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Sinusitis in children
Published by Bupa's health information team, March 2008.
This factsheet is for parents of children who have sinusitis or for people who would like information about it.
Sinusitis is inflammation of the linings of the sinuses that surround the nose. Common symptoms include a blocked or runny nose and a sore throat. It's often caused by an infection.
The sinuses are air-filled spaces behind the bones of your child's face and forehead that open up into the nose cavity. They are lined with the same membrane as the nose. This is called the mucous membrane and it produces a slimy secretion called mucus to keep the nasal passageways moist and to trap dirt particles and bacteria.
Your child has four main sets of sinuses, which will develop throughout childhood and adolescence. Your child's sinuses are not fully developed until age 20.
The maxillary sinuses are in each cheekbone.
The frontal sinuses are on either side of his/her forehead, above his/her eyes.
The smaller ethmoid sinuses are behind the bridge of his/her nose, between his/her eyes.
The sphenoid sinuses are between the upper part of his/her nose and behind his/her eyes.
The location of the frontal, ethmoid and sphenoid sinuses
What is sinusitis?
Sinusitis is inflammation of the mucous membranes of one or more of your child's sinuses.
If your child's sinusitis lasts anything from a few days up to a month it's called acute sinusitis. If it's an ongoing problem lasting three months or more it's termed chronic sinusitis. The medical terms acute and chronic refer to how long the condition lasts for, rather than how severe it is. Chronic sinusitis is relatively rare in children. If your child has symptom-free intervals between bouts of sinusitis then this usually means they have recurrent acute sinusitis rather than chronic sinusitis.
A maxillary sinus
Children often have some different symptoms to those experienced by adults. If your child has sinusitis, his/her symptoms may include:
a blocked or runny nose with green or yellow mucus, which can drain down the back of your child's nose into his/her throat and may cause a sore throat and cough
breathing through his/her mouth
a low fever
bad breath (halitosis)
feeling irritable or tired
having difficulty eating
On very rare occasions, a sinus infection can spread to the facial bones or the membranes lining the brain. Also very rarely, sinusitis can spread to form a pocket of pus (abscess) in the eye socket or the facial bone. If your child develops eye lid or cheek swelling you should take him/her to see a GP immediately.
Sinusitis is often caused by an infection of the mucous membranes with a virus, bacterium or fungus. Most bouts of acute sinusitis are caused by an infection such as a cold.
The mucus that is produced by the mucous membranes in the sinuses normally drains into his/her nose through small holes called ostia. The ostia can become narrow or even blocked if the sinuses get infected and inflamed so the mucus cannot drain properly.
This can also happen if your child's sinus membranes are irritated by something. Examples of irritants include:
airborne allergens such as grass and tree pollen
smoke and air pollution
sprays containing chemicals (eg household detergents)
overuse of nasal decongestants
Chronic sinusitis can be caused by anything that constantly or regularly irritates the lining of the nose and so results in inflammation of the mucous membranes. Children who have allergy-based asthma often have chronic sinusitis as well.
In some children, sinusitis is the result of a structural blockage, such as enlarged adenoids, or a specific medical condition such as cystic fibrosis.
Your child's GP will examine your child and will ask questions about his or her symptoms. The GP will usually be able to diagnose sinusitis just from his or her examination and no further medical tests are usually needed.
However, your child's GP may refer him/her to a doctor who specialises in ear, nose and throat conditions if further tests are needed. These may include a nasendoscopy where your child's doctor will insert a small, flexible tube with a light and a camera lens at the end (endoscope) into your child's nostril to examine the inside of the sinuses. He or she will look through this and the image will usually be projected onto a video screen. A nasendoscopy is performed under local anaesthesia, which completely blocks the feeling in the sinus area and your child will stay awake during the operation.
In some cases, the doctor may do a computerised tomography (CT) scan of your child's sinuses. A CT scan uses X-rays to build up a three-dimensional picture of the sinuses.
Most children with acute sinusitis get better without treatment.
If your child's symptoms don't get better within 10 days or if the symptoms appear to be getting worse, you may wish to visit your child's GP.
Your GP may prescribe a topical nasal steroid spray to help relieve your child's symptoms, particularly if he or she also has an allergy or has enlarged adenoids which are making the sinusitis worse. Alternatively, the GP may prescribe antibiotics if your child has a bacterial infection.
Saltwater nasal drops or sprays may help to relieve your child's symptoms by thinning the mucus in the nose. These are available from a pharmacy without prescription.
Some children find that applying a warm compress on the areas of the face that are painful, and sleeping with their head and shoulders propped up with pillows provides relief. However, there is no scientific evidence that this cures the problem.
Occasionally, surgery may be considered. A nasal endoscopy can help to improve sinus function as well as being a way of looking at the sinuses. A doctor who specialises in ear, nose and throat surgery will use an endoscope to wash out your child's sinuses and widen the drainage holes. This procedure is known as functional endoscopic nasal surgery. This can be done under a local or a general anaesthetic. A general anaesthetic means that your child will be asleep throughout the procedure.
It's a routine and generally safe procedure. For most, the benefits are much greater than the disadvantages. However, all surgery carries an element of risk. In order to make an informed decision and give consent on behalf of your child, you and your child will need to be aware of the possible side-effects and complications. Complications can include minor damage to the lining of the nose or sinuses, or damage to the skull bone.
There are a number of things you can do to help prevent your child from getting sinusitis.
Teach your child to blow his/her nose properly. When mucus is left in the nose it can get infected.
Reduce his/her exposure to environmental allergies that you know affect your child. Keep his/her allergy symptoms under control - ask your doctor or pharmacist for advice.
Reduce his/her exposure to pollutants such as cigarette smoke.
Ensure your child has good general health by encouraging him/her to eat healthily and take regular exercise.
- The British Association of Otorhinolaryngologists (ENT UK)
020 7404 8373
- Sinusitis. ENT UK. www.entuk.org, accessed 24 May 2007
- Sinusitis. Clinical Knowledge Summaries - UK Department of Health. www.cks.library.nhs.uk, accessed 23 May 2007
- Ah-See K, Evans AS. Sinusitis and its management. BMJ 2007; 334:358-361
- Sinusitis infection. National Institute of Allergy and Infectious Diseases, National Institute of Health, US department of health and human services. www.niaid.nih.gov, accessed 23 May 2007
- Collier J, Longmore M, Scally P. Oxford Handbook of Clinical Specialities. 6th ed. Oxford: Oxford University Press, 2003
- Sinusitis. Medline Plus. www.nlm.nih.gov/medlineplus, accessed 29 May 2007
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: March 2008