What are sinuses?
The sinuses are cavities, or air-filled pockets located inside the face, near the nasal passages. Like the nasal passages, the sinuses are lined with mucous membranes. There are four sinuses:
- Ethmoid sinus - located around the area of the bridge of the nose. This sinus is present at birth, and continues to grow until puberty.
- Maxillary sinus - located around the area of the cheeks. This sinus is also present at birth, and continues to grow until puberty.
- Frontal sinus - located in the area of the forehead. This sinus does not develop until around 7 years of age.
- Sphenoid sinus - located deep in the face, behind the nose. This sinus does not fully develop until adolescence.
What is sinusitis?
Sinusitis is an infection of the paranasal sinuses (sinuses near the nose). These infections usually occur after a cold or after an allergic inflammation. There are three types of sinusitis:
- Acute sinusitis - occurs quickly and improves with the appropriate treatment
- Subacute sinusitis - does not improve with treatment initially, but lasts less than three months
- Chronic sinusitis - occurs with repeated acute infections or with previous infections that were inadequately treated. The symptoms last longer than three months.
What causes sinusitis?
Sometimes, a sinus infection happens after an upper respiratory infection (URI) or common cold. The URI causes inflammation of the nasal passages that can block the opening of the paranasal sinuses, and result in a sinus infection. Allergies can also lead to sinusitis because of the swelling of the nasal tissue and increased production of mucus.
There are other possible conditions that can block the normal flow of secretions out of the sinuses and can lead to sinusitis including the following:
- Enlarged adenoids
- Trauma to the nose
- Foreign objects stuck in the nose
- Abnormalities in the structure of the nose
- Cleft palate
- Infections from a tooth
When the flow of secretions from the sinuses is blocked, bacteria may begin to grow. This leads to a sinus infection, or sinusitis.
What are the symptoms of sinusitis?
The symptoms of sinusitis depend greatly on the age of the child. The following are the most common symptoms of sinusitis. However, each child may experience symptoms differently. Symptoms may include:
In younger children
- Runny nose that lasts longer than seven to 10 days
- Nasal discharge that is usually thick green or yellow, but can be clear
- Nighttime cough
- Daytime cough, occasionally
- Swelling around the eyes
- Children younger than 5 years of age rarely have headaches from sinusitis
In older children and adults
- Runny nose or cold symptoms lasting longer than seven to 10 days
- Drip from the nose to the back of the throat
- Facial discomfort
- Bad breath
- Sore throat
- Swelling around the eye, often worse in the morning
The symptoms of sinusitis may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.
How is sinusitis diagnosed?
In addition to a complete medical history and physical examination, diagnostic procedures for sinusitis may include the following:
- Cultures from the nose or sinus fluid - laboratory tests that involve the growing of bacteria or other microorganisms to aid in diagnosis.
- Sinus X-rays - X-rays are not typically used, but may help assist in the diagnosis.
- Computed tomography (also called CT scan) - a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce detailed images of the body.
- Blood tests.
Treatment for sinusitis
The specific treatment for this condition depends on many factors and is tailored for each child. Please discuss your child's condition, treatment options and your preferences with your child's physician or healthcare provider.
Treatment of sinusitis may include the following:
- Antibiotics, as determined by your child's physician (antibiotics are usually given for 10 to 14 days, and sometimes longer)
- Acetaminophen (for pain or discomfort)
- Use of a cool mist humidifier in your child's room
- Salt water nasal drops or sprays
- Anti-inflammatory or Corticosteroid nasal sprays
- Decongestant nasal sprays (eg, AFRIN.) for short-term use only
Decongestants and antihistamines may or may not help the symptoms of sinusitis.
Reviewed by: Steven D. Handler, MD, MBE
Date: April 2009