Considerações sobre rinossinusite crônica com pólipos nasais em pediatria
Considerations on chronic rhinosinusitis with nasal polyposis in pediatrics
Victtoria Ribeiro de Alencar Araripe Ferreira, Priscila Novaes Ferraiolo, Benivaldo Ramos Ferreira Terceiro, André Welisson Marques de Araújo, Solange Oliveira Rodrigues Valle, Sergio Duarte Dortas-Junior
Resumo
A rinossinusite crônica com pólipos nasais em pediatria é uma condição inflamatória rara, porém clinicamente relevante, as‑ sociada a comprometimento significativo da qualidade de vida. Seu diagnóstico é desafiador devido à sobreposição de sintomas com outras doenças comuns na infância, como hipertrofia ade‑ noideana, rinite alérgica e infecções respiratórias recorrentes. A presença de pólipos nasais deve sempre levantar suspeita de comorbidades como fibrose cística, discinesia ciliar primária e imunodeficiências. A classificação atual da rinossinusite crônica baseada em fenótipos e endótipos permite uma abordagem mais individualizada. O tratamento ainda é predominantemente clínico, com uso criterioso de corticosteroides tópicos e lavagem nasal. Imunobiológicos como o dupilumabe emergem como alternativa terapêutica para casos refratários a partir dos 12 anos, embora ainda haja escassez de evidências em pediatria. Esse artigo revisa os principais diagnósticos diferenciais e considerações terapêuticas da rinossinusite crônica com pólipos nasais na po‑ pulação pediátrica, destacando a importância de uma abordagem multidisciplinar.
Palavras-chave
Abstract
Chronic rhinosinusitis with nasal polyps in the pediatric population is a rare but clinically significant inflammatory condition, often associated with substantial impairment in quality of life. Diagnosis is challenging due to symptom overlap with other common childhood conditions, such as adenoid hypertrophy, allergic rhinitis, and recurrent respiratory infections. The presence of nasal polyps should prompt investigation for underlying comorbidities, such as cystic fibrosis, primary ciliary dyskinesia, and inborn errors of immunity. The current classification of chronic rhinosinusitis into phenotypes and endotypes enables a more individualized approach to management. Treatment remains primarily clinical, with intranasal corticosteroids and nasal saline irrigation as the mainstays. Biologic agents such as dupilumab are emerging as therapeutic options for refractory cases in patients aged 12 years and older, although pediatric-specific data remain limited. This article reviews the main differential diagnoses and therapeutic considerations related to chronic rhinosinusitis with nasal polyps in children, emphasizing the importance of a multidisciplinary approach.
Keywords
References
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Submitted date:
09/04/2025
Accepted date:
12/03/2025
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