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Rhinosinusitis management in pediatrics: an overview
1Department of Maternal and Pediatric Sciences, University of Milan, Fondazione IRCCS, Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy. Susanna.Esposito@unimi.it
Insights
Rhinosinusitis, an inflammation of the sinuses, is diagnosed clinically in children with severe or persistent symptoms. Imaging is not typically needed for uncomplicated cases, but is essential for severe, persistent infections.
Area of Science:
- Otolaryngology
- Infectious Diseases
Background:
- Rhinosinusitis involves inflammation of the paranasal sinuses, often due to infection.
- Clinical presentation varies with age, symptom duration, and illness severity.
Purpose of the Study:
- To outline diagnostic criteria for rhinosinusitis in children.
- To define the role of imaging and antibiotic therapy in managing rhinosinusitis.
Main Methods:
- Diagnosis relies on anamnestic and clinical criteria for children with severe or persistent symptoms.
- Imaging (CT, MRI, rhinoscopy) is reserved for severe, antibiotic-refractory cases.
Main Results:
- Uncomplicated acute bacterial rhinosinusitis diagnosis does not typically require imaging.
- Antibiotics accelerate symptom resolution in mild cases and are crucial for severe cases.
Conclusions:
- Clinical assessment is primary for diagnosing pediatric rhinosinusitis.
- Judicious use of imaging and antibiotics is key for effective management and complication avoidance.
Abstract:
Rhinosinusitis is an inflammation of one or more paranasal sinuses, usually caused by an infection. The clinical appearance of rhinosinusitis may be heterogeneous and change with patient age, the duration of symptoms and, above all, the seriousness of the illness. The diagnosis of rhinosinusitis should only be based on anamnestic and clinical criteria in children with serious or persistent symptoms of upper respiratory tract infection, or which appear within a short time of an apparent recovery. Imaging studies are not usually necessary to confirm a diagnosis of uncomplicated acute bacterial rhinosinusitis. Paranasal sinus computed tomography or magnetic resonance and optical fibre rhinoscopy are required in severe cases that do not respond to antibiotic therapy. Antibiotics are recommended in cases of mild acute bacterial rhinosinusitis as a means of accelerating the resolution of symptoms, and they are mandatory in severe acute cases in order to cure the disease and avoid the possible onset of severe complications.
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