Sinusitis

What is sinusitis

Sinusitis is an infection and inflammation of the sinus passages, which can become swollen and blocked, making it difficult to breath through the nose. Sinusitis causes pain and other symptoms from the inflammation.

There are four main sinus cavities in the skull which contain air, mucous and tiny little hairs, called cilia. The sinuses exist in pairs with one side on the left and one of the right. The mucous in the sinus cavities, together with the cilia is used as a protective measure, to trap and sweep out bacteria that may try to come in and infect the body.

The four main sinus cavities that exist in the head and which can become infected are:

• Frontal sinuses – exist in the area behind the forehead
• Maxillary sinuses – exist in the area behind the cheeks
• Sphenoid sinuses – exist deep in skull behind the eyes
• Ethmoid sinuses – exist deep in the skull behind the maxillary sinuses

Sinusitis occurs when the lining of the sinuses becomes inflamed, irritated and swollen and it prevents the cilia from working properly.

Allergies ares closely associated with the development of sinusitis, due to the inflammation of nasal mucous that allergy causes, which if not resolved can lead to sinusitis.

Sinusitis can be either:

• Acute – usually caused by a bacterial infection of the sinus passages, but can also be caused by an allergy or irritation to a substance
• Chronic – when sinus infections occur regularly, last longer than an acute infection and cause longer-term symptoms

Facts about sinusitis

• Sinusitis is a very common upper respiratory condition
• Chronic sinusitis is very closely associated with the development of nasal polyps (overgrowth of inflamed tissue in the sinus passages)
• Sinusitis is also associated with allergic rhinitis, as one can predispose the other to develop
• Untreated and serious sinusitis can develop into more serious infections of the head and brain
• Always seek medical attention for babies and young children with any type of fever associated with sinusitis
• Sinusitis is also known as rhino-sinusitis (rhino means “nose”)
• The sinuses need to be able to drain mucous properly to be effective and sinusitis prevents this from happening correctly
• The sinuses are air-filled cavities inside the skull, which scientists believe evolved to make the skull lighter

Symptoms of sinusitis

Acute sinusitis and chronic sinusitis both have many common symptoms:

• Bad breath – the build-up of infected or inflamed mucous can cause a build-up of bacteria in the area to make bread smell bad (especially happens in the morning, after sleeping at night when the head has been lying down for hours)
• Coloured discharge from the nose – yellow, greenish or brown coloured discharge from the nose, which is usually an indication that there is a bacterial infection of the sinuses
• Cough – the sinus inflammation can produce a dry cough
• Fatigue – the sinusitis can cause the body to feel weakened and lethargic
• Fever – usually low grade fever, but can be high if infection is really acute
• Nasal congestion – blocked nose and difficulty breathing through the nose
• Nausea – this usually happens from swallowing the inflamed (or infected) mucous
• Pain in the face – pain in the forehead, head, nose and cheeks to the side of the nose and tenderness when they are pressed
• Redness and swelling – especially around the nose, cheeks, eyes due to the internal inflammation of the sinuses
• Reduced senses of smell and taste – these senses can be dulled
• Runny nose – clear fluid that seems to drip out of the nose
• Teeth pain – most people feel pain in their teeth, especially upper teeth

Chronic sinusitis also has the following additional symptoms

• Increased pain – the pain in the head, upper teeth and bones may become quite excruciating and pain relief (in the form of analgesic medications) may be required to reduce the severity of the pain
• Post nasal drip – discharge from the back of the throat which occurs especially when the head is laying down, most often at night, during sleep. This is a reason why people with sinusitis wake up with full nasal passages and inability to breath properly at night

In very rare cases, the sinus infection can spread to other parts of the head and even the brain, which can be serious if not treated promptly.

Children with swelling of the cheeks or eyelids should be immediately taken to a doctor for treatment, as they have smaller sinus passages and an infection could have more serious consequences.

Causes of sinusitis

Sinusitis is can be caused by any of the following:

Allergy

One of the most common causes of sinusitis is allergy. When an allergen (dust) enters the sinus passages, usually through inhalation this can cause an inflammation of the nasal mucous membranes which line the nasal passages. These inflamed nasal mucosa block proper drainage of the sinuses and this blockage encourages (usually) bacterial infection, resulting in sinusitis.

Chemical irritation

Any type of chemical can potentially irritate the nasal passages and cause an inflammation of the sinuses, to lead to sinusitis. The most commonly inhaled chemical irritants that can cause sinusitis are: cleaning products, perfumes, pest control chemicals

Dental infection

Any type of infection of any part of the teeth can be an underlying factor which can cause the symptoms of sinusitis. It is important to appropriately treat this cause of sinusitis as a dental infection can cause many complications.

Infection by virus or bacteria

The most common cause of sinusitis is due to a viral infection, usually during a cold or flu infection. The virus can infect and inflame the sinus passages and cause sinusitis symptoms. A less common cause of infection is a bacterial infection of the sinuses, which is due mainly because of the blockage of mucous that provides a perfect environment for infection.

Prevention of sinusitis

Non-preventable risk factors

Sinusitis may be unpreventable in certain circumstances:

• Dental infection – A dental infection in the upper teeth, usually an abscess, can also cause inflammation of the maxillary sinuses, which results in sinusitis
• Gastro-oesophageal reflux disease (GERD) – an uncommon, but known risk factor for for sinusitis, is gastro-eosophageal reflux disease (GERD). People who have GERD experience regurgitation of their food as it refluxes from the stomach and up the eosophagus. The acidic fumes from this refluxed foods can travel into the sinuses (and lungs) and greatly inflame the sinuses passages, causing sinusitis. This risk factor is often missed in many people because they do not realise it can cause sinusitis
• Hay fever (allergic rhinitis) – people who have allergic rhinitis (hay fever) are also much more predisposed to developing sinusitis too. This is most likely due to the allergic rhinitis (hay fever) causing inflammation of the nasal mucous membranes and this can cause a build-up of mucous and any allergens, which blocks the sinus passages. This blockages makes it much more likely for the sinuses to become infection and for sinusitis to occur
• Trauma to the sinuses – any type of injury or trauma to the sinuses has the potential to cause inflammation of the mucous membrane lining the sinuses and result in sinusitis. Injury to the sinuses is rare, but it does occur when the trauma is severe enough to impact the sinuses
• Viral or bacterial infection – any type of upper respiratory infection or dental infection of the teeth can predispose a person to developing sinusitis too. An upper respiratory infection inflames the nasal passages, making it more likely the mucous membranes are also inflamed and sinusitis to ensue, even if it is just for the duration of the infection (acute sinusitis)

Preventable risk factors

There are ways to prevent sinusitis from occurring or at least symptoms from worsening:

• Avoid allergens – if you know you have an allergy to a particular substance, then you need to ensure you avoid it as much as possible, to prevent sinusitis from occurring
• Avoid irritants – if you know your sinuses become irritated by a particular substance, then you need to ensure you avoid it as much as possible, to prevent sinusitis from occurring
• Neti pot – a neti pot is a very useful way to help drain the sinuses and reduce incidence of sinusitis
• Strengthen the immune system – the immune system needs to be strengthened so that it can more effectively fight off any type of infection (viral or bacterial) and prevent sinusitis from occurring in the first place, or at least reduce the severity of the symptoms

Complications of sinusitis

There are a number of complications that can occur due to both acute and chronic sinusitis:

• Abscesses – a common complication of sinusitis is the development of an abscess, due to the bacterial infection spreading. An abscess is a fluid filled sac that contain pus, infected material and if it bursts, it can infect the whole area in its surrounding and this can be potentially fatal
• Cellulitis – the eye is most commonly affected with cellulitis, an acute infection of the eye socket area that causes inflammation and requires emergency treatment (usually antibiotics intravenously) as it can worsen very quickly. The infection spreads to the eye from the nasopharynx or from the frontal, maxillary or ethmoidal sinuses
• Empyema (epidural and subdural) – empyema occurs when there is pus in the lining between the brain the skull bone and occurs as a result of intracranial complications of the frontal osteomyelitis
• Frontal bone osteomyelitis – this condition is also known as Potty’s puffy tumor and is a very rare complication of frontal sinusitis. It is characterised by abscesses and osteomyelitis of the frontal bone. The frontal sinuses appear very swollen. Frontal bone osteomyelitis needs to be treated with draining of the abscess(es) and a course of antibiotics for several weeks to prevent even further complications. Brain abscess is the common complication of skull osteomyelitis
• Meningitis – the meninges, which is the tissue surrounding the brain between the brain and the skull can become infected and inflamed which is know as meningitis. This very serious bacterial infection can occur when there is a very serious sinusitis infection that has resulted in abscesses forming and/or frontal bone osteomyelitis
• Nasal polyps – a very common complication of chronic sinusitis are nasal polyps, which are usually benign growths within the sinus passages and which can block the sinus cavities and obstruct breathing, especially at night and result in obstructive sleep apnoea, which is a condition where breathing stops and starts
• Paranasal mucocele – this rare complication is a chronic, cystic lesions in the paranasal sinuses which cause swelling and inflammation of the bone within the sinus cavities

When to see a doctor about sinusitis

People who have any of the symptoms of sinusitis need to make an appointment to see their doctor who can diagnose this condition (or rule it out) and prescribe appropriate treatment to relieve symptoms.

People who have been diagnosed with sinusitis need to see their doctor if:

• Their symptoms suddenly get worse and none of the medications or other strategies to alleviate symptoms are effective
• They experience different symptoms to the ones they normally experience

Diagnosis of sinusitis

Initial diagnosis of sinusitis is made through the following tests:

• Medical history of symptoms – the doctor will ask a series of questions about your symptoms (especially the duration and severity) and onset of symptoms
• Physical examination – to detect the severity of the condition and symptoms. The doctor will usually press on the areas of the face where the sinuses are located, which, if cause pain, are generally a good indication of sinusitis

Further diagnosis of sinusitis

• CAT scan – the CAT scan test can provide a good view of the sinuses and nasal passages so that any other conditions or underlying problems can be ruled out (such as nasal polyps, which are very common in people with sinusitis)

Conventional treatment of sinusitis

Conventional treatment of sinusitis consists of a combination of strategies:

Dietary modifications

Certain strategies can help help prevent sinusitis in the first place, or improve symptoms in an existing condition:

• Drink plenty of fluids – water and juice can help to rehydrate the body and replace all the fluids being lost with the runny nose and dripping mucous
• Keep immune system strong – eat plenty of fruits and vegetables which provide good levels of nutrients that may prevent sinusitis from developing in the first place

Immunotherapy

This involves gradually increasing doses of the substance (or allergen) to which the person is allergic over time, this has the effect of making the immune system less sensitive to that allergen and reducing symptoms

Lifestyle modifications

Certain strategies can help help prevent sinusitis in the first place, or improve symptoms in an existing condition:

• Avoid allergens – known allergens that cause chronic sinusitis should be avoided as much as possible
• Avoid irritants – known irritants that cause chronic sinusitis should be avoided as much as possible
• Humidifier – these moisten the air and help loosen and remove mucous from the infected sinus passages, reducing symptoms
• Rinse sinuses with saline – either purchase a saline solution (to be used in the nasal and sinus passage) or make up one (mix lukewarm water with some salt to taste like tear drops, slightly salty) which should be used to rinse out the nasal passages – this helps reduce symptoms

Medications

These can be prescribed by a doctor or purchased over-the-counter from a pharmacy:

• Antibiotics – these are usually prescribed when a bacterial infection is suspected, to help clear up the infection or when bacterial infection could occur
• Antihistamines – these are prescribed to reduce the allergic reaction which caused the inflammation of the sinus passages (for those whose sinusitis was caused by an allergy)
• Corticosteroid nasal sprays – these medicated nasal sprays help to reduce inflamed sinus passages and are very useful for people with chronic sinusitis whose sinus passages may be very inflamed and irritated
• Corticosteroid nasal tablets – these are taken orally and also help to reduce the inflammation of the sinus passages. These medications are especially used in people with chronic sinusitis
• Decongestant nasal sprays – these medicated nasal sprays help to shrink the mucous inflammation in the sinuses, which encourage sinus drainage and reduction in symptoms. These types of nasal sprays should only be used short-term (around 1 week at the most)
• Decongestant tablets – these tablets are taken orally and have the same effect as the sprays but can usually be taken for a longer period than the sprays as they have less (but not none) rebound effects
• Pain killers – a number of over-the-counter pain killers can be taken to help to relieve pain, headache and fever that is associated with sinusitis. The most common pain killers used are: Paracetamol or ibuprofen

Surgery

Surgery is usually a strategy of last resort and is recommended only for patients whose sinusitis is really chronic and does not respond to the treatment options normally recommended (medication, lifestyle and dietary modification and immunotherapy).

Surgery removes the inflamed tissue inside the sinus passages, some nasal bone and any nasal polyps that are present to try to resolve the problem.

Alternative / complementary treatment of sinusitis

Alternative / complementary treatment of sinusitis involves a combination of a number of strategies.

Herbs

Certain herbs may assist with reducing incidence of symptoms:

• Echinacea – studies show the potent herb echinacea has excellent anti-viral and anti-bacterial properties which has a positive effect on stimulating the immune system to work properly. Echinacea should only be taken for two weeks at a time, then you need to avoid it for at least two weeks before starting it again
• Fenugreek – the spice fenugreek has been traditionally used in Indian Ayurvedic medicine to clear nasal congestion and prevent infection. Studies show fenugreek does have some anti-inflammatory properties, which may help to reduce sinusitis symptoms
• Garlic – studies show the potent herb / food garlic helps to clear nasal congestion and prevents infection, as it has potent anti-bacterial and anti-viral properties. Garlic also helps to stimulate the immune system to function more effectively in fighting off infection
• Horseradish – the spice horseradish has been traditionally used to clear nasal congestion and prevent infection. Studies show horseradish has anti-inflammatory properties
• Olive leaf – studies show the herb olive leaf helps to reduce inflammation in the sinus passages and this helps to clear up congestion and blockages, which reduces symptoms of sinusitis

Vitamins

Many studies show certain vitamins have a beneficial effect on reducing length and severity of symptoms:

• Betacarotene – the antioxidant betacarotene is the precursor to vitamin A, so has the same beneficial properties on the mucous membranes, to help reduce inflammation and increase healing capacity
• Bioflavonoids – together with vitamin C, the bioflavonoids help to support the immune system to function at a much more optimal level
• Vitamin A – the antioxidant vitamin A is required to keep the mucous membranes soft, moist and healthy to prevent allergens from entering the body and causing an infection in the first place
• Vitamin B complex – the B vitamins support the immune system to function correctly and may help to reduce severity and length of symptoms
• Vitamin C – together with bioflavonoids, the antioxidant vitamin C helps to support the immune system to function at a much more optimal level. Vitamin C is also an effective and natural anti-histamine, so it is useful for people who have an underlying allergy that causes the sinusitis
• Vitamin E – studies show the antioxidant vitamin E helps to reduce symptoms of nasal congestion by helping the support the function of the immune system to fight the underlying viral or bacterial infection

Minerals

Some minerals may assist with reducing symptoms:

• Magnesium – the mineral magnesium has properties which induce relaxation in tissues and this may help to reduce inflammation in the sinus passages
• Selenium – the antioxidant mineral selenium helps support the immune system to fight infection and helps to heal the body more quickly from any type of illness or infection from viruses or bacteria
• Zinc – studies show that zinc helps with all upper respiratory conditions, stimulating the immune system to heal more quickly

Other nutrients

Studies show certain nutrients have a beneficial effect on reducing length and severity of symptoms:

• Alpha-lipoic acid – the antioxidant alpha lipoic acid helps to boost the immune system, helps to boost the infection fighting properties of other antioxidant nutrients and this may help to reduce symptoms in both acute and chronic sinusitis
• Essential fatty acids – studies show that the essential fatty acids are beneficial in reducing inflammation in all parts of the body (including the sinus passages) and this helps to reduce severity of symptoms
• Omega 3 fatty acids – the omega 3 fatty acids help reduce symptoms of inflammation in the nasal passages and help with breathing better
• Quercetin – studies show that the potent bioflavonoid antioxidant quercetin has a beneficial effect on reducing severity of symptoms
• Grapefruit seed extract – studies show that the antioxidant effects of grapefruit seed extract may help reduce the inflammation in the nasal passage and reduce symptoms of sinusitis (acute or chronic) without the rebound effects often experienced with conventional medicine

Dietary modifications

Foods that trigger allergies should be avoided to reduce symptoms:

• Avoid foods causing mucous – certain foods such as dairy, processed foods (high sugar and high fat foods) tend to cause more mucous to form which can make symptoms worse
• Drink more fluids – water helps to rehydrate the body and moisten the mucous membranes to keep the allergens out and prevent them from causing symptoms
• Eat more garlic and onions – as much as can be tolerated either fresh, cooked or as garlic supplements; both have anti-inflammatory properties which help reduce symptoms
• Eat more oily fish – these fish (mackerel, salmon, sardines, trout, tuna) contains omega 3 fatty acids which may reduce inflammation inside the sinus passages and also help to reduce the severity and duration of symptoms
• Eat more fruits and vegetables – these natural foods have a high content of vitamins, minerals and other nutrients such as antioxidants which may reduce severity and length of symptoms
• Eat more nuts – especially walnuts and pecans, as they contains the essential fatty acids which may reduce the inflammation inside the sinus passages and also help to reduce the severity and duration of symptoms
• Eliminate food allergens – there are a number of common food allergens that could be causing the sinusitis symptoms and they should be removed from the diet to try to work out if they are causing this condition. The most common food allergens are: cow’s milk products, food additives, colours and preservatives

Lifestyle modifications

Certain lifestyle factors can help to clear up symptoms more quickly:

• Avoid alcohol – studies show that excessive intake of alcohol can cause the sinus lining to swell more, making symptoms worse
• Avoid allergens – if certain allergens are known to cause chronic sinusitis, care should be taken to avoid contact with them to prevent exacerbation of symptoms
• Neti pot – the neti pot has been traditionally used in Indian culture to help clear out the sinuses and prevent sinusitis symptoms. The neti pot should be filled with lukewarm water that has had fine sea salt added and mixed thoroughly through. Tilt your head to one side and insert the nozzle of the neti pot into the nostril that is on the top side and let the water flow through to the other side. Ensure you are standing over a basin so that the water that flows through can flow into the basin and not the floor
• Relax – it is advisable to engage in relaxation techniques that lower stress to help to reduce symptoms of sinusitis as stress only exacerbates symptoms
• Rest – lying down, sleeping and taking it easy (not over-exerting the body) gives the body the best chance to heal more quickly
• Steam inhalation – the steam breaks up the mucous in the nasal passages, lessens nasal congestion assists with better sleep by enabling the sinuses to be less inflamed and clearer
• Stop smoking – studies show that cigarette smoking puts a strain on the body and exacerbates symptoms, which means that second-hand smoke should also be avoided, so stay away from it too

Alternative treatments

• Acupuncture – there are several studies which suggest that the symptoms of sinusitis may be reduced in both severity and duration through a course of acupuncture by a registered practitioner

Always ensure that you notify your medical practitioner of any supplements that you want to take – it may interfere with other medication or conditions you have. Confirm with your doctor it is safe to take before you try it.

Living with sinusitis

Self care strategies

There are a number of strategies which are recommended to help deal with sinusitis:

• Avoid alcohol – studies show that excessive intake of alcohol can cause the sinus lining to swell more, making symptoms worse so avoid alcohol especially during an acute sinusitis infection and limit it if you have chronic sinusitis, as it can only make your symptoms worse
• Avoid mucous causing foods – certain foods such as dairy, processed foods (high sugar and high fat foods) tend to cause more mucous to form which can make symptoms worse as the body has to try to get rid of the excessive mucous and fight off the sinusitis infection
• Avoid the allergens – any type of allergies to foods, plants, pets and any other allergens can trigger symptoms and should be avoided to prevent sinusitis symptoms
• Avoid chemical irritants – pollution, cigarette smoke and other environmental chemicals, can all trigger symptoms of sinusitis and should be avoided
• Drink fluids – you must maintain your fluid levels with plenty of water (around 8 glasses a day) or freshly squeezed juices, which can help provide the fluids to rehydrate the nasal mucous tissue
• Eat more garlic, ginger and onions – these foods have potent anti-inflammatory effects, which can help reduce the inflammation in the mucous membranes in the sinus passages. Garlic especially, also has anti-viral and anti-bacterial properties, so it helps boost the immune system to fight off any type of infection quickly
• Eat fresh vegetables and fruit – especially the dark green and dark purple vegetables and brightly coloured fruits, as they have more antioxidants, which can help boost the immune system to reduce the severity and duration of symptoms. Try to ensure the vegetables and fruit are organic (or pesticide-free) as studies show these have more of the nutrients than those conventionally produced
• Moist air – the congestion in your sinus passages may be broken up a little more quickly with moist air. Either use a humidifier (or vaporiser), have a warm shower (and leave the fan off), or a sink filled with warm water and a towel around your head to breath in to warm steam (steam inhalation)
• Reduce fever and pain – you may be able to reduce any fever or aches and pains with panadol, Acetimophen, ibuprofen or aspirin. People with any type of gastric (stomach) or intestinal disorder (including GERD) or anyone younger than 18 years should not take aspirin
• Rest – you need to rest if you have an acute sinusitis infection, to give your body enough energy to more effectively deal with the infection. Your doctor will let you know how long you need to rest, to give your body a better chance to fight off the infection much sooner
• Stop smoking – if you smoke, you need to at least reduce your intake for the duration of the acute sinusitis, as the cigarettes will just worsen your symptoms and may make breathing much more difficult. Do not be exposed to other people’s second hand smoke either, as it has the same detrimental effect on sinusitis as smoking yourself
• Use a neti pot to prevent sinusitis – the neti pot has been traditionally used in Indian culture to help clear out the sinuses and prevent sinusitis symptoms. The neti pot should be filled with lukewarm water that has had fine sea salt added and mixed thoroughly through. Tilt your head to one side and insert the nozzle of the neti pot into the nostril that is on the top side and let the water flow through to the other side. Ensure you are standing over a basin so that the water that flows through can flow into the basin and not the floor

Caring for someone with sinusitis

Partner

If your partner has acute or chronic sinusitis, there are some strategies you can use to help them recover more quickly:

• Allow your partner to rest – your partner’s condition (either acute or chronic sinusitis) will get better much more quickly if they can rest properly, so it may be up to you to take care of the household duties such as cooking, while your partner recovers
• Don’t smoke – your partner will be adversely affected by your cigarette smoke, so make sure you do not smoke anywhere near them as it may cause their symptoms to get worse, make their breathing difficult and possible cause them some distress
• Medication – you should try to make sure your partner is taking their medication as prescribed, especially if they have a fever or are feeling too sick to manage it themselves
• Moist air – encourage your partner to moisten the airways in their sinuses by having a humidifier in the home, or get them to have a shower (with the fan off to generate more steam) or even fill a sink with hot water and get your partner to stand over it with a towel over their head and breathe in the steam. All of these strategies will help break up the some of the congestion in their sinuses, which will help them breathe more easily
• Provide fluids to your partner – your partner needs lots of fluids, so you could get them a glass of water or juice every few hours, to make sure they are drinking enough fluids to rehydrate the mucous membranes in their sinuses. This is especially important if your partner is laying down resting – it is much easier if you can provide their fluids to them so they can rest more

Friends

If your friend has acute or chronic sinusitis, there are some strategies you can use to help them:

• Don’t smoke – your friend will be adversely affected by your cigarette smoke, so if you are going to see them, make sure you do not smoke anywhere near them as it may cause their symptoms to get worse, make their breathing difficult and possible cause them some distress

Parents

If your child has acute or chronic sinusitis, there are some strategies you can use to help them recover more quickly:

• Allow your child to rest – your child’s condition (either acute or chronic sinusitis) will get better much more quickly if they can rest properly, so you should ensure they stay in bed and rest so they can recover
• Don’t smoke – you must not smoke anywhere near your child, so that they can inhale your smoke, whether your child has acute or chronic sinusitis. Your cigarette smoke will make it more difficult for your child to breath, cause their symptoms to get worse and this may cause your child to be distressed
• Inform the school – you need to inform your child’s school of their absence as recommended by your doctor and speak to their teachers about any school work they may be missing
• Medication – you should try to make sure your child is taking their medication as prescribed, especially if they have a fever, are too young, or feeling too sick to manage it themselves. You should speak to your doctor about using alternative/complementary treatments for sinusitis before trying them
• Moist air – encourage your child to moisten the airways in their sinuses by having a humidifier in the home, or get them to have a shower (with the fan off to generate more steam) or even fill a sink with hot water and get your partner to stand over it with a towel over their head and breathe in the steam – ensure the water is not too hot and watch over your child to make sure they do not get too close to the hot water and burn themselves. All of these strategies will help break up the some of the congestion in their sinuses, which will help them breathe more easily and reduce the pain
• Provide fluids to your child – your child needs lots of fluids, so you could get them a glass of water or juice every 1-2 hours, to make sure they are drinking enough fluids to rehydrate the mucous membranes of their sinuses. This is especially important if your child is laying down resting – it is much easier if you can provide their fluids to them so they can rest more

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Last reviewed and updated: 14 May 2024