Sinusitis In Children Research Articles

1. General symptoms like meningitis representing sinusitis in children—case report

1. General symptoms like meningitis representing sinusitis in children—case report

3. Bacteriological study of rhinitis and paranasal sinusitis in children

3. Bacteriological study of rhinitis and paranasal sinusitis in children

2. Studies on sinusitis in children involving Haemophilus influenzae infection

2. Studies on sinusitis in children involving Haemophilus influenzae infection

8. Sinusitis in children: clinical features and surgical management

8. Sinusitis in children: clinical features and surgical management

4. Macrolide therapy for sinusitis in children

Using the Monte Carlo simulation method, the influence of various doses and dosing frequencies of carbapenems on the antimicrobial activities against Streptococcus pneumoniae, Haemophilus influenzae, and Pseudomonas aeruginosa, which are the main causative organisms of respiratory infections, was studied with the aim of identifying optimized effectiveness. Based on pharmacokinetic (PK) parameters of individual carbapenems in healthy adults, data on changes in the respective blood concentrations in 2000 cases were simulated by applying a lognormal distribution to probability distributions of their volume of distributions and half-life periods. Based on minimum inhibitory concentration (MIC) distribution data of the individual carbapenems against these strains, MICs in the 2000 cases were also simulated. Using these data in blood concentrations and MICs, the probabilities of attaining various percentages of the dosing interval during which drug concentrations remain above MIC (T > MIC) were calculated at several dosing regimens. Considering the probabilities of attaining the bactericidal effect (50% T>MIC) and daily drug costs, imipenem (IPM) at 500 mg i.v. BID, panipenem (PAPM) at 500 mg i.v. BID, and biapenem (BIPM) at 300 mg i.v. BID against Streptococcus pneumoniae; meropenem (MEPM) at 500 mg i.v. BID or TID against Haemophilus influenzae infections; and MEPM at 500 or 1000 mg i.v. TID against Pseudomonas aeruginosa, each over 30 min, were determined as appropriate empirical treatments. Selecting carbapenems with superior antimicrobial activities and optimizing their dose regimens are important to improve the efficacy. Application of Monte Carlo simulation to MIC distributions allows determination of appropriate empiric therapy even if drug susceptibility of a causative organism in individual patients is unknown.

2. The role of nasal allergy in chronic sinusitis in children

2. The role of nasal allergy in chronic sinusitis in children

Limited axial CT of the paranasal sinuses in screening for sinusitis.

E valuation of sinusitis. which affects 50 million people in the United States, is a major contributor to health care expenditures. Although empiric antibiotic treatment of all patients with symptoms of sinusitis is controversial I I j, most treated patients respond to initial antibiotic therapy. Radiographic documentation of sinus disease is desirable in certain patients. especially to determine the need for more comprehensive and protracted antibiotic regimens (with additional office visits) in patients whose symptoms persist after mitial therapy. Radiographic distinction of sinusitis from rhinitis can be useful in patients predisposed to rhinitis. because both can have identical clinical pictures. Such patients include smokers or those with allergies or a history of occupational exposure. Radiographic identification of isolated nasal disease (i.e., swollen turbinates) is important because rhinitis is usually treated symptomatically or with lifestyle changes. CT scans have been shown to be superior to standard sinus radiographs in evaluating recurrent sinusitis, particularly ethmoid and sphenoid sinusitis in children 12-4]. The use of sinus CT has focused mainly on coronal screening studies before functional endoscopic sinonasal surgery. Coronal CT requires prone positioning for prolonged periods ( I 520 mm) of time while 20 or more slices are obtained through the paranasal sinuses. A reliable, more comfortable, and less expensive screening examination to replace plain films is desirable in these patients.

1. Changes in the incidence of chronic sinusitis in children and its related etiologic factors in the last 15 years

1. Changes in the incidence of chronic sinusitis in children and its related etiologic factors in the last 15 years

4. Antibiotic therapy for chronic sinusitis in children and its spontaneous course

4. Antibiotic therapy for chronic sinusitis in children and its spontaneous course

A Double-Blind, Placebo-Controiled Trial of Decongestant-Antihistamine for the Treatment of Sinusitis in Children

We studied the effectiveness of nasal decongestant-antihistamine in treating acute sinusitis in children. All subjects received oral amoxicillin for 14 days. Subjects randomized to the decongestant-antihistamine group received nasal oxymetazolone and oral syrup containing brompheniramine and phenylpropanolamine. Controls received placebo nasal saline and oral syrup. In both groups symptoms resolved quickly, and radiographs improved significantly. Responses to treatment were similar between the two groups. Water's radiographs of the maxillary sinuses proved reliable in the assessment of the degree of sinus involvement. We conclude that decongestant-antihistamine need not be given to the child with acute maxillary sinusitis.

The ten-day mark as a practical diagnostic approach for acute paranasal sinusitis in children

Sinusitis is one of the diseases most frequently overlooked by the primary practitioner. We suspected the diagnosis of sinusitis in children with respiratory symptoms that persisted for > 10 days: the 10-day mark. A radiographic projection of maxillary sinuses (Water's view) was indicated, and patients with abnormal radiographs were diagnosed as having sinusitis. After antimicrobial treatment for 2 weeks, we evaluated clinical outcome and follow-up radiographs. The 10-day mark culled 146 suspected children from 2013 outpatients with respiratory complaints. Water's view radiographs revealed sinusitis in 135 patients (92.5% of the suspected children). They included 35 patients with allergy. After treatment only 4 patients in the allergy group (11%) improved completely. In contrast 61 nonallergic patients (61%) were completely improved. The 10-day mark is a simple and practical diagnostic basis for acute paranasal sinusitis. The associated allergic respiratory diseases respond infrequently to antimicrobial treatment.

Immunohistochemical Analysis of Mononuclear Inflammatory Cells in Nasal and Sinus Epithelium in Children with Sinusitis

The etiology and pathophysiology of both recurrent acute and chronic sinusitis in children are not well understood. To investigate this problem, the nature and magnitude of the local cellular inflammatory response was evaluated in the sinus mucosa of 34 children (25 with chronic sinusitis and 9 with recurrent acute sinusitis), of which 27 are atopic and 7 are nonatopic. In addition, sinus mucosa from three patients who underwent sinus surgery for noninfectious sinus disease (two with antral choanal polyp and one with facial pain syndrome) was studied for comparison and “controls. “ Immunohistochemical methods were used to identify phenotypically distinct mononuclear cells subpopulations (B cells, T cells, macrophages, and MHC class II antigen presenting cells) in the epithelium, stroma, and periglandular compartments of the uncinate and ethmoid mucosal tissue layers. Eosinophils were assessed in the same sinus mucosal tissue compartments and in nasal secretions. For all patients, most of the inflammatory cells were found in the stroma. MHC class II positive cells and T cells were found in the epithelium of greater than 50%, and in the stroma of almost 100% of either the uncinate or ethmoid mucosa. Of interest, the local accumulation of tissue eosinophils and/or their presence in nasal smears was not closely linked to the presence of atopy. In three patients with noninfectious sinusitis, the majority of inflammatory cells had also accumulated in the stroma; the mononuclear cell subset composition in those controls was indistinguishable from the sinusitis population. No difference in the number and distribution of any inflammatory cell subset was noted with respect to clinical classification, atopy or immunocompetency profile in our patient population. These observations indicate that the mucosal surfaces studied were likely to have been immunocompetent. Taken together, the uniformly modest local inflammation and the similarity of cell subpopulations in patients with different clinical profiles suggest that local inflammatory mechanisms may not account for clinical differences in the pathophysiology of sinusitis.

Chronic Sinusitis: A Medical or Surgical Disease?

Chronic sinusitis in children who do not have other underlying medical problems is a medically treatable disease, and surgery is not required often. Allergies, environmental factors, and gastroesophageal reflux are the three most important contributing causes of chronic sinusitis in children. Chronic sinusitis is not a primary infectious disease.

Allergic Fungal Sinusitis in Children

Although allergic fungal sinusitis is rare in the pediatric population, it is an important part of the differential diagnosis of unilateral nasal masses. A brief historical review is offered. The evaluation is discussed, and treatment options are proposed.

Frontal Sinus Surgery in Children

Surgery for frontal sinusitis in children is unusual. When required, surgery for ostiomeatal disease or, in certain circumstances, frontal sinus trephination is usually all that is required. Nevertheless, for a few children, surgery of the nasofrontal recess and frontal sinus is required and can be very beneficial. A variety of surgical approaches to the frontal sinus are discussed. Functional endoscopic surgery based upon physiologic principles and the concept of reversible disease is emphasized.

Bacteriological Study of Rhinitis and Paranasal Sinusitis in Children

Bacteriological Study of Rhinitis and Paranasal Sinusitis in Children

Sinusitis in Children: Clinical Features and Surgical Management

Sinusitis in Children: Clinical Features and Surgical Management

小児鼻・副鼻腔手術の治療成績

From January 1990 to June 1995, nasal and/or sinus surgery was performed on 21 children with chronic sinusitis. There were 9 males and 12 females aged 5 to 15 years, with an average age of 11.3 years. Ten children received a polypotomy alone, and functional endoscopic sinus surgery was performed on 13 patients. Three patients underwent a Caldwell-Luc operation. The follow-up information was gathered by questionnaires mailed to all 21 patients and all of the patients replied. The mean follow up period was 32 months. Before the surgery, nasal obstruction was the most predominant symptom and rhinorrhea was the second. Of the 21 patients, 18 patients (85.7%) had complete resolution of their symptoms, and when questioned as to whether their surgical therapy had been successful, 16 patients (76.2%) recorded positively.In 9 of the patients, we performed rhinoscopic and X-ray examinations 28 months after the operation. Endoscopic sinus surgery was performed on 5 patients (8 diseased sides), and a polypotomy was performed on 4 patients (6 diseased sides). In this study, we found that endoscopic sinus surgery was more effective than the polypotomy. We conclude that endoscopic sinus surgery is effective in the treatment of chronic sinusitis in children.

Sinusitis in Children, Reports of Three Hospitalized Cases

Sinusitis in Children, Reports of Three Hospitalized Cases

Antimicrobial management of chronic sinusitis in children.

This study retrospectively investigated the microbiology and management of 40 children who suffered from chronic sinusitis. The sinuses infected were the maxillary (15 cases), ethmoid (13), and frontal (seven). Pansinusitis was present in five patients. All aspirates were cultured for aerobic and anaerobic bacteria. A total of 121 isolates (97 anaerobic and 24 aerobic) were recovered. Anaerobes were recovered from all 37 culture-positive specimens, and in 14 cases (38 per cent) they were mixed with aerobes. Twenty-three beta-lactamase-producing bacteria were isolated from 16 (43 per cent) patients. The 15 patients who received clindamycin had the most rapid response to therapy and a change of therapy and surgical drainage was required in one case. Of the 16 patients who received amoxycillin or ampicillin, 16 responded to therapy, six needed a change of therapy, including four who also had surgical drainage. Of the six who were treated with erythromycin, three needed antibiotic change, two with surgical drainage. Of the three that received cefaclor, two were cured, and one had an antibiotic change. Resistant organisms were recovered in all the cases that required therapeutic change. These findings support the important role of anaerobic bacteria in the polymicrobial cause of chronic sinusitis in children, and the superiority of therapy effective against these organisms.