Sinusitis in children is a common ENT disease, referring to an inflammatory reaction of the sinus mucosa, often caused by viral or bacterial infections or allergies. Because children's nasal structure is not yet fully developed and their immune system is weaker, the incidence of sinusitis is higher. If not treated promptly, it may lead to complications such as otitis media and bronchitis, and even affect facial development and cognitive function. Therefore, parents need to closely monitor changes in their children's symptoms to ensure early detection and treatment.
Typical Symptom Analysis
Nasal Congestion: An "Invisible Shackle" on Breathing
Congestion and swelling of the sinus mucosa obstructs nasal airflow, often resulting in persistent or alternating nasal congestion in children. In the acute phase, unilateral nasal congestion may occur, while in the chronic phase, bilateral congestion is more common. During sleep at night, children may be forced to breathe through their mouths, even snoring or experiencing sleep apnea, which can lead to "adenoid facies" (short, thick, upturned upper lip and misaligned teeth) in the long term. Infants and young children often refuse to feed and become irritable and cry due to nasal congestion affecting breastfeeding.
Purulent Nasal Discharge: A "Yellow Alert" for the Nasal Cavity
Bacterial infection causes neutrophil aggregation, resulting in yellow-green purulent nasal discharge that is thick and difficult to blow out. The discharge may flow from the nostrils or back into the throat, irritating the cough. A fishy odor suggests an anaerobic bacterial infection, requiring attention to potential complications. Acute cases involve copious purulent discharge, while chronic cases are intermittent, with blood visible when blowing the nose.
Headache: A Silent "Growth Killer"
Increased pressure within the sinuses irritates nerve endings, causing swelling and pain in the forehead or cheeks. Headaches worsen upon waking, intensify when bending over, and gradually subside in the afternoon. Older children can accurately describe the location of the headache, while infants and toddlers may exhibit irritability, head-grabbing, and refusal to eat. Chronic headaches can lead to poor concentration, memory loss, and impaired learning efficiency.
Cough: A Recurring "Sleep Disruptor" at Night
Postnasal drip irritates the throat mucosa, causing paroxysmal dry cough or phlegm. Coughing often worsens upon waking and with changes in position (such as lying flat), and frequent coughing at night disrupts sleep quality. Prolonged coughing may induce pharyngitis, bronchitis, and even otitis media. If antibiotic treatment is ineffective, sinusitis should be highly suspected.
Decreased Sense of Smell: The "Stolen" Perception
Inflammation causes swelling of the olfactory mucosa or coverage with purulent secretions, reducing the child's sensitivity to odors, manifesting as decreased appetite and refusal to eat. Long-term olfactory impairment may affect nutrient intake, leading to delayed growth and development. Olfactory function usually recovers gradually after the inflammation subsides; if it persists for more than one month, further examination is necessary.
Accompanying Symptoms and Complications
Systemic Symptoms: Fever (temperature > 38.5℃), lethargy, decreased appetite; infants and young children may be irritable, cry, and have restless sleep.
Ocular Symptoms: The sinuses are adjacent to the eye sockets; the spread of inflammation may cause conjunctival congestion, tearing, eyelid swelling, and in severe cases, decreased vision.
Ear symptoms: Eustachian tube involvement leads to tinnitus, ear fullness, and hearing loss. Children may frequently pull their ears and shake their heads.
Gastrointestinal symptoms: Postnasal drip irritates the gastric mucosa after swallowing, causing abdominal pain and vomiting, easily misdiagnosed as indigestion.
Daily Care and Medical Criteria
Home Care Points
Maintain indoor humidity at 50%-60% using a humidifier or placing a water basin.
Cleanse the nasal cavity daily with a physiological saline nasal spray to remove secretions.
Elevate the head of the bed 30 degrees during sleep to reduce postnasal drip.
Avoid exposure to cold air, allergens (such as dust mites and pollen), and secondhand smoke.
Encourage children to drink plenty of water, eat a light diet, and supplement with vitamin C to enhance immunity.
Warning Signs for Prompt Medical Attention:
Symptoms persist for >10 days without relief, or worsen with high fever (>39℃), facial swelling, and eye socket pain.
Severe cough accompanied by wheezing and difficulty breathing, or headache accompanied by vomiting and confusion.
If antibiotic treatment is ineffective after 3 days, or if there are more than 3 recurrences per year.
Prevention is Better than Cure
Prevent colds: Keep warm and avoid getting chilled. During flu season, reduce visits to crowded places.
Proper nose blowing: Blow nose alternately on one side, avoiding excessive force that could cause secretions to enter the middle ear.
Strengthen physical fitness: Encourage children to participate in outdoor activities such as running and swimming (avoid choking on water).
Regular checkups: If the child has underlying conditions such as allergic rhinitis or adenoid hypertrophy, regular follow-up is necessary.
The symptoms of sinusitis in children are diverse and often subtle. Parents need to be attentive observers, noticing subtle signs in their child's breathing, nasal discharge, and cough. With proper care and timely intervention, most children can fully recover, avoiding long-term impacts on growth and development. If sinusitis is suspected, please take your child to an ENT specialist immediately. Do not self-medicate and delay treatment.
