EVMS Ear, Nose & Throat Surgeons

Sinusitis (Sinus Infection)


The sinuses are cavities, or air-filled pockets, near the nasal passage. Like the nasal passage, the sinuses are lined with mucous membranes. There are four different types of sinuses: 

  • Ethmoid sinus - located inside the face, around the area of the bridge of the nose. This sinus is present at birth, and continues to grow.
  • Maxillary sinus - located inside the face, around the area of the cheeks. This sinus is also present at birth, and continues to grow.
  • Frontal sinus - located inside the face, in the area of the forehead. This sinus does not develop until around 7 years of age.
  • Sphenoid sinus - located deep in the face, behind the nose. This sinus does not develop until adolescence.



Sinusitis is an infection of the sinuses near the nose. These infections usually occur after a cold or after an allergic inflammation. There are three types of sinusitis:

  • Acute sinusitis - occurs quickly and improves with the appropriate treatment.
  • Subacute sinusitis - does not improve with treatment initially, and lasts less than three months.
  • Chronic sinusitis - occurs with repeated acute infections or with previous infections that were inadequately treated. The symptoms last longer than three months.



Sometimes, a sinus infection happens after an upper respiratory infection ( URI) or common cold. The URI causes inflammation of the nasal passages that can block the opening of the paranasal sinuses, and result in a sinus infection. Allergies can also lead to sinusitis because of the swelling of the nasal tissue and increased production of mucus. There are other possible conditions that can block the normal flow of secretions out of the sinuses and can lead to sinusitis including the following:

  • Abnormalities in the structure of the nose enlarged adenoids
  • Diving and swimming
  • Infections from a tooth
  • Trauma to the nose
  • Foreign objects stuck in the nose
  • Cleft palate

When the flow of secretions from the sinuses is blocked, bacteria may begin to grow. This leads to a sinus infection, or sinusitis. The most common bacteria that cause sinusitis include the following:

  • Streptococcus pneumonia
  • Haemophilus influenzae
  • Moraxella catarrhalis



The symptoms of sinusitis depend greatly on the age of the child. The following are the most common symptoms of sinusitis. However, each child may experience symptoms differently. Symptoms may include:  

  • Younger children:
    • runny nose lasting longer than seven to 10 days
    • discharge is usually thick green or yellow, but can be clear
    • nighttime cough
    • occasional daytime cough
    • swelling around the eyes
    • usually no headaches younger than 5 years of age
  • Older children and adults:
    • runny nose or cold symptoms lasting longer than seven to 10 days
    • drip in the throat from the nose
    • headaches
    • facial discomfort
    • bad breath
    • cough
    • fever
    • sore throat
    • swelling around the eye, often worse in the morning

The symptoms of sinusitis may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.



In addition to a complete medical history and physical examination, diagnostic procedures for sinusitis may include the following:

  • Cultures from the nose or sinus fluid - laboratory tests that involve the growing of bacteria or other microorganisms to aid in diagnosis.
  • Sinus x-rays - diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. (X-rays are not typically used, but may help assist in the diagnosis.)
  • Computerized tomography (also called CT or CAT scan.) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called “slices”), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
  • Blood tests



Specific treatment for sinusitis will be determined by your child's physician based on:

  • Your child's age, overall health, and medical history
  • Extent of the infection
  • Your child's tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the infection
  • Your opinion or preference

Treatment of sinusitis may include the following:

  • Antibiotics, as determined by your child's physician (antibiotics are usually given for 10 to 14 days, and sometimes longer)
  • Acetaminophen (for pain or discomfort)
  • Use of a cool mist humidifier in your child's room
  • Nasal drops
  • Decongestants and antihistamines may not help the symptoms of sinusitis.