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
- a “cold” lasting more than 10 to 14 days, sometimes with a low-grade
- 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
- swelling around the eyes
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 allergens 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?
- Acute 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
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.
- Chronic sinusitis: If your child suffers from one or more
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 ear, nose, and throat (ENT) specialist. The ENT may
recommend medical or 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
When is surgery necessary?
Only a small percentage of children with severe or persistent
sinusitis require surgery to relieve symptoms that do not respond to 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.
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.
© 2004 AAO-HNS/AAO-HNSF
Please read our disclaimer. Any information provided on this Web site should not be considered medical advice or a substitute for a consultation with Dr. Hector N. Hernandez or other healthcare professional. If you have a medical problem, contact us for diagnosis and treatment.