Sinusitis in Children

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. In contrast to adults, sinusitis may be 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 fever;
• thick yellow-green nasal drainage;
• chronic cough, especially at night
• 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 sinus infection is likely.

You can reduce the risk of sinus infections for your child by reducing exposure to known environmental 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 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.

Chronic sinusitis

If your child suffers from sinus symptoms that last for twelve weeks, 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, please call the division of Pediatric Otolaryngology for an appointment for your child. Your physician may recommend surgical treatment of the sinuses. Enlarged adenoids may be implicated as a cause of chronic sinusitis, and adenoidectomy is sometimes recommended.

Diagnosis of sinusitis

Upon examining your child’s ears, nose, and throat and taking a thorough history, we can usually make a correct diagnosis. Occasionally, we will use special instruments 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.