title: Pediatric Rhinosinusitis.
abstract: Rhinosinusitis, is defined as an inflammation of the paranasal and nasal sinus mucosae. Chronic rhinosinusitis (CRS)is a common problem in the pediatric age group and the diagnosis and treatment are challenging due to the chronicity and similarity of symptoms with allergic rhinitis and adenoid hypertrophy. Although it is less common than acute rhinosinusitis, CRS is becoming more frequent and significantly affects the quality of life in children and can substantially impair daily function. CRS is characterized by sinus symptoms lasting more than 3 months despite medical therapy. Many factors are involved in the pathogenesis of this disease and include a primary insult with a virus followed bybacterial infection and mucosal inflammation, along with predisposition to allergies. The standard treatment of pediatricacute bacterial rhinosinusitis (ABRS) is nasal irrigation and antibiotic use. Medical treatment of pediatric CRS includes avoidance of allergens in allergic patients (environmental or food) and therapy with nasal irrigation, nasal corticosteroids sprays, nasal decongestants, and antibiotics directed at the most common sinonasalorganisms (Haemophilusinfluenzae, Streptococcus pneumoniae, and Moraxella catarrhalis). Surgical therapy is rarely needed after appropriate medical therapy. Referral to an otolaryngologist and allergy specialist is recommended in case of failure of medical treatment.
authors.affiliation: Department Of Pediatric and Adolescent medicine, American University of Beirut Medical Center, Lebanon.
authors.forename: Dana T
authors.initials: DT
authors.lastname: Badr
authors.affiliation: Division of Respiratory Medicine, American University of Beirut Medical Center, Lebanon; Boston Children's Hospital, Harvard Medical School, American University of Beirut Medical Center, Lebanon.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Gaffin
authors.affiliation: Boston Children's Hospital, Harvard Medical School, American University of Beirut Medical Center, Lebanon; Division of Allergy and Immunology, American University of Beirut Medical Center, Lebanon.
authors.forename: Wanda
authors.initials: W
authors.lastname: Phipatanakul
keywords: ABRS; Allergic rhinitis; Bacterial; CRS; Rhinosinusitis; pediatric rhinosinusitis