Sinusitis In Children Research Articles

Evaluation for sinusitis in children aged between 3 and 15 years with recurrent respiratory tract infection by clinical and radiological methods in a tertiary-care hospital

Background: The health of children is affected badly owing to the effects caused by pediatric sinusitis. An average child will have 6–8 upper respiratory infections per year during the first decade of life, and it is reported that these infections get complicated by 13% because of acute bacterial sinusitis. Very few reports of the prevalence of sinusitis in children with recurrent respiratory tract symptoms (RRTS) have been reported in India, and, hence, this study was carried out. Objective: To evaluate the prevalence of sinusitis in children aged 3 to 15 years by clinical and radiological paranasal sinuses (X-ray PNS) methods in children with RRTS, in Hassan Institute of Medical Sciences (HIMS), Hassan, Karnataka, India. Materials and Methods: This descriptive study was done at HIMS, a tertiary-care hospital, Hassan, over a period of 1 year. All children in the age group of 3–15 years who showed RRTS (>3 episodes in 6 months or 6 episodes in 1 year) were included in the study. Result: Of the 57 cases, 36 children were male and 21 female subjects; among the cases, 38 children were younger than 6 years and 19 children older than 6 years. Of the 57 cases, X-ray findings were found in 42 cases, of which 27 cases presented opacification and 15 cases mucosal thickening. Conclusion: In our study, it was found that there is an association between clinically diagnosed sinusitis and x-ray–diagnosed sinusitis. There is no association between clinically diagnosed sinusitis and x-ray–diagnosed sinusitis in group A and B of RRTS, but there is an association between clinically diagnosed sinusitis and x-ray–diagnosed sinusitis in group C of RRTS.

THE EFFICACY OF CYCLICAL POLYANTIBIOTIC OF CHLAMYDIAL LESIONS OF THE PARANASAL SINUSES IN CHILDREN

This article presents a scheme of antibiotic treatment of children with acute sinus infections, paired with Chlamydial infection, which is based on the use of cyclic poliantibiotikoterapii macrolide drugs. The most significant advantage of this therapy is the high degree of eradication of Chlamydial agent (87.5 %), which allows high-quality conduct antichlamydial treatment prevents the chronization inflammation, disseminated infection and helps reduce the number of complications. Recommended for use in medical practice physicians otorhinolaryngology for the treatment of acute sinusitis in children, coupled with the Chlamydial infection.

Chronic maxillary atelectasis accompanied by chronic sinusitis in children

Chronic maxillary atelectasis accompanied by chronic sinusitis in children

Актуальные аспекты профилактики и лечения ринитов и синуситов у детей

Актуальные аспекты профилактики и лечения ринитов и синуситов у детей

Chronic sinusitis in children

Clinical practice guidelines for the management of acute sinusitis in children have been published by the American Academy of Pediatrics. Of note is that in this document, a brief discussion of chronic disease concluded that the bacterial pathogens causing disease, pathogenesis and management are essentially unknown. Although there are insufficient data in the literature to develop evidence-based clinical guidelines, a careful review of the literature and clinical experience of experts who manage pediatric chronic sinusitis is presented in an effort to develop specific recommendations and to offer practical treatment options. It is apparent that anaerobic bacteria play a major role in this infection thereby influencing the natural history of disease and directing, to a great degree, medical management.

Moraxella catarrhalis: A mini review

Moraxella catarrhalis is a human-specific bacterium previously discounted as a simple commensal organism with only limited pathogenic potential. This view has changed considerably and we now know that M. catarrhalis is associated with a range of disease states affecting both children and adults. In particular, M. catarrhalis tends to be associated with upper respiratory tract infections, including otitis media and sinusitis in children and lower respiratory tract infections in adults with pre-existing pulmonary disease, e.g., exacerbations of chronic obstructive pulmonary disease. Colonization with this bacterium is especially common in infants and young children, the age group most affected by M. catarrhalis-mediated disease. Research is just beginning to unravel the complex interaction between this pathogen and the human host and is providing insights into its diverse genetic population structure and numerous virulence traits. These latter markers include multiple potential cellular adhesion molecules that are currently being researched as potential vaccine candidates. This mini-review is intended to provide the reader with a short introduction to M. catarrhalis as a pathogen and includes recent advances in the understanding of mechanisms associated with bacterial virulence.

Macroscopic findings during endoscopic sinus surgery for chronic rhinosinusitis in children

AimEndeavor to intraoperative macroscopic evaluation of changes in children with CRSs. Analysis of the type and incidence of pathological changes observed macroscopically during FESS was undertaken as well as an parallel attempt to correlate the level of inflammation markers with severity of disease. Materials and methodsRetrospective analysis of case records of 153 patients of the Department of Pediatric Otolaryngology, Medical University of Warsaw, hospitalized between 2010 and 2013. During that time 106 patients with a diagnosis of chronic maxillary sinusitis required surgical intervention. 102 children (avg-aged 11.5 years) were qualified to functional endoscopic surgery. The youngest patient was 3 years old and the oldest 18. 26 patients presented the polypoid lesions of sinuses or nasals. At 19 confirmed the coexistence of sinus polyps with nasal polyps. Results76 patients had oedematous-inflammatory lesions and 26 polypoid. Among the group of listed above 26 children, 19 had either sinuses or nasal polyps. 15% children with polyps were diagnosed with cystic fibrosis and 8.0% with asthma. A common deviation in the results of morphology in children with CRSs is higher level of monocytes. Inflammation markers within the population of FESS qualified children were low. Conclusions(1) Oedematous-inflammatory lesions are frequently intraoperatively identified. (2) The CRSs without polyps is the common type of chronic sinusitis in children. (3) Nasal polyps often coexist with sinus polyps. (4) If nasal polyps are found in pediatric population then diagnosis of CF, allergy and GERD should be considered. (5) Markers of inflammation in CRSs are low.

Effects of furoic acid mometasone nasal spray on pediatric sinusitis patients

Objective To study the effects of the pediatric sinusitis patients using furoic acid momethasone nasal spray after the treatment. Methods 60 pediatric sinusitis patients were divided into the two groups by the random number table method, gien the control group conventional treatment, and the observational group furoic acid momethasone, pediatric sinusitis nasal spray treatment, then the clinical effect and safety of the two groups of children were observe dand compared. Results After the treatment of the two groups, the observational group total effective rate(96.67%) was significantly higher than that of the control group(70.00%)(χ2= 10.23,P< 0.05), the incidence of adverse reactions(3.33%)in children with significantly less than the control group(33.33%),which was statistically significant(χ2= 12.48,P< 0.05). The observational group with bacterial clearance rate was significantly higher than that of the control group(90.91%)in children with bacterial clearance rate(61.90%), which was statistically significant(χ2= 13.26,P< 0.05). Conclusion Using mometasone furoate nasal spray in the treatment of sinusitis in children can improve the total efficiency, and with low incidence of adverse reactions, which can effectively improve the clearance rate of bacteria, beneficial to restore the health of children, safe and effective and should be widely used in clinical practice. Key words: Sinusitis; Furoic acid Momison; Nasal spray; Child

Prevalence of Sinusitis in Children Aged 3yrs to 15yrs by Clinical and Radiological (X-Ray PNS) Methods in Children with Persistent Acute or Recurrent Respiratory Tract Symptoms

Prevalence of Sinusitis in Children Aged 3yrs to 15yrs by Clinical and Radiological (X-Ray PNS) Methods in Children with Persistent Acute or Recurrent Respiratory Tract Symptoms

Complicated sinusitis in children: 18 cases report

Complicated sinusitis in children: 18 cases report

Decongestants, antihistamines and nasal irrigation for acute sinusitis in children.

The efficacy of decongestants, antihistamines and nasal irrigation in children with clinically diagnosed acute sinusitis has not been systematically evaluated. To determine the efficacy of decongestants, antihistamines or nasal irrigation in improving symptoms of acute sinusitis in children. We searched CENTRAL (2014, Issue 5), MEDLINE (1950 to June week 1, 2014) and EMBASE (1950 to June 2014). We included randomized controlled trials (RCTs) and quasi-RCTs, which evaluated children younger than 18 years of age with acute sinusitis, defined as 10 to 30 days of rhinorrhea, congestion or daytime cough. We excluded trials of children with chronic sinusitis and allergic rhinitis. Two review authors independently assessed each study for inclusion. Of the 662 studies identified through the electronic searches and handsearching, none met all the inclusion criteria. There is no evidence to determine whether the use of antihistamines, decongestants or nasal irrigation is efficacious in children with acute sinusitis. Further research is needed to determine whether these interventions are beneficial in the treatment of children with acute sinusitis.

Sinogenic intracranial complications in children - cases report

Background Although uncommon, intracranial suppurative complication of sinusitis in children can occur. The progressive pneumatization of the sinuses after birth and the late appearance of the sphenoid and frontal sinuses explain the predilection for intracranial sinogenic complications in older children and adolescents. Early imaging is crucial to diagnosis and brain MRI is the most useful test. Medical therapy combined with neurosurgical and otolaryngological surgical intervention may improve outcome and reduce the neurological sequelae.

Impact of the 13-valent pneumococcal conjugate vaccine on chronic sinusitis associated with Streptococcus pneumoniae in children.

The widespread use of the 7-valent pneumococcal conjugate vaccine has been associated with epidemiologic changes of mucosal and invasive pneumococcal disease. No study describes the impact of 13-valent pneumococcal conjugate vaccine (PCV13) on chronic sinusitis in children. We describe changes in epidemiology of Streptococcus pneumoniae chronic sinusitis after the introduction of PCV13 at Texas Children's Hospital. We identified patients <18 years with positive sinus culture for S. pneumoniae who underwent endoscopic sinus surgery because of chronic sinusitis from August 2008 to December 2013 at Texas Children's Hospital. Isolates were serotyped by the capsular swelling method. Demographic and clinical information was collected retrospectively. The χ test and Fisher's exact test were used to analyze dichotomous variables. We identified 91 cases of chronic sinusitis with positive sinus culture for S. pneumoniae. Sixty-one (67%) isolates were non-PCV13 serotypes. PCV13 cases decreased 31% in the post-PCV13 period (P = 0.003). Serotype 19A decreased 27% in the post-PCV13 period (P = 0.007), but accounted for all the isolates with penicillin minimal inhibitory concentration ≥ 4 μg/mL and ceftriaxone minimal inhibitory concentration ≥ 2 μg/mL. Serotypes 19A (38%) and 15C (17%) were the most common in the pre- and post-PCV13 periods, respectively. The most common organism co-isolated was Haemophilus influenzae (52%). Isolation of Prevotella spp. increased in the post-PCV13 period (P = 0.02). S. pneumoniae continues to represent an important pathogen in chronic sinusitis in children <5 years of age. After the introduction of PCV13, S. pneumoniae isolation declined in children with chronic sinusitis at Texas Children's Hospital. We also observed a substantial reduction of PCV13 serotypes, predominantly serotype 19A.

HERBAL DRUGS IN PEDIATRIC RHINOSINUSITS TREATMENT

The article referred to the use of herbal drugs in treatment of acute rhinosinusitis in children. Topical aspects of the etiology, pathogenesis, clinical manifestations and diagnosis of acute rhinosinusitis in children are disscussed. The advantages of application of herbal drugs in such pathology are discussed indications for these drugs and possible side effects. The results of research of the efficacy and safety of herbal drugs for the treatment and prevention of acute sinusitis in children are adduced .

Relative etiological importance of adenoid hypertrophy versus sinusitis in children with persistent rhinorrhoea.

Persistent rhinorrhoea is a common, yet often neglected, problem among Indian children. This study was designed to evaluate the relative etiological importance of adenoid hypertrophy versus sinusitis in children with persistent rhinorrhea. Additionally, the association between S. pneumoniae colonization and adenoid hypertrophy was studied. Children aged 1-14years with persistent rhinorrhea underwent clinical evaluation, rigid nasal endoscopy and xrays of the nasopharynx and paranasal sinuses to ascertain the presence of adenoid hypertrophy and sinusitis using standard criteria. Nasopharyngeal swabbing to ascertain the presence of nasopharyngeal colonization with S. pneumoniae was also performed. Adenoid hypertrophy was more consistently associated with persistent rhinorrhea than sinusitis (p<0.0001). Coincident adenoid hypertrophy and sinusitis occurred in 57%. S. pneumoniae was cultured in only 29% of children. Up to 47% of patients had features of nasal allergy. There was no association between S. pneumoniae colonization and adenoid hypertrophy (p=0.1). Adenoid hypertrophy is an important cause of persistent rhinorrhea in children. Measures to evaluate for and treat adenoid hypertrophy should be instituted early to alleviate the problem of persistent rhinorrhoea in children. S. pneumoniae colonization of the nasopharynx is not a major etiological factor for persistent rhinorrhoea in these children. Nasal allergy may be a cause of adenoid hypertrophy in roughly half the children.

Orbitocranial Complications of Acute Sinusitis in Children

BackgroundOrbitocranial complications (OCCs) of sinusitis are uncommon but potentially life threatening. OCCs carry high morbidity, mortality, and significant long-term sequelae. Late recognition leads to even worse outcomes. ObjectiveTo present four case reports showing that aggressive management of complications of sinusitis-like OCC decreases long-term sequelae and mortality in pediatric patients. Case ReportsFour pediatric patients diagnosed with OCC were treated at our institution from April 2012 to March 2013. Three were boys and one was a girl; ages ranged from 4–14 years. Magnetic resonance imaging and computed tomography were the most useful imaging modalities. All patients received broad-spectrum antibiotics. Additional interventions consisted of endoscopic sinus surgery, subdural empyema drainage, and orbital decompression. ConclusionThe difficult complications of acute sinusitis in the pediatric age group should be anticipated, recognized early, and aggressively managed to prevent morbidity and a fatal outcome.

DIAGNOSTICS OF PURULENT SINUSITIS IN CHILDREN WHO ARE AILING

The analysis of the main clinical indices of purulent sinusitis has been studied in 102 children who are ailing with acute respiratory diseases. It has been established, that the majority of clinical indices had high sensitiveness and low specificity. The acute purulent sinusitis was diagnosed in every fifth preschool child and more than 40% school-age children. The X-ray examination of paranasal sinuses is expediently for decreasing the part of mistakes in diagnostics of purulent sinusitis in children who are in poor health.

Comparison of B-mode Ultrasonography and CT-Scan in Diagnosis of Children’s Maxillary Sinusitis

: Background: Sinusitis is a common medical problem, especially in children. Diagnosis of sinusitis in children is usually based on clinical symptoms and clinicians usually tend to avoid X- ray study especially less than 6 years of age. Nowadays, the gold- standard for the diagnosis of sinusitis is CT scan but other modalities including plain X-ray and MRI are also useful. In the literature, there are few studies about the use of ultrasound for diagnosis of sinusitis as a safe, inexpensive and radiation-free method but most of these studies are limited to adults. Objectives: Therefore this study has been designed to show the accuracy of ultrasound in diagnosis and follow up of sinusitis in the pediatric age group. Patients and Methods: All children in the age range of 2-14 years who were clinically suspected for sinusitis and referred to Tabriz children’s hospital for CT scan were enrolled in this study and maxillary sinus sonography was performed for all of them before CT. Revonta method was used and sonography was done with Sonix-OP machine (by using linear- L14-5MHz and microconvex-C9-5/10MHz probes). Totally, 58 patients (116 maxillary sinuses) were evaluated over a 6 months period. Results: Based on CT findings, patients were divided into four groups: 1) normal, 2) slight mucosal thickening, 3) considerable mucosal thickening (more than 50% of the surface), 4) fluid retention in association with mucosal thickening. According to the statistical analysis undertaken in this study, and extracted cut off point, accuracy of ultrasound in group 1 is about 90% with ultrasound quantitative criteria and about 82% with qualitative criteria. In group 3 and 4 the accuracy of ultrasound is above 90% by using qualitative criteria and 75% with quantitative criteria. Conclusions: Ultrasound study of maxillary sinuses in children is easily achievable if operator has enough skills and experience. Since qualitative criteria are more operator dependent, quantitative study is more accurate and more practical. Using these results, the accuracy of ultrasonography in the diagnosis of maxillary sinusitis in children is considerably high and acceptable, therefore ultrasound can be used not only as a precise diagnostic tool for primary diagnosis of sinusitis but also it can be used as a safe, accurate, practical and repeatable tool for follow up and post treatment monitoring of these patients.

Medical treatment of allergy in children with recurrent or chronic sinusitis.

Background:Diagnosis and treatment of chronic and recurrent sinusitis in children is of potential importance and many factors can havean influence on it. This study assessed the chronic and recurrent sinusitis and affecting factors, as well as the role of allergy in its course and treatment in children.Materials and Methods:A total of 106 children with the diagnosis of chronic or recurrent sinusitis, referred to specialty clinics of otolaryngology and allergy of Tabriz Children Educational-Medical centres since 2010 to 2012, were enrolled. The history and physicalexamination findings were recorded for all patients and allergy Prick test was done for all. Response to treatment was evaluated during the follow-up visits.Results:The mean age of studied patients was 6.5 ± 2.9 years. Of all the patients, 54 (50.9%) were male and 52 (49.1%) were female. Skin Prick test was positive in 69.8%. Response to treatment was seen in 86.8% of the patients while 7.5% did not have any favourable outcome. Anti-allergic treatment caused better outcomes in patients with positive Skin Prick test than those with negative results.Conclusion:The prevalence of allergic disease in children with chronic or recurrent sinusitis is considerable and anti-allergic treatments can result infavourable therapeutic outcomes in children with sinusitis, especially with positive skin prick test results.

A comparison of the efficacy of amoxicillin and nasal irrigation in treatment of acute sinusitis in children.

PurposeThe efficacy of antibiotic therapy for acute sinusitis is controversial. This study aimed to compare the efficacies of amoxicillin with nasal irrigation and nasal irrigation alone for acute sinusitis in children.MethodsThis randomized, double-blind, controlled study included 80 children aged 4-15 years with a clinical presentation of acute sinusitis. Patients were randomly assigned to receive either amoxicillin (80 mg/kg/day) in 3 divided doses orally for 14 days with saline nasal irrigation (for 5 days) and 0.25% phenylephrine (for 2 days) or the same treatment without amoxicillin. Clinical improvements in their initial symptoms were assessed on days 3, 14, 21, and 28.ResultsOn day 3, patients in the amoxicillin with nasal irrigation group showed significant clinical improvement (P=0.001), but there was no significant difference in the degree of improvement between the amoxicillin with nasal irrigation and nasal irrigation alone groups during follow-up (P>0.05). In addition, no significant differences were seen in age, sex, and degree of improvement between groups (P>0.05).ConclusionHigh-dose amoxicillin with saline nasal irrigation relieved acute sinusitis symptoms faster and more often than saline nasal irrigation alone. However, antibiotic treatment for acute sinusitis confers only a small therapeutic benefit over nasal irrigation.