ENT Pediatric Unit, Istituti Clinici di Perfezionamento, Ospedale Buzzi, Milan, Italy.
Int J Immunopathol Pharmacol. 2010 Jan-Mar;23(1 Suppl):74-7.
The treatment of rhinosinusitis in children is mostly medical. Surgery is indicated in few but important exceptions: orbital or intracranial complications of acute rhinosinusitis not responding to medical therapy, chronic rhinosinusitis (CRS) with persisting sinonasal infection and purulent discharge, cystic fibrosis, ciliary diskinesia, dacryocystitis due to sinusitis and resistant to medical treatment, fungal rhinosinusitis. According to recent data, 50 percent of ENT specialist perform an adenoidectomy to manage CRS before endoscopic sinus surgery (ESS). ESS techniques introduced in mid 90s, has significantly modified the treatment of complications of acute rhinosinusitis and of selected cases of chronic recurrent infections. ESS consists of minimally invasive surgical procedure as middle meatal antrostomy and anterior ethmoidectomy. Evidence suggests that adenoidectomy and ESS are the most frequent surgical procedure performed in RS management.
儿童鼻窦炎的治疗主要是药物治疗。但在一些重要的特殊情况下需要手术治疗：药物治疗不能缓解的急性鼻窦炎的眶内或颅内并发症、持续存在的鼻旁窦感染和脓性分泌物的慢性鼻窦炎、囊性纤维化、纤毛运动障碍、由于鼻窦炎导致且对药物治疗有抗性的泪囊炎、真菌性鼻窦炎。根据最近的数据，50%的耳鼻喉科专家在进行内镜鼻窦手术（ESS）前会进行腺样体切除术来治疗 CRS。90 年代中期引入的 ESS 技术显著改变了急性鼻窦炎并发症和某些慢性复发性感染的治疗方法。ESS 包括微创的中鼻道窦口造口术和前筛窦切除术。有证据表明，腺样体切除术和 ESS 是治疗 RS 中最常进行的手术。
