Rodney Lusk, M.D.
The term that we use for sinusitis in children is rhino sinusitis, which really means nasal sinus disease, and that means that it starts off in the nose and goes off into the sinuses. It is most frequent in the younger children from 3 to 8 years of age, but we see chronic sinusitis in all age groups.
What causes pediatric sinusitis?
Children have more of a problem with recurrent infections for several reasons. One is they have an amateur immune system, and particularly all babies have an amateur immune system. The opening of the sinuses is smaller, and the amount of swelling associated with an infection is about the same, so the openings close off more frequently, and that predisposes them for recurrent sinus infections.
What are the symptoms of pediatric sinusitis?
Nasal congestion, some form of pussy type discharge from the nose. It’s frequently associated with coughing. It may or may not be associated with fever. Fever is actually fairly uncommon with chronic sinusitis or acute sinusitis.
What are the treatment options for pediatric sinusitis?
Most of them are viral and 80 percent of them are going to clear on their own without any antibiotics. That’s one of the reasons why pediatricians, ENT doctors, and family practice will hold off on giving antibiotics for a good seven to nine days. Other majors that we can use to treat sinusitis are nasal irrigations if the children will cooperate. Occasionally, if there is a lot of inflammation or it’s a recurrent infection we will add on topical nasal steroid sprays. These are very safe, they are not absorbed systemically, and they cut down on inflammation that’s on the inside of the nose.
When does surgery become an option?
When the children have recurrent sinus infections and they are on multiple courses of antibiotics, somewhere around four or five in a six month period or six or seven in a year, then we would consider doing something else. That something else is initially an adenoidectomy. There is now good evidence that an adenoidectomy will clear up 60-70 percent of the children that have chronic sinusitis.