caa a22 4500 388083727 CHVBK 20180307125224.0 cr unu---uuuuu 161130e199901 xx s 000 0 eng 10.1017/S0022215100143038 doi S0022215100143038 pii (NATIONALLICENCE)cambridge-10.1017/S0022215100143038 Jones N. S. Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Nottingham, UK. Current concepts in the management of paediatric rhinosinusitis [Elektronische Daten] [N. S. Jones] It is well recognized that adenoid hypertrophy and allergic rhinitis are common in children and that recurrent upper respiratory tract infections are a fact of life. The main causes of symptoms associated with rhinosinusitis in children are rhinorrhoea, nasal obstruction, mouth breathing, hyponasal speech and snoring. Most children grow out of adenoid hypertrophy and recurrent colds by the age of eight to 10 and this means that the main treatment strategy should therefore be conservative and not surgical. An explanation to anxious parents, simple non-invasive measures such as teaching nose-blowing, the use of saline sprays or a trial of allergen avoidance and age-appropriate topical nasal anti-inflammatory sprays should be tried before surgery is even contemplated. Because repeated infections are so common, antibiotics given for chronic nasal discharge often have only short-lived effects. Rhinosinusitis in children is not a surgical disease and ‘watchful waiting' is advised. Any treatment should first of all be safe, as even without any intervention the problem usually resolves with time. It is likely that growth and maturation of the immunological response to pathogens play a major role in resolution of the disease. There are few exceptions to this principle: nasal polyps (indicating possible cystic fibrosis), and periorbital cellulitis where an assessment of vision, parenteral antibiotics, and if there is concern about the possibility of a subperiosteal abscess, computerized tomography (CT) and drainage of any pus is indicated. Copyright © JLO (1984) Limited 1999 Child nationallicence Rhinitis nationallicence Sinusitis nationallicence Surgery nationallicence endoscopic nationallicence Radiology nationallicence The Journal of Laryngology & Otology Cambridge University Press 113/1(1999-01), 1-9 0022-2151 113:1<1 1999 113 JLO https://doi.org/10.1017/S0022215100143038 text/html Onlinezugriff via DOI 1 review-article jats NATIONALLICENCE 856 40 https://doi.org/10.1017/S0022215100143038 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Jones N. S. Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Nottingham, UK NATIONALLICENCE 773 0- The Journal of Laryngology & Otology Cambridge University Press 113/1(1999-01), 1-9 0022-2151 113:1<1 1999 113 JLO CC0 http://creativecommons.org/publicdomain/zero/1.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-cambridge