Chronic rhinosinusitis is a multifactorial condition, defined by symptoms lasting longer than 12 weeks.<\/p>\n\n\n\n
It affects mostly older children, in the 10-to-15-year age group.<\/p>\n\n\n\n
Diagnostic Criteria<\/strong><\/p>\n\n\n\n AND<\/strong><\/p>\n\n\n\n Predisposing factors include exposure to cigarette smoke, bacterial infection, allergy, physical obstruction, immune deficiency, cystic fibrosis and prolonged use of intranasal decongestants. <\/p>\n\n\n\n Patients with coexisting allergic rhinitis may also have symptoms such as sneezing, watery rhinorrhoea, nasal itching and itchy watery eyes.<\/p>\n\n\n\n C.M & G.T – 27-10-26<\/strong><\/p>\n\n\n\n Virtually all can be managed medically without referral as chronic rhinosinusitis is largely a chronic inflammatory condition. Please see Primary Care Management for further detail.<\/em><\/strong><\/p>\n\n\n\n Note: Periorbital cellulitis is a red flag for acute ethmoiditis, and these children should be referred to A&E without delay.<\/mark><\/p>\n\n\n\n Please refer to outpatients children and young people aged under 16 with:<\/p>\n\n\n\n Those aged 16 and older should be referred to adult services.<\/p>\n\n\n\n Anterior rhinoscopy <\/strong>(using otoscope and large speculum)<\/p>\n\n\n\n <\/p>\n\n\n\n Assess for predisposing factors<\/strong><\/p>\n\n\n\n <\/p>\n\n\n\n Management<\/strong><\/p>\n\n\n\n <\/p>\n\n\n\n Nasal corticosteroid with low bioavailability \u2013 according to age group (years):<\/strong><\/p>\n\n\n\n <\/p>\n\n\n\n If unsuccessful after 3 months:<\/span><\/p>\n\n\n\n Ensure treatment compliance<\/p>\n\n\n\n If improvement sustained, continue medical management.<\/p>\n<\/div><\/div>\n\n\n\n Key Guidance<\/strong><\/p>\n\n\n\n Nice Clinical Knowledge Summary (from age 3 months; covers acute and chronic sinusitis management) – https:\/\/cks.nice.org.uk\/sinusitis<\/a><\/p>\n\n\n\n European Position Paper on Rhinosinusitis and Nasal Polyps – Epos<\/a> Guidelines 2020:<\/p>\n\n\n\n BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis (Revised Edition 2017; First edition 2007)<\/a><\/p>\n\n\n\n Chronic rhinosinusitis in children | ENT UK<\/a> \u2013 useful information for patients and families.<\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":" Chronic rhinosinusitis is a multifactorial condition, defined by symptoms lasting longer than 12 weeks. It affects mostly older children, in the 10-to-15-year age group. Diagnostic Criteria AND Predisposing factors include exposure to cigarette smoke, bacterial infection, allergy, physical obstruction, immune deficiency, cystic fibrosis and prolonged use of intranasal decongestants. Patients with coexisting allergic rhinitis may<\/p>\n","protected":false},"author":6,"featured_media":0,"parent":22473,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[1211,183],"class_list":["post-22487","page","type-page","status-publish","hentry","category-https-apps-nhslothian-scot-refhelp-chronic-rhinosinusitis-paediatric","category-rhinosinusitischronicpaeds"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"heatherlevy","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/heatherlevy\/"},"rttpg_comment":0,"rttpg_category":" Chronic Rhinosinusitis-Paediatric<\/a>Rhinosinusitis - Chronic (Paeds)<\/a>","rttpg_excerpt":"Chronic rhinosinusitis is a multifactorial condition, defined by symptoms lasting longer than 12 weeks. It affects mostly older children, in the 10-to-15-year age group. Diagnostic Criteria AND Predisposing factors include exposure to cigarette smoke, bacterial infection, allergy, physical obstruction, immune deficiency, cystic fibrosis and prolonged use of intranasal decongestants. Patients with coexisting allergic rhinitis may","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/22487","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=22487"}],"version-history":[{"count":2,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/22487\/revisions"}],"predecessor-version":[{"id":30579,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/22487\/revisions\/30579"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/22473"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=22487"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=22487"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}\n
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Who to refer:<\/h4>\n\n\n\n
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How to refer<\/h4>\n\n\n\n
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