Treatment Of Rhinosinusitis In Children Research Articles

New opportunities of halotherapy in the prevention and medical rehabilitation of children

The article is devoted to new possibilities of using halotherapy in the prevention, treatment and medical rehabilitation of children. In recent years, active work has been carried out to develop new effective methods of reproducing the aerodispersed medium in the form of haloingalation therapy or by group method — in the conditions of a halochamber. The therapeutic effect of halotherapy is determined by the biophysical properties of a dry highly dispersed aerosol of sodium chloride. The paper presents the biophysical properties of the main active factor of halotherapy, i.e. a dry highly dispersed aerosol of sodium chloride, and reveals some aspects of the formation of the mechanism of therapeutic action. The anti-inflammatory, draining, mucolytic, immunomodulatory, sanogenetic effect of haloaerosol is shown. In pediatric practice, haloaerosol therapy is used for medical rehabilitation of children with respiratory diseases (bronchial asthma, bronchitis), ENT pathology (rhinosinusitis, tonsillitis, pharyngitis), skin diseases. Halotherapy is the method of choice in the prevention of acute respiratory diseases and improving the health of children in general education institutions. The high efficiency of the complex application of halotherapy in various diseases in children has been established. A promising direction for the development of halotherapy is the development of combined exposure technologies. The high efficiency of the use of haloingalation therapy in combination with magnetic therapy in the treatment of acute rhinosinusitis in children has been proven. Based on the conducted studies, a favorable effect of the use of halotherapy and flutter therapy on clinical and functional parameters in children with bronchial asthma was revealed. The data on the possibility of combined use of halotherapy with a pulsed low-frequency electrostatic field in the medical rehabilitation of children suffering from bronchial asthma are presented. Simplicity, safety, the possibility of personalization of exposure and good tolerability by children expands the possibilities for using halotherapy in pediatric practice.

Метод ирригационно-элиминационной терапии гипертоническими солевыми растворами при лечении риносинуситов у детей

В работе рассмотрен метод местной терапии острого риносинусита у детей, механизмы его действия, эффективность и безопасность. Представлены данные о показаниях к применению и характеристиках препарата. Показаны преимущества гипертонических солевых растворов морской воды.

Эфирные масла лекарственных растений в коррекции микробиоценоза верхних дыхательных путей у детей с риносинуситом

In this review, we analyzed the results of our studies aimed to provide a rationale for the use of ‘Dyshi’ oil for the treatment of rhinosinusitis in children. Literature data suggests high incidence of rhinosinusitis and, importantly, its frequent transition into chronic disease. The microbiota of the upper respiratory tract (URT) mucosa in healthy individuals and rhinosinusitis patients has been extensively investigated. Dysbiosis of the URT is known to have a crucial role in the pathogenesis of rhinosinusitis. It was found that opportunistic microorganisms inhabiting the URT have a number of biological properties that allow them to persist on the mucosa for a long time in case of dysbiosis. Particular attention should be paid to their abilities to form biofilms and to inactivate lysozyme, which hinders effective antimicrobial therapy of rhinosinusitis and triggers the development of chronic rhinosinusitis. This necessitates the search for alternative treatments, for example essential oils of medicinal plants. We found that ‘Dyshi’ oil can decrease the persistence potential of etiologically significant opportunistic microorganisms by inhibiting biofilm formation and suppressing lysozyme-inactivating activity at the population level. Our findings contribute to a better understanding of the mechanisms underlying antimicrobial activity of essential oils and demonstrate the efficacy of ‘Dyshi’ oil for the treatment and prevention of acute and chronic rhinosinusitis in children. Key words: essential oils, microbiota of the upper respiratory tract, rhinosinusitis, treatment, children.

Diagnosis and treatment of Chronic Rhinosinusitis in Children according European Position Paper on Rhinosinusitis and nasal Polyps –EPOS-2012 and American Academy Otolaryngology-Head and Neck Surgery 2014

Pediatric rhinosinusitis is defined as a presence of two or more symptoms and one of them should be either nasal blockage or nasal discharge and headache/facial pain or cough. Chronic rhinosinusitis - CRS is recognized when the four most common symptoms as cough, rhinorrhea, nasal congestion and post nasal drip with a slightly higher predominance of chronic cough are presented for more than 12 weeks and influence the quality of life. CRS should be considered in respect of unique conditions because of the differences in predisposing factors (immunological and others) and the anatomy of the sinuses between children and adults. The adenoids are a prominent contributor to CRS in young children, both from bacteriologic and immunologic status. The older children suffer from CRS in the same manner as adults. During evaluation a child with symptoms of CRS , one should always consider the possibility of underlying disease as a contributing factor. Diseases impacting sinuses and nasal function include CF, primary ciliary dyskinesia (PCD) and a variety of normal immune deficiencies, including the still-developing immature immunity of healthy young children. Surgical intervention for rhinosinusitis is usually considered for patients with CRS who have failed maximal pharmacological treatment. There are two important consensus statements for pediatric chronic sinusitis (CRS): European Position papers on Rhinosinusitis and Nasal Polyps -EPOS 2012 and Clinical Consensus Statement: Pediatric Chronic Sinusitis American Academy Otolaryngology-Head Neck Surgery 2014. Both of them contain necessary information and recommendation for diagnosis and treatment of CRS in children.

Low-frequency ultrasound in the treatment of acute bacterial rhinosinusitis in children

Low-frequency ultrasound in the treatment of acute bacterial rhinosinusitis in children

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 .

Safety and feasibility of balloon sinuplasty for treatment of chronic rhinosinusitis in children

Safety and feasibility of balloon sinuplasty for treatment of chronic rhinosinusitis in children

Systemic treatment of rhinosinusitis in children

Systemic acute rhinosinusitis therapy consists mostly of antibiotic treatment because pathogens play a major role. Amoxicillin is the drug of choice for treatment of acute rhinosinusitis, with second- and third- generation cephalosporins, azythromycin, clarithromycin, and telithromycin as possible options, especially in the case of allergy to amoxicillin. If the clinical course suggests that an anaerobic pathogen is more likely, clindamycin or metronidazole can be considered in combination with a broad-spectrum drug. In antimicrobial treatment of chronic sinusitis there is no consensus on treatment length, organism coverage, or which antibiotics are most effective because the bacteriology is variable with polymicrobial anaerobic and aerobic organisms present. Adjuvant therapies need to be proven by additional studies. Chronic rhinosinusitis is heterogeneous and treatment should vary according to the causative factor involved. Short courses of systemic steroids have been found very useful to decrease mucosal swelling and inflammation in chronic rhinosinusitis. However, no randomized controlled studies have been performed to validate their efficacy in children. A variety of other agents are used in the treatment of chronic rhinosinusitis including antihistamines, decongestants, and leukotriene modifiers. To date, there is no good evidence from randomized controlled studies to support the use of any of these agents in the treatment of this disease in either children or adults.

The value of Ems Mineral Salts in the treatment of rhinosinusitis in children: Prospective study on the efficacy of mineral salts versus xylometazoline in the topical nasal treatment of children

The treatment of rhinosinusitis seen in the light of uncertain pathogenesis and variable symptoms is under discussion and ranges from the administration of antibiotics, decongestants and anti-allergic agents to no treatment. In this randomized, prospective, double-blind and controlled study the effect of a 14-day treatment (1-2 sprays into each nostril t.d.) with either isotonic Ems Mineral Salts (EMS) solution (Siemens & Co., Bad Ems, Germany) or xylometazoline solution (0.05%) was tested in children (n=66) aged 2-6 years. the degree of mucosal inflammation, nasal patency, general state of health, condition of the middle ear, auditory function as well as an assessment of complaints by the parents. With the exception of the hearing defects, all parameters showed a clear improvement in both treatment groups at the end of the observation period (p>0.001). The hearing defects showed only a trend towards improvement. At the end of the study no differences between the treatment groups could be determined. However, at the intermediate examination after the first 7 days of treatment more favourable results were seen in the group treated with EMS. No undesired medicinal effects were observed, although in 7 out of 34 cases the nasal spray was improperly used in the group treated with xylometazoline. The results of the study show that there is no difference in efficacy between an exclusive treatment by EMS solution in children aged 2-6 years and a treatment with xylometazoline, but with the distinction that with EMS the length of use was not restricted, there were not the potential side effects of nasal decongestants, and there was no contraindication in the newborn and infants.