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Pediatric Rhinosinusitis and Asthma
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Pediatric Rhinosinusitis and Asthma

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Otolaryngology".

Deadline for manuscript submissions: closed (31 August 2019) | Viewed by 35896

Special Issue Editor

Dr. Sara Torretta

E-Mail Website
Guest Editor
Department of Clinical Sciences and Community Health, Ospedale Maggiore Policlinico Pad. Monteggia, Milan, Italy
Interests: infectious otolaryngology; pediatric otolaryngology; rhinosinusitis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Paediatric rhinosinusitis is frequently encountered in clinical practice and asthma may coexist in many cases. These conditions probably share common underlining pathophysiological mechanisms mediated by eosinophilic and T-helper 2 inflammatory pathways, and it is well known that an impairment in the nasosinusal homeostasis predisposes to acute exacerbation of asthmatic disease. However, the complex link between the upper and the lower airways is not completely understood, and the optimal management of children with rhinosinusitis and asthma requires a coordinated multidisciplinary approach that includes of paediatric, otorhinolaryngological, and allergology consultations.

For an upcoming Special Issue of the Journal of Clinical Medicine (PubMed indexed), we invite investigators to contribute with review articles focused on discussing the relationship between rhinosinusitis and asthma in children, as well as the more proper diagnostic and therapeutic strategies in these patients. Potential topics may include, but are not limited to:

  • Microbiological aspects of acute and chronic rhinosinusitis
  • The link between paediatric rhinosinusitis and asthma
  • Nitric oxide and biological mediators in paediatric rhinosinusitis and asthma
  • The allergology basis of paediatric rhinosinusitis and asthma
  • Imaging in the diagnostic management of paediatric rhinosinusitis
  • Medical treatment of paediatric rhinosinusitis
  • Surgical treatment paediatric rhinosinusitis
  • Chronic rhinosinusitis in children with systemic disease

Dr. Sara Torretta
Guest Editor

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • children
  • rhinosinusitis
  • asthma
  • allergy
  • nitric oxide
  • endoscopic sinus surgery
  • nasal polyposis

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Published Papers (7 papers)

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Review

15 pages, 576 KiB  
Review
Nitric Oxide and Biological Mediators in Pediatric Chronic Rhinosinusitis and Asthma
by Valentina Agnese Ferraro, Stefania Zanconato, Eugenio Baraldi and Silvia Carraro
J. Clin. Med. 2019, 8(11), 1783; https://doi.org/10.3390/jcm8111783 - 25 Oct 2019
Cited by 10 | Viewed by 3434
Abstract
Background: In the context of the so-called unified airway theory, chronic rhinosinusitis (CRS) and asthma may coexist. The inflammation underlying these conditions can be studied through the aid of biomarkers. Main body: We described the main biological mediators that have been studied in [...] Read more.
Background: In the context of the so-called unified airway theory, chronic rhinosinusitis (CRS) and asthma may coexist. The inflammation underlying these conditions can be studied through the aid of biomarkers. Main body: We described the main biological mediators that have been studied in pediatric CRS and asthma, and, according to the available literature, we reported their potential role in the diagnosis and management of these conditions. As for CRS, we discussed the studies that investigated nasal nitric oxide (nNO), pendrin, and periostin. As for asthma, we discussed the role of fractional exhaled nitric oxide (feNO), the role of periostin, and that of biological mediators measured in exhaled breath condensate (EBC) and exhaled air (volatile organic compounds, VOCs). Conclusion: Among non-invasive biomarkers, nNO seems the most informative in CRS and feNO in asthma. Other biological mediators seem promising, but further studies are needed before they can be applied in clinical practice. Full article
(This article belongs to the Special Issue Pediatric Rhinosinusitis and Asthma)
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12 pages, 640 KiB  
Review
Adenoidal Disease and Chronic Rhinosinusitis in Children—Is There a Link?
by Antonio Mario Bulfamante, Alberto Maria Saibene, Giovanni Felisati, Cecilia Rosso and Carlotta Pipolo
J. Clin. Med. 2019, 8(10), 1528; https://doi.org/10.3390/jcm8101528 - 23 Sep 2019
Cited by 18 | Viewed by 5211
Abstract
Adenoid hypertrophy (AH) is an extremely common condition in the pediatric and adolescent populations that can lead to various medical conditions, including acute rhinosusitis, with a percentage of these progressing to chronic rhinosinusitis (CRS). The relationship between AH and pediatric CRS has been [...] Read more.
Adenoid hypertrophy (AH) is an extremely common condition in the pediatric and adolescent populations that can lead to various medical conditions, including acute rhinosusitis, with a percentage of these progressing to chronic rhinosinusitis (CRS). The relationship between AH and pediatric CRS has been extensively studied over the past few years and clinical consensus on the treatment has now been reached, allowing this treatment to become the preferred clinical practice. The purpose of this study is to review existing literature and data on the relationship between AH and CRS and the options for treatment. A systematic literature review was performed using a search line for “(Adenoiditis or Adenoid Hypertrophy) and Sinusitis and (Pediatric or Children)”. At the end of the evaluation, 36 complete texts were analyzed, 17 of which were considered eligible for the final study, dating from 1997 to 2018. The total population of children assessed in the various studies was of 2371. The studies were categorized as surgical-observational, microbiological, genetic-immunological, and radiological. The analysis of the studies confirms the relationship between AH and CRS and supports the existing consensus on medical and surgical therapy. Furthermore, these studies underline the necessity to adapt medical and surgical treatment considering age, comorbidities including asthma and, if present, the Computed Tomography (CT) score. Full article
(This article belongs to the Special Issue Pediatric Rhinosinusitis and Asthma)
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13 pages, 802 KiB  
Review
Review of Systemic Antibiotic Treatments in Children with Rhinosinusitis
by Sara Torretta, Lorenzo Drago, Paola Marchisio, Lorenzo Gaini, Claudio Guastella, Antonio Moffa, Vittorio Rinaldi, Manuel Casale and Lorenzo Pignataro
J. Clin. Med. 2019, 8(8), 1162; https://doi.org/10.3390/jcm8081162 - 3 Aug 2019
Cited by 3 | Viewed by 3823
Abstract
Antibiotic treatment in paediatric rhinosinusitis is still a matter of debate, as the current guidelines have been drafted mainly based on clinical studies published before 2013. Recent modifications in the epidemiological basis of the disease might mean that current treatments are not completely [...] Read more.
Antibiotic treatment in paediatric rhinosinusitis is still a matter of debate, as the current guidelines have been drafted mainly based on clinical studies published before 2013. Recent modifications in the epidemiological basis of the disease might mean that current treatments are not completely adequate considering the evolving microbiological profile of the disease. The present paper reviews the role of systemic antibiotics in children with acute (ARS), chronic (CRS), recurrent (RARS), and complicated acute (CoARS) rhinosinusitis. A total of 14 studies (including 3 prospective non-randomised studies, 8 retrospective studies, and 3 prospective randomised studies) of the 115 initially identified papers were included in this review, corresponding to 13,425 patients. Five papers dealt with ARS, four papers with RARS or CRS, and five papers with CoARS; the remaining papers included patients with either ARS or CRS. Data about the effectiveness of antibiotic treatment in children with ARC, CRS, and CoARS is scarce, as only three randomised controlled trials have been published in the last decade, with contrasting results. There is an urgent need for dedicated controlled trials not only to test the actual clinical benefits deriving from the routine use of systemic antibiotics in different categories of patients but also to compare the effectiveness of various therapeutic protocols in terms of the type of antibacterial molecules and the duration of treatment. Full article
(This article belongs to the Special Issue Pediatric Rhinosinusitis and Asthma)
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11 pages, 680 KiB  
Review
Surgical Treatment of Paediatric Chronic Rhinosinusitis
by Sara Torretta, Claudio Guastella, Tullio Ibba, Michele Gaffuri and Lorenzo Pignataro
J. Clin. Med. 2019, 8(5), 684; https://doi.org/10.3390/jcm8050684 - 15 May 2019
Cited by 15 | Viewed by 5613
Abstract
Rhinosinusitis (RS) is a common disease in children, significantly affecting their quality of life. Chronic rhinosinusitis (CRS) is frequently linked to other respiratory diseases, including asthma. Children affected by CRS may be candidates for surgery in the case of failure of maximal medical [...] Read more.
Rhinosinusitis (RS) is a common disease in children, significantly affecting their quality of life. Chronic rhinosinusitis (CRS) is frequently linked to other respiratory diseases, including asthma. Children affected by CRS may be candidates for surgery in the case of failure of maximal medical therapy comprising three to six weeks of broad-spectrum systemic antibiotics with adjunctive therapies. Although endoscopic sinus surgery (ESS) is the surgical treatment of choice in adult patients with CRS, different surgical procedures are scheduled for refractory paediatric CRS and include adenoidectomy, paediatric ESS (PESS), and balloon catheter sinuplasty (BCS). The present paper discusses the indications and limitations of each treatment option in children with CRS. Given the amount of current evidence, it is reasonable to suggest that, in young and otherwise healthy children with refractory CRS, an adenoidectomy (eventually combined with BCS) should be offered as the first-line surgical treatment. Nevertheless, this approach may be considered ineffective in some patients who should be candidates for traditional ESS. In older children, those with asthma, or in the case of peculiar conditions, traditional ESS should be considered as the primary treatment. Full article
(This article belongs to the Special Issue Pediatric Rhinosinusitis and Asthma)
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12 pages, 1551 KiB  
Review
Role of Biofilms in Children with Chronic Adenoiditis and Middle Ear Disease
by Sara Torretta, Lorenzo Drago, Paola Marchisio, Tullio Ibba and Lorenzo Pignataro
J. Clin. Med. 2019, 8(5), 671; https://doi.org/10.3390/jcm8050671 - 13 May 2019
Cited by 19 | Viewed by 4441
Abstract
Chronic adenoiditis occurs frequently in children, and it is complicated by the subsequent development of recurrent or chronic middle ear diseases, such as recurrent acute otitis media, persistent otitis media with effusion and chronic otitis media, which may predispose a child to long-term [...] Read more.
Chronic adenoiditis occurs frequently in children, and it is complicated by the subsequent development of recurrent or chronic middle ear diseases, such as recurrent acute otitis media, persistent otitis media with effusion and chronic otitis media, which may predispose a child to long-term functional sequalae and auditory impairment. Children with chronic adenoidal disease who fail to respond to traditional antibiotic therapy are usually candidates for surgery under general anaesthesia. It has been suggested that the ineffectiveness of antibiotic therapy in children with chronic adenoiditis is partially related to nasopharyngeal bacterial biofilms, which play a role in the development of chronic nasopharyngeal inflammation due to chronic adenoiditis, which is possibly associated with chronic or recurrent middle ear disease. This paper reviews the current evidence concerning the involvement of bacterial biofilms in the development of chronic adenoiditis and related middle ear infections in children. Full article
(This article belongs to the Special Issue Pediatric Rhinosinusitis and Asthma)
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8 pages, 206 KiB  
Review
Microbiological Aspects of Acute and Chronic Pediatric Rhinosinusitis
by Lorenzo Drago, Lorenzo Pignataro and Sara Torretta
J. Clin. Med. 2019, 8(2), 149; https://doi.org/10.3390/jcm8020149 - 28 Jan 2019
Cited by 24 | Viewed by 3761
Abstract
The microbiology of acute and chronic rhinosinusitis has been extensively studied, but there are still some differences of view concerning the etiology of the former, and many disagreements regarding the microbiology of the latter. Establishing the concomitant distribution of the causative micro-organisms in [...] Read more.
The microbiology of acute and chronic rhinosinusitis has been extensively studied, but there are still some differences of view concerning the etiology of the former, and many disagreements regarding the microbiology of the latter. Establishing the concomitant distribution of the causative micro-organisms in cases that involve multiple sinuses is scientifically and practically important. The main problems are the variety of aerobes and anaerobes that may be involved, and the fact that different tracts of the sinuses of the same patient may be simultaneously affected. Rhinosinusitis may also involve the formation of biofilm, which may play a significant role in its pathogenesis and persistence. Biofilms have a number of advantages in terms of bacterial survival, and their perpetuation can create a certain degree of instability in host-bacteria interactions. Sinonasal microflora may further complicate pathogenesis and the identification of the pathogen(s) involved. Furthermore, the concentration, uniformity, and type/number of strains of nasal microbiota may vary from one site to another. The relative and total micro-organism counts can also be affected by various factors, and microbiota can modulate the course of both acute and chronic rhinosinusitis. Full article
(This article belongs to the Special Issue Pediatric Rhinosinusitis and Asthma)
9 pages, 1258 KiB  
Review
Sinonasal-Related Orbital Infections in Children: A Clinical and Therapeutic Overview
by Sara Torretta, Claudio Guastella, Paola Marchisio, Tal Marom, Samantha Bosis, Tullio Ibba, Lorenzo Drago and Lorenzo Pignataro
J. Clin. Med. 2019, 8(1), 101; https://doi.org/10.3390/jcm8010101 - 16 Jan 2019
Cited by 29 | Viewed by 9081
Abstract
Sinonasal-related orbital infections (SROIs) are typically pediatric diseases that occur in 3–4% of children with acute rhinosinusitis. They are characterised by various clinical manifestations, such as peri-orbital and orbital cellulitis or orbital and sub-periosteal abscesses that may develop anteriorly or posteriorly to the [...] Read more.
Sinonasal-related orbital infections (SROIs) are typically pediatric diseases that occur in 3–4% of children with acute rhinosinusitis. They are characterised by various clinical manifestations, such as peri-orbital and orbital cellulitis or orbital and sub-periosteal abscesses that may develop anteriorly or posteriorly to the orbital septum. Posterior septal complications are particularly dangerous, as they may lead to visual loss and life-threatening events, such as an intracranial abscess and cavernous sinus thrombosis. Given the possible risk of permanent visual loss due to optic neuritis or orbital nerve ischemia, SROIs are considered ophthalmic emergencies that need to be promptly recognised and treated in an urgent-care setting. The key to obtaining better clinical outcomes in children with SROIs is a multi-disciplinary assessment by pediatricians, otolaryngologists, ophthalmologists, radiologists, and in selected cases, neurosurgeons, neurologists, and infectious disease specialists. The aim of this paper is to provide an overview of the pathogenesis, clinical manifestations, diagnosis, and treatment of pediatric SROIs, and to make some practical recommendations for attending clinicians. Full article
(This article belongs to the Special Issue Pediatric Rhinosinusitis and Asthma)
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