Summary

Chronic pediatric rhinosinusitis is a multifactorial disease process that continues to be a topic of considerable controversy. Although many predisposing factors have been identified, the complete natural history of this disease is still unknown. It is recognized, however, that there is a spontaneous tendency toward recovery in children after the age of 6 to 8 years.24,73, 74 Thus, with maturation of a child's immune system and developing anatomy, chronic rhinosinusitis may indeed resolve, warranting a conservative approach to treatment. As our understanding of this disease process advances, it is becoming increasingly apparent that chronic pediatric rhinosinusitis is medically treatable in most cases and that surgery is very rarely indicated in infants and children (Table 69-2).

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