Pediatric frontal sinusitis

Abstract

Frontal sinusitis is a difficult clinical entity to diagnose in the pediatric population. The development of the frontal sinuses, nonspecific symptoms, inherent problems with in office examinations, and hesitancy to obtain radiographical evaluation in children contribute to the complexity of this diagnosis. In children, evaluation for suspected chronic sinusitis may require evaluations for cystic fibrosis, primary ciliary dyskinesia, allergic rhinitis, immune deficiencies, reflux or presence of adenoid tissue. First line therapy for bacterial frontal sinusitis is oral antibiotics (ex. amoxicillin with clavulanate). Culture directed antibiotic therapy is preferable but difficult to obtain in the pediatric population. Because of its proximity to the orbit and intracranial contents complications of frontal sinus can be life threatening. If infectious complications are suspected contrasted imaging should be obtained along with prompt treatment with IV antibiotics and consideration of surgical therapy.