Chronic sinusitis in children. Comments on pathogenesis and management.

Chronic sinusitis in young children does not often invoke "sinus" complaints of 
fullness, discomfort, or pain over the affected sinus, for it is 
only the older child who verbalizes these complaints. Rather, it is 
the secondary signs and symptoms that lead the physician to suspect 
this entity in children. The most common of these are chronic 
nasal discharge and chronic nasal obstruction. A careful nasal examination is 
essential for the recognition of chronic sinusitis, the most common predecessor 
of chronic sinusitis. Allergic rhinitis is probably the second most common 
background of acute and then chronic sinusitis. Chronic sinusitis in children 
with cystic fibrosis is a characteristic finding. Sinusitis is common in 
cleft lip and cleft palate children. Infants and children with clinical 
signs of chronic infection and radiographic changes should have a nose 
culture and sensitivity studies to plan appropriate antibiotic therapy. Surgical therapy 
is indicated when the symptoms, such as chronic pain, chronic otitis 
media, chronic bronchitis, orbital infections, or intracranial complications, occur. 