A serious problem for parents is sinusitis, if it was diagnosed in a 4-year-old child; the symptoms and proper treatment depend on the severity of the inflammation. The disease must be treated immediately.

Carefully monitor the child’s symptoms and immediately begin the treatment process, since in the case of late treatment, the adenoids may awaken, which disrupt the normal process of nasal breathing.

Traditionally, the symptoms of sinusitis are very similar to colds, but if a regular runny nose does not go away for more than one week, you should pay attention to this, as this may be the beginning of sinusitis.

In children, sinusitis is most often much more severe than in adults, and it is acute sinusitis that children suffer from; an additional negative property in the acute form is pain with periods, it subsides and appears again and again.

One of the destructive sinusitis is sluggish; this type is very difficult to fight, since the inflammation begins to spread to nearby tissues and damages them. Like any other disease, sinusitis should be treated immediately!

Sinusitis is an inflammation caused by a sinus infection. Sinusitis is one of the types of sinusitis. There are sinuses near the nose, they are called sinusitis. If a person is healthy, the sinuses are filled with air.

The main causes of sinusitis are associated with colds that were previously untreated or became acute; in addition, the disease could develop due to infections, allergies, injuries and birth defects.

Such as:

1. Allergy
2. Various types of colds.
3. Measles, scarlet fever
4. Tonsillitis
5. Pain in the gums, infection in the mouth and teeth.
6. A deviated septum due to injury or a congenital defect.
7. Weak immunity
8. Inflamed adenoids
9. Bacterial infections

Symptoms

They directly depend on the severity and form of the disease. Let's consider the acute form, since it is the one that most often occurs in children from 2 to 5, 6 years or more; the symptoms characteristic of this form are:

1. Pain in the sinuses, especially in the evening.
2. Heaviness and pain in the head. Mostly the pain is constant and in the forehead area. Headaches occur when there is swelling in the sinuses, so there is pressure on the frontal part.
3. Runny nose, nasal tone, nasal discharge. You can identify and diagnose them yourself; the child begins to speak through his nose and the sounds he pronounces are unclear.
4. Stuffy nose, pus discharge. In addition to these symptoms, swelling may appear, which makes breathing difficult and thick pus appears. There are painful sensations of pain in the bridge of the nose.
5. A high temperature of 37-39 degrees, in a child of 4 years old it can be constant and can be eliminated with conventional antipyretic drugs, since it is necessary to carry out treatment therapy specifically to combat sinusitis.
6. Pain in the inflamed part and redness
7. High fatigue, decreased appetite, mood swings, pallor.
8. Pain and sore throat, this is the sign that shows that sinusitis is entering a chronic stage.

Temperature in a child with sinusitis, swelling of the cheeks (maxillary sinuses are clogged)

After identifying such symptoms, it is necessary to immediately begin treatment and consult a professional doctor, since sinusitis is most often diagnosed in children from 4 to 7 years of age, because the children’s sinuses are not fully developed and formed. The duration of the illness is usually up to one week.

Sinusitis in children can be unilateral or bilateral; they differ in that inflammation occurs either on one side or on both sides at the same time.

Clinically, this disease is also divided into two: acute and chronic. Regardless of age, this can happen to a child at 4 or 5 years old or at 7 or 8 years old.

Acute is divided into:

• catarrhal
• purulent

Chronic:

• hyperplastic
• polyposis
• astronomical
• mixed

Regardless of the type of sinusitis, the symptoms in the early stages are similar, one of the main ones being damage to the lining of the nose and sinuses. It is necessary to start treatment immediately in any case!

If treatment is started late, sinusitis interferes with the normal functioning of the nasal lining, which in turn makes it difficult for the lungs to filter out impurities and cold. You should consult a doctor immediately to avoid respiratory complications in your child in the future.

Treatment of sinusitis

Two types of treatment are used: surgical and conservative. The conservative method is physical therapy and the use of medications.

Chronic sinusitis:

A child under 6-8 years of age may also have acute sinusitis, but the symptoms are not pronounced. It happens that after complete treatment, symptoms appear again. The first sign of sinusitis in a child is unpleasant odors from the mouth and nose.

Therapeutic treatment
To confirm the child’s diagnosis, the pediatrician prescribes diagnostics using ultrasound or diaphanoscopy. It happens like this: a Hering lamp is placed in the baby’s cavity, you need to grab it tightly with your lips, the procedure takes place in a room without light. This method helps to identify the level of inflammation.

Antibacterial treatment
For treatment, the doctor, based on the results of the analysis, prescribes drugs with a general spectrum of action to the child. Antibiotics are chosen taking into account allergies, tests and the individual characteristics of the baby. Choose tablets or injections, such as Amoxiclav, Solutab, Augmentin, Flemoxin. Under no circumstances should you choose antibiotics for your child yourself!

Each of them has different and individual side effects. Depending on the severity and stage of the disease, antibiotics are used in tablet form or administered by injection.

Drops for vasoconstriction:
To prevent swelling from increasing and to improve the general condition and ease the child’s breathing, you can use nasal drops and sprays:

• Nazivin
• nazol
• otrivin
• advance spray
• tizin
• xymelin
• Adrianol

Anti-edema drugs:
To make breathing easier, decongestant medications are used, they help alleviate the general condition of the baby in the first stages Koldakt, Orinol Fervex

Thinners that eliminate mucus and pus in the nose:
ACC-long, Bronchoclar, Bromhexine. An additional pleasant effect from them will be a reduction in inflammation and severe pain.

Antiseptics:
Miramistin, Collargol

Means for reducing fever:
Paracetamol, Ibuprofen. Aspirin should not be given to children!

Antiseptic Miramistin and Collargol, antipyretic Paracetamol

Additional remedies and methods of treatment:

• The pediatrician additionally prescribes multivitamins, a rinsing method (cuckoo), and physical therapy for children.
• If the nasal septum was the cause of sinusitis and medication treatment did not produce results, surgical intervention, namely a puncture, is necessary.
• In addition to the traditional treatment of sinusitis, you can perform breathing exercises and massages at home. This kind of manipulation helps fill the tissues with oxygen and improve blood circulation.

Performing acupressure on a child is very simple; you just need to massage the eyebrow area, the lower part of the eyes, the middle between the eyebrows and the nose area. One minute clockwise, if the exercises are too painful, you can reduce the massage to 30 seconds.

Breathing exercises – closing one nostril, breathing with the other and alternating.

Folk remedies:
Before using grandmothers' and mother's recipes, consult your doctor so that these kinds of recipes do not cause more harm when treating sinusitis in a child. The consequences may complicate the disease.

1. Propolis. Dip cotton swabs into propolis and insert into the nostrils. Perform the procedure for 5 minutes each time.
2. Onions, garlic. These are the strongest natural antibiotics.
3. Viburnum + honey Mix in equal proportions, need to be slightly warmed. Use 1 tablespoon before meals.

Complications and possible consequences

Complications - may exist when sinusitis has entered the chronic stage, due to improper and untimely treatment, there may be consequences such as:

• meningitis
• pneumonia
• swelling of the eyelids and eyes
• rheumatism

If a child has been noticed snoring or heavy breathing, these may be the first signs of sinusitis in children.

Prevention

Sinusitis occurs in case of illness, so symptoms should be diagnosed in advance and treated for ARVI, rhinitis, dental diseases, etc.

Monitor the child’s diet, sleep patterns, take vitamins during periods of vitamin deficiency, and take more walks in the air, especially in the summer.

Make sure that there are no injuries to the head and nose and do not self-medicate; first of all, consult a qualified doctor.

Sinusitis in childhood is a very common problem. The disease accompanies almost all viral and bacterial infections that a child’s fragile body encounters.

A lot of video lectures and programs are devoted to this topic, where Dr. Komarovsky talks about the dangers of overdiagnosis of childhood sinusitis, the characteristics of symptoms in children and its treatment.

Let's consider when sinusitis in children does not pose a serious problem, and when it is better to use all possible means so that the consequences for the child do not turn out to be disastrous.

How does the maxillary sinus develop?

One of the most common questions from parents who notice a runny nose in their child is: “At what age can a child have sinusitis and how to recognize it?” To answer this question, you need to understand a little about the development and structure of the sinus itself.

At the birth of a baby, the maxillary (maxillary) sinuses resemble narrow slits, which, as the child develops, turn into full-fledged cavities. The sinuses change their shape and fill with air only by the age of three. Therefore, until this time, inflammation in the sinus is unlikely and practically does not occur. The sinuses complete their development only at the age of 17-19 years.

There are several other differences in the structure of a child’s sinus compared to an adult. In children, it is located a little higher, and the bone wall that separates the sinus and orbit is much thinner. Therefore, with the development of purulent sinusitis, the infection quickly spreads to the orbit and orbital complications appear.

Functions of the maxillary sinuses

In the human body, the air sinuses, which include the maxillary sinus, perform several important functions:

1. They warm, moisturize and purify the air we breathe.
2. Due to the air content in the sinuses, the mass of the skull bones decreases.
3. The sinuses are involved in the formation of speech, giving the timbre of the voice different shades.
4. In case of facial injuries and bruises, they play the role of a shock barrier.
5. They contain baroreceptors - cells that detect changes in pressure.
6. They protect the nerve endings of the teeth and eyes from the effects of cold that enters the body when breathing.

For children, prolonged absence of normal nasal breathing has a detrimental effect on health and development. Nasal congestion, which develops with sinusitis, can provoke a violation of the structure of the facial bones of the skull, and can also cause delayed intellectual abilities and frequent colds.

This disease is an inflammatory process that affects the sinus mucosa. The sinus is connected by the excretory ostium to the nose. Therefore, any runny nose will automatically cause changes in the sinus.

Parents should remember that a mild form of sinusitis accompanies almost all viral and bacterial infections in children. This disease can be diagnosed with a common cold and with a common runny nose. The reason for this is the increased reactivity of the sinus mucosa, which responds with swelling to pathological changes.

There is no need to worry about this; such sinusitis ends almost immediately after the runny nose stops and does not require special treatment. But there are other types of sinusitis, which are accompanied by the formation of pus and can quickly worsen the child’s condition, leading to serious consequences. In each specific case of sinus inflammation, a differentiated approach is needed.

Source: website What can cause sinusitis in a child:

• bacteria. In children, more often than in adults, the disease can be caused by intracellular pathogens (chlamydia, mycoplasma), which are difficult to treat with conventional antibiotics;
• viruses. The most common cause of sinusitis in childhood;
• allergy;
• traumatic injury and fungi are less common.

In addition, contributing factors in the development of the disease are decreased immune defense, hypothermia, lack of protein and vitamins in the diet, caries and others.

What are the types of sinusitis?

There are acute and chronic forms of the disease. Chronic sinusitis in childhood is rare. It can develop due to an untreated acute form, long-term dental pathology, and also in children with allergic rhinitis. Chronic sinusitis is divided into hyperplastic and other variants.

Based on the cause of their occurrence, they distinguish between rhinogenic (transition from an inflammatory process in the nose), traumatic and hematogenous (infection enters the sinus through the blood, for example, in sepsis). According to the nature of inflammation in the sinus, there are catarrhal, purulent, hemorrhagic and necrotic forms of sinusitis. Each form is characterized by certain symptoms and requires proper treatment.

Signs and symptoms of sinusitis in children

It is important for the child’s parents to know what to look for in order to recognize the signs of sinusitis in time. Symptoms of the disease may vary depending on the age of the little patient and the reactivity of his body.

Typical manifestations of sinusitis, which occur in most cases:

Nasal congestion and swelling. Lack of normal breathing prevents the child from sleeping, eating, and he becomes irritable and capricious. When a child's nose is stuffy, this gives his speech a characteristic nasal quality; the baby may snore or wheeze in his sleep. Pain. The child cannot always clearly localize pain, so he may complain of soreness in the cheek area or toothache. The pain intensifies when pressing on the sinus and changing body position. In a horizontal position, it is a little easier to carry, so a previously active baby can lie down for a long time. Temperature. Fever accompanies almost all forms of sinusitis. Sometimes, against the background of reduced immunity, there may be no temperature. Nasal discharge. The disease in most cases is accompanied by discharge of various types: yellow, mucous, green, mixed with blood due to fragile blood vessels. Eye problems. A small patient may experience photophobia and lacrimation. In addition, the infection easily spreads from the sinus to the orbital area, causing severe complications. Ear complications. There is congestion, a decrease in hearing acuity, and otitis media is often associated with sinusitis.

Each manifestation of sinusitis can be expressed to a greater or lesser extent in a particular child. In children under 3 years of age, a completely different picture of sinusitis is observed.

General symptoms (lethargy, fever, weakness, headaches, etc.) prevail over local signs of the disease. This factor can significantly complicate the early diagnosis of the disease.

To cure sinusitis in a child, treatment of the disease must be timely and comprehensive. Treatment methods depend on the form of sinusitis, the age of the child and the presence of associated complications.

In the treatment of sinusitis, medications, various sinus cleansing procedures, and surgical interventions are used.

To get rid of the disease, treatment is carried out in several directions:

• cleansing and sanitization of the sinus from pathological discharge;
• combating painful symptoms of the disease;
• destruction of infection;
• prevention of complications.

How to treat sinusitis in children?

For systemic treatment of sinusitis use:

Antibacterial drugs. Antibiotic treatment is used for bacterial and purulent sinusitis. The drug of choice in children is penicillin ( Ospamox, Amoxicillin, Flemoklav etc.), in case of allergies or no effect within 3-4 days, the antibiotic is changed to a drug of another group, for example, Azithromycin from the group of macrolides. The attending doctor selects the antibiotic taking into account the baby’s body weight and age. Antiallergic drugs ( Zodak, Loratadine). The allergic component is removed and swelling of the nasal and sinus mucosa is partially relieved. Antipyretics and painkillers ( Ibufen etc.). Used for high fever and intense pain. Mucolytics ( Sinupret, ACC). They are used to liquefy viscous discharge and help remove it from the sinuses. To cure sinusitis in a child, systemic therapy is supplemented with local remedies:

Ointments (boromenthol, levomekol). They are used less frequently during the recovery period. In addition to medications, various sinus cleansing procedures are used to treat sinusitis without a nose:

• nasal rinsing at home. For this procedure, buy ready-made solutions at the pharmacy, for example, saline solution, or prepare a saline liquid for washing yourself (a teaspoon of sea salt per 100 ml of boiled water).
• Sinus rinsing using the "" method. In small children, you can simply remove the discharge with an electric suction.

If conservative treatment is ineffective or the diagnosis is unclear, a puncture is indicated. The sinus is pierced with a special needle, then it is washed and medications are administered if necessary. In the future, the sinus can be washed several more times until complete recovery.

In critical situations, with the development of life-threatening complications, surgical intervention is performed. The sinus is opened and all pathological discharge is removed from there. Then drainage is applied for subsequent rinses.

Traditional medicine in the treatment of disease

Some parents do not accept medications, preferring to treat their child with folk remedies. Such treatment can be justified only in the initial stages of the disease or in combination with traditional therapy.

Sinusitis in children is one of the most common inflammatory pathologies. With a competent and timely approach, it responds well to treatment. How the disease manifests itself in childhood and how to properly care for a sick child will be discussed below.

How does the disease develop?

The causes of sinusitis in children can be divided into the following groups:

• Developmental anomalies.
• Chronic diseases.
• Infections.
• Injuries.
• Diseases of the dentofacial apparatus.
• Medical interventions.

Developmental anomalies include curvature of the nasal septum or middle turbinate, which makes it difficult for secretions to flow out of the paranasal sinuses. The structure of the airways is also disrupted when the nose is injured. Under the influence of predisposing factors, acute or chronic inflammation develops.

Childhood sinusitis occurs with adenoid vegetations and polyps, which are latent foci of infection. It can develop as a complication of recent infections, both viral and bacterial. Inflammation of the maxillary sinus also occurs with scarlet fever, measles and influenza.

– another factor leading to sinusitis. If it lasts more than 7 days and the severity of symptoms increases or does not change, it is necessary to exclude damage to the paranasal sinuses.

Sinusitis also occurs when the upper jaw or teeth are damaged - caries, osteomyelitis, violation of the technique of medical manipulations, for example, improper rinsing of the nose.

What signs indicate sinusitis?

There are specific symptoms that will immediately suggest inflammation of the paranasal sinuses. The following signs of sinusitis in children are distinguished:

• pain;
• hyperthermia;
• local manifestations;
• decreased activity.

The pain syndrome has its own characteristics: it appears at certain times of the day or when changing body position. If the outflow of contents is impaired, it becomes intense, radiating to the eye socket, temple, teeth or forehead.

Hyperthermia with sinusitis is pronounced - 38-39⁰ C. It may not decrease after taking antipyretics or drop for several hours. There are definitely local manifestations. These include the discharge of mucus and difficulty in nasal breathing.

Interesting! The sense of smell is often reduced on the affected side.

Otolaryngologists are often asked how to recognize sinusitis in a young child. In young children, the disease can occur with nonspecific symptoms - decreased appetite, lethargy, loss of interest in toys.

It occurs as in adults - they complain of pain in the maxillary sinus, fever, and weakness.

Knowing how sinusitis manifests itself, you can immediately contact a specialist and begin a course of treatment on the same day.

What studies are needed to confirm the diagnosis?

When symptoms of sinusitis appear in children, the following examinations are performed:

• anterior and posterior rhinoscopy;
• ultrasound, radiography, endoscopy, diaphanoscopy, thermography;
• general blood test, urine test, bacteriological analysis from the nasal cavity or discharge obtained during puncture, determination of sensitivity to antibacterial agents.

Auxiliary methods include diagnostic puncture of the sinus followed by washing it. Sinusitis can be determined only after analyzing complaints and a comprehensive examination of the child.

What are the age-related features of sinusitis?

Unlike an adult, the nasal passages of small children are narrow. Therefore, sinusitis is more severe and longer.

Important! The diagnosis of “sinusitis” can be established from the age of 6, since before this period the sinuses are undeveloped.

A newborn child has only the ethmoid sinus, and the rest gradually grow until the age of 6 years. From the age of 6-7 years, intensive growth of the sinuses begins. In adolescence, around the age of 16, their size is the same as that of an adult.

How to properly treat sinusitis?

To understand how to cure sinusitis in a child, you need to know about the processes occurring in the maxillary sinus and nasal passages. Under the influence of provoking factors, the mucous membrane swells and produces a large amount of secretion. Due to edema, the outflow from the maxillary sinus is hampered and fluid accumulates in it.

Local remedies.

To eliminate these factors, local drugs are used. Decongestants are good for eliminating nasal congestion and facilitating the outflow of mucus. This group can be used from 4 weeks of age strictly according to the instructions in the appropriate dosage.

Important! It is not recommended to use the drugs for more than 5 days, as then addiction occurs.

If they are ineffective, sprays and drops with glucocorticosteroids are prescribed. To improve mucus discharge, mucolytics, sea water and saline are used.

Systemic drugs.

Appointed for 7-10 days. Sometimes the course can be extended to 14 days. Penicillin drugs, macrolides or cephalosporins are most often used. For young children, the drug is prescribed in the form of syrup. From 6-7 years old you can use tablets, capsules and intramuscular injections.

At temperatures above 38.5⁰C, antipyretics are prescribed. They are also indicated at a lower temperature if the child’s general condition is impaired or there is a tendency to convulsions. In addition to antipyretics, nonsteroidal anti-inflammatory drugs and antihistamines are prescribed for sinusitis to alleviate the course of the disease.

Irrigation.

Washing the sinuses with solutions is called irrigation. It is performed under local anesthesia for each nasal passage in turn. This procedure is often called “cuckoo” because during it patients are asked to say “cuckoo.” Irrigation is allowed from the age of 7.

YAMIK sinus catheter.

YAMIK is a procedure in which the contents of the sinus are removed through the anastomosis without surgical intervention. The outflow of mucus occurs due to the pressure difference created by the catheter. After the sinus is freed, the drug can be administered using the same catheter.

Physiotherapy and massage.

It can be therapeutic and calming. Before the procedure, you must consult a specialist, as it is contraindicated in case of purulent processes and elevated temperature.

Surgical treatment.

If the methods listed above are ineffective, a puncture of the maxillary sinus is performed. In this case, its contents are removed and the cavity is washed with saline solution. If necessary, medications are also administered there.

Important! Puncture of the sinus does not provoke the transition of sinusitis to a chronic form.

Treatment with a puncture of the anterior wall of the sinus avoids complications such as meningitis and meningoencephalitis.

Mode.

For normal nasal breathing, microclimate parameters – humidity and temperature – are important. With sufficient humidity (about 60%) and low room temperature (20-22⁰ C), it will be easier for the child to breathe.

In summer time it is necessary to ventilate the room 5-6 times a day, in the cold season it is optimal to purchase an air humidifier. If the child's condition is satisfactory, walks are not limited.

Nutrition.

Diet for sinusitis plays a secondary role. However, it is important in order not to aggravate the course of the disease. In case of inflammation of the paranasal sinuses, exclude allergens - chocolate, citrus fruits, nuts. The diet includes more vegetables and fruits typical of the region of residence.

What actions of parents lead to deterioration?

In the treatment of sinusitis in children, it is necessary to adhere to the following recommendations:

• Avoid heating the affected sinus.
• Do not instill drugs that are not medicines (for example, traditional drop recipes).
• Attend specialist examinations in a timely manner and adhere to the treatment regimen.

If the rules are not followed, the disease may become chronic or develop complications.

What are the complications of the disease?

There are such complications of sinusitis:

• Inflammation of the middle ear - otitis media.
• Damage to the membranes of the brain - meningitis.
• Inflammation of the optic nerve (neuritis).
• Formation of an abscess in the cranial cavity.

Among all the complications of the disease, otitis media comes first in frequency. This prevalence is associated with the structure of the hearing organ. The nasopharynx is connected to the middle ear through the Eustachian tube.

If there is purulent discharge, it flows down the back wall of the pharynx and can enter the tympanic cavity. Another factor in frequent otitis is that in children it is wide and short, which makes it easier for infectious agents to enter.

Prevention

It consists of the treatment of chronic pathology of the upper respiratory tract, timely treatment of acute viral and bacterial diseases.

It is important to teach children how to blow their nose correctly: cover one nostril with a finger and clean the other. You also need to monitor the condition of your teeth - treat carious teeth and, if necessary, remove them.

Sinusitis is a disease with dangerous complications, therefore it is always treated under the supervision of an otolaryngologist.

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Dear readers, along with the autumn and winter cold, many of us are faced with diseases caused by infections. Our children are no exception, as they often develop a disease such as sinusitis. In today's conversation with doctor Tatyana Antonyuk, we will look at the symptoms and treatment of sinusitis in children and how you can avoid it in the future. I give the floor to Tatyana.

Good afternoon, readers of Irina’s blog! Mothers often ask whether sinusitis occurs in children and how its course differs from that of an adult. Sinusitis is an acute inflammation of the mucous membranes of the paranasal sinuses, located on the sides of the nose. The anatomical features of the maxillary sinuses of a child differ from the structure of the sinuses of adults, so sinusitis in children occurs somewhat differently.

In newborns and infants, the sinuses are not yet developed, so they do not have this disease. As sinuses develop, the risk of developing sinusitis increases. It can occur in children older than 3-4 years. The growth and development of the sinuses is completed by the age of 16-17 years. From this age, the course of the disease is no different from that of an adult.

How to recognize sinusitis in a child

Any pathological inflammatory processes in the nasal cavity have a negative impact on the condition of the sinus cavity. Various forms of sinusitis develop against the background of viral infections and reduced immunity. Most often, sinusitis is diagnosed with rhinitis, tonsillitis, influenza, and adenoids. Provoking factors include prolonged exposure to a draft and severe hypothermia.

Much less often, the disease can be caused by injuries, pathologies of dental development, or disruptions in the functioning of the endocrine system. I rarely diagnose the chronic course of the disease.

Signs of sinusitis in children

Symptoms of sinusitis in children can vary depending on the age of the baby and the individual characteristics of his body. However, we can highlight the most characteristic of them, which occur in most cases:

• swelling and congestion of the nose, nasal sound when speaking;
• pain in the forehead and wings of the nose, aggravated by sneezing or physical activity;
• increased body temperature;
• cough that gets worse at night;
• copious discharge of yellow or green mucus, sometimes mixed with pus;
• toothache;
• lacrimation, photophobia;
• lack of sense of smell caused by swelling of the nose;
• decreased hearing acuity;
• general intoxication – weakness, lethargy, moodiness, sleep and appetite disturbances.

Symptoms of sinusitis in children

Sinusitis without fever in a child at an early age is no less dangerous. The disease develops against the background of a sluggish infection. Since the baby cannot yet clearly talk about his feelings, parents should pay attention to symptoms such as lethargy, increased moodiness, refusal to eat, and poor sleep. Mucus that penetrates the back wall of the nasopharynx causes coughing, especially at night. In the morning, yellow crusts form in the child’s nose.

The absence of fever is not a reason to take the disease lightly. This condition may indicate that the child’s body is weakened and is poorly able to fight the spreading infection.

In the absence of proper treatment, the risk of bilateral sinusitis in a child increases, in which inflammation of both sinuses is noted. The disease is much more severe, and the purulent form of the disease is especially dangerous.

Catarrhal sinusitis in children is a mild form of the disease. Swelling and pain are less significant, nasal discharge is moderate, colorless and odorless. The disease can cause complications such as conjunctivitis, brain abscess, meningitis, inflammation of the membranes and tissues of the eyeball.

How to treat sinusitis in children

In order to get rid of the disease as soon as possible, timely and comprehensive therapy is necessary. The choice of treatment methods and means depends on the form of the disease, the presence of complications, and the age of the child. Medications are aimed at relieving inflammation and pain, cleansing the sinuses, and destroying infection.

Treatment of sinusitis in children includes the following groups of drugs:

• antibiotics (“Amoxicillin”, “Flemoclav”, “Azithromycin”) – used for purulent forms of the disease;
• antipyretics (“Ibufen”) – prescribed if a child has a fever with sinusitis;
• mucolytic drugs (ACC, Sinupret) - necessary to thin the mucus and remove it from the sinuses;
• nasal rinsing products (“Aqualor”, “Aqua Maris”);
• antihistamines (Zodak, Loratadine) - to eliminate allergic reactions and severe swelling.

Indications for the treatment of sinusitis in children with antibiotics are such signs as high body temperature (38˚C and above), severe headaches, and the presence of pathogenic flora when analyzing bacterial cultures from the nose. The effectiveness of therapy is judged by the child’s condition two days after the start of treatment. In most cases, patients experience relief from headaches, a decrease in the amount of mucus produced, and an improvement in overall well-being.

Antibiotics for sinusitis in children are prescribed in the form of tablets and capsules, suspensions, and injections. Tablets are not prescribed to children under 6-7 years of age, since at this age not all patients can swallow the medicine. An allergic reaction of the body is also possible. In preschool age, a suspension is best suited.

Injections are administered when the symptoms of the disease develop rapidly; they can only be done in a hospital setting. When treating sinusitis with antibiotics, individual dosage selection is very important, taking into account possible contraindications. The choice of remedy and dose can only be made by a doctor! Remember that many antibiotics are contraindicated in children of primary school age.

How to restore nasal breathing

To eliminate swelling, moisturize the nasal mucosa, and remove mucus, various methods of rinsing the nasal cavity are used. The most commonly used medical solutions are furatsilin, saline solutions, and Aqua Maris.

The most effective solution for a child is a solution based on sea water “Aqua Maris”. The compounds of magnesium, potassium, chlorine and sodium in its composition thin out viscous mucus, relieve inflammation and pain. The drug does not cause side effects, it is convenient to use thanks to the syringe that is included in the kit. It is possible to use vasoconstrictors (Rinazolin, Nazivin, Tizin).

Among the many folk recipes, one can highlight washing with decoctions based on black currant leaves, chamomile and celandine juice. Rinsing the nasal cavity is used only in complex therapy.

For many years, a method of washing called “cuckoo” has been popular in the treatment of sinusitis. Its implementation consisted of introducing a disinfectant liquid through one nostril with the aim of removing it from the other. Such washing can be harmful in the treatment of unilateral sinusitis, since the inflammatory process can spread to another sinus.

We invite you to watch a video about methods of treating sinusitis in children - gargling, nasal rinsing, warming, massage, UHF.

What are medicinal turundas and why are they needed?

Turundas are special lotions for the nasal cavity. They are made from a gauze or cotton swab soaked in a medicinal solution. The introduction of turunda helps reduce swelling, destroy viruses and bacteria, and restore breathing through the nose. Sea buckthorn oil, Levomekol ointment, and a mixture of propolis and vegetable oil are used as a solution for preparing turundas.

Turundas soaked in the prepared solution are placed in the nasal passage for 30 minutes. Before the procedure, be sure to rinse your nose and clear it of crusts.

Is a puncture dangerous for sinusitis?

If conservative methods do not allow you to cope with the disease, they resort to surgical intervention - puncture. Most parents are afraid of this procedure, believing that it will cause great discomfort to the child. However, this manipulation is a necessary measure if there is a risk of developing otitis media or brain abscess. It is also necessary when an advanced disease has become chronic.

The operation is performed under general anesthesia. A thin needle is used to make a puncture in the sinus and then clear it of accumulated mucus. The final stage of the operation is washing the sinus using several drugs. Proper puncture by an experienced doctor will not cause complications and will allow you to successfully cope with the disease.

Doctor Komarovsky's opinion

A well-known doctor points out that sinusitis is an inevitable companion to ARVI. Komarovsky notes that sinusitis in children is a natural reaction of the body fighting infection.

Treatment of sinusitis in children according to Komarovsky is, first of all, regular washing and cleansing of the maxillary sinuses. The doctor does not recommend using antibiotics if sinusitis occurs against the background of a viral infection. With a purulent form, Komarovsky states, you cannot do without antibiotics.

Next, the doctor debunks the myth that the sinus puncture will have to be repeated throughout your life. However, he notes that such a procedure is justified only if other treatment methods have failed and the illness lasts more than two weeks without visible relief.

The doctor is very critical of traditional medicine methods. Komarovsky’s opinion is especially categorical regarding procedures for warming the nose for purulent sinusitis. Exposure to heat can cause a breakthrough of purulent masses or burn the child’s delicate skin. Various folk remedies used at home can only be used to improve the general condition of the patient and must be agreed with the attending physician.

How to prevent the disease from developing

The disease can be prevented if you follow certain rules. Prevention of sinusitis in children is as follows:

• treat viral and bacterial infections at the first signs of the disease, avoiding their complications;
• monitor the condition of the baby’s oral cavity, treat caries of baby teeth in a timely manner;
• during an exacerbation of the disease, maintain bed rest;
• carry out hardening procedures, maintain immunity;
• eliminate contact with the allergen if the child is prone to allergies;
• ensure sufficient exposure to fresh air, sports and outdoor games;
• maintain a daily routine, sleep and diet, dress warmly in cold and windy weather;
• regularly carry out wet cleaning and ventilation of the room, including during the cold season;
• Give your baby vitamins and diversify his diet.

Having noticed the first symptoms of poor health, you need to consult a doctor, and not search for miraculous home methods. Treatment of sinusitis is carried out by a pediatrician or otolaryngologist.

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Sinusitis in children is an infectious inflammation of the mucous membrane of the maxillary sinus (maxillary), located above the upper jaw on the sides of the nose inside the skull. The sinus has a free space covered with mucous membrane; it is separated from the maxillary teeth by a thin plate, and the sinus is connected to the nose using a thin anastomosis. It is this location of the sinus that causes the development of inflammation and the spread of infection.

Sinusitis can be cured using traditional medicine and folk remedies, it is only necessary to correctly determine the source of the disease and direct all efforts to destroy it.

What causes the pathology?

Like any disease, sinusitis in children has its own causes. The causative agents are viruses and bacteria of acute respiratory diseases.

1. influenza and parainfluenza;
2. coronaviruses;
3. adenoviruses;
4. respiratory syncytial virus;
5. rhinovirus;
6. metapneumovirus.

Bacteria:

1. pneumococcus;
2. hemophilus influenzae;
3. moaxella.

In the chronic course of the disease, other pathogens are added: Klebsiella, Staphylococcus aureus, anaerobes, Streptococcus pyogenes. It is also possible for a child to develop the disease with a mixed infection: bacteria and viruses.

Caries in a child can cause the development of sinusitis

Predisposing factors

The development of sinusitis in children does not occur spontaneously, but against a background of weakened immunity, due to previous or existing diseases:

• vasomotor rhinitis;
• chronic tonsillitis;
• being in a draft;
• deviated nasal septum;
• severe hypothermia;
• hypertrophy of the nasal concha;
• trauma to the nasal mucosa;
• weak immune system;
• adenoids;
• allergic predisposition;
• caries.

If there are predisposing factors, be sure to carry out prevention. If you don’t want to take medications, turn to folk remedies.

If your child has carious teeth, be sure to treat them, even if the baby teeth are affected (which “will then fall out and there will be no caries”). Caries is caused by infections that can penetrate through a thin plate into the sinus and cause inflammation there!

Pathogenesis of the disease

Symptoms of the disease directly depend on how the disease progresses!

The infection, entering through the nasal or oral cavity of the child, causes inflammation. The vessels in the mucous membrane fill with blood, causing nasal congestion. Due to the inflammatory response, thickening of the membrane and disruption of cell function, the amount of mucus produced increases. It cannot freely leave the sinus, as a result of which catarrhal sinusitis develops, most often caused by viruses.

The addition of bacteria causes an accumulation of immune cells, which, when fighting the infection, form pus, which accumulates in the free space of the sinus. Purulent sinusitis occurs. Ineffective or incorrect treatment ensures the development of chronic sinusitis.

The listed factors cause swelling and accumulation of pus, which can spread to other sinuses and lead to complications, so treatment of sinusitis in children must be carried out in a timely manner!

How does sinusitis manifest?

Signs of sinusitis in children have both features characteristic only of it and common features with other diseases.

Symptoms characteristic of sinusitis:

1. headache, aggravated by tilting the head, radiating to the cheek or temple, caused by the pressure of accumulated pus or mucus on the inner surface of the skull;
2. copious discharge from the nose of light-colored (mucus) or yellow-green (pus) fluid;
3. lack of fluid and nasal congestion due to blockage of the anastomosis between the sinus and the nasal passage;
4. nasal breathing and sense of smell are impaired;
5. swelling of the face, especially the eyelids;
6. change in voice, its nasality;
7. pain in the projection of the maxillary sinus;
8. impossible to breathe through the nose;
9. pain when tapping on the upper jaw;
10. temperature rise to 38 0C due to bacterial infection;
11. In children under one year of age, light pressure on the maxillary sinus area will cause crying.

Symptoms of intoxication in severe cases of the disease:

• fatigue;
• general weakness;
• sleep and appetite are disturbed;
• headaches;
• the child is naughty.

Chronic course

It is important to know that a viral infection takes more than ten days to treat, and ineffective treatment of sinusitis in children contributes to the chronicity of the inflammatory process for 8-12 weeks. Clinical manifestations are varied - from rare exacerbations to constant nasal discharge. The patient will be tormented by the following symptoms: headaches that get worse in the evening, pain and discomfort in the maxillary sinuses, a constantly stuffy nose, a changed voice, and a decreased sense of smell. Exacerbations can occur several times a year.

In the chronic form of the disease, the risk of infection in the meninges is increased, so be vigilant!

You cannot constantly use drugs to treat rhinitis; over time, they stop working, and the infection spreads through the child’s sinuses. If you cannot overcome rhinitis, then contact your doctor and ask to change your therapy.

How to fight the disease?

Treatment of sinusitis in children should begin immediately when the first symptoms appear.

Traditional treatment is aimed at getting rid of infection in the nose, large amounts of pus and mucus - rinsing the nose is done by slowly instilling a medicinal solution (antiseptic, saline solution) into the nostril on which the sick child is lying.

To relieve the symptoms of edema, vasoconstrictor drops are taken, which should be prescribed by a doctor, since they have many contraindications. For example: “Xilen” nasal drops can be used by those over two years old, but “Dlyanos” is contraindicated for children under six years of age. If an allergy is suspected, antihistamines are prescribed.

They use physiotherapeutic methods to combat the disease: electrophoresis, phonophoresis, laser therapy - treatment cannot be limited to just this, complex therapy is necessary. The widely used method of heating the nose with hot potato, egg and salt is only possible during the convalescent stage. Treat these folk remedies with caution!

Do not warm your nose during the acute phase of the disease, this will spread the infection throughout the body and intensify the symptoms!

Sinusitis in children caused by bacteria is treated with antibiotics: ampicillin, amoxicillin, cephalexin, stronger ones - macropen, zitrolide. The doctor chooses which antibiotics to take after determining the bacteria’s sensitivity to them and assessing the child’s allergic history.

If conservative treatment is ineffective, the doctor performs a puncture of the maxillary sinus in order to free the sinus from pus. It is possible to use anesthesia for the baby.

Painkillers may be given to relieve symptoms of pain.

• "Ketanov" and "Ketoral" should not be given to children and adolescents under 16 years of age.
• Ibuprofen tablets should not be taken by children under six years of age; with a doctor’s recommendation – by children under 12 years of age.
• Ibuprofen suppositories can be used for children from three months to two years.
• "Nurofen" suppositories can be given to children under 1 year of age.

Many procedures are performed in a hospital, so you and your baby may be admitted as a day patient or a permanent patient.

Treatment with folk remedies

There are many popular folk remedies to combat the disease, but be sure to combine them with traditional medicine.

Propolis is a strong disinfecting bactericidal folk remedy that can be used along with antibiotics. You can buy an aqueous solution at the pharmacy and drop it into your nose. Prepare an ointment from propolis and lubricate the nasal cavity. Melt propolis in hot oil, soak a cotton swab in the solution and insert it into your nose.

Essential oils: eucalyptus, pine, tea tree - good for inhalation; this is a good folk remedy for disinfecting the nasal passages and respiratory tract.

A complication of sinusitis is damage to the meninges, which leads to irreparable consequences.

Strengthen your baby's immunity, do not stop treatment immediately after the signs of the disease disappear, complete the course of treatment completely, and the baby will be healthy!

Sinusitis in children is an inflammation of the maxillary paranasal (maxillary) sinuses, often encountered in pediatric practice. The incidence of sinusitis has a pronounced seasonality - it increases sharply in the autumn-winter period, which is explained by the natural decrease in the immunity of children during this period of time.

Children under the age of 3-4 years do not have sinusitis, this is due to age-related anatomical features: by the time the child is born, the maxillary sinuses are in their infancy, their development begins after 5-6 years and continues until 10-12 years. Therefore, from 5 to 12 years, sinusitis in children is rarely observed, and after 12 years, its incidence becomes as high as among adult patients, amounting to 10 cases for every 100 people.

With sinusitis in children, inflammation in the maxillary sinuses is observed Causes and risk factors

The maxillary sinuses communicate with the nasal cavity through small openings. If for any reason (usually due to inflammatory swelling of the nasal mucosa) these openings close, then the sinuses stop being cleaned and ventilated. This creates in them a favorable environment for the activity of pathogenic microflora, which causes the development of an inflammatory process in the mucous membrane of the sinuses.

The causative agents of sinusitis in children are most often viruses. Less commonly (5–10% of cases), the disease is caused by pathogenic and opportunistic bacterial agents (Haemophilus influenzae, staphylococci, streptococci, moraxella), and even more rarely by a fungal infection.

Most often, children are diagnosed with sinusitis after 12 years of age.

Risk factors for the development of sinusitis in children are diseases that contribute to the penetration of infection into the maxillary sinus or disrupt its normal ventilation:

• chronic rhinitis of various etiologies;
• acute respiratory viral infection;
• chronic pharyngitis;
• chronic tonsillitis;
• adenoid vegetations;
• congenital anomaly of the structure of the nasal passages;
• diseases of the teeth of the upper jaw;
• dental interventions on the teeth of the upper jaw;
• deviated nasal septum.

Forms of the disease

Sinusitis in children can be catarrhal or purulent. In case of purulent inflammation, the discharge from the maxillary sinus is purulent or purulent-mucous, in case of the catarrhal form of the disease it is serous. Catarrhal inflammation can turn into a purulent form.

Depending on the route of infection into the maxillary sinus, the following types of sinusitis in children are distinguished:

• rhinogenic – microbes penetrate from the nasal cavity; this is the most common way;
• hematogenous - an infection through the bloodstream enters the sinus from another source of infection in the body;
• odontogenic – the source of infection is the carious teeth of the upper jaw;
• traumatic.

Inflammation of the maxillary sinus can be unilateral or bilateral.

With purulent sinusitis, pus accumulates in the maxillary sinus

The nature of the inflammatory process is acute and chronic.

Depending on the morphological changes, chronic sinusitis in children is:

• exudative (catarrhal or purulent) – the predominant process is the formation of exudate (serous or purulent);
• productive (parietal-hyperplastic, atrophic, necrotic, polypous, purulent-polypous). With this form of the disease, pronounced changes in the structure of the mucous membrane of the maxillary sinus occur (hyperplasia, atrophy, polyps).

In clinical practice, polypous-purulent and polypous forms of chronic sinusitis are most often encountered.

Symptoms of sinusitis in children

Acute sinusitis begins with a sudden increase in body temperature to 38-39 ° C, accompanied by chills. In rare cases, body temperature remains within normal limits. Children are bothered by pain localized in the area of ​​the root of the nose, forehead, and zygomatic bone on the affected side. The pain can radiate to the temple and intensifies with palpation. Often the pain takes on a diffuse character, that is, it is perceived as a headache without a clear localization.

On the affected side, nasal breathing is impaired; with a bilateral process, children are forced to breathe through the mouth.

Nasal discharge at the onset of the disease is liquid and serous in nature. Subsequently, they become green, cloudy and viscous, dry out quickly and form rough crusts in the nasal cavity.

Sinusitis in children is accompanied by headaches, runny nose, and impaired nasal breathing.

Swelling of the nasal mucosa often leads to compression of the lacrimal canal. As a result, tear fluid cannot flow into the nasal cavity and lacrimation occurs.

Signs of sinusitis in children are often regarded by parents as manifestations of ARVI. However, the approach to the treatment of these diseases is different, so it is important that the sick child is examined by a pediatrician, and, if necessary, by an otolaryngologist.

The outcome of acute sinusitis in children can be recovery or the disease becoming chronic.

In the remission stage of chronic sinusitis in children, there are no signs of the disease. The children feel healthy and do not have any complaints. When the inflammatory process worsens, symptoms of intoxication occur (muscle pain, weakness, headache, loss of appetite) and body temperature rises to subfebrile levels (up to 38 °C). The amount of nasal discharge increases.

Children under the age of 3-4 years do not have sinusitis, this is due to age-related anatomical features: by the time the child is born, the maxillary sinuses are in their infancy, their development begins after 5-6 years and continues until 10-12 years.

If, during an exacerbation of chronic sinusitis, the outflow from the maxillary sinus is disrupted, a headache occurs. It has a bursting or pressing character and is localized “behind the eyes.” Increased pain is caused by pressure on the eyes and cheekbones, and by looking up. In the lying position, the outflow from the maxillary sinus improves, and therefore the intensity of the headache weakens.

Another symptom of chronic sinusitis in children is a cough that occurs at night and does not respond to traditional therapy. The appearance of a cough is due to the fact that when lying down, pus from the affected maxillary sinus flows down the back wall of the pharynx and irritates it, i.e. the cough is reflexive in nature.

With chronic sinusitis in children, damage is often detected in the vestibule of the nasal cavity (weeping, maceration, swelling, cracks).

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Diagnostics

Diagnosis of sinusitis in children is carried out on the basis of the characteristic clinical picture of the disease, complaints of the patient (or his parents), the results of a medical examination and laboratory and instrumental studies.

When performing rhinoscopy, inflammation of the mucous membrane of the nasal cavity, its swelling, and the release of inflammatory exudate from the sinus are detected.

X-rays are performed to confirm the diagnosis. With sinusitis, the x-ray shows a noticeable darkening of the maxillary sinus on the side of the lesion, but it should be borne in mind that an x-ray of an acute inflammatory process, especially at the onset of the disease, may be uninformative.

To diagnose sinusitis in children, rhinoscopy and radiography are performed.

If necessary, a bacteriological examination of nasal discharge is carried out to determine the pathogen and its sensitivity to antibacterial agents.

The causative agents of sinusitis in children are most often viruses. Less commonly (5–10% of cases), the disease is caused by pathogenic and opportunistic bacterial agents, and even more rarely by a fungal infection.

Treatment of sinusitis in children

For uncomplicated acute sinusitis in children, treatment is usually conservative and carried out on an outpatient basis. The treatment regimen includes:

• antibacterial drugs (eliminate the pathogen);
• non-steroidal anti-inflammatory drugs (have antipyretic, analgesic and anti-inflammatory effects);
• vasoconstrictor drops in the nose (improves outflow from the affected sinus).

If there is no effect from the conservative treatment of sinusitis, children are hospitalized in a specialized department for punctures or probing of the maxillary sinuses.

When treating sinusitis, children are prescribed antibiotic tablets.

In case of exacerbation of chronic sinusitis in children, treatment should be comprehensive, combining methods of local and general therapy.

To suppress microbial flora, antibiotics are prescribed, selected taking into account the sensitivity of the pathogen. If the causative agent of the disease is staphylococcus, then staphylococcal γ-globulin and antistaphylococcal plasma are used. Treatment of sinusitis in children of fungal etiology is carried out with antifungal drugs.

If necessary, drain the affected sinus. Subsequently, through the drainage tube, the sinuses are washed with antiseptic solutions, antibiotics are administered, taking into account the sensitivity of the microflora to them, or antifungal drugs. Enzyme preparations can be used to liquefy the pus and improve its drainage.

In the remission stage of chronic sinusitis, children are recommended to undergo physiotherapeutic treatment methods (mud therapy, microwave currents). For cystic, polypous and hyperplastic forms of the disease, physiotherapy is contraindicated.

Pumping out pus from the maxillary sinuses

If conservative treatment of exudative forms is ineffective, as well as mixed or polypous forms of the disease, surgical treatment is performed. Most often, radical operations are performed, the purpose of which is to form an artificial anastomosis between the maxillary and nasal cavities (methods according to Dliker - Ivanov, Caldwell - Luke).

Possible consequences and complications

Sinusitis in children, especially in the absence of timely and adequate treatment, can lead to the development of a number of serious complications:

• keratitis, conjunctivitis;
• orbital cellulitis;
• optic neuritis;
• periostitis of the orbit;
• edema, abscess of retrobulbar tissue;
• panophthalmos (inflammation of all membranes and tissues of the eyeball);
• arachnoiditis;
• meningitis;
• brain abscess;
• thrombophlebitis of the superior longitudinal or cavernous sinus;
• septic cavernous thrombosis.

Chronic sinusitis in children often causes blockage of the mucous glands, resulting in the formation of small pseudocysts and true cysts of the maxillary sinus.

In case of acute sinusitis in children, in the conditions of timely initiation of therapy, the prognosis in most cases is favorable. In the chronic form of the disease, there is often a need for surgical treatment aimed at restoring normal ventilation of the maxillary sinus. After surgery, the disease usually goes into long-term remission.

Prevention

Prevention of sinusitis in children includes:

• indoor air humidification;
• the child's compliance with the water regime;
• the use of nasal saline sprays or saline solution in the treatment of rhinitis, which not only fight infectious agents, but also moisturize the mucous membrane of the nasal cavity;
• in case of acute rhinitis or exacerbation of chronic rhinitis, it is advisable to avoid traveling with a child on an airplane (if this is not possible, then a vasoconstrictor should be used before the flight, and a saline spray during the flight).

Swimming in public pools with chlorinated water is contraindicated for children suffering from chronic sinusitis.

With frequent exacerbations of sinusitis, children are referred for consultation to an allergist.

Video from YouTube on the topic of the article:

The information is generalized and is provided for informational purposes. At the first signs of illness, consult a doctor. Self-medication is dangerous to health!

Sinusitis is an inflammation of the paranasal sinuses. Inflammation of the largest maxillary sinuses is called sinusitis. The disease can be unilateral or affect both sinuses. It is more common in children of preschool and early school age.

Acute sinusitis in children and exacerbation of chronic sinusitis more often occur in the autumn-winter or spring seasons during the season of frequent respiratory infections. Untreated or undertreated acute sinusitis gradually develops into a chronic form.

At what age does sinusitis appear?

The maxillary sinuses are radiologically detected in a three-month-old child, but reach full development only by the age of 4–6 years. Therefore, sinusitis does not occur in infants - it can first be detected after 3 years. The maxillary sinuses reach their final development after 16–20 years, depending on the individual capabilities of the teenager’s body.

Children of preschool and primary school age are susceptible to frequent infections - due to the anatomical features of the structure of the nose, the air is not sufficiently warmed and moistened, which causes a runny nose. Therefore, the peak incidence of sinusitis occurs in children aged 6–7 years.

Varieties

Based on the nature of the inflammatory process, 4 types of disease can be distinguished:

• catarrhal;
• purulent;
• allergic;
• polyposis.

Depending on the form of the disease, the main symptoms differ slightly. Catarrhal sinusitis is easier, headaches and facial pain are less bothersome. Purulent has a more severe course. The allergic form is characterized by profuse mucus and conjunctivitis; at the same time, other signs of allergy can be detected.

According to the duration of inflammation, acute, subacute and chronic sinusitis are distinguished. Acute disease proceeds rapidly, with a rise in temperature, all symptoms are vivid and well expressed. Exacerbation of a chronic disease often proceeds sluggishly, with an erased clinical picture and is often tolerated by children on their feet, without treatment.

Signs

Sinusitis in children appears after the flu, an allergic or cold, but sometimes the sinuses become inflamed against the background of complete health with caries of the teeth of the upper jaw.

Spicy

Acute sinusitis is easy to recognize: on the 5th–6th day of a cold, relief does not come, the snot thickens, becomes stringy and difficult to separate, the temperature rises to high levels, chills begin, fatigue and weakness appear.

The main signs of acute sinusitis in children:

• nasal congestion; with a unilateral process, the congestion is bothersome in one nostril, with a bilateral process, in both nostrils. The nose may be blocked on one side or the other. Congestion cannot be cured with vasoconstrictor drops; they only help for a while;
• poor appetite due to congestion;
• children lose the ability to distinguish smells and complain that food is tasteless;
• Nasal discharge with catarrhal sinusitis is mucous, with purulent sinusitis it is purulent, of a mixed nature. The purulent discharge does not flow through the nose, but goes down the back of the throat. But when you blow your nose, pus can also come out through the nose.
• facial pain that radiates to the upper teeth, to the cheek area. The pain increases with coughing and sneezing. A 3-4 year old child is capricious and cries;
• headache in a specific place, in the forehead, or is manifested by tightness behind the eye, heaviness is felt when trying to lift the eyelids. In childhood, the sinuses fill with pus faster due to their small size. Therefore, headaches and facial pain bother children more often and more severely than adults;
• heaviness in the head;
• very rarely there is a throbbing pain on the cheek. Pain in the sinus occurs with odontogenic sinusitis, when carious teeth bother you. If inflammation has invaded the trigeminal nerve, sharp pain occurs in the eye and upper palate.

Symptoms of acute sinusitis in children under 6 years of age are more pronounced and severe than in older children and adolescents.

Chronic

A disease is called chronic if it occurs more than 2–4 times during the year. Chronic sinusitis in children is a long-term disease, especially if its cause is allergies or nasal polyps.

Acute sinusitis becomes chronic with frequent exacerbations, a deviated septum, thickened nasal turbinates, adenoiditis, reduced immunity or improper treatment. Therefore, in order to prevent the process from becoming chronic, it is necessary to treat it at the acute stage.

The main signs of sinusitis in children in chronic form:

• difficulty breathing through the nose - is the main symptom regardless of the cause;
• feeling of an unpleasant odor;
• mucous, purulent or watery nasal discharge;
• headache in the forehead area, worsens when tilting the head forward, the symptom is especially pronounced in the afternoon;
• There is a feeling of pressure or bursting in the area of ​​the inflamed sinus; when you press hard on this place with your finger, an unpleasant sensation appears. Sinus pain in children is usually absent;
• Temperature in chronic sinusitis may be absent or rise to low levels;
• children complain of weakness and increased fatigue.

Chronic sinusitis in children affects exclusively the maxillary sinus, and is less often combined with a disease of the ethmoid labyrinth - ethmoiditis. In young children, a catarrhal or polypous-purulent form is observed, and not exclusively purulent, as in adults and adolescents.

Other signs

• A common symptom of sinusitis is a night cough. Appears when mucus drains and stagnates in the back of the throat;
• Otitis media appears due to the drainage of pus along the posterolateral wall of the pharynx;
• Poor night sleep, snoring;
• Children's ears become blocked, their voice becomes dull and nasal;
• Often, parents do not notice the main signs of the disease and turn either to a pediatrician about repeated exacerbations of bronchitis, inflammation of the cervical lymph nodes, or to an ophthalmologist about relapses of keratitis and conjunctivitis.

The sinuses in adolescents are formed and of normal size, so the course of sinusitis in adolescents may be more hidden and sluggish, as in adults.

When to be wary

There are several symptoms and signs that you should not miss:

1. The disease can be suspected if 5–7 days have passed since the first day of a cold, and instead of improvement, the child has nasal congestion, weakness, and a second wave of high fever has occurred. If the child is bothered by a headache, pain in the forehead or sinus area while nasal discharge disappears.
2. Persistent headache that is not relieved by painkillers and anti-inflammatory drugs.
3. If a child refuses to get out of bed, it is difficult for him to raise his head, turn it in different directions, if vomiting appears against the background of a headache, his consciousness has become vague.
4. At home, you can conduct a small self-examination - when pressing on a point in the center of the cheek or near the inner corner of the eye, pain is felt. If ethmoiditis occurs, then pain occurs when pressing on the bridge of the nose.

How dangerous is sinusitis?

It is very important to identify and begin to treat the disease in time, because complications in a child develop rapidly and pose a great danger to health and life.

If sinusitis is not treated, then infection from one sinus easily spreads to others, which can lead to pansinusitis, hemisinusitis. The sinuses communicate with the orbit, so sinusitis always poses a threat to the eye. With purulent sinusitis, ulcers may appear on the roots of diseased teeth and melting of the nasal bones.

The most dangerous and formidable complication is the penetration of pus into the membranes of the brain with the development of meningitis and encephalitis; the infection can spread through the bloodstream throughout the body and settle in the internal organs.

Most often, complications arise from self-medication at home without a medical examination.

Diagnostics

Sinusitis needs to be examined by a doctor - medical manipulations at home are impossible. The doctor determines the disease by examining the nose in a speculum - stripes of pus are visible, mainly in the middle nasal passages. The mucous membrane of this area is red, inflamed and swollen. A strip of pus is not always detected; it is easier to identify it when the middle nasal passage is anemic and the head is tilted forward or to the healthy side.

On an x-ray, the sinuses are less airy, have thicker walls, and contain fluid; a contrast agent is injected to make the picture more accurate. Inflamed sinuses can be identified using an endoscope or ultrasound. In children over 6 years old, a diagnostic puncture of the sinus can be done. For children under 6 years of age, this procedure is prohibited, as there is a risk of damaging the lower wall of the orbit and disrupting the rudiments of permanent teeth.

What to do

If you suspect that your child has sinusitis, do not try to cure it at home yourself - there is a high probability that you will start the disease and the child will suffer chronically. Contact an ENT doctor or at least a local pediatrician. The doctor will be able to determine possible causes, prescribe the necessary examination and give recommendations on how to treat the disease.

Sinusitis can be treated at home - the average duration of treatment takes one to two weeks. The hospital treats children under 1 year of age with ethmoiditis or children under 3 years of age with purulent sinusitis.

Treatment of sinusitis in children begins with vasoconstrictor nasal drops - Dlynos, Nazivin, Nazol Kids; in case of allergic sinusitis, they can be replaced with Vibrocil. Vasoconstrictor drops are not safe for children under one year of age; for children under 3 years of age, it is better to choose drops containing phenylephrine and xylometazoline.

An antibiotic is always prescribed to eliminate the source of infection; at home you can treat with antibiotics in the form of drops or tablets. Broad-spectrum antibiotics can be used from the first year of life. For allergic forms, antihistamines are prescribed.

As an auxiliary therapy at home, antipyretic and analgesic drugs, rinsing the nose with saline solutions are widely used; after the pus comes out and the temperature drops, the child can undergo physical therapy. If the cause of sinusitis in a child is a deviated septum, polyps or adenoids, the disease must be treated surgically.

The earlier sinusitis is detected, the easier it is to treat. With chronic sinusitis, parents should carefully monitor the symptoms of a runny nose and cold in order to recognize sinus inflammation in time and begin treatment for sinusitis in children.

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