Department of Head and Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, 10833 Le Conte Ave, CHS 62-237, Los Angeles, CA, 90095, USA.
Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
Curr Allergy Asthma Rep. 2019 Feb 22;19(2):14. doi: 10.1007/s11882-019-0845-7.
Pediatric chronic rhinosinusitis (CRS) is a prevalent problem that can elude diagnosis. In addition, given the burgeoning interest in pediatric sinonasal disease, treatment modalities are constantly evolving.
The diagnosis of pediatric CRS is primarily based on clinical history and signs supported by objective findings (i.e., nasal endoscopy and/or computed tomography (CT) imaging). Cultures are indicated in patients who have not responded to medical therapy or have significant comorbidities. Nasal saline irrigation, nasal saline spray, and oral antibiotics are currently recommended for initial medical management. In children with CRS who have failed medical therapy, a stepwise approach to surgical intervention can lead to significant improvements in quality of life. This review provides an overview of the current guidelines and recent literature regarding the diagnosis, microbiology, and treatment options of CRS in the pediatric population.
小儿慢性鼻-鼻窦炎（CRS）是一种普遍存在的问题，可能难以诊断。此外，鉴于小儿鼻-鼻窦疾病日益受到关注，治疗方法也在不断发展。
小儿 CRS 的诊断主要基于临床病史和体征，并辅以客观发现（即鼻内镜和/或计算机断层扫描（CT）成像）。对于未对药物治疗有反应或存在严重合并症的患者，应进行培养。目前推荐使用鼻腔盐水冲洗、鼻腔盐水喷雾和口服抗生素进行初始药物治疗。对于药物治疗失败的小儿 CRS 患者，手术干预的逐步方法可显著提高生活质量。本文综述了小儿 CRS 的当前指南和最新文献，内容涉及小儿 CRS 的诊断、微生物学和治疗选择。
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