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Diseases of the nose and paranasal sinuses in child.

Stenner M, Rudack C - GMS Curr Top Otorhinolaryngol Head Neck Surg (2014)

Bottom Line: The indication for CT-imaging of the nasal sinuses is reserved for cases of chronic rhinosinusitis that have been successfully treated with medication.Nasal sinus surgery is considered nowadays as effective and safe in children.Based on the assumption that adenoids are a reservoir for bacteria, from which recurrent infections of the nose and nasal sinus originate, the adenoidectomy is still defined as a cleansing procedure in rhinosinusitis. 69.3% of the children had benefit from adenoidectomy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Münster, Germany.

ABSTRACT
Diseases of the pediatric nose and nasal sinuses as well as neighboring anatomical structures encompass a variety of pathologies, especially of inflammatory nature. Congenital disease, such as malformations and structural deviations of the nasal septum, as well as systemic metabolic pathologies affecting the nose and sinuses, rarely require medical therapy from an Otolaryngologist. The immunological function of the mucosa and genetic factors play a role in the development of disease in the pediatric upper airway tract, especially due to the constantly changing anatomy in this growth phase. Disease description of the nose and nasal sinuses due to mid-facial growth must also take developmental age differences (infant, toddler, preschool, and school age) into account. Epidemiological examinations and evidence based studies are often lacking in the pediatric population. The wide range of inflammatory diseases of the nose and paranasal sinuses, such as the acute and chronic rhinosinusitis, the allergic rhinitis, and adenoid disease, play a role in the susceptibility of a child to infection. The susceptibility to infection depends on the pediatric age structure (infant, young child) and has yet to be well defined. The acute rhinosinusitis in children develops after a viral infection of the upper airways, also referred to as the "common cold" in the literature. It usually spontaneously heals within ten days without any medical therapy. Antibiotic therapy is prudent in complicated episodes of ARS. The antibiotic therapy is reserved for children with complications or associated disease, such as bronchial asthma and/or chronic bronchitis. A chronic rhinosinusitis is defined as the inflammatory change in the nasal mucosa and nasal sinus mucosa, in which the corresponding symptoms persist for over 12 weeks. The indication for CT-imaging of the nasal sinuses is reserved for cases of chronic rhinosinusitis that have been successfully treated with medication. A staged therapeutic concept is followed in CRS based on conservative and surgical methods. Nasal sinus surgery is considered nowadays as effective and safe in children. Based on the assumption that adenoids are a reservoir for bacteria, from which recurrent infections of the nose and nasal sinus originate, the adenoidectomy is still defined as a cleansing procedure in rhinosinusitis. 69.3% of the children had benefit from adenoidectomy. Comorbidities, such as pediatric bronchial asthma, presently play an even more important role in the therapy of rhinosinusitis; therefore, it is often wise to have the support of pediatricians. In western European countries 40% of children presently suffer from allergic rhinitis, in which pronounced nasal obstruction can cause disturbed growth in facial bones. An early therapy with SIT may prevent the development of bronchial asthma and secondary sensitization to other allergens. Therefore, SIT is recommended in treatment of allergic rhinitis whenever, if possible. The assessment of diagnostic tools is for the examiner not often possible due to the lack of evidence. Rhinosurgical approaches are often described in study reports; however, they lack the standard prospective randomized long-term study design required nowadays and can only be evaluated with caution in the literature.

No MeSH data available.


Related in: MedlinePlus

Immunofluoroscence analysis for the tight junction protein claudin 7 on a histologic section of a healthy patient (left) and an eleven-year-old child with polyposis nasi (right)
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Figure 2: Immunofluoroscence analysis for the tight junction protein claudin 7 on a histologic section of a healthy patient (left) and an eleven-year-old child with polyposis nasi (right)

Mentions: The nasal mucosa is the first point of contact of the body with inspired antigens and pathogens; therefore, crucial for the immune defense. The nasal epithelium is built up of ciliated columnar epithelium. Basal cells overly a basal lamina, differentiate into intermediary cells that in turn differentiate into epithelial cells on the epithelium surface. The upper epithelial layer consists mainly (up to 70%) of nonciliated and up to 20–50% of ciliated epithelial cells, as well as 5–15% of goblet cells (Figure 2 (Fig. 2)). A 10–15 µm thick mucus layer covers the ciliated cells and fills the gaps in between the cilia. The ciliated cells are responsible for the mucociliary clearance, in which the transport of secretion is directed toward the choana.


Diseases of the nose and paranasal sinuses in child.

Stenner M, Rudack C - GMS Curr Top Otorhinolaryngol Head Neck Surg (2014)

Immunofluoroscence analysis for the tight junction protein claudin 7 on a histologic section of a healthy patient (left) and an eleven-year-old child with polyposis nasi (right)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4273171&req=5

Figure 2: Immunofluoroscence analysis for the tight junction protein claudin 7 on a histologic section of a healthy patient (left) and an eleven-year-old child with polyposis nasi (right)
Mentions: The nasal mucosa is the first point of contact of the body with inspired antigens and pathogens; therefore, crucial for the immune defense. The nasal epithelium is built up of ciliated columnar epithelium. Basal cells overly a basal lamina, differentiate into intermediary cells that in turn differentiate into epithelial cells on the epithelium surface. The upper epithelial layer consists mainly (up to 70%) of nonciliated and up to 20–50% of ciliated epithelial cells, as well as 5–15% of goblet cells (Figure 2 (Fig. 2)). A 10–15 µm thick mucus layer covers the ciliated cells and fills the gaps in between the cilia. The ciliated cells are responsible for the mucociliary clearance, in which the transport of secretion is directed toward the choana.

Bottom Line: The indication for CT-imaging of the nasal sinuses is reserved for cases of chronic rhinosinusitis that have been successfully treated with medication.Nasal sinus surgery is considered nowadays as effective and safe in children.Based on the assumption that adenoids are a reservoir for bacteria, from which recurrent infections of the nose and nasal sinus originate, the adenoidectomy is still defined as a cleansing procedure in rhinosinusitis. 69.3% of the children had benefit from adenoidectomy.

View Article: PubMed Central - HTML - PubMed

Affiliation: Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Münster, Germany.

ABSTRACT
Diseases of the pediatric nose and nasal sinuses as well as neighboring anatomical structures encompass a variety of pathologies, especially of inflammatory nature. Congenital disease, such as malformations and structural deviations of the nasal septum, as well as systemic metabolic pathologies affecting the nose and sinuses, rarely require medical therapy from an Otolaryngologist. The immunological function of the mucosa and genetic factors play a role in the development of disease in the pediatric upper airway tract, especially due to the constantly changing anatomy in this growth phase. Disease description of the nose and nasal sinuses due to mid-facial growth must also take developmental age differences (infant, toddler, preschool, and school age) into account. Epidemiological examinations and evidence based studies are often lacking in the pediatric population. The wide range of inflammatory diseases of the nose and paranasal sinuses, such as the acute and chronic rhinosinusitis, the allergic rhinitis, and adenoid disease, play a role in the susceptibility of a child to infection. The susceptibility to infection depends on the pediatric age structure (infant, young child) and has yet to be well defined. The acute rhinosinusitis in children develops after a viral infection of the upper airways, also referred to as the "common cold" in the literature. It usually spontaneously heals within ten days without any medical therapy. Antibiotic therapy is prudent in complicated episodes of ARS. The antibiotic therapy is reserved for children with complications or associated disease, such as bronchial asthma and/or chronic bronchitis. A chronic rhinosinusitis is defined as the inflammatory change in the nasal mucosa and nasal sinus mucosa, in which the corresponding symptoms persist for over 12 weeks. The indication for CT-imaging of the nasal sinuses is reserved for cases of chronic rhinosinusitis that have been successfully treated with medication. A staged therapeutic concept is followed in CRS based on conservative and surgical methods. Nasal sinus surgery is considered nowadays as effective and safe in children. Based on the assumption that adenoids are a reservoir for bacteria, from which recurrent infections of the nose and nasal sinus originate, the adenoidectomy is still defined as a cleansing procedure in rhinosinusitis. 69.3% of the children had benefit from adenoidectomy. Comorbidities, such as pediatric bronchial asthma, presently play an even more important role in the therapy of rhinosinusitis; therefore, it is often wise to have the support of pediatricians. In western European countries 40% of children presently suffer from allergic rhinitis, in which pronounced nasal obstruction can cause disturbed growth in facial bones. An early therapy with SIT may prevent the development of bronchial asthma and secondary sensitization to other allergens. Therefore, SIT is recommended in treatment of allergic rhinitis whenever, if possible. The assessment of diagnostic tools is for the examiner not often possible due to the lack of evidence. Rhinosurgical approaches are often described in study reports; however, they lack the standard prospective randomized long-term study design required nowadays and can only be evaluated with caution in the literature.

No MeSH data available.


Related in: MedlinePlus