Sinusitis in Children

Abstract

Sinusitis is a frequent cause of morbidity in children. Although the diagnosis of sinusitis is largely clinical based on suggestive history and physical examination, nasal cytology and sinus imaging may provide useful additional information in select patients. Treatment of sinusitis includes appropriate antibiotics (with choice based on likely causative micro-organisms) and adjunctive medications to help encourage ostial drainage (including nasal saline, nasal corticosteroids, newer generation antihistamines, leukotriene antagonists, and on occasion, even oral corticosteroids). Recurrent or chronic sinusitis in children should prompt consideration of possible underlying allergic rhinitis, anatomic defects, gastroesophageal reflux, immunodeficiency, or even cystic fibrosis. Subtle sinus disease may be an important factor in persistent asthma or middle ear disease.