Treatment Of Sinusitis In Children Research Articles

Возможности стартовой терапии острых синуситов у детей

Acute sinusitis (AS) is one of the most common clinical manifestations of acute upper respiratory tract infection. Topical inflammatory therapy is an important component in the treatment of AS. Objective. To assess the efficacy and safety of Cinnabsin, a comprehensive homeopathic drug, in combination with topical decongestants in the treatment of acute sinusitis in children. Patients and methods. This study included 120 AS patients aged between 5 and 13 years. Study participants were divided into two groups (60 patients in each). Patients in Group 1 received xylometazoline and Cinnabsin. Patients in Group 2 received xylometazoline alone. Patients were followed-up for 26 days; during this time, they had 3 visits with a medical researcher. To evaluate the impairments of nasal breathing, we performed active rhinomanometry using the Otopront rhinomanometer. In addition to that, we assessed the transport function of the nasal ciliated epithelium. Conclusion. We found that Cinnabsin in combination with topical decongestants facilitated the recovery of nasal breathing. Key words: acute sinusitis, cinnabsin, nasal breathing, rhinometry

Effects of nasal aspiration by the Proetz® method in pediatric patients with sinusitis.

To characterize the effects of nasal aspiration with Proetz® in peak nasal inspiratory flow (PNIF) in pediatric sinusitis (PS) patients with nasal obstruction. This is a non-randomized descriptive-analytical clinical trial with a quantitative approach. The sample comprised 30 children. Initially, the PNIF was measured and the Visual Analogical Scale (VAS) was used for nasal obstruction, followed by the nasal aspiration procedure. The SNOT-22 questionnaire was applied to the legal guardian of each child, and one week later, it was reapplied for the sake of follow-up. 16 (53.3%) patients were females and 14 (46.7%) were males, with an average age of 6.4±1.8 years (between 4 and 10 years of age). Analyses of the VAS for obstruction before the intervention revealed that 10 of the participants (33.3%) presented moderate levels, and 20 of them (66.7%) severe levels. However, after the Proetz® method was applied, all the samples (n=30) had mild levels. The PNIF significantly increased after the technique was used, with an improvement of 23.4% in mean values. There was no significant correlation between the VAS and the PNIF. Nasal aspiration with the Proetz® method significantly improved the clinical condition of sinusitis patients with nasal obstruction according to the visual analogical scale, the PNIF, and the SNOT-22 questionnaire. No correlation between the VAS and the PNIF could be found. The study confirms the importance of non-pharmacological interventions in the treatment of sinusitis in children, thus resulting in an improvement in their quality of life.

Особенности течения, диагностики и лечения синуситов у детей и подростков после трансплантации гемопоэтических стволовых клеток

Особенности течения, диагностики и лечения синуситов у детей и подростков после трансплантации гемопоэтических стволовых клеток

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

Acute Bacterial Sinusitis in Children

On the basis of strong research evidence, the pathogenesis of sinusitis involves 3 key factors: sinusostia obstruction, ciliary dysfunction, and thickening of sinus secretions. On the basis of studies of the microbiology of otitis media, H influenzae is playing an increasingly important role in the etiology of sinusitis, exceeding that of S pneumoniae in some areas, and b-lactamase production by H influenzae is increasing in respiratory isolates in the United States. On the basis of some research evidence and consensus,the presentation of acute bacterial sinusitis conforms to 1 of 3 predicable patterns; persistent, severe, and worsening symptoms. On the basis of some research evidence and consensus,the diagnosis of sinusitis should be made by applying strict clinical criteria. This approach will select children with upper respiratory infection symptoms who are most likely to benefit from an antibiotic. On the basis of some research evidence and consensus,imaging is not indicated routinely in the diagnosis of sinusitis. Computed tomography or magnetic resonance imaging provides useful information when complications of sinusitis are suspected. On the basis of some research evidence and consensus,amoxicillin-clavulanate should be considered asa first-line agent for the treatment of sinusitis.

Evidence for the Diagnosis and Treatment of Acute Uncomplicated Sinusitis in Children: A Systematic Review

In 2001, the American Academy of Pediatrics published clinical practice guidelines for the management of acute bacterial sinusitis (ABS) in children. The technical report accompanying those guidelines included 21 studies that assessed the diagnosis and management of ABS in children. This update to that report incorporates studies of pediatric ABS that have been performed since 2001. Overall, 17 randomized controlled trials of the treatment of sinusitis in children were identified and analyzed. Four randomized, double-blind, placebo-controlled trials of antimicrobial therapy have been published. The results of these studies varied, likely due to differences in inclusion and exclusion criteria. Because of this heterogeneity, formal meta-analyses were not performed. However, qualitative analysis of these studies suggests that children with greater severity of illness at presentation are more likely to benefit from antimicrobial therapy. An additional 5 trials compared different antimicrobial therapies but did not include placebo groups. Six trials assessed a variety of ancillary treatments for ABS in children,and 3 focused on subacute sinusitis. Although the number of pediatric trials has increased since 2001, there are still limited data to guide the diagnosis and management of ABS in children. Diagnostic and treatment guidelines focusing on severity of illness at the time of presentation have the potential to identify those children most likely to benefit from antimicrobial therapy and at the same time minimize unnecessary use of antibiotics

MODERN CONCEPTION OF PEDIATRIC ACUTE UPPER RESPIRATORY TRACT DISEASES TREATMENT

This article contains results of treatment of acute sinusitis in children using complex immunostimulator consisting of bacterial lysates — IRS 19, which was included into the basic treatment. There were 65 children with sinusitis under observation. Conparison was made with a control group of 65 children, age and sex comparable, that also were treated against acte sinusitis but without immunostmulants, including those with bacterial lysates.

Effectiveness of Amoxicillin/Clavulanate Potassium in the Treatment of Acute Bacterial Sinusitis in Children

Effectiveness of Amoxicillin/Clavulanate Potassium in the Treatment of Acute Bacterial Sinusitis in Children

Azythromicin Versus Amoxicillin-clavulanate in the Treatment of Acute Sinusitis in Children

In this prospective study we compared the efficiency of azithromycin and amoxicillin-clavulanate in treatment of acute sinusitis in children. Seventy patients were included in the age between 5 and 15 years. Beside ENT and pediatricians examination, nasal and throat smear on culture and antibiogram is taken from all the patients, as well as, X-ray of paranasal sinuses and laboratory findings, followed by check-up of nasal and throat smear and X-ray of paranasal sinuses. Azithromycin in single daily dose of 10 mg/kg during three days showed same efficiency as amoxicillin-clavulanate given three times per day in dose of 45 mg/kg during ten days.

Managing sinusitis in children.

Because of the prevalence of upper respiratory tract infections (URIs), sinusitis is a condition commonly encountered in the pediatric population. Some 5% to 10% of children with URIs also have sinusitis. A thorough clinical evaluation enables the health care provider to accurately diagnose sinusitis in children without overuse of computed tomography scans or antibiotics. This article discusses the diagnosis and treatment of acute sinusitis in children.

Efficacy of High-Dose Guaifenesin in the Treatment of Sinusitis in Atopic Pediatric Patients

Various adjunctive treatments are used by clinicians in the treatment of sinusitis. This prospective, randomized double-blinded study evaluates the efficacy of high-dose guaifenesin as adjunctive therapy in the treatment of sinusitis in children. Patients entered the study based on a composite score combining clinical and radiographic evidence of sinusitis. Twenty-six children were treated with the maximum Food and Drug Administration (FDA) approved dose of guaifenesin based on age, and 23 children received placebo. Both groups were prescribed trimethoprim-sulfamethoxazole 10 ng/kg/day based on the trimethoprim component. After 20 days, a post-treatment composite score was determined based on clinical and radiographic evaluation. There was no statistically significant difference between the two groups in the post-treatment composite scores or the number of subjects requiring additional therapy for unresolved sinusitis. There is no apparent benefit from the use of guaifenesin in addition to antimicrobial when compared with treatment with antimicrobial alone.

小児副鼻腔炎の病態

1. Routine treatment of sinusitis in children using one antral puncture and irrigation and examination of pituitous bacteria were performed for 195 pediatic patients (122 boys and 73 girls, aged 3-15 years) and 145 adult patients with acute sinusitis (61 men and 84 women, aged 15-70 years).2. There was little difference in causative bacteria or prognosis between sinusitis in children and acute sinusitis in adults.3. More than half of the adult patients with acute sinusitis lived with children below third grade in elementary school. We therefore suspected that the adult patients with acute sinusitis had been infected by children with sinusitis in their family.4. Of the 103 pediatric patients for whom causative bacteria and a prognosis could be determined, 28 (27%) were infected by multiple bacteria, both Haemophilus influenzae and Streptococcus pneumoniae. There were no adult patients with acute sinusitis infected by multiple bacteria. Of the pediatric sinusitis patients, many had acute or secretory otitis media, accompanied by cough while few adult acute sinusitis patients had these symptoms.5. The pathogenesis of sinusitis in children was mainly considered acute.

소아 부비동염의 진단과 치료

부비동염은 소아에서 병원을 찾게 되는 가장 흔한 원 인 중의 하나이다. 소아 부비동염의 가장 흔한 선행원인 은 바이러스에 의한 상기도감염으로 소아에서는 1년에 평균 6∼8회 바이러스에 의한 상기도감염에 이환되며 이 중 0.5∼5.0%에서 세균성 부비동염이 병발한다고 알 려져 있다. 그 외에도 알레르기성 비염, 천식, 면역결핍 (immunodeficiency), 낭성섬유증(cystic fibrosis), 원 발성 섬모운동 이상증(primary ciliary dyskinesia), 위 식도역류(gastroesophageal reflux) 등이 소아 부비동 염의 선행요인으로 알려져 있다.1-3)

副鼻腔炎に対するマクロライド療法の現状

The clinical efficacy of low-dose and long-term Macrolide therapy such as Erythromycin (EM), Roxithromycin (RXM), and Clarithromycin (CAM) in the treatment of chronic sinusitis was analysed retrospectively over the past 8 year period as represented in the Japanese literature.Patients treated with these macrolides demonstrated an improvement in both quality and quantity of nasal discharge. Notably, patients who received RXM demonstrated better improvement of rhinorrhea than patients treated with EM or CAM. CAM was judged to be useful in the treatment of sinusitis in children, showing greater improvement and a faster recovery period as compared to improvements in adults.The Excellent synergism of both Ciprofloxacin and RXM or CAM on P. aeruginosa in biofilms was discussed from the standpoint of their pharomacological action in biofilms. Combined therapy using sinus irrigation or a YAMIK catheter for treatment of sinus secretion and macrolide administration was presented as a new therapeutic modality for treatment of chronic sinusitis.Drug interactions with EM, CAM, but not with RXM, and antiallergic agents such as Terfenadine and Astemisole were demonstrated as one of the adverse effects occurring in clinical practice.

小児副鼻腔炎のクラリスロマイシン療法

The clinical efficacy of erythromycin, clarithromycin (CAM) and roxithromycin on chronic paranasal sinusitis has been reported in numerous studies. We investigated the clinical efficacy of low-dose and long-term CAM on sinusitis in children. Each child was given 5-7mg/kg of CAM as two doses daily. The clinical efficacy was assessed by the quality and quantity of nasal discharge, and by the findings on plain X-ray films of the maxillary sinuses after 8 weeks of administration. Twenty-one out of 28 (75%) patients treated with CAM demonstrated an improvement in the quality of nasal discharge. Twenty out of 28 (71%) patients treated with CAM demonstrated an improvement in the quantity of nasal discharge. Twenty-four out of 28 (86%) patients treated with CAM demonstrated an improvement in their findings on plain X-ray films of their maxillary sinuses. Patients who received CAM demonstrated significantly better quality and quantity of nasal discharge, and their findings on plain X-ray films of their maxillary sinuses were better than patients who didn't receive CAM. Clarithromycin was judged to be useful in the treatment of sinusitis in children.

Clinical classification as a guide to treatment of sinusitis in children.

Evaluation of all 153 children undergoing CT scan of the paranasal sinuses for recalcitrant sinusitis symptoms between January 1988 and July 1992 was performed. Clinical categorization into groups of patients presenting with chronic sinusitis (CS) and recurrent acute sinusitis (RAS) was based upon pattern of disease and presentation. Clinical symptoms and signs, radiological examination, treatment, and outcome were compared between these distinct clinical groups. Eighty-two (55%) children were categorized as RAS and 68 (45%) as CS. Children with CS presented more frequently with a persistent cough, purulent nasal discharge, immune deficiency, and more severe mucosal disease on CT than children with RAS. Medical therapy successfully controlled the symptoms of sinusitis in 79 (96%) with RAS versus 27 (40%) with CS. Surgery was performed in 44 children: 3 (3.6%) with RAS versus 41 (60%) with CS, p < 0.01. At a mean follow-up of 2.0 years, >80% of all the children were either asymptomatic or improved regardless of treatment modality. These data support the use of clinical classification as a guide to medical versus surgical therapy in children with sinusitis.

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.

Efficacy of the local application of dimephosphone in the treatment of exudation maxillary sinusitis in children

As many as 159 children aged 9 to 14 are examined for the clinical assessment of theefficacy of local application of 15% water solution of dimephosphone in acute and chronic purulent maxillary sinusitis. The normalization of the rhinoscopic picture in acute maxillary sinusitis in patients of the basic group is observed in 57 days, in chronic in 78 days, in the conrol group treated with 1% solution in 11 12 and 1214 days, respectively. The terms of normalization of the roentgenologic picture are approximately the same as the rhinoscopic one. The comparison of results of the effect of dimephosphone on the course of maxillary sinusitis with results of the treatment with dioxidine reveals more pronounced local antiinflammatory action of dimephosphone on the mucosa of maxillary sinuses and nose cavity.

The role of new macrolide in the treatment of sinusitis in children

The role of new macrolide in the treatment of sinusitis in children

AMERICAN SOCIETY OF PEDIATRIC OTOLARYNGOLOGY: Sinusitis and Sinus Surgery in Children

At the 97th annual meeting of the American Academy of Otolaryngology–Head and Neck Surgery held in Minneapolis, Minn, in October 1993, most of the discussion in regard to pediatric otolaryngology focused on sinusitis and sinus surgery in children. One of the features of the meeting included a session entitled "Great Debates in Otolaryngology." This discussion reviewed some of the controversies in the treatment of sinusitis in children. In addition, the pediatric otolaryngology committee presented a panel discussion on a similar topic. Below are summaries of these sessions. It is evident that there are still many questions to be answered in the treatment of sinusitis in children. At this point, our knowledge is still evolving and, as more empiric data are published, many of these questions will, hopefully, be answered. <h3>Great Debates in Otolaryngology.</h3> This forum, moderated by Mark Maslan, MD, Kansas City, Mo, centered on a recent controversy in the