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Sinuses are hollow spaces in the bones of the face. Healthy sinuses constantly produce and drain mucus, which helps keep the nasal passages clean. But an underlying problem can prevent sinuses from draining properly. This can lead to sinusitis (sinus inflammation and infection). Sinusitis can be acute or chronic. Acute sinusitis comes on suddenly, often after a cold or flu. When acute sinusitis doesn’t go away or comes back often, it’s said to be chronic. Long-lasting sinusitis is usually due to allergies or a physical blockage in the nose.
These problems can lead to sinusitis:
Upper respiratory infections: A cold or flu can cause the sinuses and nasal linings to swell. This blocks the sinus openings, allowing mucus to back up. The pooled mucus can then become infected with germs (bacteria or viruses).
Allergic reactions: Sensitivity to substances in the environment such as pollen, dust, or mold causes swelling inside the sinuses. The swelling prevents mucus from draining.
Obstructions in the nose: A polyp or deviated septum can cause sinusitis that doesn’t go away. A polyp is a sac of swollen tissue, often the result of infection. It can block the tiny opening where most of the sinuses drain. It can even grow large enough to block the nasal passage. The septum is the wall of cartilage (tough connective tissue) that divides the nasal cavity in half. When this wall is crooked (deviated), it can prevent the sinuses from draining normally.
Obstructions in the throat: The adenoids and tonsils are masses of tissue in the throat. As part of the immune system, they help trap bacteria and other germs. But the tonsils and adenoids themselves can become inflamed or infected. They can then swell, blocking the normal drainage of mucus.
Thick yellow or discolored discharge lasting 10–14 days
Nasal congestion that causes your child to mouth breathe, especially at night (colds and other health problems can also cause mouth breathing)
Pain and pressure around the eyes, nose, cheeks, or forehead
A cough that lasts more than 7 days
Postnasal drip (thick mucus draining down the back of the throat)
Your child’s doctor will ask about your child’s health history and perform a physical exam. During the exam, the doctor checks your child’s ears, nose, and throat and looks for signs of tenderness near the sinuses. Your child may have tests to check for bacteria, allergies, or polyps. X-rays or CT scans may also be done. In some cases, your child may be referred to an ear, nose, and throat (ENT) specialist. If so, the ENT doctor may use an endoscope (a long, thin instrument like a telescope) to look into the sinus openings.
Acute sinusitis often gets better on its own. When it doesn’t, your child’s doctor may prescribe:
Antibiotics: If your child’s sinuses are infected with bacteria, antibiotics are given to kill the bacteria.
Allergy medications: For sinusitis caused by allergies, antihistamines and other allergy medications can reduce swelling.
Note: Do not use over-the-counter decongestant nasal sprays to treat sinusitis. They may make the problem worse.
If sinusitis doesn’t go away or comes back, your child’s doctor may try:
A change in medication: Your child may need a longer course of treatment or a different antibiotic.
Allergy shots (immunotherapy): Allergy shots may help reduce your child’s sensitivity to allergens such as pollen, dust mites, or mold.
Surgery: Surgery may be done to remove a nasal polyp, clear a blockage, or take a small sample of tissue from your child’s nose.
Sinus infections caused by bacteria may be treated with antibiotics. To use them safely:
It may take 5-7 days for your child’s symptoms to start to improve. If your child doesn’t get better after this time, call your child’s doctor.
Be sure your child takes ALL the medication, even if he or she feels better. Otherwise, the infection may come back.
Be sure that your child takes the medication as directed. For example, some antibiotics should be taken with food.
Ask your child’s doctor or pharmacist what side effects the medication may cause and what to do about them.
Many children with sinusitis get better with rest and the following care:
Plenty of fluids: A glass of water or juice every hour or two is a good rule. Fluids help thin mucus, allowing it to drain more easily. Fluids also help prevent dehydration.
Saltwater wash: This helps keep the sinuses and nose moist. Mix a teaspoon of salt in 8 ounces of distilled water. Use a bulb syringe to gently squirt the water into your child’s nose.
Warm compresses: Apply a warm, moist towel to your child’s nose, cheeks, and eyes to help relieve facial pain.
Colds, flu, and allergies can lead to sinusitis. To help prevent these problems:
Teach your child to wash his or her hands correctly and often. It’s the best way to prevent most infections.
Make sure your child eats nutritious meals and drinks plenty of fluids.
Keep your child away from people who are sick, especially during cold and flu season.
Ask your child’s doctor about allergy testing for your child. Take steps to help your child avoid allergens to which he or she is sensitive. Your child’s doctor can tell you more.
Don’t let anyone smoke around your child.
Use warm water and plenty of soap. Work up a good lather.
Clean the whole hand, under the nails, between fingers, and up the wrists.
Wash for at least 10–15 seconds (as long as it takes to say the ABCs or sing “Happy Birthday”). Don’t just wipe—scrub well.
Rinse well. Let the water run down the fingers, not up the wrists.
In a public restroom, use a paper towel to turn off the faucet and open the door.
It’s important to find and treat the underlying cause of sinusitis in children. In rare cases, the infection from sinusitis can spread to the eyes or brain. If your child has allergies or asthma, talk with your doctor about treatment options. Tell your child’s doctor if your child gets more colds or flu than normal.
Your child’s symptoms worsen or new symptoms develop
Your child has trouble breathing
Symptoms don’t improve within 5–7 days after starting antibiotics
A skin rash, hives, or wheezing develops: these could signal an allergic reaction