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Saline Irrigation in Pediatric Rhinosinusitis

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Pediatric Rhinosinusitis

Abstract

Pediatric chronic rhinosinusitis (CRS) is an extremely common “diagnosis” by primary care and otolaryngology providers when children present with chronic daily symptoms such as nasal congestion, “stuffiness,” with or without excessive rhinorrhea. The “epidemic” and prevalence of these symptoms in otherwise healthy children, especially preschool and school-aged children, are often misdiagnosed as symptoms synonymous with “acute sinusitis” or “allergic rhinitis.” As a result of assuming either infectious or allergic etiology, systemic oral antibiotics are prescribed for the former and indefinite daily use of topical nasal steroid and antihistamines for the latter. Pediatric nasal symptoms and their impact on the quality of life account for a significant percentage of healthcare burden in both outpatient visits, urgent care, and even emergency department visits. The immense healthcare cost burden results from direct cost of clinical care, medications, and costs associated with decreased productivity at work for caretakers and school for the children. Use of nasal saline irrigation is only now gaining awareness and acceptance in recent years in the Western world despite its acceptance in the East. Very little has been published in children as adjuvant therapy or as primary modality of treatment. Increasing awareness and use can achieve symptoms resolution, minimize exposure to antibiotics, nasal steroid spray, oral antihistamines, and other medications. When treating children, one should minimize unnecessary medication use, elective surgical procedures, and exposure to general anesthesia. The use of saline irrigation can help identify children that need medications and/or and sinus surgery.

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Authors and Affiliations

  1. University of Central Florida College of Medicine, Orlando, FL, USA

    Friederike S. Luetzenberg

  2. Pediatric Otolaryngology/Audiology, Department of Surgery, Nemours Children’s Hospital, Orlando, FL, USA

    Julie L. Wei

  3. Otolaryngology-Head Neck Surgery, University of Central Florida College of Medicine, Orlando, FL, USA

    Julie L. Wei

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  1. Friederike S. Luetzenberg
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  2. Julie L. Wei
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Correspondence to Julie L. Wei .

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Editors and Affiliations

  1. Department of Otolaryngology, West Virginia University, School of Medicine, Morgantown, WV, USA

    Hassan H. Ramadan

  2. Section of Otolaryngology–Head and Neck Surgery, The University of Chicago Medicine and The Comer Children’s Hospital, Chicago, IL, USA

    Fuad M. Baroody

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Luetzenberg, F.S., Wei, J.L. (2020). Saline Irrigation in Pediatric Rhinosinusitis. In: Ramadan, H., Baroody, F. (eds) Pediatric Rhinosinusitis. Springer, Cham. https://doi.org/10.1007/978-3-030-22891-0_14

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