Rhino-sinusitis

Rhinosinusitis in children, more commonly known as sinusitis, is an infection and inflammation of the sinuses and nasal cavity.

What is rhinosinusitis?

Rhinosinusitis, also called sinusitis, is the infection and inflammation of the sinuses and nasal cavity.

There are three main types of rhinosinusitis:

• Short-term (acute) – symptoms last less than 12 weeks

• Long-term (chronic) – symptoms last longer than 12 weeks

• Recurrent – the infection comes back again and again (three or more times in a year)

Causes and symptoms of rhinosinusitis

Symptoms of rhinosinusitis in children

The symptoms of rhinosinusitis in children cross over with those of several other conditions. It’s therefore important to always seek a medical diagnosis if your child is unwell.

Symptoms of rhinosinusitis to look out for in your child include:

• A blocked or runny nose

• Thick, coloured discharge from the nose

• Postnasal drip (mucus dripping down the throat)

• Headaches

• A cough

• Pain or soreness over their cheeks/under eyes

• A temperature

• Mouth breathing

• Nasal speech

• Snoring

• Loss of smell

Causes of rhinosinusitis in children

The two most common causes of rhinosinusitis in children, particularly in those under the age of 7, are a large adenoid and recurrent colds (upper respiratory tract infections).

Children between the ages of 2 to 5 years old have an average of 8 colds (upper respiratory tract infections) a year. Symptoms include a blocked-up and runny nose which then becomes mucky before getting better without treatment in approximately 10 days. For children between the ages of 1 to 3 years, symptoms may continue for over 15 days.

If the sinuses become blocked with discharge, bacteria may start to grow, which can lead to rhinosinusitis.

Rhinosinusitis in children is also a common complication of allergic rhinitis, one of the most common chronic conditions in children (approximately 20% of children are affected). It can be classified as either intermittent (e.g. hayfever) or persistent (all year round) and chances of a child having allergic rhinitis increase when one or both parents suffer from it.

Milk allergy is also often outlined as a cause of rhinosinusitis in the media or on some websites as it is thought that milk causes excess mucus. However, there is no proven relationship between drinking milk and excess mucus. If your child has a milk allergy, they will not have nasal symptoms in isolation and will also show other symptoms such as colic, diarrhoea, lack of weight gain, vomiting, rashes, bronchitis or wheezing, cough, irritability and acute middle ear infection.

How is rhinosinusitis diagnosed?

In children, it can be difficult to diagnose what condition is responsible for the above symptoms as they often overlap and occur simultaneously. Children may also not be bothered by their symptoms.

However, at OneWelbeck, our experienced ear, nose and throat (ENT) specialists use a range of tests to make a fast and accurate diagnosis. They will first ask you for your child’s medical and family medical history before performing a physical examination.

Additional tests including culture swabs, X-rays and CT scans may also be required to determine the cause of the rhinosinusitis, which will help your consultant deliver the most effective treatment possible to your child.

Allergic rhinitis is likely to be diagnosed if sneezing, itchy eyes and family history all occur.  A large adenoid causes similar symptoms to allergic rhinitis without the sneezing or itchy eyes. Long-term health issues with rhinosinusitis could be diagnosed as chronic rhinosinusitis.

How to treat rhinosinusitis in children

Treatment of rhinosinusitis in children depends on a number of factors including the severity of your child’s condition and their age.

Your consultant will recommend the best possible treatment for your child which may include:

• Antibiotics

• Nasal or oral decongestants and anti-inflammatories

• Painkillers

• Surgery to remove their adenoids

• Endoscopic sinus surgery