Background
The paranasal sinuses consist of 4 paired sinuses, including the maxillary sinuses, ethmoid sinuses, frontal sinuses, and sphenoid sinuses. Maxillary sinuses lie under the cheek; ethmoid sinuses lie between the eyes; frontal sinuses lie above the eyes in the center of the forehead; and sphenoid sinuses lie in the back of the nose and nasal cavity. Infected fluid in the sinuses is termed sinusitis. Chronic sinusitis is an infection that lasts 3 months, and recurrent sinusitis is a condition in which acute sinusitis continues to recur following medical treatment.
Initially, treat all sinusitis cases without suppurative complications with medical therapy. If maximum medical therapy is unsuccessful in a child with chronic or recurrent sinusitis, evaluation for underlying medical disorders (eg, immunodeficiency, allergic rhinitis, cystic fibrosis [CF], immotile cilia syndrome) is warranted. If chronic sinus infections continue following treatment for an associated condition, consider surgery. Surgery for chronic sinusitis in children, as in adults, has changed over the years.