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
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Pediatric rhinosinusitis in children is defined as a presence of two or more symptoms with one of them either being nasal blockage or nasal discharge and headache/facial pain or cough. Chronic rhinosinusitis (CRS) is recognized when the four most common symptoms such as cough, rhinorrhea, nasal congestion and post-nasal drip with a slightly higher predominance of chronic cough are present for over 12 weeks and influence the quality of life. CRS should be considered in respect of unique conditions due to the differences in predisposing factors (immunological and others) as well as the anatomy of the sinuses between children and adults. Adenoids are a prominent contributor to CRS in young children, both from bacteriologic and immunologic status. Older children suffer from CRS in the same manner as adults. During evaluation of a child with CRS symptoms , one should always consider the possibility of an 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 recommendations for diagnosis and treatment of CRS in children.
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