Key Points

• A CT scan of the sinuses is not necessary to diagnose uncomplicated acute sinusitis. CT should be considered when the diagnosis is uncertain, treatment has failed, or a complication or neoplasia is suspected. MRI is useful in evaluation of sinus tumors.

• Adenoid hypertrophy is a common cause of nasal symptoms in children, but in an adult can indicate a lymphoproliferative disorder or HIV infection.

• A nasal foreign body should be suspected in a child who presents with recent unilateral nasal obstruction, rhinorrhea, and odor.

• Nasal polyps can be seen with asthma, cystic fibrosis, and rarely neoplasia.

• After allergen avoidance and antihistamines, topical corticosteroids are the mainstay of treatment for seasonal allergic rhinitis.

• Leukotriene receptor antagonists can reduce the symptoms of allergic rhinitis.

• Treatment to restore mucociliary function in sinusitis is as important as antimicrobial therapy.

• Unlike adults, children with sinusitis rarely complain of facial pain.

• Prompt diagnosis and treatment of a nasoseptal hematoma can prevent subsequent cartilage destruction.

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