What is sinusitis?
Sinusitis is inflammation of the lining (mucosa) of the sinuses. The sinuses are located in the forehead (F=frontal), between the eyes (E=ethmoid), behind the cheeks (M=maxillary), and further back in the center of the head (S=sphenoid).Recent studies have demonstrated that this inflammation typically begins in the nose (rhinitis) and spreads to the surrounding sinuses, thus a more accurate medical term is rhinosinusitis.
The time course of the inflammation determines whether rhinosinusitis is acute (less than 4 weeks), subacute (4-12 weeks), or chronic (more than 12 weeks). Recurrent acute sinusitis is frequent bouts of sinus infections that resolve with medications, but recur soon after finishing medications. Acute exacerbations of chronic sinusitis occur when a flare up occurs in addition to a patient’s baseline chronic symptoms.
While small sinuses in the maxillary (cheek) and ethmoid (between the eyes) regions are present at birth, the sinuses in children are not fully developed until their teenage years or early 20s. Unfortunately, children can still suffer from sinusitis, and it may be more difficult to diagnose in children. Due to their immature immune systems, children usually get 6-8 viral infections each year. While some of the symptoms are similar to adults with sinusitis, children may suffer more often from cough, irritability, and swelling around the eyes. Treatment of chronic sinusitis in children is similar to that of adults, beginning with reducing exposure to known environmental allergies and irritants (tobacco smoke, daycare, acid reflux) and progressing to the use of medications. Fortunately, children respond to medical therapy even better than adults with chronic sinusitis. In those rare cases where surgery is needed, an adenoidectomy is often successful as an initial approach. This removes enlarged tissue in the back of the nose that can cause many of the symptoms of chronic sinusitis. FESS is reserved for the most refractory cases.
Other Online Resources:
 Sinusitis (National Institute of Allergy and Infectious Diseases)
Sinusitis (American Academy of Family Physicians)
Sinusitis (American Academy of Family Physicians)- Español
Tips to Remember: Sinusitis (American Academy of Allergy, Asthma, and Immunology)
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