15 March 2019 Author : António Larroudé This condition is responsible for high levels of absenteeism from school and consequently for the parents, from work, which is why it is important to act. Sinusitis: inflammation of the sinuses The paranasal sinuses are cavities located in the bones of the face and skull. There are maxillary, ethmoid, frontal and sphenoid sinuses, and the infection of these is known as sinusitis . The paranasal sinuses develop gradually as the child grows. The ethmoid sinuses start forming in the fourth month of gestation and are already present at birth . The maxillary sinus The maxillary sinus , which is located in the upper jaw bone, is present from the first few months of life in the form of a small recess, which progressively increases in volume. By the age of 6 , the child’s maxillary sinuses have the same configuration as those of an adult. As milk teeth are replaced by adult teeth , these sinuses gradually increase in volume. The frontal sinuses The frontal sinuses are present at birth in the form of small pockets that continue to grow throughout the child’s life. Although their definitive development is only achieved after the age of 15, frontal sinusitis may occur from the age of 7 to 8 years . The sphenoidal sinus The sphenoidal sinus develops at a later stage, and so it is rarely responsible for sinusitis in children. What's the most common type of sinusitis in children? The most common form of sinusitis in children is acute ethmoiditis , which is generally associated with a cold or, more commonly, a flu syndrome . This is characterised by nasal obstruction accompanied by a large amount of more or less purulent secretion, fever and sometimes headache . The diagnosis is made on the basis of the history and observation of the patient, and in some cases simple X-rays of the paranasal sinus are necessary to confirm the diagnosis. Treatment is usually carried out with: Nasal decongestants; Antipyretics; Antibiotics (where necessary). Sinusitis involving other paranasal sinuses becomes more prevalent as children develop, and are therefore more likely to occur from the age of 10 to 12 . However, chronic sinusitis , a sinusitis lasting for three months or more, is becoming increasingly common among children. What causes sinusitis in children? There are various causes, in particular environmental causes such as air pollution . However, there is also a greater incidence among children whose parents are smokers . There is a high number of children with allergic rhinitis , which is probably related to the risks listed above and is also responsible for a large number of cases. The fact many children attend nurseries and crèches from an age where their immune system is still underdeveloped increases the number of upper respiratory infections and the risk of chronic sinusitis. What are the symptoms of sinusitis in children? Sinusitis in children is characterised by: Nasal obstruction with a great deal of more or less constant purulent secretion; Frequent coughing, especially at night. Sometimes it is associated with: Otitis; Tonsillitis; Bronchitis. What are the complications associated with sinusitis in children? The most common complications are: Pneumonia; Serous otitis with a reduction in hearing. Sometimes complications can occur in the eye area, in particular periorbital cellulitis . More rarely, serious complications such as meningitis may occur. What is the treatment for chronic sinusitis in children? The treatment of chronic sinusitis involves the use of antibiotics and anti-inflammatory drugs . Local and systemic anti-allergenics should be used where appropriate. It is not uncommon for adenoid surgery to be required. When symptoms appear, the child should be tested for allergies that should then be treated if this is the case. Adults, and especially parents, should avoid smoking around children. This particularly applies while at home and in cars. As with all diseases, the best treatment for sinusitis is prevention . With this in mind, you should choose a crèche or nursery school with great care. Look for large, well-ventilated rooms and a low number of children per room. Meet the otorhinolaryngology team from Hospital da Luz. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
