Sinusitis in Children

 

What is sinusitis?

Sinuses are air pockets in the facial bones, located around the nose. The normal function of sinuses is not fully understood, but they may:

• • Lighten the skull
  • Resonate sound
  • Produce mucus and immune protection for the nasal cavity
  • Regulate the temperature and humidity of air entering the body

Normally, the mucus in the sinuses drains into the nasal cavity through small openings (ostia) in the sinus walls. This mucus is used to fight infections and clear foreign substances from the nasal cavity, down the throat, or out through the nose.

 

Causes of sinusitis:

Sinusitis occurs when the sinuses become inflamed and swollen, for example, during a cold or sinus infection caused by allergies, or when there is a foreign substance blocking the ostia. This blockage can cause a buildup of mucus in the sinuses, allowing bacteria or viruses to grow and infect the sinuses, leading to pus formation and more swelling. This condition is known as "sinusitis."

 

Symptoms of Sinusitis

There are various symptoms of sinusitis depending on which sinuses are inflamed and whether the condition is acute or chronic. The most common symptoms include nasal congestion, thick and discolored mucus, bad breath, headache, postnasal drip, frequent coughing, and sometimes nosebleeds, facial pain, toothache in the upper jaw, pressure in the sinuses, fatigue, and fever in acute cases.

 

Treatment for Sinusitis

The main principles of treatment for sinusitis include three major approaches:

 

1. The use of antibiotics to kill the infectious agents causing the sinusitis.
2. The reduction of inflammation in the sinuses to allow for proper drainage of mucus.
3. Avoiding irritants that can cause inflammation in the sinuses.

 

Antibiotics

1. The infectious agents that most commonly cause sinusitis are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. Antibiotics used to treat these infections include amoxicillin, amoxicillin/clavulanic acid, cefuroxime axetil, cefaclor, clarithromycin, and clindamycin. The choice of antibiotics will depend on the specific needs of the patient.

 

2. Antibiotics are typically prescribed for longer periods than those needed to treat respiratory infections, lasting up to 2-6 weeks, to ensure that the infection is completely eradicated and the sinuses have fully drained.

 

Reducing nasal swelling can be done by:

1. Rinsing the nose with saline solution.
2. Using nasal spray.

 

Rinsing the nose with saline solution can be done easily by:

 

1. Purchase 0.9% normal saline solution without added sugar or mix it yourself easily by using clean water (250 cc) and adding 1/2 teaspoon of clean salt.
2. Pour the saline solution into a clean glass.
3. Suck up the saline solution from the glass into a rubber bulb syringe or a 10 ml syringe.
4. Spray the saline solution into the nasal passage while leaning forward, hold your breath while spraying the solution into the nose.
5. Repeat until the saline solution is gone, practice once a day for 1-3 times.
6. Sometimes, a doctor may prescribe nasal spray or rinse to be used according to their instructions.

 

Avoiding Triggers

 

1. Some patients with sinusitis (up to 50%) may experience symptoms of sinusitis due to nasal allergies, which can cause nasal swelling and subsequent infection. These patients should avoid allergens such as dust mites, according to their doctor's recommendations.
2. Patients should avoid:

• Cigarette smoke
• Infections from people around them
• Being in crowded areas
• Swimming in non-standardized pools, etc.

Following up with treatment is crucial. Patients should come for regular evaluation appointments as scheduled by their doctor.

 

Best regards,

Pediatric Department, Vibhavadi Hospital.