Sinusitis in Children

Sinusitis is common and serious in adults and in children alike.

In children the main causes are anatomical problems in the sinuses, frequent upper airway infections, and damage to the lining of the sinus.

What it feels like

• Headache
• Pain in the face
• Infection around the eye and in the teeth
• A stubborn cough that does not go
• Bad breath
• High fever
• Nausea and vomiting

Why it must be treated

Untreated sinusitis leads to far more serious health problems. It affects a child’s development. Headache, a blocked nose and a runny nose lower daily quality of life. The blocked nose and the discharge running down the back of the throat break the child’s sleep, and broken sleep makes learning difficult.

How the diagnosis is made

The doctor takes the history first.

In adults an endoscope shows whether the discharge from the sinus is infected or allergic. Neither endoscopy nor a CT scan can be applied easily to children, because a child has to be still and that needs anaesthesia. In children, plain sinus X-rays and computed tomography of the sinuses are used more often.

The diagnosis rests on the complaints and on how heavy the nasal and post-nasal discharge is.

The types

Sinusitis is grouped by how long it takes to clear.

• Acute sinusitis clears within four weeks of starting.
• Subacute sinusitis clears in 4 to 12 weeks.
• Chronic sinusitis takes longer than that.

Surgery

Sinus surgery in children is preferred from the age of 13 to 14 onwards. Surgery at a very young age is not recommended, because the face is still developing and the structures in the nose are narrow and small.

The sinuses lie close to important structures: the eye, the optic nerves, large blood vessels, the brain and the pituitary gland. Surgery there must be careful and limited, because these spaces are surrounded by very thin bone and the operation carries a risk of damaging them. Where the anatomy is difficult, guidance systems such as navigation CT are used.