Chronic Rhinosinusitis in Children

PROGRAM DESCRIPTION: Chronic rhinosinusitis in children is a common clinical problem encountered in rhinology, general, and pediatric Otolaryngology practices. Unlike adult rhinosinusitis, the disease in children has not received much attention despite the fact that it has a significant negative impact on quality of life. The presentation will discuss the prevalence of the disease and the clinical presentation as well as review the information available related to the pathophysiology. We will then go over the tools available to cement the diagnosis emphasizing exam and radiologic findings. Children with chronic rhinosinusitis often have coexisting morbidities which include asthma, allergic rhinitis, ciliary abnormalities and immune deficiencies. The importance of these comorbidities and their relationship to rhinosinusitis will be discussed. Medical therapy is mainstay in children and data supporting the use of saline irrigation, intranasal steroids, antibiotics and other treatment choices will be reviewed. Finally, when medical therapy fails, surgical therapy is considered and the evidence supporting various surgical options (adenoidectomy, sinus irrigation, balloon sinuplasty and endoscopic sinus surgery) will be reviewed. The presentation will be based on the latest evidence available in the literature including prospective and retrospective case series or randomized trials, consensus statements and various guidelines and position statements.