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Unexplained Coughing and Sinusitis

About Anisa Abbas

Anisa Abbas is currently a senior at Culver City High School. She enjoys spending time with her family and volunteering at UCLA Santa Monica Orthopedic Hospital. She hopes to attend UCLA or UC San Diego to study medicine. She wrote this article as part of the Student Mentorship Program at the Osborne Head and Neck Foundation.

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Question: Can sinusitis cause a chronic cough?

My 9-year-old daughter has been coughing for the past several weeks, especially at night. She is normally very healthy but recently recovered from a bad cold. I called her pediatrician and he suggested that her cough could be due to sinusitis. Can my daughter’s cough be due to sinusitis and what can be done to treat it?

Discussion:

Sinusitis is an often underestimated cause of a cough in children.  The typical course of events is that a child has a cold that results in congestion of their nose.  This results in the typical symptoms of runny nose, fevers, and irritability.  For most children, this resolves within 5-7 days.  However, some children develop a cough.  In these children, the cough may persist for weeks.  The child often does not act sick but they are coughing, usually a dry cough at nighttime, persistently.  No cough treatments work to solve the problem.

In this scenario, the cough is often due to sinusitis.  The preceding cold resulted in inflammation of the nose, blocking drainage of the sinuses.  The sinuses fill with mucous and bacteria.  Because children are often quite resistant to symptoms, they do not often note these symptoms during the day.  They may continue to have a runny nose but do not exhibit typical adult symptoms, such as headache, thick nasal discharge, and malaise.  However, at night, the child becomes more symptomatic.  The mucous that has collected in the sinuses all day drips down the back of the throat, aided by simple gravity allowing sinuses to drain.  The child’s defenses are down as they are sleeping, allowing the mucous to drip into their throat and upper airways (trachea, bronchi).

This will result in a cough as the mucous accumulates and the child wakes up slightly to cough the secretions out.  Until the sinuses are treated, this cough will often persist for weeks.

If you child suffers from sinusitis after a cold, you may notice:

  • Cough
  • Snoring
  • Mouth-breathing
  • Runny nose

These symptoms all suggest sinusitis may be the underlying cause.  Treatment by a pediatric otolaryngologist may include antibiotics, nasal spray, or nebulized medications.  Early treatment often resolves symptoms in 5-7 days.

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