Sinusitis in children is a more common disease in children and has a higher incidence than sinusitis in adults, with heavier symptoms and easy recurrence.
I. Etiology.
Mainly related to the anatomical structure and physiology of the nasal cavity and sinuses in children, and changes with the state of physical development of children and their specific diseases, habits and behavior. The higher incidence of sinusitis in children compared to adults is mainly related to the following factors.
(1) Sinus opening is relatively large, and nasal infection can easily invade the sinuses through the sinus opening during acute rhinitis; the nasal nasal passages are narrow, the sinuses are not fully developed, and the mucous membrane plate travels Xinxiang rhizome off Qianhan hill is bad └腥荆衬ぶ渍徒现兀曳置 谖锝隙啵滓 舫 rift feed ⒈邱迹 wasshi therefore the symptoms in children are often more serious than in adults;
(2)The body resistance and adaptability to the outside world are poor, prone to colds and other upper respiratory tract infections and acute infectious diseases (such as mazen, whooping cough, scarlet fever, nasal infections, etc.);
(3) adenoid hypertrophy, obstruction of the posterior nostril, affecting nasal and sinus ventilation and flow; posterior nostril atresia and cleft palate, etc. also affect normal nasal breathing;
(4) Immune diseases, such as allergic rhinitis, asthma, etc.;
(5) unclean water swimming;
(6) Foreign bodies in the nasal cavity and trauma, etc. The causative organisms are mostly pneumococcus, streptococcus and staphylococcus.
II. Clinical manifestations.
1, acute sinusitis early symptoms like a cold, mainly nasal congestion, runny nose, clear or cloudy snot, followed by yellow pus nasal snot, nasal reflux can cause coughing and coughing, the child more swallowed snot into the stomach, the amount of appetite and other indigestion symptoms; at the same time, the child’s systemic symptoms are heavy, accompanied by fever, depression, irritability, shortness of breath, refusal to eat, and even convulsions. It may cause acute otitis media and rhinorrhea. Older children may complain of headache or cheek pain.
2. Chronic sinusitis often manifests as intermittent or persistent nasal congestion, mucus and mucopurulent nasal discharge, and frequent rhinorrhea. In severe cases, the prolonged course of the disease may be manifested by mental depression, decreased appetite, decreased rest weight and low fever. It may be accompanied by adenoid hypertrophy, chronic otitis media, anemia, rheumatism, arthralgia, asthma and nephritis and nephropathy. Due to prolonged nasal congestion and open mouth breathing, it can lead to jaw, chest and mental retardation in children. Generally, the symptoms last for 3 months and can be diagnosed as chronic sinusitis.
3. Sinusitis in children is often not an isolated disease, but mostly a complication of upper respiratory infections, with heavier and more persistent symptom weight than the usual upper respiratory infections. Sinusitis is not uncommon in preschool children. If cold symptoms last for more than 7 days and pus nasal discharge does not decrease or even increase, sinusitis should be considered.
4, complication symptoms Due to the characteristics of children’s nasal physiological nodules and systemic development is not perfect, the incidence of complications is higher than that of adults, often complications manifested as
(1) Acute otitis media, manifested as ear pain and hearing loss, and pus flowing from the external ear canal may occur after tympanic membrane perforation, which is the most common.
(2) Lower respiratory tract infections, such as laryngitis, bronchitis, manifested by hoarseness, cough and coughing sputum, etc., most commonly.
(3) Osteomyelitis of the maxilla with painful swelling of the face and high fever. Severe
(4) Orbital cellulitis Superficial eye pain, eyelid congestion, protruding eyeballs, etc. Very serious
(5) Meningitis, cavernous sinus thrombosis, manifesting as headache, vomiting, hyperthermia, impaired consciousness, etc. Very serious
(6) Optic neuritis Surface as blurred vision, loss of vision, etc. Very serious
III. Treatment principles.
Drug conservative treatment is the main, when conservative treatment is ineffective in chronic cases, small-scale nasal endoscopic functional surgery is feasible.
1, acute sinusitis systemic application of adequate antibiotics, antihistamines, mucus foot drainage agents. Local application of decongestant (no more than 7 days) and grain corticosteroids can be applied to the nasal cavity and sinuses to facilitate ventilation and drainage. If there are complications, the complications are treated at the same time.
2, chronic sinusitis First take standardized conservative treatment. Systemic application of antibiotics, mainly oral, for at least 2 to 3 weeks. Simultaneous local application of glucocorticoids and decongestants in the nasal cavity (no more than 7 days). If adenoid hypertrophy is present, adenoidectomy should be performed, otherwise conservative treatment is almost ineffective. Sinus replacement is also one of the conservative treatment methods and is more effective in septal sinusitis and whole group sinusitis. For larger children with chronic sinusitis, maxillary sinus puncture and irrigation and maxillary sinus injection are also possible. Most children can be cured.
3.Surgical treatment Conservative treatment is ineffective, accompanied by nasal polyps, can be considered sinus surgery. children under 9 years old choose functional nasal endoscopic surgery, and the scope of surgery should be as small as possible.