General Clinical Algorithm for the Management of Chronic Rhinosinusitis (CRS) in Children - Flowchart
General Clinical Algorithm for the Management of Chronic Rhinosinusitis (CRS) in Children - Flowchart Sinusitis Sinusitis
«Flowchart»

Clinical symptoms (for ≥12 wk) and objective evidence of CRS

Clinical symptoms (for ≥12 wk) and objective evidence of CRS

Clinical symptoms (for ≥12 wk) and objective evidence of CRS

≥

<Node Text>

<Node Text>

<Node Text>

<Node Text>

<Go to node 3>

<Go to node 3>

<Go to node 3> Node 3

<Go to node 4>

<Go to node 4>

<Go to node 4> Node 4

<End Node 3>

<End Node 3>

<End Node 3>

<End Node 3>

<End Node 4>

<End Node 4>

<End Node 4>

<End Node 4>

<Next Node>

<Next Node>

<Next Node>

<Next Node>

Continue medical measure
Intranasal steroids
Nasal saline irrigation
Additional AR treatment as necessary

Continue medical measure
Intranasal steroids
Nasal saline irrigation
Additional AR treatment as necessary

Continue medical measure
Intranasal steroids
Nasal saline irrigation
Additional AR treatment as necessary




Recurrence or lack of resolution

Recurrence or lack of resolution

Recurrence or lack of resolution

Adenoidectomy

Adenoidectomy

Adenoidectomy

Adenoidectomy +/– irrigation

Adenoidectomy +/– irrigation

Adenoidectomy +/– irrigation

Failure

Failure

Failure

FESS

FESS

FESS

End

End

End

Or

Or

Or

CT scan

CT scan

CT scan

Low LM score

Low LM score

Low LM score

High LM score

High LM score

High LM score

And

And

And

Evaluate and treat comorbidities AR, asthma, PCD immune deficiency CF, AFS (esp if polyps)

Evaluate and treat comorbidities AR, asthma, PCD immune deficiency CF, AFS (esp if polyps)

Evaluate and treat comorbidities AR, asthma, PCD immune deficiency CF, AFS (esp if polyps)

Maximal medical treatment
Antibiotics
Intranasal steroids
Nasal saline irrigation
Additional treatment as necessary if AR

Maximal medical treatment
Antibiotics
Intranasal steroids
Nasal saline irrigation
Additional treatment as necessary if AR

Maximal medical treatment
Antibiotics
Intranasal steroids
Nasal saline irrigation
Additional treatment as necessary if AR





Resolution/improvement of symptoms

Resolution/improvement of symptoms

Resolution/improvement of symptoms

Persistent symptoms

Persistent symptoms

Persistent symptoms