Pediatric Sinusitis:Symptom Profiles with Associated Atopic Conditions
Chirapan Tantimongkolsuk MD*, Suwanna Pornrattanarungsee MD*, Pipat Chiewvit MD**, Nualanong Visitsunthorn MD*, Kitirat Ungkanont MD***, Pakit Vichyanond MD*
Affiliation : *Department of Pediatrics, **Department of Radiology, *** Department of Otolaryngology, Faculty of Medicine Siriraj Hospital
Introduction: Sinusitis is a very common disease in childhood. Clinical manifestations in childhood sinusitis
are different than in adult. Information in childhood sinusitis in Thailand is limited. We performed a prospec-
tive descriptive study to determine clinical characteristics of childhood sinusitis in Thailand
Materials and Methods : One hundred pediatric patients with clinical diagnosis of sinusitis attending pediatric
allergy clinic, pediatric outpatient clinic, and pediatric ENT clinic were recruited. Clinical diagnosis was
defined by presence of symptoms indicating upper respiratory infections with exudates at middle meatus by
anterior rhinoscopy. Thorough history taking and physical examinations were conducted with findings
recording into sinusitis questionnaire. Sinus radiographs were taken in 77 patients and were read blindly a
single radiologist who was unaware of clinical conditions of patients. Allergy skin prick tests were performed
with a panel of common aeroallergens in Thailand.
Results : Age range of the 100 patients were between 1.7 to 12.4 years with a mean (± SD) of 6 ± 2.72 years.
History of atopic disease among patients and their families was positive in 49 % and 47% respectively. Four
most common clinical manifestations were rhinorrhea (95%), nocturnal and productive cough (91%), nasal
congestion (74%) and posterior nasal dripping (66%). The three most common signs were obstruction of
middle meatus (100%), swelling of turbinates (92%) and granular pharynx (48%). All paranasal sinuses X-
rays were abnormal with maxillary sinus being the most commonly involved sinus (99%) followed by ethmoid
sinus (91%). The majority of patients had involvement of more than one sinus. Skin prick tests were positive
in 53.6%. The two most common sensitizing allergens were dust mites (57.7%) and cockroaches (18.6%).
Conclusion : The presence of symptoms of rhinorrhea, cough, nasal congestion and posterior nasal drip
should alert physicians for diagnosis of sinusitis in pediatric patients. Maxillary and ethmoid sinus were the
most common sinuses involved. Atopic predisposition is present in up to 53.6% in this population.
Keywords : Sinusitis, Childhood, Atopy, Maxillary sinus, Ethmoid sinus.
