Proper sinus function requires motile cilia, patent ostia, and mucus of a viscosity that lends itself to transport. Inflammation, most commonly from allergic rhinitis or viral or bacterial upper respiratory tract infections, may result in dysfunctional cilia, obstruction of the ostia, or both. Approximately 5% to 10% of childhood viral rhinosinusitis is complicated by acute bacterial sinusitis. The negative pressure that can develop in a clogged sinus,combined with sneezing and sniffing,can facilitate intranasal bacterial transport into the sinus. This creates a breeding ground for bacteria,which increases the inflammatory response and results in sinusitis.

Sinusitis in children most frequently involves the maxillary and ethmoid sinuses, which are present at birth but are not functional until 6 months of age. The frontal sinus does not become clinically significant until adolescence when its development is complete. The sinuses drain into one of two ostia that open into the nasal cavity. Maxillary sinusitis is...

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