Chronic sinusitus in children

Summary

Physicians are familiar with “catarrhal” families or catarrhal members of a family. Poor social background and infective fevers and especially whooping cough, predispose. Climatic factors are not well understood.

Symptomatology is discussed, with especial reference to the coexistence of chronic lower respiratory infections. The suggestion is made that sometimes the latter precedes the sinusitis.

Diagnostic points based upon bacteriology and radiology are described.

Treatment depends upon the stage to which the disease has progressed. The thesis is developed that it is important to try to decide whether the state of inflammation present in the lining membrane of the sinuses is reversible or irreversible. In the reversible case simple soaks, lavage, etc., will suffice, but where these methods have failed and an irreversible process is believed to be present, radical surgery is needed. Intranasal “fenestrations” and turbinectomies are condemned.

“Allergic” cases with polypi are recognised as offering especial difficulties. When uncomplicated by sepsis simple polypectomy may be sufficient; but more often radical surgery gives the greatest hope of improvement. This is especially so in the cases of co-existent infection and allergy.