Sinuses are hollow spaces in the cheekbones, in the forehead, and behind the nose. In chronic sinusitis, the sinus linings are swollen and irritated for more than three months . Kids with chronic sinusitis usually have a runny or stuffy nose, face pain or pressure, and a cough.

It’s not always clear what causes chronic sinusitis. Allergies and other medical conditions, being around cigarette smoke or air pollution, or an infection from bacteria or viruses (types of germs) may all play a role.

The main treatment for chronic sinusitis is saline (saltwater) and steroids sprayed into the nose to ease swelling and irritation and let the sinuses drain. Other treatments may include decongestants sprayed into the nose, medicines for other medical conditions, and antibiotics.

Here's how to care for your child.

• Follow your healthcare provider's instructions for:
  • Giving your child any medicines, including antibiotics. Be sure to give all medicines exactly as prescribed.
  • The order for giving the nasal sprays and how long to wait between each one (if using more than one).
  • Whether your child should see any specialists, such as an ENT (ear, nose, and throat) specialist, allergist, or gastroenterologist (doctor who specializes in problems with the digestive system).
  • Whether your child needs to go for any imaging (such as a CT scan or MRI).
  • When to follow up.
• Your child should not use a nasal decongestant more often than recommended or for more than three days. Using it too much or for too long could make your child's stuffiness worse.
• If your child is uncomfortable from pain or fever, and your healthcare provider says it's OK, you can give acetaminophen (Tylenol® or a store brand) or ibuprofen (Advil®, Motrin®, or a store brand). Follow the package directions for how much to give and how often. Don't give ibuprofen to babies under 6 months old.
• Don't give your child aspirin. It can cause Reye syndrome, a rare but serious illness.
• Don't give cough or cold medicines to children under 6 years old. These medicines can cause serious side effects. Check with your healthcare provider before giving cough or cold medicines to children 6 years and older.
• Offer your child plenty of liquids to drink.
• Let your child rest as needed.
• To help your child feel more comfortable while sleeping, try:
  • A cool-mist room humidifier (clean the humidifier as directed)
  • Having your child sleep on two pillows instead of one
• Your child should not be around cigarette smoke. Make your home and car smoke-free. Visit smokefree.gov or call 800-QUIT-NOW for help.

Your child:

• Has new or worsening symptoms, such as a fever or a headache
• Isn't improving after following your healthcare provider's instructions
• Has a nosebleed

Your child has:

• A fever above 102°F (38.9°C)
• A severe nosebleed or a lot of nosebleeds
• Changes in vision or pain with eye movements
• Neck pain and/or stiffness or a severe headache
• Bulging eyes or swelling around the eyes
• Trouble thinking clearly or seems confused

You know your child best. If they have symptoms that worry you or seem very sick, call your healthcare provider or take your child to the ER.

Who gets chronic sinusitis? Chronic sinusitis is more common in people who have allergies or asthma, have gastroesophageal reflux, smoke (or are around smoke or air pollution), or have a weakened immune system. Having a lot of colds or sinus infections (infections in the sinuses that are usually treated with antibiotics) can sometimes lead to chronic sinusitis.

What are the symptoms of chronic sinusitis? Along with a runny or stuffy nose, face pain, and a cough, kids with chronic sinusitis may also have changes in their sense of smell, feel tired or worn out, and vomit (usually after coughing a lot).

How do nasal sprays help with sinusitis? Nasal sprays work in different ways to relieve stuffiness inside the nose. Saline sprays clean and soothe inside the nose and thin the mucus, steroid nasal sprays ease inflammation (swelling), and decongestant nasal sprays tighten the blood vessels. Nasal sprays can also ease swelling at the entrance to sinuses to help the sinuses drain.

Do kids with chronic sinusitis need antibiotics? Antibiotics treat infections caused by bacteria (a type of germ). Chronic sinusitis is sometimes caused by bacteria but can happen for other reasons too. If your healthcare provider thinks your child's chronic sinusitis is caused by bacteria, they will prescribe antibiotics.