The sinuses are air-filled spaces within the bones of the face and skull. While your child is born with some of the sinuses, they are all not fully formed until about age 20.
Where are the sinuses? There is one located in the cheek bone, beneath each eye (maxillary sinus), a honeycomb of sinuses between the eyes (ethmoid sinuses), a sinus in the very back of the nose (sphenoid sinus) and in older children, sinuses in the bones of the forehead (frontal sinuses).
What is sinusitis? By definition, this means inflammation of the sinuses. Such inflammation can be due to multiple causes, including infection, allergies, exposure to chemicals or fumes, and even reflux. Other causes can include anatomic blockages that keep the sinuses from draining properly. Such abnormalities include a deviated septum, nasal polyps, and rarely nasal tumors or other rare conditions such as immune deficiency or cystic fibrosis.
Once blockage of the sinuses occurs, the natural drainage pathway can no longer allow natural mucus flow within the nose. At this point, the perfect environment exists for bacteria to take over, causing even more inflammation and the typical symptoms of sinusitis.
What are the symptoms of sinusitis? Symptoms include congestion, thick nasal drainage, headaches, and cough. Other symptoms may include post-nasal drip, facial swelling, bad breath, and vague behavioral changes. Sometimes, it can be difficult to tell the difference between sinus infection, a common cold, or nasal allergy. Typically, a cold will only last a week to 10 days, whereas a sinus infection may last longer. And while allergy can also cause nasal congestion and a runny nose, typically allergies have clear watery secretions, itchy watery eyes and nose, and often a longer duration. Allergies may change with the season or geographic location.
How can you help diagnosis sinusitis? Looking closely into the type and duration of symptoms and a physical exam are the tools that are often most useful to your doctor. When necessary, a closer look with an endoscope in the nose or possibly a CT scan may be needed.
How can sinusitis be treated? Depending on the root cause of the problem, medications are usually prescribed. These can be in the form of oral medications or nasal sprays. In addition, the use of nasal saline washes/sprays can be especially helpful. If all attempts at controlling your child's sinusitis with medications fail, sinus surgery or removal of the adenoids may be helpful.
Are there any dangers associated with sinusitis? Yes, but fortunately these are very uncommon. Rarely, a sinus infection can spread to the soft tissue around the eye (orbital cellulitis), to the bones of the face (osteomyelitis), or even the tissue and fluid surrounding the brain (meningitis or brain abscess). High fevers, stiff neck, or a bulging eye can all be danger signs that should be evaluated immediately.
The following are useful fact sheets regarding sinusitis in children: