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Pediatric Rhinosinusitis

  • Pediatric Allergy (F Baroody, Section Editor)
  • Published:
Current Treatment Options in Allergy Aims and scope Submit manuscript

Opinion statement

Rhinosinusitis is defined as an inflammation of the paranasal and nasal sinus mucosae. Chronic rhinosinusitis (CRS) is a common problem in the pediatric age group, and the diagnosis and treatment are challenging due to the chronicity and similarity of symptoms with allergic rhinitis and adenoid hypertrophy.

Although it is less common than acute rhinosinusitis, CRS is becoming more frequent and significantly affects the quality of life in children and can substantially impair daily function. CRS is characterized by sinus symptoms lasting more than 3 months despite medical therapy.

Many factors are involved in the pathogenesis of this disease and include a primary insult with a virus followed by bacterial infection and mucosal inflammation, along with predisposition to allergies.

The standard treatment of pediatricacute bacterial rhinosinusitis (ABRS) is nasal irrigation and antibiotic use. Medical treatment of pediatric CRS includes avoidance of allergens in allergic patients (environmental or food) and therapy with nasal irrigation, nasal corticosteroids sprays, nasal decongestants, and antibiotics directed at the most common sinonasalorganisms (Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis). Surgical therapy is rarely needed after appropriate medical therapy. Referral to an otolaryngologist and allergy specialist is recommended in case of failure of medical treatment.

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Abbreviations

ARS:

Acute rhinosinusitis

ABRS:

Acute bacterial rhinosinusitis

CRS:

Chronic rhinosinusitis

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Acknowledgments/Funding NIH

K24 AI 106822, K23AI106945

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Authors and Affiliations

  1. Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon

    Dana T. Badr MD

  2. Division of Respiratory Medicine, Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115, USA

    Jonathan M. Gaffin MD, MMSc

  3. Boston Children’s Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115, USA

    Jonathan M. Gaffin MD, MMSc & Wanda Phipatanakul MD, MS

  4. Division of Allergy and Immunology, Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115, USA

    Wanda Phipatanakul MD, MS

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  1. Dana T. Badr MD
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Correspondence to Wanda Phipatanakul MD, MS.

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Dr. Dana T. Badr declares that she has no conflict of interest.

Dr. Jonathan M. Gaffin declares that he has no conflict of interest.

Dr. Wanda Phipatanakul declares that she has no conflict of interest.

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Badr, D.T., Gaffin, J.M. & Phipatanakul, W. Pediatric Rhinosinusitis. Curr Treat Options Allergy 3, 268–281 (2016). https://doi.org/10.1007/s40521-016-0096-y

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