ENT Problems - Sinusitis

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What are the sinuses?
The sinuses are air filled cavities located in the bones of the face. The sinuses are divided into groups based on their location and are named maxillary, ethmoid, frontal and sphenoid sinuses.

What is sinusitis?
Sinusitis refers to inflammation, swelling, and/or infection of the sinuses. Depending on the age of your child, this may occur in the pair of sinuses located between the eyes (ethmoid) and/or the pair behind the cheekbones (maxillary), as both of these sinuses are present at birth. It can be acute, in which the sinuses fill up with pus. Children in these cases often have cold-like symptoms for more than 10 days and may complain of facial or tooth pain. Sinusitis can also be chronic, in which the lining of the sinuses start to thicken. Chronic sinusitis may have an infectious component with bacteria in the sinuses, but it can also be present without true bacterial infection. Many of these children have symptoms of nasal obstruction and drainage which can last for months.

What are the symptoms of sinusitis?
The following symptoms may indicate a sinus infection in your child:

  1. A cold which is lasting more than 10-14 days often with low grade fever.
  2. A stuffy nose or runny nose often with thick drainage.
  3. Post nasal drip which causes frequent throat clearing, sore throat, cough and bad breath.
  4. Headache usually in children six or older.
  5. Irritability or fatigue.
  6. Swelling around the eyes

Remember, the common cold will have many of the same symptoms, however, if your child remains ill beyond 7-10 days it is possible things have progressed to a sinus infection.

What causes sinusitis?
Sinusitis is usually caused by an infection within the sinus cavities. Anything which causes blockage of the natural drainage openings of the sinuses can lead to infection. This means colds, flu, allergies, or bacteria can all be responsible. Blockage may also occur from polyps which may be caused by allergies or chronic infection. Once blockage of the natural drainage passageways has occurred, mucus builds up behind the blockage. This may lead to inflammation and eventually infection of the trapped mucus, otherwise known as acute sinusitis.

How is sinusitis diagnosed?
Your doctor will diagnose sinusitis based mainly on your child's clinical history. Sinusitis is also diagnosed by how long symptoms last. If your child has a simple cold or flu, symptoms will usually last from 7-10 days. If the symptoms described above persist beyond 10-14 days, it is possible that sinusitis has developed. Sometimes X-rays and CAT scans are used to evaluate the sinuses as well, but these are not always needed to make a diagnosis.

How is sinusitis treated?
For a bout of acute sinusitis most children respond very well to antibiotics. Nasal decongestants or topical nasal sprays may also be prescribed for short-term relief of nasal stuffiness. Saltwater drops or spray can be helpful in thinning secretions and improving mucous membrane function. If the sinusitis seems to be linked to an allergic condition, your doctor may decide to involve an allergy specialist so that any underlying allergies can be treated. If your child has acute sinusitis, symptoms should start to improve within the first few days. Even if your child improves dramatically within the first week of treatment, it is important that you continue therapy until all the antibiotics have been taken.

When is surgery necessary for sinusitis?
Surgery is considered for a very small percentage of children with severe or persistent sinusitis symptoms despite prolonged medical therapy. In these cases, often a simple adenoidectomy can dramatically improve a child's sinus condition. During such a procedure, often sinus cultures are taken to help direct antibiotic therapy. A few select children end up needing formal sinus surgery which can be performed through the nose using special instruments and tiny cameras.

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Clinic Locations

Ear, Nose & Throat Clinic
University Hospital Clinics Building
1005 Harborside Drive
Galveston, Texas

Ear, Nose & Throat Consultants
Brittany Plaza
1600 West League City Parkway, Suite D
League City, Texas

Family HealthCare Center
Mainland Crossing
9300 Emmett F. Lowry Expressway
Texas City, Texas

For an appointment,
please call:

281.338.0829