title: The 10-day mark is a good way to diagnose not only acute rhinosinusitis but also adenoiditis, as confirmed by endoscopy.
abstract: OBJECTIVE
  Acute rhinosinusitis (ARS) usually presents with respiratory complaints that persist for more than 10 days with no sign of improvement. This 10-day mark is considered to separate simple upper viral respiratory infection from ARS. Thus, the aim of the study was to evaluate a group of children with suspected ARS by performing nasal endoscopy.
  
  
  METHODS
  This cross-sectional study evaluated 287 consecutive children (152 males and 135 females, aged between 2 and 15 years), in whom ARS was suspected. A detailed clinical history was recorded for each patient and a thorough physical examination was carried out by an allergist-paediatrician. Patients were also evaluated by an ENT specialist who performed nasal endoscopy.
  
  
  RESULTS
  Endoscopy confirmed the clinical diagnosis of rhinosinusitis in 256 patients (89.2%). Isolated rhinosinusitis was diagnosed in 80.85% of cases (207 patients), whereas it was associated with adenoiditis in 49 (19.15%) children. Twenty patients had adenoiditis alone (7%). The distribution of the isolated and combined diagnoses differed significantly between age groups (p=0.015), particularly between the youngest and oldest group (post hoc test p=0.005).
  
  
  CONCLUSIONS
  This study suggests that the endoscopy is a valuable tool in diagnosing children with suspected ARS and with adenoiditis too. Moreover, the age influences the diseases' pattern.
authors.affiliation: Dipartimento di Scienze Pediatriche, Fondazione IRCCS Policlinico San Matteo, Università di Pavia, P. le Golgi, 2, 27100 Pavia, Italy. gl.marseglia@smatteo.pv.it
authors.forename: Gian Luigi
authors.initials: GL
authors.lastname: Marseglia
authors.forename: Fabio
authors.initials: F
authors.lastname: Pagella
authors.forename: Catherine
authors.initials: C
authors.lastname: Klersy
authors.forename: Salvatore
authors.initials: S
authors.lastname: Barberi
authors.forename: Amelia
authors.initials: A
authors.lastname: Licari
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ciprandi
mesh_terms: D000208:Acute Disease; D000234:Adenoids; D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D012120:Respiration Disorders / Q000209:etiology*; D012141:Respiratory Tract Infections / Q000175:diagnosis; D012220:Rhinitis / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D012852:Sinusitis / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D013997:Time Factors