Your child’s sinuses are not fully developed until age 20. Although small,
the maxillary (behind the cheek) and ethmoid (between the eyes) sinuses are present
at birth. Unlike in adults, pediatric sinusitis is difficult to diagnose because
symptoms can be subtle and the causes complex.
How do I know when my child has sinusitis?
The following symptoms may indicate a sinus infection in your child:
- a “cold” lasting more than 10 to 14 days, sometimes with a low-grade
- thick yellow-green nasal drainage;
post-nasal drip, sometimes leading to or exhibited as sore throat, cough, bad
breath, nausea and/or vomiting;
- headache, usually not before age 6;
- irritability or fatigue;
- swelling around the eyes.
Young children have immature immune systems and are more prone to infections
of the nose, sinus, and ears, especially in the first several years of life.
These are most frequently caused by viral infections (colds), and they may
be aggravated by allergies. However, when your child remains ill beyond the
usual week to ten days, a serious sinus infection is likely.
You can reduce the risk of sinus infections for your child by reducing exposure
to known environmental allergies and pollutants such as tobacco smoke, reducing
his/her time at day care, and treating stomach acid reflux disease.
How will the doctor treat sinusitis?
Most children respond very well to antibiotic therapy. Nasal decongestants
or topical nasal sprays may also be prescribed for short-term relief of stuffiness.
Nasal saline (saltwater) drops or gentle spray can be helpful in thinning
secretions and improving mucous membrane function. If your child has acute
sinusitis, symptoms should improve within the first few days. Even if your
child improves dramatically within the first week of treatment, it is important
that you continue therapy until all the antibiotics have been taken.
Your doctor may decide to treat your child with additional medicines if he/she
has allergies or other conditions that make the sinus infection worse.
If your child suffers from sinus symptoms that last for two to three months,
this is known as chronic sinusitis. If your child has chronic sinusitis or
recurrent episodes of acute sinusitis numbering more than four to six per
year, you should seek consultation with an ear, nose, and throat (ENT) specialist.
The ENT may recommend surgical treatment of the sinuses.
Diagnosis of sinusitis
If your child sees an ENT specialist, the doctor will examine his/her ears,
nose, and throat. A thorough history and examination usually leads to the
correct diagnosis. Occasionally, special instruments will be used to look
into the nose during the office visit. An x-ray called a CT scan may help
to determine how your child's sinuses are formed, where the blockage has
occurred, and the reliability of a sinusitis diagnosis.
When is surgery necessary?
Surgery is considered for the small percentage of children with severe or persistent
sinusitis symptoms despite medical therapy. Using an instrument called an endoscope,
the ENT surgeon opens the natural drainage pathways of your child's sinuses
and makes the narrow passages wider. This also allows for culturing so that
antibiotics can be directed specifically against your child's sinus infection.
Opening up the sinuses and allowing air to circulate usually results in a reduction
in the number and severity of sinus infections.
Also, your doctor may advise removing adenoid tissue from behind the nose
as part of the treatment for sinusitis. Although the adenoid tissue does not
directly block the sinuses, infection of the adenoid tissue, called adenoiditis,
or obstruction of the back of the nose can cause many of the symptoms that
are similar to sinusitis, namely, runny nose, stuffy nose, post-nasal drip,
bad breath, cough, and headache.
Sinusitis in children is different than sinusitis in adults. Children more
often demonstrate a cough, bad breath, crankiness, low energy, and swelling
around the eyes along with a thick yellow-green nasal or post-nasal drip. Once
the diagnosis of sinusitis has been made, children are successfully treated
with antibiotic therapy in most cases. If medical therapy fails, surgical therapy
can be used as a safe and effective method of treating sinus disease in children.
If you have further questions about Sinusitis, please feel free to contact
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