Paediatric Sinusitis – Part 2 (What causes Paediatric Sinusitis?)

January 14, 2014

 

What causes Paediatric Sinusitis?

 

Causes
 
Viruses
Viral infections are one of the main causes of upper respiratory tract infections as these can be spread easily from one person to another via contact with an infected person. This also means that it becomes difficult for one to regulate a child’s interaction especially during day care as they often come into direct contact with other children. There is no definite cure currently available for viral infections.
Bacterial Infections
Staphylococcus Areaus is a common bacterium known to cause sinus infections. Bacterial infections are usually treatable with antibiotics.
Gastro Oesophageal Reflux (GERD)
Any reflux of stomach acids from a child’s stomach rising up the oesophagus can cause severe irritation of the tube linings close to the throat or naso-pharynx. This can result in the development of more mucus flowing down the posterior nares and increases the incidence of mucus production and post-nasal drip.
Certain environmental items
Tobacco smoke and pollutants in the air can increase a child’s susceptibility to developing sinusitis.
Immune Deficiency
A child’s immune system is immature up until the age of seven. This makes a child more susceptible to developing sinus infections.
Cystic Fibrosis
Cystic fibrosis is a hereditary condition. Children born with cystic fibrosis experience thick, mucus secretions that are sticky and difficult to dislodge. This thick nasal mucus can build-up in the digestive tract and lungs. Cystic fibrosis  is a life threatening condition in young children and can lead to chronic lung disease. Children with cystic fibrosis are also more likely to develop multiple sinus conditions over their lifetime.
A deviated nasal septum
A child can be born with a deviated nasal septum. This is an anatomical defect which in most cases does not cause further problems. In some cases the deviation can be so pronounced that it prevents effective mucus drainage.
Diseased Haller cells
Haller cells can occur in the maxillary sinus cavities and are a variant of ethmoidal air cells. When these become diseased, they grow causing an obstruction in the sinus cavities as well as cause a narrowing of the exit ways for mucus to drain from the sinus cavities.
Cilia Disorders or damage
Disorders affecting the cilia result in impaired mucus transportation and removal from the nasal passages and sinus cavities. The mucus that is not removed from the sinus cavities and nasal passages is allowed to stagnant and dry-out resulting in the development of acute sinus infections. One such disorder is known as immotile cilia syndrome.
Immunoglobulin levels
Tests for Immunoglobulin-E are not performed on children younger than three years of age due to them not being reliable at this age. Immunoglobulin tests are performed to determine if allergies are present.
Nasal Polyp Formation
The development of a non-cancerous growths or nasal polyps is very rare in children. Should your child develop a nasal polyp please have him or her tested for Cystic Fibrosis.
Allergic Rhinitis / Asthma
Allergic Rhinitis causes an increase in mucus production by the mucus membrane linings in the nasal passages and sinus cavities. Rhinitis is very common in children suffering with asthma (allergic or non-allergic). This can lead to post nasal drip and upper respiratory tract infections in children if not treated in a timely manner.
Allergic Fungal Sinusitis
Studies have found that there is a higher incidence of allergic fungal sinusitis in children when compared to adults. Allergic fungal sinusitis is an allergic reaction caused by fungi or mold. Fungi and mold are airborne and are therefore easily able to enter the sinus cavities and nasal passages. Fungal allergies are highly resilient and are why treatment should be sought immediately to prevent a further spread of fungal spores. Aspergillus is one of the main culprits of allergic fungal sinusitis in children. Blocked nasal passages, post nasal drip, headaches, excessive rhinorrhoea and a foul smell emanating from the nasal passages may be experienced. A combination of antihistamines, immunotherapy, corticosteroids and antifungal medications may be prescribed.
Rhino-Sinusitis
Any inflammation or swelling of the sinus cavities (may be caused by an allergy, infection or even an autoimmune disease) and can result in an irritation or swelling of the membrane linings. Any increase in membrane swelling results in a decrease in drainage space, allowing for the accumulation and build-up of excess nasal mucus.
Concha bullosa, (aerated middle turbinate)
Concha bullosa is an air filled cavity within the middle turbinate. In certain circumstances, a large air pocket may form within the turbinate causing it to bulge to one side. This can in turn result in a smaller nasal passage through which mucus can drain resulting in an accumulation and build-up of nasal mucus.
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