title: Sinusitis and chronic cough in children.
abstract: BACKGROUND
  Chronic cough in children is a common problem, and sinusitis is a common etiology. The diagnosis of sinusitis is often clinical, but confirmation is thought to require a CT scan due to the difficulty of interpreting a Water's view sinus X-ray.
  
  
  OBJECTIVE
  The purposes of the study were (1) to examine the frequency of an abnormal sinus X-ray in children with a chronic cough of more than 4 weeks duration; (2) to compare the interpretation of the sinus film between allergy/pulmonary clinicians and radiologists; and (3) to correlate symptoms with X-ray results.
  
  
  METHODS
  A chart review of 2- to 18-year-old patients with coughing exceeding 4 weeks was performed. Data was collected for patients who had received a Water's view sinus film as part of their evaluation. Exam, X-ray results, and clinical outcomes were categorized and statistical analyses performed.
  
  
  RESULTS
  A total of 86 patients were included. Clinicians found that 65% of the children had positive Water's view films, compared with the radiologist's reading of 62% (non significant). Significant associations between post-tussive emesis (P = 0.01) and purulence (P = 0.03) were noted with a positive film. Positive sinus X-ray was highly associated with all findings except wheeze when present together (P < 0.001).
  
  
  CONCLUSIONS
  Sinus abnormalities on X-ray are associated with prolonged cough in 65% of children. The Water's view sinus film is a clinically useful screening tool for clinicians in the workup of chronic cough. Certain physical findings and clinical complaints, when present concurrently, correlate with the X-ray results.
authors.affiliation: University of Nevada School of Medicine, Department of Pediatrics, Section of Allergy, Immunology and Pulmonology, Reno, NV, USA.
authors.forename: Nevin W
authors.initials: NW
authors.lastname: Wilson
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Hogan
authors.forename: Charles Bruce
authors.initials: CB
authors.lastname: Harper
authors.forename: Kathy
authors.initials: K
authors.lastname: Peele
authors.forename: Sonia
authors.initials: S
authors.lastname: Budhecha
authors.forename: Vincent
authors.initials: V
authors.lastname: Loffredo
authors.forename: Vanessa
authors.initials: V
authors.lastname: Wong