Dr David Lowinger MBBS FRACS Ear Nose & Throat Specialist Surgeon
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Children

Sinus, Polyps & Allergy

Sinus :: Nasal polyps :: Allergy

Sinus

Sinus is an open, air filled cavity found in the four different areas of the head and facial bones such as in cheek bones, forehead, behind the nasal passages, and bones in the head.

When the sinuses are infected with bacteria or virus it leads to a condition called as sinusitis, inflammation of sinuses.. This condition occurs when your child suffers from cold or other viral infections, excess amount of mucous is secreted as a result the drainage system of the sinuses gets blocked and mucous gets trapped in the sinuses. Growth of bacteria and other organism in this mucus leads to sinusitis.

Sinusitis can be caused by viral infections such as cold, allergies, nasal polyps, hay fever, and other abnormalities of nose and sinus cavities. In this condition your child will develop stuffy nose and slight fever. Older children will have daytime dry cough which will remain for around a week along with fever, nasal congestion, dental and ear pain, and swelling in the face. Other symptoms include nausea, headache, and pain behind their ears.


Nasal polyps

Nasal polyps are fleshy growths inside the nasal passages and sinuses that block the passages. They are caused by inflammation of the mucous membrane. They may also develop as a result of other chronic disease such as allergic rhinitis, chronic sinusitis, asthma, and aspirin allergy and these polyps lasts for a long time. Polyps usually tend to grow back even after the surgical or medical treatment. Nasal polyps in children can be a sign of cystic fibrosis and other immunodeficiency conditions.

Nasal congestion is most commonly observed which can be treated upon medications. Other symptoms include running nose, loss or impaired sense of smell and taste, headache, and sinus pressure.

Your ENT doctor performs nasal endoscopy which will give a better view of the nasal passages and confirm polyps and provide necessary treatment.

The treatment involves surgical and non-surgical procedures. The most commonly suggested procedure is the surgical removal of polyps followed by medical therapies which will reduce the recurrence of polyps. Surgery is performed using an endoscope which will help the better view of nasal cavities. Medical therapies include nasal steroid sprays, corticosteroids, antileukotriene medications (in aspirin allergic children), nasal saline (for sinus infections and allergic rhinitis), and allergy shots or injection.


Allergy

Allergy is a reaction of the immune system to foreign substances (allergens) that enter the body. Allergies are very common in children and risk increases in those with family history of allergies.

The most commonly occurring allergy in children is allergic rhinitis (inflammatory disease of the nasal mucous) and asthma. Children with allergic rhinitis will have symptoms such as sneezing, hay fever, nasal congestion, itchy nose, itchy eyes, and running nose. Child may also develop sore throat, headache and cough which disturbs their sleep and causes day time irritability. Allergies cause ear infections which may lead to hearing loss in children.

Nasal congestion makes breathing uneasy; child may breathe through mouth while sleeping and may have a disturbed sleep. Children with allergies will have dark circles under their eyes and crease under their nose as they keep rubbing their nose too often.

Your allergist will obtain a detailed medical history and examine your child before the treatment is started. Skin tests and other allergy tests will be needed to identify the exact cause of allergy.

Treatment will be initiated based on diagnostic results and may include:

  • Medications: Certain over-the-counter medications can be used with the consent of your doctor. Some medicines should be avoided because they will sedate your child.
  • Allergy shots: If your allergist identifies specific allergy, allergic shots are prepared from the allergen which your child is sensitive to and is injected to your child. This decreases your child's sensitivity to allergens and confers resistance. It also stimulates immune system to fight against allergens

Prevention

If the cause of the symptom or allergy is identified it should be eliminated or avoided.

  • Avoid exposure to allergens at home such as pets, mold, and dust mites
  • Wash your child's bed sheet and pillow cover with warm water
  • Breast feed your child as mother's milk boosts immunity
  • Avoid your child's exposure to tobacco smoke
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Royal Australasian College of Surgeons The Australian Society Of Otolaryngology Head And Neck Surgery Australian New Zealand Society of Paediatric Otorhinolaryngology (ANZSPO) The University of New South Wales The University of Sydney Harvard Medical School

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