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child-sinus-shapiro

Children’s Sinus Allergies Frequently Asked Questions

By Nina Shapiro MD
Professor of Pediatric Otolaryngology at UCLA

Originally Published 2006

Index    

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?

Ever
since my eighteen month old toddler has entered day care he
gets ear infections about once every three weeks…?
Is
it possible to have sinusitis in childhood? How does it manifest
itself?
  You
hear more and more about children getting surgery for sinus
problems…?
Can
you take a sinus X ray on a 5 year old?
     
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.

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.

Hope that helps!
Dr Nina Shapiro.

If
you are interested in contacting Dr Nina Shapiro, she can
be contacted by telephone or email.

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