Sinuses and Sinusitis

The sinuses are the hollow cavities in the facial bones. There are several sinuses including below the eyes (maxillary), above the eyes (frontal), and behind the nose (ethmoid).Babies are born with fewer sinuses, only with the maxillary and ethmoid sinuses. As they get older, their frontal sinuses develop, and the ethmoid and maxillary sinuses continue to grow.

What is sinusitis?

Sinusitis is an infection, either viral or bacterial, of the sinuses. The exact same bacteria that cause ear infections cause sinusitis. Normally, fluid in the sinuses drains into the nose. When these are blocked and not working properly, the fluid backs up and becomes infected by the bacteria. The typical symptoms of a sinus infection are usually:

  • Pain around the sinus,
  • Pain around the eye,
  • Green discharge coming out of the nose.

In younger children, the symptoms are less specific, including irritability, prolonged fever, or a cold that won’t go away. Importantly they may cough a lot, especially when they lie down at night. X-rays or CT scans are the only way to confirm the presence of a sinus infection or problem.

There are three types of sinusitis, depending on how long the infection has been going on:

  • Acute sinusitis: symptoms have lasted less than two weeks.
  • Sub-acute sinusitis: symptoms last for up to two months.
  • Chronic sinusitis: symptoms recur or are persistent for more than two months.

Treating sinusitis

Antibiotics taken by mouth are usually required to treat sinusitis. The duration and type of antibiotic depends on the age of the child, the individual situation, and the duration of symptoms. One potentially serious complications of sinus infections in children is periorbital cellulitis. This is when the bacteria that causes the sinus infection spreads to the area around the eye. This relatively rare condition requires admission to hospital for intravenous antibiotics and evaluation by an eye specialist (ophthalmologist).