Early And Late Childhood

You can inspect the anterior portion of the nose by using a large speculum on your otoscope. Inspect the nasal mucous membranes, noting their color and condition. Look for nasal septal deviation and the presence of polyps.

Pale, boggy nasal mucous membranes are found in children with chronic (perennial) allergic rhinitis.

Purulent rhinitis is common in viral infections, but may be part of the constellation of symptoms of sinusitis.

Foul-smelling purulent, unilateral discharge from the nose may be due to a foreign body in the nose.

Maxillary sinuses are noted on x-rays by age 4 years, sphenoid sinuses by age 6, and frontal sinuses by age 6 to 7. The sinuses of older children can be palpated like adult sinuses, looking for tenderness. Traditionally, transillumination of the paranasal sinuses of younger children has been taught; however, this technique has poor sensitivity and specificity for diagnosing sinusitis or fluid in the sinuses.

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