[Childhood sinusitis. A description and comments based on a 10-year series of cases]

Following a review of the embryology, evolution, anatomy and physiopathology of the paranasal naso-sinus apparatus, the paper briefly describes the history of pathological studies in this area. The main clinical symptoms connected to infantile sinusal pathologies are outlined and, on the basis of a series of 1982 affected subjects (16.45% of subjects studied), the frequency of these diseases is underlined together with the net prevalence of maxillary sinusal involvement in childhood, as is confirmed by data published in pediatric literature. After having described the pathogenesis, clinical symptoms and the possibilities of prophylaxis, the paper discusses a successful therapy using: a macrolide (erythromycin); a drug with a mixed action on the synthesis and composition of mucus and on the permeability of the mucosa (ambroxol); and a true mucolytic compound (acetylcysteine). The cost/benefit ratio of this treatment is advantageous compared to other immunomodulating treatments. In conclusion, the paper suggests a careful search for this pathology among the recurrent respiratory infections, using the therapeutic protocol described in the event of sinusal infection, and reserving the use of immunomodulating drugs for those cases which do not form part of this group.