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 a fairly common phenomenon, and often occurs as a complication of a common respiratory viral infection. The essence of the process is the disruption of the outflow of mucous secretions due to blockage of the outlets of the maxillary sinus. This type of condition, in addition to ARVI, can be caused by any inflammatory processes that occur in the spaces of the sinuses, oral cavity, and upper respiratory tract.

Types of sinusitis in children

All of the following applies to any sinusitis (sinusitis, sinusitis, etc.).

It is necessary to understand that the duration of the disease can vary significantly. On this basis, it is customary to divide sinusitis (and other sinusitis) as follows:

• Acute sinusitis continues in children up to 3 months. That is, after the episode that provokes sinus inflammation, about 3 months should pass, after which recovery can be stated. Bacterial infection is very fond of sinuses, since the pressure of immunocompetent cells there is somewhat lower, so the processes take a long time and are prone to chronicity;
• Recurrent acute sinusitis. In principle, we are talking about a chronic disease that manifests itself 2 to 4 times every year of a child’s life. The name of this type of sinusitis has been established for the reason that children often outgrow the disease, and there is a fairly high probability of getting rid of this trouble;

The ability to “outgrow” chronic sinusitis is associated with the anatomical component of the inflammatory process - when hormonal levels change, the mucous membrane that partially clogs the maxillary sinus can free the passage. When normal communication is restored, the inflammatory process disappears quite quickly.

• Chronic sinusitis. If acute sinusitis lasts more than 3 months, the process is considered chronic.

Due to the danger of any nosocomial forms of infection, nosocomial sinusitis was also identified. Symptoms of this form can appear as early as 2 days after infection in the hospital.

Features of development in children of different age groups

The clinical picture of sinusitis in children differs depending on age. Doctors have identified three main age groups of children with sinusitis:

• Children under 3 years old. Due to incomplete development of the paranasal sinuses, the disease may be asymptomatic. Some experts generally believe that this age group does not have sinusitis in principle. However, there are observations confirming the point of view that frequent inflammatory diseases in children under 3 years of age form the basis of chronic sinusitis, characteristic of older age groups. Thus, young children with adenoids and frequent viral respiratory infections should be considered at risk for chronic sinusitis;

If the child frequently, contact a pediatric otolaryngologist (ENT doctor) to rule out sinusitis (or another form of sinusitis). This will prevent the formation of a chronic inflammatory process in the paranasal sinuses. Without special diagnostic measures, “by eye,” it is impossible to diagnose sinusitis in children under 3 years of age.

• The preschool age of the child is from 3 to 7 years. At this age, as a rule, all types of sinusitis form. It is necessary to understand that sinusitis can be combined with damage to another sinus or all of them at the same time (polysinusitis - total inflammation of the paranasal sinuses). Sinusitis is often combined with diseases of the middle ear, which can be considered one of the manifestations of sinusitis.
• Schoolchildren – from 8 to 16 years old. At this age, the infection, as a rule, becomes chronic and persists with exacerbations until puberty. In some cases, sinusitis goes away after hormonal changes.

Symptoms of inflammation of the maxillary sinuses in children

The severity of symptoms depends on the nature of the process. The following signs are common:

• Runny nose lasting more than 2 weeks in a row;
• Copious discharge from the nose. The mucus may be transparent at the beginning of the process (infiltrate), then it becomes yellow or green;

The color of the discharge indicates the type of process. Viral sinusitis is accompanied by a clear discharge, a bacterial infection - green (yellow). As a rule, the process begins with a viral attack, then a bacterial infection “lands” on the inflamed mucosa, which causes the chronic course of sinusitis.

In some cases, the inflamed mucous membrane of the pharynx, when provoked by discharge, can potentiate vomiting. At night, this creates a danger of aspiration, i.e. the child may suffocate. Therefore, during the acute phase (or during the primary acute process) of sinusitis, it is better to be near the sleeping child.

Diagnosis of sinusitis in children

The most standard diagnostic method has been and remains x-ray. The reliability of this diagnostic method is about 90%.

If the doctor has any doubts, or if there are obvious signs of inflammation of the maxillary sinuses, it is recommended to perform a puncture for therapeutic and diagnostic purposes (puncture).

Puncture is not the only diagnostic method, so it is not worth resorting to it immediately in the absence of manifestation of pus in the sinuses (some older otorhinolaryngologists consider this the only correct path). To clarify the diagnosis, you can use computed tomography and endoscopic examination.

A general blood test allows you to determine the scale of the inflammatory process and suspect pus before its manifestation.

You will not be able to diagnose sinusitis on your own. As a rule, this leads to a significant loss of time. When the process enters its chronic stage, diagnosis is not difficult, but curing the child becomes very difficult.

Children at risk

• Having hay fever, adenoids, chronic inflammatory diseases of the upper respiratory tract;
• Children with weakened immune systems who are often ill;
• With a tendency to allergic reactions of any type;

Sinusitis– a very dangerous disease even for adults. As for children, due to the anatomical features of the structure and location of the maxillary sinuses, it often causes complications such as meningitis, pneumonia, otitis and rheumatism. In addition, pus accumulated in the sinus irritates the sensitive nerves of the face and provokes severe headaches in children. Therefore, only timely diagnosis and treatment of sinusitis can protect your child from the negative consequences and accompanying symptoms of this disease. And taking preventive measures will help you avoid frequent, recurring rhinitis and sinusitis.

Let us consider in more detail all the features of this disease and methods of combating it.

General information about sinusitis

The air a person inhales passes through the paranasal sinuses. The inner surface of these sinuses is lined with mucous membrane, upon contact with which the air is warmed and moistened. Any external factor (virus or allergen) that causes rhinitis in a child enters the paranasal sinuses, resulting in the formation of sinusitis - an inflammatory process in the sinuses.

Sinusitis is a common concomitant of a runny nose and does not require additional treatment if it does not impair the patency of the sinus openings - the narrow openings through which air enters. Otherwise, an acute inflammatory process begins in the sinuses and pus accumulates.

Depending on the location of inflammation, sinusitis is divided into the following types:

• Sinusitis- with inflammation of the maxillary paranasal sinus.
• Frontit- with inflammation of the frontal paranasal sinus.
• Ethmoiditis- with inflammation of the cells of the ethmoid bone.
• Sphenoiditis- with inflammation of the sphenoid sinus.

Thus, sinusitis is an acute or chronic inflammation of one or two maxillary sinuses.

The mechanism of development of sinusitis as a type of sinusitis is simple: a bacteria, virus or allergen, entering the maxillary sinus, provokes the appearance of edema, as a result of which the lumen of its opening decreases. In addition, an excess amount of mucus begins to form and the motor activity of the “cilia” of the sinus mucosa is disrupted. Thus, mucus accumulates in the sinuses, blocking the opening and access of air, and anaerobic bacteria actively begin to multiply in it, producing pus.

It should be noted that due to the physiological characteristics of the development of children, up to two or three years of age they are not susceptible to this disease, since their maxillary sinuses are just developing, and there is no place for the accumulation of pus. At the same time, due to the fact that the air does not have time to warm up and become humidified, children under 3 years of age are more likely to suffer from rhinitis.

Classification and causes of sinusitis development

The classification of sinusitis is quite complex. Depending on the source, nature of origin and route of infection into the maxillary sinus, the following types are distinguished:

• Rhinogenic– occurs as a complication of infectious diseases such as influenza, acute respiratory infections, which interfere with the normal outflow of mucus. The infection enters the sinus through the nasal passages.
• Hematogenous– the infection enters through the blood. This type is most often diagnosed in children. It is caused by many infectious diseases such as measles, diphtheria, etc.
• Odontogenic– the infection enters through the lower wall of the sinus. This species is rarely diagnosed in children and is caused by diseases such as periodontitis, periostitis and osteomyelitis.
• Traumatic– occurs in case of injury, bruise of the maxillary sinus area, or fracture of the nasal septum.
• Allergic– manifests itself as a reaction to the action of an allergen. Accompanied by severe swelling of the sinuses.
• Vasomotor– the reason for its occurrence is reduced tone of blood vessels, as a result of which the secretion is poorly separated from the sinus. In adolescents it can be caused by vegetative-vascular dystonia.

In addition, sinusitis is divided depending on the course of the disease into:

• Spicy– most often is a complication of acute rhinitis, measles, influenza, scarlet fever and other infectious diseases. Children are especially susceptible to this type.
• Chronic– it is caused by repeated acute inflammation of the maxillary sinuses. The anatomical features of the maxillary sinus or pathological changes in the nasal cavity, including the curvature of the nasal septum, contribute to the transition of the disease into a chronic form.

According to morphological changes, sinusitis is:

• Catarrhal (swelling without pus formation is observed).
• Purulent.
• Hyperplastic (proliferation of the mucous membrane and narrowing of the inlet are observed).
• Polypous (polyps form in the maxillary sinus).
• Atrophic (characterized by impaired functioning of the mucous glands).

With sinusitis, either one sinus (unilateral) or both (bilateral sinusitis) can be affected. Children most often suffer from bilateral sinusitis due to the physiological structure of the nose and sinuses.

The main symptoms and signs of sinusitis in children

Diagnosing sinusitis in children of early life can be very difficult, since they cannot reliably explain where the pain is localized and what sensations they experience.

Symptoms of acute sinusitis in children include:

• Feeling of tension or pressure in the area of ​​the affected sinus.
• Toothache in the upper jaw, aggravated by chewing.
• Difficulty in nasal breathing, the appearance of clear or purulent discharge.
• The appearance of a “pressing” headache “behind the eyes”, which disappears when lying down.
• In children, the temperature may rise to high levels, photophobia occurs, and the sense of smell deteriorates.
• The child becomes lethargic, capricious, inactive, and refuses to eat.
• Swelling and redness occurs on the side of the affected cheek.

Diagnosing chronic sinusitis is somewhat more difficult. Symptoms are most often blurred, the most striking being long-term (more than a month) rhinitis and headaches, which are localized in the orbital area. In addition, dry cough and conjunctivitis are common in children.

Modern methods for diagnosing sinusitis

Clinical diagnosis of sinusitis consists of clarifying the patient’s complaints, interviewing parents and examining the child. The doctor identifies reflex dilation of blood vessels in the infraorbital region and examines the inner surface of the nasal mucosa.

The most effective and reliable diagnostic method for adults is x-ray examination of the paranasal sinuses. With sinusitis, the maxillary sinus is darkened (looks white on the picture). In children, x-rays cannot always give a reliable answer, because even with ordinary rhinitis, the same changes in the maxillary sinus can be observed in the picture as with sinusitis. In addition, X-ray examinations are not recommended for young children.

If the otolaryngologist has doubts when diagnosing sinusitis, he may recommend a puncture: using a special needle, the doctor pierces the wall of the sinus and sucks out its contents. Most often, the sinuses are immediately washed with a disinfectant solution. But foreign medicine opposes the use of this method in children due to the following circumstances:

• A puncture most often only proves that the sinus is clean.
• After puncture, the formation of emphysema of the cheek and orbit, abscess, phlegmon and blockage of blood vessels is possible.
• For children, puncture should be performed only under anesthesia.

At the moment, diaphanoscopy can be considered the most effective, efficient and harmless method for diagnosing sinusitis in children. A doctor in a darkened room inserts a Hering light bulb into the child’s mouth and forces him to tightly clasp his lips around it. At the same time, the transparency of the inflamed maxillary sinus is always reduced. In addition to this method, an ultrasound diagnostic method can also be used for children.

Consequences of sinusitis in children

In children, the following complications are possible after sinusitis:

• Intracranial complications: meningitis, rhinogenic brain abscess, meningoencephalitis, pachymeningitis, phlebitis of the dural sinuses and meningeal edema.
• Reactive swelling of the tissue of the eyelids and orbits, thrombosis of the veins of the orbit.
• Periostitis of the upper jaw.
• Otitis.
• Pneumonia.
• Rheumatism.

Most often, these complications are observed when sinusitis becomes chronic. Timely initiation of treatment helps to minimize these risks.

Treatment of sinusitis in children

Most often, sinusitis in children is treated with pharmacotherapy. In severe forms, severe pain and discharge of pus, it is recommended to rinse the paranasal sinuses without puncture (the moving method, or “cuckoo”).

The principle of operation of the “cuckoo” is as follows: the child is laid horizontally, 2 catheters are inserted into the nasal passages, through one of them a medicinal solution enters the sinus, and through the second a pump under vacuum sucks out all the liquid along with the pathological contents of the sinus. The course of treatment is designed for 5-7 procedures, and the patient immediately feels a noticeable improvement. The method got its name due to the fact that the child has to constantly say “ku-ku-ku...” so that the liquid does not get into the larynx.

Another option for treating sinusitis in children without a puncture is the use of a Yamik sinus catheter. Purulent accumulations are removed by creating positive and negative pressure in the nasal cavity. Laser therapy is also widely used today. It eliminates inflammation and enhances the drug effect. In rare cases, reflexology and acupuncture may be prescribed.

As an anti-inflammatory therapy, the doctor may recommend physical treatment: ultrasound, ultraviolet irradiation of the nasal area, UHF, or taking homeopathic medications.

Along with the above methods, the doctor often prescribes the use of vasoconstrictors or antihistamines to improve the outflow of fluid from the sinus. In severe cases, antibiotic therapy and hospitalization of the child may be prescribed. Typically, acute sinusitis in children goes away in 1-2 weeks, chronic - in 3 weeks.

As for traditional methods of treatment, their use for children is unacceptable without prior consultation with a specialist. There are only a few activities that can be carried out at home without harm to your health:

• Massage. During the first day of illness, the child should tap the bridge of the nose for 2-3 minutes with the phalanx of the thumb once every half hour. In addition, you can massage the following points clockwise for 30 seconds: the upper inner corner of the eyebrow, the inner lower part of the eye socket and the central point between the eyebrows.
• Breathing exercises. The child should be asked to breathe alternately through the right and left nostrils for 4-6 seconds, 10 times. The second nostril is closed with a finger.

The above procedures stimulate blood supply and enrich tissues with oxygen.

Prevention of sinusitis in children

All preventive measures should be aimed at strengthening the child’s body and increasing immunity. It is important to carry out timely treatment of viral and infectious diseases and teach your child how to properly clean his nose when he has a runny nose. If there are predisposing factors, such as a deviated septum, artesia or synechiae in the nasal cavity, they must be eliminated. In addition, special attention should be paid to hardening children, including wiping and air baths for the youngest.

Sinusitis appears more often if the room where the child is located has dry air and a lot of dust. Constant hydration, ventilation and wet cleaning contribute to the healthy development of children and are preventive measures to prevent sinusitis.

Sinusitis in children (2,3,4,5,6,7 years old) - how to treat a child and how not to harm it?

Sinusitis in children occurs when viruses and bacteria penetrate the maxillary sinuses.

At the initial stage, inflammation is provoked by influenza and parainfluenza viruses, adenoviruses, respiratory syncytial virus, metapneumovirus, rhinovirus, and coronaviruses. Popular bacteria include Haemophilus influenzae and pneumococcus. When chronic, Klebsiella, streptococcus pyogenes, Staphylococcus aureus, and anaerobes are added.

The main reasons are a prolonged runny nose after an acute respiratory infection, sore teeth, weakened immunity, tonsillitis or its chronic course, deviated septum, hypothermia, nasal injuries, adenoids. Untreated sinusitis becomes chronic and can cause a purulent course followed by an abscess and meningitis.

Symptoms and first signs

Signs of sinusitis in each child can be individual in intensity, but they are united by a number of symptoms:

• Headache and discomfort in the sinuses and bridge of the nose. The discomfort is of a pressing nature and increases when the head is tilted. May radiate to the temples and cheeks.
• Serous or purulent nasal discharge.
• Nasal congestion.
• Loss or distortion of the sense of smell.
• Swelling of the affected area and face.
• Nasality.
• Body temperature is above 38.5 C.
• Increased fatigue.
• Irritability.
• Decreased appetite.
• Muscle pain.
• Intoxication.

Many parents wonder how to recognize the onset of sinusitis in a child under 2 years of age, but the answer is simple - this disease is diagnosed in children after 4-5 years of age. Until this moment, their sinuses are forming, therefore, according to the anatomical structure, it is considered impossible for children under 5 years of age to develop the disease.

Drug treatment

If parents suspect sinusitis, then the first symptoms should lead to a visit to the doctor and treatment in children is prescribed only by a specialist, in order to avoid complications. When choosing the optimal therapy, it must fulfill a number of requirements:

• Eliminate the infectious carrier that provoked inflammation.
• Relieve swelling.
• Normalize sinus drainage and free breathing by thinning and evacuating mucus.
• Be safe for the baby.
• Restore damaged mucous membrane of the nasal passages.
• Strengthen local immunity.

The main method of treatment of sinusitis is carried out using:

• Antibiotics.
• Antihistamines.
• Vasoconstrictors and anti-inflammatory drugs.
• Mucolytics.
• Immunomodulators and immunostimulants.

Physiotherapy, YAMIK, and cuckoo are no less effective.

Video

Sinusitis in a child

Antibacterial therapy

If sinusitis in children is bacterial in nature, then active antibiotics are prescribed after analyzing the pathogen and its resistance. The drugs quickly eliminate pathogenic flora, blocking growth and reproduction, and stop the inflammatory process. For mild cases, local agents are indicated - sprays, drops. This helps prevent the development of dysbiosis.

In moderate and severe cases, due to difficulties with the penetration of local medicine into the maxillary sinuses, systemic broad-spectrum antibiotics are indicated. Usually, children are prescribed suspensions and syrups; after 10 years, capsules and tablets can be given. In severe cases, injections may be used.

Groups of systemic agents effective for sinus inflammation:

• Penicillins: Amoxicillin. They disrupt synthesis in the bacterial membrane, which causes its destruction. Bacteria quickly develop resistance to these drugs, which makes them less popular every year. In this case, products with clavulonic acid are indicated: Ampicillin, Augmentin, Amoxiclav.
• Macrolides: Erythromycin, Azithromycin, Sumamed. They are similar in principle to the penicillin series, but are able to suppress inflammatory processes in the mucous layer without complications, even in patients with allergies to the first group. They are less toxic, have immunostimulating and anti-inflammatory effects.
• Cephalosporins: Ceftriaxone, Cefadox. This series is effective even in severe cases of pathology, but it also has a large number of side effects.

Vasoconstrictor drugs

With a runny nose, inflammatory processes lead to swelling of the mucous membranes and the cessation of proper evacuation of mucus. In order to solve the problem, they resort to the use of adrenergic agonists. The drugs affect alpha-adrenaline receptors, anemia occurs, which causes a decrease in swelling and improved breathing. Vasoconstrictor drugs come in the form of drops and sprays, where the latter are more effective. Adrenergic agonists are used only for a short course, as they can be addictive and destroy the mucous membrane. The most popular in pediatrics: Oxymetazoline, Galazolin, Sanorin.

Antihistamines

Viral and allergic sinusitis often require the use of antiallergic drugs. They help reduce swelling and inflammation and improve mucus drainage. These drugs can have either a short prophylactic course or a long course for chronic allergic rhinitis. The most popular in children with sinusitis are Erius, Loratadine, Fenistil, and Cetrin.

Anti-inflammatory drugs

Treatment of moderate to severe sinusitis in children may require the use of anti-inflammatory drugs. They help relieve inflammation and have an analgesic effect. Children are most often given Nurofen syrup; in adolescents, Nimesulide powder and Paracetamol tablets can be used. They are taken only in a short course on the recommendation of a doctor, since these drugs negatively affect the mucous membranes of the gastrointestinal tract.

Mucolytics

Swelling and thickness of the secretion impairs the outflow of mucus; the accumulation of exudate is fraught with the addition of a bacterial infection and the appearance of pus. To prevent complications of sinusitis, mucolytics are prescribed. They thin the mucus, reduce the tension of the mucous membranes, improve the patency of the mouths, and promote the drainage of the contents of the sinuses. Fluimucil, Rinofluimucil, Fluditek are popular.

Immunomodulatory drugs

To strengthen the membranes of the maxillary sinuses and nasal passages and prevent relapse, immunomodulatory agents should be included in the complex of therapy. For example, Cinnabsin, Sinupret.

Bacteriophages are also popular. These are viruses that are aimed at destroying one group of bacteria.

They are safe, unlike antibiotics, and no less effective.

Physiotherapy

Physiotherapy is an additional set of procedures to drug treatment. It helps improve the absorption of drugs, accelerate tissue regeneration, relieve swelling, reduce pain, and restore metabolic processes. The most popular:

• UHF and microwave.
• Ultrasound.
• Electrophoresis.
• Diadynamic currents.
• Vibroacoustics.

Nasal rinsing

Sinusitis in a child in the early stages responds well to treatment by rinsing the sinuses. After the manipulation, the mucus thins, the patency of passages and breathing improve. This procedure in children is often performed in a hospital setting, but with sufficiently qualified parents it can be performed at home. For this you need special solutions, for example, Dolphin. In the hospital they use the cuckoo method or YAMIK procedure. Where do you take a solution of Furacilin, Miramistin, Chlorhexidine, Dioxidine for washing.

Cuckoo method

This procedure is identical to adult manipulation. It is painless and safe if you follow your doctor's advice. However, it is not performed on children under 5 years of age and children with vascular fragility or a deviated septum. The patient is placed on the couch. The rinsing solution is supplied to one nostril, and the waste material is simultaneously sucked out with a special device from the second. During this period, the child says peek-a-boo to prevent liquid from entering other channels. The main disadvantage of the cuckoo is that children are afraid of choking and do not always agree to the manipulation.

Yamik procedure

To completely clear the sinuses, soft latex catheters are used. After their insertion, mucus from the sinuses is drained through them. Then antiseptics are administered. Since during normal rinsing some of the mucus is drawn into the nasopharynx, it is better to resort to the YAMIK procedure where this is not possible. The manipulation is safe and painless. A particular advantage is the possibility of obtaining exudate material for research. It is not recommended for fragility of blood vessels and the presence of a large number of polyps.

Nasal rinsing at home

If it is not possible to go to the clinic for rinsing, then such manipulations are carried out at home. Parents should be extremely careful to ensure that the contents do not get into the ear canals.

Having purchased the drug Dolphin or prepared a saline or soda solution yourself, take the baby to the bathroom and tilt his head forward and slightly to one side. Using a bulb or syringe without a needle, pour the solution into the upper nostril. At this moment, the child should not breathe, having first taken a deep breath. If the procedure is carried out correctly, then the used liquid with mucus will flow out from the other nostril. Sometimes it can go through the mouth, this is a natural process. Next, the manipulation is repeated from the second nostril.

When preparing the solution, take a glass of water and a teaspoon of sea salt or soda. If rinsing is done with Dolphin, then you must follow the instructions completely. You should not rinse your nose more than 2-3 times a day. After the procedure, you should not go outside or go to bed for about 30 minutes. The manipulation cannot be performed if the nose is completely blocked or the nasal septum is deviated.

Puncture of the maxillary sinus

If parents do not know how to cure chronic sinusitis for a child and conservative methods are ineffective, then the doctor may recommend a sinus puncture. This is an effective method of restoring breathing even in advanced cases. The procedure is performed in a hospital setting under local anesthesia. A special curved needle is used to puncture the sinus and rinse the cavity with the introduction of drugs to prevent relapse. If the baby is very excitable, a course of sedatives may be prescribed.

Since such a procedure is a great stress for the child, doctors try to avoid it and prescribe it only in extreme cases.

If there is a child with sinusitis in the house, then parents need to control the humidity of the room, carry out wet cleaning and ventilation daily, and follow all the doctor’s recommendations. Treatment should begin when the first symptoms occur, this will protect against a number of negative consequences. Therapy should be prepared by a doctor and be comprehensive; this is the only way to achieve good results in a short time.

Particular attention should be paid to the treatment of the disease when the diagnosis has already been made. Doctors often recommend piercing the maxillary sinuses. There is a popular belief that if such a procedure is performed on a child once, the child will become a regular visitor to the ENT office. Parents should understand how to properly treat sinusitis in a child, and whether it can be done at home.

After the child’s immune system is suppressed by a viral infection, inflammation also occurs in the paranasal sinuses.

It is imperative to pay attention to the child’s drinking regime in order to avoid dehydration and drying out of the mucus in the sinuses and blockage of the anastomosis.

The use of vasoconstrictor drops and rinsing the nasal cavity with saline solutions are also suitable for this purpose.

All measures should be aimed at preventing the formation of thick mucus and blockage of the canal connecting the sinus to the nasal cavity. It is unacceptable for the baby to breathe dry, warm air. Maintaining optimal humidity and temperature in the room is an important factor in the prevention of bacterial sinusitis.

2) How to treat bacterial sinusitis in a child over 3 years old?

For the treatment of sinusitis, the most effective is the use of a treatment regimen aimed at restoring nasal breathing, combating pathogens, and preventing relapses.

There are several ways to restore respiratory function and moisturize the mucous membrane.

• Irrigation of the mucous membrane.

For this purpose, special sprays are suitable, which are made on the basis of saline solutions and sea water. For example, “Aquamaris”, “Saline”. They gently remove swelling and restore the protective function of the nasal mucosa. The medications are absolutely safe and non-addictive.

• Rinsing the nasal cavity.

This method requires some skill and is suitable for children with symptoms of sinusitis over 7 years of age. Preference should be given to saline and antiseptic solutions for rinsing the nasal cavity.

Before rinsing the nasal cavity, you should consult a doctor, because incorrectly performing the procedure can cause the spread of infection and the occurrence of. To remove mucus for children under 7 years old, it is better to use a special aspirator.

You need to do the rinsing by bending over the sink, pouring a warm solution into a container with a narrow neck, or a watering can. A small amount of liquid should be poured into the nostril so that the solution flows out of the opposite nostril, while the head should be tilted to the side. The procedure is repeated several times on each side and helps remove purulent masses from the sinuses and facilitate breathing.

• The "cuckoo" method.

Performed by a medical specialist with the help of an assistant. To do this, the baby is placed on the couch and an antiseptic solution is carefully poured into one nostril. At the same time, the nurse removes the liquefied mucus from the other nostril using a special suction.

The method acquired its name because of the need to repeat “peek-a-boo” to the child during the procedure. Thus, the soft palate blocks the exit from the nasopharynx and prevents liquid from entering the baby’s mouth.

The method does not cause pain and allows you to get rid of sinusitis in a short time.

Vasoconstrictor drugs must be selected taking into account the age characteristics of the child and contraindications. For children under 3 years of age, the drop form is preferable; for older children, nasal sprays can be used. Such drugs as “Nazol-baby”, “Vibrocil” have proven themselves well; they quickly and gently reduce swelling of the mucous membrane and reduce the amount of discharge.

Long-term use of vasoconstrictor drops is unacceptable - more than 10 days. This causes addiction to the medicine and changes in the nasal mucosa.

• Paranasal sinus puncture.

A puncture is used when it is impossible to remove pus by other means, when there is a risk of complications, when the child is in serious condition, or for diagnostic purposes. The puncture is performed under local anesthesia using a needle inserted into the lower or middle nasal passage, followed by pumping out mucus and pus.

There are myths among people about the chronicity of sinusitis and the need for repeated punctures with this method of treatment. In fact, the puncture has nothing to do with the baby’s further illnesses and can serve not only as a therapeutic procedure, but also as a diagnostic procedure. A small amount of mucus is collected and the microorganism that caused the disease is determined.

Antibacterial therapy

In the event of the development of bacterial sinusitis, the use of antibacterial agents cannot be avoided. But for viral sinusitis, antibacterial drugs are not only not indicated, but also dangerous. The use of antibiotics for a viral disease increases the risk of complications and increases the resistance of bacteria to antibacterial drugs.

The choice of antibiotic is made by the doctor, taking into account the ability of the medicine to enter the maxillary sinuses and the sensitivity of the microorganism. Cephalosporins and macrolides are usually used, and the course of treatment is at least 10 days.

Antihistamines (Fenistil, Citrine and others) reduce swelling of the nasal mucosa. The use of drugs during treatment with antibiotics for the prevention of allergies is especially indicated.

Physiotherapy

Physiotherapeutic procedures are effective and safe for any age. UHF, magnetic and laser therapy, ultrasound improve blood circulation and increase lymph flow, help get rid of mucus and reduce inflammation in the sinuses.

How to cure chronic sinusitis in a child?

To get rid of the disease and forget about repeated episodes of the disease for a long time, you need to find the cause of the disease. To determine the factor causing disruption of the outflow and stagnation of mucus, it is necessary to conduct a comprehensive examination of the baby. It is necessary to pay attention to the presence of adenoids, hypertrophic conditions of the mucous membrane, and the presence of carious teeth.

Without removing the factor that causes sinusitis, it is impossible to get rid of the disease.

When choosing antibacterial agents, it is necessary to determine the sensitivity of the microorganism to the antibiotic. And during periods when the disease has subsided, sanatorium-resort treatment and physiotherapy are recommended.

• Treatment of illness with folk remedies.

Irrational therapy and treatment with folk remedies often lead to aggravation of the process or recurrence of sinusitis. Time spent on incorrect treatment can worsen the baby’s condition and lead to the development of complications.

• Inhalations, warming.

Any warming procedures are contraindicated during the inflammatory process. In heat, bacterial growth increases and the process spreads. Such methods can not only be ineffective, but also dangerous, leading to injuries and burns.

• Self-medicate.

Treatment of sinusitis should be determined by an experienced pediatrician, taking into account the age of the child, the cause of the disease and the sensitivity of the microorganism. Otherwise, there is a high risk of developing dangerous complications.

Complications of sinusitis:

• transition of the disease to a chronic form;
• osteomyelitis - spread of infection deep into the bones of the skull;
• meningitis - penetration of the pathogen into the membranes of the brain;
• otitis media, middle ear diseases, hearing loss;
• exacerbation of concomitant pathologies.

conclusions

A runny nose can occur to a child at any time of the year, even in summer. Sometimes it does not go away for a long time and does not respond to conventional treatment. These symptoms indicate the need to seek advice from a specialist. After examination and diagnosis, correct and competent treatment will be prescribed.

There is no need to try to treat sinusitis on your own, because it can easily be confused with other diseases. And incorrect treatment will only worsen the baby’s condition and increase the risk of developing dangerous complications. Using simple recommendations, you can protect your baby from serious illnesses and prevent illness.