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Sinusitis, symptoms and treatment of sinusitis


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

Before talking about sinusitis, you should decide on what the sinuses are. The last term is called special sinuses (or cavities) in the skull, which perform several functions. Firstly, they greatly facilitate its weight, and secondly, they are important for the resonance of sound. Inside the sinuses are covered with mucous membrane, somewhat reminiscent of that in the nose. There are several main sinuses: maxillary (or maxillary), frontal (located in the frontal bone), ethmoidal (ethmoid) and sphenoidal.

Sinusitis and its causes

So, sinusitis is a sinusitis that develops in the maxillary sinus. Now let's try to figure out what happens in this pathological process. Since the sinuses are closely associated with the nasal cavity, any disease that causes active inflammation of the mucous membrane of the nose can lead to the described sinusitis. In addition, it is also possible to carry microbes through the bloodstream, which is most common in such common infections of the body as scarlet fever , influenza or measles. Quite often, sinusitis is associated with chronic rhinitis, 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 summarize some results. Below is an almost complete list of pathological conditions that could cause inflammation of the maxillary sinus:

  • difficulty of nasal breathing caused by rhinitis of any nature (infectious or allergic), curvature of the median nasal septum;
  • reduced immune readiness of the body: prolonged sluggish chronic diseases, irrational use of antibiotics, AIDS, treatment with certain hormonal and / or antitumor agents;
  • carriage in the nose or mouth of pathogens of various infections;
  • diabetes;
  • constant stress, hypothermia, excessive exercise;
  • late treatment of respiratory infections, disregard for the rational and reasonable use of antibiotics;
  • various congenital anomalies of the structure of the paranasal sinuses or skull (presence of the maxillary cleft);
  • chronic tooth infections;
  • adenoids ;
  • tumors of the paranasal sinuses.

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

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

Symptoms of sinusitis

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

  • violation of the general condition of the body, manifested by weakness, nausea, feeling excessive fatigue or "weakness";
  • body temperature in most cases rises above 38 0 C. It is accompanied by chills and excessive sweating;
  • in all cases, there is a rather intense headache of the arching nature, of high intensity, which irradiates (is reflected) in the region of the forehead, teeth or root of the nose. You can provoke it by touching the nose. The pain increases when the head is tilted (especially forward), straining, exertion, sneezing or coughing;
  • in some cases, a significant amount of tear fluid may be produced, there may be a fear of bright light;
  • nasal breathing is difficult, with this symptom being more pronounced on the affected side;
  • depending on the nature of the inflammatory process in the maxillary sinus, a runny nose may be clear (slimy), yellow-green (purulent) or mixed with blood;
  • the sense of smell, as a rule, is completely absent or significantly reduced;
  • in the event that the inflammatory process has passed to the periosteum, then the patient has a cheek on the affected side, and the lower eyelid swells.

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

  • temperature reaction is practically absent. Only occasionally can body temperature rise, but not higher than 37 ° C;
  • the most pronounced signs of intoxication, which manifest weakness, severe fatigue. For many patients, symptoms of chronic fatigue and / or emotional burnout are characteristic;
  • in the evenings, these patients are worried about a widening headache, which disappears after the use of nonsteroidal anti-inflammatory drugs (nimesulide, paracetamol);
  • Smell reduced almost constantly;
  • If chronic sinusitis persists for several years, then the symptoms of bronchial irritation may occur. There is a cough with a scanty sputum;
  • the patient is constantly worried about a runny nose (purulent — if the disease is exacerbated, mucous — during remission).

Vasomotor sinusitis is most characteristic of patients suffering from the same name rhinitis. Its flow is undulating, not associated with infectious agents. Vasomotor sinusitis may be exacerbated or provoked by various stressful situations, chronic overstrain.

For allergic sinusitis is most characteristic of the relationship with various allergens (ie, substances that the body perceives as foreign and produces antibodies against them). In most cases, these are any respiratory allergens (dust, pollen, fluff, etc.).

Diagnosis of sinusitis

To establish this diagnosis is quite simple. This will require the following examinations:

  • clinical blood test;
  • blood culture on nutrient media (only in case of fever and severe condition of the patient);
  • nasal and throat swab with obligatory determination of sensitivity to antimicrobial drugs and phages;
  • examination of the nose with a special nose mirror;
  • examination of the ears;
  • x-ray of the paranasal sinuses (with an emphasis on maxillary sinus);
  • in difficult to diagnose cases - CT of the skull.

Treatment of sinusitis

It is quite a difficult and time consuming process. Treatment of acute inflammation of the paranasal sinuses includes the following:

  • intensive antibiotic therapy. Initially, it is chosen blindly, but after receiving the results of smear sowing, the patient is recommended the most optimal drug;
  • detoxification activities;
  • anti-inflammatory drugs;
  • instillation into the nose of special drops that reduce swelling and inflammation;
  • in case of a pronounced purulent process, the maxillary sinus is punctured with a special needle. Next, the cavity is sucked in, and an antibacterial agent is introduced instead;
  • with complete subsidence of the inflammatory process, physiotherapy is indicated.

It should be remembered that the entire period of treatment (especially if it falls on the cold season) the patient must wrap the face high with a scarf to prevent hypothermia. A full course of treatment of the acute process can last up to 2 months.

Chronic sinusitis is quite difficult to treat due to the fact that the microbes during a long stay in the body have acquired a certain resistance, and therefore their response to drugs is significantly reduced. Antibiotics in this case are appointed only after sowing. In the future, various biological additives, vitamins and other stimulants of the body's defenses can be used. Treatment with a laser may also be helpful: it leads to the final subsiding of the inflammatory process.

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

In both acute and chronic sinus the patient undergoes outpatient treatment (ie at home).

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

Technique of the puncture of the maxillary sinus

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

In order to prevent the patient from experiencing any pain, the puncture is performed after the injection of a local anesthetic drug. Puncture is performed through the nasal passage by puncture of a thin bone plate.

In cases where it is necessary to repeatedly inject drugs into the maxillary sinus or to remove pus from it, the ENT specialist may recommend the installation of microscopic tubes through which the inflammatory fluid outflows, which accelerates the recovery process.

It is also worth clarifying that the puncture is diagnostic, since the resulting contents of the maxillary sinus is sent to the laboratory for analysis.

Possible complications of puncture:

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

It is also worth debunking the most common misconception among ordinary people that a puncture performed once means to have it all the time. In fact, there may be a complete cure after a single execution. It is only important that the patient see a specialist at the very beginning of the disease.

Local antibacterial agents

In addition to drugs that are recommended for patients inside, perhaps even local administration of pharmacological drugs. Most often they are used in the form of drops or special sprays.

They include the following ingredients:

  • vasoconstrictor, which reduce the swelling of the mucous membrane and facilitate nasal breathing;
  • anti-inflammatory;
  • enhancing local immune defenses;
  • antiseptic;
  • glucocorticosteroid;
  • antiallergic.

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

When are intravenous or antibiotic tablets given?

There are the following indications for the appointment of these groups of drugs:

  • acute purulent sinusitis;
  • high body temperature;
  • purulent discharge from the nasal cavity;
  • combination of sinusitis with otitis;
  • tonsillopharyngitis;
  • the ineffectiveness of anti-inflammatory drugs.   

Flushing the nose with sinus

Many patients from childhood are familiar with the method of washing the nose and its paranasal sinuses with the aid of an apparatus called “cuckoo”. Among doctors, this technique is the name of Proets.

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 those patients who have a sufficiently pronounced local immunity. In some cases, washing the maxillary sinus using the described method is combined with laser therapy. This gives a more pronounced effect and contributes to the speedy recovery.

The essence of washing according to the method of Proatz is that catheters are inserted into both nasal passages. Through one of them comes a solution with the drug, and through the other, aspiration of the administered contents is carried out. During this manipulation, the patient lying on his back must often say “ku-ku”. This is necessary so that the drug does not get into the lower respiratory tract and does not cause suffocation. As a rule, 6–7 procedures are enough to relieve the inflammatory process. However, a significant improvement comes after the first session.

What is a sinus catheter?

Recently, the Yamik system has been using quite a lot of success, which allows you to remove pathological secretions from the nasal cavity and sinuses due to the difference in pressure created by them. This procedure is quite short (about 15-20 minutes) and is performed after anesthesia of the mucous membranes.

For most patients, the installation of a sinus catheter is not particularly discomfort, however, for those with curvature of the nasal septum, it can become quite unpleasant.    

If possible, that Try to carry out this manipulation at the weekend, because the sinus catheter causes an intense outflow of the sinuses from the nasal cavity. It can break your usual 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 atraumatic, which excludes infection with certain infections (hepatitis, HIV);
  • intake of the drug is directed to the sinuses.

A few words about physiotherapy for sinus

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

  • UHF, the essence of which is the impact on the body of an electric field with a variable quantity. Under the influence of this method, the tissues are heated, which leads to the expansion of blood vessels, a significant improvement in microcirculation, and an increase in lymphatic drainage. As a result, the availability of drugs to the cells of the body is increased. In addition, UHF has a fairly strong anti-edema, analgesic, and anti-inflammatory effect.
  • UV - treatment with ultraviolet radiation, the action of which resembles UHF.

It should be repeated once again 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 cases where the process is too pronounced and does not respond to therapy, the patient may be recommended surgery, which is performed under general anesthesia. When this is done, an incision is made in the upper part of the gum on the affected side, the mucous membrane is removed, and then a small section of the bone is removed. Next, the affected sinus is cleared of pathological contents.

How to improve the outflow from the nasal cavity at home?

Above were listed procedures that help remove abnormal contents from the nasal cavity. However, they are carried out only under the supervision of medical professionals.

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

Complications of sinusitis

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

  1. . Meningitis This term is called the inflammatory process that affects the lining of the brain (both brain and spinal). At the same time deafness, dementia, epilepsy, hydrocephalus develops. The cause of meningitis in sinusitis is easy to understand, if we recall that the nasal sinuses communicate not only among themselves, but also with the cavity of the skull;
  2. – тяжелое состояние, связанное с поражением головного мозга. Encephalitis is a serious condition associated with brain damage. Manifested in the form of convulsive syndrome, which can lead to progressive memory loss and decrease in intellectual abilities;
  3. – закупорка кровяным сгустком сосудов, расположенных в основании черепа на нижней поверхности головного мозга. Thrombosis of the cerebral sinuses - blockage of blood vessels in the blood clot located at the base of the skull on the lower surface of the brain. The cavernous (cavernous) sinus is most often affected by the pathological process. This pathological condition manifests itself with increasing headache, indomitable vomiting, nausea, protrusion outward of the eyeballs (so-called exophthalmos), edema, and intense cyanosis of the eyelids;
  4. – это генерализованное бактериальное заражение крови, которое вызвано массивным поступлением микроорганизмов из носовых пазух. Sepsis is a generalized bacterial infection of the blood, which is caused by a massive influx of microorganisms from the sinuses. It is extremely difficult to treat this pathology, the mortality with it is very high.

How to prevent sinusitis?

Для того, чтобы не допустить развития данного заболевания, необходимо пользоваться приведенными ниже правилами:

  • своевременно лечите инфекционные заболевания. Не допускайте перехода их в хроническую форму;
  • не назначайте сами себе антибактериальную терапию. Это приведет к формированию устойчивости у микроорганизмов;
  • не стоит отменять антибактериальные средства при первом улучшении самочувствия, поскольку в дальнейшем состояние может ухудшиться;
  • не пренебрегайте своевременным визитом к стоматологу;
  • в холодное время года не забывайте про ношение шапки, шарфа, а также куртки с высоким воротником;
  • при занятиях спортом в прохладную погоду надевайте шапку;
  • закаливайтесь;
  • регулярно бывайте на свежем воздухе;
  • при выраженном насморке не стоит слишком сильно высмаркиваться. Это не только может привести к повреждению сосудов носа, но и вызвать осложнение в виде отита. Помимо этого происходит заброс содержимого полости носа в гайморову пазуху.

Эффективна ли народная медицина при гайморите?

Воспаление верхнечелюстной пазухи – это, как правило, хронический процесс, протекающий с периодами обострений и ремиссий. Поэтому многие пациенты в состав лечения дополнительно включают народные средства, чтобы усилить (или иногда полностью заменить) действие лекарственных препаратов. Однако в данном случае необходимо помнить следующее:

Не существует каких-либо лекарственных растений, которые могли бы полностью заменить антибактериальный препарат.

Далеко не всегда настои и отвары, приготовленные по рецептам народной медицины, сочетаются с официальными лекарственными средствами.

Не доверяйте всей полученной информации о подобных методах лечения из Интернета. Помните, что лучше всего проконсультироваться с лечащим врачом или со специалистом в области народной медицины.

Не стоит лечить гайморит растительными средствами при остром процессе.

«Симптомы тревоги» или когда нужна немедленная помощь врача

Важно помнить, что немедленная консультация врача может понадобиться в следующих случаях:

  • головная боль достигла высокой интенсивности;
  • появились судороги ;
  • речь стала запутанной и/или невнятной;
  • пациент галлюцинирует;
  • температура тела превышает 39 0 С;
  • снизилось артериальное давление (менее, чем 90/60 мм рт.ст.);
  • сердечная деятельность или сильно участилась, или стала аритмичной;
  • появился выраженный отек лица.

| 18 March 2014 | | 2,012 | Uncategorized
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