Over the last 13 years, we have performed maxillary antral irrigation with excellent results using a Killian's cannula inserted through the middle nasal meatus in more than 2600 cases of sinusitis in children. We have encountered many cases of young children (3, 4 and 5 year-olds) who required maxillary antral irrigation and have found irrigation in these cases practicable and beneficial. We report a therapy for sinusitis in young children using maxillary antral irrigation as a main treatment.
Our first choice of treatment for sinusitis in young children is a local treatment and administration of Cefditoren, Cefcapene and Cefdoxime because of the high detection rate of penicillin resistant Streptococcus pneumoniae as pathogenic bacteria in these cases. For intractable cases to this treatment, we administer Clarithromycin. When these drug therapies are not effective, maxillary antral irrigation is performed with good results. Owing to the application of Triple Therapy (irrigation and administration of a new macrolide and Azeptine), the recovery rate is increasing.
Indications of maxillary antral irrigation for sinusitis in young children are as follows;
1) Intractable cases against preservative treatment. We treated 19 intractable cases and found the irrigation markedly effective.
2) Sinusitis with complications.
(1) Acute sinusitis accompanied by headache or fever, in which the drug therapies are not effective.
(2) Sinobronchitis and its subform such as cases accompanied by continuous coughing, sputum and nasal discharge.
(3) Cases accompanied by intractable exudative otitis media.
(4) Cases accompanied by intractable bronchial asthma with frequent attacks.
