Sinusitis

Pediatric Sinusitis. Zacharisen M, Casper R. Immunol Allergy Clin North Am. 2005;25 :313– 332OpenUrlCrossRefPubMedTreatment of Pediatric Sinusitis. Goldsmith AJ, Rosenfeld RM. Pediatr Clin North Am. 2003;50 :413– 426OpenUrlCrossRefPubMedManagement of Sinusitis. Clinical Practice Guideline: American Academy of Pediatrics Subcommittee on Management of Sinusitis and Committee on Quality Improvement. Pediatrics. 2001;108 :798– 808OpenUrlAbstract/FREE Full Text

Sinusitis is one of the more poorly understood and inadequately studied entities in pediatrics. In the absence of any reliable tests or physical examination findings, the diagnosis often depends on the history alone as the means of distinguishing it from the common cold. For a seemingly benign entity that often resolves spontaneously, sinusitis is associated with symptoms that can affect a patient’s quality of life and complications that can be life-threatening.

Sinusitis is defined as inflammation of the normally sterile paranasal sinuses due to bacterial infection. Rhinosinusitis (RS) is the term currently used because the inflammation is believed to begin in the nasal epithelium (rhinitis). The exact incidence of sinusitis is unknown. However, it is estimated that of the average six to eight upper respiratory tract infections (URIs) per year experienced by school-age children, 5% to 10% will be complicated by RS. It also is estimated that 6% to 13% of children will have had one case of RS by the age of 3 years. RS also is classified by the duration of days of persistent symptoms. Acute rhinosinusitis (ARS) refers to symptoms that last longer than 10 days but fewer than 30. Subacute infection lasts between 30 and 90 days, recurrent infection lasts for fewer than 30 days but recurs after an asymptomatic period of 10 or more days, and chronic infection is defined as symptoms lasting longer than 90 days.

There are four …