ABSTRACT
Paediatric rhinosinusitis and its complications describe a spectrum of disease, varying in aetiology, pathophysiology and duration, which influences clinical presentation and management. The diagnosis of rhinosinusitis in children is typically clinical and does not require imaging. There is evidence to support the use of intranasal steroids in conjunction with antibiotics in the management of children with Acute rhinosinusitis. Preseptal cellulitis usually responds to an oral antibiotic but may spread beyond the orbital septum, with intraorbital complications. Intracranial complications including cavernous sinus thrombosis may occur without prior abscess formation. The role of the adenoids in the pathogenesis of paediatric rhinosinusitis remains uncertain, but adenoidectomy is known to improve symptoms in at least half of young children with Chronic rhinosinusitis (CRS). Children with CRS will often have an atopic history, including allergic rhinitis. Cystic fibrosis is an autosomal recessive condition affecting 1 in 2500 live births in the UK, and is associated with high incidence of CRS and nasal polyposis in children.
