9. Pediatric Rhinosinuitis. Orbital complications in diseases of the nose and paranasal sinuses. Cerebrospinal Fluid Rhinorrhea

Question 1

What is PAEDIATRIC RHINOSINUSITIS?

Answer 1

• Children with VERY POORLY DEVELOPED Sinuses
• Occur at any child at OVER Age 1

0 SYMPTOMS
- Irritability
- Lethargy
- Snoring
- Mouth Breathing
- Difficulty Feeding
- Hyponasal Speech

Question 2

What are ORBITAL COMPLICATIONS in Diseases of Nose / Paranasal Sinuses?

Answer 2

• Commonly ARISE from ETHMOID Cells / FRONTAL Sinus
• Predispose with Inflammatory Complications FROM Spread of Infx

1) ORBITAL OEDEMA
- Swelling / Erythema of Eyelids
- Tx = Nose drops in Intranasal Cotton Pack

2) PERIOSTEITIS
- Persistent Eyelid Oedema leading to PAIN at Medial Canthus of Eye

3) SUBPERIOSTEAL ABSCESS
- Severe Inflammatory Process
- Limitation of Ocular Movement
- Tx = Surgical Drainage via Endoscope / Nose Drops / Antibiotics

4) ORBITAL CELLULITIS
- Spread of infection causing inflammation to Eye Tissues BEHIND Orbital Septum
- Tx = Surgery (Abscess) / Nose drops / Antibiotics

Question 3

What is CEREBROSPINAL FLUID RHINORRHEA?

Answer 3

• Drainage of CSF from the Nose
• Where there’s a BREACH in the Dura, that’s over / adjacent to nose / sinuses
• Allowing pathway for CSF to drain FROM Subarachnoid Space INTO the Nose

0 DUE to, Head Trauma / Nasal, Ear Surgery

0 SYMPTOMS
- Basal Skull Fracture
- Fever
- Chills
- Changes in Consciousness