21 October 2003

Sinusitis can strike kids, too

The next time your child complains of a runny nose, headache and fatigue, you may have to reach for more than cold medication.

The next time your child complains of a runny nose, headache and fatigue, you may have to reach for more than cold medication.

It could be the common chronic problem of sinusitis, a condition that is usually associated with adults.

Just as common in children
It is as common in children as in adults, and when sinus problems get worse, asthma and bronchial problems get worse, says Dr Jordan Josephson, a New York City otolaryngologic surgeon who specialises in paediatric care.

Kids can be particularly susceptible to sinus problems because their sinuses aren't fully formed until age 12, and their sinuses are narrower than an adult's.

If you factor in any allergies a child might have - as well as environmental triggers like second-hand smoke, air pollution and exposure to bacteria - that child's susceptibility to sinusitis increases, Josephson says.

Signs, symptoms and effects
Telltale signs of possible sinusitis in a child include a frequent runny nose with yellow mucus, pain near the cheeks or eye areas, and difficulty staying awake in school, Josephson says.

Sinusitis in children - as well as adults - can also produce emotional troubles like irritability and a general unhappiness. But a child is often unable to convey this sense of discomfort to a doctor, says Dr Alexander Chester, an internist at Georgetown University Medical Center in the US.

It can be really tough for kids who feel poorly but whose illness is not validated by doctors or parents, he says. A doctor looks at a kid with a runny nose and listlessness and basically tells him to shape up.

Sinusitis is characterised by inflammation of the nasal passages. It can be caused by any number of problems, from a cold to allergies to an infection, doctors say. The inflammation narrows the nasal passages so mucus can't drain properly, causing discomfort and sometimes infection.

Left untreated, sinusitis can become chronic, lasting for anywhere from three to eight weeks, to months or even years, according to the American National Institute of Allergies and Infectious Diseases.

What parents should be on the lookout for
Parents should be alert to potential sinusitis symptoms in their children and get them to the doctor.

If a cold lasts for 72 hours or less, it's nothing to worry about, says Josephson. But if a child has a runny nose all the time and is home sick once a month, if he's falling asleep in school, getting bad grades or taking his hand and rubbing it up his nose because he can't get relief, you shouldn't dismiss these symptoms.

A paediatrician can prescribe a nasal spray and/or antibiotics if there is a bacterial infection, Josephson says.

If after two to four weeks the child isn't better, he or she needs to see a specialist, he adds.

Specialist treatment and surgery
An otolaryngologist will examine the child in the same way an adult is examined, using CAT scans and maybe an endoscopy. This is a procedure where the doctor, using a slim tube with a camera at the end, can look directly at the sinus passages. Paediatric otolaryngologists have a smaller paediatric endoscope for this purpose, Josephson says. These tests allow the doctor to check for polyps, which can block the nasal passages, or anatomical abnormalities that constrict the natural flow of mucus.

While surgery is rarely performed on children, specialists typically recommend a longer course of antibiotic treatment, usually for a three- to eight-week period, Josephson says.

Parents are resistant to the idea of an antibiotic for a long period of time, he says. They often don't want to give kids antibiotics for more than 10 days. But living with an infection for a year isn't good, either. There could be polyp formation and long-term effects of doing poorly in school. - (HealthDayNews)

Read more:
Natural approach to respiratory tract infections
Fatigue, pain, sinusitis link


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Dr Elliot Shevel is a South African migraine surgery pioneer and the founder and medical director of The Headache Clinic in Johannesburg, Durban and Cape Town, South Africa. The Headache Clinic is a multidisciplinary practice dedicated to the diagnosis and treatment of Primary Headaches and Migraines. Dr Shevel is also the main author of all scientific publications generated by his team. He recently won a high level science debate in which he was able to prove that the current migraine diagnosis and classification is not based on data. Tertiary Education - Dr Shevel holds both Dental and Medical degrees, and practises as a specialist Maxillo-facial and Oral Surgeon. Follow the Headache Clinic on Twitter@HeadacheClinic.

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