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Chronic rhinosinusitis and age: is the pathogenesis different?

Mahboobeh Mahdavinia1, Leslie C Grammer

  • 1Department of Medicine, Division of Allergy-Immunology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Expert Review of Anti-Infective Therapy
|October 1, 2013
PubMed

Insights

Chronic rhinosinusitis (CRS) presents differently in children and adults, affecting symptoms, tissue characteristics, and related conditions. Understanding these pediatric versus adult CRS distinctions is key for effective management.

Area of Science:

  • Otolaryngology
  • Pediatric Medicine
  • Immunology

Background:

  • Chronic rhinosinusitis (CRS) is a prevalent condition impacting quality of life across all age groups.
  • Significant differences exist in symptomatology, histopathology, and associated comorbidities between pediatric and adult CRS patients.
  • Existing research highlights a need for better understanding of age-specific CRS characteristics.

Purpose of the Study:

  • To delineate the key differences in chronic rhinosinusitis (CRS) between pediatric and adult populations.
  • To compare symptomatology, histopathological findings, and associated diseases in pediatric versus adult CRS.
  • To identify age-specific factors influencing CRS presentation and management.

Main Methods:

  • Comparative analysis of existing literature on pediatric and adult chronic rhinosinusitis (CRS).
  • Review of studies focusing on symptomatology, histopathology (e.g., cellularity, infiltration, glandular hyperplasia), and comorbidities.
  • Synthesis of data regarding the role of specific conditions like nasal polyposis, cystic fibrosis, allergic fungal rhinosinusitis, gastroesophageal reflux disease, otitis media, adenoids, immunodeficiencies, and asthma in different age groups.

Main Results:

  • Nasal polyposis is less common in pediatric CRS, except in cases of cystic fibrosis or allergic fungal rhinosinusitis.
  • Pediatric CRS shows higher cellularity and lymphocytic infiltration, while adult CRS exhibits more eosinophilic infiltration and glandular hyperplasia.
  • Stronger associations are noted between pediatric CRS and gastroesophageal reflux disease, otitis media, and potentially adenoids, whereas immunodeficiencies and asthma are common across all ages.

Conclusions:

  • Significant age-related disparities exist in the clinical presentation, underlying pathology, and associated conditions of chronic rhinosinusitis (CRS).
  • These differences underscore the importance of age-specific diagnostic and therapeutic approaches for CRS.
  • Further research is needed, particularly on the pathophysiology of CRS in the elderly population.

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