title: Management of chronic rhinosinusitis.
abstract: : Chronic rhinosinusitis (CRS) in children is difficult to treat, with resultant frequent recurrences and failures. There are controversies in the treatment, mirroring the debate over the exact etiology of this disorder. The available medical treatments are antibiotics, topical nasal corticosteroids, and nasal lavage with saline solutions; though, there is no general agreement on the efficacy of the latter. The new technique of balloon sinuplasty allows ventilation to the sinuses to be restored with minimal risk and trauma to the tissues, and initial outcome seems promising, being successful in most treated children. Concerning the surgical approach, adenoidectomy is among the most frequent surgical procedures performed on children, but its therapeutic effect is controversial, because randomized studies have failed to prove that adenoidectomy alone is sufficient in curing CRS. Instead, functional endoscopic sinus surgery is a minimally invasive technique which restores the sinus ostia patency and can re-establish ventilation and drainage through the natural pathways. It is important that the effectiveness of any treatment is also evaluated by patient-reported outcomes (PROs) that refer to all health-related reports coming from the patients, without any involvement or interpretations by physician or others. Among PROs, health-related quality of life (HRQL) is the one most widely known and used. HRQL can be measured by means of validated questionnaires, which provide scores proportional to the degree of well-being perceived by patients. Concerning diseases of the upper airway including RS, there are numerous instruments specifically designed for children and caregivers, which allow to assess the effects of treatments in a more extensive and complete manner.
authors: Pediatric ENT Department, Buzzi Children's Hospital, Istituti Clinici di Perfezionamento, Via Castelvetro 32, Milan, Italy. a.cazzavillan@icp.mi.it
authors: Alessandro
authors: A
authors: Cazzavillan
authors: Paolo
authors: P
authors: Castelnuovo
authors: Marco
authors: M
authors: Berlucchi
authors: Ilaria
authors: I
authors: Baiardini
authors: Andrea
authors: A
authors: Franzetti
authors: Piero
authors: P
authors: Nicolai
authors: Stefania
authors: S
authors: Gallo
authors: Giovanni
authors: G
authors: Passalacqua
mesh_terms: D000233:Adenoidectomy; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002908:Chronic Disease; D004724:Endoscopy; D006801:Humans; D010256:Paranasal Sinuses / Q000187:drug effects / Q000276:immunology / Q000601:surgery; D017060:Patient Satisfaction; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012220:Rhinitis / Q000276:immunology / Q000601:surgery / Q000628:therapy*; D012852:Sinusitis / Q000276:immunology / Q000601:surgery / Q000628:therapy*; D007507:Therapeutic Irrigation
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents