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.
Second, why children are susceptible to sinusitis?
1, children’s sinus sinus mouth is relatively large, the cold is easy to invade the sinuses through the sinus mouth; 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 enlarged adenoids affecting normal breathing.
4. congenital immune insufficiency or atopic constitution, 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, nasal foreign body, nasal trauma and secondary infection.
Three, the symptoms of pediatric sinusitis?
1, acute sinusitis: early symptoms are similar to acute rhinitis or cold, 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. Flowing mucous or mucopurulent nasal discharge, often hanging from the upper lip. Repeated coughing with pus sputum and hearing loss in both ears, sometimes the nasal mucus flows backward into the pharynx, then there is no runny symptom. Sometimes there may be rhinorrhea, or nasal vestibule eczema symptoms such as nasolabial groove flushing, erosion, oozing.
What auxiliary examinations 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 the mucosa of the nasal cavity, inferior turbinates, and nasal cavity for abnormal secretions. It is found that there is a large amount of pus in the nasal cavity and the nasal discharge flows backward into the pharynx, etc. It is necessary to cooperate with pharyngeal examination to observe whether there is pus flowing down from the posterior nasal aperture at the posterior pharyngeal wall. In the case of chronic sinusitis, crusting of the nasal vestibule can be seen; in the case of children with enlarged inferior turbinates, pus accumulation in the middle nasal passage and olfactory groove can be seen after liquid contraction of inferior turbinates.
2.X-ray film and CT scan: X-ray film is not significant 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. Treatment of pediatric sinusitis?
1, the treatment of acute sinusitis: should be early systemic application of adequate antibiotics to control the infection, if allergic factors are suspected to add anti-allergic reactions to the drug. Local application of nasal mucosal constrictors (nasal inflammation net is prohibited) and glucocorticoids 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, chronic sinusitis treatment: children with sinusitis can mostly recover after appropriate treatment, generally do not take surgery, because the nasal mucus is often sticky, available some drugs to make the nasal mucus thinning, after repeated treatment of unsatisfactory symptom improvement, or after nasal examination and sinus CT examination found nasal polyps in the nasal cavity and seriously affect the ventilation of the nose, you can consider sinus surgery. 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 it is also important to try to preserve the normal nasal structures so as not to affect the jaw and facial development.
The main reason for this is that it is a good idea to have a good look at the adenoids, and if necessary, perform adenoidectomy. If complications of sinusitis are suspected (orbital or intracranial complications, etc.) or combined nasal polyps (mostly posterior nostril polyps), neoplasia, etc. can be considered for surgical management.
Six, the prevention of pediatric sinusitis?
1, timely treatment of colds, when there are repeated attacks of tonsillitis should be thoroughly treated.
2, the morning can be used to wash the face with cold water, can effectively enhance the resistance of the nasal mucosa.
3, usually 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 side of the nostril and blow it slightly with force. 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 you go 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.