Chronic sinusitis. The disease of all ages.

Sinusitis is one of the most frequently overlooked and poorly understood diseases of childhood. There is a lack of information regarding criteria for diagnosis and the most effective method of management of sinusiSee also p 938. tis in children. Controversy exists regarding whether a sinus cavity is infected, how to diagnose sinusitis, and what the best treatment choice and duration is. The article by Tinkelman and Silk 1 in this issue of AJDC has prompted this editorial to bring the pediatrician up to date regarding these issues. I will limit my remarks to chronic sinusitis, that is, compatible symptoms that have been present for at least 3 weeks. (Some experts in the field would shorten this time to 10 days. 2,3 ) The nasal sinuses are four paired structures: the maxillary, ethmoidal, sphenoidal, and frontal sinuses that develop as evaginations of the mucous membranes of the nasal meatuses. The origin of