Posted by: kerry | 2010-09-08

2 year old sinus and coughing

hi Dr, my 2 year old son has been battling with sinus problems throughout this winter. he got sick in april and developed a post nasal drip which didnt go away since, a month ago he had a very bad ear infection (he has never batted with his ears before) and had to have grommets put in and his ears drained, thereafter his cough got worse. my ent did a chest and sinus xray. his chest is clear but it showed he had a chronic sinus infection. he was on a 10 days course of anti biotics and a 7 day course of flagyl thereafter he was 100% but last week he caught a virus at his playgroup and now has a post nasal drip again. my ent has given me a 5 day course of celestemine. he seems to be 1 day good 1 day bad. i will give the meds time to work but im just very worried about the situation and it is unpleasant and the poor child can''t sleep. the ent spoke last time of draining his sinuses if the anti bios didnt work but they did but now he is coughing again. do you have any advice at all please? i am also using nasonex and sterimar to try get the snot out as he cant blow his nose. would any major problems have been seen on the sinus xray? thanks so much for your time.

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Our expert says:
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Dear Kerry

At the age of two, children still have very underdeveloped sinusses, and the maxillary sinus is generally filled with mucous until the age of two. This makes XRay interpretation very difficult. The best way to really examine the sinusses is with a CT scan, but because of the radiation involved, this is reserved for extreme cases, as one needs to reduce radiation exposure in children to the minimum.
Your ENT has maximised treatment at this stage, so I suggest you seek the advice of your paediatrician, in order to exclude and/or treat an underlying cause. Your ENT should consult with your Paediatrician, to try and find an underlying reason. Being in a creche does expose your child to recurrent infections, the question is whether he is suffering more than one would expect.
The reality is that most children need daycare, and that they do get sick, so it would be good if your doctor could suggest something that improves his immunity.
The Nasonex is very good to improve swelling in the nose, so it seems that your doctor is thinking along the lines of an underlying allergy.


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