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Pediatric sinusitis: update

Hassan H Ramadan1

  • 1Department of Otolaryngology Head and Neck Surgery, West Virginia University, PO Box 9200, Morgantown, WV 26506-9200, USA.

The Journal of Otolaryngology
|August 11, 2005
PubMed

Insights

Pediatric sinusitis, or sinus infections in children, often mimic colds. Prompt medical treatment with antibiotics is key, with surgery reserved for complex or persistent cases.

Area of Science:

  • Pediatrics
  • Otolaryngology
  • Infectious Diseases

Background:

  • Pediatric sinusitis is a common condition encountered by primary care physicians and pediatricians.
  • Children experience frequent colds, with a small percentage developing secondary sinus infections (0.5-5%).
  • Differentiating sinusitis from common colds or allergies can be challenging, but persistent symptoms beyond 7-10 days warrant consideration of infection.

Purpose of the Study:

  • To review the diagnosis and management of sinusitis in children.
  • To outline appropriate diagnostic imaging and treatment strategies.
  • To discuss indications for surgical intervention.

Main Methods:

  • Review of current literature and clinical guidelines for pediatric sinusitis.
  • Discussion of diagnostic modalities including plain radiographs and computed tomography (CT).
  • Analysis of medical and surgical treatment options.

Main Results:

  • Plain radiographs have limited utility, mainly for maxillary sinusitis with air-fluid levels.
  • Computed tomography (CT) is not recommended for routine diagnosis but is essential for complicated or chronic sinusitis cases.
  • Medical management, primarily with antibiotics for at least 14 days, is effective for most cases.

Conclusions:

  • Most pediatric sinusitis cases are successfully managed with appropriate medical therapy, including antibiotics and supportive care.
  • Surgical intervention is reserved for complicated cases or those refractory to prolonged medical treatment.
  • Adenoidectomy and endoscopic sinus surgery are common surgical procedures, but required in a small percentage of children.

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