Sinusitis in a 3-year-old child is a rather rare phenomenon, since this disease is accompanied by an inflammatory process and an accumulation of pathogenic exudate in the maxillary sinuses. Children are born with tiny sinuses, so mucopurulent secretions simply have nowhere to accumulate. As a rule, only by the age of 5 years the maxillary sinuses in children develop to their normal size. Consequently, in the overwhelming majority of cases, pathology can occur no earlier than 5 years of age. However, it happens, although quite rarely, that the maxillary sinuses are formed ahead of schedule. Until one year old, of course, it cannot go about sinusitis, but by the age of 2 years the sinuses can form and, accordingly, along with this, there is a risk of developing the disease.
Rhinitis and sinusitis
Despite the fact that there are cases of early development of the paranasal sinuses in children, parents often raise the alarm in vain, mistaking ordinary rhinitis (runny nose) for sinusitis, which does not go away for more than a week.
It is important to be able to distinguish between these diseases as they require different approaches to treatment.
In this case, any rhinovirus that enters the mucous membrane of the nasal cavity, along with the flow of inhaled air, also penetrates the paranasal sinuses, including the maxillary sinuses. As a result, inflammation begins in the sinuses, which provokes the production of mucus.
Nevertheless, the presence of mucous secretions in the cavity, which are usually clearly visible on an X-ray, is not yet a reason to diagnose and resort to antibacterial treatment. In such a situation, most likely, we are talking about non-suppurative viral sinusitis, which occurs against the background of ARVI. With a decrease in inflammation and edema of the mucous membrane of the nasal cavity, the affected maxillary sinuses also return to their normal state. Thus, viral sinusitis passes with the correct and timely treatment of ARVI and does not require specific therapy.
The reasons for the development of sinusitis
As noted above, in children 3 years of age, viral sinusitis most often develops with an acute respiratory viral infection and passes with its successful treatment. However, if you let the disease take its course or treat it 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 (it complicates the outflow of purulent masses through the fistula) and through the blood. In addition, sinusitis can be triggered by an allergic reaction of the body, trauma or curvature of the nasal septum. There is also the likelihood 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
Given that the maxillary sinuses are located close to the cranial cavity, incorrect or late treatment of pathology threatens with very serious consequences, up to visual impairment and meningitis. Therefore, it is important to be able to recognize the signs of sinusitis in children in order to timely seek qualified medical care. The classic clinical picture of sinusitis is as follows:
- long lasting nasal congestion;
- yellow-green nasal discharge and runoff down the back of the throat;
- headache (pressure or a feeling of heaviness in the forehead and temporal region);
- subfebrile temperature (37-38 degrees);
- swelling of the brow or cheek (pain on palpation of these areas);
- violation of the sense of smell.
In children, the symptoms of sinusitis may be less pronounced than in adults. In addition, at an early age, it is difficult for a child to clearly describe his feelings, therefore, the presence of at least a few signs is already a reason for contacting a doctor, because it is better to start therapy at the early stages of the development of pathology. Thus, the effectiveness of the treatment of sinusitis in a 3-year-old child depends on the timing of the detection of symptoms.
Conservative treatment of sinusitis
Before starting treatment, the child must be shown to the doctor for an accurate diagnosis.
Symptoms of sinusitis in children are not yet a reason to start antibiotic therapy, traditional for this disease. So, antibiotics are not used for viral sinusitis (antibiotics are powerless against viruses), since their intake 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 it is the most reliable and effective method of treatment for both adults and children.
In view of the fact that for an effective fight against pathogenic bacteria, it is necessary that the antibiotic accumulates not just in the blood, but in the maxillary sinus itself, usually even children need to take drugs in sufficiently high doses. Now there are a large number of high-quality and effective drugs in the form of tablets, so the practice of prescribing antibiotics in an injectable form is gradually becoming obsolete. Moreover, there are many topical antibacterial agents (sprays, drops). After the first days of therapy in the patient's condition, as a rule, noticeable improvements occur, but it is important not to interrupt the course of treatment, which is 10-14 days. Otherwise, the likelihood of a relapse of the disease or its acquisition of a chronic nature is high.
In addition to antibiotics, specialists, as a rule, prescribe vasoconstrictor drops to the patient, designed to reduce the edema of the mucous membrane, which in turn helps to 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 drugs, 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 curvature of the nasal septum, then it has to be treated without affecting the main cause. Surgical intervention (septoplasty) is not recommended until the age of 15, until the process of formation of the septum 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 of exposure, in particular to a puncture. When treating children, they try to avoid this procedure, but if the case is especially difficult, it is performed under anesthesia using a Kulikovsky needle. The wall of the maxillary sinus is punctured from the inside of the nose. With the help of a syringe attached to the needle, saline enters the sinus, which promotes the outflow of pathogenic exudate through the oral cavity. Then, antiseptic and antibacterial solutions are injected into the sinus, preventing the re-accumulation of mucopurulent masses there.
Many parents are afraid to make a puncture, because they believe that the child will be doomed to treat sinusitis in this way all his life. However, according to many qualified specialists, this is nothing more than a myth. And, nevertheless, in many countries of the world, the puncture has long ceased to be used as a therapeutic procedure. Abroad, a puncture is done 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 gets the opportunity to study the nature of the pathogenic bacteria and prescribe adequate treatment.
Liquid transfer according to Proetz
The movement of fluid according to Proetz ("cuckoo") is a lavage of the sinuses on an outpatient basis. This procedure is aimed at destroying bacteria and cleaning the maxillary sinuses from the accumulated exudate. A catheter is inserted into one nasal passage of the patient, with the help of which a special solution is injected, and into the other - a suction through which 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 conduct it with tears and shouts “I can’t”. As in such cases, the majority of domestic experts say, "We must." However, at the same time, one must be aware that, in addition to the unwillingness of the child himself, there is a risk of complications. Since the organ of hearing in children is too close to the paranasal sinuses, flushing fluid can enter the tympanic cavity and provoke 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 physiotherapy. The attending physician selects procedures that help to activate blood circulation, reduce swelling, remove exudate from the maxillary sinuses, and relieve pain in the area of the sinuses. As a rule, experts recommend UHF (ultra-high frequencies), microwave (ultra-high frequencies), UHF (ultraviolet irradiation), UST (ultrasound therapy), electrophoresis, etc. Physiotherapeutic methods of treatment can be used only after consulting 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 condition of the child and accelerate the process of his recovery, they often resort to using the methods of traditional medicine. 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 
necessarily agreed with the attending physician. Otherwise, the child's health may be at risk, because the same manipulations can affect the body in different ways at different stages of the disease.
It is strictly forbidden to exert a thermal effect on the sinuses (compresses, heating with eggs or cereals) if pus has accumulated in them, since 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, cyclamen juice can be found among the ingredients, since there is a risk of burning the mucous membrane. Parents should be wary of inhalation, which can burn the airways. The temperature of the liquid should not exceed 30-40 degrees, and you need to bend over the container no lower than 30-40 centimeters.
Among the most effective folk recipes for sinusitis for children, the following are distinguished:
- Massage the nose. With gentle pressing movements, you need to act on 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.
- Rinsing the nose with saline. Dissolve 1 teaspoon of food or sea salt in 1 liter of boiled water. A few drops of iodine and 1 teaspoon of baking soda can be added to this solution. A special teapot should be used for rinsing, since with the help of a syringe and a syringe, liquid enters the nose under pressure and can damage or provoke otitis media.
- Rinsing 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 instill 3 drops in each nostril 3 times a day.
- Nasal drops. Mix freshly squeezed juice of beets and carrots in equal proportions and instill 3 drops in 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 turunda and insert into nose for 20 minutes.
- Inhalation based on herbal decoction or 5 drops of eucalyptus essential oil (you can also use fir oil).
