1.What is childhood sinusitis?
Sinusitis is a purulent inflammation of the sinuses, and sinusitis in children under the age of 14 is called pediatric sinusitis.
2.Why are children susceptible to sinusitis?
(1) children’s sinus sinus opening is relatively large, the cold is easy to invade the sinuses through the sinus opening; and the nasal cavity and nasal passage is narrow, ventilation and drainage is not smooth.
2) their own resistance to disease and adaptability 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) Congenital immune insufficiency or atopic constitution, such as asthma and 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.
3, 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, such as 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 nasal vestibule eczema symptoms such as nasolabial groove flushing, erosion, oozing.
4.What auxiliary examinations are needed for the diagnosis of pediatric sinusitis?
(1) Nasal and local examination: A pediatric nasal endoscope can be used for anterior nostril examination to observe the mucosa of the nasal cavity, inferior turbinates, and nasal cavity for abnormal secretions. If a large amount of pus is found 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 pharynx wall. In the case of chronic sinusitis, crusting of the nasal vestibule can be seen; in 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 radiographs and CT scans:: X-ray radiographs are of little significance for the diagnosis of sinusitis. When occupying lesions are considered or conventional treatment is ineffective CT scan is of good value for the diagnosis of sinusitis in children.
(3) If sinusitis does not heal repeatedly or is accompanied by open-mouth breathing and snoring, the adenoids need to be examined.
5.Treatment of pediatric sinusitis?
(1) Treatment of acute sinusitis: A sufficient amount of systemic antibiotics should be applied early to control the 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, easily digestible 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 can be used. 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 nose ventilation, 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 surgery should not be too extensive and should also try to preserve the normal nasal structures so as not to affect the maxillofacial development.
(3) In general, children with sinusitis are mainly treated conservatively with medication, but if it does not heal over time, the adenoids can be examined and adenoidectomy can be 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.
6.Prevention of pediatric sinusitis?
(1) Timely treatment of colds, when there are repeated episodes of tonsillitis should be thoroughly treated.
2）Cold water can be used to wash the face in the morning, which can effectively enhance the anti-disease ability of the nasal mucosa.
3) Usually you can 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 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.