{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T17:09:25Z","timestamp":1784740165078,"version":"3.55.0"},"reference-count":79,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2015,11,1]],"date-time":"2015-11-01T00:00:00Z","timestamp":1446336000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Rhinol\ufffdAllergy"],"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:p>The goal of this review is to elucidate the pathogenic factors, histopathologic features, and special considerations that relate to pediatric versus adult chronic rhinosinusitis (CRS) and to emphasize differences and similarities between the adult and pediatric conditions. Emphasis is placed on understanding of the differences in pathogenic mechanisms, host-microbial interactions, potential defects in innate antimicrobial immunity, and the role of biofilm formation in pediatric versus adult CRS and how these translate to different approaches toward both medical and surgical management. Pediatric CRS can be viewed as evolving from acute bacterial rhinosinusitis into an uncomplicated \u201cearly\u201d stage of CRS, later evolving into a persistent stage and, in some cases, evolving into a late \u201cmaladaptive-eosinophilic\u201d stage disease. Given this potential evolution toward more irreversible disease, a plea can be made for improved recognition of and more aggressive early intervention for pediatric CRS, it is hoped, to prevent these long-term consequences. For the primary care physician, this may necessitate enlisting the support of a sinus specialist before the symptoms of CRS have persisted for months or years. It may also necessitate, in some cases, the use of sinus computed tomography imaging to demonstrate that sinus abnormalities have resolved. Other arguments can be made for prompt and comprehensive management of pediatric CRS, including the need to reduce the burden of illness, reduce health care costs, avoid unnecessary antibiotic use and its attendant effects toward promoting antibiotic resistant infections and, potentially, to reduce the development of important comorbidities, e.g., asthma.<\/jats:p>","DOI":"10.2500\/ajra.2015.29.4238","type":"journal-article","created":{"date-parts":[[2015,12,3]],"date-time":"2015-12-03T19:20:45Z","timestamp":1449170445000},"page":"414-420","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":49,"title":["Pediatric Chronic Rhinosinusitis"],"prefix":"10.1177","volume":"29","author":[{"given":"Daniel L.","family":"Hamilos","sequence":"first","affiliation":[{"name":"Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2015,11,1]]},"reference":[{"key":"bibr1-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2011.08.004"},{"key":"bibr2-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199401063300105"},{"key":"bibr3-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1002\/alr.20030"},{"key":"bibr4-ajra.2015.29.4238","first-page":"39","volume":"11","author":"Kabaalioglu N.","year":"2003","journal-title":"Kulak Burun Bogaz Ihtis Derg"},{"key":"bibr5-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2273.1997.00862.x"},{"key":"bibr6-ajra.2015.29.4238","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1542\/peds.87.3.311","volume":"87","author":"Shapiro G.G.","year":"1991","journal-title":"Pediatrics"},{"key":"bibr7-ajra.2015.29.4238","first-page":"161","volume":"2","author":"Vanlerberghe L.","year":"2006","journal-title":"B-ENT"},{"key":"bibr8-ajra.2015.29.4238","first-page":"299","volume":"20","author":"Hamilos D.L.","year":"2007","journal-title":"Clin Allergy Immunol"},{"key":"bibr9-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1159\/000228159"},{"key":"bibr10-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.10.1316"},{"key":"bibr11-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1084\/jem.20040111"},{"key":"bibr12-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2008.11.014"},{"key":"bibr13-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e31806009b0"},{"key":"bibr14-ajra.2015.29.4238","first-page":"52","volume":"39","author":"Oncel S.","year":"2010","journal-title":"J Otolaryngol Head Neck Surg"},{"key":"bibr15-ajra.2015.29.4238","first-page":"182","volume":"39","author":"Stephenson M.F.","year":"2010","journal-title":"J Otolaryngol Head Neck Surg"},{"key":"bibr16-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1159\/000079994"},{"key":"bibr17-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1177\/194589240501900506"},{"key":"bibr18-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000161346.30752.18"},{"key":"bibr19-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2010.24.3462"},{"key":"bibr20-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2010.07.017"},{"key":"bibr21-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1177\/194589240401800607"},{"key":"bibr22-ajra.2015.29.4238","first-page":"3","volume":"45","author":"Harvey R.J.","year":"2007","journal-title":"Rhinology"},{"key":"bibr23-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1177\/00034894061150S906"},{"key":"bibr24-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2014.28.4030"},{"key":"bibr25-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.2500\/ajr.2008.22.3119"},{"key":"bibr26-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21024"},{"key":"bibr27-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.02.002"},{"key":"bibr28-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-012-0246-7"},{"key":"bibr29-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.133.2.110"},{"key":"bibr30-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-59989770264-X"},{"key":"bibr31-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1991.01870140067008"},{"key":"bibr32-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1165\/rcmb.2010-0133OC"},{"key":"bibr33-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2013.06.049"},{"key":"bibr34-ajra.2015.29.4238","first-page":"219","volume":"33","author":"Zhang L.","year":"1998","journal-title":"Zhonghua Er Bi Yan Hou Ke Za Zhi"},{"key":"bibr35-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e31812e01ab"},{"key":"bibr36-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e31816381d4"},{"key":"bibr37-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1038\/nm0495-370"},{"key":"bibr38-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1002\/ar.20782"},{"key":"bibr39-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/21.Supplement_2.S162"},{"key":"bibr40-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-004-0027-z"},{"key":"bibr41-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1177\/194589240602000203"},{"key":"bibr42-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.2500\/ajr.2007.21.2997"},{"key":"bibr43-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1172\/JCI64240"},{"key":"bibr44-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1159\/000323296"},{"key":"bibr45-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2009.07.013"},{"key":"bibr46-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2012.05.052"},{"key":"bibr47-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.2500\/ar.2014.5.0102"},{"key":"bibr48-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1165\/ajrcmb.21.2.3691"},{"key":"bibr49-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1165\/rcmb.2009-0118OC"},{"key":"bibr50-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.physiol.69.040705.141301"},{"key":"bibr51-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1007\/s004050050109"},{"key":"bibr52-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1007\/s004050050158"},{"key":"bibr53-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1007\/BF00879275"},{"key":"bibr54-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1177\/014556139707601211"},{"key":"bibr55-ajra.2015.29.4238","first-page":"265","volume":"28","author":"Shone G.R.","year":"1990","journal-title":"Rhinology"},{"key":"bibr56-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.2500\/ajr.2007.21.3029"},{"key":"bibr57-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2011.09.001"},{"key":"bibr58-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-011-0189-4"},{"key":"bibr59-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2003.11.009"},{"key":"bibr60-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1177\/0194599810390443"},{"key":"bibr61-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1995.01890120054010"},{"key":"bibr62-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199303000-00002"},{"key":"bibr63-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2011.04.045"},{"key":"bibr64-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000150671.45484.87"},{"key":"bibr65-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1995.01890070015005"},{"key":"bibr66-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.125.11.1208"},{"key":"bibr67-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1997.01900070013002"},{"key":"bibr68-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1097\/00020840-200502000-00014"},{"key":"bibr69-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(99)70410-9"},{"key":"bibr70-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2006.03.003"},{"key":"bibr71-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2007.11.003"},{"key":"bibr72-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.127.9.1093"},{"issue":"7","key":"bibr73-ajra.2015.29.4238","first-page":"CD008515","author":"Ahmed J.","year":"2011","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr74-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21156"},{"key":"bibr75-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1177\/014556139207101203"},{"key":"bibr76-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1016\/0165-5876(94)01139-O"},{"key":"bibr77-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2002.125607"},{"key":"bibr78-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2014.07.025"},{"key":"bibr79-ajra.2015.29.4238","doi-asserted-by":"publisher","DOI":"10.2349\/biij.5.3.e13"}],"container-title":["American Journal of Rhinology &amp; Allergy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.2500\/ajra.2015.29.4238","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.2500\/ajra.2015.29.4238","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.2500\/ajra.2015.29.4238","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T09:33:39Z","timestamp":1777368819000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.2500\/ajra.2015.29.4238"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,11]]},"references-count":79,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2015,11]]}},"alternative-id":["10.2500\/ajra.2015.29.4238"],"URL":"https:\/\/doi.org\/10.2500\/ajra.2015.29.4238","relation":{},"ISSN":["1945-8924","1945-8932"],"issn-type":[{"value":"1945-8924","type":"print"},{"value":"1945-8932","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,11]]}}}