Sinusitis is the inflammation of one or more of the sinuses that drain into the nose. In children, a common cold or viral infection is the most common event that may lead to a sinus infection. Also, foreign bodies, such as food or a toy, pushed into the nose, may cause a nasal infection.
When a viral infection begins, the lining of the sinuses becomes swollen, blocking the passage where normal sinus mucus drains. This results in a backup of mucus that cannot get out of the sinuses. When this mucus remains in the sinuses too long, it can become infected. This secondary infection can produce further inflammation and worsening or prolonging of nasal symptoms.
The symptoms of acute sinusitis may include:
- General fatigue
- Nasal congestion
- Pain or pressure in face and sinuses
- Runny nose with thick drainage (bacterial infections are suspected with progressive to persistent discolored drainage)
Your child’s ENT doctor inserts a thin, flexible tube (endoscope) with a tiny camera attached to a high definition monitor, to visually inspect the inside of the sinuses to help determine the cause of the sinusitis. This test is more likely to be used in the case of chronic sinusitis.
Images obtained from computerized tomography (CT) scan or magnetic resonance imaging (MRI) can help your child’s doctor see details of your child’s sinuses and nasal passages. Note that a child’s sinuses tend to develop with age. At birth, only the ethmoid and maxillary sinuses are developed. The frontal and sphenoid sinuses don’t develop until late childhood to early adolescence.
Scans are more likely to be used in the case of chronic sinusitis, and not for an acute viral upper respiratory infection or acute bacterial sinusitis. In most cases, a CT scan is the preferred scan for chronic sinusitis, whereas an MRI is the preferred scan if tumor or other lesions are suspected.
Nasal and Sinus Cultures
When your child’s sinusitis is long lasting and does not respond to medical treatment, your ENT specialist may recommend taking a culture (mucus or tissue sample) from the nasal area or sinuses to further assess the condition and determine next steps for treatments, such as a different antibiotic medication.
If your child’s ENT specialist thinks that allergies may play a role in their chronic sinusitis or chronic rhinitis (inflammation of the nose only), they may order an allergy skin test or consult an allergist. This test may help pinpoint the allergen that’s causing your child’s nasal inflammatory condition or worsening their chronic sinusitis or asthma.
Your child’s ENT doctor may recommend a prescription or over-the-counter medication to help ease the symptoms or treat the underlying cause of the sinusitis. If bacteria caused the infection, antibiotics can treat that bacteria.
Generally, if symptoms due to viral upper respiratory infection progress or worsen after 10 days, or discolored mucous progresses or worsens over five days, a bacterial infection is suspected, and antibiotics are usually in order. In general, we try to avoid prescribing antibiotics as much as possible for viral URIs, so as to reduce the chance of growth of antibiotic-resistant organisms over time.
Nasal decongestant sprays can be used to treat nasal stuffiness, though they should not be used longer than three days. With long-term use of nasal decongestant sprays, the nose can become dependent on them, causing turbinate enlargement. Nasal stuffiness can worsen, ultimately requiring turbinate surgery.
Your child’s ENT specialist may recommend a nasal/sinus irrigation to treat the sinusitis as an initial treatment, with other over-the-counter medications to reduce inflammation and congestion.
With recent advances in technology, ENT surgeons can now perform endoscopic sinus surgery entirely through the nose in children without face or mouth incisions. Alternately, your child’s ENT specialist may recommend sinus surgery using a balloon catheter to help manage select patients with chronic sinusitis. Although rarely necessary, when minimally invasive surgery is not an option, the ENT surgeon may need to perform sinus surgery via an external approach.
Why Choose UHealth?
Ranked No. 28 in the nation according to U.S. News & World Report. The ranking reflects the team’s dedication to excellence in research patient care and outcomes. Surgeons, audiologists, biomedical engineers, speech pathologists, researchers, and psychologists collaborate with many research programs at the University of Miami Miller School of Medicine to deliver the best possible multidisciplinary care to pediatric and adult ear, nose, and throat patients.
Highly specialized rhinology doctors. The experts at University of Miami Health are here to help you breathe easier, smell better, and rest better with an accurate diagnosis and leading edge treatments in a compassionate setting. Our fellowship-trained providers specialize in the nasal airway, and our rhinology specialists have completed specialized training in nasal and sinus disorders. They have dedicated their clinical and research careers to caring for nasal and sinus disorders.
Our academic health center provides you with more treatment options. Our ENT specialists are experts in the field of rhinology. As part of an academic health center, we are proud to offer breakthrough treatments not available to other facilities in South Florida. We also offer our patients early access to clinical trials and new medical and procedural treatments. We provide comprehensive care for a wide array of rhinologic conditions, backed by expertise, research, and education.
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