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Sinusitis

sinus; sinusitis; facial; bones; nose; spray; nostril; para-nasal; maxillary; ethmoid; frontal; infectious; diseases; adenoids ;

Sinusitis is an infection in small air spaces (sinuses) in the bones of the face, mostly around the side and back of the nose and in the forehead. Many children get sinusitis when they have a cold. Usually the infection goes away within a week or so, but sometimes it can last for many weeks.

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What is sinusitis?

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  • There are air spaces (para-nasal sinuses) in the bones of the face which open into the nose.
    • They warm and dampen the air as we breathe in so that it is not too cold and dry for the lungs.
    • They are also lined with cells that make mucus. Mucus traps particles of dirt and bacteria, helping to protect us from some infections.
  • There are several groups of sinuses including some just below the eye sockets (maxillary sinuses), some at the back of the nose (ethmoid sinuses) and some in the middle of the forehead (frontal sinuses).
  • All these sinuses are present at birth although most are very small. They grow during childhood and reach adult size by age 14.
  • Sinusitis is common and happens after 5 to 10% of 'colds', even in young children.
  • Chronic sinusitis (sinusitis that does not clear up quickly) can (very rarely) lead to infection of the bones of the face.
  • Treatment with antibiotics when needed, has meant that now far fewer people get complications from sinusitis.

Causes of sinusitis

  • Usually sinusitis follows a cold.
    • The child will have the normal symptoms of a cold (runny nose, blocked nose and sneezing).
    • The cold causes the lining of the nose and sinuses to swell, and fluid (mucus) gets trapped in the sinuses.
    • Bacteria (germs) can grow in this fluid, causing sinusitis.
  • Children who get hayfever are more likely to get sinusitis.
  • Sometimes sinusitis is caused by chemical irritation (eg from a swimming pool).
  • Large adenoids make it more likely that a child will get sinusitis because they can block the openings from the sinuses into the nose.
  • Children exposed to cigarette smoke (passive smoking) are also more likely to get sinusitis.

Symptoms of sinusitis

  • If the runny nose of a 'cold' lasts more than a few days this may mean that the child has sinusitis. The mucus from sinusitis is usually yellow or green.
  • Other signs in young children include a blocked nose, breathing through the mouth, cough (at night and during the day), swelling around the eyes, bad breath and sometimes the child may complain of a headache. The child may also have a fever.
  • Older children, adolescents and adults, may also complain of headache, or aching of the face and teeth, and it can hurt if they are touched on the face over where the sinuses are.

Important note

When only one side of the nose is running, it may mean that the child has pushed something into his nose and it has got stuck there. The mucous may be very smelly.

What parents can do

  • The main treatment of sinusitis is antibiotics, so you need to take your child to a doctor. (Note: without treatment the child will recover unless there are other problems present, but it will take longer than with antibiotics and you need the doctor to check whether there are any other problems.)
  • Cough and cold medicines such as decongestants should not be given to children under 6 years of age. They should only be given to children aged 6 to 11 years on the advice of a doctor, pharmacist or nurse practitioner. The benefits have not been proven and they can have upsetting side-effects such as irritability, restlessness, difficulty with sleeping, or drowsiness depending on which is used. Decongestant medicines do not seem to prevent ear infections.
  • Paracetamol or ibuprofen can help with pain. (Do not give aspirin to children!) See 'Using paracetamol or ibuprofen'.
  • Breathing in heated oils (such as eucalyptus oil) may help the child feel better for a while, but it probably does not work very well, and there is a danger of scalds.
  • Some adults need to have an operation for chronic sinusitis, but this is rarely needed for children.

The topic 'Feeling sick' has suggestions for caring for a sick child.

References

Australian Government - Therapeutic Goods Administration 'Children's cough and cold medicines - TGA advice' 15 August 2012 
http://www.tga.gov.au/industry/otc-notices-cough-cold-review-outcomes.htm

Better Health Channel (Victoria) 
http://www.betterhealth.vic.gov.au/ 

Raslich MA, 'Sinusitis' in Garfunkel et al (Eds) 'Pediatric Clinical Advisor' Mosby 2007

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The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).

This topic may use 'he' and 'she' in turn - please change to suit your child's sex.

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