Chronic rhinosinusitis in children: evolution of concepts

The concept of chronic rhinosinusitis in children has been recently individualized. The diagnosis is based upon the clinical history. It may be part of a diffuse inflammatory disease of the respiratory tract. Allergic and environmental polluting factors are possibly involved and must be looked for. Drainage of the rhinopharynx and local steroids are usually the first line treatment. In case of failure, a CT-scan of the sinuses should be performed looking for an obstructive anomaly of the sinuses requiring functional endoscopic sinus surgery.