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Acute and chronic sinusitis in children.

N S Jones1

  • 1Department of Otorhinolaryngology, University Hospital, Nottingham, United Kingdom. nick.jones@nottingham.ac.uk

Current Opinion in Pulmonary Medicine
|April 27, 2000
PubMed
Summary

Pediatric sinusitis treatment should prioritize medical management over antibiotics for purulent nasal discharge. Anatomical variations are not key factors; mucosal immunity and pathogen response are more important for rhinosinusitis in children.

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Area of Science:

  • Pediatric Otolaryngology
  • Infectious Diseases

Background:

  • Current practices for pediatric sinusitis often involve antibiotic prescription based on purulent nasal discharge.
  • There's a need to re-evaluate the indications for antibiotic use and diagnostic methods in pediatric rhinosinusitis.

Purpose of the Study:

  • To review current literature on pediatric sinusitis management.
  • To emphasize appropriate treatment strategies and diagnostic considerations.

Main Methods:

  • Literature review of recent publications on pediatric sinusitis.
  • Analysis of studies comparing anatomical variations in children with and without rhinosinusitis.

Main Results:

  • Most authors agree that antibiotics should not be prescribed solely for purulent nasal discharge in children.

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  • Prevalence of anatomical variations does not differ between children with and without rhinosinusitis.
  • Computed tomography (CT) scans are often inadequate for diagnosing sinusitis in children.

    • Conclusions:

    • Medical management is preferred for pediatric sinusitis, reserving surgery for complications.
    • Immunity and mucosal response to pathogens are likely more critical than anatomical factors.
    • Antibiotic stewardship and appropriate diagnostic approaches are essential for pediatric rhinosinusitis.