Your frequent questions answered by the experts at Nationwide Children's Hospital

My son has been having a lot of sinus infections. His doctor says he has narrow nasal passages and may need surgery. How common is this, and what can we expect?

Frequent sinus infections in children are a common problem, especially for children in daycare settings. The average child may experience six to 10 upper-respiratory-tract infections over one year that have symptoms including nasal discharge and blockage.

Most viral infections will resolve without treatment. A small percentage will progress to bacterial sinusitis that will require antibiotics for treatment. Narrowing or blockage of the nasal passages or sinus openings may increase the chances that a cold will progress to bacterial sinusitis.

In a small percentage of children, surgery may be necessary to relieve the blockage and open the sinuses or nasal passages. Younger children do not typically need surgery on the sinuses as their sinuses are still developing.

Younger children with frequent sinus infections often have their adenoid, a patch of tissue located where the nose and throat join, removed. The adenoid can be a haven for bacteria and block the nasal passages.

If sinus openings are blocked, they can be enlarged using special instruments. Both surgeries have a short recovery and can help immensely in the right patient.
Nationwide Children's Hospital's Rhinology Clinic is unique in that it offers allergy testing and endoscopic evaluation during the same visit. This allows both the allergist and otolaryngologist to determine an appropriate treatment plan.


Our family doctor says that our 10-year-old son may be developing Osgood-Schlatter Disease. I realize it has something to do with him growing so quickly, but what exactly is it and how serious is it? And is it something he'll have all his life?

Osgood-Schlatter Disease is an injury to a growth plate in the shin bone (tibia) in the front of the knee.A growth plate is softer and weaker than fully mature bone. Therefore, it is more susceptible to injury from either direct trauma (falling onto the front of the knee) or from repeated pulling on the growth plate from the tendon that attaches to it, which occurs during running, jumping and squatting activities.

Over time, this growth plate gets irritated and inflamed.Osgood-Schlatter Disease presents most commonly in girls ages 9 to 13 and boys ages 11 to 15 as pain, swelling and tenderness in the front of the knee below the kneecap.

It is typically a self-limited condition that resolves once the growth plate matures into adult bone, but symptoms can fluctuate over a few years. Symptoms usually get worse with increased levels of activity.

Treatment consists of activity modification, ice, anti-inflammatory medicines, exercises to improve lower extremity flexibility and strength and sometimes a knee strap or knee pad. Often, a course of physical therapy or functional rehab can correct the underlying strength and flexibility deficits and help ease the pain.

Coaches and parents should remind kids to warm up for 15 to 30 minutes before and after sports, and kids should never be encouraged to continue playing if injured.

We're hearing so much about pertussis this year. Why has it become such a problem again?

Pertussis, commonly known as "whooping cough," is a highly contagious bacterial disease that causes uncontrollable, violent coughing; it can even be life-threatening. According to the Centers for Disease Control and Prevention, more than half of infected infants less than 1 year of age must be hospitalized.

From January 2010 to Nov. 27, 2010, there were 1,546 cases of pertussis reported to the Ohio Department of Health. At the same time in 2009, only 995 cases were reported.

The pertussis vaccine offers immunity for about three years, then gradually decreases over the next few years. As this immunity wears off in children, reported pertussis cases increase.

The increase may also be a result of an increase in awareness among health care providers, an increase in the use of more sensitive diagnostic tests, an increase in reporting and an overall increase in circulating pertussis.

When an infected person sneezes or coughs, tiny droplets containing the bacteria move through the air, and the disease is easily spread from person to person. This makes it highly contagious in environments where kids are near each other, such as schools and daycares.

The best way to protect your child from pertussis is to get him or her vaccinated. It is also important for adults to be immunized, especially those in homes with infants under 12 months of age.