The Sinusitis, symptoms and treatment of sinusitis
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Sinusitis, symptoms and treatment of sinusitis


Today it is difficult to meet a person who does not know about what is genyantritis. However, the information received by many patients from different sources is quite contradictory. Therefore, now we will try to summarize the most relevant and proven information about this disease.

Before talking about sinusitis, you should decide what sinuses are. The latter term refers to the special sinuses (or cavities) in the skull, which perform several functions. First, they greatly facilitate its weight, and secondly, they are important for resonating sound. Inside the sinuses are covered with a mucous membrane, somewhat reminiscent of that in the nose. There are several basic sinuses: the maxillary (or maxillary), frontal (located in the frontal bone), ethmoidal (latticed) and sphenoidal.

Sinusitis and its causes

So, genyantritis is a sinusitis that develops in the maxillary sinus. Now let's try to figure out what happens in this pathological process. Since the sinus sinus is closely related to the nasal cavity, any disease that causes active inflammation of its mucous membrane can lead to the described sinusitis. In addition, it is also possible to transfer microbes with blood flow, which is most common in such common infections as scarlet fever , influenza, or measles. Quite often, sinusitis joins a chronic cold, which initially may not have an infectious nature. For example, chronic allergic rhinitis causes swelling of the nasal mucosa, which makes it difficult to cleanse. This leads to a decrease in local immunity and infection of the maxillary sinus.

So, let's sum up some results. Below is an almost complete list of pathological conditions that could cause inflammation of the maxillary sinus:

  • Obstruction of nasal breathing caused by rhinitis of any nature (infectious or allergic), curvature of the median septum of the nose;
  • Reduced immune readiness of the organism: prolonged sluggish chronic diseases, irrational use of antibiotics, AIDS, treatment with some hormonal and / or antitumor agents;
  • Carrier in the nose or oral cavity of pathogens of various infections;
  • diabetes;
  • Constant stresses, hypothermia, excessive physical exertion;
  • Untimely treatment of respiratory infections, neglect of rational and justified use of antibiotics;
  • Various congenital anomalies of the structure of the paranasal sinuses or the skull (presence of the maxillary crevice);
  • Chronic dental infections;
  • Adenoids ;
  • Tumors of the paranasal sinuses.

In addition to infectious forms of sinusitis, non-infectious ones are also isolated. These include allergic and vasomotor. The latter is a consequence of impaired innervation of blood vessels, which leads to swelling, swelling of the mucous membrane of the sinus, a violation of the outflow of mucus and, accordingly, to the inflammatory process.

Depending on the duration of the disease, sinusitis can be classified into acute and chronic.

Symptoms of genyantritis

So, how do all the forms of sinusitis described above manifest themselves? The following clinical symptoms are typical for an acute process:

  • Violation of the general state of the body, manifested by weakness, nausea, a feeling of excessive fatigue or "weakness";
  • Body temperature in most cases rises above 38 0 C. It is accompanied by chills and profuse sweating;
  • In all cases there is a rather intense headache of a bursting nature, of high intensity, which irradiates (reflects) to the forehead, teeth or root of the nose. You can provoke it by touching the bridge of the nose. Pain is intensified when the head is tilted (especially forward), straining, physical exertion, sneezing or coughing;
  • In some cases, a significant amount of tear fluid can be produced, a fear of bright light;
  • Nasal breathing is difficult, with this symptom being more pronounced on the side of the lesion;
  • Depending on the nature of the inflammatory process in the maxillary sinus, the rhinitis may be transparent (mucous), yellow-green (purulent) or with an admixture of blood;
  • The sense of smell, as a rule, is absent altogether or significantly reduced;
  • In the event that the inflammatory process has passed to the periosteum, the patient swells up his cheek on the side of the lesion, and also swells the lower eyelid.

If the inflammatory process in the maxillary sinus acquires a chronic course, the signs of the disease become somewhat different:

  • There is practically no temperature reaction. Only occasionally can the body temperature rise, but not more than 37 ° C;
  • The most marked signs of intoxication, which manifest weakness, severe fatigue. For many patients, there is a symptom of chronic fatigue and / or emotional burnout;
  • In the evenings, such patients are concerned about the bursting headache that occurs after using non-steroidal anti-inflammatory drugs (nimesulide, paracetamol);
  • The sense of smell is almost constant;
  • If chronic sinusitis persists for several years, then symptoms of bronchial irritation may appear. There is a cough with the allocation of scant sputum;
  • The patient is constantly concerned about a runny nose (purulent - with exacerbation of the disease, mucous - during remission).

Vasomotor sinusitis is most typical for patients suffering from the rhinitis of the same name. Its course is undulating, not associated with infectious agents. Vasomotor sinusitis can become aggravated or provoked by various psychotraumatic situations, chronic overstrain.

For allergic sinusitis, the most common is the association with various allergens (ie, substances that the body perceives as alien and produces antibodies against them). In most cases, these are all respiratory allergens (dust, pollen, fluff, etc.).

Diagnosis of sinusitis

It is not difficult to establish this diagnosis. To do this, you will need to perform the following examinations:

  • clinical blood test;
  • Sowing blood on nutrient media (only with fever and severe patient condition);
  • A smear from the nose and throat with mandatory determination of sensitivity to antimicrobial drugs and phages;
  • Nose examination with a special nasal mirror;
  • Examination of the ears;
  • X-ray of the paranasal sinuses (with emphasis on the maxillary sinusitis);
  • In difficult cases for diagnosis - CT of the skull.

Treatment of genyantritis

It is quite a complicated and time-consuming process. Treatment of acute inflammation of the paranasal sinuses provides for the following:

  • Intensive antibiotic therapy. Initially, it is selected blindly, however, after receiving the results of sowing the smear, the patient is recommended the most optimal drug;
  • Carrying out detoxification activities;
  • Anti-inflammatory drugs;
  • Burying in the nose of special drops that reduce swelling and inflammation;
  • With a pronounced purulent process, a puncture of the maxillary sinus with a special needle is performed. Further, the contents of the cavity are sucked off, and an antibacterial agent is introduced instead;
  • When the inflammatory process is completely suppressed, physiotherapy is shown.

It should be remembered that the entire period of treatment (especially if it is in the cold season), the patient must highly wrap the face of the scarf to prevent hypothermia. A full course of acute therapy can last up to 2 months.

Chronic maxillary sinusitis is difficult to treat because of the fact that the microbes have acquired a certain stability for a long time in the body, and therefore their reaction to medications is significantly reduced. Antibiotics in this case are prescribed only after sowing. In the future, various biological supplements, vitamins and other stimulants of the body's defenses can be used. The treatment with a laser can also be useful: it leads to the final stifling of the inflammatory process.

The main in the pharmacotherapy of allergic sinusitis is the use of antihistamines, glucocorticoids, etc.

Both in acute and chronic maxillary sinusitis the patient undergoes outpatient treatment (ie at home).

It is important to remember that in acute inflammation of the paranasal sinuses a strict bed rest is recommended. This will help prevent the emergence of many life-threatening conditions.

The procedure for the puncture of the maxillary sinus

Since this manipulation is extremely common among ENT doctors, we will briefly outline the main stages of its implementation.

To ensure that the patient does not experience any pain, a puncture is performed after the introduction of a local anesthetic. Puncture is performed through the nasal passage by puncturing a thin bone plate.

In cases where it is necessary to repeatedly inject medicinal products into the maxillary sinus or extract pus from it, the ENT doctor can recommend the installation of microscopic tubes through which the outflow of inflammatory fluid occurs, which contributes to the acceleration of the recovery process.

Also it is worthwhile to clarify that the puncture is also diagnostic, because the contents of the maxillary sinus are sent for analysis to the laboratory.

Possible complications of puncture:

  • A headache, the duration of which is sometimes several days;
  • Allocation of a small amount of blood from the nose.

Also worth debunking the most common in the midst of the layman's misconception that a once-performed puncture involves a constant holding it. In fact, there can come a complete cure after a single execution. It is only important that the patient consult a specialist at the very beginning of the disease.

Local antibacterial agents

In addition to the drugs that are recommended to patients inside, it is still possible to prescribe pharmacological drugs locally. Most often they are used in the form of drops or special sprays.

They include the following ingredients:

  • Vasoconstrictive, which reduce the swelling of the mucous membrane and facilitate nasal breathing;
  • Anti-inflammatory;
  • Enhancing local immune defense;
  • Antiseptic;
  • Glucocorticosteroid;
  • Antiallergic.

It is better to give preference to sprays, since they are more comfortable to use and provide a more even distribution of the drug in the nasal cavity.

When are intravenous or tableted antibiotics shown?

There are the following indications for the designation of these groups of medicines:

  • Acute purulent maxillary sinusitis;
  • high body temperature;
  • Purulent discharge from the nasal cavity;
  • Combination of sinusitis with otitis media;
  • Tonsillopharyngitis;
  • Inefficiency of anti-inflammatory drugs.   

Rinsing of the nose with genyantritis

Many patients since childhood know the method of washing the nose and its adnexal sinuses with an apparatus called a cuckoo. Among doctors this technique carries the name of Proetz.

The described method is much more comfortable than a puncture, however, it can be used only in the early stages of the disease, as well as in patients who have sufficiently pronounced local immunity. In some cases, the washing of the maxillary sinus with the method described is combined with laser therapy. This gives a more pronounced effect and promotes a speedy recovery.

The essence of washing according to the method of the Proetz is that catheters are inserted into both nasal passages. One of them receives a solution with a drug, and another aspiration of the injected content. During this manipulation, the patient lying on the back should say "ku-ku" quite often. This is necessary to ensure that the drug does not enter the lower respiratory tract and does not cause suffocation. As a rule, 6-7 procedures are sufficient to stop the inflammatory process. However, a significant improvement occurs after the first session.

What is a sinus catheter?

Recently the Yamik system has been quite successful, which allows to remove pathological discharges from the nasal cavity and sinuses due to the difference in pressure created by it. This procedure is rather short (about 15-20 minutes) and it is performed after anesthesia of the mucous membranes.

For most patients, the placement of a sinus catheter does not present any particular discomfort, but for persons with a curvature of the nasal septum, it can become quite unpleasant.    

If there is a possibility, Then Try to perform this manipulation on weekends, since the sinus catheter causes an intensive outflow of sinus contents from the nasal cavity. This can disrupt your habitual rhythm of life.

It is also worth pointing out that after this manipulation, a number of patients complain of a high-intensity headache.

In most cases, 8-10 procedures are sufficient to cure the disease.

Significant advantages of this technique are:

  • Complete atraumaticity, which excludes infection with certain infections (hepatitis, HIV);
  • The receipt of the drug is directed in the sinuses.

A few words about physiotherapy with genyantritis

Physiotherapeutic effects help to strengthen general and local immunity and significantly improve the results of drug treatment. The following procedures are most often used:   

  • UHF, the essence of which is the effect on the body of an electric field with a variable value. Under the influence of this method, tissues are heated, which leads to vasodilation, significant improvement in microcirculation, and increased lymphatic drainage. As a result, the availability of drugs for the cells of the body increases. In addition, UHF has a strong anti-edematous, analgesic, and anti-inflammatory effect.
  • UFO - treatment with ultraviolet, whose action resembles UHF.

It should be reiterated that any physiotherapy can be carried out only in the absence of active symptoms of inflammation.

And if the treatment of sinusitis is completely ineffective?

In those cases when the process is too pronounced and can not be treated, the patient can be recommended surgical intervention, which is carried out under general anesthesia. In this case, an incision is made in the upper part of the gum on the affected side, the mucous membrane is moved away, and then a small portion of the bone is removed. Next, the affected sinus is cleared of pathological contents.

How to improve the outflow from the nasal cavity of the house?

Above, procedures have been listed that facilitate the removal of pathological contents from the nasal cavity. However, they are conducted only under the supervision of medical personnel.

Recently, devices have been developed that allow you to perform washing at home (for example, Dolphin). They are very simple in operation and have a high safety profile: their use is allowed even in pregnant women and children after the first year of life.

Complications of genyantritis

Despite the fact that the sinusitis is mainly a local process, the given disease is fraught with the development of complications, many of which are extremely dangerous for the body. So, among them are life-threatening conditions like:

  1. . Meningitis . This term is called the inflammatory process, which affects the membranes of the brain (both the head and spinal cord). In this case, deafness, dementia, epilepsy, hydrocephalus develops. The cause of meningitis with genyantritis is easy to understand if we recall that the nasal sinuses are not only communicating with each other, but also with the cranial cavity;
  2. – тяжелое состояние, связанное с поражением головного мозга. Encephalitis is a serious condition associated with brain damage. It manifests itself in the form of convulsive syndrome, which can lead to a progressive loss of memory and a decrease in intellectual abilities;
  3. – закупорка кровяным сгустком сосудов, расположенных в основании черепа на нижней поверхности головного мозга. Thrombosis of cerebral sinuses is a clogging of a blood clot of vessels located at the base of the skull on the lower surface of the brain. The most frequently pathological process affects the cavernous (cavernous) sinus. This pathological condition is manifested with an increasing headache, indomitable vomiting, nausea, bulging out of the eyeballs (the so-called exophthalmos), swelling and intense eyelid cyanosis;
  4. – это генерализованное бактериальное заражение крови, которое вызвано массивным поступлением микроорганизмов из носовых пазух. Sepsis is a generalized bacterial contamination of blood, which is caused by a massive intake of microorganisms from the sinuses. To treat this pathology is extremely difficult, the lethality with it is very high.

How to prevent sinusitis?

In order to prevent the development of this disease, you must use the following rules:

  • Timely treat infectious diseases. Do not let them go into a chronic form;
  • Do not prescribe antibacterial therapy. This will lead to the formation of resistance in microorganisms;
  • It is not necessary to cancel antibacterial agents at the first improvement of state of health, because in the future the condition may worsen;
  • Do not neglect a timely visit to the dentist;
  • In the cold season, do not forget about wearing a hat, scarf, as well as jackets with a high collar;
  • When playing sports in cool weather wear a hat;
  • Be tempered;
  • Regularly visit the open air;
  • With a pronounced rhinitis should not be too much vysmarkivatsya. This not only can lead to damage to the vessels of the nose, but also cause a complication in the form of otitis. In addition, there is a casting of the contents of the nasal cavity in the maxillary sinus.

Is folk medicine effective in sinusitis?

Inflammation of the maxillary sinus is, as a rule, a chronic process that occurs with periods of exacerbations and remissions. Therefore, many patients in the treatment additionally include folk remedies to strengthen (or sometimes completely replace) the effect of medications. However, in this case, remember the following:

There are no medicinal plants that could completely replace the antibacterial drug.

Not always infusions and broths, cooked according to the recipes of traditional medicine, combined with official medicines.

Do not trust all the information received about such treatment methods from the Internet. Remember that it is best to consult a doctor or a specialist in traditional medicine.

It is not necessary to treat sinusitis with herbal remedies for an acute process.

"Symptoms of anxiety" or when immediate medical help is needed

It is important to remember that immediate medical advice may be needed in the following cases:

  • The headache reached a high intensity;
  • There were cramps ;
  • Speech became confusing and / or indistinct;
  • The patient hallucinates;
  • Body temperature exceeds 39 0 C;
  • Decreased blood pressure (less than 90/60 mm Hg);
  • Cardiac activity or greatly increased, or became arrhythmic;
  • There was a pronounced edema of the face.

| 18 March 2014 | | 2 012 | Uncategorized
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