Rhinitis and sinusitis, whether acute or chronic, can cause some of the complications described below, both for adults and for children. However, due to the physiopathological characteristics of children, rhinitis and sinusitis have a more significant and common impact on children, and therefore are more important and need to be given adequate attention. Although the following content is mainly about children, the impact on adults can also be referred to.
A. What is pediatric rhinitis, sinusitis
Pediatric rhinitis, mainly refers to the acute rhinitis and chronic rhinitis in children. The nose is part of the upper respiratory tract, and when acute rhinitis, in Chinese internal medicine is called a cold, in Western internal medicine you for upper respiratory tract infection, in otorhinolaryngology is called acute rhinitis. Acute rhinitis is the part of the upper respiratory tract infection that can be accompanied by lesions such as acute pharyngitis and acute laryngitis. Chronic rhinitis is the chronic inflammation of the mucous membrane of the nasal cavity. Either acute rhinitis or chronic rhinitis can cause nasal swelling to produce nasal congestion; cause increased nasal secretions and blowing or runny nose.
Pediatric sinusitis, both acute and chronic, is a purulent inflammation of the mucosa and submucosal tissue of the pediatric sinuses, also called nasal-sinusitis because it often causes or is accompanied by inflammation of the mucosa of the nasal cavity.
Sinuses, also known as paranasal sinuses, are sinus cavities within the skull, each with an opening leading to the nasal cavity. There are at least eight (maxillary sinus, frontal sinus, septal sinus, and pterygoid sinus) sinuses, named according to the skull in which they are located, centered on the nose and on the left and right sides. Among them, the maxillary sinus is the largest, located in the maxilla on both sides of the nose, below the orbits, and inside the zygomatic bone. Depending on the development of the child, the maxilla is already formed at birth, and its sinus cavity is also large; inflammatory symptoms of the septal sinus may appear after the age of 2, frontal sinusitis after the age of 10, and pterygoid sinusitis in older children. Therefore, maxillary sinusitis is the most common clinical condition, and it is not uncommon for older children to have multiple sinusitis successively or simultaneously.
What are the dangers of pediatric rhinitis and sinusitis?
Pediatric acute rhinitis, acute sinusitis, chronic rhinitis, chronic sinusitis, which is especially long-term chronic sinusitis is prone to many complications: the main reason is the inflammation to the adjacent surrounding tissues and organs directly diffuse, such as nasal, jaw, eye inflammation; second is due to the postnasal flow or swallowed into the stomach, causing symptoms in the throat, lungs and lower respiratory tract, middle ear, digestive system, and mental nervous system.
Third, why rhinitis, sinusitis is more harmful to children?
The main reason is that children are delicate, inflammatory response is often stronger, acute rhinitis and acute sinusitis, the nasal mucosa is prone to high edema and polyp-like changes, making the condition heavier and faster than adults, especially acute purulent inflammation is also likely to surrounding infection, causing eye and jaw complications. Since children do not mainly eliminate nasal discharge, post-nasal flow is more serious than adults, which can easily cause otitis media, inflammation of the throat and lower respiratory tract disease; inflammatory secretions are easily swallowed into the stomach, resulting in the absorption of bacteria and toxins, which can more easily produce gastrointestinal symptoms (poor appetite, diarrhea, constipation, abdominal pain, etc.) than adults. If it is a chronic rhinopathy, it will easily cause mental neurological symptoms (nocturnal drying, restless sleep, teeth grinding, hyperactivity, mental retardation, etc.); long-term digestive disorders and poor nutrition will easily lead to pediatric developmental disorders (yellowing and thinness, height, etc.). So pediatric rhinitis, pediatric sinusitis is more harmful than adults.
Four, what are the common pediatric rhinitis and sinusitis complications
1, nasal complications.
(1) Allergic rhinitis and chronic rhinitis.
Allergic rhinitis can cause or aggravate sinusitis; sinusitis when the body’s resistance decreases, in some patients there will be changes in the enhanced sensitivity of the nose, therefore leading to or aggravating allergic rhinitis. And inflammation of the sinuses, pus outflow to the nasal cavity, is bound to cause rhinitis. Thus, chronic sinusitis is often accompanied by chronic rhinitis. Therefore, in the case of both sinusitis and chronic rhinitis, the treatment of sinusitis is the main focus.
(2) Nasal polyps.
Due to the edema of the nasal mucosa caused by inflammation, it is possible to cause polypoid changes in the turbinates or polyps in the nasal cavity and sinus polyps. The polyps in the nasal cavity are easily obstructed, making it difficult to cure sinusitis and allergic rhinitis. Measures to remove nasal polyps need to be given priority in order to better treat sinusitis and allergic rhinitis.
Please refer to: how to treat nasal polyps and sinus cysts that are prone to recurrence?
(3) Olfactory disturbances.
In pediatric patients often do not complain, in older children or adults with long-term chronic sinusitis, can be complicated by olfactory disorders. Acute sinusitis caused by the smell disorder is irrelevant, when the sinusitis gets better or healed, when the normal sense of smell is restored. Long-term chronic sinusitis can be caused by nasal obstruction causing obstructive olfactory disorder, which is also irrelevant; it can also be caused by inflammatory damage to the mucous membrane of the nasal olfactory area, producing peripheral neuropathic olfactory disorder, which requires special targeted treatment.
2. Ocular and intracranial complications.
(1) It may cause dacryocystitis and conjunctivitis, mainly due to inflammation through the nasolacrimal duct to the eye infection. In the treatment of nasal disease, it is necessary to cooperate with ophthalmologic treatment, or vice versa, to treat ophthalmologic disease with rhinologic treatment.
(2) Optic neuritis: The eye (spherical, called the “eyeball”) is located in the orbit, and the optic nerve enters the eye in the orbital fissure behind the eye, which is closely adjacent to the sinuses (mainly the “septal sinus”). When the septal sinus is inflamed, the inflammation may invade the area, leading to the development of optic neuritis, which can cause rapid vision loss in a short period of time. Ophthalmic treatment is required in the treatment of sinusitis.
(3) Intraorbital infection: i.e., infection in the orbit. The orbit is in close proximity to several sinuses, and inflammation of the sinuses may enter the orbit and cause an intraorbital infection with serious consequences.
(4) Intracranial infections: The sinuses themselves are grown inside the skull, and the skull encases the soft tissue of the brain. If the inflammation of the sinus penetrates the skull, it will enter inside the skull and cause inflammation of the soft tissues of the brain, with serious and even life-threatening consequences, fortunately the incidence of this situation is not {, but it is by no means impossible.
3. Ear complications.
It is easy to complicate otitis media, including purulent otitis media and non-purulent otitis media. There are three possible reasons why rhinitis and sinusitis can cause otitis media. One, when the nasal cavity is inflamed, there is a regular flow of secretions (pus and mucus) with a large amount of bacteria. If the nasal secretions flow backward, they enter the nasopharynx (the junction of the nose and pharynx) and can cause inflammation of the nasopharynx. There is an orifice in the nasopharynx (called the “eustachian tube”) that leads to the ear (the “middle ear cavity”, also known as the “tympanic chamber”). If inflammation in the nasopharynx causes congestion and swelling of the mucosa there, it can block the opening of the middle ear orifice in the nasopharynx (called the “pharyngeal orifice”) and cause exudative otitis media; if bacteria enter the middle ear cavity along this orifice (pharyngeal tube), it can cause purulent otitis media. Secondly, in the case of sinusitis, you need to blow your nose regularly. If you blow your nose in the wrong way, it will cause snot to gush into the nasopharynx and further occur as described above, causing otitis media. Third, chronic sinusitis, body resistance is often reduced, when the nasal secretions into the nasopharynx, middle ear cavity, easy to make inflammation to develop, resulting in otitis media, Chinese medicine is the view that “the righteousness is insufficient, then the evil is easy to invade”.
4. Throat complications.
Inflammatory secretions (nasal snot) flow backward into the nasopharynx and pharynx, stimulating the pharyngeal mucosa and causing inflammation of the pharynx, including nasopharyngitis, pharyngitis, tonsillitis, adenoiditis, adenoid hypertrophy, laryngitis, causing pain in the throat, sometimes wanting to “utter”, coughing with phlegm or less phlegm, snoring, hoarseness, etc.
5. Lower respiratory tract and lung complications.
The trachea goes up to the throat and down to the lungs. When sinusitis, on the one hand, because the nasal secretions into the pharynx, causing inflammation in the throat, and can further spread down again, causing tracheal and bronchial inflammation, cough and other symptoms; on the other hand, the nasal cavity has the role of cleaning, filtering and disinfecting the inhaled air, and is the first line of defense of the body against disease. When sinusitis occurs, this line of defense is damaged, and dust and harmful substances in the air drive straight into the trachea and lungs, thus predisposing to tracheal and lung diseases. Clinically, stubborn bronchitis, bronchitis, bronchial asthma often coexist with chronic sinusitis, mostly related to the allergic reactions caused by sinusitis.
6. Digestive system complications.
In sinusitis, especially in chronic sinusitis, there is a large amount of nasal cavity with pus. These pus snot is sometimes blown out, sometimes backward from the nasal cavity, into the pharynx, swallowed by the patient, into the gastrointestinal tract. The toxic substances that enter the gastrointestinal tract irritate the mucous membrane of the gastrointestinal tract and cause damaging changes such as congestion and edema, so that the function of the gastrointestinal tract is affected, causing discomfort or pain in the gastrointestinal tract, gastric distention, indigestion, then loss of appetite, and mesenteric lymphadenitis (pain around the umbilicus, and abdominal ultrasound can confirm the diagnosis). Long-term loss of appetite will be malnutrition and developmental disorders in children (weakness, easy to catch a cold, yellow face, short stature). Since children do not actively blow snot, in most cases, nasal secretions flow backwards into the pharynx and then are swallowed and enter the gastrointestinal tract. Therefore, chronic sinusitis has a greater and more pronounced impact on the pediatric gastrointestinal tract. This is one of the reasons why sinusitis is more harmful to pediatric patients.
7. Psychoneurological complications.
Due to the toxic and harmful substances in the purulent secretions in the nasal cavity and sinuses being absorbed locally or through the gastrointestinal tract, it leads to the dysfunction of the nerves. The main symptoms are mental weakness, easy fatigue, inactivity, dizziness or lightheadedness, headache, insomnia, lack of brain power, memory loss, mood swings, inattention, restless sleep, teeth grinding, hyperactivity, and decreased academic performance. This is one of the reasons why sinusitis is more harmful to pediatricians.
8, causing developmental disorders in children
As the saying goes, “those who scratch are easy to break, and those who shine are easy to stain”. Children are in the process of growth and development, Chinese medicine believes that the body of the infantile yin and Yang, and therefore vulnerable to external factors that lead to disease and stunted development. As a result of long-term chronic sinusitis, purulent secretions are regularly swallowed into the gastrointestinal tract, causing a loss of appetite, resulting in reduced feeding and reduced nutritional intake, which does not meet the needs of children’s growth and development. If the needs of growth and development are not met for a long time, the growth and development of children will be hindered and the manifestations of stunted growth will appear, such as weakness, easy to catch a cold, lack of spirit, and lack of liveliness. Therefore, pediatric sinusitis should be of great concern to parents and actively treated.
V. Why are children prone to sinusitis?
In recent years, medical doctors and parents have been paying more and more attention to sinusitis in children. Some scientists have X-rayed seemingly healthy children and found that about 50% of them have sinus lesions. If these children are examined by maxillary sinus puncture, about 1/3 of them can flush out purulent secretions, indicating a higher incidence of sinusitis in children {. The reasons for the incidence of sinusitis in children { are related to the physiological characteristics of children in the growth and development period.
(1) Sinuses begin to develop mainly after birth. Children’s sinuses are not well developed, and the channel that communicates with the nasal cavity is thin and long, and this channel appears wider at the opening of the nasal cavity than in adults, so bacteria can easily enter the sinuses; the mucous membrane in children’s sinuses is delicate and poorly resisted, and inflammation can easily occur after infection.
(2) Children’s resistance is poorer than adults, poor adaptation to the external environment, such as climate change, cold and warmth disorders, it is easy to catch a cold; if the body is already weak, it is likely to further cause sinusitis. Moreover, childhood-specific infectious diseases such as measles, scarlet fever, whooping cough, and pneumonia are also more common and can easily cause inflammation of the nasal cavity, which can lead to sinusitis. Children at the age of 3-9 years old need to pay special attention to the prevention of colds because the immunity brought from the mother has been depleted and their own immunity is not yet established or open to be fully established, therefore, children at this age are the most susceptible to illness at this age. For children with chronic nasal disease or chronic throat disease (such as chronic rhinitis, chronic sinusitis, allergic rhinitis, tonsillitis, adenoid hypertrophy) as well as bronchitis, allergic constitution (due to genetic factors, such as parents or grandparents with allergic rhinitis diseases – including asthma, chronic bronchitis, allergic rhinitis, etc.) children are often particularly prone to upper respiratory tract infections, or recurrent chronic rhinopathy. When they grow older, the situation improves significantly.
Six, how to prevent sinusitis in children?
Prevent sinusitis mainly pay attention to these aspects as follows.
1, prevention of colds: sinusitis is often caused after a cold, so to prevent colds. There are many ways to prevent colds, such as strengthening physical exercise, strengthening physical fitness; washing your face with cold water in the morning, and soaking your feet in warm water before bed in the winter; regularly massaging the back of your nose back and forth with your index fingers of both hands until you get warm; after sweating and sudden changes in the weather, as well as paying attention to cold and warmth when sleeping on cold days.
2, active treatment of acute sinusitis, do not make the transformation into chronic sinusitis. Chronic sinusitis is often acute sinusitis treatment is not complete, the course of the disease is prolonged and caused, therefore, to actively treat acute sinusitis, do not make the course of the disease is prolonged.
3, active treatment of nose, throat, oral inflammation: for other nasal diseases that can cause sinusitis (such as nasal polyps, nasal foreign bodies), oral diseases (such as dental caries), pharyngeal diseases (such as tonsillitis, pediatric adenoid hypertrophy), active prevention, early cure.
4.After catching a cold, it is better not to take a flight to avoid causing sinusitis or otitis media.
5, pay attention to the regulation of children’s diet, promote appetite, supplement trace elements, to ensure nutrition, in order to enhance physical fitness.
Increase children’s appetite: Astragalus essence meat soup (experience formula)
Ingredients: Astragalus membranaceus 15g, 15 red dates, pitted, lean pork 100g
How to use: Add water and salt to the above three flavors, stew or steam, eat meat and dates, drink soup, 1 to 2 times a week.
Functions: Benefit qi and fix the surface, support the righteousness and dispel the evil. For the prevention of chronic rhinitis, allergic rhinitis, sinusitis, chronic pharyngeal disease, adenoid hypertrophy, easy to catch a cold, often recurrent or repeatedly aggravated.