SINUSITIS IN CHILDREN

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SINUSITISIN CHILDREN

• Dr.M.Ravindran

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DEFINITION
Sinusitis is an inflammation of the lining of one
or more of the sinus cavities in the facial bones
around nose.
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INTRODUCTION

• Respiratory allergies and infections are very
  common in developing countries.
• Growing population and pollution affects the
  children in India .
• Humid weather of the city and the eating habits
  of the children make them easily prone to
  allergies.
• Because now there are bacteria which are
  resistant to antibiotics, in such cases
  homoeopathy helps a lot.
• Sinuses are not fully developed until 20 years.
• Maxillary and ethmoid sinuses are present from
  birth.
• Sinusitis is caused by bacterial, viral and
  rarely by fungal infections of the sinuses.

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PREVALANCE

• According to the American Academy of
  Otolaryngology - more than 37 million Americans
  have at least one episode of sinusitis a year. It
  may be caused by a cold or allergies, which cause
  the sinuses to become inflamed.
• "Chronic sinusitis, lasting more than eight to 12
  weeks, can significantly affect worker
  productivity and school performance on an
  individual level." (American Academy of Allergy,
  Asthma, and Immunology).
• Sinusitis can be fatal if not treated in its
  early stages.
• The National Institute of Allergy and Infectious
  Diseases list asthma and allergies, as causes of
  frequent episodes of chronic sinusitis.
• Sinusitis is one of the leading chronic diseases
  in the United States.  According to the National
  Academy on an Aging Society, it is the most
  common chronic condition among Americans.
• Damp weather and pollutants in the air can also
  affect chronic sinusitis sufferers.

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SYMPTOMS

• 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.  
• Colds lasting for 10- 14 days with a low grade
  fever.
• Intense headache in children aged 6 years and
  above.
• Thick yellow greenish discharge and nasal
  congestion.
• Fatigue and irritability.
• Posterior nasal drip leading to sore throat (lt
  night), bad breath, nausea, vomiting.
• Facial pain.
• Swelling around eyes.
• Reduced sense of smell or taste
• Cough
• Tooth pain
• Bad breath

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POSSIBLE CAUSES

• Allergies.
• Deviated nasal septum.
• Nasal polyp.
• Other medical conditions.

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COMMON TRIGGERS
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RISK FACTORS

• Chronic or frequent adenoids or tonsil infections
• Asthma and other allergies.
• Cystic fibrosis.
• Having asthma
• Overuse of nasal decongestants
• Chronic drug misuse (snorting substances)
• Having a foreign body in your nose
• Frequent swimming and diving
• Dental work
• Changes in altitude (flying or diving)
• Air pollution
• Gastro-esophageal reflux disease (GERD)
• Hospitalization that involves installed
  nasogastric tube

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INVESTIGATIONS

• Usually made clinically.
• No way to test function of sinuses.
• Difficult to aspirate fluid from sinuses.
• X-ray and C T Scan helpful in visualisation.

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CT SCAN OF PARANASALSINUSES

• Normal Maxillary
• Sinuses Sinusitis

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CASE NO 1

• A girl aged 15 yrs, complaints of
• Recurrent headache lt morning on raising up.
• Forehead pain extending to occiput.
• Nasal block on alternating sides.
• Hearing difficulty with discharge.
• Particulars heavy thirst for cold water.
• Mind irritable, angered easily, quarrels with
  sister.
• X-ray Pan sinusitis.
• Hb -10.5mgms.
• Based on totality Nux vomica cured her.

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CASE NO 2

• A boy of 10 yrs. regular swimmer, complaints of
• Recurrent headache after swimming classes
• Profuse sweat over the head
• Thin built
• History of constipation
• Silicea followed by Thuja as intercurrent
  cured the illness.

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CASE NO 3

• A boy aged 13 years complaints of
• Acute frontal headache
• Severe recurrent cough initially dry turning to
  wet
• Thick ropy discharge from the nose
• Loss of appetite
• History of primary complex
• Hydrastis and Tuberculinum as intercurrent
  cured him. He was advised to discontinue usage
  of mosquito repellents.

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PREVENTION

• Avoid mosquito repellents.
• Avoid flavoured, coloured foods and foods with
  preservatives.
• Add protein and vit c rich foods.
• Promote open door physical activities.

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PREVENTION

• Simple changes in your lifestyle or home
  environment can help lower the risk of sinusitis.
  For example, during the winter, when the cold air
  outside and your heating system make the air
  inside your home abnormally dry, consider using a
  humidifier to keep home humidity at 45-50. This
  will stop dry air from irritating the sinuses and
  make them less of a target for infection. It's
  important to clean your humidifier regularly to
  prevent mold growth.
• Although sinusitis itself is not contagious, it
  is often preceded by a cold, which can spread
  easily, particularly among family or friends. The
  most effective way to prevent germs from
  spreading is to teach kids the importance of
  frequent hand washing, particularly when they're
  sick.

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COMMONLY USED MEDICINES

• ARS ALB
• BELLADONA
• BRYONIA
• CINNABARIS
• EUCALYPTUS
• KALI BICH
• KALI MUR
• LUFFA
• MERC SOL
• NAT MUR
• SILICEA
• STICTA

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CONCLUSION

• The above study shows the effectiveness of
  homoeopathic medicine in the treatment of
  sinusitis in children. It is also observed the
  need for constitutional correction to have a
  permanent cure. The family history, past history
  of various ailments, problems of other organs,
  mental attitudes, personal desires, aversions,
  thermal modalities have contributed in the
  selection of remedies.
• Medicines like Kali bich., Silicea, Belladonna,
  Hydrastis etc., were found to be highly useful in
  treating the Sinusitis in children. These
  medicines also improved the immune status of
  children thus preventing the recurrences.

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REFERENCES

• Oxford Handbook of Clinical Medicine 15th
  edition, page 330)
• Harrison's Manual of Medicine 16/e
• Schreiber C, Hutchinson S, Webster C, Ames M,
  Richardson M, Powers C (2004). "Prevalence of
  migraine in patients with a history of
  self-reported or physician-diagnosed "sinus"
  headache". Arch. Intern. Med. 164 (16) 176972.
  
• Mehle ME, Schreiber CP (2005). "Sinus headache,
  migraine, and the otolaryngologist".
  Otolaryngologyhead and neck surgery official
  journal of American Academy of Otolaryngology-Head
  and Neck Surgery 133 (4) 48996.
• Tichenor, Wellington S. (2007-04-22). "FAQ -
  Sinusitis - WS Tichenor M.D.". Retrieved on
  2007-10-28.
• "Resources on Chronic Rhinosinusitis". Accentia
  Biopharmaceuticals Company and Mayo Clinic
  (2004).
• Bailey and Love

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THANK YOU