“Sinusitis” means inflammation of the sinuses, whether caused by a virus, bacteria, or fungus. Based on the frequency of diagnosis, sinus infections are one of the most common reasons for patients to present to a primary care office. A child’s sinuses are anatomically different than an adult’s sinuses. Although very small, the maxillary (behind the cheek) and ethmoid (between the eyes) sinuses are present at birth, but the frontal and sphenoid sinuses develop later. A child’s sinuses reach full development in the late teen years.
Sinusitis is often diagnosed based on the history of the child’s symptoms and should include a complete ear, nose and throat exam. Sinusitis in children may present differently than it does 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. Often, sinusitis symptoms may mimic those of allergies or colds, sometimes making it difficult to differentiate it from less significant simple upper respiratory tract viral illnesses. Our doctors consider factors that make your child more likely to get sinus infections, including structural changes, allergies, and problems with the immune system.
Occasionally, special instruments may be used to look into the child’s nose during the exam. The exam can identify conditions that inhibit sinus drainage, such as polyps, enlarged turbinates (shelves of thin bone on the side wall of the nose), a deviated septum, or mucosal swelling from allergies, colds or inhaled irritants. When there is a need to confirm a diagnosis or to plan a surgical treatment, a CT scan of the sinuses may be needed.
Treatment: Medical and Surgical
Once the diagnosis of sinusitis has been made, most children are successfully treated with antibiotic therapy. If your child has acute sinusitis, symptoms should improve within the first few days of antibiotic treatment (but all prescriptions should be completed as prescribed even after symptoms subside). Not all cases of acute sinusitis, however, resolve so easily. If your child suffers from one or more symptoms of sinusitis for at least 12 weeks, he or she may have chronic sinusitis. Chronic sinusitis, or recurrent episodes of acute sinusitis numbering more than four to six per year, may indicate a potential need to surgically treat the underlying problem. When prolonged medical therapy fails, endoscopic surgery may be recommended to help open the normal drainage pathways of the sinuses.
Image Guided Surgery
Since the sinuses are physically close to the brain, eyes and major vessels, a new technology, image guided endoscopic surgery, assists in alleviating the concern of injury during surgery. Image guidance surgery may be recommended for severe forms of chronic sinusitis, in cases when previous sinus surgery has altered anatomical landmarks, or where a patients sinus anatomy is very unusual, making typical surgery difficult. Image guidance is a near-three-dimensional mapping system that combines computed tomography (CT) scans with infrared signals to provide real-time information about the exact position of the surgical instruments. With this technology, our surgeons can navigate through complex sinus passages and provide precise surgical relief. More info.