© Borgis - New Medicine 2/2005, s. 24-25
Lechosław P. Chmielik, Agata Kuniszyk, Mieczysław Chmielik
Diseases in chronic rhinosinusitis in children – initial report
Clinic of Paediatric Otorhinolaryngology Medical University of Warsaw, Poland
Head: Prof. Mieczysław Chmielik MD, PhD
Chronic rhinosinusitis in children is one of the most common conditions of this age. However, there is a wide range of other diseases with similar symptoms differing in aetiopathogenesis and treatment methods, such as prolonged rhinosinusitis or recurring acute rhinosinusitis. The present paper presents a collection and incidence analysis of symptoms characteristic for chronic rhinosinusitis. Headache and its location have been particularly important in the present study. Based on the analysis of 103 medical histories of children hospitalized and surgically treated for chronic rhinosinusitis, it has been established that the most common disorders were headaches and catarrh. The prevalent location of lesions was maxillary sinuses. The most common lesion was swelling.
Advances in diagnostic methods allow more and more accurate diagnostics of various diseases. Disorders undiagnosed until recently or classified in wider disease scopes may now be diagnosed with more accuracy (owing to computed tomography among others), thus more effectively managed. Progress in medicine also provides more advanced methods for the management of rhinitis and sinusitis. According to the classical definition, the term ´rhinosinusitis´ is applicable to inflammation of the mucous membranes of the nose and sinuses, connected with one or more of the following symptoms:
1. Nasal obstruction
2. Nasal discharge
3. Sneezing and pruritus
In the inflammatory stage of rhinosinusitis, as in any inflammatory state, pain may occur, especially in cases with inflammatory involvement paranasal sinuses. Such cases generate headaches, a common, interdisciplinary problem that should also be managed as a neurological and ophthalmologic disorder.
When analyzing available literature, authors found only a few reports regarding diseases that accompany rhinosinusitis in adults, and did not find any reports on rhinosinusitis in children. (2, 3).
In the course of rhinosinusitis, pain may have a radiating nature due to innervation by the trigeminal nerve. According to Kennedy, in the course of acute rhinosinusitis, symptoms are as follows:
– in case of ethmoid sinuses inflammation: pressure pain in eye corners, headaches around eye orbits, temporal pain
– in acute maxillary sinuses inflammation: cheek pain on one side, toothaches, orbital pain, temporal temples
– in frontal sinuses inflammation: acute headaches
– in sphenoid sinuses inflammation: posterior headaches in the occipital area, anterior temporal area, orbital area and jaw.
According to Levin (4), pain is experienced in the following areas:
– in case of frontal sinuses: pain in the frontal, temporal and occipital areas
– in case of maxillary sinuses: teeth, temporal area and cheeks
– in case of ethmoid sinuses: top of head, base of nose, upper neck
– in case of sphenoid sinuses: top of skull, temporal, occipital, mastoid areas, arms
In chronic rhinosinusitis, pain symptoms can either lessen or not occur at all.
AIM OF THE STUDY
The objective of the present study was to analyze the subjective and objective symptoms in children with chronic rhinosinusitis.
MATERIAL AND METHOD
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1. Chmielik M.: Otorynolaryngologia dziecięca (red.) PZWL 2001; 67-68. 2.Paediatric Otolaryngology. Bluestone Ch., Stool S., Alper C., et all. Saunders 2003, 933-939. 3.Antonelli A., Bisetti A., Ferrara A., et all: Fisiologia e fistiopatologia del tratto respiratorio integrato. E.S. Valeas 1995. 4.Krzeski A., Janczewski G.: Choroby nosa i zatok przynosowych. Sanmedia 1998, 209-226.