Request an Appointment Online, or call us at (888) 824-0200

The University of Chicago Medicine - Comer Children's Hospital

Frequently Asked Questions About Pediatric Sinusitis

Learn more about sinusitis in children.

Sinusitis is an infection of the sinuses near the nose. It is sometimes called rhinosinusitis because most sinus infections begin with nasal symptoms, like a stuffy nose.

Most types of sinusitis are acute, and they often start with a common cold. This can cause the nasal passages to become swollen, which can block drainage and lead to an infection. The infection is often caused by a virus, and like regular colds, usually goes away on its own after seven to 10 days. However, 1 percent to 2 percent of these viral infections can progress to bacterial infections that require an antibiotic. These infections tend to last longer than seven to 10 days and may get worse over time.

Some rare cases of acute sinusitis can cause serious complications, including infections in the eye or the brain. The symptoms of these infections are more obvious and more severe, and they need to be tended to quickly and effectively. The University of Chicago Medicine Comer Children’s Hospital is equipped to treat these uncommon complications of acute sinusitis using minimally invasive techniques.

Other types of sinusitis are chronic, which means that they last longer and may develop after repeated infections or from previous infections that did not improve with treatment.

Studies show that chronic sinusitis can have a significant impact on children’s quality of life. That’s why it’s important to get symptoms of sinusitis checked if they are severe or last several weeks.

Symptoms include:

  • Frequent nasal congestion
  • Runny nose, usually with discolored drainage
  • Cough, especially at night
  • Postnasal drip
  • Facial pain
  • Headaches, although these are less common in young children.

A detailed history and examination is usually the first step toward diagnosing sinusitis in children. Some older children may require an in-office procedure called a nasal endoscopy, during which the physician examines the inside of the nose and sinuses using a small tube attached to a camera.

Some, but not all, children may need a computed tomography (CT) scan to help diagnose their sinus problem. These are typically children whose sinusitis has failed to improve after multiple courses of antibiotics. At Comer Children's, our pediatric sedation experts can help keep children comfortable during this testing, if necessary.

When diagnosing sinusitis, it’s important for physicians to check for other conditions that could make sinus problems worse, harder to treat, or more likely to return. These include:

  • Allergy problems. Our team works with pediatric allergy specialists at Comer Children's to check for allergy problems such as allergic rhinitis that could cause sinus symptoms in children.
  • Immunodeficiencies. Our physicians may evaluate a child’s immune system to look for immune disorders that can lead to sinusitis.
  • Asthma. Since many children with sinusitis also have asthma, our team works with the child’s pediatrician or asthma specialist to ensure that this condition is managed properly. Research suggests that improving sinusitis also helps asthma symptoms.
  • Cystic fibrosis. A child with chronic sinus problems may require sweat chloride testing to rule out this genetic disease that causes thick mucus to build up in the sinuses, lungs and digestive tract.
  • Ciliary dysmotility. Children with this rare problem often have difficulty clearing their sinuses, ears, and lungs of mucus and have repeated infections in all these areas. The physicians at Comer Children’s have special expertise in diagnosing and managing this condition.

Most children with sinusitis get better with medicines and other conservative treatments. At Comer Children’s, our otolaryngologists work with the rest of the child’s care team to design an appropriate treatment plan. For many children, a course of antibiotics is all that is needed to treat sinusitis. Nasal sprays and nasal rinses may also help ease symptoms.

When medical treatment fails to improve a child’s sinusitis, surgery may be considered. One option is removing the adenoids, which are part of the immune system. These tissues are located in the back of the nose above the roof of the mouth. Research shows that removing a child’s adenoids can improve sinusitis. This procedure is done through the mouth, and children go home the same day.

Another treatment for pediatric sinusitis is balloon sinuplasty. Although this technique has not been widely available for children, it has been used by the treatment team at Comer Children's for several years. During a balloon sinuplasty, the surgeon inflates a small balloon into the sinus passageways to open them up and restore normal drainage. The surgeon may also wash mucus out of the sinuses during this procedure. It requires general anesthesia and is usually done at the same time as the adenoids are removed. This is often more effective than just removing the adenoids. There is minimal bleeding, and children return home the same day.

Another option, sinus surgery, is more involved but can help children with more severe sinusitis who don’t find relief from other therapies. Research suggests surgery can help 80 percent to 85 percent of children with chronic sinusitis. At Comer Children’s, otolaryngologists perform sinus surgery with guidance from CT scans. This results in a safer, more complete procedure for young patients.