Sinusitis

A child’s sinuses are not fully developed until age 20. Although small, the maxillary (behind the cheek) and ethmoid (between the eyes) sinuses are present at birth.

Rhinosinusitis in children is common and will usually last a few days to weeks following an upper respiratory tract infection (URTI). You may feel that your child has a constant cold during the first few years of life. This is understandable as the average child under the aged five years or under will have approximately 6-8 URTI’s every year. These are most frequently caused by viral infections (colds), and they may be aggravated by allergies. However if the symptoms last longer, a sinus infection is likely.

Common symptoms include a “cold” lasting more than 10 to 14 days, sometimes with a low-grade fever, thick yellow-green nasal drainage, post-nasal drip, sometimes leading to or exhibited as sore throat or cough, headache, irritability or fatigue and swelling around the eyes.

Reassurance is frequently all that is required. Where the discharge is extremely problematic and is affecting the child’s every day quality of life the use of topical saline spray or drops may prove helpful. In more prolonged cases sometimes oral antibiotics or short course of steroid nasal drops or spray may be recommended. One should consider the diagnosis of allergic rhinitis as an underlying factor and thus the child may require prolonged anti-allergic treatment.

Where medical and conservative measures have failed surgery may be considered in a small percentage of children. Prior to this, we would examine the nose with an endoscope and a CT scan may be required. Surgery would include endoscopic sinus surgery (FESS), to open up the blocked sinus openings and maybe an adenoidectomy, as enlarged adenoids can contribute to the development of sinusitis and cause many of the symptoms that are similar.

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