Allergy and sinus conditions are common in children, whose sinuses continue to develop well into the teen years. Allergy and sinus symptoms are similar, making a proper diagnosis a bit challenging. An ENT specialist can recommend diagnostic testing to help pinpoint the cause of what is ailing your child.
When allergies are to blame, the immune system responds to a perceived threat by flooding the bloodstream with chemicals called histamines, which attack the offending substance but cause inflammation and swelling of the airways in the process. Common allergy triggers include pollen, mold, animal dander, dust mites, chemicals, medications, and certain foods.
Pediatric sinusitis is usually the result of cold viruses, and may be aggravated by allergies. It can be either acute (short-term) or chronic (lasting longer than 12 weeks and recurring frequently). Distinguishing whether your child’s symptoms are the result of allergies or a sinus condition is the key to successful treatment.
Symptoms of allergy and sinus conditions include runny nose, sneezing, stuffiness, coughing, sore throat, wheezing, headaches, snoring, and itchy eyes (these may also be watery) and nose.
In addition to a physical examination, your child’s doctor will carefully inspect the ears, nose, and throat for signs of infection. Skin and blood tests will likely be administered to determine whether an allergen trigger is responsible.
When your child is diagnosed with allergies and avoiding the allergen trigger isn’t possible, treatment consists of a variety of medications. These include antihistamines, decongestants, nasal corticosteroid sprays, eye drops, and prescription drugs. Severe cases that don’t respond to medical treatment may require immunotherapy, usually delivered through weekly injections (i.e., allergy shots). This enables the body to build up a tolerance to the allergen over time, bringing long-term symptom relief.
Pediatric Sublingual Immunotherapy
SLIT, or sublingual immunotherapy, is an increasingly popular method of treating allergies. It is similar to immunotherapy (allergy shots), but instead of needles, the medicine is taken orally. It’s ideal for pediatric patients whose allergies most likely haven’t progressed to an advanced stage, and can be helpful in preventing asthma in some patients.
The goal of SLIT is to enable the body to build up a tolerance to a specific allergen by introducing it through controlled doses over a period of time. Gradually the size of the dosage is increased, and the immune system becomes less sensitive to it.
In children, the benefits are especially strong. Studies show that SLIT not only decreases the immunological response to allergens, but it prevents the onset of new allergic reactions and, as previously stated, has been shown to limit the onset of asthma in patients who suffer from allergic rhinitis. From a safety standpoint, SLIT is considered a better choice for children because traditional allergy shots carry a risk of severe side effects in younger patients. Additionally, the medication consists of drops that are kept under the tongue for a minute or two and then swallowed, so home-based treatment is easily managed.
Children suffering from allergies (hay fever, dust mites, animal dander, etc.) that are unresponsive to medical treatment are good candidates for SLIT. The first step involves finding out which allergen is triggering your child’s immune response. Once that has been identified through allergy skin testing, an extract is prepared in drop form to be taken daily. The full course of treatment lasts three to five years.
Children’s sinuses aren’t fully developed until they are teenagers, making them more prone to sinus infections than adults. These may be difficult to diagnose since the symptoms of sinusitis are identical to those found in other conditions such as colds and allergies.
Sinusitis occurs when the tissues lining the sinuses become swollen and inflamed, interfering with the drainage of mucus. It is usually caused by a cold or allergies, but can also occur as the result of structural abnormalities like nasal polyps or a deviated septum, injuries to the face, or immune system disorders.
Symptoms of sinusitis in children mimic those of the common cold and include irritability, runny nose, congestion, sore throat, cough, postnasal drip, facial pressure and swelling, headache, fever, fatigue, loss of smell and taste, and a thick yellow-green nasal discharge. When sinusitis is the culprit, symptoms usually persist longer than a week to ten days, the typical duration of a cold.
Children who are exposed to tobacco smoke, suffer from allergies, attend daycare or preschool, and experience acid reflux are more prone to developing sinusitis.
Your child’s doctor or an ENT specialist will examine the ears, nose, and throat, and may order a CT scan to look for physical obstructions of the sinuses, to confirm a diagnosis of sinusitis.
Treatment depends on whether the condition is acute (short-term) or chronic (lasting 12 weeks or longer). Acute cases can be treated with antibiotics and nasal decongestant or saline sprays or drops. Symptoms should improve after a few days of treatment, but the full course of antibiotics (if prescribed) must be taken in order to prevent the sinus infection from returning. Chronic sinusitis is more serious, and requires a long-term medical or surgical solution. An appointment with an otolaryngologist should be made in order to determine the best option for treatment.