis lends support to the theory that the natural regression of lymphoid tissue in the nasopharynx about puberty may determine this limitation of infection in the sinuses.…”