The management of paediatric rhinosinusitis

Area of Science:

• Otolaryngology
• Pediatrics
• Immunology

Background:

• Paediatric rhinosinusitis (PDRS) is often conflated with rhinitis, despite distinct pathophysiology involving nasal mucosa and sinus inflammation.
• Lack of clear guidelines contributes to misconceptions in PDRS diagnosis and treatment.
• PDRS significantly impacts children's immediate health, long-term well-being, and educational outcomes.

Purpose of the Study:

• To provide a comprehensive overview of paediatric rhinosinusitis (PDRS) epidemiology, pathophysiology, symptoms, diagnosis, and management.
• To emphasize the critical aspects of PDRS diagnosis and management due to existing guideline deficiencies.
• To differentiate PDRS from rhinitis and other upper respiratory conditions, correcting common misconceptions.

Main Methods:

• Systematic literature review focusing on paediatric rhinosinusitis.
• Analysis of epidemiological data, pathophysiological mechanisms, and clinical presentations.
• Evaluation of current diagnostic and management strategies, with an emphasis on European and UK contexts.

Main Results:

• PDRS involves inflammation of both nasal mucosa and sinuses, unlike rhinitis which affects only the nasal mucosa.
• Current management approaches for PDRS are often inadequate due to a lack of specific guidelines.
• The review highlights the detrimental effects of PDRS on children's health and education.

Conclusions:

• Accurate diagnosis and tailored management of PDRS are crucial for improving children's health outcomes.
• A comprehensive understanding of PDRS pathophysiology and distinct treatment protocols is necessary.
• Recommendations provided, primarily from European and UK perspectives, offer a framework applicable globally for PDRS care.