Your child’s sinuses are not fully developed until late in the teen years. 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 of sinusitis can be caused by other problems, such as viral illness and allergy.
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 fever
- 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 in children age six or older
- irritability or fatigue
Young children 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, if your child remains ill beyond the usual week to ten days, a sinus infection may be the cause.
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.
Treatment of Pediatric Sinusitis
Initial treatment includes saline (saltwater) sprays to thin secretion and improve mucus membrane functions. Nasal decongestant sprays may be used for a short period of time to relieve stuffiness. Anti-inflammatory sprays can be used to decrease congestion. Over-the-counter decongestants and antihistamines are not general effective for viral upper respiratory infections in children, and the role of such medications for treatment of sinusitis is not well defined. Such medications should not be given to children younger than two years old.
If your child has persistent symptoms for greater than 7-10 days, then antibiotics may be warranted. Even if your child improves dramatically within the first week of treatment, it is important that you complete the antibiotic therapy. 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.
Chronic sinusitis: If your child suffers from symptoms of sinusitis for at least 12 weeks, he or she may have chronic sinusitis. Chronic sinusitis or recurrent episodes of acute sinusitis numbering more than four to six per year, are indications that you should seek consultation with an otolaryngologist (an ear, nose, and throat—ENT—specialist). The ENT may recommend medical or surgical treatment of the sinuses.
When is sugery necessary for sinusitis?
Surgery is considered for a very small percentage of children with severe or persistent sinusitis symptoms despite medical therapy. Typically removal of the adenoids (adenoidectomy) is recommended first. In children who continue to have sinus problems despite appropriate management by an otolaryngologist (an ear, nose and throat—ENT—specialists) surgery may be warranted. 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.