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Chronic Rhinosinusitis in Children
Lourdes Quintanilla-Dieck1, Derek J Lam1
1Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, PV-01, Portland, OR 97239-3098.
Insights
Pediatric chronic rhinosinusitis (CRS) is a common, poorly studied condition. While medical treatments have limited evidence, surgery like adenoidectomy, balloon sinuplasty, and FESS show promise for children who do not respond to medical management.
Area of Science:
- Otolaryngology
- Pediatric Medicine
- Allergy and Immunology
Background:
- Pediatric chronic rhinosinusitis (CRS) is a prevalent condition often misdiagnosed and difficult to manage.
- Significant symptomatic overlap with related conditions contributes to diagnostic and therapeutic challenges.
Purpose of the Study:
- To review the definitions, presentation, complications, and management strategies for CRS in children.
- To emphasize the limited evidence base for current pediatric CRS management protocols.
Main Methods:
- Literature review focusing on pediatric chronic rhinosinusitis.
- Analysis of existing evidence for medical and surgical treatment modalities.
Main Results:
- Limited studies support standard medical therapies (antibiotics, saline irrigations, intranasal steroids) for pediatric CRS.
- Adenoidectomy is a primary surgical option, with balloon sinuplasty and functional endoscopic sinus surgery (FESS) showing utility in refractory cases.
Conclusions:
- Pediatric CRS is a distinct entity from acute rhinosinusitis (ARS) and adult CRS.
- Surgical interventions are increasingly supported for children unresponsive to medical management.
- Further outcome studies are essential to validate current medical and surgical protocols for pediatric CRS.
Purpose Of Review:
Pediatric chronic rhinosinusitis (CRS) is a common condition that is often misdiagnosed and can be challenging to treat. This review aims to 1) Review definitions, presentation, complications, and management of CRS in children. 2) Highlight the paucity of evidence in the management of pediatric CRS.
Recent Findings:
There are few studies supporting the usual recommended medical therapy for pediatric CRS (antibiotics, nasal saline irrigations, intranasal steroid). Adenoidectomy remains a mainstay of surgical treatment, but recent evidence demonstrates the utility of balloon sinuplasty and functional endoscopic sinus surgery (FESS) for patients who fail adenoidectomy alone.
Summary:
Pediatric CRS is distinct from ARS and adult CRS. It is a common problem that is poorly studied, in part because of significant symptomatic overlap with related conditions. Recent evidence supports the use of surgical treatment in children who fail medical management. However, further outcome studies are needed to better evaluate the effectiveness of current medical and surgical management protocols.
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