1. SINUSITIS IN CHILDREN
PRESENTED BY:
A.PRIYADHARSHINI, M.Sc(N),
LECTURER,
JAI INSTITUTE OF NURSING AND
RESEARCH,
GWALIOR.

2. DEFINITION:
 Sinusitis is the inflammation of sinuses.

3. EPIDEMIOLOGY
 Although the exact incidence of sinusitis in the
pediatric population is unclear, it is diagnosed
commonly, most often following a viral URTI.
 Approximately 5-13% of URTIs are complicated
by bacterial sinusitis.
 It affects only 1% of infants and 5% of children
aged 5-9 years, while 15% of the adolescent
population is affected.
 Allergic rhinitis is one of the most common
predisposing factors for sinusitis.

4. CAUSES:
 Acute and subacute pathogens Streptococcus
pneumoniae - 20-30%
 Haemophilus influenzae - 15-20%
 Streptococcus pyogenes (beta-hemolytic) - 5%
 Staphylococcus aureus
 Anatomical abnormalities: Several anatomical
abnormalities of the lateral nasal wall can
predispose to sinusitis.
 Deviated septum

5. CONTD…
 GER may lead to inflammation of the eustachian
tube orifices or sinus ostia secondary to mucosal
irritation.
 Polypoid mass or mucosal changes associated
with allergic fungal sinusitis

6. CLINICAL MANIFESTATIONS:
 ACUTE SINUSITIS
 URTI symptoms persisting longer than 7-10 days
suggest acute sinusitis.
 Daytime cough and rhinorrhea are the 2 most
common symptoms.
 Other common signs and symptoms include the
following:
 Nasal congestion
 Infrequent low-grade fever
 Otitis media (50-60% of patients)
 Irritability
 Headache

8. CONTD…
 Subacute sinusitis:
This condition is defined as signs and
symptoms lasting between 30-90 days.
 Chronic sinusitis:
Chronic sinusitis is defined as low-grade
persistence of signs and/or symptoms lasting
longer than 90 days without improvement.
 Nighttime cough is more prevalent.

9. DIAGNOSTIC EVALUATION:
 Head and neck
examination
 Otoscopy
 Anterior rhinoscopy
 Nasal endoscopy
 CT scan
 Plain radiography
 MRI
 Ultrasonography can be
used to evaluate the
maxillary sinuses

10. CONTD..
 Maxillary sinus puncture-This test is the criterion
standard for obtaining maxillary sinus cultures.
 Middle meatal swab Cultures

11. MEDICAL MANAGEMENT:
 Antibiotic therapy for acute sinusitis -Because of
the growing problem of bacterial resistance, do
not administer antibiotics indiscriminately or
without confirmation of history by physical
examination.
 Treat for 10-14 days or for 1 week

12. CONTD..
 Saline sinus irrigation has demonstrated efficacy
in the treatment of acute and chronic sinusitis. It
mechanically clears secretions, decreases
bacterial counts, and clears allergens and
environmental irritants from the nose.
 Nasal steroids are essential for patients with
concurrent allergic rhinitis.
 Nasal decongestants are variably effective.
Topical decongestants may improve patients'
level of comfort.

13. CONTD..
 Mucolytics are variably effective.
 Antihistamines
 Immunotherapy is effective for patients with
known specific allergies who have symptoms not
responsive to other forms of traditional medical
therapy.

14. SURGICAL MANAGEMENT:
 Adenoidectomy
 Functional endoscopic sinus surgery
 Balloon sinuplasty
 Consider surgery as a last resort in the pediatric
population.

15. SUPPORTIVE MANAGEMENT:
 Patients with GER should eliminate caffeine,
chocolate, and acidic beverages from their diets.
 Also, patients should not lie supine after meals,
and no food should be consumed for 2 hours
before bedtime.
 With food allergies, which are common in the
pediatric population, appropriate restrictions are
necessary.

16. COMPLICATIONS:
 Osteomyelitis
 Orbital infection
 Abscesses
 Meningitis

17. THANK YOU