Rhinosinusitis management in pediatrics: an overview.

Rhinosinusitis is an inflammation of one or more paranasal sinuses, usually caused by an infection. The clinical appearance of rhinosinusitis may be heterogeneous and change with patient age, the duration of symptoms and, above all, the seriousness of the illness. The diagnosis of rhinosinusitis should only be based on anamnestic and clinical criteria in children with serious or persistent symptoms of upper respiratory tract infection, or which appear within a short time of an apparent recovery. Imaging studies are not usually necessary to confirm a diagnosis of uncomplicated acute bacterial rhinosinusitis. Paranasal sinus computed tomography or magnetic resonance and optical fibre rhinoscopy are required in severe cases that do not respond to antibiotic therapy. Antibiotics are recommended in cases of mild acute bacterial rhinosinusitis as a means of accelerating the resolution of symptoms, and they are mandatory in severe acute cases in order to cure the disease and avoid the possible onset of severe complications.