EVIDENCE FOR THE EXISTENCE OF CHRONIC ETH MOIDO-MAXILLARY SINUSITIS IN INFANTS YOUNGER THAN 18 MONTHS

Oto-rhino-laryngologists usually deny the existence of infant chronic ethmoido-maxillary sinusitis, generally agreeing that the earliest sig ns of pneumatization of the maxillary sinuses cannot be observed earli er than 18 months of age. Based upon ten cases we present evidence tha t this notion of ''late sinusal pneumatization'' should be re-examined , pneumatized maxillary sinuses being possible as early as 11 months o f age. Thus, at that age, radiodiagnosed apneumatosis which is conside red as physiological, may express various conditions, such as true ana tomical apneumatosis, chronic glue sinusitis, or simple inflammatory s inusitis of the mucous membrane. Because it is impossible to clinicall y differentiate these different conditions we believe that in some par ticular cases, a short course of combined corticoid-antibiotics treatm ent with sinus X ray before and after treatment, may be useful. In cas e of confirmed sinusitis (sinus visualization after treatment), a seco ndary preventive treatment may reduce the risk of chronic maxillary si nusitis. We suggest that further studies should be performed in order to better define the reality of chronic ethmoido-maxillary sinusitis i n infants younger than 18 months of age, and to study the possible rol e of a phenomenon of immuno-inflammatory trapping in its pathologenesi s.