Chronic Rhinosinusitis in Children

PROGRAM DESCRIPTION: Chronic rhinosinusitis in children is a common clinical problem encountered in rhinology, general, and pediatric Otolaryngology practices. Unlike adult rhinosinusitis, the disease in children has not received much attention despite the fact that it has a significant negative impact on quality of life. The presentation will discuss the prevalence of the disease and the clinical presentation as well as review the information available related to the pathophysiology. We will then go over the tools available to cement the diagnosis emphasizing exam and radiologic findings. Children with chronic rhinosinusitis often have coexisting morbidities which include asthma, allergic rhinitis, ciliary abnormalities and immune deficiencies. The importance of these comorbidities and their relationship to rhinosinusitis will be discussed. Medical therapy is mainstay in children and data supporting the use of saline irrigation, intranasal steroids, antibiotics and other treatment choices will be reviewed. Finally, when medical therapy fails, surgical therapy is considered and the evidence supporting various surgical options (adenoidectomy, sinus irrigation, balloon sinuplasty and endoscopic sinus surgery) will be reviewed. The presentation will be based on the latest evidence available in the literature including prospective and retrospective case series or randomized trials, consensus statements and various guidelines and position statements.

OUTCOME OBJECTIVE 1: Recognize the prevalence of chronic rhinosinusitis in children and understand various factors that influence disease pathophysiology

OUTCOME OBJECTIVE 2: Understand presenting signs and symptoms and best practice to establish the diagnosis of chronic rhinosinusitis in children and evaluate concurrent comorbidities

OUTCOME OBJECTIVE 3: Appreciate evidence related to various medical and surgical therapy options for children with chronic rhinosinusitis

BACKGROUND STATEMENT: Children with chronic rhinosinusitis commonly present to otolaryngologists. The entity is not as investigated or discussed as its adult counterpart. This presentation aims to review evidence supporting best practice in the diagnosis and treatment (medical and surgical) of this entity.