How does sinusitis manifest in 3-year-old children? Sinusitis in children: signs, symptoms and proper treatment

The site’s parents’ questions are answered by a child/adult ENT doctor of the highest category, otolaryngologist surgeon, consultant of the LIKAR.INFO site, Kot Vyacheslav Fedorovich.

Vyacheslav Fedorovich, tell us what sinusitis is and what are its causes?

Sinusitis is an inflammation of the mucous membrane of the maxillary (or maxillary) sinuses. The inflammatory process is caused in 90% of cases by respiratory infections (viral or bacterial), less often - about 10% of cases, by infections of the dental system (in this case, sinusitis is called odontogenic). In rare cases, post-traumatic sinusitis, sinusitis caused by a fungal infection, a foreign body in the maxillary sinus, etc., may develop.

What are frontitis and ethmoiditis?

Along the nasal passages there are several air cavities: large paired sinuses: frontal, maxillary, sphenoidal and many small ones: anterior, middle and posterior ethmoid sinuses. These are bone cells, continuously lined with mucous membrane on the inside. The localization of the inflammatory process of the mucous membrane in the frontal or ethmoidal (ethmoidal) sinuses has a corresponding name. The reasons, as in the case of sinusitis, are the same: respiratory infections (viral or bacterial).

At what age can children develop sinusitis?

From birth, the maxillary sinus exists as a small gap - without air. The formation of the sinus occurs by the age of 4 and, further, it increases in volume according to the development of the facial skeleton. It is generally accepted that the diagnosis of “Sinusitis” is appropriate from the age of 4, with the caveat of individual variability in the timing of development of the maxillary (maxillary) sinus.

What are the first signs of sinusitis in children and what should parents pay attention to?

Since sinusitis, in most cases, is a complication of an acute respiratory infection (ARVI or ARI), the first signs of its development will be prolonged cold symptoms: the duration of the cold is more than 5-7 days, an increase in body temperature on the 5-7th day from the onset of the cold, discharge from the nose become purulent (colored, with an unpleasant odor), a headache appears in the area of ​​the cheeks and bridge of the nose. It is especially necessary to closely monitor your well-being for those who have already had sinusitis.

Based on what examinations or methods is the diagnosis made?

To reliably identify the presence of sinusitis, the doctor needs to interview the patient, examine him, analyze data from additional research methods: a general blood test, radiography of the paranasal sinuses, and examine the nasal passages and nasopharynx using a video endoscope. The most reliable and informative method (used in doubtful cases or in case of exacerbation of chronic sinusitis, previous operations on the paranasal sinuses, or suspected odontogenic (dental) nature of sinusitis) is spiral computed tomography of the paranasal sinuses (SCT SPN). The more information the doctor has to analyze, the more accurate the diagnosis will be.

What complications does untreated sinusitis cause in the future?

In most cases, after an inflammatory process for more than 3 months, irreversible damage to the mucous membrane of the maxillary sinus develops, and it loses its protective properties. In this case, acute sinusitis becomes chronic. Much less often, intraorbital or intracranial complications of sinusitis occur, when from the cavity of the maxillary sinus the infection penetrates into neighboring sections: the orbit or the cranial cavity, damaging the tissue and function of these areas. These are serious complications and not in all cases it is possible to restore damaged organs, and sometimes even save lives.

How are sinusitis treated in children?

Depending on the severity of sinusitis and its cause, one or another treatment regimen is selected. Home or hospital treatment is required for 7-10 days. For a bacterial infection, the main treatment is antibacterial drugs orally for 7-10 days, vasoconstrictor drugs locally, anti-inflammatory, analgesic, antipyretic, and herbal medicines are prescribed symptomatically. According to indications, treatment is supplemented with appropriate procedures: puncture of the maxillary sinus, placement of a YAMIK sinus catheter, lavage of the nasal passages according to Proetz (cuckoo), etc. Additional procedures can increase the effectiveness of treatment, reduce its duration and the duration of taking antibacterial drugs. In the recovery stage, physiotherapeutic procedures and herbal remedies are indicated for another 1-2 weeks, until the mucous membrane is completely restored.

If, after a prolonged acute respiratory viral infection, accompanied by a runny nose and cough, the baby is pale, has blue under the eyes and the temperature is constantly low (a little over 37o C), the nose is still stuffy. Is this already chronic sinusitis? What to do next?

Chronic sinusitis develops after 3 months of untreated or ineffectively treated sinusitis. Self-medication is the longest and riskiest path to recovery. You should choose a doctor whom you can trust and follow all his recommendations.

What treatment methods are used for acute sinusitis?

Depending on the severity of sinusitis and the cause that caused it, one or another treatment regimen is used. Home or hospital treatment is required for 7-10 days. For a bacterial infection, the main treatment is antibacterial drugs orally for 7-10 days, vasoconstrictor drugs locally, anti-inflammatory, analgesic, antipyretic, and herbal medicines are prescribed symptomatically. According to indications, treatment is supplemented with appropriate procedures: puncture of the maxillary sinus, placement of a YAMIK sinus catheter, lavage of the nasal passages according to Proetz (cuckoo), etc. Additional procedures can increase the effectiveness of treatment, shorten its duration, reduce the duration and dosage of taking common antibacterial drugs . In the recovery stage, physiotherapeutic procedures and herbal medicines are indicated for another 1-2 weeks, until the mucous membrane of the maxillary sinus is completely restored.

Do herbs help in treating this disease?

Herbal medicines are prescribed as auxiliary and symptomatic agents. They are selected according to the stage of the disease or the stage of treatment, help to increase the effectiveness of basic therapeutic drugs, reduce treatment time, and stimulate recovery processes in the mucous membrane of the maxillary sinuses.

Is it possible to warm up the nose with sinusitis?

At the stage of purulent infection, this can aggravate the course of sinusitis or cause complications - the spread of infection to surrounding organs and tissues. During the recovery stage, dry heat will accelerate the recovery processes in the mucous membrane.

What is the prevention of sinusitis in children?

Timely and complete treatment of acute respiratory infections and acute respiratory viral infections: initiation of treatment as early as possible, adherence to a home regimen, monitoring by an ENT doctor.

Planned elimination of predisposing factors (deviated nasal septum, enlarged adenoid vegetations, etc.).

Strengthening general and local immunity (hardening, proper sleep, regular meals, fresh air, adherence to work and rest regime)

Preventive measures: vaccinations according to the calendar (the only purpose of vaccinations is the prevention of diseases, including respiratory ones), seasonal use of local vaccinating drugs (IRS 19, Immudon), oral vaccines (ribomunil, bronchomunal, etc.), immunomodulating agents (amixin , arbidol, groprinosin, etc.) under the supervision of a doctor.

Kot Vyacheslav Fedorovich

pediatric/adult ENT doctor

otolaryngologist surgeon

The symptoms of sinusitis are known to almost every adult. With a prolonged runny nose, accompanied by nasal congestion, fever, headache and pain directly in the maxillary sinuses, men and women know that they should immediately go to the hospital and undergo appropriate treatment. With young patients things are more complicated. Sinusitis, which occurs quite often due to the imperfection of the immune system in children, manifests itself with nonspecific symptoms, which, moreover, children are not always able to describe. It is important for parents to recognize the disease as early as possible in order to provide timely treatment to the child and avoid worsening his condition.

Causes of inflammation of the maxillary sinuses in children

Inflammation of the maxillary (maxillary) sinuses can occur in people of any age. According to medical statistics, sinusitis is diagnosed in children even more often than in adults. There are a number of explanations for this.

1. Most often, inflammation of the maxillary sinuses has a viral or bacterial etiology. Children under 12-14 years of age are most susceptible to ARVI and other viral and bacterial infections. Firstly, due to the age-related characteristics of the immune system. Secondly, because they are constantly in an aggressive environment - kindergartens and schools, where they constantly come into contact with carriers of one or another microflora. Bacteria or viruses that provoke respiratory diseases, in particular sinusitis, spread through the nasal passages into the maxillary sinuses, where the inflammatory process occurs. In this case, it is necessary to treat the disease-cause and the sinusitis itself.
2. The same imperfection of the child’s immune system explains their susceptibility to allergic reactions. Sinusitis in young children can be of allergic origin. Therefore, after the inflammation has been treated, it is necessary to determine what exactly the baby is allergic to and carry out sensitization.
3. The baby may be a carrier of opportunistic microflora. If his body is attacked by a virus, all the body’s defenses are directed to repel it. Against the background of weakened immunity, bacteria begin to multiply, and sinusitis develops. To prevent the disease from recurring after it has been cured, you need to do a bacterial culture and determine which bacteria is causing it. An analysis of the sensitivity of bacteria to antibiotics, carried out simultaneously with bacterial culture, significantly facilitates treatment.
4. Sinusitis in children 3-12 years old can occur due to adenoids. Inflamed and enlarged, they prevent full nasal breathing and create a warm and moist environment in the nasal cavity. This is ideal for the growth of bacteria, including in the maxillary sinuses.

Sinusitis in a child under one year, and sometimes up to three years, is diagnosed very rarely. The fact is that at that age the maxillary sinuses are physiologically immature, and there is little room for the development of infection.

Inflammation of the maxillary sinuses of odontogenic origin is also quite rare in children under 10-12 years of age due to the underdevelopment of dental roots. Teenagers are recommended to undergo timely dental sanitation and treatment so that problems with them do not lead to sinusitis.

Signs that will help identify sinusitis in a child in time

Symptoms of sinusitis in children are nonspecific, often similar to the symptoms of acute respiratory viral infection, accompanied by rhinitis. But the treatment of inflammation of the maxillary sinuses is completely different, and often includes antibacterial therapy and surgical techniques.

In order to promptly recognize the disease, parents should monitor the child and, if the following signs are detected, immediately describe them to the doctor.

Based on the symptoms described by the parents or the baby himself, a clinical blood test, and the results of an ultrasound examination of the maxillary sinuses, the doctor makes a final diagnosis and determines treatment tactics. If the little patient’s condition is moderate, he is treated at home. In parallel with antibiotics, vasoconstrictors, anti-inflammatory drugs, and drugs to relieve symptoms of sinusitis, traditional methods can be used. Usually, the child recovers completely within 10-14 days. He will need a restorative regime for another month.

When we hear the word “sinusitis,” we immediately understand that it is a serious matter. If a three-year-old child suffers from this, and the diagnosis is confirmed by an ENT doctor, then many parents panic, which is understandable. But this does not need to be done, since the main thing is to start treatment as early as possible.

Treatment of sinusitis in children

Note! Sinusitis is an inflammation of the mucous membrane of the maxillary (maxillary) sinus. Children often experience an acute form of the disease, but sometimes the disease becomes chronic.

In preschool age, children suffer from this disease more often than others, because the defense system of their bodies is not yet strong enough. The peak occurs in winter, characterized by a weakened immune system and hypovitaminosis.

Development of the sinuses in children

Sinusitis in a 3 year old child: symptoms

Sinusitis at such a young age can develop not only due to immunity disorders, but also due to infectious (such as measles, stomatitis, caries, etc.) and viral diseases (ARVI, influenza), allergic rhinitis, the presence of adenoids or polyps in the nose, deformation of the nasal septum. Due to the physiological characteristics of the child’s body (insufficient development of the maxillary sinuses and, as a consequence, lack of space for the accumulation of pus), the disease is quite rare until one or two years of age. But from the age of three, everything changes dramatically.

How does sinusitis manifest?

Depending on the method of occurrence, the following types of sinusitis are distinguished:

• rhinogenic (occurs as a result of rhinitis);
• traumatic (mentioned septal deformation);
• odontogenic (develops against the background of dental disease);
• hematogenous (the causative agent is an infection).

Signs of sinusitis include difficulty in nasal breathing, swelling of the mucous membrane, and severe pain in the area of ​​the maxillary sinuses. When your baby bends over, he may get a headache. The temperature also rises, and the discharge takes on a greenish tint, becomes thick and abundant.

Manifestations of sinusitis

Note! Another sign of sinusitis is the recurrence of a runny nose within ten days from the moment of temporary improvement.

In fact, sinusitis develops in the same way as other diseases from the group of sinusitis: the maxillary sinuses swell, as a result of which the openings narrow, a large amount of mucus accumulates, in addition, the activity of the “cilia” of the mucous membrane is noticeably impaired. Accumulated mucus clogs the openings, preventing air access. Anaerobic microorganisms that produce pus actively multiply.

But how do you know that a child has exactly the disease described, and what symptoms should you pay attention to? With a simple runny nose, both nostrils become clogged, while sinusitis is characterized by alternating congestion.

Mucus in the maxillary sinus

Symptoms of sinusitis also include dull pain and sinus congestion, which does not go away even after thoroughly blowing your nose. And if you lightly press the baby’s “dog pits” (these are points in the middle of the cheeks), then pain will occur in the inner corners of the eyes. Another phenomenon that should alert you is an increase in temperature on the sixth or seventh day after the onset of a cold.

If no improvement in a long-term illness is observed after a week, and purulent mucus is released from the nose, then the child should be urgently shown to a doctor. Deterioration of the sense of smell, lack of appetite, lethargy, moodiness, nasality, chills, swelling of the cheeks and eyelids - all this is also typical for children suffering from sinusitis.

Examination of a child by an ENT specialist

To finally confirm the diagnosis, the doctor must perform an instrumental examination and do a blood test. Radiography is considered a reliable method for detecting sinusitis: dark areas near the sinuses will be clearly visible on the x-ray. Final confirmation will be provided by a puncture of the maxillary sinus, but such a procedure is done extremely rarely due to possible complications (such as blockage of blood vessels, emphysema of the eye or cheek, abscess).

In the photo - x-ray of the paranasal sinuses, diagnosis - sinusitis

If odontogenic sinusitis is suspected, the child undergoes a computed tomography scan of the maxillary sinuses.

CT scan of the sinuses

Features of the treatment of sinusitis

Often the disease can be treated at home; there is no need to go to the hospital (provided it is detected early). The child needs to rinse the nose from accumulated mucus, ensure comfortable nasal breathing and, of course, fight germs.

Rinsing a child's nose

To alleviate the patient's condition, parents can take additional measures.

1. The indoor air can be humidified using a household humidifier (40% to 60% required).

   Humidifier

2. Also, the child must be protected from all sources of pollution - dust, cigarette smoke, exhaust gases, etc.
3. The room temperature should be within 20-22°C.
4. To remove mucus from the nose, it must be regularly treated with “sea” water (for example, with the drug “No-Salt”).

   No-Sol moisturizing

   For small children this water is instilled in the form of drops. Mucus is also sucked out of the nose using a special bulb or suction.

   Syringe for suctioning mucus

5. If the body temperature exceeds 38.5°C, then the baby should be given an antipyretic drug (for example, Ibuprofen in a dosage appropriate for age).

   Ibuprofen for children

In addition to home treatment, parents should visit a doctor who, if necessary, will prescribe sprays to improve nasal breathing (for example, Sanorin) and antibacterial agents.

If we are talking about an advanced form of the disease or sinusitis lasts for several weeks, then doctors resort to more serious measures: the child has pus sucked out from the maxillary sinuses, after which they are washed with antibiotic solutions. Typically, this should be done exclusively by an otolaryngologist in strict accordance with the indications.

"Cuckoo" method

Washing using the cuckoo method

This method is used for severely advanced disease that is no longer amenable to drug treatment. The procedure is painless, which is an important advantage for a child aged three years. A tube is placed in one nostril of the baby, through which a disinfectant mixture is supplied, and from the other the mucus is sucked out with a vacuum. To prevent the drug from entering the larynx, the patient is asked to constantly say “ku-ku” (hence the name of the method). Along with mucus, germs are removed from the nose, resulting in normal breathing. After the first procedure, the child will already feel relief, but for complete recovery it must be done at least five times.

Nasal rinsing using the cuckoo method

Surgery

The puncture is performed extremely rarely, only in the most complex and advanced cases. If you go to the hospital in a timely manner and undergo further treatment, there is no need for a puncture.

Surgical treatment of sinusitis

In addition, the sinuses are cleaned using an endoscope, and at the same time, secondary problems (polyps, hypertrophy), which are often the cause of the long-term progression of the disease, are removed.

Note! Chronic sinusitis in young children is characterized by symptoms such as pain and sore throat, recurrent runny nose, severe cough, which does not respond to conventional treatment methods, because pus moves along the back wall of the pharynx. Therapy in such cases is no different from the treatment of acute sinusitis, except that the course can last up to three weeks.

Preventive measures

It happens that sinusitis appears every year, if not more often. And in each case, after a runny nose, the inflammatory processes go further, purulent discharge is formed, and sinusitis can drag on for months.

Prevention of sinusitis

In such cases, a professional examination of the nasal cavity is required. Very often, sinusitis is caused, as noted above, by polyps, painful enlargement of shells, deformation of the septum, cysts, etc. In the case of a three-year-old child, it is difficult to overestimate the impact of the environment, or more precisely, the level of humidity and air temperature, as well as the number of sources of air pollution. And if the air in your area is dirty and the child is sick all the time, then the best way out of the situation would be to move to a more favorable area. If this is not possible, then you should resort to simpler measures: walk with your child outside for at least three hours every day, maintain normal humidity and temperature in the house, and, if possible, purchase an air purifier.

Hardening children in winter

As they grow older, it is recommended to instill in your child the habit of daily cleaning his nose with “sea” water, especially in winter. This can be made part of a familiar ritual - brushing your teeth, for example. This habit will reduce the number of exacerbations several times, and there are practically no contraindications for this method (the exception is otitis media).

Sprays for rinsing the nose with sea water

Video - How to treat sinusitis in a child

Sinusitis in 3 year old children - how to diagnose and treat?

Sinusitis is a fairly common inflammatory disease. The pathology develops against the background of infections, allergic rhinitis, and in young children in the early stages it is asymptomatic. Before treating sinusitis in a 3-year-old child, you must seek medical help; traditional methods can be dangerous.

Lack of treatment, especially in young children, can lead to serious complications that develop faster than in adults, with a high probability of disability and death. The article describes the symptoms, methods of treatment and prevention of the disease.

Sinusitis - what is it, how does the disease progress?

Sinusitis is an inflammation of the paranasal sinuses that occurs due to the penetration of harmful microorganisms into them; the disease can be confused with rhinitis and other colds. Sinusitis is based on inflammation, the signs of which are: pain, swelling of the mucous membrane of the maxillary sinuses, increased production of exudate (mucus), which in nature (and depending on the stage of the infectious process) can be serous or purulent.

Types of disease

Many parents are interested in the question: what forms of sinusitis exist? In medicine, there are several classifications of the disease. Sinusitis can occur in chronic and acute (purulent, catarrhal) forms.

Classification according to the prevalence of pathology:

• unilateral - only one sinus is affected;
• bilateral - both sinuses are involved.

By etiology:

• viral;
• allergic;
• fungal;
• traumatic;
• mixed.

According to clinical manifestations:

• allergic;
• catarrhal;
• polyposis;
• atrophic;
• mixed.

The reasons for the development of sinusitis, why does it appear?

The causes of the disease in a three-year-old child coincide with those in adults, but the course of the disease has certain characteristics. Most often, diseases develop as complications of acute respiratory viral infections. According to the famous pediatrician E.O. Komarovsky, any infection accompanied by a runny nose affects the sinuses.

At the initial stage, the disease is asymptomatic; when pathological fluid accumulates, the baby’s nose becomes blocked, his behavior changes, he begins to be capricious and cry. If the symptoms do not go away on days 5-7, then with a high degree of probability the development of sinusitis (sinusitis in particular) can be suspected.

Other reasons:

• congenital anomalies of the nasal cavity;
• allergic rhinitis;
• adenoids, enlarged tonsils;
• chronic infections;
• nasal septum injuries;
• vascular disorders.

The risk of developing the disease increases with hypothermia, unbalanced nutrition, and stressful situations.

How to recognize sinusitis in a child?

How to determine sinusitis in a 3-year-old child who cannot clearly say where it hurts? The inflammatory process with sinusitis in a young child is extremely rare, since the maxillary sinuses, where inflammation occurs, are not yet fully formed. The disease is asymptomatic because the fluid flows into the nasal cavity or down the back of the throat.

Does sinusitis occur in children under 3 years of age? Rarely, but it occurs, for example, if the final formation of the maxillary sinuses in a child occurs faster due to the individual characteristics of the body. In such cases, there is a risk of developing sinusitis in very young children. Parents may not immediately notice the inflammatory process, since the baby, due to his age, cannot talk about his feelings. Many mothers are interested in whether a 3-year-old child can have sinusitis, what are the symptoms, and what signs should one be wary of? First of all, you should focus on changes in the baby’s behavior, secondly, it is important to carefully examine the nasal cavity.

The main differences between sinusitis and rhinitis (common runny nose) are as follows:

• nervous behavior, moodiness, screaming, crying;
• nasal congestion, strong mucous (purulent) discharge;
• heaviness and dull pain in the sinuses, lack of relief after blowing your nose;
• pain when lightly pressing a point in the central part of the cheek and near the inner corner of the eye;
• signs of intoxication;
• the duration of the disease exceeds a week;
• temperature increase;
• loss of interest in toys and regular games.

The following symptoms of sinusitis in children indicate transformation into a chronic form of the disease:

• temperature up to 37 – 38 ºС;
• treatment-resistant night cough caused by the flow of nasal contents down the back of the throat;
• keratitis, conjunctivitis.

If there are noticeable changes in the baby’s behavior or symptoms of intoxication, medical attention is needed; its absence can lead to serious complications and consequences.

Examination of the child, diagnostic methods

It is not easy to make a diagnosis in 3-year-old children; even an experienced doctor can do this only based on test results and with the help of additional studies. As part of the diagnosis, the otolaryngologist examines the mucous membranes of the mouth and nasal cavity. Signs of sinusitis in children 3 years old are swelling and redness. If you have a toothache, you need to be examined by a dentist, as the pain syndrome can be caused by dental pathology.

Based on the initial examination, suspicions may arise, which can be confirmed by the following methods for diagnosing sinusitis:

• radiography of the paranasal sinuses;
• general blood analysis;
• Ultrasound of the sinuses;
• microbiological examination of discharge from the nose/sinuses themselves.

Sinusitis poses a danger to others only if it is of viral origin; the main route of infection is airborne. In this case, if there are two children in the apartment, the second one should be isolated.

Effective treatments

Many parents are interested in how to cure sinusitis in a 3-year-old child? The main therapeutic method is taking medications; complex therapy includes physiotherapy, rinsing of the nasal cavities and paranasal sinuses. How else to treat babies? In difficult situations, a puncture may be required.

Medicines - what medicines help?

Preparations:

• local antibiotics (drops, sprays), incl. penicillins, cephalosporins, macrolides, the choice depends on the type of pathogen;
• vasoconstrictor drugs - help reduce swelling;
• antihistamines - if the disease develops against the background of allergic rhinitis;
• anti-inflammatory drugs (NSAIDs, corticosteroids);
• mucolytics;
• immunomodulators.

Physiotherapeutic techniques

Physiotherapy is widely used in the treatment of sinusitis in children; it is considered an effective method as part of complex therapy, but only a doctor can select adequate methods. The mechanism of development of inflammatory processes plays an important role; most often, a specialist prescribes procedures whose action is aimed at activating blood circulation and reducing swelling of the mucous membrane of the nasal passages. The main goal of physiotherapy is to remove pus from the maxillary sinuses; ultrasound, electrophoresis, UHF therapy, and ultraviolet irradiation are most often used.

In case of sinusitis in children, vibroacoustic therapy is recommended. The Vitafon device helps reduce swelling of the mucous membranes, activates lymphatic drainage and venous outflow, resulting in improved blood circulation, reduced intoxication, stimulated regeneration, and increased body defenses. Therapy with the device is available at home, which is very convenient when treating children, since daily trips to hospitals can provoke relapses and the development of other diseases.

“Cuckoo” method - rinsing the sinuses with solutions

The method of introducing fluid using the method under consideration consists of washing the sinuses, after which bacteria and residual exudate are mechanically removed from the sinuses. The doctor inserts a catheter into one nasal sinus through which a special solution is passed, and a suction is inserted into the other nostril to remove mucus, but the procedure shows effectiveness only in the initial stages.

The “cuckoo” method is not recommended for children under 3 years of age, as it can be frightening. In addition, in this case there is a risk of complications; there is a high probability of the solution getting into the lumen of the auditory tubes, which can lead to otitis media. Experts believe that the benefits in this case are lower compared to the possible risks.

Sinus piercing

In severe cases, inflammation of the maxillary sinuses is often treated with a puncture; the procedure is performed under anesthesia. The wall of the affected sinus is pierced from the inside, through the nasal passage, and then a physiological solution is injected into the sinus through a syringe, which, under pressure, pushes the contents of the sinus into the oral cavity, from where it is subsequently evacuated by suction. The introduction of special liquids into the sinus prevents the re-accumulation of mucus and pus.

Many mothers are afraid to get a puncture even with strong nasal discharge that occurs as the disease progresses. They are afraid that subsequently the child will be forced to constantly treat runny noses and sinusitis in this way, which is not true.

In many countries, puncture has not been used for a long time as a routine treatment for sinusitis in children; puncture is recommended for rare cases when standard methods are ineffective, as well as when there is a real danger to the baby’s life. The puncture is considered in this case as a diagnostic method; after it is carried out, the specialist receives materials to study the microbiological picture of the pathogens, on the basis of which treatment is prescribed.

What will be the consequences and complications?

If there are signs of sinusitis in a 3-year-old child, it is necessary to begin treatment; its absence threatens with serious consequences, which may include: purulent processes in other organs of the head and neck, the spread of purulent exudate through the tissue, with the development of mediastenitis and other dangerous pathological conditions

Other complications:

• inflammation, brain abscesses (meningitis, encephalitis), vascular thrombosis - can lead to disability and death;
• sepsis is the spread of infectious processes throughout the body, accompanied by damage to various systems and organs.

The best treatment is prevention

There is no vaccination against sinusitis; the most effective way to prevent diseases before the onset of symptoms is considered to be the correct organization of the baby’s daily routine. He should wake up and fall asleep at the same time, regularly walk outside, hardening plays an important role. In order to prevent acute respiratory viral infections and acute respiratory infections, the correct microclimate must be created in the children's room, the optimal temperature is 18-20 ºС, humidity should not be lower than 50-70%. Dry indoor air weakens the immune system, resulting in decreased resistance to microorganisms.

The baby should be protected from dust and cigarette smoke; it is recommended to purchase an air humidifier. One of the causes of the disease is allergic rhinitis; timely comprehensive examination will help identify the allergen and prevent the development of sinusitis as a complication of rhinitis. In order to prevent the spread of infection, it is recommended to sanitize the oral cavity and remove adenoids and tonsils if necessary.

Conclusion

Sinusitis is a dangerous disease, the symptoms of which can be confused with signs of a common runny nose or colds. It is very difficult to independently diagnose the disease in children under 3 years of age, especially in one-year-old babies. Only a doctor can make a diagnosis based on examination data; self-administration of antibiotics is contraindicated; you should also refrain from using traditional prescriptions. All doctor’s recommendations should be strictly followed, this also applies to treatment at home.

Article rating:

In childhood, acute sinusitis ranks second among inflammatory processes of the ENT organs. Sinusitis is diagnosed in children starting from 1 year of age. Parents should know the peculiarities of the course of the disease in order to consult a doctor in time. After all, many young mothers associate nasal congestion in their child and the presence of mucous discharge with a common runny nose due to a viral infection. And the lack of timely treatment can lead to serious consequences. In this article we will look at the main symptoms of sinusitis in children, methods of diagnosis and treatment.

Causes

The main pathogens are streptococci, pneumococci, E. coli, influenza virus and their combinations. The most favorable conditions are created during acute viral infection, since viruses suppress the work of epithelial cells, disrupt the production of immunoglobulins, and reduce the content of lymphocytes and macrophages - the body’s protective cells. And the “bare” layers of the nasal mucosa are the optimal factor for the proliferation of coccal flora.

The source of infection in the body is also often an inflamed pharyngeal tonsil. Acute sinusitis occurs in most cases as a complication of rhinitis or adenoiditis.

Experts divide acute sinusitis depending on the source of infection into:

• rhinogenic;
• hematogenous;
• odontogenic.

According to the form of the inflammatory process, they are distinguished:

1. Catarrhal sinusitis.
2. Purulent sinusitis.
3. Hemorrhagic sinusitis.
4. Necrotizing sinusitis.

Pathogenesis

Why can sinusitis develop as a result of banal rhinitis? This occurs due to dysfunction of the mucous membrane, blocking drainage and aeration of the sinus.

Occlusion of the natural openings connecting the nasal cavity with the maxillary sinus occurs due to swelling of the mucous membrane, in the presence of thick exudate, hyperproduction of mucus containing a high concentration of mucoid. All this ultimately leads to disruption of ventilation, a decrease in the partial pressure of oxygen, an increase in carbon dioxide content, and suppression of the function of the ciliated epithelium. This creates favorable conditions for the development of anaerobic infection.

Acute sinusitis is most often diagnosed in children. This is due to the anatomical structure of the sinus. Due to the low location of the outlet openings, slight swelling of the nasal mucosa may impair its drainage, which leads to congestion.

Clinic

With sinusitis, there is a clear deterioration in the general condition. Acute sinusitis occurs with fever, weakness, and loss of appetite (a complete refusal to eat is also possible). Children become capricious and irritable. Locally, it is possible to detect impaired nasal breathing and nasal congestion (usually bilateral). With the catarrhal form of inflammation, nasal discharge is insignificant.

Purulent, necrotic, hemorrhagic sinusitis in a 3-year-old child is severe. There are pronounced general and local manifestations of the disease. Mucous, mucopurulent discharge appears, and sometimes snot streaked with blood. Children 5 years old can also report having a severe headache. In children 3 years old, it is not always possible to identify subjective signs. This complicates the diagnostic process a little.

During a clinical examination, the otolaryngologist diagnoses swelling of the cheek, swelling of the eyelid, and signs of conjunctivitis. On palpation, the area that corresponds to the outer wall of the maxillary sinus is painful. Breathing through the corresponding half of the nose is difficult.

Diagnostics

To confirm whether a child has sinusitis, otolaryngologists perform an additional examination - anterior rhinoscopy. With inflammation of the maxillary sinus, it is possible to identify:

• Hyperemic, swollen nasal mucosa.
• Mucous, mucopurulent discharge under the middle concha. With severe edema due to compression of the outlet, pathological exudate is often absent.

Since the presence of discharge in the area of ​​the middle nasal meatus may also indicate acute ethmoiditis, frontal sinusitis (in children over 5 years old), radiography is indicated for a more accurate diagnosis.

Treatment

How to treat acute sinusitis? When acute sinusitis is combined with viral rhinitis, therapeutic measures are carried out in accordance with protocols for the treatment of respiratory infections. Primary antibiotic therapy for sinusitis in children is indicated if at least one of the following symptoms is present:

1. Soreness in the sinus area.
2. Presence of purulent discharge.
3. The appearance of signs of intraorbital and intracranial complications.

Interesting fact: when symptoms of the disease are detected in France, treatment is carried out from the very first days. Whereas in America, drug therapy is prescribed while maintaining the characteristic clinical picture for up to 10 days or even more (in the case of a bacterial infection).

Antibacterial drugs are used from the group of semisynthetic penicillins and cephalosporins. Amoxicillin is considered the most effective drug against penicillin-resistant pneumococci.

Amoxicillin clavulanate (Augmentin) is active against Haemophilus influenzae and Moraxella. A good alternative to Augmentin are medications such as Sumamed, Clarithromycin.

If sinusitis is detected in a 3-year-old child with characteristic symptoms, physiotherapeutic treatment is carried out only if there is an outflow of exudate. In case of severe disease, hospitalization is indicated. Inpatient therapy for sinusitis includes:

1. Antibacterial agents, the purpose of which is to eliminate pathogens, prevent chronicity of the process, and prevent severe complications.
2. Antihistamines are used to eliminate sensitization in the body.
3. General restorative measures: bed rest, taking multivitamin complexes, eating protein foods, drinking plenty of fluids.

Vasoconstrictor drops (Nazivin, Sanorin) and aerosols (Miramistin) are prescribed locally. It is better to use turundas previously soaked in the same solutions. If conservative treatment is ineffective or there is purulent discharge, sinus puncture is indicated. Next, a Teflon drainage is installed, which improves the outflow of exudate and creates the necessary conditions for washing the sinus. The effectiveness of using the Yamik sinus catheter in children is still being studied.

Surgical intervention is performed regardless of the child’s age if intracranial or orbital complications are suspected.

If nasal congestion has been observed for more than 7 days, while your baby has a fever, is capricious, eats poorly, or has trouble sleeping, do not waste time, consult a doctor immediately. These may be the first symptoms of sinusitis.

Sinusitis in a 3-year-old child is a rather rare occurrence, since this disease is accompanied by an inflammatory process and the accumulation of pathogenic exudate in the maxillary sinuses. Children are born with tiny sinuses, so mucopurulent discharge simply has nowhere to accumulate. As a rule, only by the age of 5 do the maxillary sinuses in children develop to normal size. Consequently, in the vast majority of cases, pathology can occur no earlier than 5 years of age. However, it happens, although quite rarely, that the maxillary sinuses form ahead of schedule. Of course, we cannot talk about sinusitis until one is a year old, but by the age of 2, sinuses can form and, accordingly, along with this, the risk of developing the disease appears.

Rhinitis and sinusitis

Despite the fact that there are cases of early development of paranasal sinuses in children, parents often raise the alarm in vain, mistaking for sinusitis ordinary rhinitis (runny nose), which does not go away for more than a week.

It is important to be able to differentiate between these diseases as they require different treatment approaches.

In this case, any rhinovirus that enters the mucous membrane of the nasal cavity, along with the flow of inhaled air, also penetrates into the paranasal sinuses, including the maxillary sinuses. As a result, inflammation begins in the sinuses, which provokes the production of mucus.

However, the presence of mucous discharge in the cavity, which is usually clearly visible on an x-ray, is not yet a reason to make a diagnosis and resort to antibacterial treatment. In such a situation, most likely, we are talking about non-purulent viral sinusitis, which occurs against the background of ARVI. With a decrease in inflammation and swelling of the nasal mucosa, the affected maxillary sinuses also return to normal. Thus, viral sinusitis goes away with proper and timely treatment of ARVI and does not require specific therapy.

Reasons for the development of sinusitis

As noted above, in children 3 years of age, viral sinusitis most often develops during an acute respiratory viral infection and resolves with its successful treatment. However, if the disease is left to chance or treated incorrectly, then one of the possible consequences is bacterial inflammation of the maxillary sinuses. Bacteria can appear in the maxillary cavity both due to edema (impeding the outflow of purulent masses through the anastomosis) and through the blood. In addition, sinusitis can be triggered by an allergic reaction of the body, injury or a deviated nasal septum. There is also the possibility of developing the disease due to the formation of cysts or polyps in the nasal cavity, but in children, especially at three years old, this happens extremely rarely.

Symptoms of sinusitis

Considering that the maxillary sinuses are located close to the cranial cavity, incorrect or late treatment of the pathology can have very serious consequences, including visual impairment and meningitis. Therefore, it is important to be able to recognize the signs of sinusitis in children in order to promptly seek qualified medical help. The classic clinical picture of sinusitis is as follows:

• long-lasting nasal congestion;
• yellow-green discharge from the nose and its flow down the back of the throat;
• headache (pressure or feeling of heaviness in the forehead and temporal region);
• low-grade fever (37-38 degrees);
• swelling of the eyebrows or cheeks (pain when palpating these areas);
• impaired sense of smell.

In children, the symptoms of sinusitis may be less severe than in adults. In addition, at an early age it is difficult for a child to clearly describe his feelings, so the presence of at least a few signs is already a reason to consult a doctor, because it is better to start therapy in the early stages of the development of pathology. Thus, the effectiveness of treatment of sinusitis in a 3-year-old child depends on the timely detection of symptoms.

Conservative treatment of sinusitis

Before starting treatment, the child must be shown to a doctor to make an accurate diagnosis.

Symptoms of sinusitis in children are not yet a reason to start traditional antibacterial therapy for this disease. Thus, antibiotics are not used for viral sinusitis (antibiotics are powerless against viruses), since taking them does not contribute to recovery, but can only harm the body and increase the risk of complications. However, if a child is diagnosed with bacterial sinusitis, then it is impossible to do without antibiotic therapy, since this is the most reliable and effective method of treatment for both adults and children.

Due to the fact that in order to effectively combat pathogenic bacteria, it is necessary for the antibiotic to accumulate not just in the blood, but in the maxillary sinus itself, usually even children need to take the drugs in fairly high doses. Nowadays, there are a large number of high-quality and effective medications in the form of tablets, so the practice of prescribing antibiotics in injection form is gradually becoming obsolete. Moreover, there are many topical antibacterial agents (sprays, drops). After the first days of therapy, the patient’s condition usually shows noticeable improvements, but it is important not to interrupt the course of treatment, which lasts 10-14 days. Otherwise, there is a high probability of the disease relapse or becoming chronic.

In addition to antibiotics, specialists, as a rule, prescribe vasoconstrictor drops to the patient, designed to reduce swelling of the mucous membrane, which in turn helps restore normal air exchange and the outflow of pathogenic exudate. If sinusitis occurs due to an allergic reaction of the body, then in addition to the above medications, the patient is prescribed antihistamines. It is also necessary, if possible, to limit the child’s contact with the allergen. If the occurrence of sinusitis is associated with a deviated nasal septum, then it must be treated without affecting the main cause. Surgery (septoplasty) is not recommended until the age of 15, until the process of septum formation is completed.

Puncture

In addition to conservative treatment, which is carried out mainly at home and does not require hospitalization, domestic specialists often resort to surgical methods, in particular puncture. When treating children, they try to avoid this procedure, but if the case is particularly severe, it is performed under anesthesia using a Kulikovsky needle. The wall of the maxillary sinus is punctured from the inside of the nose. Using a syringe attached to the needle, saline solution enters the sinus, which promotes the outflow of pathogenic exudate through the oral cavity. Then antiseptic and antibacterial solutions are injected into the sinus to prevent the re-accumulation of mucopurulent masses there.

Many parents are afraid to get a puncture because they believe that the child will be doomed to treat sinusitis this way all his life. However, according to many qualified experts, this is nothing more than a myth. And yet, in many countries around the world, puncture has long ceased to be used as a therapeutic procedure. Abroad, a puncture is performed only in extreme cases, when the disease cannot be treated with standard methods and there is a real threat to the child’s life. In such cases, a puncture is considered a diagnostic procedure, thanks to which the doctor has the opportunity to study the nature of the causative bacteria and prescribe adequate treatment.

Moving fluid through Proetz

Proetz fluid transfer (“cuckoo”) is a sinus lavage performed on an outpatient basis. This procedure is aimed at destroying bacteria and cleaning the maxillary sinuses from the exudate that has accumulated there. A catheter is inserted into one nasal passage, through which a special solution is injected, and into the other, a suction is inserted through which the mucus is removed. However, the “cuckoo” is effective only in the early stages of the development of pathology. In addition, it is not recommended for young children.

This manipulation can simply scare a 3-year-old child. Children often refuse to carry it out with tears and cries of “I can’t.” As most domestic specialists say in such cases, “We must be able to.” However, at the same time, one must be aware that, in addition to the reluctance of the child himself, there is a risk of complications. Since in children the hearing organ is located too close to the paranasal sinuses, the rinsing fluid can enter the tympanic cavity and cause otitis media. Also, if the procedure is performed incorrectly, the olfactory function of the body can be disrupted. Thus, the potential benefits of this procedure for the child are clearly lower than the risks associated with it.

Physiotherapy

An integrated approach to the treatment of sinusitis often includes physical therapy. The attending physician selects procedures that help stimulate blood circulation, reduce swelling, remove exudate from the maxillary sinuses, and relieve pain in the sinus area. As a rule, experts recommend UHF (ultra high frequencies), microwave (ultra high frequencies), UVR (ultraviolet irradiation), UT (ultrasound therapy), electrophoresis, etc. Physiotherapeutic treatment methods can be used only after consultation with a doctor, since they are prescribed depending on the severity and stage of development of the disease.

Traditional methods of treating sinusitis

In order to alleviate the child’s condition and speed up the process of his recovery, they often resort to the use of traditional medicine methods. Some recipes really have a positive effect on the body and help in the fight against sinusitis. However, the use of such methods should be must be agreed with the attending physician. Otherwise, the child’s health may be at risk, because the same manipulations can have different effects on the body at different stages of the disease.

It is strictly forbidden to apply heat to the sinuses (compresses, heating with eggs or cereals) if pus has accumulated in them, as there is a risk of pathogenic exudate breaking into the cranial cavity.

In addition, it is not recommended to use recipes in which onions, garlic, radishes, and cyclamen juice can be found among the ingredients, since there is a risk of burning the mucous membrane. Parents should be careful when using inhalations, which can cause burns to the respiratory tract. The temperature of the liquid should not exceed 30-40 degrees, and you should bend over the container no lower than 30-40 centimeters.

Among the most effective folk recipes for sinusitis for children are the following:

• Nose massage. Gently pressing movements should be applied to the wings and tip of the nose, the outer corners of the eyes, the junction of the nose with the upper lip and the point between the eyebrows.
• Rinse the nose with saline solution. Dissolve 1 teaspoon of table or sea salt in 1 liter of boiled water. You can add a few drops of iodine and 1 teaspoon of soda to this solution. For rinsing, you should use a special kettle, since with the help of a syringe and a syringe, liquid enters the nose under pressure and can cause damage or provoke otitis media.
• Rinse the nose with herbal decoction. You can use chamomile, St. John's wort, sage, string, eucalyptus, etc.
• Nasal drops. Mix boiled water with flower honey in equal proportions and drop 3 drops into each nostril 3 times a day.
• Nasal drops. Mix freshly squeezed beet and carrot juice in equal proportions and drop 3 drops into each nostril 3 times a day.
• Gauze turundas. Soak them in sea buckthorn oil and leave in the nose for 1 hour.
• Gauze turundas. Prepare a mixture of 1 teaspoon of propolis, 50 ml. melted butter and 50 ml. vegetable oil. Moisten the turundas and insert into the nose for 20 minutes.
• Inhalation based on herbal decoction or 5 drops of eucalyptus essential oil (fir oil can also be used).

A fairly common disease is sinusitis in children, the symptoms of which are not immediately detected by parents. An erroneous diagnosis prevents timely initiation of adequate treatment for sinusitis in children. Because of this, the disease often takes on a chronic form and is complicated by other pathologies. The disease is difficult not only to diagnose, but also to treat. The acute phase of the disease can only subside for a while, periodically resuming with renewed vigor. Sluggish sinusitis has a devastating effect on the health of a small child. The inflammatory process spreads to neighboring tissues, causing their damage. Therefore, it is important to detect the disease in time and cope with it at an early stage.

Sinusitis is one of the types of sinusitis.

Sinusitis is an infectious and inflammatory disease of the paranasal cavities (sinuses).

There are several paranasal sinuses located around the olfactory organ. They are called sines. In a healthy person, the sinuses are filled with air. There are 4 groups of sinuses: paired maxillary, frontal and ethmoid labyrinth, in addition, the unpaired sphenoid (main) sinus.

Sinusitis of the maxillary sinuses is called sinusitis. The causes of sinusitis vary. Sinusitis in children can be caused by a runny nose, flu and infectious diseases.

This disease is caused by various microorganisms. In infants under 2 years of age, the causative agents of sinusitis are most often staphylococci. Other pathogenic microorganisms are much less common before the 3rd year of life due to mother-transmitted immunity to them. In a child 3 years of age and older, sinusitis is provoked by various infections, not only staphylococci. The most common cause of inflammation of the paranasal sinuses in children 3 years of age is pneumococcus. Slightly less common pathogens are Haemophilus influenzae, streptococci and staphylococci.

Children 3-4 years old most often suffer from sinusitis. Viruses play a major role in the development of the disease in preschool children. Therefore, sinusitis is more often diagnosed in children in the cold season, when viruses feel most comfortable.

Viruses reduce the local anti-infective defense of the mucous membrane and cause its swelling. Due to the decreased patency of the nasal passages, the natural outflow of fluid from the sinuses is hampered. Accumulating in the cavities, the liquid creates ideal conditions for the proliferation of various pathogenic bacteria.

The reason for the frequent diagnosis of sinusitis in children under 5 years of age is the poor development of the maxillary sinuses.

In addition to infections of the ENT organs, sinusitis can be caused by immune disorders, diseases of the upper teeth and oral cavity, adenoids, trauma, allergies and surgery. Exacerbation of sinusitis in summer may indicate its allergic nature. According to the nature of its course, sinusitis can be acute or chronic.

How to recognize sinusitis in a child? The first signs of the disease appear in children on the 5th-6th day of acute respiratory illness. At this stage, there is a sharp deterioration in the condition of the sick child after a period of obvious improvement. Body temperature rises again, nasal congestion resumes and nasal breathing becomes difficult. Nasal discharge becomes mucopurulent or purulent in nature. They become thick and sticky and difficult to get rid of. Children may complain of pain in the ears or in the upper jaw area.

The pain may be more pronounced with severe nasal congestion and the absence or scarcity of discharge. The pain syndrome in this case is caused by the high pressure of fluid accumulated in the sinuses, the complete outflow of which is impossible. Impaired outflow can be caused by swelling of the mucous membrane of the nasal passages or a violation of the structure of the nasal septum.

A characteristic feature of sinus blockage is pain that appears when you tap your finger on the projections of the nasal sinuses. With sinusitis, a child often suffers from a headache. When the branches of the trigeminal nerve are affected, the pain may radiate to the palate or the eye. Such pain cannot be relieved with analgesics.

After just a few hours, the disease can enter the purulent phase, accompanied by copious purulent discharge and a slight decrease in pain. Despite the abundant discharge from the sinuses, they continue to fill intensively. Within a few days, the sinuses may become overcrowded again.

One of the main signs of sinusitis is a nagging pain in the sinus area that appears when the body bends forward. In addition, a rough cough may appear, which gets worse when lying on your back. Its appearance is associated with the entry of discharge from the nasal passages into the nasopharynx. Another characteristic sign of sinusitis is the lack of effect from using nasal drops. Despite their introduction, nasal congestion does not disappear.

The transition of the disease to a chronic form is often caused by a decrease in the resistance of the child’s body, vitamin deficiency, an allergic reaction, as well as narrowing of the nasal passages caused by injury or proliferation of adenoids. At this stage, the pain becomes moderate or disappears completely. Headache is rare. There is persistent nasal congestion. Painful sensations of low intensity or discomfort are localized mainly in the sinus area or in the depths of the eye sockets.

Due to the drainage of pus, otitis media may worsen or cause conjunctivitis. Parents often mistake the signs of sinusitis in children for symptoms of other diseases. They go to the pediatrician for bronchitis or to the ophthalmologist for conjunctivitis, unaware of the development of sinusitis.

The chronic form of the disease tends to worsen after acute respiratory diseases. In this case, the symptoms of sinusitis in children intensify again. Body temperature rises, pain becomes more intense, and the headache returns. General weakness appears, and nasal breathing becomes very difficult.

The chronic form of the disease is purulent, catarrhal and polyposis.

1. Purulent chronic sinusitis is accompanied by an unpleasant odor. In the absence or scarcity of nasal discharge, this may be the only sign of a purulent form of the disease.
2. The catarrhal form is considered the mildest. It is characterized by stringy and viscous nasal discharge.
3. In the polypous form, growths of the tissues of the mucous membrane of the nasal passages are observed. As tissues grow, they reduce their permeability and make it difficult for mucus to escape. Tissue changes take a long time, so the severe stage of the polyposis form is inherent in advanced inflammatory processes.

Due to the fact that the size of the paranasal cavities in children is smaller than in adults, they are more likely to develop various complications of the disease.

If acute sinusitis is not adequately treated on day 4-5, the inflammatory process may spread to adjacent tissues. An abscess (purulent inflammation of tissue) of the periosteum or a fistula of the bottom of the nasal cavity may appear. The untreated chronic form of the disease provokes the development of sinusitis in other paranasal sinuses, since bacteria from the maxillary sinuses freely move through the nasal passages to other cavities. If the inflammation covers all the sinuses, then pansinusitis develops. To treat such a disease, the child is placed in a hospital.

Chronic purulent sinusitis often causes the development of sore throat. If your baby has adenoids, adenoiditis (retronasal tonsillitis) may occur. This is a serious disease that requires treatment with antibiotics.

The constant flow of secretions into the lower respiratory tract leads to tracheitis, bronchitis and pneumonia. These secondary diseases are very difficult for a sick child against the background of reduced immunity caused by chronic sinusitis. Therefore, if the first signs of bronchitis or pneumonia are detected, treatment of sinusitis in children is carried out in a hospital.

More serious complications are also possible. An infection from the paranasal sinuses can spread to the eyes. Symptoms of an intraocular complication include: severe headache, swelling of the eyelid, swelling of the cheek near the affected eye, weakness, high body temperature and vomiting. There may be double vision in the eye and part of the vision may fall out of the field of vision. It is not uncommon to feel pain behind the eye. In addition to intraocular complications, some diseases of the kidneys, heart and liver, as well as trigeminal neuritis, are periodically diagnosed. The inflammatory process can reach the brain and cause meningitis, encephalitis or brain abscess.

X-ray examination is used to diagnose the disease. However, in children, this diagnostic method does not always provide one hundred percent confidence in the presence of sinusitis. A similar picture is observed in chronic and allergic rhinitis. If such doubts remain, an x-ray is done using a contrast agent.

The method of magnetic resonance therapy is informative and safe. Layer-by-layer photographs of the head make it possible to determine the degree of damage to the sinuses and their anatomical features. Using this diagnostic method, it is possible to detect the presence of lesions in neighboring tissues at an early stage and prevent the development of complications.

In the results of a blood test, the disease will be indicated by leukocytosis - an increase in the number of white blood cells. Bacteriological culture of nasal discharge will provide information about the causative agent of the infection. This will help the doctor choose the most effective medicine.

Puncture of the maxillary sinus is of great diagnostic importance. It is performed on children aged 7 years and older under local anesthesia. Carrying out this procedure in children under this age is associated with the risk of damage to the lower wall of the orbit or injury to the buds of permanent teeth.

During the manipulation, a washing liquid is injected into the sinus. It washes out the contents of the sinus and allows you to determine what caused the darkening on the x-ray, a mucopurulent lump or swelling of the mucous membrane of the cavity. When determining how to treat sinusitis in a child, the doctor is guided by the severity of the disease and the presence of complications.

Tactics for managing a small patient

How to treat sinusitis in children? Treatment of sinusitis is primarily aimed at restoring the outflow of fluid from the paranasal sinuses. Adenoid growths must be removed surgically. Swelling is reduced by introducing vasoconstrictor drugs into the nasal cavity. Antibiotics are administered along with these drugs. General antibiotic therapy is also carried out. For mild to moderate severity of the disease, drugs are prescribed orally. If the disease is in an advanced stage, the doctor will prescribe medications intravenously.

The acute form of sinusitis is treated for about 10-14 days. The chronic and advanced form will require therapy for 3-4 weeks.

In rare, especially advanced cases, surgical intervention is possible to remove pus, pathologically changed mucous membrane and rinse the cavity with an antibiotic solution.

Treatment of the disease should only be carried out by a doctor. It is strictly forbidden to independently change the doses recommended by the doctor and reduce the duration of medication. Ineffective treatment can provoke the development of a chronic form of the disease or the occurrence of complications.

Sinusitis in children is an extremely common pathology. Up to 20% of children suffer from rhinitis and inflammation of the paranasal sinuses. Parents should know the symptoms of sinusitis in order to promptly identify the disease in their child. in children should be under medical supervision.

Often sinusitis in children is combined with ethmoiditis (inflammation of the ethmoid sinus). This is due to the structural features of the nasal sinuses in childhood and their small size. Acute respiratory viral infections in children are often complicated by sinusitis and ethmoiditis.

Rice. 1. The photo shows the location of the paranasal sinuses.

Causes of sinusitis

Viruses and bacteria are the most common cause of sinusitis in children. The leading role is played by microorganisms such as Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis. Sinusitis of an allergic nature is much less common.

What contributes to the development of sinusitis in children

Acute respiratory infections, allergies, dental diseases, damp and cold weather contribute to the development of acute and exacerbation of chronic sinusitis.

How the disease develops

Inflammation of any nature, including allergies, causes the mucous membrane to swell; excessive mucus formation and an increase in its viscosity blocks the outflow of fluid from the cavities. The contents of the sinuses become trapped. High blood pressure leads to pain in the child. Due to the lack of periosteum, inflammation in some cases quickly spreads to the bone structure.

Signs and symptoms of sinusitis in children

Signs and symptoms of sinusitis in children are manifested primarily by difficulty in nasal breathing. Mucous discharge from the nose quickly becomes mucopurulent. They flow from the nose when blowing the nose and enter the nasopharynx. The drainage of purulent contents along the back or side wall of the nasopharynx causes the child to cough, which often bothers the child at night.

Pain in the face is a common sign of sinusitis. Conventional analgesics do not relieve pain associated with inflammation of the sinuses. After the contents are released, short-term relief occurs.

Due to the small volume of the sinuses, the accumulation of mucus in their cavities occurs very quickly - within several hours and then, after short-term relief, all the symptoms of sinusitis resume again.

Complications of sinusitis in children

Complications of sinusitis in children are much more common than in adults due to the structural features of the sinuses.

• Inflammation can spread to the eye tissue, meninges, and the brain itself. The spread of inflammation to the meninges and brain leads to meningitis and encephalitis. Both of these diseases are extremely life-threatening for the child.
• There have been cases of exacerbation of inflammation of the middle ear, which is associated with the drainage of purulent sinus contents along the back or side wall of the nasopharynx.
• Branches of the trigeminal nerve may be involved in the process. Then the pain will radiate to the area of ​​the eye and palate. Painkillers in this case have no effect.
• In children, osteomyelitis, the occurrence of which is associated with carious teeth, is often the cause of damage to the bone septum.

Chronic sinusitis in children

Chronic sinusitis in a child develops as a result of decreased immunity associated with vitamin deficiency. Allergies, narrow nasal passages, a deviated nasal septum and adenoid growths contribute to the development of the disease. Very often, inflammation of the maxillary sinus is combined with diseases of the ethmoid labyrinth. The purulent form of sinusitis is less common in children than in adults. The symptoms of chronic sinusitis in children are somewhat different from those in acute forms of the disease.

During chronic exacerbations, nasal discharge and local soreness are often absent. The headache is localized in the forehead. There is a feeling of pressure in the eye area; when trying to lift the eyelid, a feeling of heaviness is felt. Throbbing pain in the cheek area is often associated with carious teeth located in the upper jaw. Due to the lack of local pain in chronic sinusitis, the reason for contacting a pediatrician is often a child’s cough and inflammation of the cervical lymph node, or an ophthalmologist for conjunctivitis or keratitis.

Rice. 2. Nasal discharge in a child with chronic sinusitis.

Diagnosis of sinusitis in children

Sinusitis in children is often well diagnosed. A detailed study is necessary to diagnose chronic oligosymptomatic, post-traumatic and fungal sinusitis. In-depth diagnosis in this case will be the key to prescribing adequate therapy and cure. A correctly collected medical history and examination of the patient (rhinoscopy) is often sufficient to make a diagnosis. If the diagnosis after examination is still not clear or treatment of sinusitis in children with antibiotics has not yielded results, or if complications arise, additional examination is required.

Rice. 3. Rhinoscopy.

X-ray examination

An X-ray examination will reveal all the dense structures inside the maxillary sinus: secretion, thickening of the mucous membrane, thickening and destruction of the bone wall, polypous growths, cysts and neoplasms.

A uniform decrease in transparency and a clear outline of the walls of the sinus indicate acute sinusitis. A decrease in the transparency of the sinus and thickening of its side wall indicates chronic sinusitis. If a fistula has formed as a result of chronic sinusitis, then a bone defect in the sinus wall is diagnosed by inserting a probe into the fistula tract.

Rice. 4. On the right side of the x-ray, the appearance of the maxillary sinuses is normal. On the left - left-sided sinusitis.

Rice. 5. Acute right-sided sinusitis. Liquid pus in the maxillary sinus has a horizontal level on the x-ray.

Rice. 6. Left-sided sinusitis. On the x-ray we see a total darkening of the left maxillary sinus.

Computed and magnetic resonance imaging (CT)

These research methods have increased accuracy and sensitivity. However, due to the high radiation exposure and high cost of research, they have limited use. Using CT and MRI, the size of the sinuses, the volume of secretions, and the presence of complications are determined; these techniques are indispensable for injuries and detection of tumors.

Rice. 7. In the photo, the hypertrophied mucous membrane of the maxillary sinuses is indicated in blue (color MRI), on the left is a blocked nasal passage.

Rice. 8. On a computed tomogram we see an accumulation of fluid in the right maxillary sinus (horizontal level). The nasal septum is deviated.

Endoscopic diagnostics

Endoscopic diagnosis is used for chronic sinusitis, which is characterized by cystic and polypous growths. During the manipulation, abnormal elements are removed and, if necessary, plastic surgery of the sinus wall and nasal passage is performed. The material obtained during manipulation is subjected to histological examination. Endoscopic diagnostics are carried out in a hospital setting.

Rice. 9. The photo shows an endoscopy view of nasal polyps.

Treatment of sinusitis in children

Antibiotics for sinusitis in children

Sinusitis in children, which occurs in a mild form, can be cured without the use of antibiotics, since it is often caused by a viral infection.

Antibiotics do not work on viruses.

There are often situations when there is no time to wait for the results of a bacteriological study. In such cases, the choice of antibiotic is made empirically.

The most common causative agents of sinusitis in children are Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, which are sensitive to amoxicillin and amoxicillin/clavulatan.

Oral antibiotics are prescribed. Modern antibiotics have 93% absorption in the gastrointestinal tract. Tablets made using Solutab technology, which can be “dissolved” in a glass of water before use, have proven themselves well. The tablet filler contains microcapsules that are not subject to destruction in the aggressive environment of the stomach. Upon reaching the intestines, the capsule shell dissolves and the antibiotic is released. Very quickly it enters the blood and reaches a high concentration in the affected organ.

Pros of pediatric oral antibiotics:

• availability according to price characteristics;
• high efficiency;
• significantly fewer side effects.
• they can be prescribed to very young children.

If for some reason penicillin antibiotics cannot be used, then 2nd generation tsalosporins or macrolides are prescribed. Macrolides are prescribed in case of allergies to the above-described antibacterial drugs. The course of antibiotic therapy should be 10 days. Severe sinusitis, which occurs with complications, is carried out in a hospital setting. Antibiotics in this case will be administered intramuscularly or intravenously.

Rice. 10. Modern forms of antibiotics are convenient for small patients to take, as they have a pleasant smell and taste and can be dissolved in water.

Use of nasal decongestants

Increased secretion production and decreased activity of epithelial cells create favorable conditions for the development of infection. Most diseases of the nasal cavity, middle ear and paranasal sinuses are manifested by swelling of the mucous membrane. In addition, an increase in secretion production and a decrease in the activity of epithelial cells lead to the creation of ideal conditions for the development of infection.

Vasoconstrictor medications will help cure sinusitis. The use of vasoconstrictor drugs in the form of nasal decongestants (from congestion - blockage, stagnation) alleviates the child’s condition, reducing swelling of the mucous membrane and nasal discharge with subsequent restoration of nasal breathing.

Decongestants come in different durations of action - from 4 to 12 hours. They are produced in the form of drops and sprays.

Benefits of decongestant sprays

• Spray decongestants are easy to use.
• They evenly irrigate the mucous membrane.
• Precise dosage prevents the risk of side effects.
• They are allowed to be used by children from 2 years old.

Selection of decongestants

• It is recommended to choose decondensers with a long shelf life.
• Combined decondensers are considered the best. They contain components with antiallergic effects, mucolytics and antibiotics.
• The drug of choice for children 2–6 years old is 0.025% Nazivin, which has a long-term clinical effect. A 0.01% solution of Nazivin is allowed to be used even in the treatment of newborns.
• The drug of choice when using a nasal spray is only 0.05% Xymelin.
• In cases where nasal discharge is profuse and purulent in nature, the use of oil-based decongestants is not recommended. These drugs negatively affect the function of epithelial cells of the mucous membrane, reducing the functioning of the ciliated epithelium.

Side effects of decongestants

Decongestants cause dryness of the nasal mucosa, which is why their duration of use is limited.

Do not use decongestants in the form of sprays for more than 3 - 5 days!

Rice. 11. The photo shows Nazivin drops for babies.

Rice. 12. In the photo, nasal spray 0.05% Xymelin.

Rice. 13. Before using decongestants, it is necessary to clean the nasal cavity.

Analgesics for sinusitis

Analgesics are used to reduce pain and inflammation during sinusitis. It is recommended to use drugs from the group of non-narcotic analgesics: Paracetamol and Ibuprofen and their analogues.

Rice. 14. The photo shows a medicine for pain relief. The active ingredient is paracetamol.

Rice. 15. The photo shows a medicine for pain relief. The active ingredient is ibuprofen.

Before using painkillers, you must carefully read the instructions. Like any drugs, medicinal substances in this group have side effects.

Strictly follow the instructions for use of the drugs. Do not use painkillers for more than 10 days!

Use of mucolytics

In pediatric practice, the drug Fluimucil is used to thin sputum and nasopharyngeal secretions. In addition to liquefying sputum, Fluimucil has a strong antioxidant effect, protecting the respiratory system from the damaging effects of inflammatory metabolites and environmental factors, including tobacco smoke.

The combination drug Rinofluimucil has a mucolytic and mild vasoconstrictor effect. It does not cause excessive dryness of the nasal mucosa. Under its influence, sputum loses viscosity and is easily removed by blowing the nose and coughing. The drug is indicated for sinusitis and rhinitis, which occurs with the formation of a thick viscous secretion.

Fluimucil-antibiotic contains fluimucil (acetylcysteine) and the antibiotic thiamphenicol. The rapid removal of mucus due to the presence of acetylcysteine ​​is enhanced by the antibacterial effect of the antibiotic thiamphenicol.

Therapeutic and diagnostic puncture

Therapeutic and diagnostic puncture is used to extract the contents of the maxillary sinus, followed by histological and bacteriological examination of the material and determination of sensitivity to antibacterial drugs. This type of study is carried out for children over six years of age. The therapeutic and diagnostic puncture ends with the action of drugs on the sinus mucosa - antibiotics, corticosteroids, antiseptics and enzymes.

The puncture is carried out under local anesthesia with a special needle, which pierces the wall of the maxillary sinus through the nasal passage in its thinnest place.

Therapeutic and diagnostic puncture of the maxillary sinus is the most effective diagnostic and therapeutic technique currently used in our country.

Rice. 16. When performing a diagnostic and treatment puncture, the needle is located under the inferior concha of the nose (a). Schematic representation of the liquid flow of the sinus contents when washing the sinuses with medications (b).

Rice. 17. The photo shows a diagnostic and treatment puncture.

Rice. 18. The photo shows a diagnostic and treatment puncture. Rinsing the maxillary sinus.

Drainage of the maxillary cavity

The technique of catheterization of the maxillary sinuses with a polyethylene tube, which is inserted into the cavity through a puncture needle, is widely used. Upon completion of the puncture, the needle is removed, and the drainage tube remains for the entire period of treatment of sinusitis. Through the drainage tube, not only the maxillary cavity is washed with medications, but also laser and ultrasound effects are applied to the walls of the sinus. Flushing the sinuses with medications through a drainage tube is carried out for a week.

Maintenance therapy

In order to prevent exacerbations in chronic sinusitis and during acute inflammation of the upper respiratory tract, bacterial lysates have been successfully used. The drug IRS 19 is available in the form of a spray and contains lysates of 19 pathogens that especially often affect the upper respiratory tract. Its main effect is to obtain a rapid immune response after spraying onto the nasal mucosa.

Rice. 19. Preparation IRS 19.

Treatment of sinusitis in children at home

At the beginning of the disease, when the child’s condition remains satisfactory, sinusitis can be treated at home. Recommended:

Hydration

• Humidifying the air in the room where the child spends most of his time. Use humidifiers. Change filters in humidification systems more often.
• Breathing moist air over the steam will help thin the mucus.
• You can put a warm, damp towel on your face for a while.

Using salt sprays

Saline sprays can help restore breathing by thinning thick or dried mucus.

Rinsing the nasal passages

The saline solution helps cleanse the nasal passages of dust, germs and mucus, improves the functioning of the cilia of the mucous membrane and prevents the spread of infection.

Use boiled or distilled water to prepare the saline solution. Irrigation devices are rinsed and dried in the open air. The solution contains salt and baking soda in the proportion: 0.5 liters of boiled water: 1 tsp. salt: ½ tsp. soda A saline solution can be prepared with sea salt: take 2 tsp per glass of boiled water. salt.

Carrying out the procedure for young children

Hold the child over the basin in an upright position. Draw the solution into a syringe (without a needle) or syringe. Do not close your mouth during the procedure. At first, inject the solution into one of the nostrils slowly. Give the baby a chance to get used to it. Further introduction can be strengthened. Carry out the procedure with two sinuses.

Carrying out the procedure for older children

Tilt your head over the sink at an angle of 45°C. Carefully pour the solution into the upper nostril and allow it to flow out through the other nostril. Next, blow your nose. Repeat the procedure several times.

Rice. 20. Rinsing the nasal passages at home.

Rice. 21. Rinsing the nasal passages at home.

Drinking plenty of hot liquid (tea, chicken broth, etc.) will help thin the mucus that accumulates in the sinuses. When sleeping, it is necessary to raise the child's head higher. Use rest to recuperate.

Sinusitis in children can often be easily cured at home. If the symptoms of sinusitis do not subside within a week, and your general condition worsens, you should consult a doctor.