Back to Journals » Journal of Asthma and Allergy » Volume 5

Sinusitis and chronic cough in children

Authors Wilson NW, Hogan MB, Harper, Peele, Budhecha, Loffredo, Wong

Received 17 March 2012

Accepted for publication 18 April 2012

Published 3 July 2012 Volume 2012:5 Pages 27—32


Review by Single anonymous peer review

Peer reviewer comments 4

Nevin W Wilson, Mary Beth Hogan, Charles Bruce Harper, Kathy Peele, Sonia Budhecha, Vincent Loffredo, Vanessa Wong

University of Nevada School of Medicine, Department of Pediatrics, Section of Allergy, Immunology and Pulmonology, Reno, NV, USA

Background: Chronic cough in children is a common problem, and sinusitis is a common etiology. The diagnosis of sinusitis is often clinical, but confirmation is thought to require a CT scan due to the difficulty of interpreting a Water’s view sinus X-ray.
Objectives: The purposes of the study were (1) to examine the frequency of an abnormal sinus X-ray in children with a chronic cough of more than 4 weeks duration; (2) to compare the interpretation of the sinus film between allergy/pulmonary clinicians and radiologists; and (3) to correlate symptoms with X-ray results.
Methods: A chart review of 2- to 18-year-old patients with coughing exceeding 4 weeks was performed. Data was collected for patients who had received a Water’s view sinus film as part of their evaluation. Exam, X-ray results, and clinical outcomes were categorized and statistical analyses performed.
Results: A total of 86 patients were included. Clinicians found that 65% of the children had positive Water’s view films, compared with the radiologist’s reading of 62% (non significant). Significant associations between post-tussive emesis (P = 0.01) and purulence (P = 0.03) were noted with a positive film. Positive sinus X-ray was highly associated with all findings except wheeze when present together (P < 0.001).
Conclusions: Sinus abnormalities on X-ray are associated with prolonged cough in 65% of children. The Water’s view sinus film is a clinically useful screening tool for clinicians in the workup of chronic cough. Certain physical findings and clinical complaints, when present concurrently, correlate with the X-ray results.

Keywords: Water’s view sinus X-ray, asthma, allergic rhinitis, radiologist, post-tussive emesis, wheezing

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.