Sinusitis in Children

What are sinus infection signs and symptoms in kids?

Common sinusitis symptoms in children include:

• Fever (generally associated with acute sinusitis and colds)
• Yellow or green nasal discharge
• Cough
• Headache
• Facial pain or pressure
• Nasal congestion (snoring and mouth breathing)
• Postnasal drip (the feeling of mucus building up in the throat or dripping from the back of your nose)

Learn how to spot the differences between sinus infection symptoms and symptoms of other respiratory infections.

How do we diagnose sinus infections in children?

Generally, we diagnose acute sinusitis based on symptoms that last longer than 10 days after a cold.

If your child has chronic sinusitis, we may recommend an extended periods of taking antibiotics (about 20 days), along with nasal saline washes and steroid nasal spray. If the infection remains, your child’s doctor may recommend a CT scan to rule out complications from acute sinusitis or to diagnose chronic sinusitis. Occasionally, they may use other imaging tests like  magnetic resonance imaging (MRI) or X-rays to get an more detailed image of inside the nasal cavity.

What can I expect from imaging tests? 

A CT scan takes less than three minutes. An MRI scan takes 30 minutes. Children older than 7 years are generally able to lie still for an MRI. Younger children might require sedation or anesthesia to keep them comfortable during these tests.

Why choose Children’s Hospital Colorado for imaging studies?

Our Radiology Department only does imaging scans for children. We understand how to make these tests more comfortable and less scary for kids. When possible, we use spiral CT technology, which makes scans faster and uses a lower dose of radiation.

How do we treat sinus infections?

In general, our doctors do not recommend antibiotics to treat cold symptoms that have lasted fewer than 10 days. That’s because a cold is a virus, and antibiotics aren’t effective against viruses.

If your child’s cold progresses to acute sinusitis, we may treat it with an antibiotic to treat the bacteria found in the mucus in the nose. If your child has significant nasal congestion, their doctor may also recommend a topical nasal decongestant.

How do we treat chronic sinus infections in children?

Chronic sinusitis is more difficult to treat. Primary treatment includes:

• Antibiotics (generally at least for 20 days)
• Nasal saline washes
• Nasal steroid sprays

Children with chronic sinusitis that does not respond to antibiotics may need additional treatment, which can include:

• Antral irrigation to wash out the maxillary sinuses (located in the cheeks, next to the nose)
• Targeted antibiotic therapy
• Adenoidectomy is a surgery to remove the adenoid, lymphoid tissue located behind the nose. Adenoids help build up the body's immunity by trapping viruses that enter through the mouth. But enlarged adenoids can cause chronic sinusitis or sleep issues and no longer provide health benefits.

In older children and children with cystic fibrosis, we may recommend endoscopic sinus surgery to open the sinus passages and allow them to work more effectively.

In rare cases, children may develop serious eye problems or other infections from chronic sinusitis. In these cases, your child may be admitted to the hospital for antibiotics given through an IV or surgery.

How can I treat my child’s sinus infection symptoms at home?

If your child’s symptoms last longer than 10 days, they should see a doctor to get the condition accurately diagnosed.

For nasal symptoms that less than 10 days, there are several things you can try at home:

• Gentle nasal irrigation or suctioning for nasal secretions
• Short-term use of nasal topical decongestants (generally 4 days or less)
• Acetaminophen or ibuprofen for fever control

Why choose Children’s Colorado for your child’s sinusitis? 

The Sinusitis Clinic at Children's Colorado has more than two decades of experience treating kids with sinus infections. Our pediatric otolaryngologists (ear, nose and throat doctors), infectious diseases specialists, allergists and immunologists are experts at diagnosing and treating sinusitis in children.

This multidisciplinary clinic combines ear, nose and throat experts from our Department of Pediatric Otolaryngology with specialists from other departments so your child can see everyone specialist then need in one place. Our clinic also gives you access to any diagnostic testing your child may need. And because our doctors are at the forefront of research on sinusitis in children, we offer the latest in treatment for all types of sinusitis.

• The Academy of Pediatrics’ Healthy Children website provides information on how to tell the difference between colds and sinus infections.