What is Sinusitis in Children

Sinusitis is soreness and inflammation of the sinuses. Sinuses are hollow spaces in the bones around the face. The sinuses are located:

• Around your child’s eyes.
• In the middle of your child’s forehead.
• Behind your child’s nose.
• In your child’s cheekbones.

Sinuses and nasal passages are lined with stringy fluid (mucus). Mucus normally drains out of the sinuses. When nasal tissues become inflamed or swollen, mucus can become trapped or blocked. Blocked or trapped mucus makes it difficult for air to flow through the sinuses. This allows bacteria, viruses, and funguses to grow, which leads to infection. Most infections of the sinuses are caused by a virus. Young children are more likely to develop infections of the nose, sinus, and ears because their sinuses are small and not fully formed until their teen years.

Sinusitis can develop quickly. It can last for 7‒10 days (acute) or for more than 12 weeks (chronic).

What are the causes?

This condition is caused by anything that creates swelling in the sinuses or stops mucus from draining, including:

• Allergies.
• Asthma.
• A common cold or viral infection.
• A bacterial infection.
• A foreign object stuck in the nose, such as a peanut or raisin.
• Pollutants, such as chemicals or irritants in the air.
• Abnormal growths in the nose (nasal polyps).
• Abnormally shaped bones between the nasal passages.
• Enlarged tissues behind the nose (adenoids).
• A fungal infection. This is rare.

What increases the risk?

The following factors may make your child more likely to develop this condition:

• Having:
  • Allergies or asthma.
  • A weak immune system.
  • Structural deformities or blockages in the nose or sinuses.
  • A recent cold or respiratory infection.
• Attending daycare.
• Drinking fluids while lying down.
• Using a pacifier.
• Being around secondhand smoke.
• Doing a lot of swimming or diving.

What are the signs or symptoms?

The main symptoms of this condition are pain and a feeling of pressure around the affected sinuses. Other symptoms include:

• Upper toothache.
• Earache.
• Headache, if your child is older.
• Bad breath.
• Decreased sense of smell and taste.
• A cough that gets worse at night.
• Fatigue or lack of energy.
• Fever.
• Thick drainage from the nose that is often green and may contain pus (purulent).
• Swelling and warmth over the affected sinuses.
• Swelling and redness around the eyes.
• Vomiting.
• Crankiness or irritability.
• Sensitivity to light.
• Sore throat.

How is this diagnosed?

This condition is diagnosed based on symptoms, a medical history, and a physical exam. To find out if your child’s condition is acute or chronic, your child’s health care provider may:

• Look in your child’s nose for signs of nasal polyps.
• Tap over the affected sinus to check for signs of infection.
• View the inside of your child’s sinuses using an imaging device that has a light attached (endoscope).

If your child’s health care provider suspects chronic sinusitis, your child also may:

• Be tested for allergies.
• Have a sample of mucus taken from the nose (nasal culture) and checked for bacteria.
• Have a mucus sample taken from the nose and examined to see if the sinusitis is related to an allergy.

Your child may also have an MRI or CT scan to give the child’s healthcare provider a more detailed picture of the child’s sinuses and adenoids.

How is this treated?

Treatment depends on the cause of your child’s sinusitis and whether it is chronic or acute. If a virus is causing the sinusitis, your child’s symptoms will go away on their own within 10 days. Your child may be given medicines to help with symptoms. Medicines may include:

• Nasal saline washes to help get rid of thick mucus in the child’s nose.
• A topical nasal corticosteroid to ease inflammation and swelling.
• Antihistamines, if swelling and inflammation continue.

If your child’s condition is caused by bacteria, your child’s health care provider may recommend waiting to see if symptoms improve. Most bacterial infections will get better without antibiotic medicine. If your child has a severe infection or a weak immune system, he or she may be prescribed antibiotics.

Surgery may be needed to correct any underlying conditions, such as enlarged adenoids.

Follow these instructions at home:

Medicines

• Give over-the-counter and prescription medicines only as told by your child’s health care provider. These may include nasal sprays.
  • Do not give your child aspirin because of the association with Reye syndrome.
• If your child was prescribed an antibiotic, give it as told by your child’s health care provider. Do not stop giving the antibiotic even if your child starts to feel better.

Hydrate and Humidify

• Have your child drink enough fluid to keep his or her urine clear or pale yellow.
• Use a cool mist humidifier to keep the humidity level in your home and the child’s room above 50%.
• Run a hot shower in a closed bathroom for several minutes. Sit with your child in the bathroom to inhale the steam from the shower for 10–15 minutes. Do this 3–4 times a day or as told by your child’s health care provider.
• Limit your child’s exposure to cool or dry air.

Rest

• Have your child rest as much as possible.
• Have your child sleep with his or her head raised (elevated).
• Make sure your child gets enough sleep each night.

General instructions

• Do not expose your child to secondhand smoke.
• Keep all follow-up visits as told by your child’s health care provider. This is important.
• Apply a warm, moist washcloth to your child’s face 3–4 times a day or as told by your child’s health care provider. This will help with discomfort.
• Remind your child to wash his or her hands with soap and water often to limit the spread of germs. If soap and water are not available, have your child use hand sanitizer.

Contact a health care provider if:

• Your child has a fever.
• Your child’s pain, swelling, or other symptoms get worse.
• Your child’s symptoms do not improve after about a week of treatment.

Get help right away if:

• Your child has:
  • A severe headache.
  • Persistent vomiting.
  • Vision problems.
  • Neck pain or stiffness.
  • Trouble breathing.
  • A seizure.
• Your child seems confused.
• Your child who is younger than 3 months has a temperature of 100°F (38°C) or higher.