| Q. |
My
child has chronic sinus problems and now the doctor recommends
adenoidectomy...?
|
| A. |
The
adenoids (actually one structure, resembling a raw clam) are
located in the back of the nose, above the roof of the mouth.
If a child has enlarged adenoids, the front part of the nose
may become swollen and blocked. This swelling may lead to
blockage of drainage of the sinuses into the nose, leading
to chronic sinusitis. Removal of the adenoids may relieve
nasal blockage and swelling, allowing for better drainage
of sinuses. Therefore, adenoidectomy may alleviate symptoms
of chronic sinusitis in young children.
|
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|
| Q. |
I
have a number of food and environmental allergies and I am pregnant
for the first time. Is it likely that my newborn will have allergies? |
| A. |
Not
necessarily, "Rhinitis of Pregnancy" is an entity
whereby the nasal passages become engorged and swollen due
to hormonal changes of pregnancy. This will usually abate
following delivery of your baby.
"Neonatal Rhinitis", or swollen nasal passages in
the newborn is relatively common. Symptoms may include nasal
'snorting' sounds, and occasional difficulty breathing. This
often becomes more noticeable during or soon after feeding.
If your newborn has nasal stuffiness, which causes him or
her to struggle to breathe, your pediatrician should evaluate
him.
|
|
|
| Q. |
My
three year old daughter has constant colds and ear infections.
What do I do for this?
|
| A. |
There
are many potential reasons that a three-year old may have
chronic colds and ear infections. The sources may be environmental,
physiologic, or anatomic. Children in daycare settings, especially
if there are more than 10 other children in the facility,
are more prone to recurrent ear infections and colds. Children
who have been treated with multiple antibiotics are also more
prone to develop colds and ear infections-- the incidence
of 'resistant' bacteria, meaning bacteria that are 'stronger'
than antibiotics, is higher in these children. Your child
may also have enlarged adenoids, which can lead to chronic
colds and ear infections. Allergies may also be a source of
chronic cold symptoms and ear infections.
|
|
|
| Q. |
Ever
since my eighteen month old toddler has entered day care he
gets ear infections about once every three weeks...? |
| A. |
Daycare
has certainly been a 'catch-22' for young children in the past
few decades. With higher proportions of dual-income families,
children are enrolled in daycare settings at a much younger
age, and the number of such children continues to increase.
While it is not feasible to have your child out of daycare,
perhaps finding a group with fewer children may cut down on
frequency of cold symptoms. If ear infections persist for greater
than three months, your child may be at risk for hearing loss
secondary to fluid build-up. Current recommendation* is that
such children should undergo formal hearing evaluation by a
trained audiologist.
*AHCPR (Agency for Health Care Policy and Research) |
|
|
| Q. |
Is
it possible to have sinusitis in childhood? How does it manifest
itself? |
| A. |
Two
sets of sinuses, the maxillary (cheek sinuses) and ethmoid
(between the eyes, behind the nose) are present at birth.
The frontal sinuses (forehead) and sphenoid sinuses (behind
the ethmoid sinuses) develop in the early teen years. It is
certainly possible to have sinusitis in childhood. The main
issue is to identify the SOURCE of the sinusitis. Possible
sources include: 1) Allergies; 2) Enlarged adenoids; 3) Chronic/Recurrent
colds; 4) Rare disorders such as cystic fibrosis and abnormalities
of the tissues lining the sinuses (ciliary dyskinesias); 5)
Rare anatomic problems such as 'small' maxillary sinuses (hypoplastic
maxillary sinus)
Sinusitis in children may seem similar to a 'cold'. However,
some differences should be noted. Sinusitis may last several
weeks to months. Symptoms may include headache if your child
is old enough to describe one, yellow or green nasal drainage,
swelling or redness in their cheeks; dark circles under their
eyes, fevers, foul-smelling breath, nasal blockage, or 'mouth-breathing'.
|
|
|
| Q. |
You
hear more and more about children getting surgery for sinus
problems...? |
| A. |
It has recently been shown that there is a connection with sinusitis
and asthma. It has also been shown that improving a child's
sinus condition will reduce asthmatic symptoms. Sinus drainage
causes chronic irritation to the airways, which may worsen symptoms
of asthma. |
|
|
| Q. |
Can
you take a sinus X ray on a 5 year old? |
| A. |
Yes.
A sinus X-ray can give several pieces of information:
1)Size of sinuses--Is there an unusually small ('hypoplastic')
sinus that may be contributing to sinus symptoms?
2) Fluid in sinuses--Normally, sinuses should be filled with
air. A sinus x-ray will demonstrate fluid, thickening, or partial
fluid ('air-fluid level') in the sinuses.
3) Adenoid size--If a 'side view' of the sinuses is obtained,
the adenoids can be visualized. This will give a determination
of the size of the adenoids in relation to the nasal airway
passage.
4) Most children over 3 are able to hold still for a sinus x-ray.
No shots or sedation are needed. |
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|
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Hope
that helps!
Dr
Nina Shapiro.
If
you are interested in contacting Dr Nina Shapiro, she can
be contacted by telephone or email.
For more information on Nina Shapiro, see her bio.
Phone
number: 310-825-2749 (academic office); 310-206-6688 (appointments);
310-206-1393 (fax).
Address: Dr Nina Shapiro, 200 UCLA Medical Plaza, Suite 550,
Los Angeles, CA 90095
Email:
nshapiro@ucla.edu
nshapiro@pop.ben2.ucla.edu
|
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