Management of Chronic Rhinosinusitis in Pediatric Patients
Summary
Chronic rhinosinusitis in children is defined by persistent nasal and sinus inflammation lasting more than 12 weeks and significantly impairs quality of life. Management begins with accurate diagnosis through clinical history, nasal endoscopy and imaging when indicated. Initial therapy centres on medical measures: prolonged courses of broad‐spectrum antibiotics targeting common respiratory pathogens, regular saline irrigation to clear secretions, and intranasal corticosteroids to reduce mucosal inflammation. Adjunctive treatments may include antihistamines for atopic comorbidities and mucolytics in selected cases. In children who fail maximal medical therapy, surgical intervention is considered. Adenoidectomy, often combined with balloon catheter sinuplasty, is widely regarded as first‐line surgery in young, otherwise healthy patients. More extensive endoscopic sinus surgery is reserved for older children, those with asthma or persistent disease despite prior procedures. Multidisciplinary care involving paediatricians, allergists and otolaryngologists ensures that comorbidities such as asthma, allergy and immunodeficiency are optimally managed. Emerging research explores targeted biological therapies for underlying endotypes and seeks to personalise treatment based on microbiome and immunological profiling. Globally, improving access to both medical and surgical interventions remains a priority to reduce the burden of paediatric chronic rhinosinusitis.
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Management of Chronic Rhinosinusitis in Pediatric Patients publication trend
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Technical terms
Chronic rhinosinusitis (CRS): Persistent inflammation of the nasal passages and paranasal sinuses lasting ≥12 weeks.
CRSwNP/CRSsNP: Subtypes of CRS distinguished by presence (with) or absence (without) nasal polyps.
Endoscopic sinus surgery (ESS): Minimally invasive procedure to restore sinus drainage using nasal endoscopes.
Adenoidectomy: Surgical removal of the adenoids to reduce obstruction and bacterial load.
Balloon catheter sinuplasty (BCS): Technique using an inflatable balloon to dilate sinus ostia and improve drainage.
References
- Comorbidities of chronic rhinosinusitis in children and adults. Clinical and Translational Allergy (2024).
- The Role of the Adenoids in Pediatric Chronic Rhinosinusitis. Medical Sciences (2019).
- Health-Related Quality of Life Assessed in Children with Chronic Rhinitis and Sinusitis. Children (2021).
- Surgical Treatment of Paediatric Chronic Rhinosinusitis. Journal of Clinical Medicine (2019).
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