Sinusitis - what is it, types, causes, signs, symptoms and treatment of sinusitis in adults

Acute sinusitis: treatment, symptoms in adults and children?

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11/15/2017 The most common disease of the ENT organs is acute sinusitis.
The inflammatory process in the paranasal sinuses is provoked by viruses and microorganisms that enter the body through the respiratory system. Acute sinusitis can be diagnosed as a separate disease, or as a complication of other infectious diseases.

Chronic sinusitis - what is it?

Chronic sinusitis lasts for 3 months or more. The bony structures of the face and head include the sinuses (sinuses), which are hollow chambers filled with air. At the time of injury, the pockets provide shock absorption to the brain. The sinuses are connected to the nasal passages by narrow canals.

The nasal turbinates are lined with thin tissue. They produce mucus in moderate quantities. The liquid washes the sinuses, collects pathogenic microorganisms and, flowing through the anastomosis, removes them through the nasal passages and out of the body. It keeps air pockets clean and healthy.

When the mucous membranes become infected and irritated, fluid is intensively produced. The outflow of abundantly synthesized sputum is difficult due to swelling of the mucous membranes caused by inflammation, destructive tissue changes (thickening and overgrowth with polyps) and excessive narrowing of the anastomosis. Mucus accumulates in the sinuses, stagnates, thickens, and purulent processes develop in it. There is a complete or partial blockage of the canals.

The abundant production of pathogenic sputum continues until the infectious-inflammatory process that has broken out in the nasal sinuses stops. The described mechanism gives an understanding of what chronic sinusitis is. Manifestations that began in the acute period develop into the chronic stage after 12 weeks.

Sinusitis is caused by various pathogens. The disease is classified depending on the type of infectious agent. The following types of sinusitis are distinguished:

• bacterial;
• viral;
• fungal;
• allergic;
• polypous (formation of polyps on the mucous membranes);
• odontogenic (infection in the sinuses penetrates from nearby organs).

Chronic sinusitis manifests itself in the form of:

1. Sinusitis. The maxillary recesses become inflamed.
2. Frontita. The frontal turbinates become infected.
3. Sphenoiditis. The sphenoid sinus is affected.
4. Ethmoiditis. An infectious and inflammatory process develops in the voids of the ethmoid bone.

Factors that provoke the development of chronic sinusitis:

• allergic reactions;
• air polluted by tobacco smoke, chemical emissions, dust and other toxins;
• problems with the immune system;
• infections caused by viruses (influenza, ARVI, chronic rhinitis, tonsillitis);
• deviated nasal septum;
• nasal injuries.

Treatment

Drug treatment

Therapy for any form of sinusitis is always combined and includes local, symptomatic treatment and the use of antibacterial drugs.

Antibiotics. The main component in the treatment of sinusitis. Broad-spectrum antibiotics are necessary to destroy pathogenic bacteria that cause the progression of the disease and poison the body with released toxins.

Drugs in this group can be prescribed from the first day (after contacting an otolaryngologist), without waiting for the results of a clinical examination of the contents of the nasal cavity.

After receiving a response from the laboratory, as well as if the drug used is ineffective, the drug can be replaced with another antibacterial agent with dose adjustment.

Antihistamines . They are used in cases where there is a suspicion of an allergic nature of the disease or severe swelling of the mucous membrane. Necessary to block the production of histamine, which causes the clinical symptoms of sinusitis. Most often, patients are prescribed Suprastin, Tavegil, Claritin, Loratadine, etc.

Vasoconstrictors (“Naphthyzin”, “Sanorin”, etc.). They reduce nasal flow, reduce mucus production, eliminate swelling by widening the anastomosis and allowing the contents of the sinuses to drain naturally.

Mucolytic drugs (Sinupret, ACC, Rinofluimucil). They thin the mucus and make it less viscous.

Antipyretics and analgesics . They reduce the severity of the symptomatic picture of the disease - lower the temperature, relieve increased pain, and improve overall well-being. This includes all drugs based on paracetamol and ibuprofen.

Antipyretics are not the best choice when treated with antibiotics simultaneously , as they put a lot of strain on the liver. In addition, a decrease in temperature weakens the body's defenses. You can use such drugs only in case of hyperthermia of more than 38.5 degrees (38 in children and adolescents) or if fever is poorly tolerated. In other cases, their use is not justified.

Victoria Druzhikina

Neurologist, Therapist

Physiotherapy

Prescribed only as an auxiliary component of therapy while taking antibiotics and other medications. Physiotherapy has a beneficial effect on metabolic processes in the affected area, strengthens local immunity, which speeds up recovery.

Depending on the location of the inflammation and other indications, the patient may be prescribed the following procedures:

• Ural Federal District;
• electrophoresis;
• UHF, etc.

Surgery

If conservative treatment is ineffective, the doctor may prescribe a surgical puncture or puncture of the sinuses. During this operation, a puncture is made with a sterile needle, the purulent contents are washed out of the sinus, after which an antiseptic solution is injected inside.

The procedure is a simple surgical procedure, and complications after it are diagnosed extremely rarely.

To perform a puncture, the patient must be admitted to a hospital; this procedure is not performed on an outpatient basis.

To learn how to recognize sinusitis and how to treat it correctly, watch the video:

This article has been verified by a current qualified physician, Victoria Druzhikina, and can be considered a reliable source of information for site users.

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Symptoms

Thickening of the sinus membranes is a typical sign of chronic sinusitis. In chronic sinusitis, the symptoms are not as severe as in the acute form of the disease. The exacerbation period lasts only 10 days. Before signs of a chronic form of the disease appear, the patient is able to endure several phases of the acute stage of the disease over the course of a month.

Symptoms of the chronic stage:

• discharge of thick, purulent yellow-green sputum;
• swelling in the localization of the sinuses (on the eye sockets, nose, cheeks and forehead);
• feeling of pressure in the affected area;
• dulled sense of smell;
• loss of taste;
• headache;
• pain in the affected areas, radiating to the ears, cheeks, jaw, teeth;
• a sore throat;
• discomfort in the ears;
• cough that gets worse at night;
• bad odor from the mouth;
• nasal congestion, runny nose;
• violation of nasal breathing;
• lethargy, fatigue, irritability;
• temperature, chills, fever;
• nausea.

Classification of frontal sinusitis

The disease is distinguished according to several characteristics.

By origin of infection:

• bacterial;
• viral;
• allergic;
• fungal;
• traumatic;
• medicinal;
• mixed.

According to the course of the disease, they are distinguished:

• spicy;
• chronic.

The infection is also classified according to the nature of the discharge:

• catarrhal;
• purulent.

Based on the localization of the process, left-sided and right-sided frontal sinusitis is distinguished.

Consequences

The chronic stage of the disease leads to serious complications. She calls:

• infection of the lacrimal sac;
• diseases of the ENT organs: tonsillitis, pharyngitis, laryngitis, otitis media;
• oxygen starvation is a characteristic factor of sinusitis in the chronic stage (with hypoxia, the whole body suffers, but most of all the brain - attention, memory, thinking are impaired, and performance decreases);
• infection of facial tissues;
• respiratory diseases (bronchitis, pneumonia, tracheitis);
• meningitis, encephalitis, brain abscess (when a complication causes the development of purulent-inflammatory processes in the cavity of the cranium, a threat to the patient’s life is created);
• decreased vision up to its loss;
• sepsis (infection, having penetrated the blood, spreads to all organs and tissues).

We must understand that any type of sinusitis that occurs chronically leads to dangerous consequences that undermine health and threaten life. Infectious and inflammatory processes are localized near the brain and other important organs. Therefore, you need to consult a doctor on how to cure chronic sinusitis and what adequate methods to suppress the manifestation of the disease.

Surgery

When medications are not able to fight the disease,

Performing trephine puncture in acute frontal sinusitis

The patient is scheduled for surgery. It is especially indicated if, in addition to the main symptoms of acute frontal sinusitis, there are constant and prolonged headaches and frequent increases in body temperature.

The most popular method of surgical intervention is trephine puncture, which is determined by dissection of the frontal lobes and release of purulent contents. In addition to its widespread use, the procedure has some disadvantages. The main one is injuries to the skin and bones, which take a long time to heal.

Modern, increasingly popular, procedures for the treatment of acute sinusitis are:

1. Sinus puncture is performed using a special thin needle; the manipulation lasts no more than 15 minutes and is quick and painless. Complications and scars are usually absent.
2. An operation using an endoscope is aimed at widening the opening in the frontal sinus and the natural outflow of discharge.

How to treat sinusitis in the chronic stage

Treatment of chronic sinusitis in adults is carried out comprehensively. Combination treatment helps to cope with the disease and its root cause. First of all, they eliminate infections that support inflammation that frolics in the nasal pockets (they treat caries, pulpitis, stomatitis, remove adenoids, polyps, and eliminate other associated pathologies).

Restore and stimulate the outflow of pathogenic mucus stagnant in the nasal sinuses and anastomoses. To remove sputum, various medicines and folk remedies, physiotherapeutic methods and radical methods are used.

Drug therapy

For chronic sinusitis, treatment is carried out with the following medications:

1. Local steroid drops and sprays. They are suitable for eliminating all types of disease and advanced conditions. Prescribe Betamethasone or Triamcinolone. Medicines suppress inflammation and relieve swelling. In severe cases, the attending physician prescribes glucocorticoid tablets - Prednisolone. The medicine suppresses immune reactions in the body and produces many side effects. It is not prescribed unless absolutely necessary. The course of treatment with corticosteroids can last 3 months. They are not prescribed during pregnancy, lactation, or elderly patients (55 plus).
2. Antibiotics. Antibacterial drugs for chronic sinusitis are prescribed for 10-30 days. They kill pathogenic microflora. Prescribed drugs from the class of penicillins or cephalosporins.
3. Antifungal medications. These medications are taken if the disease is caused by fungi.
4. Antileukotriene drugs (Montelukast, Zafirlukast or Zileuton). They reduce inflammation. They are recommended to be taken for nasal congestion, which is accompanied by asthma and polyposis.
5. Anesthetics. For pain relief, take Aspirin, Acetaminophen, Ibuprofen.
6. Antihistamines (Tavegil, Suprastin). They are prescribed if chronic sinusitis in adults caused by allergens has developed.

Causes

In frequent cases, acute frontal sinusitis is a consequence of the activity of pathogenic microbes. Therefore, the presence of an infectious process aggravates the course of the disease and provokes the formation of complications.

When various microbes and viruses are adsorbed on the mucous membrane, they quickly multiply and penetrate deep into the body, localizing in one or two sinuses.

In addition to this reason, factors in the development of pathology can be:

1. Low immune status resulting from
   Always receive further treatment for acute respiratory viral infections, influenza, acute respiratory infections to avoid the development of frontal sinusitis

   deficiency of vitamins and important elements, after surgery and other reasons.

2. Acute respiratory diseases affecting the nasal cavity and sinuses.
3. Infectious processes that currently exist or have not been fully cured (ARVI, acute respiratory infections, influenza).
4. The appearance of polyps.
5. Various forms of injury to the nose, septum and skull bones.
6. Poor environment (dirty air, presence of physical or chemical irritants).
7. Penetration of foreign bodies into the nasal cavity.

The risk of acute frontal sinusitis is especially high among people with chronic pathologies of an infectious nature, for example, sinusitis, tonsillitis, and others.

In this case, the microbes enter an environment that is already formed and favorable for them, and quickly multiply.

Methods of surgical treatment

If conservative therapy does not help, then how to treat chronic sinusitis? Drainage in the nasal sinuses is restored through surgery. The patient undergoes endoscopy. The surgeon removes damaged tissue that has blocked the natural flow of mucus from the nasal pockets, or performs partial excision.

Endoscopy improves the outflow of mucus, nasal breathing, natural ventilation of tissue structures, and returns the functioning of the sinuses to normal. The technique refers to minimally invasive surgical interventions. During the procedure, minor injuries are caused to the patient.

Features of treatment in children

As for small children, all treatment procedures must be carried out in a hospital setting under the close supervision of a doctor.

Treatment in this case is determined by several methods, which are determined by a medical specialist, based on the condition of the baby and the form of the disease.

• To ease breathing and reduce swelling in the nasal cavity, nasal drops, inhalations, antibiotics and surgery are used.
• Sinupret drops are considered effective; they must be used for a certain time; long-term use is prohibited. Due to their minimal contraindications and side effects, they are widely used for the treatment of acute frontal sinusitis.
• Inhalations are done using medications or folk remedies - bay leaves, medicinal plants and potatoes.
• Surgical treatment is prescribed in extreme cases if drug therapy does not have the desired effect.

How to treat sinusitis at home

Many patients use methods that explain how to cure sinusitis at home. Home methods include: inhalation, washing the nasal turbinates, using folk remedies (drops, ointments, decoctions, infusions).

Effective home treatment methods:

1. A 2% mummy solution is instilled into the nasal passages. Inject daily 3 times, 3 drops into each channel. Take a 10-day course.
2. Take 0.1 g of mumiyo orally. Treatment lasts 10 days.
3. Steam inhalations. For the procedure, take fir or eucalyptus oil, soda, chamomile or sage infusion. Warm water vapor is inhaled while the scent of essential oils and herbs is felt. An important rule for inhalations is that the procedure is not performed if the body temperature is elevated. In this case, the infection instantly spreads throughout the body.
4. Washing the sinuses and nasal canals helps a lot. For rinsing, use saline solution, herbal decoctions: St. John's wort, chamomile, calendula, sage. Brew 1 teaspoon of raw material into 200 ml, allow to cool to 40 0 ​​C, filter, and use for the procedure.
5. To relieve inflammation and strengthen the immune system, drink an infusion of St. John's wort. Brew 20 g of herb in 200 ml of water, leave until it cools down, filter, divide into 3 portions and drink throughout the day. Treatment lasts 10-14 days.

Treatment methods in adults

Treatment procedures for adults are almost no different from those prescribed for children. The only differences are in the types of drugs and the fact that children use more gentle methods.

The following is used as treatment in adults:

1. Medicines.
2. Surgical intervention.
3. Traditional methods.

Treatment procedures begin only after a full examination, when the doctor makes an accurate diagnosis. In this case, according to the severity and form of the pathology, the patient is prescribed antibiotics, vasoconstrictor drops, decongestants and antiallergic drugs.

On our portal you can read what antibiotics are used for Frontitis.

The full range of treatment for Frontitis is also presented in this article.

• With an infectious etiology, the patient may need antipyretic drugs - Paracetamol, Ibuprofen. All medications must be used only after the indication of a medical specialist, so as not to provoke the development of side effects and overdose.
• When using traditional medicine in treatment, you should also consult a doctor. If there are no contraindications, you can use prescriptions. They are most effective at the initial stage, when the symptoms are less pronounced and there are few of them.
• At home, to treat acute frontal sinusitis, medicinal decoctions are used to rinse, drops are made, and turunda is injected into the nasal passages to reduce swelling and nasal discharge.

Prevention

Cured chronic sinusitis can return; to avoid relapses, prevention should be followed:

• do not expose the body to hypothermia. Pathogens are easily activated at low temperatures. After being in the cold, you need to take warm drinks and take foot baths;
• use vitamin-mineral complexes. A person who is not deficient in minerals and vitamins has a strong immune system. His body is able to resist infections;
• treat completely infectious diseases (flu, acute respiratory infections, sore throat and other pathologies). Untreated exacerbations easily degenerate into chronic forms and cause serious complications.

Chronic sinusitis is a serious infectious disease that results in dangerous complications. Strong immunity and timely treatment of viral diseases prevent the occurrence of undesirable consequences.

When the doctor has identified the symptoms and prescribed treatment for adults, all that remains is to strictly follow all the recommendations and take the prescribed medications. This will prevent the disease from developing into severe forms and will avoid surgical intervention.

Sinusitis

– an infectious-inflammatory process affecting the mucous membrane of the paranasal sinuses. May be viral, bacterial, fungal or allergic in nature. Common symptoms that characterize the course of sinusitis include increased body temperature, pain in the projection of the paranasal sinuses, difficulty in nasal breathing, and serous-purulent discharge from the nose. Sinusitis is recognized on the basis of radiography, ultrasound, CT and MRI of the paranasal sinuses, and diagnostic puncture. For sinusitis, antibiotic therapy, physiotherapy, therapeutic lavage, puncture and drainage, traditional and endoscopic operations on the paranasal sinuses are carried out.

What is the frontal sinus?

Location of the frontal paranasal sinuses

The frontal sinus is one of the accessory sinuses (pockets) of the nose. It is steamy, located in the forehead area directly above the eyes and is connected to the nasal cavity by deep channels. The inside of the sinus is lined with mucous membrane and contains air.

When viruses or bacteria enter the frontal sinus through the nose, its mucous membrane becomes inflamed. Fluid drainage is difficult due to swelling of the drainage channels and the viscosity of the discharge.

The accumulated inflammatory exudate presses on the walls of the sinus and causes headaches. The peculiarity of the pain syndrome is that it intensifies in the morning, because mucus drainage worsens at night. The pain also intensifies when tilting the head forward or to the sides.

General information

Sinusitis is an inflammatory process in one or more paranasal sinuses. Sinusitis is diagnosed in 0.02% of the adult population; In children, upper respiratory tract infections are complicated by the development of sinusitis in 0.5% of cases. In otolaryngology, sinusitis includes inflammation of the maxillary sinus - sinusitis, frontal sinus - frontal sinusitis, sphenoid sinus - sphenoiditis, ethmoid labyrinth - ethmoiditis. According to the current, acute and chronic sinusitis are distinguished. There is fever, headache, congestion and purulent discharge from the nose, swelling of the face in the area of ​​the inflamed sinus. If left untreated, serious complications develop: inflammation of the optic nerve and membranes of the eye, osteomyelitis, brain abscess, meningitis.

Diagnostics

Methods for diagnosing chronic sinusitis are:

1. Anamnesis collection (patient interview). The ENT doctor determines the duration of the disease, the patient’s complaints and risk factors for the development of sinusitis.
2. Visual inspection. Pay attention to the area of ​​the nose and bridge of the nose, periorbital space, eyelids and eyeballs.
3. Rhinoscopy. Allows you to determine the condition of the nasal mucosa. The inspection is carried out using mirrors and an expander. Signs of inflammation are redness, swelling, the presence of pus in the upper nasal passages and a decrease in the lumen of the nasal passage.
4. Ultrasound of the sinuses.
5. Radiography. The image shows a darkening (an area with accumulated secretions).
6. Diagnostic puncture.
7. General blood analysis. During periods of exacerbation, moderate leukocytosis (increased white blood cells) and accelerated ESR are observed.
8. Bacteriological analysis of secretions. Helps identify the pathogen and select medications.
9. CT scan. It is an alternative to radiography. Allows a detailed assessment of the condition of the cavities of the skull and bones.
10. Cytological analysis. It is carried out when new growths are detected.

Causes of sinusitis

The nasal cavity communicates with seven paranasal sinuses: two frontal, two maxillary, two ethmoid and one sphenoid. The sinuses are connected to the nasal cavity by narrow passages. Through these passages, constant drainage (cleaning) of the sinuses is carried out. If the sinuses for some reason stop clearing, secretions stagnate in them and favorable conditions are created for the development of sinusitis.

The openings of the nasal sinuses can be blocked due to various deformations of the intranasal structures (hypertrophic rhinitis, curvature of the nasal septum, abnormalities in the structure of the ethmoid labyrinth and nasal concha). Viral infection is another risk factor for sinusitis. As a result of inflammation, the mucous membrane of the paranasal sinuses and nasal cavity swells. The mucous glands begin to produce large amounts of secretion. The openings of the paranasal sinuses narrow further due to swelling of the mucous membrane and become clogged with thick pathological secretions.

Impaired ventilation, stagnation of secretions and oxygen deficiency in the tissues of the sinuses become the impetus for the intensive development of opportunistic flora. A viral infection is accompanied by a bacterial one. The severity of sinusitis depends on the virulence of the microbes that cause inflammation. The widespread use of antibiotics leads to the fact that the bacterial flora that causes the development of sinusitis is often characterized by increased resistance (resistance) to most antibiotics.

In recent years, sinusitis is increasingly caused by fungi. The reason for this trend also lies in the unjustified use of antibiotic therapy, which negatively affects the state of the immune system, disrupts the normal composition of the microflora and creates favorable conditions for the development of mycotic infections. Sinusitis at the initial stage is not necessarily caused by microbes. Swelling of the mucous membrane, leading to the closure of the anastomosis of the paranasal sinuses, can be caused by inhalation of cold air and a number of chemicals.

Causes and risk factors

Inflammation of the paranasal sinuses (sinuses) is promoted by:

1. Acute viral and bacterial infections (adenovirus, rhinovirus, influenza, parainfluenza, measles, scarlet fever, respiratory syncytial infection).
2. Mycoses (diseases caused by fungi).
3. Rhinitis (inflammation of the nasal mucosa).
4. Contact with allergens. Promotes the development of allergic sinusitis. A large number of cases of acute sinusitis are caused by contact with household, natural and industrial allergens (dust, pollen). Less commonly, the nasal mucosa becomes inflamed and swollen due to consumption of allergenic foods (strawberries, nuts, citrus fruits), taking medications, administration of immunological drugs and contact with insects.
5. Sepsis.
6. Foci of bacterial infection in other organs (tonsils, lungs, teeth, middle and inner ear).
7. Caries.
8. Abscesses.
9. Hypothermia.
10. Contact with sick people (sources of infection).

Predisposing factors for the development of sinusitis in adults include smoking, head injuries, the presence of polyps in the nasal passages, an uneven nasal septum, foreign objects, increased allergies (a history of allergic pathology), abnormalities in the structure of the sinuses and nasal turbinates, cysts, tumors, harmful occupational factors and adenoids.

Classification

Depending on the location of the process, the following types of sinusitis are distinguished:

• Sinusitis. The inflammatory process affects the maxillary (maxillary) sinus.
• Ethmoiditis. Inflammation develops in the ethmoid labyrinth.
• Frontit. The pathological process covers the frontal sinus.
• Sphenoiditis. Inflammation occurs in the sphenoid sinus.

The first place in prevalence is occupied by sinusitis, the second by ethmoiditis, the third by frontal sinusitis and the fourth by sphenoiditis. One- or two-sided damage is possible. The process may involve one or more sinuses. If the inflammation covers all the paranasal sinuses, the disease is called pansinusitis.

All sinusitis can occur acutely, subacutely or chronically. Acute sinusitis is usually provoked by a runny nose, flu, scarlet fever, measles and other infectious diseases. The disease lasts 2-4 weeks. Subacute sinusitis most often results from improper or insufficient treatment of acute sinusitis. Symptoms of the disease in subacute sinusitis last from 4 to 12 weeks. Chronic sinusitis becomes the outcome of repeated acute sinusitis of infectious etiology or develops as a complication of allergic rhinitis. The criterion for chronicity of the process is the presence of sinusitis symptoms for 12 weeks or more.

Depending on the nature of the inflammation, there are three forms of sinusitis:

• edematous-catarrhal. Only the mucous membrane of the paranasal sinuses is affected. The process is accompanied by the release of serous discharge;
• purulent. Inflammation spreads to the deep layers of tissue of the paranasal sinuses. The discharge becomes purulent;
• mixed. There are signs of edematous-catarrhal and purulent sinusitis.

What is sinusitis - video

Types of acute sinusitis:

1. Frontal sinusitis, or frontal sinusitis, affects only the frontal parts of the paranasal space.
2. The ethmoidal type of disease affects the ethmoid sinuses.
3. Sinusitis occurs when the maxillary sinuses become inflamed. Depending on the nature of the spread of the inflammatory process, sinusitis can be left-sided, right-sided or bilateral.
4. Sphenoiditis - the disease affects the wedge-shaped sections of the paranasal space.

Forms of acute sinusitis:

• Catarrhal. In this case, nasal discharge has a transparent appearance and a liquid consistency.
• Purulent form. With purulent acute sinusitis, thick mucus mixed with pus is released from the nasal passages.

Often the inflammatory process affects both sides of the paranasal space. With bilateral sinusitis, the clinical symptoms are symmetrical: the patient feels pain on both sides, both nasal passages are blocked.

Symptoms of sinusitis

Clinical manifestations of sinusitis are described in detail in the article “Sinusitis”.

Symptoms of ethmoiditis

As a rule, the inflammatory process in the anterior sections of the ethmoid labyrinth develops simultaneously with frontal sinusitis or sinusitis. Inflammation of the posterior sections of the ethmoidal labyrinth is often accompanied by sphenoiditis.

A patient with ethmoiditis complains of headaches, pressing pain in the bridge of the nose and root of the nose. In children, pain is often accompanied by conjunctival hyperemia and swelling of the internal parts of the lower and upper eyelids. Some patients experience neurological pain.

Body temperature usually rises. The discharge in the first days of the disease is serous, then becomes purulent. The sense of smell is sharply reduced, nasal breathing is difficult. With severe sinusitis, inflammation can spread to the orbit, causing protrusion of the eyeball and severe swelling of the eyelids.

Symptoms of sinusitis

Frontal sinusitis, as a rule, is more severe than other sinusitis. Characterized by hyperthermia, difficulty in nasal breathing, and discharge from half of the nose on the affected side. Patients are concerned about intense pain in the forehead area, more pronounced in the morning. Some patients develop a decreased sense of smell and photophobia, and pain in the eyes.

The intensity of headaches decreases after emptying the affected sinus and increases when the outflow of contents becomes difficult. In some cases (usually with influenza frontal sinusitis), a change in skin color in the forehead, swelling of the eyebrow area and the upper eyelid on the affected side are detected.

Chronic sinusitis is often accompanied by hypertrophy of the mucous membrane of the middle nasal meatus. Polyps may appear. Sometimes inflammation spreads to bone structures, leading to their necrosis and the formation of fistulas.

Symptoms of sphenoiditis

Sphenoiditis rarely occurs in isolation. Usually develops simultaneously with inflammation of the ethmoid sinus. Patients complain of headaches in the orbit, the area of ​​the crown and back of the head, or the depth of the head. In chronic sphenoiditis, inflammation sometimes spreads to the optic chiasm, leading to progressive loss of vision. Often chronic sphenoiditis is accompanied by mild clinical symptoms.

How it manifests itself

Sinusitis can be difficult to distinguish from a common runny nose, especially in the early stages. Symptoms indicating the development of the disease include:

• copious discharge from the nose, which can have a different character - transparent, yellowish, greenish, etc.;
• pain localized in the area of ​​the upper jaw, forehead or bridge of the nose;
• unpleasant sensations that occur when pressing on the bridge of the nose and points at the wings of the nose;
• weakness, fatigue, fever and deterioration in general health.

If you have such symptoms, you should consult a doctor as soon as possible - timely diagnosis and treatment will help avoid serious complications.

REFERENCE! To determine sinusitis, you can do a small test - tilt your head forward for a few minutes. If there is a feeling of heaviness in the forehead, upper jaw or nose, the likelihood of sinus inflammation is very high, but only a doctor can make an accurate diagnosis.

Complications of sinusitis

With sinusitis, the pathological process may involve the orbit and intracranial structures. Inflammation spreading deeper can lead to bone damage and the development of osteomyelitis. The most common complication of sinusitis is meningitis. The disease most often occurs with inflammation of the ethmoid labyrinth and sphenoid sinus. With frontal sinusitis, an epidural abscess or subdural (less commonly) brain abscess may develop.

Timely diagnosis of complications with sinusitis is sometimes difficult due to mild clinical symptoms. Advanced intracranial complications of sinusitis have an unfavorable prognosis and can cause death.

Case history of acute frontal sinusitis and where is it localized?

Acute frontal bilateral sinusitis
Acute frontal sinusitis is determined by a severe clinical course. Therefore, it is especially dangerous in childhood. Various processes and a sharp decrease in immune status can provoke the appearance of the disease.

As a rule, depending on the severity and cause, acute frontal sinusitis, according to localization, is divided into:

- left-sided - this form of the disease is characterized by a predominant lesion of the left side of the frontal sinus. A person experiences unpleasant symptoms, severe headaches, respiratory problems, high fever and general malaise.

Depending on the development factors of acute frontal sinusitis on the left side, it can be exudative or productive. In the first case, purulent or catarrhal contents are formed. In the second type, cyst-like compactions often form or parietal hyperplastic processes occur. In any case, timely treatment is necessary in both situations, especially if the patient has additional infectious pathologies.

- right-sided - expressed by damage to the right part of the frontal sinus. This acute frontal sinusitis has similar symptoms to left-sided sinusitis. The patient, as a rule, experiences vivid symptoms, his performance decreases and problems with nasal breathing appear.

In the absence of therapeutic intervention, the disease can progress and spread to both sides. Therefore, if an initial pathology clinic occurs, you should immediately visit a doctor.

- bilateral - the most severe form of acute frontal sinusitis, since two parts of the frontal sinuses are affected at once. In this case, the most striking symptoms are observed, the person experiences significant breathing problems, and there are throbbing headaches localized on the brow ridges. This form is especially dangerous for young children, since the risk of death is high in advanced conditions. If acute frontal sinusitis is at the initial stage of development, the prognosis is more favorable. Treatment depends on the cause, the patient’s age and other characteristics.

According to the ICD, acute frontal sinusitis is assigned code J01.1.

Diagnosis of sinusitis

The diagnosis of sinusitis is made on the basis of a characteristic clinical picture, an objective examination and additional research data. In the diagnostic process, radiography of the paranasal sinuses in two projections, ultrasound, nuclear magnetic resonance and CT scan of the paranasal sinuses are used. According to indications, a CT or MRI of the brain is performed to exclude complications.

Physiotherapy

Magnetic therapy device for the treatment of acute sinusitis

For better separation of nasal mucus and quick recovery, doctors often resort to physiotherapy. Of these, magnetic therapy is considered the most common for acute frontal sinusitis. It is prescribed to both adults and children and is determined by the use of high-frequency electromagnetic waves.

UHF is not used that often. For additional therapy, the patient may be prescribed a blue lamp, thermal manipulation and compresses if there is no purulent substance in the frontal sinuses.

Physiotherapy lasts no more than 21 days; for each patient, the duration of therapy is set individually, depending on the form and severity of the disease.

Treatment of sinusitis

Therapy for acute sinusitis is aimed at relieving pain, eliminating the cause of the inflammatory process and restoring drainage of the sinuses. To normalize the outflow, otolaryngologists use vasoconstrictor drugs (naphazoline, oxymetazoline, xylometazoline, etc.), which eliminate swelling of the mucous membrane of the nasal cavity and sinus cavity.

The sinus evacuation method finds practical application for sinusitis. The procedure is carried out as follows: two catheters are inserted into different nasal passages. The antiseptic is fed into one catheter and aspirated through the other. Together with the antiseptic, pus and mucus are removed from the nasal cavity and sinus cavity.

For bacterial sinusitis, antibiotics are used. To free the sinus from pus, it is opened (sinusrotomy, etc.). For viral sinusitis, antibiotic therapy is not indicated, since antibiotics in this case are ineffective, can aggravate the disorder of the immune status, disrupt the normal composition of the microflora in the ENT organs and cause the process to become chronic.

Patients with acute sinusitis are prescribed antihistamines and absorbable drugs (to prevent the formation of adhesions in the inflamed sinuses). Antiallergic therapy is indicated for patients with sinusitis of allergic etiology. Treatment of exacerbation of chronic sinusitis is carried out according to principles similar to the treatment of acute inflammation. Physiotherapeutic procedures (diadynamic currents, UHF, etc.) are used during the treatment process.

Acute sinusitis: treatment methods

Effective treatment of acute sinusitis involves the use of different medications.

Antibiotics

Before prescribing an antibacterial agent, the attending physician must know which pathogen provoked the disease, and also take into account the severity of the disease and possible side effects. Typically, the patient is prescribed broad-spectrum antibiotics: Amoxiclav, Amoxicillin, Ciprofloxacin and other drugs . Self-prescribing antibiotics is not recommended.

Vasoconstrictors.

Vasoconstrictors based on xylometazoline and oxymetazoline will help ease breathing and relieve swelling of the mucous membrane. However, it is worth remembering that drugs in this group are not used for more than a week, otherwise addiction to them may occur.

Antihistamines.

Typically, antiallergic drugs are prescribed if acute sinusitis is of an allergic nature. Antihistamines quickly relieve swelling and help normalize breathing.

Illness season: sinusitis

How to recognize sinusitis in all its guises and how to treat it

It’s autumn outside, the rainy season is open, which means that very soon patients with fever and complaints of headache, runny nose, and loss of the ability to smell will come to see an ENT doctor. When an otolaryngologist hears about these symptoms, the first thing they will think about is acute sinusitis.

What is sinusitis and how does it happen?

In order to better understand what, where and how it hurts, you need to imagine what the upper respiratory tract looks like.

Around the nasal cavity, in the thickness of the bones of the same name, there are four paired air-bearing formations - the maxillary, frontal, ethmoid and sphenoid sinuses. All of them are covered from the inside with a mucous membrane and communicate with the nasal cavity through small anastomoses. Normally, the mucous membrane of the paranasal sinuses constantly produces a small amount of fluid, thereby self-cleaning itself from dust and microorganisms that enter it from the nasal cavity.

When a person gets sick, the mucous membrane of the sinuses ceases to cleanse itself, swells, swells, which is why the already narrow communication between the sinus and the nose becomes even smaller, the amount of fluid produced increases, and its outflow becomes more difficult, and air circulation worsens. All this creates excellent conditions for the proliferation of microorganisms, which cause symptoms of the disease.

Sinusitis is an inflammation of the mucous membrane of the sinuses, which are located around the nasal passages. Many people believe that sinusitis and sinusitis are the same thing, but this is not entirely true. Sinusitis is a subtype of sinusitis, one of five.

If the maxillary sinus becomes inflamed, it really is sinusitis. Inflammation of the frontal sinus is called “frontitis,” the ethmoid sinus (these sinuses are located in the area of ​​the bridge of the nose) is called ethmoiditis, and the sphenoid sinus (above the bridge of the nose) is called sphenoiditis. In some “lucky” people, all sinuses become inflamed at once, and this disease is called pansinusitis. The share of sinusitis among all ENT diseases is 36%.

Causes and most common symptoms

The cause of sinusitis can also be an allergy, but most often sinusitis is an infectious disease caused by microorganisms (viruses, less often bacteria or fungi).

For example, sinusitis can occur after a sore throat or acute respiratory viral infection, in rare cases - as a complication of caries of the teeth of the upper jaw. People most often suffer from sinusitis in the fall and winter, when due to vitamin deficiency and constant stress the body is weakened and cannot resist infection. But cases of the disease also occur in the warm season.

Read also: Mister Cough: how to treat him

You can suspect sinusitis if:

• you recently had an acute respiratory viral infection, a sore throat, or your upper tooth hurt;
• you have a stuffy nose, there is constant nasal discharge, often purulent in nature - yellow-green, thick;
• you feel general malaise, weakness, you have a high temperature, reaching 38–39 degrees;
• you are accompanied by a constant headache, which may intensify when you tilt your head and change your body position;
• you stopped smelling;
• In children, the disease may be accompanied by a cough.

We determine the type of sinusitis ourselves

With sinusitis, pain in the area of ​​the upper jaw and cheekbones bothers you; due to severe inflammation, half of the face or head on the side of the diseased sinus may hurt. If you press on the upper jaw near the nose, the discomfort will intensify. Sometimes redness and swelling may be observed in the upper jaw area. The nose is blocked on the side of the diseased sinus; if both sides are affected, a person can only breathe through the mouth due to the impossibility of nasal breathing. The general condition worsens, body temperature rises, weakness and fatigue appear.

Frontal sinusitis is more severe than other sinusitis. Patients complain of intense pain in the forehead due to inflammation and headache. If you press on the eyebrows - the projection of the frontal sinus - the unpleasant sensations intensify. With severe inflammation, redness and swelling of the skin over the sinus may occur. The nose may be blocked and unable to smell. Symptoms of intoxication of the body are very pronounced. The temperature rises to 38–39 degrees.

Ethmoiditis can be suspected if the pain is localized in the bridge of the nose; people often say that their eyes hurt. The nose is stuffy on the affected side, and the sense of smell may be more or less reduced. The general condition suffers moderately. The temperature can rise to 38 degrees.

Sphenoiditis very rarely comes alone. Most often it is accompanied by ethmoiditis, less often by frontal sinusitis and sinusitis, so very often its symptoms are masked by the more striking manifestations of other sinusitis. However, sphenoiditis can be suspected if the pain is localized to the back of the head or deep in the head. The temperature does not rise much.

What will the doctor prescribe?

If you find symptoms of acute sinusitis, you need to contact an otolaryngologist who will prescribe you the appropriate list of examinations and treatment. He will listen to you, examine you, and perhaps prescribe an X-ray examination of the paranasal sinuses, CT, or MRI.

Therapy for sinusitis has two goals: to improve the outflow of fluid from the paranasal sinuses and to eliminate the cause of inflammation. Vasoconstrictor nasal drops are usually prescribed; in a hospital setting, the sinuses are washed with an antiseptic solution. The procedure is performed using two catheters that are inserted into the sinus. An antiseptic solution is supplied through one, and the medicine flows out through the other.

Together with the antiseptic, everything unnecessary - pus and pathogens - goes away. If the cause of sinusitis is bacteria, a course of antibiotics is prescribed. If nothing helps, the doctor will suggest surgery. But this is the most extreme case, to which it is better not to go. This means you need to see a doctor as soon as possible.

Forms and symptoms of the disease

There are two stages of sinusitis – acute and chronic.

It is much more difficult to treat chronic sinusitis, so it is important to contact an ENT doctor at the first signs of the disease, which always begins in the acute stage.

The most important symptom of any form of sinusitis is headache. It is intense and intensifies when the position of the head changes (tilts, turns, etc.). For example, with sinusitis, painful sensations become almost unbearable when bending down and forward. Find out about other possible causes of headaches here.

Since pain is the only sign of damage at the initial stage, some ignore this symptom, trying to neutralize the sensations with the help of analgesics. As a rule, this measure does not bring the expected result.

It is quite simple to distinguish pain due to sinusitis from migraine, since it is not tied to any specific area, but can spread throughout the entire head, frontal, occipital parts, and also affect the face and even the jaw (this especially often happens when the maxillary sinuses are affected) .

Localization of pain depending on the type of sinusitis

If the disease occurs in an acute form, it will be characterized by the following symptoms:

• difficulty breathing through the nose caused by swelling of the mucous membranes;
• discharge of pus (green, brown or yellow) or mucus mixed with blood streaks;
• cough and sore throat (without sputum discharge);
• dryness of the nasal mucosa;
• temperature rise to 38-39 degrees;
• disruption of the olfactory receptors.

The acute stage is always accompanied by signs of intoxication of the body.

This occurs due to the activity of bacteria that release toxic substances and poison the body.

With chronic sinusitis, which appears as a result of improper or delayed treatment, the symptoms are less pronounced. Headaches subside, appearing mainly after physical activity or sudden movements. The temperature remains at low-grade levels and rarely rises above 37.2-37.5 degrees.

Doctor's advice

Vasoconstrictor drops should not be used without medical supervision for more than a week. They lead to drying out of the mucous membrane, the vessels become brittle, and nosebleeds occur, which are difficult to stop due to thinned vessels. Also, addiction occurs, the drops stop helping. In addition, blood pressure may increase due to the fact that the vessels collapse not only in the nasal cavity, this especially often occurs with an overdose of drugs.

Victoria Druzhikina Neurologist, Therapist

Also, the chronic form is characterized by sluggish symptoms of respiratory diseases: cough, nasal congestion, signs of a prolonged runny nose, etc.

Taking medications for the purpose of symptomatic therapy for chronic sinusitis is ineffective.

What are the symptoms of chronic sinusitis?

The most obvious and unpleasant symptom is nasal congestion. In addition, the patient may be concerned about:

• runny nose;
• greenish or yellow discharge;
• decreased sense of smell;
• discomfort or pain over the affected sinus;
• headache;
• bad breath;
• toothache;
• cough;
• a feeling of pressure or fullness in the ears;
• general fatigue.

What are the signs and where does it hurt with sinusitis?

The severity of symptoms may increase or decrease. Sinusitis is considered chronic when symptoms last more than 12 weeks.

The following factors can increase the risk of chronic sinusitis:

• allergy;
• exposure to tobacco smoke or environmental toxins (formaldehyde, etc.);
• immune system problems;
• viral infections.

Traditional recipes for chronic sinusitis

For prolonged sinusitis for treatment in adults, steam inhalations with herbs with anti-inflammatory properties: chamomile, sage, calendula are considered an effective means of traditional medicine. Such procedures help free the sinuses from purulent contents.

To treat chronic sinusitis, drops from Kalanchoe juice are used, which relieve inflammation and exhibit antibacterial properties. To prepare drops from Kalanchoe juice, the lower leaves are thoroughly crushed, the juice is squeezed out and filtered. Then mix with water in a 1:1 ratio and instill 2 drops into each nasal passage 4 times a day.

Honey is used to treat sinusitis when mixed with beet juice. Add 3 parts juice to 1 part honey and mix. Instill 3 drops of the product into each nasal passage 5 times a day.

Propolis is considered an effective folk remedy, used in the form of inhalations or mixed with vegetable oil for instillation into the nose.

Treatment with folk remedies includes a common method - rinsing the nasal passages with a saline solution, which helps remove mucus containing microorganisms and facilitates nasal breathing. Washing is especially often used in the treatment of chronic allergic sinusitis.

It is recommended to treat sinusitis with folk remedies only in adults, because children may have an unpredictable reaction to substances of plant and animal origin.

Perspective

Many sinus infections clear up in 1-2 weeks on their own or with the help of medication.

It may take several weeks for your sinuses to clear completely. It is always important to take the full course of treatment as directed, even if symptoms seem to improve.

A person with frequent sinus infections or chronic sinusitis may benefit from developing a treatment plan with an allergist or ENT specialist. Proper management helps prevent complications and improve quality of life.

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Nasal rinsing

Sinus rinsing can be helpful in clearing nasal mucus and relieving sinusitis symptoms. Rinsing the nose also cleanses the nasal passages of dirt, dust, secretions, germs, allergens that accumulate there, and can also be used as a preventive measure.

A rinse solution can be easily prepared at home, for example, by mixing 1 teaspoon of table or sea salt with 2 cups of warm water. Some people add a pinch of baking soda. You can also use a weak solution of potassium permanganate, chlorhexidine or furatsilin.

Rinse your nose several times a day.

diagnosing

A doctor, often an ear, nose and throat specialist, diagnoses frontal sinusitis after conducting a physical examination and taking into account the patient's symptoms and medical history.

Imaging tests, such as computed tomography and magnetic resonance imaging, can show the extent of sinusitis and, in some cases, the most likely cause.

A scan is not usually needed in cases of acute frontal sinusitis. Doctors may use them to find out how well a course of treatment is working for chronic sinusitis, or to help diagnose other problems affecting the sinuses.

If frontal sinusitis is common, a useful diagnostic test may be nasal endoscopy, in which the doctor uses a thin tube with a light source and images to take pictures of the inside of the sinuses. The doctor can then view these images on a computer screen and recommend appropriate treatment.

Prevention

Good personal hygiene is essential to reducing the risk of sinus infections. This includes, but is not limited to, regular hand washing:

• before and after meals
• during cooking
• caring for children.
• after using the toilet.

Avoid common allergens such as tobacco products, smoke, pollution and dust as they can cause respiratory reactions.

Maintaining a healthy lifestyle that includes regular physical activity and a balanced diet is important for maintaining a healthy immune system and reducing the risk of sinus infections.

Physiotherapy and massage

For sinusitis, it is recommended to use not only drug therapy, but local methods of influence - physiotherapy and massage. Physiotherapy is aimed at various manifestations of the disease; conditionally, all procedures can be divided into several groups:

• immunocorrective procedures (SUV - irradiation);
• anti-inflammatory procedures (UHF, ultrasound);
• bactericidal procedures (electrophoresis, darsonvalization);
• sedative procedures (electrophoresis, galvanization).

The necessary funds must be selected by the attending physician. In addition, you can do massage, which is especially effective for sinusitis. It is available to everyone, the procedure can be done at home.

How to treat acute sinusitis: basic treatment methods

Treatment of acute sinusitis is carried out after diagnostic measures. Depending on the situation you will need:

• examination and collection of patient history data;
• x-ray;
• diagnostic puncture.

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Symptoms and treatment of frontal sinusitis and its forms in adults

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The last two types of examination are prescribed by the attending physician if a complicated course of sinusitis is suspected.

Treatment in adults consists of:

• compliance with general recommendations;
• use of drug therapy;
• using traditional methods of cleansing the nasal cavity.

In the most severe situations, surgical intervention is indicated.

General recommendations for treatment

As soon as symptoms appear and treatment is prescribed, the patient must follow general recommendations.

From the first days, patients are recommended:

• maintain bed rest;
• exclude visiting the street;
• increase the amount of warm liquid consumed;
• regularly ventilate the room;
• take a semi-recumbent position during rest and sleep;
• follow the instructions of the attending physician.

Following general recommendations during sinusitis will significantly reduce treatment time and avoid surgical intervention or the development of complications.

Drug treatment

Prescription of medications is the main method of treatment for acute sinusitis. Drug treatment includes drugs of different directions of action.

• Moisturizers. Used to moisturize the nasal mucosa and cleanse it. The following drugs are available: Aqualor, AquaMaris, No-salt, Saline solution.
• Vasoconstrictor drops. Necessary to relieve swelling from the nose. Some of the effective ones are: Nazivin, Otrivin, Snoop, Rinofluimucil, Euphorbium, Ingaron.

• Antibacterial drugs. Used to fight bacterial infection. High efficiency was shown by: Dioxidin 1%, Miramistin, Furacilin, alcohol solution of Chlorophyllipt. Drops with topical antibiotics are used: Isofra, Sofradex, Polydex.
• Antihistamines. The use of new generation drugs is recommended: Loratadine, Zyrtec, Zodac.

• Antipyretics. At elevated temperatures, it is recommended to take Paracetamol, Aspirin, Ibuprofen, Nurofen.
• Mucolytic agents. Mucolytic drugs can prevent infection from entering the lungs and remove sputum. The following drugs have a high therapeutic effect: Mucodin, Fluditek, Lazolvan, Ambroxol.

• Antibiotics. For sinusitis, treatment with broad-spectrum antibiotics is indicated. The most effective: Amoxicillin, Amoxiclav, Sumamed, Azithromycin.

Additionally, patients may be prescribed anti-inflammatory drugs, vitamin complexes, and immunomodulatory drugs.

Surgery

In cases where conservative treatment does not produce results and a severe form of sinusitis is diagnosed, patients are indicated for surgical intervention. It consists of nasal puncture.

Surgical treatment is carried out in several stages.

1. Puncture. To make a puncture, the ENT doctor uses a surgical game. It makes a hole in soft or cartilaginous tissue.
2. Installation of drainage. A thin tube is inserted into the resulting hole - drainage. It is necessary to cleanse the sinuses.
3. Flushing. Antiseptic solutions are injected into the sinuses through the installed drainage to remove accumulations.

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Depending on the complexity of the treatment, from 1 to 4-5 procedures may be required. Surgery is accompanied by the prescription of drug treatment with antibacterial drugs.

Physiotherapy and traditional medicine

To increase the effectiveness of drug treatment for sinusitis, physiotherapeutic procedures, as well as traditional medicine methods, are used.

Physiotherapy includes:

• laser therapy;
• magnetic therapy;
• UHF;
• treatment with pulsed currents and microwaves.

Among the traditional methods, inhalations are recommended, as well as the use of solutions for rinsing the nasal sinuses. In the absence of contraindications, inhalations with chamomile, sage, plantain, and calendula have shown high effectiveness. Solutions of calendula, chamomile, salt with iodine are actively used to cleanse the nasal cavity before using medicinal drops.

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How to cure chronic sinusitis

If the first symptoms actively begin to appear in adults and children, then chronic sinusitis should be treated. Currently, treatment of chronic sinusitis in adults is carried out in several ways.

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Medication

Quite often, special medications in the form of drops or sprays are used to cure sinusitis in children and adults. Before you cure chronic sinusitis, you need to familiarize yourself with the most effective medications.

Nasonex

To eliminate exacerbation of chronic sinusitis, you can use the medicinal drug Nasonex. This is a fairly effective spray, which differs from other similar drugs in its anti-allergic and anti-inflammatory effects. It is recommended to use Nasonex for the treatment of chronic allergenic sinusitis.

Not all people can use this spray to treat the disease, as it has contraindications. Treatment with Nasonex is contraindicated for children under two years of age. Also, patients with untreated bacterial or fungal diseases of the respiratory organs and tuberculosis should not use the nasal spray. Some experts do not advise using the medicine for people who have recently had nasal surgery.

Before treating sinusitis in adults, it is recommended that you become familiar with the side effects of this drug. If dosages are not observed, some patients experienced severe burning in the nostrils and even bleeding. During treatment, children may experience irritation of the mucous membrane, dizziness, sneezing and increased lacrimation.

To reduce the likelihood of the above side effects, you should follow the dosage of Nasonex.

The disease is treated with a spray daily for ten days. Every day the patient should inject the drug into each nostril once a day. The very next day after the first injection you can notice a positive result.

Flixonase

Congestion can be completely cured without surgery using the drug Flixonase. This product is made on the basis of fluticasone propionate. With the help of this substance, the amount of cytokines decreases and the inflammatory process in the nasal cavities gradually stops. Flixonase can be used to treat early and late stages of the disease.

This drug cannot be used to treat sinusitis in a child under four years of age, as the drug was made for adolescents and adults. Flixonase should also be avoided by people who are allergic to fluticasone propionate.

Many patients treated with this drug complain of side effects. After prolonged use of Flixonase, the nasal mucosa may dry out, bad breath and severe burning in the nostrils may appear. Less commonly, people complain of minor bleeding and headaches.

Before eliminating the exacerbation of chronic sinusitis, you need to familiarize yourself with the features of using Flixonase. The drug is made for intranasal use, so it must be instilled into the nasal cavity. It is recommended to instill the medicine early in the morning, 80 mcg into each nasal passage. Treatment should continue for at least one week.

Avamis

You can get rid of chronic sinusitis in adults with the help of the drug Avamis. This nasal spray is made based on a component such as fluticasone fuorate. Thanks to this substance, Avamis allows you to quickly get rid of inflammatory processes and cure chronic sinusitis.

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Before using the medicine, it is recommended to study its contraindications in detail. This drug is not suitable for children under six years of age or people with impaired liver function. Also, patients taking Ritonavir will have to refrain from using Avamis.

Avamis does not have many side effects, but they do exist, and it is better to familiarize yourself with them in advance. After prolonged use of the spray, some patients complained of severe rashes and itchy skin. During treatment, children may experience growth retardation.

Treatment of chronic sinusitis with Avamys must be carried out with correct dosages. The spray is injected into the nasal cavities every day. In this case, the drug should be injected into each nostril twice. The duration of treatment should be determined by the attending physician.

Surgical

Sometimes treatment of chronic sinusitis with medications does not bring any positive results and more radical methods have to be used. In this case, chronic maxillary sinusitis can be cured surgically.

So that the doctor can get to the sinuses, during the operation a small incision is made in the transitional fold between the fifth and second tooth. Then, using the created incision, the doctor visually inspects the cavity and cleans it of fluid. Then, in order to permanently cure chronic sinusitis, a small hole is made between the nasal passages and the sinus for a tube with which the sinuses will be washed. When the cavities are completely cleaned, the incision is sutured.

After bilateral maxillary sinusitis is cured surgically, the patient must visit a doctor within three days after surgery for antibiotic therapy and wound treatment with an antiseptic.

Folk remedies

Some people treat chronic sinusitis with special folk remedies. There are many recipes that will help cure bilateral sinusitis.

Aloe juice

Many people are interested in whether it is possible to cure chronic sinusitis with aloe juice. It’s definitely possible, since many nasal drops for runny noses are made from this juice. Prevention and treatment of the disease with medicine from this plant will help quickly eliminate inflammation in the nose and get rid of swelling. To prepare a medicinal mixture, you need to extract 200 ml of juice from the plant and mix it with 350 ml of water. Every day you need to instill three drops of the drug into each nasal passage.

Herbal tinctures

To stop the manifestation of the disease, it is recommended to prepare medicinal herbal tinctures. To create a medicine, you need to add a teaspoon of dry chamomile or cloves to a liter of hot boiled water. The decoction should be infused for about three hours, then it can be instilled into the nostrils.

Possible complications

The following pathological processes are considered the most dangerous consequences of frontal sinusitis:

• spread of infection to the bone tissue of the sinus, accompanied by necrosis and the formation of fistulas through which purulent contents are released;
• transition of the inflammatory process to the eye sockets (accompanied by the formation of an abscess or phlegmon);
• spread of infection to brain tissue with the development of meningitis or abscess);
• sepsis (penetration of pathogenic microorganisms into the circulatory system).

If treated incorrectly, complete or partial loss of smell may occur. Inflammation of the tissues of the paranasal sinuses negatively affects the functioning of the visual organs. Polyps and granules can form in the cavity of the frontal sinus. Large tumors can destroy bones.

Common signs of sinusitis

Among the primary signs of sinusitis, which are usually sufficient to accurately identify this type of disease, are headache and significant nasal congestion.

Main signs of sinusitis:

• dry frequent cough and sneezing;
• increased body temperature (fever);
• increased pressure in the face;
• mucous discharge from the nose;
• lack of smell;
• discomfort and congestion in the ears;
• painful reaction when turning the neck;
• lack of appetite;
• unnatural odors from the oral cavity;
• severe fatigue and loss of strength;
• acute pain in the teeth;
• feeling of excess foreign mass in the nose and above the eyes;
• nasal voice.

Other symptoms of chronic sinusitis include:

• slight but persistent nasal congestion;
• difficulty in nasal breathing;
• slight discharge, which can stand out for a long time, drying out in the form of crusts;
• leakage of mucus, leading to rubbing of the skin under the nose and the formation of cracks;
• dry throat;
• headache;
• displacement of the discharge to the back wall of the throat and flowing down it;
• bad breath.

Other symptoms, such as fever, are extremely rare and can only be caused by particularly acute and advanced forms of sinusitis, and are determined exclusively by specialists who can recommend hospitalization and outpatient tests.

Complications and consequences

With untimely and poor-quality treatment of acute frontal sinusitis, the pathology can provoke the development of serious complications that can affect the eye area and intracranial areas.

The first case is characterized by:

1. Periostitis is determined by the inflammatory process of the periosteum, according to the form of frontal sinusitis, occurs with the presence or absence of pus and an infiltrate is formed at the site of the orbit.
2. Ostiomyelitis is a lesion of bone tissue.
3. Cellulitis - characterized by inflammation of the retina, as a result of which the eye protrudes somewhat from the orbit.

The second case is characterized by:

1. Subdural abscess.
2. Epidural abscess.
3. Meningitis.

The common consequences of acute sinusitis are sepsis, pansinusitis and polysinusitis.

Diagnosis of the disease

You need to know not only the symptoms and treatment of this pathology, but also diagnostic methods. Before curing sinusitis, it is necessary to exclude other diseases (inflammation of the nasal mucosa, polyps, tumors, cysts). To examine the ENT organs (examination of the paranasal sinuses) you will need:

• patient survey data (complaints at the time of admission, risk factors);
• examination (external and physical);
• X-ray examination of the sinuses;
• MRI or CT;
• rhinoscopy;
• general blood analysis;
• nasal swab examination;
• microbiological (bacteriological) studies.

Causes

The cause of inflammation of the paranasal sinuses is a viral infection. The virus, penetrating the mucous membrane, causes swelling, as well as an increase in the secretion production of the mucous glands and desquamation of the epithelium.

As a result, the natural anastomosis of the paranasal sinuses is blocked by the edematous mucous membrane and pathological secretion. In this case, the opposite edges of the anastomosis come into contact with each other, complicating the transport of secretions from the sinuses. If this regular drainage is disrupted, favorable conditions are created for the development of sinusitis.

The leading role in the development of sinusitis is given to:

• Pfeiffer bacillus (Haemophilus influenzae) and pneumococcus (Streptococcus pneumoniae), which are the causative agents of the disease in more than 50% of cases.
• Less commonly, hemolytic streptococcus (Streptococcus pyogenes), Moraxella catarrhalis, Staphylococcus aureus, various viruses, fungi and anaerobes are sown.

Sinusitis often occurs as a result of complications of infectious and inflammatory diseases of the nasal cavity (influenza, acute respiratory infections, rhinorrhea, acute respiratory viral infections).

1. Viruses. Viruses cause 90 - 98% of cases of acute sinusitis. Most people with a cold experience sinus inflammation. These inflammations are usually brief and mild, and very few people who get a cold develop true sinusitis.
2. Bacteria. A small percentage of cases of acute and possibly chronic sinusitis are caused by bacteria. The bacteria are usually present in the nasal passages and throat and are generally harmless. However, in the cold or with a viral infection of the upper respiratory tract, the nasal passages are blocked, the natural cleansing of the paranasal sinuses is disrupted, and secretions stagnate inside the sinuses, which provides fertile ground for the proliferation of pathogenic bacteria.
3. Fungi. It is very important to monitor the microflora in the premises, because... under certain conditions (lack of ventilation, high humidity and temperature), the fungus can settle in the paranasal sinuses, and if complicated, provoke the development of a mycotic infection. Aspergillus is the most common fungus associated with sinusitis.

Risk factors for sinusitis

The development of infection in the sinuses, regardless of the type of microorganism, provokes a violation of the outflow of mucus from the sinuses into the nasal cavity, which is facilitated by the following factors:

• flu, colds;
• dental infections;
• allergic rhinitis;
• cystic fibrosis;
• bronchial asthma;
• sarcondosis;
• immunodeficiency;
• tumors of the respiratory system;
• pregnancy;
• smoking.