sinusitis

 Sinusitis

Sinusitis is infection of sinuses., Cold and allergic inflammation.

Sinuses cavities or  air filled pockets, near nasal passage lined with mucus membrane.

1. Ethmoid sinus

Locate inside face area of bridge of nose. Present at birth.

2. Maxillary sinus

Located inside face, around area of cheeks, present at birth.

3. Frontal sinus

Located inside face, area of forehead, doesn't developed until years of age.

4. Sphenoid sinus

Located deep in face behind the nose. Doesn't develop until adolescence.

Types of sinuitis

1. Acute sinusitis

Symptoms lasts than 4 weeks, better with appropriate treatment.

2. Subacute sinusitis

Doesn't better with treatment initially, symptoms last for 4 to 8 weeks.

3. Chronic sinusitis

Occur due to repeated acute infection or previous infection.

Symptoms last for 8 weeks or longer.

4. Recurrent sinusitis 

Three or more episode of sinusitis occur in year.

Etiology

1. Upper respiratory infection or common cold.

Streptococcus pneumonia

Haemophilus influenza

Exposure to cigarette, smoking,  passive smoker.

Infection from teeth

Allergy

Nasal polyps

Abnormalities in structural in nose.

Foreign objects stuck in nose.

Clinical features

Symptoms depends upon age of child;

In younger children symptoms;

Running nose longer than 7-10 days. (Discharge thick green/yellow)

Night time cough 

Swelling around eyes

In older children symptoms;

Running nose or cold (lasting longer than 7-10 days)

Post nasal drip

Bad breath

Cough 

Headache

Fever upto 102 degree fahrenheit.

Sore throat

Periorbital swelling

Facial discomfort

Diagnostic Evaluation

1. Child history taking and physical examination

2. Sinus X ray

3. CT scan

4. Culture from sinus

Management

Antibiotics (10-14 days)

Antihistamine; allergic sinusitis 

Acetaminophen; for pain/discomfort 

Decongestant and mucus thinner; Guaifenesin

Nasal sprays; reduce inflammation 

Surgical management

Surgery to remove polyps/ or adenoids.

Endoscopic sinus surgery; if the treatment failed