Badr Dana T, Gaffin Jonathan M, Phipatanakul Wanda
Department Of Pediatric and Adolescent medicine, American University of Beirut Medical Center, Lebanon.
Division of Respiratory Medicine, American University of Beirut Medical Center, Lebanon; Boston Children's Hospital, Harvard Medical School, American University of Beirut Medical Center, Lebanon.
Curr Treat Options Allergy. 2016 Sep;3(3):268-281. doi: 10.1007/s40521-016-0096-y. Epub 2016 Jul 11.
Rhinosinusitis, is defined as an inflammation of the paranasal and nasal sinus mucosae. Chronic rhinosinusitis (CRS)is a common problem in the pediatric age group and the diagnosis and treatment are challenging due to the chronicity and similarity of symptoms with allergic rhinitis and adenoid hypertrophy. Although it is less common than acute rhinosinusitis, CRS is becoming more frequent and significantly affects the quality of life in children and can substantially impair daily function. CRS is characterized by sinus symptoms lasting more than 3 months despite medical therapy. Many factors are involved in the pathogenesis of this disease and include a primary insult with a virus followed bybacterial infection and mucosal inflammation, along with predisposition to allergies. The standard treatment of pediatricacute bacterial rhinosinusitis (ABRS) is nasal irrigation and antibiotic use. Medical treatment of pediatric CRS includes avoidance of allergens in allergic patients (environmental or food) and therapy with nasal irrigation, nasal corticosteroids sprays, nasal decongestants, and antibiotics directed at the most common sinonasalorganisms (Haemophilusinfluenzae, Streptococcus pneumoniae, and Moraxella catarrhalis). Surgical therapy is rarely needed after appropriate medical therapy. Referral to an otolaryngologist and allergy specialist is recommended in case of failure of medical treatment.
鼻窦炎被定义为鼻旁窦和鼻腔黏膜的炎症。慢性鼻窦炎（CRS）是儿童年龄段的常见问题，由于其慢性病程以及与过敏性鼻炎和腺样体肥大症状的相似性，其诊断和治疗具有挑战性。尽管CRS不如急性鼻窦炎常见，但它正变得越来越频繁，并且显著影响儿童的生活质量，还会严重损害日常功能。CRS的特征是尽管进行了药物治疗，鼻窦症状仍持续超过3个月。该疾病的发病机制涉及许多因素，包括病毒的原发性侵袭，随后是细菌感染和黏膜炎症，以及易患过敏症。小儿急性细菌性鼻窦炎（ABRS）的标准治疗方法是鼻腔冲洗和使用抗生素。小儿CRS的药物治疗包括避免过敏患者接触过敏原（环境或食物），以及采用鼻腔冲洗、鼻用皮质类固醇喷雾剂、鼻减充血剂和针对最常见鼻窦病原体（流感嗜血杆菌、肺炎链球菌和卡他莫拉菌）的抗生素进行治疗。经过适当的药物治疗后很少需要手术治疗。如果药物治疗失败，建议转诊至耳鼻喉科医生和过敏专科医生处。
