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Clinical Characteristics of Rhinosinusitis in Children in a Tertiary Care Center
Abdullah M Alqahtani1, Nawaf D Aljehani1, Abdulazeez Alzailaie1
1College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Insights
Rhinosinusitis (RS) in children is common, often presenting as chronic maxillary sinus inflammation. Medical treatment is usually effective, but functional endoscopic sinus surgery may be needed for persistent cases.
Area of Science:
- Pediatric Otolaryngology
- Rhinology
- Epidemiology
Background:
- Rhinosinusitis (RS) involves nasal and sinus inflammation, categorized by duration (acute, subacute, chronic).
- Pediatric RS presents distinct symptoms like cough, irritability, and fatigue, differing from adult manifestations.
- Understanding pediatric RS prevalence and characteristics is crucial for effective management.
Purpose of the Study:
- To determine the prevalence of Rhinosinusitis (RS) in pediatric patients.
- To describe the clinical characteristics and common symptoms of pediatric RS.
- To analyze treatment outcomes and surgical interventions for pediatric RS.
Main Methods:
- Retrospective cohort study at King Abdullah Specialized Children's Hospital (KASCH) in Riyadh, Saudi Arabia.
- Analysis of medical records for pediatric patients diagnosed with RS between 2019 and 2022.
- Examination of patient demographics, symptom presentation, sinus involvement, and treatment responses.
Main Results:
- 345 pediatric patients with RS were analyzed; 60.9% were male, and 30.7% were over 12 years old.
- Chronic RS without nasal polyps was most common (86.7%), predominantly affecting the maxillary sinus (58%).
- Nasal congestion (67.5%), discharge (58.6%), and facial discomfort (55.4%) were key symptoms; 91% improved with medical treatment.
Conclusions:
- Rhinosinusitis is a prevalent condition in children, characterized by nasal obstruction, discharge, and facial discomfort.
- Chronic maxillary RS is the most common form in pediatric patients.
- Medical management is typically effective, with functional endoscopic sinus surgery being a primary surgical option when necessary.
Background:
Rhinosinusitis (RS) is a term used in clinical practice to describe inflammation of the paranasal and nasal sinuses. This condition can be categorized based on the duration of symptoms into acute, subacute, and chronic RS. It is important to note that RS presents differently in pediatric patients compared to adults. In children, typical symptoms include cough, bad breath (halitosis), irritability, fatigue, and swelling around the eyes. This study aims to shed light on the prevalence and clinical characteristics of RS in the pediatric age group.
Methods:
This retrospective cohort study was conducted at King Abdullah Specialized Children's Hospital (KASCH) in Riyadh, Saudi Arabia, which is a tertiary care center under the authority of the Ministry of National Guard Health Affairs (MNGHA) in Saudi Arabia, using the medical records of all patients diagnosed with RS between 2019 and 2022.
Results:
In this study, 345 pediatric patients with RS were examined. A significant portion (n = 106, 30.7%) were older than 12 years, and males made up the majority (n = 210, 60.9%). Chronic RS without nasal polyps prevailed (n = 299, 86.7%), mainly affecting the maxillary sinus (n = 200, 58%). Notably, 29% (n = 100) were diagnosed after age 12. Key symptoms included nasal congestion (n = 233, 67.5%), nasal discharge (n = 202, 58.6%), and facial discomfort (n = 191, 55.4%). Most (n = 314, 91%) received medical treatment, resulting in improvement for 78.8% (n = 272). Of those not improving (n = 73, 21.2%), 47.9% (n = 35) received medical management, and the rest underwent surgery, primarily functional endoscopic sinus surgery (n = 38, 52.1%).
Conclusion:
RS is a common condition affecting children, with symptoms like nasal obstruction, discharge, and facial discomfort. Chronic RS, particularly in the maxillary sinus, is the most prevalent type. Medical treatment was the first choice and generally effective, but when needed, surgical intervention, mainly functional endoscopic sinus surgery, was pursued.
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