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Childhood sinusitis
N L Ott1, E J O'Connell, A D Hoffmans
1Section of General Pediatrics, Southdale Pediatric Clinic, Edina, Minnesota.
Mayo Clinic Proceedings
|December 1, 1991
Summary
Diagnosing childhood sinusitis requires differentiating between acute and chronic forms, infectious and noninfectious causes. Effective treatments include antibiotics for infectious sinusitis and corticosteroids for noninfectious sinusitis, with surgery as a last resort.
Area of Science:
- Pediatrics
- Otolaryngology
- Allergy and Immunology
Background:
- Childhood sinusitis diagnosis is challenging, with classification based on duration (acute/chronic) and cause (infectious/noninfectious).
- Infectious sinusitis often stems from osteomeatal complex obstruction, while noninfectious sinusitis shares inflammatory patterns with asthma.
- Plain radiography has limited utility in diagnosing acute sinusitis in children.
Purpose of the Study:
- To outline the diagnostic challenges and treatment strategies for childhood sinusitis.
- To differentiate between acute and chronic sinusitis presentations and etiologies.
- To review current therapeutic options for various sinusitis subtypes in pediatric patients.
Main Methods:
- Review of existing literature on childhood sinusitis classification, diagnosis, and treatment.
- Comparison of diagnostic imaging modalities and their effectiveness.
- Analysis of treatment outcomes for antibiotic, corticosteroid, and surgical interventions.
Main Results:
- Acute sinusitis is primarily infectious, treated effectively with beta-lactamase-resistant antibiotics.
- Chronic sinusitis can be infectious, noninfectious, or mixed, requiring tailored treatment.
- Coronal computed tomography and nasal endoscopy are preferred for diagnosing chronic sinusitis.
- Topical intranasal corticosteroids are effective for chronic noninfectious sinusitis; surgery may be needed if medical management fails within 3 months.
Conclusions:
- Accurate diagnosis of childhood sinusitis is crucial for effective management.
- Treatment should be guided by the specific type and cause of sinusitis.
- An association between asthma and sinusitis is noted, but causality is not established.