Department of Maternal and Pediatric Sciences, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, Milan, Italy.
Pediatr Allergy Immunol. 2012 Aug;23 Suppl 22:17-9. doi: 10.1111/j.1399-3038.2012.01319.x.
Rhinosinusitis is almost always a complication of a viral infection involving the upper respiratory tract. A common cold is the first symptom of rhinosinusitis, but infectious processes involving the nose inevitably affect the paranasal sinuses because of their anatomical contiguity. The symptoms remain those of a common cold as long as nasal phlogosis is moderate and the ostia between the nose and sinuses are patent. If the inflammation is intense, edema may obliterate the ostia and isolate the sinuses, thus stopping the removal of the exudates. The duration of symptoms makes it possible to distinguish acute (10-30 days) from subacute (30-90 days) and chronic rhinosinusitis (>90 days). 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. Computed tomography and magnetic resonance images of the paranasal sinuses should be reserved for children reasonably considered to be candidates for surgery. Antibiotics are recommended in cases of mild acute bacterial rhinosinusitis as a means of accelerating the resolution of symptoms. The use of antibiotics is mandatory in severe acute bacterial rhinosinusitis to cure the disease and avoid the possible onset of severe complications.
鼻窦炎几乎总是上呼吸道病毒感染的并发症。普通感冒是鼻窦炎的第一个症状，但由于鼻与鼻窦解剖上的毗邻关系，涉及鼻腔的感染过程不可避免地会累及副鼻窦。只要鼻黏膜炎处于中度且鼻与鼻窦之间的窦口通畅，其症状就与普通感冒相同。如果炎症强烈，可能会发生水肿而使窦口闭塞，将鼻窦隔离，从而阻止渗出物的排出。根据症状的持续时间，可将急性（10-30 天）、亚急性（30-90 天）和慢性鼻窦炎（>90 天）区分开来。儿童上呼吸道感染的症状严重或持续，或在明显恢复后不久出现，应仅根据病史和临床标准诊断鼻窦炎，且鼻窦 CT 和磁共振成像应保留给合理考虑手术候选者的儿童。对于轻度急性细菌性鼻窦炎，推荐使用抗生素以加速症状缓解。对于严重急性细菌性鼻窦炎，使用抗生素是必需的，以治愈疾病并避免可能出现严重并发症。
