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Pediatric Unilateral Chronic Sinusitis: Clinical and Radiological Patterns Compared to Adults
Ahmed Adel Sadek1, Maisara Mohamed Mahmoud Nasr1, Ahmed Ali Mohamed Badawi1
1Department of Otorhinolaryngology, Faculty of Medicine, Minia University, Egypt.
Insights
Pediatric unilateral sinusitis often involves antrochoanal polyps and fungal sinusitis, presenting with faster symptom onset and more bone erosion than in adults. Early diagnosis and management are crucial for preventing complications in children.
Area of Science:
- Otolaryngology
- Pediatric Rhinology
- Medical Imaging
Background:
- Upper respiratory tract infections and sinusitis are common in children.
- Unilateral sinusitis, while not uncommon, has distinct characteristics in pediatric versus adult populations.
Purpose of the Study:
- To analyze and compare the disease characteristics of unilateral sinusitis in children and adults.
- To identify differences in pathology, clinical presentation, and radiological findings between pediatric and adult unilateral sinusitis.
Main Methods:
- A comparative study of 124 patients with unilateral chronic sinusitis.
- Patients were divided into pediatric (≤18 years, 66 cases) and adult (>18 years, 58 cases) groups.
- Comparison included demographic data, side of involvement, clinical manifestations, and computed tomography (CT) findings.
Main Results:
- Pediatric patients showed a higher incidence of antrochoanal polyps and allergic fungal sinusitis compared to adults.
- Clinical manifestations were significantly shorter in pediatric patients (P=0.001).
- Bone expansion, erosion, and adjacent structure involvement were significantly higher in pediatric patients (P<0.05). Proptosis was also more common in children.
Conclusions:
- Unilateral inflammatory lesions in pediatric sinusitis frequently include antrochoanal polyps and allergic fungal sinusitis, often requiring surgical intervention.
- Pediatric unilateral sinusitis presents with a shorter duration of symptoms and a greater propensity for bone erosion and adjacent structure involvement.
- Early diagnosis and prompt management are essential in pediatric cases to prevent potential complications.
Introduction:
Upper respiratory tract infections and sinusitis are more prevalent in children than in adults. Unilateral sinusitis is not uncommon disease. Our aim was to analyze the disease characteristics in children with unilateral sinusitis and compare them with those of adults.
Materials And Methods:
This study included 124 patients with unilateral chronic sinusitis divided according to age into two groups: pediatric group ≤18 years (66 cases) and adult group >18 years (58 cases). The groups were compared in terms of demographic data, side, clinical manifestations and radiological findings.
Results:
In pediatric patients, the most common inflammatory pathology was antrochoanal polyps, followed by allergic fungal sinusitis. On the other hand, chronic sinusitis without nasal polyps is the most common in adults, followed by antrochoanal polyps. The mean duration of clinical manifestations before diagnosis in pediatric patients was significantly shorter than that in adults (P=0.001). The most common symptoms in both pediatric and adult patients were anterior nasal discharge and nasal obstruction. Proptosis was significantly higher in pediatric group than in adult group (P=0.015). On computed tomography (CT), the most commonly affected sinus in both pediatric and adult patients was the maxillary sinus followed by the anterior ethmoid sinus. Bone expansion, erosion and involvement of adjacent structures were significantly higher in pediatric patients (P=0.028, 0.027 respectively).
Conclusion:
Pediatric patients have a high incidence of antrochoanal polyps and allergic fungal sinusitis as unilateral inflammatory lesions. These lesions require surgical management. Inflammatory paranasal sinus lesions in pediatric patients have a shorter duration of clinical manifestations and a higher incidence of bone erosion and involvement of adjacent structures; therefore, early diagnosis and management prevent complications.
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