Management of Rhinosinusitis in Children

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Abstract
THE MANAGEMENT of rhinosinusitis in children is a controversial and rapidly evolving issue. Opinions regarding treatment vary from no therapy to extensive sphenoethmoidectomy. Those who favor minimal or no intervention argue that spontaneous resolution of chronic rhinosinusitis in the young child is the norm.1,2 At the opposite end of the therapeutic spectrum, surgeons are abandoning the more aggressive surgical techniques in favor of a concept of minimally invasive sinus surgery.3,4 Even the use of antibiotics, still the mainstay in the medical management of rhinosinusitis, has to be questioned. The combination of emerging antibiotic resistance of the microorganisms commonly involved in rhinosinusitis plus the infrequency of complications in children treated without antibiotics5 has prompted some authors to encourage limiting antibiotic therapy to highly selected patients.1

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