Sinusitis in children

Physicians caring for children must recognize that children do indeed develop acute and chronic infections of their sinuses with signs and symptoms that may be quite different from those of adults. The lack of classical signs and symptoms of sinusitis in children, particularly in the very young, is well recognized. Acute sinusitis occurs as a complication of approximately 0.5% of common colds. If one considers that children have an average of six to eight colds a year, sinusitis may be regarded as a frequently encountered disease. The paranasal sinuses appear radiologically at different age periods in children, and it is important to note that there is much variation in the shape and size of the sinuses at all ages. The pathogenesis of sinusitis usually involves blockage of the ostia, which can be initiated by infection, allergy, structural abnormalities, or any edema of the nasal mucosa. The most commonly found pathogens of sinusitis in children are similar to those found in adults. The diagnosis of sinusitis is based on a clinical history, physical examination, laboratory results, and imaging studies. Standard radiographs are still the most frequently used radiologic modality for evaluating sinus disease. However, computed tomography is the gold standard for the precise delineation of inflammatory sinus disease. Sinusitis in children is associated with allergic rhinitis and/or asthma. In asthmatic children, there is an improvement of asthmatic symptoms and pulmonary function following diagnosis and optimal treatment of concomitant sinusitis.Univ Fed Sao Paulo, Dept Pediat, Div Rheumatol Allergy & Clin Immunol, Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Pediat, Div Rheumatol Allergy & Clin Immunol, Sao Paulo, BrazilWeb of Scienc