PubMed Health⌕ Search

PubMed · 16089235

Pediatric sinusitis: update.

Abstract

Sinusitis in children is a very common condition. It is being seen more and more by primary care physicians and pediatricians. Children average six to eight colds per year. Of those, 0.5 to 5% will develop a sinus infection. Symptoms of a cold or allergy overlap with those of rhinosinusitis in the child. Distinguishing rhinosinusitis from a cold or allergy may be challenging. It is agreed that if cold symptoms are not improving by 7 to 10 days, a sinus infection should be seriously considered. Plain radiographs can be helpful for maxillary sinusitis especially if an air-fluid level is seen; otherwise, the sensitivity and specificity of plain radiographs are poor. Computed tomography (CT) should not be used for diagnostic purposes. The role of CTis mainly in children with chronic rhinosinusitis when surgery is being considered. In cases of complicated sinusitis, a CT scan is necessary. Treatment of most rhinosinusitis cases in children is medical. Antibiotics constitute the mainstay of medical treatment. Medical treatment should be with an appropriate antibiotic and for at least 14 days. Adjunctive treatment with saline irrigations and topical and systemic decongestants may be helpful. Surgical intervention is necessary for complicated cases and for cases that do not respond to prolonged course of medical management. Currently adenoidectomy and endoscopic sinus surgery are the most common procedures used. Children needing surgical intervention are a small percentage because of the success of medical treatment. When and which surgical procedure to use are discussed in detail.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

Hassan H Ramadan. 2005. Pediatric sinusitis: update.. https://pubmed.ncbi.nlm.nih.gov/16089235/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Extramedullary plasmacytoma of the adenoids.

Extramedullary plasmacytomas are extremely rarely diagnosed in children. We report two cases of extramedullary plasmacytoma detected coincidentally in the adenoidectomy specimens of children younger than 4 years. We show that these children are disease-free after local excision as the only treatment. Surgical treatment without anti-neoplastic therapy in pediatric plasma cell dyscrasias of the pharyngeal lymphoid tissue may be a sufficient curative therapy.

Adenoidectomy↗

Changes in dentofacial morphology after adeno-/tonsillectomy in young children with obstructive sleep apnoea--a 5-year follow-up study.

The aim of this study was to compare a number of dentofacial variables and airway space in children suffering from obstructive sleep apnoea (OSA) syndrome with the corresponding variables in control children exhibiting a normal breathing pattern, to study the development of these variables prospectively over a 5-year-period following treatment for OSA, and to compare the recorded changes with the corresponding changes occurring in the controls. The subjects were 17 children (10 boys and 7 girls, mean age 5.6 years) diagnosed with OSA syndrome. The treatment for the OSA was adeno-/tonsillectomy. The control group comprised 17 age- and gender-matched children (mean age 5.8 years) without breathing problems. Lateral cephalograms were taken of the OSA children at baseline and then at 1, 3, and 5 years post-treatment. The control records comprised registrations at baseline and then after 1 and 5 years. In comparison with the controls, the OSA children exhibited a more posteriorly inclined mandible (P < 0.05), a more anteriorly inclined maxilla (P < 0.001), a greater lower anterior face height (P < 0.01), a shorter anterior cranial base (P < 0.01), retroclined upper and lower incisors (P < 0.05 and P < 0.01, respectively), reduced airway space (P < 0.05 and P < 0.01), and a less pronounced nose (P < 0.05). At 5 years post-treatment, there were no statistically significant differences between the groups except for the lengths of the anterior cranial base and the nose which were still shorter (P < 0.05) in the patient group. OSA in young children has an unfavourable effect on the development of several dental and facial components. However, if OSA is diagnosed and treated at an early age, an almost complete normalization of dentofacial morphology may be achieved.

Adenoidectomy↗

Comparison of lingual tonsil size as depicted on MR imaging between children with obstructive sleep apnea despite previous tonsillectomy and adenoidectomy and normal controls.

BACKGROUND: Cine MRI has become a useful tool in the evaluation of patients with persistent obstructive sleep apnea (OSA) despite previous surgical intervention and in patients with underlying conditions that render them susceptible to multilevel airway obstruction. Findings on cine MRI studies have also increased our understanding of the mechanisms and anatomic causes of OSA in children. OBJECTIVE: To compare lingual tonsil size between children with OSA and a group of normal controls. In addition, a subanalysis was made of the group of children with OSA comparing lingual tonsils between children with and without underlying Down syndrome. MATERIALS AND METHODS: Children with persistent OSA despite previous palatine tonsillectomy and adenoidectomy and controls without OSA underwent MR imaging with sagittal fast spin echo inversion-recovery images, and lingual tonsils were categorized as nonperceptible at imaging or present and measurable. When present, lingual tonsils were measured in the maximum anterior-posterior diameter. If lingual tonsils were greater than 10 mm in diameter and abutting both the posterior border of the tongue and the posterior pharyngeal wall, they were considered markedly enlarged. RESULTS: There were statistically significant differences between the OSA and control groups for the presence vs. nonvisualization of lingual tonsils (OSA 33% vs. control 0%, P=0.0001) and mean diameter of the lingual tonsils (OSA 9.50 mm vs. control 0.0 mm, P=0.00001). Within the OSA group, there were statistically significant differences between children with and without Down syndrome for the three lingual tonsil width categories (P=0.0070) and occurrence of markedly enlarged lingual tonsils (with Down syndrome 35% vs. without Down syndrome 3%, P=0.0035). CONCLUSIONS: Enlargement of the lingual tonsils is relatively common in children with persistent obstructive sleep apnea after palatine tonsillectomy and adenoidectomy. This is particularly true in patients with Down syndrome.

Adenoidectomy↗