A More Conservative Approach

In younger children, an otoscope can be used to visualize the nasal cavity. Radiographic findings are often inconclusive.¹² Nevertheless, CT scanning is the standard criterion for the evaluation of chronic sinusitis in children to look for anatomic abnormalities, mucosal disease, and chronic stasis of secretions. The use of CT scanning is generally reserved for patients with chronic sinusitis not responding to medical treatment.²

Maximum Medical Treatment

Antibiotics are the cornerstone of medical treatment. The choice of antibiotic is empiric, keeping in mind the most common pathogens in pediatric sinusitis (see Table 2). Maximum medical therapy should include several two- to three-week courses of appropriate antibiotics, as well as the use of adjuvant medications, including antihistamines, decongestants, steroid sprays, saline sprays and irrigations, and others (see Table 2). Underlying medical conditions should also be addressed.²

©2007 The Triological Society