Accessory nasal sinusitis in childhood: With a record of bacteriological examinations

Chronic Maxillary Sinusitis in Children

“…To find mucopus or pus in the antra of only 13 9% of a series of patients diagnosed clinically and radiologically as cases of chronic sinusitis compares sbtangely with the 59 -6% of Crooks (1947) and the 76% of Walker (1947). The obvious explanation is that the latter figures are those of antral wash-outs, and not of proof punctures.…”

“…Admittedly only a small percentage of cases required this operation, and it was only resorted to when other methods failed, but it seems a serious operation to undertake in a child of 4 years of age, the case' reported by Harpman. At the Caldwell-Luc operation, it is reported that the mucosa shows changes in no way inferior to the changes found in adults with chronic sinus suppuration (Crooks, 1947). Yet an investigation by Bowen-Davies (1938) showed that while the average time of elimination of lipiodol from the antra in sterile cases was 17 9 days, the average time of elimination in infected cases was only 14 9 days.…”

“…The operation of current choice appears to be the Caldwell-Luc or radical antrostomy (Crooks, 1947;Harpman, 1947;Scott Stevenson, 1947;Macbeth, 1950, and others) though Crooks in 1936 recommended intranasal drainage. Admittedly only a small percentage of cases required this operation, and it was only resorted to when other methods failed, but it seems a serious operation to undertake in a child of 4 years of age, the case' reported by Harpman.…”

“…There are two reports of proof puncture results in known or suspected sinus cases. Crooks (1947) found evidence of infection in 59-6% of 570 cases with opaque antra seen during 1946during , while Walker (1947 obtained positive findings in 76 % of 442 cases with sufficient signs and symptoms to warrant puncture out of 1,779 tonsil and adenoid patients. Lastly, Ebbs (1938) has obtained post-mortem evidence of sinus infection in 30-6% of 496 routine necropsies.…”

Nasal Sinusitis in Childhood

“…had muco-pus in the antra, and Carmack (1931) 30 per cent. In a series of 100 children at Great Ormond Street I found that twenty-four had muco-pus in the antra (Crooks and Signy, 1936). All these children were from a tonsillectomy list, and obviously had something wrong with their noses or throats, or they would not have been undergoing that operation.…”