Chronic rhinosinusitis (CRS) is an inflammatory process involving the mucosa of the nose and one or more sinuses. Because the mucosa of the nose and sinuses form a func-tional and anatomic continuum, the sinuses are always involved in nasal diseases. Of fundamental importance of the normal physiology of the paranasal sinuses are the patency of the sinus ostia, the function of the epithelial and the ciliary apparatus, and the quality and quantity of secretions (1). Any mechanical obstruction of the sinus ostia, generally con-sequent to an acute upper respiratory tract infection (URI) or to a persistent rhinitis or both, can modify the normal ventilation and clearance function of the paranasal sinuses, thus causing a CRS (2). Pathophysiology and pathogenesis of CRS are still insuffi-ciently defined and for these reasons are difficult to treat. The diagnosis, which is largely clinical, is sometimes confused by pediatricians as allergic rhinitis or by otolaryngologist as a consequence of chronic hyperplastic adenoiditis, thus lead-ing to inappropriate medical or surgical treatment (3). These two disorders are indeed frequently associated with CRS and cooperate in maintaining or causing partial or incomplete resolution of CRS. Symptoms, especially in children, lack speci-ficity, but rhinorrhea, nasal congestion and obstruction, chronic cough, purulent nasal discharge, and postnasal drip are the most frequently seen. CRS is defined by a duration longer than 3 months and is one of the major causes of morbidity in the pediatric population (4). A widely accepted classification of CRS based on temporal time frames is reported by Slavin et al. (5): acute rhinosinusitis (ARS), 7 days to 4 wk; subacute rhinosinusitis (SRS), 1–3 month.
|Data di pubblicazione:||2012|
|Titolo:||Management of chronic rhinosinusitis|
|Rivista:||PEDIATRIC ALLERGY AND IMMUNOLOGY|
|Digital Object Identifier (DOI):||10.1111/j.1399-3038.2012.01322.x|
|Codice identificativo ISI:||WOS:000306001800007|
|Codice identificativo Scopus:||2-s2.0-84863538684|
|Appare nelle tipologie:||Articolo su Rivista|