CHRONIC SINUSITIS AMONG PEDIATRIC-PATIENTS WITH CHRONIC RESPIRATORY COMPLAINTS

We examined the prevalence of chronic sinusitis among children who pre sented to allergy clinics with chronic ( a 3 months) respiratory sympt oms. Ninety-one patients, ranging from 2 to 17 years of age with 62% m ale and 72% white, completed the study. Fifty-nine percent of patients had positive skin test results, and 25.3% had chronic asthma. Paranas al sinuses were examined by coronal sinus computed tomographic scan. S ixty-three percent (58 of 91) had chronic sinusitis, 5.5% (5 of 91) ha d concha bullosa, 1% (I of 91) had foreign body, and 19% (19 of 91) ha d deviated nasal septums. Among symptoms of sneezing, nasal congestion , postnasal drip, coughing, wheezing, rhinorrhea, and headache, no sin gle symptom was an acceptable predictor of abnormality on computed tom ographic scan examinations. Combining the symptoms of moderate to seve re rhinorrhea and cough with minimum sneezing had a specificity of 95% and a sensitivity of 38% in predicting the presence of chronic sinusi tis. Allergic rhinitis (p = 0.27), mild deviated nasal septum (p = 0.1 1), unobstructive concha bullosa (p = 0.13), and passive exposure to c igarette smoke (p = 0. 53) were not risk factors associated with sinus abnormalities. Age (r = 0.30, p = 0. 004) in pediatric patients with chronic respiratory symptoms was the single risk factor significantly associated with abnormalities on sinus computed tomographic scan. Seve nty-three percent of children 2 to 6 years of age, 74% of children 6 t o 10 years of age, and 38% of children older than 10 had chronic sinus itis. Chronic sinusitis is common among pediatric patients with chroni c respiratory symptoms. Because the clinical symptoms are not acceptab ly sensitive, imaging studies of the sinus such as a Waters' view roen tgenogram should be considered as part of an allergy evaluation, espec ially in a high-risk group of patients from 2 to 10 years of age.