Chronic Sinusitis in Children
Sinus disease is largely a medical disease in children. Treatment of allergic disease is critical in most children who have recurrent sinusitis. Removal of adenoids can also be very helpful. Any child who has more than 3 sinus infections per year should be evaluated. If your child needs imaging (CT scan or xray), this can be done safely and quickly in my Fort Worth office. Seven (7) second scans can be performed successfully on children as young as 3 years of age. Radiation levels are much less than traditional CT scans of the sinuses. This scan also shows if the adenoids are enlarged.
- Swelling around the eyes
- Fatigue and weakness
- Thick nasal discharge, yellow-green
- Cold or illness and sometimes fever lasting more than 10 days
- Chronic cough clearing the postnasal drip (PND)
- Headache (usually 6 y and older), nausea, vomiting
Treament for Sinusitis
- Antibiotic therapy, most children respond very well
- Nasal decongestant sprays or saline nasal sprays
- Nasal saline (saltwater) drops or gentle spray can be helpful in thinning secretions
- Over-the-counter decongestants and antihistamines
Balloon Sinuplasty in Children (Minimally Invasive Sinus Surgery)
Children who do not respond successfully to medical treatment of allergies and sinus infections may need their adenoids out. In the past, this was typically done prior to any sinus surgery. Some studies had reported success rates of adenoid removal on sinusitis as high as 60%. Now with balloon sinuplasty, the maxillary sinuses can be safely dilated–without the removal of tissue–and irrigated to rinse any infection out. Although no tissue is removed–so scarring is minimal to none–the dilated opening stays dilated due to tiny fractures in the thin bone around the opening that is covered with functional mucosal tissue. This procedure increases the success of adenoidectomy alone without increasing postoperative pain or recovery times.
Nasal Obstruction in Children
This is commonly the result of large adenoids or allergic disease causing inferior turbinate obstruction in the nose. Children who breathe through their mouths instead of the noses may suffer from poor sleep quality or even obstructive sleep apnea. This may also cause problems with tooth and palate development. The first steps in treatment are to assess for allergic disease and consider a 1 to 2 month trial of a nasal steroid spray. Nasal steroids will reduce the inflammation and congestion in the nose. They have also been known to decrease adenoid size. Because they are absorbed mostly in the nose, they have little to no side effects. If this does not resolve the problem, adenoid removal with reduction of the turbinates using coblation can be very effective. Your child may need to be assessed for chronic sinusitis prior to surgery.
Nose Bleeds – Epistaxis
The common site for a nosebleed to start is from just inside the entrance of the nostril, on the nasal septum (the middle harder part of the nostril). The blood vessels on the nasal septum (the midline harder) are quite fragile and can rupture easily. The tissue lining the septum is more likely to bleed with the following:
- Colds and nasal congestion
- Chronic sinusitis
- Nose picking
- Nose injuries
- Nose blowing forcefully
In these situations, epistaxis (nose bleeds) tend to last a short time and can be stopped with proper home treatment.
Treatment for Nose Bleeds in Children
- Pinch the nostrils shut
- Apply light pressure for 20 minutes
- Cold compress to face to constrict (narrow) the blood vessels
Recurring Epistaxis (Nosebleed) in Children
Recurring nosebleeds can be distressing to children. They may be mild, however frequent nose bleeds can decrease a child’s activity. Recurring nosebleeds can be treated with cauterization at Trimble ENT. In small children, cauterization may need to be done under anesthesia.
If you have any questions or if you would like to learn more about the services we provide, please call TRIMBLE ENT and Sinus at 817-529-6200 or complete our contact form.