[Rhinosinusitis in childhood]

Rhinosinusitis is a pathology having a multifactorial genesis, in which predisposing factors can help the transition from simple rhinitis, that is a very frequent disease in pediatric patient, to a more severe acute bacterial infection of nasal and paranasal cavities. Usually rhinosinusitis, at least at the beginning, has viral origin. Symptomatology of rhinosinusitis is aspecific and clinical data are modest. The course can be acute, subacute or chronic and sometimes recourrent. Diagnosis is given by clinical data, and nasal endoscopy with optics fibers, if necessary. Radiological examination, computed axial tomography and nuclear magnetic resonance, are required in complex and recourrent forms. In 70-80% of cases it recuperates spontaneously, without followings, otherwise it needs a support therapy to relieve symptoms, and to prevent complications. This can be made using hypertonic solutions (Iperclean), in order to remove nasal secretion, to decongest mucosa and improve ciliary clearance. Some researcers demonstrated the effectiveness of this approach, also preventig otitis. Nasal decongestants and antinflammatories are useful, too. Antihistaminic, overall those of 2nd generation, like levocetirizina, are used in allergic forms. Antibiotic therapy is required when rhinosinusitis lasts over 15-20 days, to prevent complications and to avoid the illness to become chronic. Endoscopic nasal surgery allows to reopen natural ways of drainage of paranasal cavities, and it is anyway suggested in more complicated cases.