Clinical Reference Systems: Pediatric Advisor 10.0
- Your child has a sensation of fullness, pressure, or pain
on the face in an area overlying a sinus. The pain can
be above the eyebrow, behind the eye, or over the cheek
- The pain is usually on just one side of the face.
- The nose is runny or blocked.
- Your child has a sensation of continuous postnasal drip.
- It is helpful if a physician has diagnosed your child
with sinus congestion one or more times in the past.
This condition tends to be recurrent.
The nose has seven bony air-filled chambers (sinuses) that
help to warm and humidify the air passing through it. Sinus
congestion occurs when the sinus openings are blocked and
normal sinus secretions accumulate and cause a sensation of
pressure and fullness. Sinus congestion occurs mainly with
colds and hay fever.
Without treatment, the sinuses usually open after about a
week. The main complication occurs when bacteria multiply
within the blocked sinus, causing a sinus infection
(sinusitis). This leads to a profuse yellow nasal
discharge, fever, and increased pain. Sometimes the
overlying skin (around the eyes or cheeks) becomes red or
swollen. This type of sinusitis needs antibiotics.
For information on sinusitis, see:
Frequent throat-clearing of postnasal secretions usually
leads to a sore throat. Recent studies have shown that
sinus infections can cause a chronic cough (or even wheezing
by children with asthma).
- Nasal washes
Use warm water or saline nosedrops followed by suction
or noseblowing to wash dried mucus or pus out of the
nose. Do these nasal washes at least four times a day
or whenever your child can't breathe through the nose.
If the air in your home is dry, run a humidifier.
- Decongestant nosedrops or spray
If the sinus still seems blocked after the nasal washes,
use long-acting decongestant nosedrops or sprays. These
are nonprescription items; ask your pharmacist to
recommend a brand. The usual dose for adolescents is
two drops or sprays per side, twice a day. For children
over age 6 use one drop or spray.
Before you use nosedrops or a spray, your child should
clear his nose by sniffing or nasal suction. The
openings to the sinuses are on the outer side of the
nasal passages. Point the nasal spray in this
direction. To deliver nosedrops to the sinuses, put
them in while your child is lying on a bed with his head
tipped back and turned to one side.
Use nosedrops or a spray routinely for the first 2 or
3 days of treatment. Then don't use them again unless
the sinus congestion or pain recurs. The drops or spray
must be stopped after 5 days to prevent rebound
- Pain relief
Your child may take acetaminophen or ibuprofen to
relieve pain until the obstructed sinus is opened. The
application of ice over the sinus may also help to
- Oral antihistamines
If your child also has hay fever, give him his allergy
Sinus infections are not contagious. Your child can
return to school or day care when he is feeling better
and the fever is gone.
Jumping into the water feet first can cause sinusitis of
the frontal sinuses and should be avoided unless the
nose is pinched. Swimming does not worsen sinusitis,
but deep diving should be forbidden unless your child
CALL YOUR CHILD'S PHYSICIAN IMMEDIATELY IF:
- Redness or swelling occurs on the cheeks or eyelids.
- Your child starts acting very sick.
CALL YOUR CHILD'S PHYSICIAN WITHIN 24 HOURS IF:
- Sinus pain persists more than 1 day after your child
- The sinus congestion persists for more than 1 week.
- Your child has a fever for more than 3 days.
- Nasal secretions become yellow or green for more than
3 days with sinus pressure.
- You have other concerns or questions.