Pediatric Sinusitis Treatment in Singapore

Acute sinusitis in children typically lasts less than 12 weeks and often follows an upper respiratory infection. Symptoms appear suddenly and may include thick nasal discharge, facial pain, and fever. Many cases may improve with appropriate medical treatment, though some children may experience recurring episodes.

When symptoms persist for more than 12 weeks despite medical treatment, the condition is classified as chronic sinusitis. Children with chronic sinusitis may experience continuous nasal congestion, post-nasal drip, and cough. This form requires a more comprehensive evaluation to identify underlying causes such as allergies, structural abnormalities, or immune system issues.

Some children experience multiple episodes of acute sinusitis within a year, with symptom-free periods between infections. This pattern, known as recurrent acute sinusitis, may indicate underlying predisposing factors requiring investigation.

• Clear or coloured nasal discharge lasting more than 10 day
• Nasal congestion or stuffiness
• Mild cough, especially at night
• Low-grade fever
• Fatigue or irritability
• Decreased appetite
• Mild headache in older children

• Thick, yellow-green nasal discharge
• Facial pain or pressure, particularly when bending forward
• Persistent cough throughout the day
• Post-nasal drip causing throat clearing
• Bad breath (halitosis)
• Reduced sense of smell in older children
• Ear pressure or fullness
• Disrupted sleep patterns

• High fever
• Severe facial pain or swelling
• Swelling around the eyes
• Vision changes or eye pain
• Severe headache
• Stiff neck
• Confusion or altered mental state
• Persistent vomiting

Symptoms in younger children may differ from those in older children and adults, as young children may not always be able to articulate their discomfort. Parents often notice behavioural changes such as increased irritability or decreased activity levels before specific symptoms become apparent.

The foundation of paediatric sinusitis treatment involves supportive care measures that can be implemented at home. Nasal saline irrigation using age-appropriate devices helps clear mucus and may reduce inflammation. Adequate hydration thins secretions, making them easier to drain. Humidification of the child’s environment, particularly during sleep, may provide symptom relief. Elevating the head during sleep promotes sinus drainage and may reduce nighttime coughing.

Saline nasal sprays are safe for all ages and help moisturise nasal passages while flushing out irritants and mucus. These can be used multiple times daily without risk of side effects. Nasal corticosteroid sprays may reduce inflammation in the nasal passages and sinuses, particularly beneficial for children with allergic components. These medications require consistent use for optimal effectiveness and are generally well-tolerated in paediatric patients.

Antibiotics may be prescribed for bacterial sinusitis, with amoxicillin or amoxicillin-clavulanate being common first-line treatments. Treatment duration typically ranges from 10 to 14 days, though some cases may require an extended course. Antihistamines may help children with underlying allergies contributing to sinus inflammation. Decongestants may provide temporary relief but may be used cautiously and for a limited duration in children. Pain relievers such as paracetamol or ibuprofen can help manage facial pain and fever.

For children with allergic rhinitis contributing to sinusitis, comprehensive allergy management is important. This includes identifying and avoiding triggers, using appropriate allergy medications, and considering immunotherapy for severe cases. Environmental controls such as dust mite covers, air purifiers, and the removal of indoor allergens may help reduce symptom frequency.

Enlarged or chronically infected adenoids can obstruct sinus drainage and harbour bacteria. Adenoidectomy, surgical removal of the adenoids, may be recommended for children with recurrent or chronic sinusitis not responding to medical treatment. This procedure is performed under general anaesthesia and typically requires minimal recovery time. Many children may experience improvement in sinus symptoms following adenoidectomy.

For select cases of chronic sinusitis with anatomical abnormalities or failed medical management, paediatric endoscopic sinus surgery may be considered. This minimally invasive procedure uses specialised instruments to improve sinus drainage while preserving normal anatomy. The surgery is tailored to the child’s age and stage of sinus development. Post-operative care includes nasal irrigation and close follow-up for proper healing.

This minimally invasive procedure uses a small balloon to dilate blocked sinus openings, improving drainage without removing tissue. Suitable for older children with specific anatomical issues, balloon sinuplasty can often be performed with minimal discomfort and a faster recovery than traditional surgery. The procedure preserves natural sinus anatomy while providing relief.

Preventing paediatric sinusitis involves multiple strategies to reduce infection risk and manage predisposing factors. Teaching proper hand hygiene helps reduce viral transmission, particularly during cold and flu season. Encourage regular handwashing with soap and water, especially before meals and after playing with other children.

Managing allergies through environmental controls and appropriate medications may reduce sinus inflammation. Keep your home smoke-free, as secondhand smoke may increase your risk of sinusitis. Use air purifiers during haze periods and limit outdoor activities when air quality is poor.

Make sure that your child receives recommended vaccinations, including annual flu vaccines and pneumococcal vaccines, which protect against common bacterial causes of sinusitis. Maintain optimal indoor humidity levels between 40-50% to prevent dry nasal passages while avoiding excess moisture that promotes mould growth. Address swimming pool exposure by using nose clips if chlorine triggers symptoms, and by establishing proper technique to prevent water from entering the sinuses.