Many parents have heard of paranasal sinusitis (or sinusitis for short) and even have paranasal sinusitis themselves. Can children get paranasal sinusitis too? The answer is yes. Moreover, in my clinical work, I found that the incidence of paranasal sinusitis is increasing. The reasons for this, I think, are many, but one of the important reasons is the increasing incidence of allergic rhinitis in children, and the lack of awareness of allergic rhinitis among many doctors and parents, resulting in untimely treatment, is an important reason for the increasing incidence of sinusitis. So what is the difference between paranasal sinusitis in children and adult paranasal sinusitis? Does my child have paranasal sinusitis? How to treat paranasal sinusitis? Please read the following introduction with your questions.
First, a brief overview of sinusitis. There are four sets of paranasal sinuses in the human body (as shown in the figure), but they are not all formed at birth. The frontal sinuses are located in the frontal bone and begin to develop at the age of 2. They pneumatize rapidly at the age of 6-7 and reach their annual form at the age of 20. The septal sinus is formed at birth, develops rapidly at 1-2 years of age, and completes its pneumatization around 20 years of age. The maxillary sinus is present at birth and is a tubular air-containing cavity that is clearly visible at 2-4 years of age, develops rapidly at 6-7 years of age, and completes pneumatization at around 20 years of age. The pterygoid sinus is located within the pterygoid bone and is a very small air chamber after birth, the sinus cavity is more visible after the age of 9, develops rapidly during adolescence and is fully developed by the age of 20. Paranasal sinusitis, on the other hand, is the inflammation of the mucous membrane of the sinuses, with maxillary sinusitis being the most common, followed by inflammation of the septal sinus, frontal sinus and pterion sinus. Paranasal sinusitis can occur singly or in many cases. Paranasal sinusitis in children is divided into three categories: acute, acute recurrent and chronic. Typical manifestations are: pus, nasal congestion, headache, fever, and cough due to postnasal drip. It can also be accompanied by otitis media, adenoiditis, bronchitis, asthma and other diseases. Acute sinusitis symptoms are obvious, while chronic sinusitis symptoms are relatively mild or even asymptomatic. Due to the young age of children, the expression is not clear, the acute attack of sinusitis may be manifested as fever, headache, runny nose, nasal congestion performance, easily misdiagnosed as acute upper respiratory tract infection or tonsillitis, and not given the appropriate treatment in a timely manner, resulting in sinusitis is prolonged, and even have acute to chronic.
Infection of the nasal mucosa is the root cause of sinusitis. Another significant difference in the pathogenesis of sinusitis in children and adults is that the proportion of allergic reactions (allergic reactions) in the development of sinusitis in children is higher. Because the nasal mucosa is congested and edematous, this leads to narrowing of the sinuses, causing poor drainage, resulting in inflammatory secretions in the sinuses that cannot be discharged in time, which over time causes chronic inflammation of the sinuses and even destruction of sinus bone.
So how is paranasal sinusitis in children determined? First, parents of children with allergic rhinitis should be alert to the occurrence of sinusitis, which, as mentioned earlier, is an important cause of the onset of paranasal sinusitis. Secondly, children with frequent nasal congestion on one or both sides, runny nose, especially yellow-green nasal discharge, accompanied by throat-clearing cough and phlegm in the throat should be alert to combined sinusitis. Again, school-age children with frequent nasal congestion, runny nose and headache should also be alerted to sinusitis. Chronic sinusitis is often accompanied by other nonspecific symptoms, such as dizziness, decreased sense of smell, mental disturbance, memory loss, and inattention. Once paranasal sinusitis is suspected, the diagnosis can be confirmed by sinus imaging (CT or MRI), or by nasal endoscopy at an ENT specialist.
The treatment of paranasal sinusitis in children mainly includes the following aspects.
The first, anti-infection: acute sinusitis and chronic sinusitis infection pathogen has some differences, the former to Streptococcus pneumoniae, Haemophilus influenzae, the latter to anaerobic bacteria. Therefore, in the selection of antibiotics should pay attention to the difference. Acute and acute recurrent sinusitis preferred amoxicillin clavulanic acid potassium, but because penicillin requires skin test, outpatient treatment is more troublesome, can also choose II or III generation cephalosporin antibiotics.
Second, anti-allergic treatment: it has been repeatedly stressed that allergic reactions play a very important role in the development of sinusitis in children, so it is important to actively control allergic rhinitis. You can nasal spray hormones (such as endosulfan, coleus), oral II generation anti-allergy drugs to reduce sinus and nasal mucosa congestion and edema. Leukotriene receptor antagonists (e.g. montelukast sodium) can also effectively reduce nasal mucosal sensitivity and relieve nasal congestion.
Third, promote the discharge of sinus and nasal secretions. Both myrtle oil or ambroxol can be used to promote cilia movement, seawater preparations can be used to rinse the nasal cavity, and even negative pressure replacement has been used in the past to promote the discharge of inflammatory secretions in the sinuses.
Fourth, vasoconstrictors such as 0.5% ephedrine nasal drops can be used for a short period of time to facilitate ventilation and drainage. However, children should not use nazoline hydrochloride (nasal drops), because this drug can inhibit nasal cilia movement, vascular rebound dilation phenomenon, long-term use is likely to cause drug rhinitis.
Fifth, surgical treatment: such as adenoid removal, removal of nasal polyps, transnasal endoscopic functional sinus minimally invasive surgery, etc..
The most common and important of the above is the combination of antibiotics and local hormones, which can significantly shorten the course of the disease and prolong the second cycle of sinusitis. We hope that conservative medical treatment can effectively control sinusitis attacks, reduce sinusitis complications and reduce the chance of surgery.
We hope the above explanation is helpful for you to understand sinusitis and treat sinusitis.