Pediatric Perspectives of Rhinosinusitis

  • Lisa Elden
  • Lawrence W.C. Tom

Embryology And Anatomic Considerations

The paranasal sinuses begin to develop during the third week of gestation and continue to grow throughout early childhood and adolescence (Fig. 13.1). Two mesenchymal grooves develop along the lateral wall of the nasal cavity that become the inferior turbinate, the middle meatus, and the inferior meatus. The ethmoidoturbinate mesenchymal folds develop superiorly to give rise to the middle and superior turbinates. Once the turbinates are established, the sinuses begin to develop. During the third month of gestation, the maxillary sinus arises as an ectodermal outpocket from within the region of the middle meatal groove developing laterally. At birth, the cavity of the maxillary sinus is relatively small, with dimensions 7 × 4 × 4 mm. The sinus cavity continues to grow inferiorly and posteriorly and does not become level with the floor of the nose until age 12 years after the adult teeth have erupted [ 1]. As a result, the tooth buds are at...


Maxillary Sinus Frontal Sinus Chronic Sinusitis Mometasone Furoate Functional Endoscopic Sinus Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Sobol SE. Management of acute sinusitis and its complications. In: Pediatric Otolaryngology: The Requisites in Pediatrics. Philadelphia: Mosby Elsevier, 2007:118–128.Google Scholar
  2. 2.
    Willner A, Choi SS, Vezina LG, Lazar RH. Intranasal anatomic variations in pediatric sinusitis. Am J Rhinol 1997;11(5):355–360.PubMedCrossRefGoogle Scholar
  3. 3.
    Brook I, Gooch WM III, Jenkins SG, et al. Medical management of acute bacterial sinusitis. Recommendations of a clinical advisory committee on pediatric and adult sinusitis. Ann Otol Rhinol Laryngol 2000;109(suppl):2–20.Google Scholar
  4. 4.
    Sinus and Allergy Health Partnership: Antimicrobial treatment guidelines for acute bacterial rhinosinusitis. Otolaryngol Head Neck Surg 2000;123(suppl 1, pt 2):S1–S32.CrossRefGoogle Scholar
  5. 5.
    O’Brien KL, Dowell SF, Schwartz B, et al. Acute sinusitis: principles of judicious use of antimicrobial agents. Pediatrics 1998;101:174–177.Google Scholar
  6. 6.
    Conrad DA, Jenson HB. Management of acute bacterial rhinosinusitis. Curr Opin Pediatr 2002;14:86–90.PubMedCrossRefGoogle Scholar
  7. 7.
    American Academy of Pediatrics Subcommittee on Management of Sinusitis and Committee on Quality Improvement. Clinical practice guideline: management of sinusitis. Pediatrics 2001;108(3):798–808.Google Scholar
  8. 8.
    Lee D, Rosenfeld RM. Adenoid bacteriology and sinonasal symptoms in children. Otolaryngol Head Neck Surg 1997;116:301–307.PubMedCrossRefGoogle Scholar
  9. 9.
    Talmor M, Li P, Barie PS. Acute paranasal sinusitis in critically ill patients: Guidelines for prevention, diagnosis and treatment. Clin Infect Dis 1997;25:1441–1446.PubMedCrossRefGoogle Scholar
  10. 10.
    Wang X, Kim J, McWilliams R, Cutting GR. Increased prevalence of chronic rhinosinusitis in carriers of a cystic fibrosis mutation. Arch Otolaryngol Head Neck Surg 2005;131(3): 237–240.PubMedCrossRefGoogle Scholar
  11. 11.
    Morris P, Leach A. Antibiotics for persistent nasal discharge (rhinosinusitis) in children. Cochrane Database of Systemic Reviews 2002;4:CD001094.Google Scholar
  12. 12.
    Sinus and Allergy Health Partnership. Antimicrobial treatment guidelines for acute bacterial rhinosinusitis. Otolaryngol Head Neck Surg 2004;130(suppl):1–45.Google Scholar
  13. 13.
    Expert Panel on Pediatric Imaging. Sinusitis in the pediatric population: ACR Appropriateness Criteria. Reston, VA: American College of Radiology, 1999.Google Scholar
  14. 14.
    Gwaltney JM Jr, Phillips CD, Miller RD, Riker DK. Computed tomographic study of the common cold. N Engl J Med 1994;330:25–30.PubMedCrossRefGoogle Scholar
  15. 15.
    Gwaltney JM Jr. Acute community-acquired sinusitis. Clin Infect Dis 1996;23:1209–1223.PubMedCrossRefGoogle Scholar
  16. 16.
    Hickner JM, Bartlett JG, Besser RE, et al. Principles of appropriate antibiotic use for acute rhinosinusitis in adults: background. Ann Intern Med 2001;134:498–505.PubMedGoogle Scholar
  17. 17.
    Poole MD, Jacobs MR, Anon JB, Marchant CD, Hoberman A, Harrison CJ. Antimicrobial guidelines for the treatment of acute bacterial rhinosinusitis in immunocompetent children. Int J Pediatr Otorhinolaryngol 2002;63:1–13.PubMedCrossRefGoogle Scholar
  18. 18.
    Rosenfeld RM, Andes D, Bhattacharyya N, Cheung D, Eisenberg S, Ganiats TG, Gelzer A, Hamilos D, , Hudgins PA, Jones S, Krouse HJ, Lee LH, Mahoney MC, Marple BF, Mitchell JP, Nathan R, Shiffman RN, Smith TL, Witsell DL. Clinical practice guideline: adult sinusitis. Otolaryngol Head Neck Surg 2007;137:S1–S31.Google Scholar
  19. 19.
    Wald ER. Expanded role of group A streptococci in children with upper respiratory infections. Pediatr Infect Dis J 1999;18:663–665.PubMedCrossRefGoogle Scholar
  20. 20.
    Shapiro ED, Milmoe GJ, Wald ER, Rodnan JB, Bowen AD. Bacteriology of the maxillary sinuses in patient with cystic fibrosis. J Infect Dis 1982;146:589–593.PubMedCrossRefGoogle Scholar
  21. 21.
    Hui Y, Gaffney R, Crysdale WS. Sinusitis in patients with cystic fibrosis. Eur Arch Otorhinolaryngol 1995;252:191–196.PubMedCrossRefGoogle Scholar
  22. 22.
    Garau J, Dagan R. Accurate diagnosis and appropriate treatment of acute bacterial rhinosinusitis: minimizing bacterial resistance. Clin Ther 2003;25(7):1936–1951.PubMedCrossRefGoogle Scholar
  23. 23.
    Ip S, Fu L, Balk E, Chew P, Devine D, Lau J. Update on acute bacterial rhinosinusitis. Evid Rep Technol Assess (Summ) 2005;124:1–3.Google Scholar
  24. 24.
    Schwartz B, Bell DM, Hughes JM. Preventing the emergence of antimicrobial resistance. A call for action by clinicians, public health officials, and patients. JAMA 1997;278:944–945.PubMedCrossRefGoogle Scholar
  25. 25.
    Bussey MF, Moon RY. Acute sinusitis. Pediatr Rev 1999;20(4):142.PubMedCrossRefGoogle Scholar
  26. 26.
    Scadding GK. Corticosteroids in the treatment of pediatric allergic rhinitis. J Allergy Clin Immunol 2001;108:S59–S64.PubMedCrossRefGoogle Scholar
  27. 27.
    Buchman CA, Yellon RF, Bluestone CD. Alternative to endoscopic sinus surgery in the management of pediatric chronic rhinosinusitis refractory to oral antimicrobial therapy. Otolaryngol Head Neck Surg 1999;120(2):219–224.PubMedCrossRefGoogle Scholar
  28. 28.
    Mair EA, Bolger WE, Breisch EA. Sinus and facial growth after pediatric endoscopic sinus surgery. Arch Otolaryngol Head Neck Surg 1995;121(5):547–552.PubMedCrossRefGoogle Scholar
  29. 29.
    Van Peteghem A, Clement PA. Influence of extensive functional endoscopic sinus surgery (FESS) on facial growth in children with cystic fibrosis. Comparison of 10 cephalometric parameters of the midface for three study groups. Int J Pediatr Otorhinolaryngol 2006;70(8):1407–1413.PubMedCrossRefGoogle Scholar
  30. 30.
    White CB, Foshee WS. Upper respiratory tract infections in adolescents. Adolesc Med 2000;11(2):225–249.PubMedGoogle Scholar
  31. 31.
    Chandler JR, Langenbrunner DJ, Stevens ER. The pathogenesis of orbital complications in acute sinusitis. Laryngoscope 1970;80:1414–1428.PubMedCrossRefGoogle Scholar
  32. 32.
    Arjmand EM, Lusk RP, Muntz HR. Pediatric sinusitis and subperiosteal orbital abscess formation: diagnosis and treatment. Otolaryngol Head Neck Surg 1993;109:886–894.PubMedGoogle Scholar
  33. 33.
    Froehlich P, Pransky SM, Fontaine P, et al. Minimal endoscopic approach to superiosteal orbital abscess. Arch Otolaryngol Head Neck Surg 1997;123:280–282.PubMedCrossRefGoogle Scholar
  34. 34.
    Lerner DN, Choi SS, Zalzal GH, Johnson DL. Intracranial complications of sinusitis in childhood. Ann Otol Rhinol Laryngol 1995;104:288–293.PubMedGoogle Scholar
  35. 35.
    Glickstein JS, Chandra RK, Thompson JW. Intracranial complications of pediatric sinusitis. Otolaryngol Head Neck Surg 2006;134:733–736.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Lisa Elden
    • 1
  • Lawrence W.C. Tom
  1. 1.Department of Otorhinolaryngology, Head and Neck SurgeryUniversity of Pennsylvania School of Medicine, The Children’s Hospital of PhiladelphiaPhiladelphiaUSA

Personalised recommendations