Pediatric Versus Adult Chronic Rhinosinusitis

Abstract

Purpose of Review

Pediatric and adult chronic rhinosinusitis (CRS) have some similarities but a number of differences. This article reviews the similarities and differences between pediatric and adult CRS.

Recent Findings

Rhinosinusitis is an inflammatory disease of the nose and the paranasal sinuses. In adults, inflammation in CRS without polyps (CRSsNP) mainly manifests with T-helper 1 lymphocytes while in CRS with polyps (CRSwNP) manifests with T-helper 2 lymphocytes and eosinophilic inflammation. In children, CRS inflammation manifests with neutrophils, macrophages, and lymphocytes. The associations between the ostiomeatal complex occlusion and CRS are revealed in adults but are not so evident in children. Although the relationship between the CRS and allergic rhinitis is still controversial, recent findings have shown an association between allergen sensitization and a specific group of adults with rhinosinusitis. Intranasal corticosteroids and saline constitute the first-line of medical treatment for both pediatric and adult rhinosinusitis. Low-dose macrolides are used for immunomodulatory activities and beneficial effects to adult patients with CRSsNP were demonstrated by recent meta-analyses. For surgical treatment, adenoidectomy is a key strategy to eradicate mature biofilms in pediatric CRS and effective in treating children with CRS regardless of the adenoid size. Although endoscopic sinus surgery has been proven to improve quality of life outcomes in adult CRS, it should be only considered in the pediatric CRS after failure of adenoidectomy.

Summary

Pediatric and adult CRS are different in many aspects, including immunopathogenesis and management. Investigations should be considered in specific cases. After failure of medical treatments, endoscopic sinus surgery is recommended for adults, while adenoidectomy is primarily considered for children.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.

    Brietzke SE, Shin JJ, Choi S, Lee JT, Parikh SR, Pena M, et al. Clinical consensus statement: pediatric chronic rhinosinusitis. Otolaryngol Head Neck Surg. 2014;151(4):542–53.

    Google Scholar 

  2. 2.

    Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, et al. european position paper on rhinosinusitis and nasal polyps 2020. Rhinology. 2020;58(Suppl S29):1–464.

    PubMed  PubMed Central  Google Scholar 

  3. 3.

    •• Chandy Z, Ference E, Lee JT. Clinical guidelines on chronic rhinosinusitis in chil-dren. Curr Allergy Asthma Rep. 2019;19(2):14 The update of the guidelines and literature regarding the diagnosis, microbiology, and treatment options of CRS in the pediatric population. Management schemes are summarized.

    Google Scholar 

  4. 4.

    Heath J, Hartzell L, Putt C, Kennedy JL. Chronic rhinosinusitis in children: pathophysiology, evaluation, and medical management. Curr Allergy Asthma Rep. 2018;18(7):37.

    Google Scholar 

  5. 5.

    Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, et al. Executive summary of EPOS 2020 including integrated care pathways. Rhinology. 2020;58(2):82–111.

    Google Scholar 

  6. 6.

    Moore KL, Persaud TVN, Torchia MG. The developing human clinically oriented embryology. 9th ed. Elsevier Saunders: Canada; 2013.

  7. 7.

    Moore KL, Dalley AF, Ager AMR. Clinically oriented anatomy. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2010.

    Google Scholar 

  8. 8.

    Davcheva-Chakar M, Kaftandzhieva A, Zafirovska B. Adenoid vegetations - reservoir of bacteria for chronic otitis media with effusion and chronic rhinosinusitis. Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2015;36(3):71–6.

    Google Scholar 

  9. 9.

    Elwany S, El-Dine AN, El-Medany A, Omran A, Mandour Z, El-Salam AA. Relationship between bacteriology of the adenoid core and middle meatus in children with sinusitis. J Laryngol Otol. 2011;125(3):279–81.

    CAS  Google Scholar 

  10. 10.

    Zuliani G, Carron M, Gurrola J, Coleman C, Haupert M, Berk R, et al. Identification of adenoid biofilms in chronic rhinosinusitis. Int J Pediatr Otorhinolaryngol. 2006;70(9):1613–7.

    Google Scholar 

  11. 11.

    Hamilos DL. Biofilm formations in pediatric respiratory tract infection part 2: mucosal biofilm formation by respiratory pathogens and current and future therapeutic strategies to inhibit biofilm formation or eradicate established biofilm. Curr Infect Dis Rep. 2019;21(2):8.

    Google Scholar 

  12. 12.

    Shin KS, Cho SH, Kim KR, Tae K, Lee SH, Park CW, et al. The role of adenoids in pediatric rhinosinusitis. Int J Pediatr Otorhinolaryngol. 2008;72(11):1643–50.

    Google Scholar 

  13. 13.

    Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F, et al. European position paper on rhinosinusitis and nasal polyps. Rhinol Suppl. 2012;2012(23):1–298.

    Google Scholar 

  14. 14.

    Avdeeva K, Fokkens W. Precision medicine in chronic rhinosinusitis with nasal polyps. Curr Allergy Asthma Rep. 2018;18(4):25.

    PubMed  PubMed Central  Google Scholar 

  15. 15.

    Dietz de Loos D, Lourijsen ES, Wildeman MAM, Freling NJM, Wolvers MDJ, Reitsma S, et al. Prevalence of chronic rhinosinusitis in the general population based on sinus radiology and symptomatology. J Allergy Clin Immunol. 2019;143(3):1207–14.

    Google Scholar 

  16. 16.

    Hastan D, Fokkens WJ, Bachert C, Newson RB, Bislimovska J, Bockelbrink A, et al. Chronic rhinosinusitis in Europe--an underestimated disease. A GA(2)LEN study. Allergy. 2011;66(9):1216–23.

    CAS  PubMed  PubMed Central  Google Scholar 

  17. 17.

    Sami AS, Scadding GK. Rhinosinusitis in secondary school children-part 2: main project analysis of MSNOT-20 Young Persons Questionnaire (MSYPQ). Rhinology. 2014;52(3):225–30.

    CAS  Google Scholar 

  18. 18.

    Westman M, Stjarne P, Bergstrom A, Kull I, Toskala E, Cardell LO, et al. Chronic rhinosinusitis is rare but bothersome in adolescents from a Swedish population-based cohort. J Allergy Clin Immunol. 2015;136(2):512–4 e6.

    Google Scholar 

  19. 19.

    Shashy RG, Moore EJ, Weaver A. Prevalence of the chronic sinusitis diagnosis in Olmsted County. Minnesota Arch Otolaryngol Head Neck Surg. 2004;130(3):320–3.

    Google Scholar 

  20. 20.

    Sidell D, Shapiro NL, Bhattacharyya N. Obesity and the risk of chronic rhinosinusitis, allergic rhinitis, and acute otitis media in school-age children. Laryngoscope. 2013;123(10):2360–3.

    Google Scholar 

  21. 21.

    Gilani S, Shin JJ. The burden and visit prevalence of pediatric chronic rhinosinusitis. Otolaryngol Head Neck Surg. 2017;157(6):1048–52.

    Google Scholar 

  22. 22.

    Johansson L, Bramerson A, Holmberg K, Melen I, Akerlund A, Bende M. Clinical relevance of nasal polyps in individuals recruited from a general population-based study. Acta Otolaryngol. 2004;124(1):77–81.

    CAS  Google Scholar 

  23. 23.

    Min YG, Jung HW, Kim HS, Park SK, Yoo KY. Prevalence and risk factors of chronic sinusitis in Korea: results of a nationwide survey. Eur Arch Otorhinolaryngol. 1996;253(7):435–9.

    CAS  Google Scholar 

  24. 24.

    Moloney JR. Nasal polyps, nasal polypectomy, asthma, and aspirin sensitivity. Their association in 445 cases of nasal polyps. J Laryngol Otol. 1977;91(10):837–46.

    CAS  Google Scholar 

  25. 25.

    Cunningham MJ, Chiu EJ, Landgraf JM, Gliklich RE. The health impact of chronic recurrent rhinosinusitis in children. Arch Otolaryngol Head Neck Surg. 2000;126(11):1363–8.

    CAS  Google Scholar 

  26. 26.

    Khan A, Huynh TMT, Vandeplas G, Joish VN, Mannent LP, Tomassen P, et al. The GALEN rhinosinusitis cohort: chronic rhinosinusitis with nasal polyps affects health-related quality of life. Rhinology. 2019;57(5):343–51.

    CAS  PubMed  PubMed Central  Google Scholar 

  27. 27.

    Stammberger H, Posawetz W. Functional endoscopic sinus surgery. Concept, indications and results of the Messerklinger technique. Eur Arch Otorhinolaryngol. 1990;247(2):63–76.

    CAS  Google Scholar 

  28. 28.

    Al-Qudah M. The relationship between anatomical variations of the sino-nasal region and chronic sinusitis extension in children. Int J Pediatr Otorhinolaryngol. 2008;72(6):817–21.

    Google Scholar 

  29. 29.

    Kim HJ, Jung Cho M, Lee JW, Tae Kim Y, Kahng H, Sung Kim H, et al. The relationship between anatomic variations of paranasal sinuses and chronic sinusitis in children. Acta Otolaryngol. 2006;126(10):1067–72.

    Google Scholar 

  30. 30.

    Haruna S, Sawada K, Nakajima T, Moriyama H. Relationship between pediatric sinusitis and middle turbinate pneumatization--ethmoidal sinus pyocele thought to be caused by middle turbinate pneumatization. Int J Pediatr Otorhinolaryngol. 2005;69(3):375–9.

    Google Scholar 

  31. 31.

    Badr DT, Gaffin JM, Phipatanakul W. Pediatric rhinosinusitis. Curr Treat Options Allergy. 2016;3(3):268–81.

    PubMed  PubMed Central  Google Scholar 

  32. 32.

    Schleimer RP. Immunopathogenesis of chronic rhinosinusitis and nasal polyposis. Annu Rev Pathol. 2017;12:331–57.

    CAS  Google Scholar 

  33. 33.

    Barham HP, Osborn JL, Snidvongs K, Mrad N, Sacks R, Harvey RJ. Remodeling changes of the upper airway with chronic rhinosinusitis. Int Forum Allergy Rhinol. 2015;5(7):565–72.

    Google Scholar 

  34. 34.

    Coffinet L, Chan KH, Abzug MJ, Simoes EAF, Cool C, Liu AH. Immunopathology of chronic rhinosinusitis in young children. J Pediatr. 2009;154(5):754–8.

    CAS  Google Scholar 

  35. 35.

    Hamizan AW, Loftus PA, Alvarado R, Ho J, Kalish L, Sacks R, et al. Allergic phenotype of chronic rhinosinusitis based on radiologic pattern of disease. Laryngoscope. 2018;128(9):2015–21.

    Google Scholar 

  36. 36.

    Tantimongkolsuk C, Pornrattanarungsee S, Chiewvit P, Visitsunthorn N, Ungkanont K, Vichyanond P. Pediatric sinusitis:symptom profiles with associated atopic conditions. J Med Assoc Thail. 2005;88(Suppl 8):S149–55.

    Google Scholar 

  37. 37.

    •• Anamika A, Chakravarti A, Kumar R. Atopy and quality of life in pediatric chronic rhinosinusitis. Am J Rhinol Allergy. 2019;33(5):586–90 An experiment which assessed the impact of atopic status on disease severity and quality of life in 110 pediatric patients with chronic rhinosinusitis.

    Google Scholar 

  38. 38.

    Leo G, Piacentini E, Incorvaia C, Consonni D, Frati F. Chronic rhinosinusitis and allergy. Pediatr Allergy Immunol. 2007;18(Suppl 18):19–21.

    Google Scholar 

  39. 39.

    Sedaghat AR, Phipatanakul W, Cunningham MJ. Prevalence of and associations with allergic rhinitis in children with chronic rhinosinusitis. Int J Pediatr Otorhinolaryngol. 2014;78(2):343–7.

    Google Scholar 

  40. 40.

    Iwens P, Clement PA. Sinusitis in allergic patients. Rhinology. 1994;32(2):65–7.

    CAS  Google Scholar 

  41. 41.

    Bonfils P, Avan P, Malinvaud D. Influence of allergy on the symptoms and treatment of nasal polyposis. Acta Otolaryngol. 2006;126(8):839–44.

    Google Scholar 

  42. 42.

    Davila I, Rondon C, Navarro A, Anton E, Colas C, Dordal MT, et al. Aeroallergen sensitization influences quality of life and comorbidities in patients with nasal polyposis. Am J Rhinol Allergy. 2012;26(5):e126–31.

    PubMed  PubMed Central  Google Scholar 

  43. 43.

    Munoz del Castillo F, Jurado-Ramos A, Fernandez-Conde BL, Soler R, Barasona MJ, Cantillo E, et al. Allergenic profile of nasal polyposis. J Investig Allergol Clin Immunol. 2009;19(2):110–6.

    CAS  Google Scholar 

  44. 44.

    Nayan S, Alizadehfar R, Desrosiers M. Humoral primary immunodeficiencies in chronic rhinosinusitis. Curr Allergy Asthma Rep. 2015;15(8):46.

    Google Scholar 

  45. 45.

    Baek JH, Seo HK, Jee HM, Shin YH, Han MY, Oh ES, et al. Antibody response to pneumococcal vaccination in children with chronic or recurrent rhinosinusitis. Korean J Pediatr. 2013;56(7):286–90.

    CAS  PubMed  PubMed Central  Google Scholar 

  46. 46.

    Shapiro GG, Virant FS, Furukawa CT, Pierson WE, Bierman CW. Immunologic defects in patients with refractory sinusitis. Pediatrics. 1991;87(3):311–6.

    CAS  Google Scholar 

  47. 47.

    Vanlerberghe L, Joniau S, Jorissen M. The prevalence of humoral immunodeficiency in refractory rhinosinusitis: a retrospective analysis. B-ENT. 2006;2(4):161–6.

    CAS  Google Scholar 

  48. 48.

    Ramesh S, Brodsky L, Afshani E, Pizzuto M, Ishman M, Helm J, et al. Open trial of intravenous immune serum globulin for chronic sinusitis in children. Ann Allergy Asthma Immunol. 1997;79(2):119–24.

    CAS  Google Scholar 

  49. 49.

    Oomen KP, April MM. Sinonasal manifestations in cystic fibrosis. Int J Otolaryngol. 2012;2012:789572.

    PubMed  PubMed Central  Google Scholar 

  50. 50.

    Farrell PM, Rosenstein BJ, White TB, Accurso FJ, Castellani C, Cutting GR, et al. Guidelines for diagnosis of cystic fibrosis in newborns through older adults: Cystic Fibrosis Foundation consensus report. J Pediatr. 2008;153(2):S4–S14.

  51. 51.

    Fretzayas A, Moustaki M. Clinical spectrum of primary ciliary dyskinesia in childhood. World J Clin Pediatr. 2016;5(1):57–62.

    PubMed  PubMed Central  Google Scholar 

  52. 52.

    Mener DJ, Lin SY, Ishman SL, Boss EF. Treatment and outcomes of chronic rhinosinusitis in children with primary ciliary dyskinesia: where is the evidence? A qualitative systematic review. Int Forum Allergy Rhinol. 2013;3(12):986–91.

    Google Scholar 

  53. 53.

    Lobo J, Zariwala MA, Noone PG. Primary ciliary dyskinesia. Semin Respir Crit Care Med. 2015;36(2):169–79.

    PubMed  PubMed Central  Google Scholar 

  54. 54.

    Poachanukoon O, Nanthapisal S, Chaumrattanakul U. Pediatric acute and chronic rhinosinusitis: comparison of clinical characteristics and outcome of treatment. Asian Pac J Allergy Immunol. 2012;30(2):146–51.

    Google Scholar 

  55. 55.

    Mullol J, Marino-Sanchez F, Valls M, Alobid I, Marin C. The sense of smell in chronic rhinosinusitis. J Allergy Clin Immunol. 2020;145(3):773–6. https://doi.org/10.1016/j.jaci.2020.01.024.

    Article  Google Scholar 

  56. 56.

    Ferguson BJ, Narita M, Yu VL, Wagener MM, Gwaltney JM Jr. Prospective observational study of chronic rhinosinusitis: environmental triggers and antibiotic implications. Clin Infect Dis. 2012;54(1):62–8.

    Google Scholar 

  57. 57.

    Tomassen P, Newson RB, Hoffmans R, Lotvall J, Cardell LO, Gunnbjornsdottir M, et al. Reliability of EP3OS symptom criteria and nasal endoscopy in the assessment of chronic rhinosinusitis--a GA(2) LEN study. Allergy. 2011;66(4):556–61.

    CAS  Google Scholar 

  58. 58.

    Leo G, Triulzi F, Incorvaia C. Sinus imaging for diagnosis of chronic rhinosinusitis in children. Curr Allergy Asthma Rep. 2012;12(2):136–43.

    Google Scholar 

  59. 59.

    Orlandi RR, Kingdom TT, Hwang PH, Smith TL, Alt JA, Baroody FM, et al. International consensus statement on allergy and rhinology: rhinosinusitis. Int Forum Allergy Rhinol. 2016;6(Suppl 1):S22–209.

    PubMed  Google Scholar 

  60. 60.

    Sabino HA, Valera FC, Aragon DC, Fantucci MZ, Titoneli CC, Martinez R, et al. Amoxicillin-clavulanate for patients with acute exacerbation of chronic rhinosinusitis: a prospective, double-blinded, placebo-controlled trial. Int Forum Allergy Rhinol. 2017;7(2):135–42.

    Google Scholar 

  61. 61.

    Otten HW, Antvelink JB, Ruyter de Wildt H, Rietema SJ, Siemelink RJ, Hordijk GJ. Is antibiotic treatment of chronic sinusitis effective in children? Clin Otolaryngol Allied Sci. 1994;19(3):215–7.

    CAS  Google Scholar 

  62. 62.

    Adappa ND, Coticchia JM. Management of refractory chronic rhinosinusitis in children. Am J Otolaryngol. 2006;27(6):384–9.

    Google Scholar 

  63. 63.

    •• Seresirikachorn K, Suwanparin N, Srisunthornphanich C, Chitsuthipakorn W, Kan-janawasee D, Snidvongs K. Factors of success of low-dose macrolides in chronic sinusitis: systematic review and meta-analysis. Laryngoscope. 2019;129(7):1510–9 A systematic review of the effects of long-term low-dose macrolides in treating patients with chronic rhinosinusitis. The group included 10 randomized controlled trials with a total of 608 participants including both nasal polyps and without nasal polyps. Meta-analyses for all symptoms were performed. Factors of success were assessed.

    CAS  Google Scholar 

  64. 64.

    Iino Y, Sasaki Y, Miyazawa T, Kodera K. Nasopharyngeal flora and drug susceptibility in children with macrolide therapy. Laryngoscope. 2003;113(10):1780–5.

    Google Scholar 

  65. 65.

    Shin YH, Kim HS, Lee EK, Kim YJ, Lee HS, Jang PS, et al. Eosinophil-related markers and total immunoglobulin E as a predictive marker for antibiotic response in chronic rhinosinusitis. Ann Saudi Med. 2015;35(4):312–7.

    PubMed  PubMed Central  Google Scholar 

  66. 66.

    Van Zele T, Gevaert P, Holtappels G, Beule A, Wormald PJ, Mayr S, et al. Oral steroids and doxycycline: two different approaches to treat nasal polyps. J Allergy Clin Immunol. 2010;125(5):1069–76 e4.

    Google Scholar 

  67. 67.

    Snidvongs K, Kalish L, Sacks R, Sivasubramaniam R, Cope D, Harvey R. Sinus surgery and delivery method influence the effectiveness of topical corticosteroid for chronic rhinosinusitis; systematic review and meta-analysis. Am J Rhinol Allergy. 2013;27(3):221–33.

    PubMed  PubMed Central  Google Scholar 

  68. 68.

    Snidvongs K, Thanaviratananich S. Update on intranasal medications in rhinosinusitis. Curr Allergy Asthma Rep. 2017;17(7):47.

    Google Scholar 

  69. 69.

    Chur V, Small CB, Stryszak P, Teper A. Safety of mometasone furoate nasal spray in the treatment of nasal polyps in children. Pediatr Allergy Immunol. 2013;24(1):33–8.

    Google Scholar 

  70. 70.

    Ozturk F, Bakirtas A, Ileri F, Turktas I. Efficacy and tolerability of systemic methylprednisolone in children and adolescents with chronic rhinosinusitis: a double-blind, placebo-controlled randomized trial. J Allergy Clin Immunol. 2011;128(2):348–52.

    CAS  Google Scholar 

  71. 71.

    Hox V, Lourijsen E, Jordens A, Aasbjerg K, Agache I, Alobid I, et al. Benefits and harm of systemic steroids for short- and long-term use in rhinitis and rhinosinusitis: an EAACI position paper. Clin Transl Allergy. 2020;10:1.

    CAS  PubMed  PubMed Central  Google Scholar 

  72. 72.

    Taccariello M, Parikh A, Darby Y, Scadding G. Nasal douching as a valuable adjunct in the management of chronic rhinosinusitis. Rhinology. 1999;37(1):29–32.

    CAS  Google Scholar 

  73. 73.

    Shoseyov D, Bibi H, Shai P, Shoseyov N, Shazberg G, Hurvitz H. Treatment with hypertonic saline versus normal saline nasal wash of pediatric chronic sinusitis. J Allergy Clin Immunol. 1998;101(5):602–5.

    CAS  Google Scholar 

  74. 74.

    Cho HJ, Min HJ, Chung HJ, Park DY, Seong SY, Yoon JH, et al. Improved outcomes after low-concentration hypochlorous acid nasal irrigation in pediatric chronic sinusitis. Laryngoscope. 2016;126(4):791–5.

    Google Scholar 

  75. 75.

    Wei JL, Sykes KJ, Johnson P, He J, Mayo MS. Safety and efficacy of once-daily nasal irrigation for the treatment of pediatric chronic rhinosinusitis. Laryngoscope. 2011;121(9):1989–2000.

    Google Scholar 

  76. 76.

    Bettadahalli V, Chakravarti A. Post-adenoidectomy quality of life in children with refractory chronic rhinosinusitis. J Laryngol Otol. 2017;131(9):773–8.

    CAS  Google Scholar 

  77. 77.

    Brietzke SE, Brigger MT. Adenoidectomy outcomes in pediatric rhinosinusitis: a meta-analysis. Int J Pediatr Otorhinolaryngol. 2008;72(10):1541–5.

    Google Scholar 

  78. 78.

    Ramadan HH, Tiu J. Failures of adenoidectomy for chronic rhinosinusitis in children: for whom and when do they fail? Laryngoscope. 2007;117(6):1080–3.

    Google Scholar 

  79. 79.

    Ramadan HH, Cost JL. Outcome of adenoidectomy versus adenoidectomy with maxillary sinus wash for chronic rhinosinusitis in children. Laryngoscope. 2008;118(5):871–3.

    Google Scholar 

  80. 80.

    Snidvongs K, Chin D, Sacks R, Earls P, Harvey R. Eosinophilic rhinosinusitis is not a disease of ostiomeatal occlusion. Laryngoscope. 2013;123(5):1070–4.

    Google Scholar 

  81. 81.

    • Soler ZM, Jones R, Le P, Rudmik L, Mattos JL, Nguyen SA, et al. Sino-nasal outcome test-22 outcomes after sinus surgery: a systematic review and meta-analysis. Laryngoscope. 2018;128(3):581–92 A systematic review of the improvement in Sino-nasal Outcome Test-22 in patients with chronic rhinosinusitis after endoscopic sinus surgery. The group included 40 published cohorts. Meta-analyses for all symptoms were performed. The impacts of patient factors were assessed.

    PubMed  PubMed Central  Google Scholar 

  82. 82.

    Lusk RP, Bothwell MR, Piccirillo J. Long-term follow-up for children treated with surgical intervention for chronic rhinosinusitis. Laryngoscope. 2006;116(12):2099–107.

    Google Scholar 

  83. 83.

    Ramadan HH. Adenoidectomy vs endoscopic sinus surgery for the treatment of pediatric sinusitis. Arch Otolaryngol Head Neck Surg. 1999;125(11):1208–11.

    CAS  Google Scholar 

  84. 84.

    Vlastarakos PV, Fetta M, Segas JV, Maragoudakis P, Nikolopoulos TP. Functional endoscopic sinus surgery improves sinus-related symptoms and quality of life in children with chronic rhinosinusitis: a systematic analysis and meta-analysis of published interventional studies. Clin Pediatr (Phila). 2013;52(12):1091–7.

    Google Scholar 

  85. 85.

    Hebert RL 2nd, Bent JP 3rd. Meta-analysis of outcomes of pediatric functional endoscopic sinus surgery. Laryngoscope. 1998;108(6):796–9.

    Google Scholar 

  86. 86.

    Bothwell MR, Piccirillo JF, Lusk RP, Ridenour BD. Long-term outcome of facial growth after functional endoscopic sinus surgery. Otolaryngol Head Neck Surg. 2002;126(6):628–34.

    Google Scholar 

  87. 87.

    Gevaert P, Van Bruaene N, Cattaert T, Van Steen K, Van Zele T, Acke F et al. Mepolizumab, a humanized anti-IL-5 mAb, as a treatment option for severe nasal polyposis. J Allergy Clin Immunol. 2011;128(5):989–95 e1–8.

  88. 88.

    Pinto JM, Mehta N, DiTineo M, Wang J, Baroody FM, Naclerio RM. A randomized, double-blind, placebo-controlled trial of anti-IgE for chronic rhinosinusitis. Rhinology. 2010;48(3):318–24.

    CAS  Google Scholar 

  89. 89.

    Bachert C, Han JK, Desrosiers M, Hellings PW, Amin N, Lee SE, et al. Efficacy and safety of dupilumab in patients with severe chronic rhinosinusitis with nasal polyps (LIBERTY NP SINUS-24 and LIBERTY NP SINUS-52): results from two multicentre, randomised, double-blind, placebo-controlled, parallel-group phase 3 trials. Lancet. 2019;394(10209):1638–50.

    CAS  Google Scholar 

  90. 90.

    Bachert C, Sousa AR, Lund VJ, Scadding GK, Gevaert P, Nasser S, et al. Reduced need for surgery in severe nasal polyposis with mepolizumab: randomized trial. J Allergy Clin Immunol. 2017;140(4):1024–31 e14.

    CAS  PubMed  Google Scholar 

  91. 91.

    Gevaert P, Omachi TA, Corren J, Mullol J, Han J, Lee SE. Efficacy and safety of omalizumab in patients with chronic rhinosinusitis with nasal polyps: results from two, multicenter, randomized, double-blind, placebo-controlled phase III trials (POLYP 1 and POLYP 2). The Journal of allergy and clinical immunology. 2020;[Epub ahead of Print].

  92. 92.

    Wongsa C, Sompornrattanaphan M, Tantilipikorn P, Thongngarm T. Clinical characteristics and aspirin desensitization in Thai patients with a suggestive history of NSAID-exacerbated respiratory disease. Asian Pac J Allergy Immunol. 2019. doi:https://doi.org/10.12932/AP-150619-0583.

  93. 93.

    Kowalski ML, Agache I, Bavbek S, Bakirtas A, Blanca M, Bochenek G, et al. Diagnosis and management of NSAID-exacerbated respiratory disease (N-ERD)-a EAACI position paper. Allergy. 2019;74(1):28–39.

    Google Scholar 

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Snidvongs, K., Sangubol, M. & Poachanukoon, O. Pediatric Versus Adult Chronic Rhinosinusitis. Curr Allergy Asthma Rep 20, 29 (2020). https://doi.org/10.1007/s11882-020-00924-6

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Keywords

  • Children
  • Adults
  • Intranasal corticosteroids
  • Saline
  • Adenoidectomy
  • Endoscopic sinus surgery