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Erschienen in: Monatsschrift Kinderheilkunde 3/2018

01.03.2018 | Antibiotika | Leitthema

Rhinosinusitis bei Kindern und Jugendlichen

Wissensstand und aktuelle AWMF-/europäische Leitlinien

verfasst von: Prof. Dr. M. A. Rose, M.P.H., PD Dr. J. G. Mainz

Erschienen in: Monatsschrift Kinderheilkunde | Ausgabe 3/2018

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Zusammenfassung

Die akute nicht-allergieassoziierte Rhinosinusitis (ARS) ist eine häufige Entzündung der Nasen- und Nasenebenhöhlenschleimhäute, die typischerweise nach viraler Infektion der oberen Atemwege auftritt und meistens – therapieunabhängig – binnen 10 Tagen ausheilt. Antiinfektiva sind nur bei Komplikationen und/oder mit Abwehrschwäche oder Clearance-Störung einhergehenden Grunderkrankungen angezeigt. Bei ca. 5–10 % aller ARS kommt es zur eitrigen Sinusitis, orbitale Komplikationen sind jedoch sehr selten (1:10.000–50.000), wobei keine aktuellen Sinusitisbeschwerden vorliegen müssen. Dennoch muss bei orbitaler Pathologie immer an Sinusitiskomplikationen gedacht werden. Beeinträchtigte Okulomotorik und/oder Visusverlust indizieren die Durchführung eines Computertomogramms (CT); bei Bestätigung muss nach Stufenschema konsequent antibiotisch, ggf. auch chirurgisch interveniert werden. Ansonsten ist das CT der therapierefraktären chronischen RS vorbehalten. Bleiben konservative Maßnahmen, einschließlich die mehrwöchige topische Verabreichung nasaler Steroide erfolglos, ist die nasale Sinuschirurgie eine effektive Option.
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Metadaten
Titel
Rhinosinusitis bei Kindern und Jugendlichen
Wissensstand und aktuelle AWMF-/europäische Leitlinien
verfasst von
Prof. Dr. M. A. Rose, M.P.H.
PD Dr. J. G. Mainz
Publikationsdatum
01.03.2018
Verlag
Springer Medizin
Erschienen in
Monatsschrift Kinderheilkunde / Ausgabe 3/2018
Print ISSN: 0026-9298
Elektronische ISSN: 1433-0474
DOI
https://doi.org/10.1007/s00112-018-0444-z

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