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Sinusitis (Pediatric)

Rhinosinusitis, commonly referred to as sinusitis, describes when you or your child has nasal congestion, facial pressure, cough and thick nasal discharge.

People with allergic rhinitis or asthma are more likely to suffer from chronic sinusitis. This is because the airways are more likely to become inflamed when allergic rhinitis or asthma are present. Sinusitis also may be caused by an infection, a fungus, deviated nasal septum, nasal polyps or in rare cases an immune system deficiency.

The sinuses are hollow cavities within your cheekbones, around your eyes and behind your nose. They are lined with mucus, helping to warm, moisten and filter breathed air. When there is a mucus blockage and the sinuses don't drain normally, an infection can happen.

Acute sinusitis refers to sinusitis symptoms lasting less than a month. Most times it starts as a common cold. Symptoms often wane within a week to 10 days; but in some people, a bacterial infection develops.

Chronic sinusitis, also referred to as chronic rhinosinusitis, is when symptoms have gone on for more than 3 months, despite treatment.

What are the symptoms of sinusitis?

Often, both acute or chronic sinusitis symptoms develop after a cold or during periods of severe or ongoing allergic rhinitis. The most pronounced symptom of sinusitis is a painful pressure in the cheeks and forehead. Other symptoms may include:

  • Cough
  • Congestion
  • Thick yellow-green nasal discharge
  • Postnasal drip, often with a bad taste
  • Fever
  • Toothache

How is sinusitis diagnosed?

Allergy testing done by an allergist can determine what allergic triggers might be causing your child's chronic or reoccurring sinus infections.

In chronic or severe cases, your doctor may perform a rhinoscopy, in which your doctor examines your child's nasal passages. In this procedure, a thin, flexible instrument is inserted into the nostril to inspect the sinuses and look for blockages.

In some cases, a MRI or CT scan may be used to check for abnormalities in the sinuses, such as narrow drainage passages, polyps or a deviated septum.

How is sinusitis treated?

The treatment of sinusitis depends on the cause, severity, and duration of symptoms.

Acute Sinusitis: The majority of people with acute sinusitis recover without any prescribed medications. If the cause is from a bacterial infection, an antibiotic may lessen the duration of acute sinusitis and can also reduce the severity of symptoms. Other options for treatment include:

  • Decongestants or nasal sprays might help relieve your symptoms and enable better drainage of the infection. Many people find relief by using this sinus saline recipe.
  • Get plenty of rest and sleep
  • Drink several glasses of water a day to stay hydrated
  • Over-the-counter pain relievers such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) may be helpful.
  • Do NOT give aspirin to children or adolescents under the age of 18.
  • In addition to medications, some people with sinusitis find breathing hot, moist air, using hot packs or washing the nasal cavities with a saline rinse provides relief.

Chronic sinusitis

Typically the culprit is not a bacterial infection, so antibiotics usually will not help. People suffering from chronic sinusitis should avoid doing things that trigger or worsen symptoms, especially if the cause is an allergy.

A doctor may recommend an intranasal corticosteroid sprays when appropriate for recurrent sinusitis. If a doctor identifies the cause as fungus, he or she may prescribe an antifungal medication.

Treatment of sinusitis caused by allergies

If an allergy is the cause of your child's sinusitis, an allergist will lay out a plan to avoid triggers. Additionally, your child's allergist may treat you or your child with medications or allergy shots that can help prevent future periods of sinusitis.

Environmental control measures such as avoiding allergens are crucial for people with rhinitis triggered by indoor allergens such as dust mites, molds or animal dander. This can prevent the need for surgery or prevent the return of sinusitis after surgery.

When other treatments or medications are unsuccessful, endoscopic sinus surgery may be considered. When contemplating sinus surgery, be sure to weigh the many factors. This can be a very difficult decision and you should seek the opinion of your allergist. Sinus surgery does not guarantee that sinusitis will not reoccur. Most patients still need medical treatment to prevent the return of chronic sinusitis.