Sinusitis In Children

Key points about sinusitis in children

• sinusitis is when the small spaces (sinuses) in your child's face become swollen
• a virus is the most common cause of sinusitis
• common symptoms include a blocked or runny nose, face pain or pressure, and cough
• most tamariki get completely better without antibiotics
• some tamariki may need antibiotics to help clear their sinusitis
• see a health professional if your child has a high fever, swelling or redness around the eyes, or a severe headache that is not improving

What is sinusitis?

Sinusitis is when the linings of the sinuses become swollen or inflamed. The sinuses are air-filled spaces in the bones of the face — around the nose, cheeks, forehead, and eyes. Normally, they make mucus that drains freely into the nose.

Acute sinusitis

Acute sinusitis can happen when your child catches a cold. The virus causes swelling of the sinus linings, which then produce more mucus. This causes a blocked or runny nose and facial pressure. If the mucus can’t drain properly, bacteria can grow and cause a bacterial sinus infection. Most tamariki get completely better after acute sinusitis with no ongoing nasal symptoms.

Chronic sinusitis

Some tamariki  have chronic sinusitis. This is where the sinus linings stay swollen even when they are not sick. They often seem like they have a mild cold all the time.

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The illustration shows a child’s face with a circular area enlarged to show the sinuses.

• The top circle is labelled Normal and shows a clear, open sinus cavity.
• The lower circle is labelled Sinusitis and shows inflammation and swelling in the sinus, with a build-up of yellow mucus inside.

At the top right is the KidsHealth logo with the website: kidshealth.org.nz. 

A bit about the sinuses

Tamariki are born with some sinuses, but not all of them. Others develop as your child grows. The sinuses are air-filled spaces within the skull.

There are 4 main sinuses.

expand_circle_down expand_circle_upMaxillary sinus

In the cheek area. They are present at birth and fully developed by about 12 years of age.

expand_circle_down expand_circle_upEthmoid sinus

Between the eyes. They are present at birth and fully developed by about 12 years of age.

expand_circle_down expand_circle_upFrontal sinus

In the forehead just above the eyebrows. They start to appear around 3 years of age and are fully developed by around 20 years of age.

expand_circle_down expand_circle_upSphenoid sinus

Deeper in the skull behind the nose. They start to appear around 8 years of age and fully develop by about 15 years.

 

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The illustration shows a child’s face from the front and the side, with each sinus area shaded pink.

• On the front view, the Ethmoid sinus, Frontal sinus, and Maxillary sinus are labelled.
• On the side view, the Sphenoid sinus and Maxillary sinus are labelled.

At the top left is the KidsHealth logo with the website: kidshealth.org.nz.

Causes of acute sinusitis in children

Viruses

A viral infection, like a cold, is the most common cause of sinusitis.

Colds In Children

Bacteria

Bacteria can also cause sinusitis in tamariki.

Allergies

Allergies such as hay fever can also trigger symptoms that are like sinusitis. This may only happen at certain times of the year, like spring when pollen is high. Some tamariki may have symptoms all year round if allergic to something like dust mites. Allergy doesn't actually cause sinusitis, but the symptoms are similar to chronic sinusitis.

Allergy In Children

Other

Some tamariki with structural problems in their nose may get sinusitis. An example is a bend in the dividing wall between the two nostrils. This is called a deviated septum. 

Having something stuck in the nose, such as a pea or a piece of LEGO, can also cause ongoing nasal mucus.Irritants in the air, such as smoke, can also trigger sinusitis.

Symptoms of sinusitis in children

Symptoms depend on your child’s age and the cause of their sinusitis.

Common symptoms in tamariki and rangatahi include:

• a blocked or runny nose
• thick yellow or green mucus
• a cough, which may be worse at night
• pain around the eyes, cheeks and forehead
• swelling or pressure around the eyes, cheeks or forehead
• headache
• fever
• tiredness

Diagnosing sinusitis in children

A health professional can diagnose sinusitis based on symptoms and an examination. Most tamariki do not need tests or scans. 

Your health professional may refer your child to an ear, nose and throat (ENT) specialist if:

• your child’s symptoms are very severe
• your child's symptoms do not improve with treatment
• your child's symptoms keep coming back

Managing sinusitis in children

Most cases of sinusitis are mild and clear up in about 1 to 2 weeks. If a virus causes your child’s sinusitis, antibiotics will not help.

Pain relief medicine

Paracetamol

If your child has pain, you can give paracetamol to make them more comfortable. Always follow the dosage instructions on the bottle. It is dangerous to give more than the recommended dose.

Other medicine

Your health professional may prescribe your child ibuprofen (such as Nurofen or Fenpaed). You can also buy it at the pharmacy. In both cases, follow the dosage instructions carefully. It is dangerous to give more than the recommended dose. Never give your child aspirin, as this may increase the risk of Reye syndrome, a rare and serious illness.

Antibiotics

Viruses cause most sinusitis, so tamariki usually don't need antibiotics. But a bacterial infection can sometimes also occur. 

Your health professional may prescribe antibiotics if your child:

• has symptoms that are not improving after 10 days
• has severe symptoms such as high fever, facial pain, or swelling
• starts to get worse after first seeming to improve

Looking after your child with sinusitis

Encourage your child to rest

Your child may feel tired and low in energy when they are unwell. Encourage them to rest. 

Give plenty of fluids

Encourage your child to drink plenty of fluids. Offer small, frequent sips of water.

Warm compress over the face

Holding a warm folded face cloth over the painful areas of your child’s face may help. Make sure the face cloth is not too hot.

Sinus rinse

Some older tamariki may get relief from a sinus rinse. A sinus rinse uses saline to help clear mucus from the nose. It flushes out mucus and uses no medicine, just salt water, so it is gentle on the nose. You can buy a saline rinse bottle and saline sachets at the pharmacy.

Saline drops 

You can try saline drops or sprays for younger tamariki. You can find these at the pharmacy. Saline helps loosen and clear mucus and can improve stuffiness.

Treatments to avoid giving your child

Research shows oral decongestants do not help tamariki with sinusitis. Do not use them.

Breathing in steam (steam inhalation) is a traditional remedy but it’s not recommended. There is little research to show it helps. There is also a risk your child might burn themselves.

Antihistamines usually don't help sinusitis unless an allergy has triggered it. For allergies, your health professional may suggest a steroid nasal spray.

When to get medical help for your child with sinusitis

If you think your child has sinusitis, see a health professional. They can suggest the right treatment for your child.

See a health professional urgently if: 

• your child has a high fever
• your child has swelling or redness around the eyes
• your child complains of a severe headache
• your child’s symptoms suddenly get worse
• your child is not eating or drinking well
• your child’s symptoms last more than 10 days
• you feel worried for any reason

Can sinusitis come back?

Yes, sinusitis can come back, especially if your child often gets colds or has allergies. Most tamariki only get it now and then, but some may have repeated episodes. If sinusitis keeps coming back, talk with your health professional. 

If your child is well but they have ongoing mild cold-like symptoms, see a health professional. They can look for causes and suggest the best treatment.