Sinusitis in Children: Current Management

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(Free-Press-Release.com) July 23, 2009 -- About Dr. Rande Lazar

Dr. Rande Lazar is a Memphis Otolaryngologist with a primary focus in pediatric ear, nose and throat disorders, including ear infections, throat infections, tonsil infections, sinus infections and sleep disorders. Dr. Rande Lazar has special expertise in adult and pediatric sleep and snoring disorders and surgery, as well as adult and pediatric sinus disorders. Dr. Rande Lazar is experienced in a wide range of disorders of the ear, nose, throat, sinus, respiratory system and the other head and neck systems, as well as children’s disorders of the larynx (voicebox), and hearing problems.

Other places where Dr. Rande Lazar can be found include:

* Dr Rande Lazar's Facebook
* Memphis Ear Nose and Throat blog by Dr. Rande Lazar

Article Abstract:

Chronic sinusitis and recurrent acute sinusitis are relatively common clinical disorders in children. Chronic sinusitis describes signs and symptoms of sinusitis that persist longer than 3 months despite optimal medical therapy. In recurrent acute sinusitis, sufficient change has occurred in the anatomic structure of the infundibulum or in the efficacy of the mucociliary system to predispose the patient to recurrent bouts of sinusitis. In addition to the immediate discomfort of a about of sinusitis, the disease may exacerbate other conditions, such as asthma and otitis media, or lead to suppurative complications, such as orbital abscess or cavernous sinus thrombosis.

During the last decade, opinions have changed about the pathogenesis and treatment of chronic sinusitis. It had long been accepted that chronic sinusitis originated in the maxillary sinus and that removal of diseased mucosa by means of a Caldwell-Luc procedure or aeration of the sinus by antrostomy would reinstate the normal sinonasal condition. These concepts and practices were challenged by Messerklinger, who made it clear that the origin of sinusitis is the ostiomeatal complex. This region, which includes the uncinate process, the bulla ethmoidalis, the hiatus semilunaris, and the infundibulum, forms the dominant drainage system of the anterior ethmoid, frontal, and maxillary sinuses.

The development of the rod-lens telescope and other effective instrumentation has enabled otolaryngologists to address disease in the ostiomeatal complex endoscopically. In 1989, Gross and Lazar described the successful use of functional endonasal sinus surgery (FESS) in treating children. Since then, its use and efficacy have been reported by many physicians, and the indications for the procedures have greatly expanded. In addition to treating chronic sinusitis, FESS is now used for the treatment of orbital complications such as subperiosteal abscesses, for dacryocystorhinostomy creation, for the repair of limited cranial defects, and for the removal of benign lesions.

This review delineates the current ideas about the development of the sinuses, the pathophysiology of sinusitis, and the treatment of chronic rhinosinusitis.

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