Sinusitis is a medical condition which refers to the inflammation of the sinuses around the nose (the paranasal sinuses). The paranasal sinuses are air-filled pockets - within the bones of the face and skull - which are found near the nose. They include the maxillary, ethmoid, frontal and sphenoid sinuses. Sinusitis results from bacterial, fungal and viral infections of these air spaces, and from allergies and autoimmune disorders that affect the sinuses. Sinusitis in children usually occurs after a cold or allergic inflammation of the nose.

Causes of Sinusitis in Children

1.       Infections for example, a common cold or sore throat; or from a dental infection or infected adenoids

2.       Allergies

3.       Abnormally narrow sinus passages and abnormal nasal structures

4.       Foreign objects stuck in the nose

5.       Congenital deformities like a cleft palate

6.       Trauma (injury to the nose)

7.       Diving and swimming

8.       Autoimmune conditions that cause inflammation in the body

9.       Air pollution from dust, smoke, chemical sprays, and so on

10.   Overuse of nasal decongestants

Types of Sinusitis in Children

1.       Maxillary sinusitis

2.       Ethmoid sinusitis

3.       Frontal sinusitis: This only occurs in children 7 years of age or older as this sinus does not develop until then.

4.       Sphenoid sinusitis: This occurs in children around adolescence as the sphenoid sinus does not develop until then.

Sinusitis can be acute, sub-acute or chronic. Acute sinusitis is usually caused by an infection of viral or bacterial origin and improves quickly with treatment. A Sub-acute sinusitis is an acute sinusitis that does not respond to treatment initially but lasts less than three months. Chronic sinusitis is usually due to a combination of causative factors such as allergy, infection, abnormally narrow sinus passages, and other causes. Chronic sinusitis lasts for longer than three months.

Symptoms of Sinusitis

1.       Blocked and runny nose which lasts for longer than a week. The discharge may be clear or purulent (green or yellow)

2.       Headaches. Children younger than 5 years do not have these headaches

3.       Breathing through the mouth

4.       Swelling around the eyes which is usually worse in the mornings

5.       Cough

6.       Bad breath, usually in older children

7.       Fever

8.       Sore throat

9.       Drip in the back of the mouth or throat

10.   Pain and facial discomfort

11.   Reduced sense of smell and/or taste

12.   Difficulty eating

13.   Feeling irritable or tired

Treatment of Sinusitis in Children

1.       Antibiotics to treat bacterial infection. This depends on the age of the child

2.       Pain relievers such as aspirin or acetaminophen. This also depends on the age of the child

3.       Steroid nasal spray to reduce the inflammation

4.       Saltwater nasal spray or drops which may help relieve the symptoms by thinning the mucus in the nose

5.       Decongestants which reduce the swelling the nasal passages

6.       Mucolytics such as Robitussin (brand name) to thin the mucus and improve nasal drainage

7.       Antihistamines to treat allergies. These should be used with caution, they can cause excessive drying of the nasal membranes

8.       Nasal irrigation by a physician

9.       Surgery: This may be required in some cases

Some children with acute sinusitis get better without treatment. Use of a warm compress over areas of the face that are painful can provide relief in some children. The use of a cool mist humidifier in a child’s room can also relieve symptoms.