Chronic Sinusitis: Signs, Symptoms And Treatment

If your child has persistent colds accompanied by headaches and pain on the face, she could be suffering from chronic sinusitis. Here’s what you can do to help.

By Dr Asmita Mahajan

Chronic Sinusitis: Signs, Symptoms And Treatment

Ten-year-old Ruchika suffered from headaches whenever she caught a cold. Initially, her mother dismissed it, thinking it must be due to the cold. But when the headaches started becoming severe, she took Ruchika to the doctor. After a complete check-up, the doctor said Ruchika was suffering from chronic sinusitis, which was why she was getting the throbbing headaches.

What are sinuses?

Sinuses are air-filled cavities just above and on both sides of the nose. They are positioned under, above, in between and behind the eyes. They are of different sizes and are interconnected. Like the nose, these cavities are lined by a mucous membrane. All the sinuses are not present at birth. Some form as children grow older and development is complete only in the teens.

Chronic sinusitis

Most viral infections of the upper respiratory area involve the nose and the sinuses around it. On an average, children have six to eight episodes of upper respiratory infections per year. When inflammation of the paranasal sinuses lasts more than 90 days, the condition is called chronic sinusitis. Those suffering from it have persistent symptoms such as cough, runny nose or nasal obstruction.

Signs and symptoms

Here are some symptoms that could tell you that your child is suffering from chronic sinusitis:

  • Cold lasting more than 10 to 14 days, accompanied by low-grade fever
  • Thick yellow-green discharge from the nose
  • Painful areas on the face
  • Thick mucus running from the nose to the back of the throat – it’s called ‘post-nasal drip’
  • Night time cough and sore throat
  • Nausea and /or vomiting
  • Swelling around the eyes
  • A severe headache behind or around the eyes that gets worse when bending over
  • Persistent bad breath along with cold symptoms

Caution: In very rare cases, a bacterial sinus infection may spread to the eye or the central nervous system. Watch out for symptoms like pain in the neck and sensitivity to light.

Treatment

Sinusitis, even chronic sinusitis, can be treated. Here are some steps your child’s doctor may take:

1. Antibiotics: Antibiotics may be prescribed if the child has high fever or the symptoms become severe. The course of medicine may last from 10 to 14 days. The doctor may give some pain medication as well.

Tip: To treat a headache or sinus pain, place a warm towel on your child's face for a few minutes at a time.

2. Saline nose drops: If the secretions in your child's nose are especially thick, your paediatrician may recommend saline nose drops.

Caution: Do not use medicated nose drops, if the doctor doesn’t prescribe it as there can be side effects.

3. Antihistamines: Your child’s paediatrician may prescribe antihistamines, if the complaint of chronic sinusitis is the result of an allergy.

Note: An allergist or immunologist may help to diagnose this.

4. Steroids: The doctor could prescribe some ointment containing corticosteroids that can be applied externally on the affected areas to provide relief from inflammation, as part of the efforts to manage chronic sinusitis. This may have to be applied for up to three months.

Note: It will take two weeks for this ointment to start taking effect. So, be patient.

5. Surgery: If the child is suffering from certain medical conditions like deviated nasal septum, adenoids or polyps, the doctor may decide to go in for a procedure called endoscopic sinus surgery.

What you can do at home

1. Cool-mist humidifier: Placing a cool-mist humidifier in your child's room may help keep him comfortable. The humidifier should be cleaned and dried every day, as per the company’s instructions, to prevent bacteria or mould from growing in it.

2. Steam inhalation: This can be used to help relieve symptoms in an older child. But take care that the steam doesn’t harm her.

Caution: Hot water vaporisers are not advisable because they can cause injuries or burns in children.

3. Saline nasal irrigation: This is a process of washing out the nasal cavity with a salt-water solution. It will bring the mucus out quickly. However, you need to consult your doctor before using it, and it should be done with care. The practice should not be continued for more than three or four days, as it can cause rebound congestion.

The next time your child catches a cold, do check for the symptoms of chronic sinusitis as well. It can be troublesome, but timely diagnosis and proper treatment can provide relief to a great extent.

The author is a Consultant Neonatologist and Paediatrician at a leading hospital. 

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