Pediatric Rhinosinusitis and Its Relationship to Asthma and Allergic Rhinitis

Update on pediatric sinus surgery: indications and outcomes

PURPOSE OF REVIEW

To review the recent literature of pediatric endoscopic sinus surgery (ESS).

RECENT FINDINGS

Sinus balloon catheter dilation is an important addition to the surgical treatment tools for pediatric chronic rhinosinusitis (PCRS). ESS is a safe and effective therapeutic modality for uncomplicated PCRS. For PCRS complicated by comorbidities including cystic fibrosis and primary ciliary dyskinesia, ESS and adjuvant medical therapy confers significant sinus, pulmonary, and quality of life benefits to pediatric patients.

SUMMARY

ESS is a safe and effective treatment modality in the management of pediatric acute and chronic sinus disorders.

Macroscopic findings during endoscopic sinus surgery for chronic rhinosinusitis in children

AIM

Endeavor to intraoperative macroscopic evaluation of changes in children with CRSs. Analysis of the type and incidence of pathological changes observed macroscopically during FESS was undertaken as well as an parallel attempt to correlate the level of inflammation markers with severity of disease.

MATERIALS AND METHODS

Retrospective analysis of case records of 153 patients of the Department of Pediatric Otolaryngology, Medical University of Warsaw, hospitalized between 2010 and 2013. During that time 106 patients with a diagnosis of chronic maxillary sinusitis required surgical intervention. 102 children (avg-aged 11.5 years) were qualified to functional endoscopic surgery. The youngest patient was 3 years old and the oldest 18. 26 patients presented the polypoid lesions of sinuses or nasals. At 19 confirmed the coexistence of sinus polyps with nasal polyps.

RESULTS

76 patients had oedematous-inflammatory lesions and 26 polypoid. Among the group of listed above 26 children, 19 had either sinuses or nasal polyps. 15% children with polyps were diagnosed with cystic fibrosis and 8.0% with asthma. A common deviation in the results of morphology in children with CRSs is higher level of monocytes. Inflammation markers within the population of FESS qualified children were low.

CONCLUSIONS

(1) Oedematous-inflammatory lesions are frequently intraoperatively identified. (2) The CRSs without polyps is the common type of chronic sinusitis in children. (3) Nasal polyps often coexist with sinus polyps. (4) If nasal polyps are found in pediatric population then diagnosis of CF, allergy and GERD should be considered. (5) Markers of inflammation in CRSs are low.

Conditions associated with childhood asthma in north Texas

Introduction. The purpose of this study was to identify significant associations between asthma diagnosis, comorbid conditions, and social problems in children. Method. This study explored data collected in a unique, regional survey of children's health in north Texas originally administered in 2009 to a random sample of 21,530 households with children from 0 to 14 years of age. Descriptive statistics were compiled for the subsample of children with asthma, associations of interest were identified, and strengths of relevant associations were calculated. Results. The prevalence of asthma in school-aged children in the target area is 19-25%, which exceeds both national and state values. Statistically significant associations were found between asthma and allergies, sleep problems, and tonsillectomy. Significant associations were identified between asthma and school absences, academic problems, and behavior problems in school. There was a significantly greater prevalence of obesity/overweight among children with asthma than without asthma. Discussion. Children with asthma are at high risk for impairment in multiple dimensions. Thorough assessment, including comprehensive medical, social, and environmental histories, is critical in management of pediatric asthma.

Pediatric chronic sinusitis and asthma: a review

Rhinosinusitis and asthma are common conditions associated with significant morbidity and health care costs. Recent studies in adults have suggested that rhinosinusitis and asthma may be manifestations of an inflammatory process within a continuous airway rather than fully separate diseases that only act locally; and, in fact, the presence of upper airway disease may influence lower airway disease. Controlling upper airway infection, inflammation, and symptoms may improve signs and symptoms of asthma. Pediatric studies regarding this matter are few, but the impact of rhinosinusitis and asthma is still immense and significant in children. This article discusses several pediatric studies regarding medical or surgical management of sinusitis and asthma outcome. These studies show that aggressive treatment of sinusitis when present can significantly improve asthma symptoms and quality of life in children, indicating that sinusitis may play an important role in initiating or exacerbating asthma. These findings have important implications for the physician treating a child with chronic asthma.