I. What is sinusitis in children?
Sinusitis is a purulent inflammation of the sinuses, and sinusitis in children under the age of 14 is called pediatric sinusitis.
II. Why are children prone to sinusitis?
1, children’s sinus sinus mouth is relatively large, easy to invade the sinuses through the sinus mouth cold; and nasal cavity and nasal channel narrow, ventilation and drainage is not smooth;
2, their own resistance to disease and the ability to adapt to the outside world are poor, prone to colds, upper respiratory tract infections and acute infectious diseases (such as measles, whooping cough, scarlet fever and influenza, etc.).
3, enlarged tonsils or adenoid hypertrophy affect normal breathing.
4, innate immune insufficiency or atopic physique, such as asthma, allergic rhinitis, etc. About 65% of allergic rhinitis in children will be complicated by sinusitis.
5.Swimming or diving in unclean water.
6. Foreign body in the nasal cavity, nasal trauma and secondary infection.
III. Symptoms of pediatric sinusitis?
1. Acute sinusitis: early symptoms are similar to acute rhinitis or cold, the systemic body symptoms are more obvious than adults, like nasal congestion, pus, may have fever or pus sputum, no symptoms after cure.
2. Chronic sinusitis: intermittent or frequent nasal congestion in children. Mucous or mucopurulent nasal discharge, often hanging from the upper lip. Repeated cough with pus sputum and hearing loss in both ears. Sometimes there is no runny symptom when the nasal discharge flows backward into the pharynx. Sometimes there may be rhinorrhea or eczema in the nasal vestibule such as flushing, erosion and oozing in the nasolabial groove.
IV. What auxiliary tests are needed for the diagnosis of pediatric sinusitis?
1. Nasal and local examination: Pediatric nasal endoscopy can be used for anterior nostril examination to observe whether there are abnormal secretions in the mucosa of the nasal cavity, inferior turbinates, and nasal cavity. If there is a large amount of pus in the nasal cavity and the nasal discharge flows backward into the pharynx, it is necessary to cooperate with the pharyngeal examination to observe whether there is pus flowing down from the posterior nasal aperture at the posterior pharyngeal wall. In chronic sinusitis, the nasal vestibule is crusted, the inferior turbinate is enlarged in children, and when the inferior turbinate is contracted, pus accumulation in the middle nasal tract and olfactory groove can be seen.
2. X-ray radiographs and CT scan:: X-ray radiographs are of little significance for the diagnosis of sinusitis. CT scan is of good value for the diagnosis of sinusitis in children when an occupying lesion is considered or when conventional treatment is ineffective.
3. If sinusitis does not heal repeatedly or is accompanied by open-mouth breathing and snoring, the adenoids need to be examined.
V. What is the treatment of pediatric sinusitis?
1. Treatment of acute sinusitis: A sufficient amount of systemic antibiotics should be applied early to control infection, and if allergic factors are suspected, anti-allergic drugs can be added. Local application of nasal mucosal constrictor (nasal inflammation net is prohibited) and glucocorticoid to facilitate nasal and sinus ventilation and drainage. In addition, rest and nutritious, easy-to-digest food should be given. If there is a combination of complications, they should be treated at the same time.
2. Treatment of chronic sinusitis: Most children can recover from sinusitis after proper treatment, and surgery is generally not taken.
As the nasal mucus is often sticky, some drugs that make the nasal mucus thinner are available. After repeated treatment with unsatisfactory improvement of symptoms, or if nasal polyps are found in the nasal cavity after nasal examination and sinus CT examination and seriously affect the ventilation of the nose, sinus surgery can be considered. There are some children with intraorbital or intracranial complications of sinusitis due to structural abnormalities in the nasal cavity, which is also an indication for surgery. However, since children are still growing and developing, the scope of surgery should not be too large and should also try to preserve the normal nasal structures so as not to affect the jaw and facial development.
In general, children with sinusitis are treated conservatively with medication, but if it does not heal over time, the adenoids can be examined and adenoidectomy performed if necessary. If complications of sinusitis (orbital or intracranial complications, etc.) or combined nasal polyps (mostly posterior nostril polyps), neoplasia, etc. are suspected, surgical management can be considered.
VI. Prevention of pediatric sinusitis?
1. timely treatment of colds, when there are repeated attacks of tonsillitis should be thoroughly treated.
2. Cold water can be used to wash your face in the morning, which can effectively enhance the resistance of the nasal mucosa to disease.
3. Normally, you can often do nasal massage.
4. Pay attention to the method of blowing snot. In case of nasal congestion, it is advisable to press one nostril and blow slightly. After that, blow alternately. When the snot is too thick, wash the nose with salt water to avoid hurting the nasal mucosa.
5. During the epidemic period, wear a mask when going out, avoid public gatherings, go to public places as little as possible, do a good job of isolating the sick, and disinfect the air by fumigation with white vinegar in the polluted room.