The ability of parents to correctly recognize and also distinguish symptoms of sinusitis in children from signs of similar childhood diseases (rhinitis, ethmoiditis, etc.) makes it possible to start appropriate treatment in a timely manner. Initiation of therapy early in the development of the disease often plays a key role in the successful prevention of serious complications (otitis media, optic neuritis, periostitis, meningitis, sepsis, etc.). Also, timely medical care will help to avoid chronic disease.
Features of the development of the paranasal sinuses in children
In the human body there are 4 pairs of paranasal sinuses (maxillary, frontal, wedge-shaped and ethmoid), which are actively involved in ensuring normal air exchange. Thanks to the sinuses, the inhaled air reaches the lungs humidified, purified and warmed. However, in newborns, the frontal (frontal) sinuses are absent altogether, and the maxillary sinuses are tiny slits. Therefore, with the rare exception of premature sinus formation (at the age of about 2 years), neither frontal sinusitis nor sinusitis can be diagnosed in children under 5 years of age. Moreover, this disease does not occur in infants and children under one year old. Full-fledged paranasal cavities are usually formed in a child's body only with age (maxillary - from 5 years old, frontal - from 7 years old), after which there is a risk of developing the aforementioned pathologies.
Sinusitis and rhinitis
Due to the peculiarities of the development of the airways, as well as due to the fact that the strength of the respiratory muscles in children is much lower, and the respiratory rate is noticeably higher than in adults, the quality of the air (its freshness, cleanliness and moisture) plays an important role for the child. In unfavorable conditions and against the background of reduced immunity, children easily pick up a variety of infections, especially rhinoviruses, and they get sick much more often than adults. Many experts argue that there can be no rhinitis without sinusitis, despite the fact that, in their own words, there is a big difference between these diseases.
The fact is that when a rhinovirus enters the child's body along with the air currents, it spreads not only to the mucous membrane of the nasal cavity, but also penetrates the mucous membrane of the accessory cavities. As a result, inflammation and mucus production begins in the maxillary sinuses. Since it is difficult to determine sinusitis by external manifestations in this situation, for the purpose of diagnosis, specialists often resort to radiography. If a child is X-rayed for ARVI, then in most cases the picture will show characteristic darkening, indicating the development of inflammation and the presence of exudate in the maxillary sinuses.
However, such a reaction of the body is considered absolutely natural, since mucus contains components with bactericidal properties that help the body fight infection. In this case, the child suffers from acute viral sinusitis, which is accompanied by the same symptoms as a runny nose - severe nasal congestion and impaired olfactory function. This type of sinusitis does not have any special manifestations, therefore, no specific antibiotic therapy is required in such a situation. It is only necessary to treat ARVI correctly and in a timely manner and the sinus inflammation will pass along with nasal congestion. If you let the disease take its course, then there is a high probability of developing bacterial (purulent) sinusitis. In any case, in order not to sound the alarm ahead of time, but also not to miss the moment when rhinitis turns into purulent sinusitis, it is important to be able to distinguish one disease from another. Correct diagnosis of the disease also plays a role in the choice of therapy. So, in order to avoid complications in the form of purulent inflammation of the maxillary sinuses, many parents independently begin to give antibiotics to children with a prolonged runny nose.
However, it is strictly not recommended to do this, because antibiotic therapy does not bring any results in the fight against viruses and may even subsequently harm the child's body.
The first thing that parents should pay attention to when trying to distinguish rhinitis from sinusitis is exactly what difficulties a child experiences when breathing. With a runny nose, both nostrils are blocked, and maxillary sinusitis can be both 2-sided and unilateral. Therefore, if congestion is felt on the one hand, then this may be a sure sign of sinusitis. In addition, you should ask the child to report in case of headache or discomfort in the area of the sinuses (symptoms not typical for rhinitis). Also, the transition of rhinitis to sinusitis will be evidenced by pain when pressing on the inner corner of the child's eye.
Symptoms of sinusitis
If acute viral sinusitis in most cases (with adequate and timely treatment of ARVI) goes unnoticed and in its symptoms does not differ from rhinitis, then the development of bacterial sinusitis in a child is accompanied by a number of pronounced symptoms. This is due to the fact that the fistula connecting the sinus with the nasal cavity is blocked due to edema and impedes the outflow of mucous masses. As a result, the sinus turns into a closed capsule and creates favorable conditions for the reproduction of pathogenic microorganisms, and the mucous masses gradually turn into purulent ones. In this state, treatment at home is not enough for the child. In addition, due to the close location of the sinuses to the cranial cavity, there is a danger of pus breakthrough, so it is imperative to go to the hospital.
In order to start treating the pathology on time, parents should know how to recognize sinusitis in a child and what to look for in case of prolonged rhinitis, the wrong treatment of which is often the main cause of maxillary inflammation.
So, the main signs of sinusitis in children:
discharge from the nose, yellowish or greenish, accompanied by an unpleasant odor;- pain in the bridge of the nose and on palpation at the location of the maxillary sinuses;
- swelling of the cheek or brow;
- headache, aggravated by tilting and turning the head;
- feeling of pressure in the head;
- night cough;
- subfebrile temperature (37.1-38 degrees).
discharge from the nose, yellowish or greenish, accompanied by an unpleasant odor;The appearance of at least a few of the above symptoms is a reason to consult an otolaryngologist. Depending on the form, stage and severity of the disease, not all signs can be observed equally clearly. In addition, in babies in whom the sinuses begin to form ahead of schedule (about 2 years), as well as in children under 7 years of age, the symptoms may be much weaker, since the sinuses have not yet developed to the size of full-fledged cavities. In addition, small children cannot always explain what exactly and how much worries them, so parents should also pay attention to the general condition of the child (fatigue, lack of appetite, etc.).
In addition to the classic symptoms of sinusitis, children sometimes have indirect signs that can help diagnose maxillary sinusitis and facilitate the choice of therapy. In addition to bacterial and viral, odontogenic and allergic forms of the disease are also isolated. Starting from about 12 years of age, when children have already grown permanent teeth, the cause of sinus inflammation can be caries or improperly grown teeth, the roots of which are located in the lower part of the maxillary cavities.In this case, the teenager may suffer from toothaches, sometimes gum inflammation is observed. In the case of a pathology caused by an allergic reaction of the body, the disease is paroxysmal. Often, nasal congestion occurs unexpectedly (after contact with an allergen) and is accompanied by itching in the nasal cavity and frequent sneezing.
Symptoms of chronic sinusitis
In the chronic form of the disease, as a rule, only individual symptoms appear, which presents certain difficulties in the diagnosis of pathology. During the period of remission, from time to time, the following signs of sinusitis may occur:
- stuffy nose and lack of effect from the use of drops;
- discomfort in the throat due to mucus flowing down the back of the throat;
- recurrent headaches;
- permanent violation of the olfactory function;
- tearing without irritating factors;
- edema of the eyelids and conjunctivitis;
- nasalness.
Sinusitis treatment
Modern medicine offers a wide range of methods for treating sinusitis in children. As noted above, acute viral maxillary sinusitis does not need a special approach, provided that the ARVI that caused it is properly treated. If ARVI is in a neglected state, and pathogenic organisms have penetrated into the maxillary cavity, then the treatment of the bacterial form of sinusitis must be agreed with the otolaryngologist. If the patient's condition is not too severe, then treatment usually takes place at home, but as prescribed by a doctor.
In order to relieve swelling of the mucous membrane and open the anastomosis for the outflow of pathogenic exudate, specialists, as a rule, prescribe vasoconstrictor nasal drops. To liquefy the contents of the sinuses, patients usually take mucolytic drugs. However, the mainstay of treatment is antibiotic therapy. In most cases, either local antibiotics are prescribed, which have a direct effect on the inflammation focus, or systemic ones. The course of antibiotic therapy lasts 10-14 days and it is important not to interrupt it after the first improvements in the child's condition, since there is a risk of chronicity or recurrence of the disease.
In addition, in domestic medicine, they traditionally resort to puncturing the sinus wall and pumping out purulent exudate from the sinus. Although more and more young professionals refuse to use this method for medicinal purposes. Puncture is undesirable for young children, since the size of the cavities themselves is still small, and vital organs are located next to them. It is worth resorting to this procedure only for diagnostic purposes and if antibiotic treatment does not work, and the child's life is in danger.
Another common form of sinusitis treatment, which is usually prescribed in addition to the main therapy, is washing according to the Proetz method, or simply "cuckoo" among the people. This procedure is performed on an outpatient basis, and the essence of it consists in flushing out their contents from the sinuses and introducing 
there antiseptic drugs. However, children are often afraid of this procedure, so it becomes quite difficult to carry out it. In addition, flushing is not recommended for unilateral sinusitis, since in the process the infection can spread to a healthy sinus.
When carrying out the procedure, young children are at risk of provoking otitis media, since the auditory organs are in the immediate vicinity of the sinuses.
In addition to conservative treatment and puncture, there are also a large number of folk recipes. Their use in the treatment of children must necessarily be coordinated with the attending physician, since at different stages of the disease the same methods can give different results. So, parents should know that with purulent sinusitis, it is impossible to carry out procedures associated with thermal effects on the sinuses (heating, inhalation, compresses). In addition, it is not recommended to use ingredients that can burn the mucous membrane (onion, garlic, radish, etc.).
