Rational strategies for treating acute rhinosinusitis in children

Acute rhinosinusitis ranks among the leaders in the otolaryngological pathology patterns of the pediatric population. Orbital and intracranial complications after rhinosinusitis constitute a major health and life challenge for children. Decongestants (short-term courses for no more than 3–5 days), elimination-irrigation therapy, topical glucocorticosteroids (for the treatment of acute post-viral rhinosinusitis), and herbal medicines are the mainstay of treatment for acute viral/post-viral rhinosinusitis. Sinupret is one of the most fully studied and effective herbal medicines to treat acute rhinosinusitis with secretolytic, secretomotor, anti-inflammatory, decongestant, moderate antibacterial, and antiviral effects, as evidenced by international and domestic studies. This article presents a clinical case report of how acute viral rhinosinusitis aggravated by adenoiditis, and grade II–III adenoid hypertrophy was diagnosed and treated in a 2.5-year-old child. The patient's complaints included nasal congestion, viscous, yellowish nasal discharge, rhinolalia, unproductive cough, and stertorous breathing at night time. Acute viral rhinosinusitis and adenoiditis were suspected due to patient's complaints, medical history, and physical examination findings. A comprehensive treatment, including elimination and irrigation therapy, as well as phytotherapeutic agent Sinupret were prescribed. A follow-up examination was performed 3 days later and showed progressive improvement: relief of nasal breathing, practically absent rhinolalia, and significantly less frequent cough. Thus, the use of herbal medicine allowed us to avoid polypharmacy and achieve the primary goals in the treatment of acute rhinosinusitis.