Sinusitis in children maybe divided into an acute sinusitis which lasts less than 6 -8 weeks and chronic sinusitis which may occur after 6-12 weeks of persistent symptoms. Causes of this condition are often related to air pollution, allergic rhinitis, day care attendance the common cold or reflux and it is usually due to a bacterial infection which may well be super imposed upon a viral or respiratory tract infection
The child may complain of nasal obstruction, congestion, have face pressure or headache, thick nasal discharge, tooth ache, fever and cough and irritability.
Most children with acute sinusitis respond to a 10-14 day course broad-spectrum antibiotic together with topical decongestants. Inhalations may be useful but antihistamines are not always of much help. The child with chronic sinusitis who has failed all medical treatment may require a surgical approach and this usually begins with adenoidectomy with perhaps turbinate cautery together with a smaller procedure on the maxillary or cheek sinuses. In more significant problems the child may require more extensive sinus surgery which today can be done through a telescope down the nasal cavity and is known as functional endoscopic sinus surgery (FESS).