Controversy on diagnostic and treatment of rhinosinusitis in children

: Rhinosinusitis (RS) is a significant health problem both in children and adult. A growing interest in RS resulted in two documents of European Position Paper on Rhinosinusitis and Nasal Polyps group (EPOS). This consensus offers evidence-based recommendations on diagnosis and treatment of RS and is intended to be a state-of- the art review for the specialists as well as the general practitioners.The recommendations divide rhinosinusitis as follows: acute viral or acute bacterial, recurrent and chronic RS. The symptoms of acute RS may increase after 5 day or persist after 10 days with less than 12 weeks duration. In recurrent RS there are about 6 episodes of acute RS during one year. Chronic RS is likely when symptoms of RS persist for longer than 12 weeks. Treatment of common cold is only symptomatic, while antibiotics and/or nasal steroids are recommended in severe acute RS. Endoscopic sinus surgery is indicated in chronic RS only when medical treatment fails and optimal medical treatment should always be continued after surgery. The computer tomography is the gold standard for diagnostics in cases of complication of RS or planning functional endoscopic sinus surgery (FESS).