Inasmuch as the paranasal sinuses hide within the calvarium, they are literally out of sight and too often out of mind. Although the pediatrician is quick to recognize an abnormal eardrum or an impetiginous rash, the presence of copious purulent rhinorrhea may be labeled an upper respiratory tract infection even when the history suggests chronic duration. Frequently these children are dismissed as being "just" allergic. Why is sinus disease the source of confusion today? Much of the problem relates to radiologic studies that showed a significant incidence of abnormal sinus films in asymptomatic children1-3 as well as the casual comment in Caffey's radiologic textbook4 that any child who is crying would probably have cloudy sinuses, a statement never actually verified.