Treatment of pediatric sinusitis

Abstract

The successful management of RS in children relies on careful diagnosis, recognition of causative factors, and judicious yet adequate antibiotic usage. Refractory cases will require surgical therapy, with adenoidectomy as the first-line intervention and ESS reserved for those cases refractory to adenoidectomy. This overall approach will improve quality of life and prevent complications in children with RS.

The relationship between anatomical variations of the sino-nasal region and chronic sinusitis extension in children

“…However, we think that proper knowledge of these variations is vital for carrying out good surgical therapy intraoperatively. Other predisposing factors like upper respiratory tract infection, allergic rhinitis, adenoid hypertrophy, impaired immunity, gastroesophageal reflux disease and environmental factors are probably more important [5].…”

“…Surgical results from external approaches for paranasal sinus diseases in children were disappointing and accompanied by major complications. Recently endoscopic sinus surgery (ESS) has been proven to be an effective procedure and has improved quality of life in pediatric CRS after failure of medical treatment and becomes relatively a common rhinology procedure [3][4][5].…”

Nutritional supplements as adjunctive therapy for children with chronic/recurrent sinusitis: pilot research

“…Although the reported success rate for pediatric ESS ranges from 80 to 93%, pediatric ESS has serious risks; in addition, because children have smaller anatomy, pediatric ESS requires greater technical skill and a more meticulous approach than ESS surgery in adults [7]. When properly performed, the incidence of major complications from ESS in children is less than 1%; however, Goldsmith and Rosenfeld [8] state that the surgery should be performed only by an otolaryngologist experienced in pediatric ESS. Even at tertiary care children's hospital, ESS was not successful in children younger than 3 years of age, and surgical revision was needed for some children who underwent ESS when they were younger than 6 years of age [9].…”

The role of allergy in pediatric rhinosinusitis

“…Children less than 6 years of age average six to eight upper respiratory infections (URIs) annually with symptoms lasting 10-14 days [25]. Of these, 5-10% is complicated by acute rhinosinusitis (ARS) [26].…”