Ear Infections and Earache
What Is Otitis Media?
Otitis media means inflammation of the middle ear. The inflammation
occurs as a result of a middle ear infection. It can occur in one
or both ears. Otitis media is the most frequent diagnosis recorded
for children who visit physicians for illness. It is also the most
common cause of hearing loss in children.
Although otitis media is most common in young children, it
also affects adults occasionally. It occurs most commonly in the
winter and early spring months.
Is It Serious?
Yes, it is serious because of the severe earache and hearing
loss it can create. Hearing loss, especially in children, may impair
learning capacity and even delay speech development. However, if
it is treated promptly and effectively, hearing can almost always
be restored to normal.
Otitis media is also serious because the infection can spread
to nearby structures in the head, especially the mastoid. Thus, it
is very important to recognize the symptoms (see list) of otitis
media and to get immediate attention from your doctor.
How Does the Ear Work?
The outer ear collects sounds. The middle
ear is a pea sized,
air-filled cavity separated from the outer ear by the paper-thin
eardrum. Attached to the eardrum
are three tiny ear bones. When sound waves strike the eardrum, it vibrates
and sets the bones in motion that transmit to the inner ear.
The inner ear converts
vibrations to electrical signals and sends these signals to the brain. It
also helps maintain balance.
A healthy middle ear contains air at the same atmospheric pressure as outside
of the ear, allowing free vibration. Air enters the middle ear through the narrow
eustachian tube that connects the back of the nose to the ear. When you yawn
and hear a pop, your eustachian tube has just sent a tiny air bubble to your
middle ear to equalize the air pressure.
What Causes Otitis Media?
Blockage of the eustachian tube during a cold, allergy, or upper respiratory
infection and the presence of bacteria or viruses lead to the accumulation of
fluid (a build-up of pus and mucus) behind the eardrum. This is the infection
called acute otitis media. The build up of pressurized pus in the middle ear
causes earache, swelling, and redness. Since the eardrum cannot vibrate properly,
you or your child may have hearing problems.
Sometimes the eardrum ruptures, and pus drains out of the ear. But more commonly,
the pus and mucus remain in the middle ear due to the swollen and inflamed eustachian
tube. This is called middle ear effusion or serous otitis media. Often after
the acute infection has passed, the effusion remains and becomes chronic, lasting
for weeks, months, or even years. This condition makes one subject to frequent
recurrences of the acute infection and may cause difficulty in hearing.
What Are the Symptoms?
In infants and toddlers look for:
• pulling or scratching at the ear, especially if accompanied by the following...
1. hearing problems
2. crying, irritability
3. fever
4. vomiting
5. ear drainage
In young children, adolescents, and adults look for:
• earache
• feeling of fullness or pressure
• hearing problems
• dizziness, loss of balance
• nausea, vomiting
• ear drainage
• fever
Remember, without proper treatment, damage from an ear infection can cause chronic
or permanent hearing loss.
What Will Happen at the Doctor’s Office?
During an examination, the doctor will use an instrument called an otoscope
to assess the ear’s condition. With it, the doctor will perform an examination
to check for redness in the ear and/or fluid behind the eardrum. With the gentle
use of air pressure, the doctor can also see if the eardrum moves. If the eardrum
doesn’t move and/or is red, an ear infection is probably present.
Two other tests may be performed for more information.
An audiogram tests if hearing loss has occurred by presenting tones at various
pitches.
A tympanogram measures the air pressure in the middle ear to see how well the
eustachian tube is working and how well the eardrum can move.
The Importance of Medication
The doctor may prescribe one or more medications. It is important that all the
medication(s) be taken as directed and that any follow-up visits be kept. Often,
antibiotics to fight the infection will make the earache go away rapidly, but
the infection may need more time to clear up. So, be sure that the medication
is taken for the full time your doctor has indicated. Other medications that
your doctor may prescribe include an antihistamine (for allergies), a decongestant
(especially with a cold), or both.
Sometimes the doctor may recommend a medication to reduce fever and/or pain.
Analgesic ear drops can ease the pain of an earache. Call your doctor if
you have any questions about you or your child’s medication or if symptoms
do not clear.
What Other Treatment May Be Necessary?
Most of the time, otitis media clears up with proper medication and home treatment.
In many cases, however, further treatment may be recommended by your physician.
An operation, called a myringotomy may be recommended. This involves a small
surgical incision (opening) into the eardrum to promote drainage of fluid and
to relieve pain. The incision heals within a few days with practically no scarring
or injury to the eardrum. In fact, the surgical opening can heal so fast that
it often closes before the infection and the fluid are gone. A ventilation
tube can be placed in the incision, preventing fluid accumulation and thus improving
hearing.
The surgeon selects a ventilation tube for your child that will remain in place
for as long as required for the middle ear infection to improve and for the eustachian
tube to return to normal. This may require several weeks or months. During this
time, you must keep water out of the ears because it could start an infection.
Otherwise, the tube causes no trouble, and you will probably notice a remarkable
improvement in hearing and a decrease in the frequency of ear infections.
Otitis media may recur as a result of chronically infected adenoids
and tonsils.
If this becomes a problem, your doctor may recommend removal of one or both.
This can be done at the same time as ventilation tubes are inserted.
Allergies may also require treatment.
So, Remember . . .
Otitis media is generally not serious if it is promptly and properly treated.
With the help of your physician, you and/or your child can feel and hear better
very soon.
Be sure to follow the treatment plan, and see your physician until he/she tells
you that the condition is fully cured.
Doctor, Please Explain Ear Tubes
Painful ear infections are a rite of passage for children – by
the age of five, nearly every child has experienced at least one episode.
Most ear infections
either resolve on their own (viral) or are effectively treated by antibiotics
(bacterial). But sometimes, ear infections and/or fluid in the middle ear
may become a chronic problem leading to other issues such as hearing loss,
behavior,
and speech problems. In these cases, insertion of an ear tube by an otolaryngologist
(ear, nose, and throat surgeon) may be considered.
What are ear tubes?
Ear tubes are tiny cylinders placed through the ear drum (tympanic membrane)
to allow air into the middle ear. They also may be called tympanostomy tubes,
myringotomy tubes, ventilation tubes, or PE (pressure equalization) tubes. These
tubes can be made out of plastic, metal, or Teflon and may have a coating intended
to reduce the possibility of infection. There are two basic types of ear tubes:
short-term and long-term. Short-term tubes are smaller and typically stay in
place for six months to a year before falling out on their own. Long-term tubes
are larger and have flanges that secure them in place for a longer period of
time. Long term tubes may fall out on their own, but removal by an otolaryngologist
is often necessary.
Who needs ear tubes and why?
Ear tubes are often recommended when a person experiences repeated middle ear
infection (acute otitis media) or has hearing loss caused by the persistent presence
of middle ear fluid (otitis media with effusion). These conditions most commonly
occur in children, but can also be present in teens and adults and can lead to
speech and balance problems, hearing loss, or changes in the structure of the
ear drum. Other less common conditions that may warrant the placement of ear
tubes are malformation of the ear drum or Eustachian tube, Down Syndrome, cleft
palate, and barotrauma (injury to the middle ear caused by a reduction of air
pressure), usually seen with altitude changes such as flying and scuba diving.
Each year, more than half a million ear tube surgeries are performed on children,
making it the most common childhood surgery performed with anesthesia. The average
age of ear tube insertion is one to three years old. Inserting ear tubes may:
• reduce the risk of future ear infection,
• restore hearing loss caused by middle ear fluid,
• improve speech problems and balance problems, and
• improve behavior and sleep problems caused by chronic ear infections.
How are ear tubes inserted in the ear?
Ear tubes are inserted through an outpatient surgical procedure called a myringotomy.
A myringotomy refers to an incision (a hole) in the ear drum or tympanic membrane.
This is most often done under a surgical microscope with a small scalpel (tiny
knife), but it can also be accomplished with a laser. If an ear tube is not inserted,
the hole would heal and close within a few days. To prevent this, an ear tube
is placed in the hole to keep it open and allow air to reach the middle ear space
(ventilation).
What happens during surgery?
A light general anesthetic (laughing gas) is administered for young children.
Some older children and adults may be able to tolerate the procedure without
anesthetic. A myringotomy is performed and the fluid behind the ear drum (in
the middle ear space) is suctioned out. The ear tube is then placed in the hole.
Ear drops may be administered after the ear tube is placed and may be necessary
for a few days. The procedure usually lasts less than 15 minutes and patients
awaken quickly. Sometimes the otolaryngologist will recommend removal of the
adenoid tissue (lymph tissue located in the upper airway behind the nose) when
ear tubes are placed. This is often considered when a repeat tube insertion is
necessary. Current research indicates that removing adenoid tissue concurrent
with placement of ear tubes can reduce the risk of recurrent ear infection and
the need for repeat surgery.
What to expect after surgery?
After surgery, the patient is monitored in the recovery room and will usually
go home within an hour if no complications are present. Patients usually experience
little or no postoperative pain but grogginess, irritability, and/or nausea from
the anesthesia can occur temporarily. Hearing loss caused by the presence of
middle ear fluid is immediately resolved by surgery. Sometimes children can hear
so much better that they complain that normal sounds seem too loud. The otolaryngologist
will provide specific postoperative instructions for each patient including when
to seek immediate attention and follow-up appointments. He or she may also prescribe
antibiotic ear drops for a few days.
To avoid the possibility of bacteria entering the middle ear through the ventilation
tube, physicians may recommend keeping ears dry by using ear plugs or other water-tight
devices during bathing, swimming, and water activities. However, recent research
suggests that protecting the ear may not be necessary, except when diving or
engaging in water activities in unclean water such as lakes and rivers. Parents
should consult with the treating physician about ear protection after surgery.
Possible complications
Myringotomy with insertion of ear tubes is an extremely common and safe procedure
with minimal complications. When complications do occur, they may include:
•
Perforation – This can happen when a tube comes out or a long-term tube
is removed and the hole in the tympanic membrane (ear drum) does not close. The
hole can be patched through a minor surgical procedure called a tympanoplasty
or myringoplasty.
•
Scarring – Any irritation of the ear drum (recurrent ear infections), including
repeated in-sertion of ear tubes, can cause scarring called tympanosclerosis
or myringosclerosis. In most cases, this causes no problems with hearing.
•
Infection – Ear infections can still occur in the
middle ear or around the ear tube. However, these infections are usually
less frequent, result in
less hearing loss, and are easier to treat – often only with ear drops.
Sometimes an oral antibiotic is still needed.
•
Ear tubes come out too early or stay in too long – If an ear tube expels
from the ear drum too soon (which is unpredictable), fluid may return and repeat
surgery may be needed. Ear tubes that remain too long may result in perforation
or may require removal by the otolaryngologist.
Doctor, Explain Tonsils and Adenoids
Insight into Tonsillectomy and Adenoidectomy
Tonsils and adenoids are masses of tissue that are similar to the lymph nodes
or "glands" found in the neck, groin, and armpits. Tonsils are the
two masses on the back of the throat. Adenoids are high in the throat behind
the nose and the roof of the mouth (soft palate) and are not visible through
the mouth without special instruments.
Tonsils and adenoids are near the entrance to the breathing passages where they
can catch incoming germs, which cause infections. They "sample" bacteria
and viruses and can become infected themselves. Scientists believe they work
as part of the body's immune system by filtering germs that attempt to invade
the body, and that they help to develop antibodies to germs.
This happens primarily during the first few years of life, becoming less important
as we get older. Children who must have their tonsils and adenoids removed suffer
no loss in their resistance.
What Affects Tonsils and Adenoids?
The most common problems affecting the tonsils and adenoids are recurrent infections
(throat or ear) and significant enlargement or obstruction that causes breathing
and swallowing problems.
Abscesses around the tonsils, chronic tonsillitis, and infections of small pockets
within the tonsils that produce foul-smelling, cheese-like formations can also
affect the tonsils and adenoids, making them sore and swollen. Tumors are rare,
but can grow on the tonsils.
When Should I See My Doctor?
You should see your doctor when you or your child suffer the common symptoms
of infected or enlarged tonsils or adenoids.
The Exam
The primary methods used to check tonsils and adenoids are:
• Medical history
• Physical examination
• Throat cultures/Strep tests
• X-rays
• Blood tests
What Should I Expect At the Exam?
Your physician will ask about problems of the ear, nose, and throat and examine
the head and neck. He or she will use a small mirror or a flexible lighted instrument
to see these areas.
Cultures/strep tests are important in diagnosing certain infections in
the throat, especially "strep" throat.
X-rays are sometimes helpful in determining the size and shape of the adenoids.
Blood tests can determine problems such as mononucleosis.
How Are Tonsil and Adenoid Diseases Treated?
Bacterial infections of the tonsils, especially those caused by streptococcus,
are first treated with antibiotics. Sometimes, removal of the tonsils and/or
adenoids may be recommended. The two primary reasons for tonsil and/or adenoid
removal are (1) recurrent infection despite antibiotic therapy and (2) difficulty
breathing due to enlarged tonsils and/or adenoids.
Such obstruction to breathing causes snoring and disturbed sleep that leads to
daytime sleepiness in adults and behavioral problems in children. Some orthodontists
believe chronic mouth breathing from large tonsils and adenoids causes malformations
of the face and improper alignment of the teeth.
Chronic infection can affect other areas such as the eustachian tube – the
passage between the back of the nose and the inside of the ear. This can
lead to frequent ear infections and potential hearing loss.
Recent studies indicate adenoidectomy may be a beneficial treatment for some
children with chronic earaches accompanied by fluid in the middle ear (otitis
media with effusion).
In adults, the possibility of cancer or a tumor may be another reason for removing
the tonsils and adenoids.
In some patients, especially those with infectious mononucleosis, severe enlargement
may obstruct the airway. For those patients, treatment with steroids (e.g., cortisone)
is sometimes helpful.
Tonsillitis and Its Symptoms
Tonsillitis is an infection in one or both tonsils. One sign is swelling of the
tonsils. Other signs or symptoms are:
• Redder than normal tonsils
• A white or yellow coating on the tonsils
• A slight voice change due to swelling
• Sore throat
• Uncomfortable or painful swallowing
• Swollen lymph nodes (glands) in the neck
• Fever
• Bad breath
Enlarged Adenoids and Their Symptoms
If you or your child's adenoids are enlarged, it may be hard to breathe through
the nose.
Other signs of constant enlargement are:
• Breathing through the mouth instead of the nose most of the time
•
Nose sounds "blocked" when the person speaks
• Noisy breathing during the day
• Recurrent ear infections
• Snoring at night
• Breathing stops for a few seconds at night during snoring or loud breathing
(sleep
apnea)
Surgery
Your child: Talk to your child about his/her feelings and provide strong reassurance
and support throughout the process. Encourage the idea that the procedure will
make him/her healthier. Be with your child as much as possible before and after
the surgery. Tell him/her to expect a sore throat after surgery. Reassure your
child that the operation does not remove any important parts of the body, and
that he/she will not look any different afterward. If your child has a friend
who has had this surgery, it may be helpful to talk about it with that friend.
Adults and children: For at least two weeks before any surgery, the patient should
refrain from taking aspirin or other medications containing aspirin. (WARNING:
Children should never be given aspirin because of the risk of developing Reye's
syndrome).
• If the patient or patient's family has had any problems with anesthesia,
the surgeon should be informed. If the patient is taking any other medications,
has
sickle cell anemia, has a bleeding disorder, is pregnant, has concerns
about the transfusion of blood, or has used steroids in the past year, the surgeon
should be informed.
• A blood test and possibly a urine test may be required prior to surgery.
• Generally, after midnight prior to the operation, nothing (chewing gum,
mouthwashes, throat lozenges, toothpaste, water) may be taken by mouth.
Anything in the stomach
may be vomited when anesthesia is induced, and this is dangerous.
When the patient arrives at the hospital or surgery center, the anesthesiologist
or nursing staff may meet with the patient and family to review the patient's
history. The patient will then be taken to the operating room and given an anesthetic.
Intravenous fluids are usually given during and after surgery.
After the operation, the patient will be taken to the recovery area. Recovery
room staff will observe the patient until discharged. Every patient is
special, and recovery times vary for each individual. Many patients are
released after
2–10 hours. Others are kept overnight. Intensive care may be needed
for select cases.
Your ENT specialist will provide you with the details of pre-operative and postoperative
care and answer any questions you may have.
After Surgery
There are several postoperative symptoms that may arise. These include (but are
not limited to) swallowing problems, vomiting, fever, throat pain, and ear pain.
Occasionally, bleeding may occur after surgery. If the patient has any bleeding,
your surgeon should be notified immediately.
Allergic
Rhinitis (Hay Fever)
- Causes
- Symptoms
- When to see a doctor
- Treatment
Allergic rhinitis (hay fever) is an especially common chronic nasal problem in
adolescents and young adults. Allergies to inhalants like pollen, dust, and animal
dander begin to cause sinus and nasal symptoms in early childhood. Infants and
young children are especially susceptible to allergic sensitivity to foods and
indoor allergens.
What causes allergic rhinitis?
Allergic rhinitis typically results from two conditions: family history/genetic
predisposition to allergic disease and exposure to allergens. Allergens are substances
that produce an allergic response.
Children are not born with allergies but develop symptoms upon repeated exposure
to environmental allergens. The earliest exposure is through food—and infants
may develop eczema, nasal congestion, nasal discharge, and wheezing caused by
one or more allergens (milk protein is the most common). Allergies can also contribute
to repeated ear infections in children. In early childhood, indoor exposure to
dust mites, animal dander, and mold spores may cause an allergic reaction, often
lasting throughout the year. Outdoor allergens including pollen from trees, grasses,
and weeds primarily cause seasonal symptoms.
The number of patients with allergic rhinitis has increased in the past decade,
especially in urban areas. Before adolescence, twice as many boys as girls are
affected; however, after adolescence, females are slightly more affected than
males. Researchers have found that children born to a large family with several
older siblings and day care attendance seem to have less likelihood of developing
allergic disease later in life.
What are allergic rhinitis symptoms?
Symptoms can vary with the season and type of allergen and include sneezing,
runny nose, nasal congestion, and itchy eyes and nose. A year-long exposure usually
produces nasal congestion (chronic stuffy nose).
In children, allergen exposure and subsequent inflammation in the upper respiratory
system cause nasal obstruction. This obstruction becomes worse with the gradual
enlargement of the adenoid tissue and the tonsils inherent with age. Consequently,
the young patient may have mouth-breathing, snoring, and sleep-disordered breathing
such as obstructive sleep apnea. Sleep problems such as insomnia, bed-wetting,
and sleepwalking may accompany these symptoms along with behavioral changes including
short attention span, irritability, poor school performance, and excessive daytime
sleepiness.
In these patients, upper respiratory infections such as colds and ear infections
are more frequent and last longer. A child’s symptoms after exposure to
pollutants such as tobacco smoke are usually amplified in the presence of ongoing
allergic inflammation.
When should my child see a doctor?
If your child’s cold-like symptoms (sneezing and runny nose) persist for
more than two weeks, it is appropriate to contact a physician.
Emergency treatment is rarely necessary except for upper airway obstruction causing
severe sleep apnea or an anaphylactic reaction caused by exposure to a food allergen.
Treatment of anaphylactic shock should be immediate and requires continued observation
and care.
What happens during a physician visit?
The doctor will first obtain an extensive history about the child, the home environment,
possible exposures, and progression of symptoms. Family history of atopic/allergic
disease and the presence of other disorders such as eczema and asthma strongly
support the diagnosis of allergic rhinitis. The physician will seek a link between
the symptoms and exposure to certain allergens.
The physician will examine the skin, eyes, face and facial structures, ears,
nose, and throat. In some cases, a nasal endoscopy may be performed. If the history
and the physical exam suggest allergic rhinitis, a screening allergy test is
ordered. This can be a blood test or a skin prick test. In most children it is
easier to obtain a blood test known as the RadioAllergoSorbent Test or RAST.
This test measures the amount of specific Immunoglobulin E antibodies (IgE) in
the blood responding to various environmental and food allergens.
The skin test results, often immediately available, may be affected by the recent
use of antihistamines and other medications, dermatologic conditions, and age
of the patient. The blood test is not affected by medication, and results are
usually available in several days.
How is allergic rhinitis treated?
The most common treatment recommendation is to have the child avoid the allergens
causing the allergic sensitivity. The physician will work with caregivers to
develop an avoidance strategy based on the nature of the allergen, exposure,
and availability of avoidance measures.
Cost and lifestyle are important factors to consider. For mild, seasonal allergies,
avoidance could be the most effective course of action. If pet dander is the
offender, consideration should be given to removing the pet from the child’s
environment.
Severe symptoms, multiple allergens, year-long exposure, and limited resources
for environmental control may call for additional treatment measures. Nasal saline
irrigations, nasal steroid sprays, and non-sedating antihistamines are indicated
for symptom control. Nasal steroids are the most effective in reducing nasal
symptoms of allergic rhinitis. A short burst of oral steroids may be appropriate
for some patients with severe symptoms or to gain control during acute attacks.
If symptoms are severe and due to multiple allergens, the child is symptomatic
more than six months in a year, and if all other measures fail, then immunotherapy
(IT) (or desensitization) may be suggested. IT is delivered by injections of
the allergen in doses that are increased incrementally to a maximum that is tolerated
without a reaction. Maintenance injections can be delivered at increasing intervals
starting from weekly to bi-weekly to monthly injections for up to three to five
years. Children with pollen sensitivities benefit most from this treatment. IT
is also effective in reducing the onset of pollen-induced asthma.
Pediatric Sinusitis
Your child’s sinuses are not fully developed until
age 20. Although small, the maxillary (behind the cheek)
and ethmoid (between the eyes)
sinuses are present
at birth. Unlike in adults, pediatric sinusitis is difficult to diagnose
because symptoms can be subtle and the causes complex.
How do I know when my child has sinusitis?
The following symptoms may indicate a sinus infection in your child:
•
a “cold” lasting more than 10 to 14 days, sometimes with
a low-grade fever thick,
• yellow-green nasal drainage
• post-nasal drip, sometimes leading to or exhibited as sore throat, cough,
bad
breath, nausea, and/or vomiting
• headache, usually in children age six or older
• irritability or fatigue
• swelling around the eyes
Young children have immature immune systems and are more prone to infections
of the nose, sinus, and ears, especially in the first several years of
life. These are most frequently caused by viral infections (colds), and they
may be
aggravated by allergies. However, when your child remains ill beyond
the usual week to ten days, a serious sinus infection is likely.
You can reduce the risk of sinus infections for your child by reducing
exposure to known allergens and pollutants such as tobacco smoke, reducing
his/her time
at day care, and treating stomach acid reflux disease.
How will the doctor treat sinusitis?
• Acute sinusitis: Most children respond very
well to antibiotic therapy. Nasal decongestants or topical nasal sprays
may also be prescribed for short-term
relief
of stuffiness. Nasal saline (saltwater) drops or gentle spray can be
helpful in thinning secretions and improving mucous membrane function.
If your child has acute sinusitis, symptoms should improve within the
first few days. Even if your child improves dramatically within the first
week of treatment,
it is important that you continue therapy until all the antibiotics have
been taken. Your doctor may decide to treat your child with additional
medicines if
he/she has allergies or other conditions that make the sinus infection
worse.
• Chronic sinusitis: If your child suffers from
one or more symptoms of sinusitis for at least 12 weeks, he or she may
have chronic sinusitis. Chronic
sinusitis
or recurrent episodes of acute sinusitis numbering more than four to
six per year are indications that you should seek consultation with an
ear, nose, and
throat (ENT) specialist. The ENT may recommend medical or surgical treatment
of the sinuses.
• Diagnosis of sinusitis: If your child sees an
ENT specialist, the doctor will examine his/her ears, nose, and throat.
A thorough history and examination
usually
leads to the correct diagnosis. Occasionally, special instruments will
be used to look into the nose during the office visit. An x-ray called
a CT scan may
help to determine how your child's sinuses are formed, where the blockage
has occurred, and the reliability of a sinusitis diagnosis.
When is surgery necessary?
Only a small percentage of children with severe or persistent sinusitis
require surgery to relieve symptoms that do not respond to medical therapy.
Using an
instrument called an endoscope, the ENT surgeon opens the natural drainage
pathways of your child's sinuses and makes the narrow passages wider.
This also allows
for culturing so that antibiotics can be directed specifically against
your child's sinus infection. Opening up the sinuses and allowing air
to circulate usually
results in a reduction in the number and severity of sinus infections.
Your doctor may advise removing adenoid tissue from behind the nose as
part of the treatment for sinusitis. Although the adenoid tissue does
not directly block
the sinuses, infection of the adenoid tissue, called adenoiditis, or
obstruction of the back of the nose, can cause many of the symptoms that
are similar to sinusitis,
namely, runny nose, stuffy nose, post-nasal drip, bad breath, cough,
and headache.
Sinusitis in children is different than sinusitis in adults. Children more often
demonstrate a cough, bad breath, crankiness, low energy, and swelling around
the eyes along with a thick yellow-green nasal or post-nasal drip. Once the diagnosis
of sinusitis has been made, children are successfully treated with antibiotic
therapy in most cases. If medical therapy fails, surgical therapy can be used
as a safe and effective method of treating sinus disease in children.
