Acute rhinosinusitis in children in outpatient practice: The possibilities of rational therapy and prevention of complications

Abstract

In outpatient practice, both pediatrician and otorhinolaryngologist, acute rhinosinusitis is the most common infectious disease of the upper respiratory tract. The formation of sinusitis against the background of acute respiratory viral infection (colds) in children is facilitated by the unjustified administration of antibiotics, decreased immunity, allergies, changes in the structure of the nose and paranasal sinuses, metabolic disorders, beriberi, chronic diseases, adverse environmental factors. The administration of systemic antibiotics for viral infections of the upper respiratory tract leads to a violation of the immune response of the mucous membranes and does not prevent the development of bacterial complications. Mucociliary transport is the main mechanism for cleaning the nasal cavity and paranasal sinuses from mucus and pathogens, preventing the development of inflammation. Violation of mucociliary transport against the background of viral infections leads to the development of acute sinusitis, which can be complicated by acute otitis media, eustachiitis, adenoiditis. Sometimes intracranial and orbital complications develop. The article presents a clinical case of a 12-year-old patient with complaints of difficulty in nasal breathing, mucopurulent nasal discharge, discharge from the back of the throat, unproductive cough, especially disturbing at night, periodic facial pain on the right, pain and congestion in the right ear. An endoscopic examination of the nose, nasopharynx and ear, as well as a computed tomography scan were performed. When prescribing complex treatment, including a combined mucolytic drug, a complete recovery was achieved on the 7th day of treatment. The use of the topical mucolytic drug (acetylcysteine, tuaminoheptane) in children improves the rheology of discharge from the nose and paranasal sinuses and prevents the development of complications of acute rhinosinusitis.