Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

Pediatric Unilateral Chronic Sinusitis: Clinical and Radiological Patterns Compared to Adults

Document Type : Original

Authors
Ahmed Adel Sadek 1
Maisara Mohamed Mahmoud Nasr 1
Ahmed Ali Mohamad Badawi 1
Tamer El Zaeem Esmaeel 2
Osama Galal Awad 1
1 Department of otorhinolaryngology- faculty of medicine- Minia University – Egypt.
2 Department of Diagnostic Radiology, Faculty of Medicine, Minia University, Egypt..
10.22038/ijorl.2024.75788.3539
Abstract
Introduction:
Upper respiratory tract infections and sinusitis are more prevalent in children than in adults. Unilateral sinusitis is not uncommon disease. Our aim was to analyze the disease characteristics in children with unilateral sinusitis and compare them with those of adults.
Materials and Methods:
This study included 124 patients with unilateral chronic sinusitis divided according to age into two groups: pediatric group ≤18 years (66 cases) and adult group >18 years (58 cases). The groups were compared in terms of demographic data, side, clinical manifestations and radiological findings.
Results:
In pediatric patients, the most common inflammatory pathology was antrochoanal polyps, followed by allergic fungal sinusitis. On the other hand, chronic sinusitis without nasal polyps is the most common in adults, followed by antrochoanal polyps. The mean duration of clinical manifestations before diagnosis in pediatric patients was significantly shorter than that in adults (P=0.001). The most common symptoms in both pediatric and adult patients were anterior nasal discharge and nasal obstruction. Proptosis was significantly higher in pediatric group than in adult group (P=0.015). On computed tomography (CT), the most commonly affected sinus in both pediatric and adult patients was the maxillary sinus followed by the anterior ethmoid sinus. Bone expansion, erosion and involvement of adjacent structures were significantly higher in pediatric patients (P=0.028, 0.027 respectively).
Conclusion:
Pediatric patients have a high incidence of antrochoanal polyps and allergic fungal sinusitis as unilateral inflammatory lesions. These lesions require surgical management. Inflammatory paranasal sinus lesions in pediatric patients have a shorter duration of clinical manifestations and a higher incidence of bone erosion and involvement of adjacent structures; therefore, early diagnosis and management prevent complications.
Keywords
Chronic sinusitis
Computed tomography
Unilateral sinusitis
Pediatrics
Subjects
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Iranian Journal of Otorhinolaryngology
Volume 36, Issue 3
May and June 2024
Pages 443-449