Rhinosinusitis in children is different than rhinosinusitis in adults. Children more often demonstrate a cough, bad breath, crankiness, low energy, and swelling around the eyes along with a thick yellow-green nasal or post-nasal drip. In acute rhinosinusitis, children will often have pain and typically have a fever and purulent nasal discharge. In chronic rhinosinusitis, pain and fever are not evident. Some children may have mood or behavior changes. Most will have a purulent, runny nose and nasal congestion even to the point where they must breathe through their mouths. The infected sinus drains around the eustachian tube, and therefore many of the children will also have a middle ear infection.
For the first six months or so, infants enjoy the protection of the mother’s immune system. After this grace period, young children are very prone to infections of the ear, nose, sinuses, and throat. These are most frequently caused by viral infections (colds), and they may be aggravated by allergies.
Studies suggest that the average child can get up to eight colds per year. These occur more frequently in the winter months and can last up to ten days. This means a normal child, especially if they are in a large day care, could potentially be sick almost half of the winter. Secondhand smoke and a family history of allergies seem to be additional risk factors for this scenario.
Keeping these facts in mind, we see lots of children who suffer from far too many sinus issues. Fortunately, we offer a multidisciplinary Pediatric Center to diagnose and treat these children appropriately.
Small anatomy combined with enlarged tonsils and adenoids make for overall tight spaces and may predispose children to blockage and subsequent infections.
Most children with acute rhinosinusitis respond very well to antibiotic therapy.
Although there are always exceptions, it is rare in children to have a lot of inhalant allergies.