Acute maxillary sinusitis in children. Stages of disease development

Sinusitis in children is a very common phenomenon. It often appears as a consequence of a common runny nose. Against the backdrop of a weakened children's immunity the infection can quite easily penetrate the paranasal sinuses. There it causes inflammation, which provokes the occurrence of sinusitis.

Clinical picture

Depending on the duration, several forms of the disease can be distinguished:

• acute sinusitis in children, lasting up to 3 months;
• recurrent acute sinusitis, occurring 2 to 4 times during the year;
• chronic sinusitis lasting more than 3 months;
• nosocomial sinusitis is a special type of disease; its symptoms develop after 48 hours of the child’s stay in the hospital.

The general clinical picture of sinus inflammation depends on the age of the child. Taking this into account, all young patients can be divided into 3 groups:

• children under 3 years old;
• children preschool age 4-7 years;
• schoolchildren 8-15 years old.

The course of sinusitis in children has some characteristic features. They are associated with the specifics of the child’s body and incomplete development paranasal sinuses. Since in most cases in this age group the main causes of the disease are adenoids and viral infections, then sinusitis in children is usually asymptomatic. After all, subjective signs of sinus inflammation in this case are difficult to identify.

At an older age, when all the sinuses are fully formed, all known forms of sinusitis are possible. In addition, polysinusitis (inflammation of several types of paranasal sinuses) and pansinusitis (inflammation of all paranasal sinuses) occur much more often. In this case, monosinusitis (inflammation of one sinus) practically does not occur.

Quite often, sinusitis in children is accompanied by separate forms otitis media, as there is a possibility of infection spreading into the middle ear cavity.

Symptoms of sinus inflammation in children

With a disease such as sinusitis, the symptoms in children depend, first of all, on the nature of the inflammatory process. Parents need to pay special attention to the following signs:

Symptoms of sinusitis in children can vary somewhat. For example, pain may be felt in various parts heads. It is also important whether the child’s form of the disease is acute or chronic. In acute sinusitis, the symptoms are more intense.. When chronic inflammation symptoms periodically worsen.

Diagnosing sinusitis in children

Diagnosis of sinus inflammation in children is quite traditional. It includes mandatory x-ray examination. X-ray in 80-100% of cases allows us to identify the existing pathological process.

In the case of inflammation of the maxillary sinuses, the nature of the disease is usually established using a diagnostic and treatment puncture. This procedure is very important for determining tactics further treatment. But for patients, puncture still remains an unattractive event.

If non-inflammatory sinusitis is suspected (with a deviated septum, cyst or other neoplasm), a computed tomography scan is usually performed. But The most informative method for diagnosing sinusitis is endoscopic examination. nasal cavity. Although not every ENT office yet has the necessary equipment to carry out this procedure.

In addition to all this, considerable importance is given clinical analysis blood, which shows inflammatory changes in the body.

It is worth understanding that attempts to independently diagnose sinusitis in children will only lead to a waste of time. And this may cause the disease to become chronic.

Not every parent knows how to treat sinusitis in children so that the therapy quickly improves the child’s condition and does not cause any complications. Therefore, it is better to contact a specialist who will prescribe the correct treatment. At the same time, it is extremely important not to miss the first symptoms of inflammation and to completely get rid of the disease.

In general, treatment of rhinosinusitis in children is traditional. Therapy includes:

• antibacterial drugs;
• vasoconstrictors;
• antihistamines;
• physiotherapy.

In addition, according to indications, it is possible to rinse by moving fluid or puncture the maxillary sinuses. You can also contact alternative medicine(folk methods, warming, massage, etc.).

Inflammation of the sinuses can occur due to carious teeth. In this case, rhinosinusitis in children has almost the same symptoms as viral sinusitis. But treatment must begin with eliminating the source of the disease and only then get rid of the signs of inflammation.

Antibacterial drugs

IN ideally antibacterial therapy sinusitis is based on the results microbiological research pathogen. At the same time, its sensitivity to antibiotics is also revealed. But in most cases, unfortunately, treatment begins without obtaining tests, since their results can usually be found out on the 5-7th day.

But in case of general intoxication, copious amounts pathogenic discharge, acute purulent sinusitis with severe symptoms, antibacterial therapy should be prescribed immediately. Also required surgical treatment sinusitis in children of very young age - up to 5 years, since complications arise much faster in them.

That is why doctors, at their own peril and risk, can prescribe pills without test results. But after receiving additional information about the disease, treatment must be adjusted.

Choice of antibiotic

The selection of antibacterial drugs is based on knowledge of the typical pathogens of sinusitis and the epidemiological situation. Most commonly prescribed medications wide range actions of the penicillin group:

• Ampicillin;
• Amoxiclav;
• Augmentin (in the form of syrup);
• Flemoxin Solutab (in the form of soluble tablets).

It is also possible to use drugs of a number of tetracyclines:

• Doxycycline;
• Unidox Solutab.

But the use of such drugs in pediatrics is limited. They should not be given to children under 10 years of age.

The last group of medications that are often prescribed to children for sinusitis are macrolides. Among them is Clarithromycin. Except antibacterial action it also has anti-inflammatory and immunomodulatory effects. This gives additional positive effect during treatment.

Vasoconstrictors

When diagnosed with rhinosinusitis, treatment in children is based on relieving swelling of the mucous membrane in the nasal cavity. For this purpose, special vasoconstrictor drugs are used, such as:

• Sanorin;
• Naphthyzin;
• Galazolin;
• Nazivin and others.

These medications help make breathing easier. True, this effect is quite short-lived. At the same time, quite frequent use similar drugs within 5-7 days it can become addictive, as a result of which it will not give the expected result. Therefore, they must be taken in accordance with the prescription.

By purchasing vasoconstrictor medications, it is better to give preference to products in the form of sprays and aerosols. They are evenly distributed throughout the mucous membrane of the nasal cavity. This allows you to create a more pronounced therapeutic effect. But you can also buy drops.

To obtain the proper result from taking vasoconstrictor drugs, instillation must be done correctly - lying on your side. In this case, the medicine should reach the wall of the nasal passage.

After use vasoconstrictors use various medicinal substances, which help cope with inflammation in the paranasal sinuses. Typically this is antiseptic drops(Collargol, Protargol), infusions medicinal herbs(decoction of oak bark), as well as local antibacterial drugs (Bioparox).

Alternative medicine

Treatment of sinusitis in children is not a case where you can get carried away with methods traditional medicine. It is better to leave the use of beet or carrot juice to cure a mild runny nose or a common cold. Also, herbal medicine methods are not very effective as a treatment for sinus inflammation. After all, it is not uncommon that herbal infusions dripped into a baby’s nose aggravated the situation and caused an allergy instead of improving the condition.

Moreover, If you have sinusitis, you should not warm up your sinuses and rinse your nasal cavity without consulting a specialist.. An incorrect rinsing procedure can lead to injury. The exception is the instillation of solutions based on sea salt. Warming can be done only in forms of sinusitis when there is no purulent discharge. In other cases this event can only intensify the inflammatory process.

However, for example, it is quite possible to give inhalations to a child. But they should be carried out no earlier than the 5th day of illness, provided that the runny nose has not stopped. The following composition has worked well for this procedure: calendula and chamomile flowers, sage leaves. These components must be filled hot water, bring the solution to a boil and remove from heat. Then the child needs to breathe the resulting therapeutic fumes.

Homeopathy also shows good results. And since the drugs in this group are based on natural substances, they practically do not give side effects. In the same time, homeopathic remedies strengthen protective properties body, which plays an important role in the treatment of a child.

For chronic sinusitis, it is possible to carry out special breathing exercises and facial massage. This improves blood circulation and reduces sinus symptoms.

For a disease such as sinusitis, treatment in children under any circumstances should be carried out under the supervision of a doctor. Moreover, you should know that the chronic form of sinusitis is much more expensive and difficult to treat. Therefore, in order to prevent complications, it is necessary to carefully monitor the manifestation of any signs of sinus inflammation and, of course, not self-medicate.

A runny nose is the most common ailment that occurs in both adults and children. But there are situations when difficulty breathing and nasal congestion are symptoms of sinusitis in children.

Parents often write off mucus discharge as a common cold. In most cases this is true. But every mother needs to know how to distinguish mild rhinitis from a serious illness.

1. Prolonged runny nose. If it does not go away within 14–21 days, you should be wary and consult an otolaryngologist.
2. Greenish-yellow discharge. They say that pus has begun to accumulate. Sometimes blood may be present.
3. Labored breathing. It is difficult for the baby to inhale and exhale. During sleep, the patient feels discomfort; he wakes up from breathing through his mouth. Snoring appears.
4. Headache. It often appears at the end of the day.
5. Pain in the nose area. Pressure on the bridge of the nose causes the child discomfort. Sometimes there is discomfort while chewing.
6. Heat. It can reach 39. Appear febrile state, delirium, confusion.
7. Fatigue. As well as lethargy and apathy. A sick baby may feel exhausted in the morning. The nose is breathing poorly, there is not enough oxygen. Add to this sleepless night, and you will get a typical portrait of a child who has acute sinusitis.
8. Night cough. It occurs due to the dryness of the irritated nasopharynx, deprived of healthy moisture. Another cause of cough is the flow of mucus into the larynx.
9. Loss of smell. The patient ceases to smell. For the same reason, appetite decreases.
10. Swelling of the face. The child's eyelids and cheeks become swollen. The eyes begin to water.

The condition of the sinuses is normal and with sinusitis

The severity of symptoms depends on the phase and type of disease.

Why is sinusitis dangerous in a child?

Inflammation of the paranasal sinuses brings severe discomfort. Causes of the disease: virus, infection, hypothermia or allergies. Infants do not know how to blow their nose. Therefore, mucus must be removed using aspirators. If this is not done, the discharge will stagnate. This is how sinusitis occurs in children under one year of age.

The formation of the paranasal sinuses in babies under three years of age is not yet complete. Therefore, viral infections that enter there do not penetrate all parts of the nasopharynx. Sinusitis in children of this age occurs without obvious symptoms.

In preschoolers aged four to seven years, the sinuses are already developed, so viral infections can lead to complications. Sometimes otitis media develops as the nasopharynx and middle ear area interact with each other.

Sometimes the little one manages to push it into his nose foreign object, most often small construction parts or small toys. This causes inflammation, and the acute period of the disease begins.

Acute form of sinusitis

Sanorin drops accelerate the release of purulent mucus from the sinuses

How to treat this disease to avoid complications? If you notice signs indicating inflammation, you should consult a specialist. He must diagnose and prescribe therapy for the child. A general blood test is taken. Sometimes you can’t do without x-rays and computed tomography.

Acute sinusitis is accompanied by obvious symptoms that are difficult to miss.

An experienced doctor sets himself the following goals:

• Remove nasal congestion. To do this, the necessary drops are prescribed to constrict the blood vessels. They eliminate swelling by accelerating the release of purulent mucus from the sinuses:

1. "Galazolin";
2. "Nazivin."

Important! You can take vasoconstrictor medications for no more than 6-7 days! Otherwise, addiction develops, the drug begins to bring harm rather than benefit!

Modern medications are often available in the form of a spray or aerosol. The solution is applied gently, evenly distributed on the nasal mucosa. After a week's course, antiseptic drops are prescribed:

1. "Ectericide";
2. "Protargol".

• Destroy pathogenic organisms. They are the ones that cause inflammation. This is where broad-spectrum antibiotics come to the rescue:

Amoxicillin should be taken three times a day

1. Augmentin (syrup). It is given to children after meals. There are suspensions with 8-hour and 12-hour action. The doctor calculates the dose suitable for baby. The amount of mg depends on body weight.
2. Amoxiclav. For very young patients, the tablets are dissolved in water. The dosage is determined by the otolaryngologist.
3. The dosage is calculated depending on the child’s body weight. Per 1 kg there are 30 - 60 mg of the drug per day. This dose should be divided into three doses. It is important to maintain the same interval between doses. Food has no effect on effectiveness
4. Flemoxin Salutab. Available in the form of instant tablets.

Possible use of tetracyclines:

1. "Doxycycline";
2. Unidox Salutab.

Antibiotics are also prescribed when the disease is caused by viruses, but time was lost and the purulent stage began.

• Prevention of complications. Physiotherapy is prescribed and recommended antihistamines. It is important that otitis media does not develop.

Chronic form

If the disease is not diagnosed and therapy is not carried out, the disease can become chronic. It's not easy to cure. Then the signs will not be so obvious, and identifying the disease will be more difficult. The main goal of the prescribed treatment is to eliminate the provoking factor.

Sinus piercing diagram

Doctors may use medications or choose surgery:

• Medication method.

1. Steroid nasal aerosols (Nasonex) are prescribed. If sprays are ineffective, the otolaryngologist prescribes oral steroids.
2. A course of antibiotics.
3. For fungal infections, antifungal agents are recommended.

• Surgery.

If there is no result, a surgical puncture of the sinuses is prescribed. With the help of suction, purulent stagnation is eliminated. Then the doctor rinses and treats the mucous membrane with antibiotic and anti-inflammatory agents.

Traditional medicine

Treatment of sinusitis in children using folk methods at home is quite effective. But it should be carried out only as an addition to the main course of therapy prescribed by a doctor.

Inhalations

Treatment of a child with herbal infusions. Collections of chamomile, sage, and calendula leaves are suitable. They can be purchased at your nearest pharmacy. The plants are filled with hot water and placed on the stove. Then the broth is brought to a boil and the baby is allowed to breathe in the healing vapors.

Important! To protect your child from possible burns, use a towel! Cover the hot edges of the dish with a cloth and make sure that the fumes do not burn your face!

If you don't want to risk using heated liquids, use an inhaler. A special device with a capacity for herbal infusions equipped with convenient flexible tubes and a mask for inhalation. In stores you can find devices designed specifically for children. They are complemented with entertaining elements and imitate the shape of animals.

Nasal rinsing

Sea salt is an indispensable companion for home therapy. It disinfects the mucous membrane. But it is necessary to discuss such rinsing of the baby’s sinuses with the attending physician. Perhaps he will advise ready-made solutions, which are sold in pharmacies, or will prescribe an aerosol based on sea salt:

1. "Aquamaris";
2. "Aqualor".

Microclimate

A hygrometer allows you to monitor humidity levels

Sinusitis in children goes away faster if a favorable climate is created in the house. The optimal temperature for maintaining the health of a child is 18 - 19 degrees. If the apartment is hot, the mucous membrane begins to dry out. A characteristic cough appears. In addition, the baby will begin to sweat and may easily catch a cold. If the house is too cold, the child is also at risk of getting sick. Normal room temperature will protect your baby from illness.

If your baby has acute sinusitis, monitor the humidity level. To do this, you can purchase a hygrometer. The inflammation will go away if the air in the room is not dry. Insufficient humidity in winter can be caused by heating devices. Normal level humidity – 50 – 70%. You can regulate it by turning on the humidifier. Daily wet cleaning, as well as the presence of aquariums, will not hurt. When you have a runny nose, breathing is difficult. Dry air creates additional load to work the sinuses. Stuffiness and warmth are the causes of the development of the disease. Try to create for the child necessary degree humidity. And then the night cough will subside.

Air purity - important factor. Ventilate the room in which the sick baby is located. In summer, you can leave the window slightly open all day. The cough will go away, giving way to healthy sleep.

It speeds up blood flow and reduces sinus inflammation. Lightly tap for three minutes using thumb. These manipulations cause a drainage effect. They allow the mucus to get out. Then massage the following points:

Facial massage successfully launches healing processes

1. area between the eyebrows;
2. points under the eyebrows;
3. places under the eye sockets;
4. middle of the nasolabial fold;
5. base of the wings of the nose.

Massage is not able to rid the baby of the disease completely. But it successfully launches the processes of recovery and recovery.

Warming up

This disease can be treated with heating if the acute period of the disease is over and the baby does not have a fever. To create dry heat you can use:

1. Egg. It is hard-boiled and wrapped in a cotton cloth. Warming up is best done before bed. Treating sinusitis in this way is convenient and simple.
2. A bag of salt. Coarse salt is heated in microwave oven or in a frying pan. Then they place it in a canvas bag and place it on the bridge of the nose. This is an excellent therapy for sinusitis.
3. Paraffin. The wax is heated and applied to the site of inflammation. To avoid burns, you can place a thin cotton cloth between the skin and the paraffin.
4. Heated stones (stone therapy). This type of therapy is offered by spas and health centers. If desired, you can treat the disease at home in this way. The pebble is heated in a frying pan, and then placed in a bag or a clean sock and applied to the nose.
5. Blue lamp. It emits infrared light and gives dry heat. This reflector can be used to treat the nose if there is no exacerbation of the disease at this time. The heat penetrates the tissue by 4 cm, warming the entire nasopharynx. The lamp will help if you have a cough.

Sinusitis often “hides” under the guise of a common runny nose. The task of each parent is to identify the signs characteristic of this particular disease. Be sure to consult an otolaryngologist. He will prescribe medications and monitor the treatment.

Sinusitis is a disease during which an inflammatory process occurs in the paranasal sinuses. Sinusitis can be caused by viruses, bacteria, fungi, or allergens. This disease is one of the most common. Depending on the duration of the disease, acute and chronic forms of the disease are distinguished. Acute sinusitis can last up to 8 weeks, but the chronic form lasts much longer and occurs more than four times a year. An inflammatory process in the paranasal sinuses can occur in children and adults. Sinusitis can occur in any sinus on one or both sides of the nose.

Causes

Sinusitis in newborns appears much less frequently than in adults, but it still sometimes occurs if the baby has a cold or has become infected from someone. Without treatment, irreversible processes can occur that have a very detrimental effect on the child’s condition and threaten his life.

Sinusitis can be acute, unilateral or bilateral. The disease develops slowly and without treatment can lead to a more serious illness - sinusitis.

The main causes of sinusitis in infants are pathogens belonging to bacteria of the genus Streptococcus pneumoniae and Haemophilus influenzae. They are most often the cause and are eliminated after bacterial culture from the nose. Other bacteria may also be the cause, such as M. catarralis, Str. pyogenes, Staph. aureus. Sinusitis appears due to respiratory infections that affect the upper respiratory tract. There is also another type of sinusitis in children: nosocomial (nosocomial) sinusitis, which appears after prolonged nasal tamponade, so you need to very carefully clean the children’s nose with cotton swabs or swabs. There are cases when sinusitis occurs in children due to Staphylococcus aureus, which is present in the microflora of every person, including very young children.

Acute sinusitis can develop due to allergies or allergic rhinitis. Also due to disruption of normal drainage and irrigation of the paranasal sinuses.

Factors that influence the development of sinusitis in infants:

• hypertrophy of the nasal mucosa
• deviated nasal septum
• as a consequence of injury
• weak immunity
• poor hygiene and nasal drainage

The main reasons that can cause acute sinusitis in a newborn are low innate immunity and a bad atmosphere, too low or high humidity in the room, polluted air. Today, a hereditary connection with the development of sinusitis in a child is also noted.

Often, another cause of sinusitis in children can be dry mucous membranes and bacteria or viruses from the air entering the nose. Therefore, you should monitor the humidity at home and try to moisturize the nasal mucosa more often to prevent it from drying out.

Symptoms

At the very first stage, sinusitis usually goes unnoticed and not all parents can immediately understand that something is wrong with the baby. One of the most obvious symptoms is difficulty nasal breathing, nasal congestion or runny nose. Sinusitis in babies is associated with some characteristic features. They are explained by the structure of the child’s body and undeveloped paranasal sinuses. Sinusitis in children often occurs without symptoms. The first signs are very easy to miss, since the clinical picture of the disease is early stage weakly expressed.

The following symptoms of sinusitis in infants can be identified:

• increase in body temperature to 39 degrees
• difficulty breathing through the nose
• dry mouth and nose
• a large amount of nasal discharge, in other words, snot and runny nose, which does not go away for more than 2 weeks
• cough that gets worse at night
• poor appetite and sleep disturbances

Diagnosis of sinusitis in newborns

Only a qualified pediatrician or otolaryngologist can make an accurate diagnosis of the baby. He may order an x-ray, which is a necessary medical measure taken in exceptional cases.

As a rule, the X-ray examination is painless and quick.

Complications

If untimely, incorrect or insufficient treatment is used, sinusitis can lead to severe serious complications and can significantly harm the body. There is a risk of the following consequences:

• microflora from the sinuses can lead to inflammation of the brain, so-called meningitis;
• inflammation of the mucous membrane can lead to infection of bone tissue;
• Bacteria from the paranasal sinuses can penetrate the upper respiratory tract and lead to pneumonia, asthma, and bronchitis.

All these consequences are not just unpleasant, they are extremely dangerous for the child’s health and require immediate intervention.

Treatment

What can you do?

Sinusitis always requires professional treatment. You can perform some procedures at home that will additional therapy. For example, rinse your nose with various saline solutions, saline, sea water. And then use an aspirator to suck out the discharge from the nose. But this must be done carefully so as not to drive excess liquid into the middle ear, which can then lead to otitis media. You also need to take into account that babies have weak eardrums.

It is better not to resort to self-medication, but to quickly contact a specialized institution, clinic or hospital. If the child is very small, then call a doctor at home. It is important not to delay the examination, as this can lead to various complications.

What will the doctor do?

When the first symptoms of sinusitis appear in a newborn, parents should immediately contact their pediatrician and not try to determine the treatment method on their own. The doctor, in turn, determines how to treat the child; this can be either medicinal or surgical. But, as a rule, first of all they are appointed medications, taking into account the presence of contraindications and the age of the child.

All medications for the treatment of sinusitis in infant can be divided into several groups according to their healing properties:

• vasoconstrictor drops are used to improve the outflow of mucus from the nasal cavity and reduce swelling of the mucous membrane;
• medicinal preparations based on silver, used after vasoconstrictor drugs and have a therapeutic effect;
• antibacterial drugs used when joining bacterial microflora;
• antihistamines to reduce mucosal swelling.

The doctor may also prescribe physiotherapy, in addition to drug treatment.

In the case when drug treatment does not lead to the desired result and sinusitis becomes complicated, the doctor prescribes surgical treatment. It involves piercing the paranasal sinuses. Pus is pumped out from the paranasal sinuses and washed with antibiotics and anti-inflammatory drugs. However, this is an extreme measure and very rarely happens to infants.

Prevention

In order to avoid sinusitis in a newborn, it is necessary to treat other diseases. These are mainly flu, runny nose and infectious diseases that cause inflammation. Under no circumstances should you start them and follow all the doctor’s recommendations for the prescribed treatment.

It is necessary to develop the child’s own immunity by performing the following activities:

• ensure that the child does not become hypothermic when outdoors or in water while swimming;
• frequent ventilation of living spaces.

Sinusitis is a disease during which an inflammatory process occurs in the paranasal sinuses. Sinusitis can be caused by viruses, bacteria, fungi, or allergens. This disease is one of the most common. Depending on the duration of the disease, acute and chronic forms of the disease are distinguished. Acute sinusitis can last up to 8 weeks, but the chronic form lasts much longer and occurs more than four times a year. An inflammatory process in the paranasal sinuses can occur in children and adults. Sinusitis can occur in any sinus on one or both sides of the nose.

Causes

The occurrence of an inflammatory disease in a child can be caused by a number of reasons.

• Viruses that penetrate a child's body.
• Bacterial pathogens that affect the paranasal sinuses.
• Getting a head injury, bruise or broken nose.
• Fungal microorganisms also provoke the development of sinusitis in a child.
• Allergic reaction of the baby's body. An allergen can be animal fur, some plants, pollen, dust and other irritants.
• In some cases, sinusitis in a child occurs for mixed reasons. For example, when viral and bacterial infections enter the body at the same time.

Symptoms

Inflammatory processes in the baby’s paranasal sinuses can be acute or chronic. In the acute form of sinusitis, symptoms appear suddenly, and the disease lasts no more than 2-3 weeks. If during this period the immune system cannot cope with pathogens, sinusitis becomes chronic. Chronic processes last a long period, but the symptoms of sinusitis are less pronounced. The onset of the disease can be recognized by certain symptoms.

• Nasal congestion is the first sign of the onset of inflammatory processes. The child has difficulty inhaling and exhaling, and his voice changes.
• Along with nasal congestion due to sinusitis, the baby develops a runny nose. Nasal discharge is thin, yellowish or green color. Sometimes the mucus may be clear.
• The child may feel pain in the bridge of the nose or in the nose. Feel especially good painful sensations V evening time. Gradually the pain moves to the head area.
• Body temperature may rise to 38 degrees. Fever usually occurs with acute sinusitis.
• The child becomes weak, his mood often changes, his appetite worsens and problems with sleep arise.
• There may be a dry throat, which provokes minor coughing attacks. But at night the cough gets worse.

Each child exhibits symptoms of sinusitis differently. The head may hurt in different parts. This is explained by inflammatory processes in various paranasal sinuses.

Diagnosis of sinusitis in a child

The disease can be diagnosed by external symptoms.

• To make an accurate diagnosis, the doctor sends the child for testing. general analysis blood. Using the test results, you can find out about the level of leukocytes, which are significantly increased in acute sinusitis. An increase in ESR is also noticeable.
• In addition to a general blood test, the child must undergo an x-ray. The thickening of the mucous membrane of the sinuses will be clearly visible in the picture. X-rays help to see the amount of fluid in the paranasal sinuses.
• For a more accurate diagnosis, the child may be referred for a computed tomography scan. This type of examination is more informative compared to x-rays. CT scan allows you to find out about the condition of the paranasal sinuses.

Complications

How dangerous is the inflammatory process in a baby?

• Because if diagnosed untimely and untreated, the inflammatory process can affect the brain. Meningitis or an abscess may occur.
• When the eye sockets become infected, the risk of vision loss increases.
• A common complication of sinusitis in children is osteomyelitis of the facial bones.
• In advanced cases, sinusitis can cause sepsis, which is very dangerous for the child’s life.

Treatment

What can you do

Once the doctor prescribes treatment, parents must adhere to it. But to relieve symptoms and speed up recovery, moms and dads can help their baby.

• It is necessary to ventilate the room, humidify the air if possible, and also regularly do wet cleaning.
• During the warm season, you can turn on the air conditioning in the room. But at this moment the child should be in another room. During the cold season, you should not get carried away with using heating devices that dry out the air too much.
• A good remedy for treating sinusitis is massage. It is necessary to lightly press on certain points on the face and nose. You should first ask your doctor how to massage your child yourself.
• Breathing exercises are another effective method for treating the inflammatory process in the paranasal sinuses. Children from 3-4 years old can do breathing exercises.
• It is important to increase the effectiveness of the immune system. For this it is necessary good nutrition, eating vegetables and fruits, walking fresh air and classes physical exercise. After consulting a doctor, you can give your child vitamin and mineral complexes.
• Rinse your sinuses daily with a saline solution.

What does a doctor do

After making a diagnosis, the doctor will tell you how to treat sinus inflammation. First of all, the doctor decides on drug treatment. The doctor prescribes the dosage and number of drug uses in accordance with individual characteristics child's body.

• Vasoconstrictors are used to reduce swelling of the mucous membrane. These drugs help improve the outflow of mucus, which allows you to breathe fully.
• After using vasoconstrictors, medicinal fluids are used. For example, with the content of protargol.
• Antibacterial agents help cure sinusitis in a child.
• If the cause of inflammation of the paranasal sinuses is allergic reaction, antihistamines are used.
• Physiotherapy procedures are prescribed for a speedy recovery.
• If drug treatment is ineffective, the doctor decides on surgical intervention. The child undergoes a puncture and removes mucus from the paranasal sinuses. After removing the purulent masses, antibiotics or anti-inflammatory drugs are introduced into the cleaned cavities.
• If puncture of the nasal passages is ineffective, active surgical intervention is performed.

Prevention

In order to prevent the occurrence of inflammatory processes in the child’s nasal passages, you should monitor his health.

• When diagnosing viral, fungal, bacterial diseases, prompt treatment is necessary.
• If a runny nose occurs, surgical treatment is also required.
• Strengthening the child’s immunity is of great importance in the quality of preventive measures to prevent sinusitis.

The immune system of babies does not develop immediately, but over several years after birth. That is why babies are often exposed to various infectious lesions. All parents need to know what sinusitis is in children, since this disease, which affects the nasal passages and sinuses, can very often develop in a small child and in most cases is difficult to treat. Often this rather dangerous disease becomes a consequence of a common runny nose.

Sinusitis in children: features of the disease

Respiratory disease is, in fact, collectively speaking. Under the general name, several pathologies are combined that are directly combined into one concept - inflammation of the paranasal sinuses. Thus, the pronounced process of inflammation that characterizes ethmoiditis destroys the sinuses located in the ethmoid bone. Sphenoiditis is localized in the sinuses sphenoid bone. Sinusitis is characterized by the location of the lesion in the maxillary regions, and frontal sinusitis is a frontal pathology.

Inflammation of the paranasal sinuses in children

The main features that provoke the frequent development of this pathological condition in children are the anatomical features of the structure of the nasal passages:

• the narrowness of the drainage and ventilation openings of the olfactory organ, directly connecting the nasal cavity and sinuses. The narrower these nasal passages (ostia), the faster they are closed by swollen mucous tissues and accumulations of thick exudate;
• dramatic anatomical differences internal structure baby’s nose and underdevelopment of the nasal sinuses, passages and valves. The reason for this lies in the lack of development facial skeleton. Full formation bone structures skull development occurs only at 7-12 years of age.

The narrowness of the anastomosis contributes to their rapid closure under the influence of negative factors. The consequence is the accumulation of inflammatory fluid inside the sinuses, which is a favorable environment for the life of pathogenic microorganisms actively populating it. It is this pathological process that provokes the development of sinusitis. Big influence The clinical picture of this type of respiratory disease is influenced by the age of the child.

The direct relationship between the age category of young patients and the manifestations of the disease is shown in the table:

AGE GROUPS	CHARACTERISTIC FEATURES OF THE DEVELOPMENT OF THE PATHOLOGICAL CONDITION
Up to 3 years	Poor development of the sinuses provokes the development of a destructive process in the bone structures of the ethmoid labyrinth. The pathological condition in young children usually develops against the background of an adenoid or and is often asymptomatic. Due to the baby’s inability to correctly convey his sensations, acute sinusitis in this category of young patients is diagnosed quite rarely.
From 4 to 7 years	Not only the ethmoid bones are affected, but also the maxillary and maxillary sinuses.
From 8 to 15 years	In this age category of patients, the negative process can be localized in any of the nasal sinuses, since they are all quite developed. In some cases, several sinuses are affected simultaneously.

Important! Parents should know how dangerous it is for children to develop sinusitis, which provokes almost complete closure of the air-bearing nasal passages due to age-related characteristics. Such a pathological condition, left unattended, can lead to serious problems in the child. inflammatory complications, provoked by active reproduction of pathogenic microorganisms filled with mucous or purulent exudate.

Types of sinusitis

At the core of this is enough dangerous disease The site of localization of the inflammation process is located. This factor pathological condition gives specialists the opportunity to subdivide the pathological condition that develops in the upper respiratory tract into (the infectious process occurs in one or more sinuses at the same time) and in which all paranasal sinuses are affected. Depending on the prevalence of the destructive process, the disease is divided into unilateral (left-sided or right-sided) and characterized by simultaneous damage to both sinuses.

If we are talking about the form of a pathological condition, then it has a direct connection with the duration of the disease. Most often diagnosed in children. This type of disease has pronounced symptoms and is characterized by a rapid course (from 2 to 3 weeks). In the case when acute negative state The child could not be treated in a timely manner, and he develops. This variety The disease is recurrent in nature and occurs with constant alternation of periods of remission and relapse.

According to the form of a small child, the following types of sinusitis are distinguished:

1. . Process acute inflammation, in which there is copious discharge of mucus of a non-purulent nature, occurs in the paranasal sinuses.
2. . Develops as a result of the attachment of bacterial microflora to the pathological process occurring in the upper respiratory organs, provoking the formation of purulent exudate, the outflow of which is difficult due to the narrowness of the nasal passages.

Both of these types are combined in medical terminology and can occur either separately or together. An example of the latter type is the filling of one of the nasal sinuses with non-purulent contents, while in the other, under the influence of pathogenic bacterial microflora, pus accumulates. This type of disease is considered the most dangerous in children, which is associated with the difficulty of selecting a therapeutic course designed to eliminate it.

What causes sinusitis in children?

The main factor provoking the development of a respiratory disease of this type is the frequent infection of the upper respiratory tract by any pathogenic microorganisms, which is associated with insufficient development of the baby’s immune system.

Specialists stand out following reasons sinusitis in children:

• influence of pathogenic bacteria. considered the most severe form pathology, since under the influence of pathogenic microflora the mucous exudate that accumulates in the nasal passages and sinuses is transformed into a purulent form, the elimination of which requires a course of antibacterial therapy;
• damage to the mucous membranes of the nasal septum by viruses that provoke the development of respiratory diseases. In this case, the type of pathological condition is diagnosed;
• exposure to pathogenic fungi (Mucor, Candida and others). occurs in children less often than other forms, but is considered the most dangerous. To dock this form pathological condition often requires surgical intervention.

The main factor of the disease, as already mentioned, is the child’s insufficiently developed immunity. For this reason, any cold can develop into one of the types of sinusitis. Certain circumstances that constitute a risk group accelerate the development of pathology in children. The main place among them is occupied by accidental entry into a solid foreign body or water during bathing, the presence in the nasal passages, infectious foci, for example, stomatitis or caries localized in the oral cavity.

It is often diagnosed in children. Its development is associated with the penetration of any allergen into the child’s defenseless body. Special meaning in the development of this form of pathology in children is attributed to the appearance of worms, routine vaccinations (inoculations), excessive and monotonous diet or penetration of food allergens into the gastrointestinal tract.

Symptoms of sinusitis in children

Basic negative manifestations, accompanying this type of disease localized directly in the upper respiratory tract, boils down to the appearance of acute headaches in the child. Unpleasant painful sensations during the development of this disease usually occur in the frontal or temporal areas. The prerequisite that provokes severe painful symptoms sinusitis in children, aggravated by any head movements, always causes a long runny nose.

Also, the presence of thick nasal discharge and its constant congestion are accompanied by the appearance of a set of certain symptoms, indicating the beginning of the development of an inflammatory process in the nasal sinuses.

• difficulty breathing through the nose - from time to time the left or right nostril “does not breathe”;
• the appearance of thick, difficult to blow off snot that has a dark green tint.
• the presence of a regular morning cough with the release of purulent sputum, and the inability to completely cough up during the daytime.

In addition to the above manifestations acute form pathological condition is accompanied by general physiological symptoms sinusitis in a child. They consist in the baby’s loss of appetite, the appearance of increased irritability and insomnia and constantly elevated body temperature to subfebrile levels (37-38 °C).

At chronic form pathology, the signs of sinusitis in a child are mild, but this does not mean that the disease is close to being cured. Dangerous process continues to actively develop further, but this happens already in hidden form. Negative symptoms in this case become more pronounced only when the disease relapses.

Disease severity

In addition to the clinical picture, specialists also evaluate such indicators of the disease as the degree of its severity. It is established based on the small patient’s complaints about his symptoms.

Gradation (sequence of occurrence) of this indicator and its main characteristics:

1. Easy. With a mild course of the disease, no characteristic radiological signs are observed. Also almost completely absent clinical symptoms. The main manifestations observed at this stage of development are the appearance of mild headaches in the baby, localized on the side of the nasal sinus that has undergone an inflammatory process. The temperature is mostly normal, not exceeding 37°C.
2. Medium-heavy. A pathological condition that has reached this degree of severity is accompanied by a moderate pain syndrome, localized in the part of the head where the sinus damaged by the inflammatory process is located, and initial signs intoxication. The body temperature of a sick child at this stage reaches 38.5°C.
3. Heavy. When the disease passes into this stage, which is when this disease the latter, children exposed to it develop obvious signs of intoxication of the body and acute headaches, intensifying even with the slightest movement. Temperatures can reach a critical level of 40°C.

Identification of the severity of the pathological condition is necessary for correct purpose treatment course. Depending on how severe the negative manifestations of the disease are, the specialist selects the medication necessary to relieve them.

Diagnosis of the disease

Detection of a pathological condition in children developing in the nasal sinuses does not involve the use of any extraordinary techniques. Diagnosis of sinusitis in children is quite traditional. First of all, it consists in mandatory X-ray, which in more than 80% of cases makes it possible to detect the onset of the development of the disease.

Also, depending on the location of the pathological condition, sick children may be prescribed the following studies:

• puncture for diagnostic and treatment purposes. It is used to identify the extent of damage localized in maxillary sinuses, and determining the further course of their treatment;
• CT scan. This diagnostic procedure not necessary for sinusitis inflammatory in nature;
• endoscopic examination. This research method is considered the most informative and can be used for any type of pathological condition.

Laboratory blood tests also play an important role in the diagnosis of sinusitis. The results of these clinical studies can show the presence of any inflammatory changes in the baby’s body. Based on all the data obtained as a result of the diagnosis, the specialist can prescribe the most adequate treatment for sinusitis, which makes it possible to achieve complete cure and avoid complications that may arise from this disease.

Important! Under no circumstances should you try to independently diagnose a pathological condition developing in the baby’s nasal sinuses, or take any measures to get rid of this respiratory ailment. If a doctor has detected sinusitis in a child, treatment should be his sole prerogative. Only experienced specialist will be able to conduct a competent course of therapy and achieve a speedy recovery for the little patient.

How and with what to treat sinusitis in children?

For appointment adequate therapy, which can help relieve a child from a pathological condition in a short time, the attending physician must know the specific cause that provoked it. In order to cure sinusitis in a child, it is necessary to use several therapeutic techniques, each of which helps exclusively in a specific case of the disease.

Most often, children are prescribed conservative therapy. To carry it out, medications for sinusitis are used that are completely safe for a weak child’s body and are not capable of causing side effects in the child.

Their main list is given in the table:

GROUP OF MEDICINES	OPERATING PRINCIPLE AND ADVANTAGES	DRUGS OF CHOICE
Antibiotics	Antibacterial tablets for sinusitis are prescribed exclusively in case of bacterial origin. This therapy is required in acute phase diseases, as it allows for the elimination of the pathogenic agent that provoked the development of the disease in a short time	, Clavulanate or alternative medicines. Cefuroxime-axetil. At severe course for illness, Ceftriaxone is prescribed, and for allergies, Chloramphenicol
Local preparations	Data pharmaceutical forms drugs are considered the most convenient for children. This is due to their ability to have an antibacterial, vasoconstrictor or antiallergic effect directly on the lesion - the nose or. To these forms medicines include sinusitis sprays or nasal drops	Experts include Polydex with phenylephrine, Isofra and Bioparox as completely safe sprays recommended for children, and the best drops for sinusitis, such as Xylen, Rinostop and Nazivin

Treatment of sinusitis in children with the help of these drugs aims to achieve the following goals - destruction of the pathogenic agent, relief negative symptoms, restoration of normal drainage in the nasal sinuses, preventing the transition of the pathological condition into chronic stage and preventing the development of possible complications.

Surgical treatment of sinusitis

Any, among which sinusitis is not the least important, can be eliminated not only with the help of complex therapy. In case it turns out to be ineffective, as well as during the transition chronic condition in an advanced stage, small patients are prescribed surgery. It is carried out traditional way(removal of affected tissue or bone structures through a buccal or intraoral incision) or through minimally invasive endoscopic surgery.

Indications for surgical interventions serve:

• heaviness general condition small patient;
• osteomyelitis developing in the frontal or maxillary bone;
• signs of sepsis;
• severe intoxication of the body.

In order to stop sinusitis complicated by the development of a purulent-necrotic process in children, treatment is carried out by opening and subsequent drainage of subperiosteal (located directly under the periosteum - a fibrous membrane covering the bone on top) abscesses. This form of complications can affect the frontal sinuses, upper jaw, any of the nasal septums, palate or orbits during sinusitis.

Treatment of sinusitis in children at home

When uncomplicated, occurring in mild form disease, it is permissible to use home therapy methods in children. The only prerequisite is a preliminary consultation with an otolaryngologist. It is he who will talk about. Will make certain adjustments so as not to cause irreparable harm to the baby, since in each specific case self-therapy has some nuances.
But there are also general techniques, acceptable for almost any form of this pathology.

In order to stop just beginning sinusitis in a child, treatment at home is carried out using the following measures, which are most popular among parents:

1. Washing. Quick cleansing nasal cavities using sea ​​water or herbal decoctions of calendula, chamomile, peppermint, eucalyptus and others medicinal plants recommended by a specialist. The actual procedure involves administering a syringe into one nostril and withdrawing the drug from the other.
2. . Relief of negative symptoms and cleansing of the nasal passages is carried out by inhaling a vapor of medicinal plants or potatoes by the little patient. Steam inhalations for sinusitis last approximately 10 minutes.
3. Warming up. Relieving nasal congestion using dry heat. The procedure involves applying to the affected pathological process nasal sinuses bags with heated sea ​​salt or hard-boiled eggs.

Treatment of sinusitis in children with traditional methods

For many centuries, our ancestors used to relieve small children from respiratory diseases. natural remedies, prepared on the basis medicinal plants. All medicinal infusions and decoctions for the preparation of which they are used healing herbs, are quite safe and do not cause addiction in a small child even with prolonged use.

• tartar juice. This herb is rich in inulin, which has effective assistance at respiratory diseases. Freshly squeezed plant juice is used instead of nasal drops. It is instilled 5 drops into each nostril for a week;
• May honey and agave juice. These ingredients are mixed in a 2:1 ratio, kept in the refrigerator for a week and given to the child to eat a teaspoon before each meal;
• onion juice with honey. This tool intended for rinsing the nose. To prepare it, grate a small onion, add a teaspoon of honey to the juice squeezed out of it and dilute it in half a glass of cold boiled water.

You can also cook homemade ointment. For sinusitis in a child, it is prepared on the basis baby cream. To 20 grams of this fatty substance add 0.5 g of camphor and menthol, which have good irritating effect. They cause a reflex spasm in the nasal vessels, which leads to a decrease in swelling of the mucous membrane and, accordingly, the restoration of breathing in the child.

Important! Treatment of sinusitis folk remedies, for the preparation of which time-tested recipes are used, it has long been recognized traditional medicine. But before you start using such therapy, you should discuss all its nuances with a pediatrician and otolaryngologist. Only doctors with these qualifications will help you choose the most suitable prescriptions for a particular small child based on his medical history, general condition and existing contraindications.

Why sinusitis is dangerous in children: possible complications

This disease, which often affects children, is perceived differently by parents. Some immediately, when the first ones appear warning signs, sound the alarm, and someone treats pathological condition quite calmly, without making a distinction between it and a regular runny nose. Experts consider the latter belief to be fundamentally wrong, because in the absence of adequate therapy, young patients develop serious complications of sinusitis in a short time.

The most common health threatening or, in some cases, the children's lives are as follows serious consequences diseases:

• intracranial complications. Among them, thrombosis of the nasal sinuses and meningitis are most often detected soft shape, intracranial abscesses;
• eye and orbital problems lie in the development of children in the area upper eyelid and eye swelling of an inflammatory nature, phlegmon, abscesses. Often, young patients develop a disease such as optic neuritis.

Most dangerous purulent form sinusitis. It is this that provokes the development of sepsis - the movement of pathogenic microorganisms through the bloodstream into all internal organs child, including the brain, leading to the development of secondary inflammatory foci in them.

Prevention of sinusitis in childhood

Respiratory diseases are not as simple as they might seem. Parents of small children should take them seriously. Any child of preschool age should undergo daily prevention of sinusitis, because this disease is easier to prevent than to treat.

The main measures to prevent the development of pathology are:

• regular adequate treatment of any colds or infectious diseases respiratory tract;
• avoiding any contact with sick people and taking antiviral drugs to prevent the development of influenza during epidemics;
• prevention of curvature of the nasal septum (in case of injury to the nose, an urgent visit to a traumatologist is necessary to correct it);
• strengthening the immune system and hardening the body.

These preventive actions will help protect your child from dangerous consequences caused by sinusitis. Experts also strongly recommend that parents of small children, if their child develops suspicious symptoms of this upper respiratory tract pathology, urgently contact an otolaryngologist and strictly follow all his advice regarding the treatment of sinusitis.

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