Pediatric Sinus Disease
The management of sinus disease in children utilizes maximal medical therapy while sinus surgery is only indicated in limited cases. The most frequently affected sinuses in children are the maxillary and ethmoid sinuses. A common cold is most often responsible in the development of an acute bacterial sinus infection. Acute bacterial sinusitis requires antibiotic therapy. Pediatric patients are often treated with long courses of antibiotics.
[caption id="attachment_126" align="alignnone" width="238" caption="Child that developed a severe ethmoid and frontal sinus infection that went untreated for 2 weeks. A left periorbital abscess developed and required emergent endoscopic sinus surgery. "]
Many of the signs and symptoms of pediatric sinus disease are similar to the common cold. When symptoms last longer than 10 days, an acute bacterial sinus infection is suspected. Patients experience low grade fevers, discolored nasal discharge, nagging cough, facial pressure, headache and occasional facial swelling.
If children do not improve with long courses of antibiotics, decongestants and nasal sprays, your doctor will order a CT scan of the sinuses. The CT scan will allow for precise identification of the problem.
[caption id="attachment_127" align="alignnone" width="242" caption="Coronal CT scan demonstrating the gray area involving the left ethmoid and frontal sinuses. The infection spread from the ethmoid sinus through the thin bone separating the sinus and the eye."]
Complications are rare in pediatric sinus disease, but if a sinus infection is left untreated it can spread to the eye or brain with the potential for blindness or brain abscess.
[caption id="attachment_128" align="alignnone" width="292" caption="Axial CT scan demonstrating development of a brain abscess in the same patient."]