Rational strategies for treating acute rhinosinusitis in children
https://doi.org/10.21518/ms2026-019
Abstract
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.
About the Authors
E. V. KasanaveRussian Federation
Elena V. Kasanave - Cand. Sci. (Med.), Assistant Professor of the Department of Childhood Diseases, Clinical Institute of Child Health named after N.F. Filatov, Sechenov First Moscow State Medical University (Sechenov University).
2, Bldg. 4, Bolshaya Pirogovskaya St., Moscow, 119435
A. A. Fedotova
Russian Federation
Anna A. Fedotova - Student of the Clinical Institute of Child Health named after N.F. Filatov, Sechenov First Moscow State Medical University (Sechenov University).
2, Bldg. 4, Bolshaya Pirogovskaya St., Moscow, 119435
References
1. Карнеева ОВ, Юнусов АС, Гуров АВ, Абдулкеримов ХТ, Рязанцев СВ, Карпова ЕП и др. Острый синусит: клинические рекомендации. М.; 2024. 49 с. Режим доступа: https://cr.minzdrav.gov.ru/view-cr/313_3.
2. Arcimowicz M. Acute sinusitis in daily clinical practice. Otolaryngol Pol. 2021;75(4):40–50. https://doi.org/10.5604/01.3001.0015.2378.
3. Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020;58(Suppl. 29):1–464. https://doi.org/10.4193/RHIN20.600.
4. Karpischenko SA, Tikhomirova EK. Rhinitis in children of the first years of life. Pediatrics. Consilium Medicum. 2021;(3):224–230. https://doi.org/10.26442/26586630.2021.3.201147.
5. Ryazantsev SV, Krivopalov AA, Shamkina PA, Lezhneva KA, Donskaya OS. Highlights of prescribing herbal medicines in the complex therapy of acute rhinosinusitis. Meditsinskiy Sovet. 2020;(16):18–25. (In Russ.) https://doi.org/10.21518/2079-701X-2020-16-18-25.
6. Garashchenko TI, Kirichenko IM. Mucolytics in the treatment of acute and chronic diseases of the nose and paranasal sinuses and nonpurulent middle ear disease in children. Meditsinskiy Sovet. 2017;(1):108–114. (In Russ.) https://doi.org/10.21518/2079-701X-2017-1-108-114.
7. Huang F, Liu F, Zhen X, Gong S, Chen W, Song Z. Pathogenesis, Diagnosis, and Treatment of Infectious Rhinosinusitis. Microorganisms. 2024;12(8):1690. https://doi.org/10.3390/microorganisms12081690.
8. Robinot R, Hubert M, de Melo GD, Lazarini F, Bruel T, Smith N et al. SARS-CoV-2 infection induces the dedifferentiation of multiciliated cells and impairs mucociliary clearance. Nat Commun. 2021;12(1):4354. https://doi.org/10.1038/s41467-021-24521-x.
9. Laipan ASh, Morozov SP, Nizovtsova LA, Blokhin IA, Gombolevsky VA. Ulltra-low-dose computed tomography in the diagnosis of diseases of the paranasal sinuses in pediatric population: literature review. Medical Visualization. 2021;25(3):109–118. (In Russ.) https://doi.org/10.24835/1607-0763-908.
10. Lopatin AS. Acute rhinosinusitis in EPOS 2020 and updated guidelines of the Russian Rhinologic Society. Pharmacology & Pharmacotherapy. 2022;(S1):30–36. (In Russ.) https://doi.org/10.46393/27132129_2022_S_30.
11. Starostina SV, Sivokhin DA. Topical therapy in the treatment of patients with acute rhinosinusitis in adults. Consilium Medicum. 2021;23(3):210–215. (In Russ.) Available at: https://consilium.orscience.ru/2075-1753/article/view/95431.
12. Карнеева ОВ, Гуров АВ, Карпова ЕП, Тулупов ДА, Рязанцев СВ, Гаращенко ТИ и др. Острый синусит: клинические рекомендации. М.; 2021. 53 c. Режим доступа: https://otolar-centre.ru/images/2022/Clinical/Острый_синусит.pdf.
13. Karpishchenko SA, Rodneva YuA. The role of irrigation salt solutions with silver ions in the treatment and prevention of ENT diseases in children. Meditsinskiy Sovet. 2023;17(12):7–13. (In Russ.) https://doi.org/10.21518/ms2023-193.
14. Kolosova NG, Shatalina SI. Management approach to acute rhinosinusitis: a pediatrician’s perspective. RMJ. Medical Review. 2023;7(8):537–542. (In Russ.) https://doi.org/10.32364/2587-6821-2023-7-8-11.
15. Mamatova ShR, Karabaev KhE, Ismatova KA, Yusupov ZhB. Clinical case from practice with orbital complications in rhinosinusitis in young children. Young Scientist. 2025;(9):228–234. (In Russ.) Available at: https://moluch.ru/archive/560/123098.
16. Wong SJ, Levi J. Management of pediatric orbital cellulitis: A systematic review. Int J Pediatr Otorhinolaryngol. 2018;110:123−129. https://doi.org/10.1016/j.ijporl.2018.05.006.
17. Torretta S, Guastella C, Marchisio P, Marom T, Bosis S, Ibba T et al. Sinonasal-Related Orbital Infections in Children: A Clinical and Therapeutic Overview. J Clin Med. 2019;8(1):101. https://doi.org/10.3390/jcm8010101.
18. Welkoborsky HJ, Pitz S, Grass S, Breuer B, Holte APV, Bertram O, Wiechens B. Sinogenic Orbital Complications. Dtsch Arztebl Int. 2022;119(3):31–37. https://doi.org/10.3238/arztebl.m2021.0379.
19. Veshkurtseva IM, Kuznetsova NE, Izvin AI, Ponomareva MN, Izmailova AА, Yudina SS. Orbital complications of rhinogenic etiology in children: some aspects. Ural Medical Journal. 2023;22(3):37–45. (In Russ.) https://doi.org/10.52420/2071-5943-2023-22-3-37-45.
20. Boiko NV, Stagnieva IV, Gukasyan EL, Stateshnaya PA. Children’s rhinosinusitis orbital complications. Vestnik Otorinolaringologii. 2022;88(2):74–79. (In Russ.) https://doi.org/10.17116/otorino20228802174.
21. Morozova SV, Keda LA. Rational approach to the treatment of acute rhinosinusitis in comorbides with dysosmia. Meditsinskiy Sovet. 2020;(6):7–13. (In Russ.) https://doi.org/10.21518/2079-701X-2020-6-7-13.
22. Wannasuphoprasit Y, Bhutta MF. Management of acute rhinosinusitis in children. Paediatr Respir Rev. 2025;56:3–9. https://doi.org/10.1016/j.prrv.2025.04.004.
23. Sawada S, Matsubara S. Microbiology of Acute Maxillary Sinusitis in Children. Laryngoscope. 2021;131(10):E2705–E2711. https://doi.org/10.1002/lary.29564.
24. Venturini E, Del Bene M, Fusani L, Fusco E, Morlando A, Chiappini E et al. Treatment of sinusitis in children: an Italian intersociety consensus (SIPPS-SIP-SITIP-FIMP-SIAIP-SIMRI-SIM-FIMMG). Ital J Pediatr. 2025;51(1):102. https://doi.org/10.1186/s13052-025-01868-1.
25. Arcimowicz M. Rational treatment of acute rhinosinusitis in the context of increasing antibiotic resistance. Otolaryngol Pol. 2024;78(6):1–11. https://doi.org/10.5604/01.3001.0054.7506.
26. Nurova GU, Khairullayeva ZSh. Optimization of Conservative Treatment of Rhinosinusitis in Children. Otolaryngology. Eastern Europe. 2023;13(1):87–92. (In Russ.) https://doi.org/10.34883/PI.2023.13.1.029.
27. Kunelskaya NL, Ivoylov AYu, Arkhangelskaya II. The drug Sinupret in the treatment of acute sinusitis in children. RMJ. 2012;20(27):1352–1354. (In Russ.) Available at: https://www.rmj.ru/articles/otorinolaringologiya/Preparat_Sinupret_v_lechenii_ostrogo_sinusita_u_detey/.
28. Svistushkin VM, Mokoyan ZhT, Sagova DI. Nasal irrigation during seasonal epidemics of influenza and acute respiratory viral infections. Meditsinskiy Sovet. 2024;18(7):78–84. (In Russ.) https://doi.org/10.21518/ms2024-109.
29. Zawadzka-Głos L. Microbiota and antibiotic therapy in rhinosinusitis. Otolaryngol Pol. 2023;77(5):36–42. https://doi.org/10.5604/01.3001.0053.8709.
30. Matl CM, Jang W, Salley JR, Fort CL, Demke JC, Tran P, Wang JC. Effects of Essential Oils in the Treatment of Acute Rhinosinusitis: A Systematic Review. Laryngoscope Investig Otolaryngol. 2025;10(3):e70189. https://doi.org/10.1002/lio2.70189.
31. Jund R, Mondigler M, Stammer H, Stierna P, Bachert C. Herbal medicinal product Sinupret extract (BNO 1016) is safe and effective in the treatment of acute viral rhinosinusitis. Consilium Medicum. 2022;24(3):186–192. (In Russ.) https://doi.org/10.26442/20751753.2022.3.201314.
32. Poudineh M, Nikzad F, Parvin S, Ghaheri M, Sabbaghi S, Kazemi E et al. Therapeutic Effects of Vitamins and Nutritional Supplements on Sinusitis: A Narrative Review. Nutr Metab Insights. 2024;17:11786388241263680. https://doi.org/10.1177/11786388241263680.
33. Tran HTT, Peterburs P, Seibel J, Abramov-Sommariva D, Lamy E. In vitro Screening of Herbal Medicinal Products for Their Supportive Curing Potential in the Context of SARS-CoV-2. Evid Based Complement Alternat Med. 2022;2022:8038195. https://doi.org/10.1155/2022/8038195.
34. Virgin F, Zhang S, Schuster D, Azbell C, Fortenberry J, Sorscher EJ, Woodworth B. The bioflavonoid compound, sinupret, stimulates transepithelial chloride transport in vitro and in vivo. Laryngoscope. 2010;120(5):1051–1056. https://doi.org/10.1002/lary.20871.
35. Karpishchenko SA, Rodneva IuA, Ekushov KA. Experience of using a combination of herbal preparations in the treatment of acute rhinosinusitis in children. Meditsinskiy Sovet. 2024;18(11):37–47. (In Russ.) https://doi.org/10.21518/ms2024-282.
36. Bittner CB, Steindl H, Abramov-Sommariva D, Plach M, Abels C, Bachert C. Efficacy and effectiveness of the herbal medicinal product BNO 1016 in the management of acute rhinosinusitis in the context of antibiotic stewardship. Postgrad Med. 2023;135(6):607–614. https://doi.org/10.1080/00325481.2023.2234274.
37. Abdulkerimov KhT, Kartashova KI, Abdulkerimov ZKh, Egorushkina AV, Shamanskaya KV, Davydov RS et al. Comparative evaluation of the effectiveness of the drug Sinupretin preoperative preparation and the postoperative period of observation (treatment) during planned rhino-surgical interventions. Vestnik Otorinolaringologii. 2023;88(4):103–109. (In Russ.) https://doi.org/10.17116/otorino202288041103.
38. Vishnyakov VV, Egiyan SS, Akopyan LV. Rhinosinusitis: Modern Herbal Medicine Based on Traditions and Scientic Evidence. Effective Pharmacotherapy. 2022;18(4):30–38. (In Russ.) Available at: https://elibrary.ru/mgbsiw.
39. Korkmazov MYu, Kornova NV, Korkmazov АМ. Possibilities of improving the efficacy and safety of etiopathogenetic therapy of acute sinusitis. Meditsinskiy Sovet. 2025;19(7):81–91. (In Russ.) https://doi.org/10.21518/ms2025-136.
Review
For citations:
Kasanave EV, Fedotova AA. Rational strategies for treating acute rhinosinusitis in children. Meditsinskiy sovet = Medical Council. 2026;(1):54-61. (In Russ.) https://doi.org/10.21518/ms2026-019
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