Chronic (and acute) sinusitis (& cystic fibrosis, hypogammaglobulinemia)




Radiologic considerations



The time to refer a patient who has sinusitis is when he or she continues to have recurrence of disease after adequate treatment. This usually requires 3 weeks of antibiotic therapy, sometimes also including topical nasal therapy. Referral to either an allergist or ENT physician is appropriate, depending on whether allergy is suspected. The allergist would evaluate for possible triggers that are causing the nasal obstruction and subsequently the recurrence of sinusitis. The ENT physician is better able to evaluate the structural features of the sinuses and perform any necessary surgical interventions.



Slavin RG. Nasal polyps and sinusitis. In: Middleton E Jr, Reed CE,
Ellis EF, Adkinson NF Jr, Yunginger JW, Busse WW, eds. Allergy:
Principles and Practice. 5th ed. St Louis, Mo: Mosby-Year Book, Inc;
Slavin RG. Nasal polyps and sinusitis. JAMA. 1997;278:1849-1854
Sly M. Allergic rhinitis. In: Behrman RE, Kliegman RM, Jenson HB, eds.
Nelson Textbook of Pediatrics. 16th ed. Philadelphia, Pa: WB Saunders
Co; 2000:662-663

Pediatrics in Review 22(4) april 2001