Pediatric Sinusitis: How is It Treated?

Although the skull looks solid, there are multiple hollow air spaces inside the facial bones called sinuses. When the membranous lining of the sinuses becomes inflamed, swollen or infected, it can result in a condition known as sinusitis. Sinusitis can have different causes, and the causes may affect treatment.

How Does Sinusitis Occur?

Under normal conditions, the mucous produced by the sinus membranes drains away into the throat or when you blow your nose. Sinusitis occurs when the drainage system in the sinuses becomes blocked. If you have a cold or allergies, the membranes in the sinuses produce more mucous. At the same time, the nasal passages and sinus tissues become swollen and irritated. When the mucous builds up in the sinuses, bacteria, viruses, and fungi can gain a foothold and begin to grow, the result is sinusitis.

Sinusitis Symptoms: Younger Children

Sinusitis symptoms vary according to the cause of the problem, the severity of the problem, and the age of the child. In an adult, a frontal headache can mean sinusitis. Kids under the age of seven haven't yet developed frontal sinuses, so a headache in a child of that age doesn't indicate sinusitis the way it can in a teen or adult. Younger children who have sinusitis typically develop symptoms similar to that of the common cold – like a stuffy or runny nose or a slight fever. Some may complain of ear pain, and it's not uncommon for an ear infection to co-exist with sinusitis.

Sinusitis Symptoms: Older Children

A cough that hangs around after a week of cold symptoms usually indicates a sinus infection in older kids and teens. Other signs of sinusitis in older children and teens are fever, foul-smelling breath, pain in the jaw, teeth or ears, and facial tenderness or pain behind the eyes. Chest congestion may occur and become worse as the infection progresses. Some teens will complain of headaches, an upset stomach, or nausea.

Pediatric Sinusitis Treatment

The treatment of a pediatric sinusitis depends on the cause. If the indications are that a bacterial infection is causing the sinusitis, the doctor will often wait a few days to see if the child can fight off the infection, as frequent antibiotic use increases the risk of drug-resistant bacteria. If symptoms worsen or don't get better after about three days, the doctor will usually prescribe antibiotics. Decongestants and antihistamines may help decrease swelling and relieve congestion. In most cases, a viral sinusitis goes away on its own, and supportive care is all that's necessary. Fungal sinusitis is much less common and usually occurs in patients who are immunocompromised; surgery is required, along with antifungals and steroids.

In dealing with children's sinus problems, parents should seek care from an ENT doctor (otolarygngologist) if the cold lasts more than 10 days, gets worse after a week, or when symptoms of allergies don't respond to the usual treatments.

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