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Sinusitis (Sinus Infection)

Dr. Sandra Lin, Johns Hopkins Pediatric Otolaryngoloist, with a patient

Dr. Sandra Lin, Johns Hopkins Pediatric Otolaryngoloist, with a patient.

Sinusitis is an inflammation of one or more of the four sets of sinuses, air-filled cavities in the facial bones, usually due to infection. When irritated, the mucous membrane lining the sinus may swell and block the small drainage channels that permit mucus to flow into the nose. The buildup in pressure often results in headache, nasal congestion, and facial pain.

Acute sinusitis is a common disorder that often occurs with a cold or other viral illness; chronic sinusitis refers to persistent or recurrent episodes that are generally milder than acute cases but persist over a longer period of time (months). Sinusitis may subside without specific treatment; however, it may require antibiotics and other medications for cure. In very rare cases, however, infection may spread to the eyes or the brain, and urgent treatment is necessary.

In children, sinusitis usually gets better on its own. However, if it recurs frequently, or if it is chronic, our experts, a team of pediatric otolaryngologists (ENTs) at the Johns Hopkins Division of Pediatric Otolaryngology, have the experience and expertise to determine why the sinusitis does not resolve.

Our physicians will order diagnostic testing to evaluate your child for allergies and/or immune dysfunction. If your doctor thinks your child needs sinus surgery, he or she will recommend endoscopic sinus surgery, a minimally-invasive approach to correcting sinus problems.

Symptoms

  • Cough
  • Nasal drainage
  • Bad breath

Causes

  • A viral or bacterial infection that spreads to the sinuses from the nose
  • Anatomical irregularities, such as a deviated septum
  • Nasal allergy resulting in swelling and polyps
  • Infection spread from abscesses in the upper teeth
  • Environmental irritants like dust, air pollutants, or excessive exposure to tobacco smoke

Diagnosis

Your doctor will ask for a complete medical history and will perform a thorough physical examination.

  • X-rays, including a CT scan, may be used to locate areas of blockage.
  • Endoscopy (use of a lighted instrument) may be used to survey the sinuses and clear blockage. Our pediatric ENTs may use also endoscopes to get a culture of the fluid to help select the right medicine to treat the infection.

Treatment

  • Nonprescription pain relievers, ice packs, or warm compresses may soothe sinus pain; in severe cases prescription pain medicine may be prescribed.
  • Antihistamines and other allergy medications are used to treat allergic symptoms.
  • Steroid nasal sprays may be prescribed to reduce inflammation.
  • Antibiotics are prescribed for bacterial infections. It may be necessary to use antibiotics for two to six weeks in difficult cases.
  • Nasal rinses or irrigation may help sinus symptoms. For more information about nasal rinse please review our handout.

Adenoidectomy and/or sinus surgery may be recommended if other treatments have not resolved the infections.

Minimally-invasive sinus surgery for chronic sinusitis

Minimally-invasive sinus surgery using balloon dilation is a new approach being used at Johns Hopkins to treat chronic sinusitis. Under general anesthesia, the doctor will thread a small wire into the sinus and inflate a balloon. This creates a larger opening to improve sinus drainage.

Request an Appointment

Please call us at 443-997-6467 (443-997-OHNS) to make an appointment at any of our three locations.

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