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Pediatric chronic rhinosinusitis
1ENT Institute, Boys Town National Research Hospital, Omaha, NE 68131, USA. luskr@boystown.org
Current Opinion in Otolaryngology & Head and Neck Surgery
|November 14, 2006
Summary
Pediatric chronic rhinosinusitis lacks clear practice guidelines due to insufficient prospective studies. Current treatments involve prolonged antibiotics and staged surgeries, but knowledge gaps remain, especially regarding gastroesophageal reflux disease.
Area of Science:
- Pediatric Otolaryngology
- Rhinology
- Infectious Diseases
Background:
- Pediatric acute and chronic rhinosinusitis are prevalent, with a subset progressing to chronic forms.
- Significant healthcare resources are allocated to treating pediatric sinus infections.
- A need exists for evidence-based practice guidelines for pediatric chronic rhinosinusitis.
Purpose of the Study:
- To review the current understanding and management of pediatric chronic rhinosinusitis.
- To identify knowledge deficits and areas for future research in pediatric rhinosinusitis.
Main Methods:
- Review of recent literature focusing on pathophysiology and medical management.
- Identification of limitations in prospective studies and their impact on guideline development.
Main Results:
- Lack of robust prospective studies hinders the development of pediatric chronic rhinosinusitis guidelines.
- Recent research primarily addresses pathophysiology and medical management.
- The role of gastroesophageal reflux disease in pediatric chronic sinusitis is an area of significant knowledge deficit.
- No major recent changes in medical or surgical management, except for the rationale of adenoidectomy before endoscopic sinus surgery for biofilm eradication.
Conclusions:
- Current therapy involves extended antibiotic courses and staged surgical interventions (adenoidectomy, ethmoidectomy).
- There is a critical need for improved research to establish definitive practice guidelines for pediatric chronic rhinosinusitis.
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