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Pediatric chronic rhinosinusitis: a retrospective review

Michael W Criddle1, Amy Stinson, Mohammedi Savliwala

  • 1Department of Otolaryngology-Head and Neck Surgery, Wayne State University, 5E-UHC, Detroit, MI 48202, USA. mcriddle@med.wayne.edu

American Journal of Otolaryngology
|January 16, 2009
PubMed

Insights

A stepped treatment protocol using long-term oral antibiotics is effective for pediatric chronic rhinosinusitis (CRS), with 78% achieving resolution. This approach avoids surgery and intravenous antibiotics for most children with CRS.

Area of Science:

  • Otolaryngology
  • Pediatric Pulmonology
  • Allergy and Immunology

Background:

  • Pediatric chronic rhinosinusitis (CRS) presents significant morbidity and treatment challenges.
  • Current treatments like functional endoscopic sinus surgery (FESS) raise concerns about facial growth interference.
  • Alternative stepwise protocols involving maxillary sinus irrigation and intravenous (IV) antibiotics show efficacy but have drawbacks.

Purpose of the Study:

  • To review institutional experience in treating medically refractory pediatric CRS.
  • To describe the epidemiology of pediatric CRS patients.
  • To assess the success of a stepped treatment protocol using long-term oral antibiotics.

Main Methods:

  • Retrospective review of medical records for 23 pediatric patients.
  • Analysis of treatment outcomes for a stepwise protocol including adenoidectomy, maxillary sinus irrigation, and oral antibiotics.

Main Results:

  • Overall clinical resolution was achieved in 96% of patients.
  • 78% of patients achieved resolution with oral antibiotics alone, without IV therapy.
  • Four patients requiring IV antibiotics were diagnosed with immune deficiency.
  • Long-term resolution was 78% overall and 86% for those not requiring IV antibiotics.
  • No patients required FESS, and no complications were reported.

Conclusions:

  • A stepwise protocol with adenoidectomy, maxillary sinus irrigation, and long-term oral antibiotics is safe and effective for pediatric CRS.
  • Patients with underlying immunodeficiency may necessitate long-term IV antibiotic therapy for symptom resolution.
  • This protocol offers a viable alternative to FESS for medically refractory pediatric CRS.
Abstract

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