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Sinusitis Can Strike Kids, Too

The condition can cause a variety of health problems if left untreated

MONDAY, Oct. 20, 2003 (HealthDayNews) -- 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.

"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 specializes in pediatric 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 secondhand smoke, air pollution and exposure to bacteria -- that child's susceptibility to sinusitis increases, Josephson says.

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.

"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 characterized 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 National Institute of Allergies and Infectious Diseases.

Statistics on the prevalence of sinusitis in children are hard to come by. But the National Center for Health Statistics reports that the condition affects about 32 million American adults a year, or approximately 16 percent of the adult population.

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 pediatrician 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.

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. Pediatric otolaryngologists have a smaller pediatric 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."

More information

Visit The Nemours Foundation for tips on helping your child avoid sinusitis. For more information on sinusitis, check with the American Academy of Allergy, Asthma and Immunology.

SOURCES: Jordan S. Josephson, M.D., ear, nose and throat surgeon, Lenox Hill Hospital, New York City; Alexander C. Chester, M.D., clinical professor of medicine, Georgetown University Medical Center, Washington, D.C.
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