Sinusitis - signs, symptoms and treatment in adults, causes, exacerbation of the disease. Sinusitis: what to do so that a runny nose does not become a nightmare Causes of sinusitis in adults

Sinusitis is an inflammation of the maxillary sinus, which is called the maxillary sinus by the name of the English doctor who first described it. It is connected to the nasal cavity by narrow outlet openings (ostia) only 1–3 mm in diameter (slightly larger than the diameter of a fountain pen refill). Inflammation of the nasal cavity causes edema, and the edema quickly covers these fistulas. As a result, the maxillary sinus initially closes partially, and if treatment is not started on time, it turns out to be completely blocked. White blood cells rush into the blocked sinus to fight inflammation. From the school biology course, everyone probably remembers that their task is to destroy the infection. This is how acute catarrhal sinusitis begins. If at this time the treatment is started correctly, the chance that the sinusitis will not become purulent is very high.

Purulent sinusitis: treatment and correct diagnosis

The number of foreign bacteria can be huge, then in response the body produces the same huge number of leukocytes (diagnosed with such a symptom as leukocytosis). Increased ESR(erythrocyte sedimentation rate) and a significantly higher than usual level of leukocytes in general analysis blood will show the doctor the state of the so-called inflamed blood.

But it also happens that leukocytes are unable to overcome the infection, and die. Pus is formed - an accumulation of dead leukocytes. Then it is already purulent sinusitis - treatment should be immediate and correct.

When the mucopurulent masses cannot get out of the maxillary sinuses, they begin to "roam". Any sane person will understand - it's time to go to the ENT clinic. It is better not to joke with purulent inflammation that flares up next to the brain! You need to see a doctor.

Complications with sinusitis

Secondary rhinogenic meningitis (inflammation of the meninges), perhaps the most dangerous consequence illness. But other rhinogenic intracranial complications are also not the best life acquisitions.

As soon as a disease is suspected, it is urgent to seek an experienced doctor.

How to recognize sinusitis: symptoms

The first sign of sinusitis is a constantly stuffy nose. Usually congestion is more strongly felt on the side of inflammation. Bilateral - on both sides. Nasalness may appear.

Another symptom is nasal pressure. Often - pain in the cheeks, as well as at the bottom of the orbit. The patient may feel pressure in eyeballs ah and lower eyelids. In the morning, the pain is usually imperceptible, but becomes very noticeable in the evening. Due to the fuzzy localization, it sometimes seems to the patient that the reason is simply a headache. Pain in the maxillary sinus in the perception of a person can be transferred to the teeth of the upper jaw.

A common symptom of sinusitis is swollen cheeks and lower eyelids. And sometimes on the side of inflammation - and the upper ones.

Yellow and green discharge bad smell is another sign of inflammation.

The thermometer usually shows up to 38 ° C and above. But subfebrile (37.1–37.5 ° C) temperature with sinusitis is not a rare sign. This is more common in chronic disease.

Fatigue and loss of appetite are also symptoms. In patients, due to general weakness, they usually have reduced performance and are disturbed by restless sleep.

Factors that provoke sinusitis

People with a deformed nasal septum are at risk of getting sick. Hypertrophied (enlarged) lower nasal conchas also contribute to the development of sinusitis, since they close the exit to the anastomosis. Other anatomical changes in the nasal cavity can also provoke the disease.

Various formations, what ENT doctors themselves usually call "plus tissue": polyps in the nasal cavity and paranasal sinuses, cystic formations and other growths also increase the risk of sinusitis.

Weakened local immune defense due to illness, allergies and autoimmune diseases can also contribute to the development of sinusitis.

Factors of the human environment can also provoke the development of this disease: gas pollution, harmful conditions at work, dust, and so on.

How to treat sinusitis?

Even from the previously stated it is clear that the factors of the disease differ, respectively, the course of recovery is selected individually. But the first task of the doctor is always to “uncork” the sinus fistulas closed by edema in order to provide the possibility of outflow of mucus and pus.

Modern treatment of sinusitis without puncture

To treat sinusitis without a puncture, they carry out “soft” antibacterial and probiotic therapy, that is, they use antibiotics, so to speak, of medium strength. Of the probiotics, normoflorin, linex, bion-3 and others are most often used. Prescribe drugs to relieve edema, as well as vasoconstrictor action. Use emollients to restore the nasal mucosa. It can be pinosol, euphorbium compositum, etc. Sinupret is most often used to restore the mucosa. To rid the body of microbes and inflamed masses, the paranasal sinuses are washed with aqualor, dolphin, aquamaris (at the doctor's choice and, of course, depending on the patient's tolerance), octenisept, dioxidine, miramistin and other antiseptics are used.

"Cuckoo" (washing all paranasal sinuses) is prescribed as a procedure for extracting mucopurulent masses, as well as for antiseptic and antibacterial treatment of the nasal cavity and nasopharynx.

Physiotherapy

So, the primary task is solved - the pus from the sinuses is removed! It's time for ancillaries. For this purpose, sessions of infrared laser and vibroacoustic therapy, as well as quartzization of the nasal mucosa (UVR) are effective.

Surgical path

When the disease is started, you can no longer manage with medicines alone. Then they make a hole. Or, in medical terms, a puncture maxillary sinus. The goal is still the same - to extract the mucopurulent discharge and deliver the medicine to the inflamed area.

Puncture of the maxillary sinus is a therapeutic and diagnostic procedure. It is also carried out in cases where it is difficult to determine the type of sinusitis, or there are doubts about the cause of the patient's illness.

With all the perfect modern equipment, there are situations when the results of the research, the patient's complaints and the history of the disease contradict each other. It will help the doctor to understand what is the matter, and only a puncture will dot the “i”.

Friends! Timely and proper treatment ensure you a speedy recovery!

Despite the fears of patients, the Kulikovsky needle puncture is the most effective technique, which is why it is used more often than non-surgical techniques.

Having made a diagnosis, the ENT doctor informs the patient in detail about the disease and treatment options, but the patient will have to decide whether to make a puncture or not.

Sinus catheter YAMIK: is it a panacea?

Let me tell you, it is not a panacea. But the methodology also has disadvantages. And alas, quite significant.

1. The YAMIK catheter cannot be sterilized in a dry-heat cabinet - it will simply melt. In an autoclave - difficult, but possible. After autoclaving, the properties of the rubber change, it becomes less elastic, the balloon itself often sticks together and this makes subsequent rinsing difficult. Another method of sterilization is a strong antiseptic solution. But if you overdo it with its concentration, the shell of the balloon may become thinner, and the balloon may break during the procedure. An explosion of a balloon in the nasopharynx is painful and unexpected, and it is impossible to make a claim to the doctor: the office or dressing nurse sterilizes the instruments.
2. One YAMIK procedure is performed - on one inflamed side. With bilateral inflammation, you will have to do a full-fledged second manipulation.
3. Yamik catheterization is not effective or, more correctly, difficult to perform for patients with a deviated nasal septum.
4. Sometimes, due to strong contact with the nasal mucosa, the YAMIK catheter tears the nasal mucosa and provokes severe and poorly controlled bleeding. The problem in the vestibule of the nose is solved quite quickly, but if the posterior sections of the nasal cavity are “bleeded”, then everything is much more complicated.
5. Washing of the sinuses of YAMIK occurs due to the jerky movement of the liquid, which creates a piston of a plastic syringe (by propulsion). Accordingly, there is no need to talk about the exact hit of the drug in the inflamed maxillary sinuses.
6. There is a possibility of contamination of healthy neighboring sinuses on the side of washing with purulent masses, since pus under pressure can get there as well. And the technique, alas, does not allow to wash only the inflamed sinus.
7. Yes, there will be no crack. But the increase in the volume of the balloon in the nasopharynx is painful enough for patients to regret that they did not agree to a puncture. Otherwise, it is impossible - you need to create a certain level of pressure for washing.
8. It is impossible to wash the sinuses in one minute (more precisely, it is possible, of course, but carelessly). The quality procedure takes 10-15 minutes. Otherwise it is impossible, it is inefficient. And all the while, the patient is moaning in pain. despite anesthesia. The method of complete anesthesia, alas, does not provide.
9. With a deviated nasal septum, the YAMIK catheter sometimes has to be inserted with tweezers and with force. It hurts too. And the catheter can be torn.
10. And one more important detail: the cost of medications and medical instruments. With this procedure, the patient will have to pay for the Yamik catheter itself, and for anesthesia, and for washing. If the inflammation is bilateral, then there will be two manipulations: two sets of drugs, two anesthesias, bilateral mucosal contraction and bilateral washing. Expensive. Twice as long. And it will hurt twice as well.

Yamik, of course, is not a puncture, but it is not a panacea either. But a patient who has read medical advertising begins to understand this only during the procedure itself, when it is already necessary to endure for the doctor to complete the matter. And then he regrets that he did not listen to the doctor.

So how do you treat sinusitis? There is an answer! Complex!

To cure sinusitis sparingly and effectively, it is better to apply a complex technique. Its general meaning is in the connection drug treatment with physiotherapy procedures and washing the sinuses by moving fluids ("cuckoo"). A puncture is a last resort.

The general course of recovery will be as follows:

• remove the swelling of the nasal mucosa as a whole;
• we remove the edema of the mucous membranes in the fistula zone;
• we carry out the procedure of vacuum washing of the paranasal sinuses - "cuckoo";
• after we have washed the nasal mucosa, when the nasal mucosa has become clean, we irrigate the cavity to the nasopharynx with an antiseptic - dioxidine;
• we conduct a session of infrared laser therapy (the laser relieves swelling and inflammation of the nasal mucosa);
• we carry out ultraviolet exposure to the nasal cavity (quartz treatment). UVR kills microbes in the nasal cavity, sterilizes and dries the mucous membranes;
• we conduct a session of vibroacoustic therapy (Vibroacoustics is similar to ultrasound. The device operates at different frequencies. Sensors are placed on the skin in the projection of the maxillary sinuses and act through the bone directly on the sinus, as a result, microcirculation of tissues and capillary blood circulation improve, and inflammation in the sinus subsides).

Each of this method and each procedure is pathogenetically substantiated. One machine cannot replace another. In combination, the technique gives excellent results. It is well tolerated even by children from the age of three. The final individualized treatment option depends on the intensity of the inflammatory process, the amount of pus, the duration of the disease, and other factors.

But, forgive me colleagues from state medical institutions, most likely it will not be possible to do this in a regular clinic. According to the stories of the patients themselves, events unfold like this. The patient comes with acute illness to the clinic. And they will tell him: either a puncture here, in the clinic, or go to the hospital, and let them treat you there as they want (most likely, with the same puncture), or write a refusal of a puncture and hospitalization! This is done so as not to fool around and play it safe. If something goes wrong, there will be a trial, and they will ask why they didn’t offer a puncture, you can’t blame the doctor for anything. Plus - the influx of patients is large. The tactic is simple: send the patient to the hospital - and you're done! A sparing individualized comprehensive approach in the clinic, most likely, will not be offered. To make a "cuckoo" in the state clinic, the patient will not be interrogated either, not to mention YAMIK. They are simply not there.

Very often, people, having discovered the first signs of rhinitis, accompanied by weakness and loss of efficiency, do not pay due attention to this, believing that it is mild form colds will go away on their own. Sometimes behind such seemingly frivolous symptoms, a very dangerous disease can be hidden, which, if not properly treated, has various side effects and complications.

What is sinusitis?

Sinusitis is an inflammation of the paranasal sinuses. Almost always it appears due to repeated deep or colds that have been badly and dishonestly cured. But, in addition to colds and runny nose, neglected teeth, especially the upper ones, are another reason. The nose is blocked and mucus begins to accumulate inside. After that, pus begins to stand out.

The usual symptoms of sinusitis are loss of smell, heaviness in the head, pain in the temples and bridge of the nose, enough - within 37-38 ° C. But, besides all this, a person's memory worsens, working capacity decreases and fatigue increases.

It should be noted that if you do not start treating sinusitis for initial stage, then it will develop into the next, purulent stage. As a result, you will develop other serious diseases.

In the acute course of the disease, the thin mucous membrane that covers the maxillary sinuses becomes inflamed. There is also a negative impact on those located in this area. blood vessels, as well as on connective tissue. When sinusitis passes into the chronic stage, damage to the bone walls of the maxillary sinuses and submucosa is observed. Any people are susceptible to sinusitis age category. This disease develops regardless of the gender of patients. According to statistics, which can be found on specialized Internet resources, as well as in the media, the peak of sinusitis occurs in the autumn and winter seasons. In early spring, exacerbations of this disease also occur.

Causes of sinusitis

As a rule, the cause of sinusitis is an infection that enters the nasal cavity through the blood or when breathing. There are several underlying conditions that interfere with nasal breathing. This is a curvature of the nasal septum, vasomotor rhinitis, hypertrophic rhinitis (enlarged turbinates), in children - adenoids, allergic diseases of the nose.

When people take swabs from the nose during a physical examination, as a rule, a so-called person is found in a person, which lives in the human nasopharynx for a long time. The latter, if he had not been examined, would not have known that he was a carrier of bacteria. For a long time, these bacteria may not cause serious damage to health. But even with a common cold, staphylococcus aureus can become more active and show its pathogenic properties.

modern medicine Numerous reasons for the development of sinusitis have been identified:

injury to the mucous membrane of the maxillary sinuses;

penetration into the nasopharynx of viruses and pathogenic bacteria;

poorly treated runny nose;

advanced form of a cold;

prolonged stay in a room where the air is too dry and heated to a high temperature;

being in a draft;

inhalation of chemical fumes (usually this occurs in hazardous production);

neglected teeth and poor hygiene oral cavity;

external impact of aggressive environments on the mucous membrane;

an allergic reaction of the body to various external stimuli;

dangerous diseases, such as, fungal infection of the mucous membrane, etc.

Regular use of drops intended for the treatment of rhinitis is the main cause of the accumulation of a large amount of mucus in the maxillary sinuses, against which sinusitis develops.

The use of various medications, in the form of drops, can cause nosebleeds to start. This is due to the fact that drugs are too strong an irritant for the mucous membranes and tissues of the maxillary sinuses, as a result of which blood vessels can burst and nosebleeds begin.

Symptoms of sinusitis in adults

Symptoms of sinusitis is the appearance of pain in a person in the nose and near the nasal region, which gradually increase. Pain is less pronounced in the morning, increasing in the evening. Then the patient begins to lose a specific place with unpleasant sensations and his head begins to hurt. If the process is one-sided, then the pain is noted on one side.

Also, the patient is constantly tormented by a runny nose. Mucous (clear) or purulent (yellow, green) discharge from the nose is observed. This symptom may not be present if the nose is severely blocked.

Patients have a fever: sometimes it reaches 38 ° C, and sometimes higher. This temperature occurs in people who are sick with acute sinusitis. If the process is chronic, then high temperature rarely appears. Patients experience malaise, which is expressed by fatigue, weakness, patients refuse food, sleep is disturbed.

The disease of sinusitis is accompanied by certain symptoms:

the appearance of mucous discharge from the nose (over time, particles of pus may be present in them);

nasal congestion;

memory impairment;

a feeling of strong pressure in the region of the nose, which increases when the head is tilted;

sleep disturbance;

labored breathing;

loss of working capacity;

increased fatigue;

fever (often the temperature can rise to 40 ° C);

the appearance of chills;

lethargy, weakness and general malaise;

pain in the nose area, extending to other parts of the body (forehead, eye sockets, etc.);

apathy, lethargy, sleep disturbance, etc.

Bilateral sinusitis is considered a fairly rare disease that has a pronounced clinical picture and proceeding in a more severe form. The cause of the development of this disease can be any inflammatory or infectious diseases. When conducting diagnostic measures specialists palpate the region of the maxillary sinuses, causing pain in patients. In the treatment of bilateral sinusitis, patients are prescribed complex medication and physiotherapy.

This disease is widespread among patients of different ages. Polypous sinusitis is not amenable to medical treatment. The only way to treat the disease is through surgery. Polypous sinusitis develops against the background of: acute course of various allergic diseases; congenital or acquired anomalies of the nasal septum; inflammatory processes progressing in the sinuses.

The manifestation of this form of sinusitis begins with the occurrence of problems with nasal breathing. Patients begin to breathe through their mouths as their nasal cavities are blocked. Polypous sinusitis is often accompanied by copious secretions of mucus (clear or yellow-green) from the nose. Many patients complain of dullness of taste buds, lack of appetite, distraction, headaches, etc.

Treatment of polyposis sinusitis is carried out in a hospital. The patient is transferred to the operating room and surgically remove overgrown tissues that interfere with normal nasal breathing. Some specialists try to treat small polyps with medication, prescribing steroids, antibiotics, antihistamines, etc. to their patients. Such therapy only in isolated cases brings positive result, since the desired effect is achieved only with surgical treatment.

Chronic sinusitis

Chronic sinusitis is most often diagnosed in patients who have an inflammatory process in the maxillary sinuses. This disease often passes into the stage of exacerbation, which, if not properly treated, can lead to the development of various complications. During the progression of this disease, many patients experience inflammation in the organs that are in the area of ​​the maxillary sinuses.

The cause of the development of chronic sinusitis can be any pathogens: viruses, fungi, bacteria, etc. This form of the disease can develop against the background of existing defects in the nasal septum, which can be either congenital or obtained as a result of mechanical impact. Very often, chronic sinusitis is diagnosed in patients who have problems with their teeth. Even simple caries can act as a distributor of infection and provoke the appearance of this disease.

The allergic form of sinusitis can develop against the background of any external factor, aggressively affecting the mucous membrane of the maxillary sinuses. The body, when exposed to an allergen, begins to show a response, which manifests itself in increased tearing, removal of mucus from the sinuses, swelling, etc. In most cases, this form of the disease progresses in spring and autumn.

With allergic sinusitis, patients experience the following symptoms:

temperature increase;

nasal congestion;

the appearance of pain in the eyeballs, cheekbones;

weakness;

headaches, etc.

With allergic sinusitis, some patients have experienced complications, which in most cases are caused by the growth of polyps in the nose. Such growths interfere with normal nasal breathing, and therefore are subject to surgical treatment. Traditional medical and physiotherapeutic treatment does not bring a positive result in this case.

Patients first need to determine the origin of the allergen that caused the development of sinusitis. If it is detected, any contacts with it should be urgently limited. It is advisable to pass comprehensive examination, which will reveal which allergens the patient's body reacts to. After completing a course of antiallergic therapy, patients are prescribed special drugs.

At the stage of recovery, patients need to restore nasal breathing by doing special exercises. Proper nutrition(in most cases, a special diet is prescribed) and a complete rejection of bad habits will contribute to the speedy restoration of the work of many internal organs and systems. With allergic sinusitis, patients are very useful for long walks in coniferous forests, the air of which has healing properties and is ideal for people who have problems with the bronchopulmonary system and respiratory tract.

Purulent sinusitis

Purulent sinusitis often develops against the background of infectious, viral and catarrhal diseases suffered by patients, which were not treated in a timely manner. In most cases, this form of the disease is diagnosed in patients who, with the manifestation of symptoms of sinusitis, neglected the quality medical care and instead self-medicated.

The main reasons for the development of purulent sinusitis are harmful microorganisms and bacteria, the products, the vital activity of which provoke the appearance of inflammation and the accumulation of purulent deposits in the maxillary sinuses. In an advanced stage, this disease can affect bone tissue and closely located organs. In order to prevent the appearance of purulent sinusitis, it is necessary at the first manifestations of the disease to contact the local doctor, who, after the examination, will refer the patient to a highly specialized specialist.

Acute sinusitis

With the development of an acute form of sinusitis, patients often complain of general malaise, weakness, chronic fatigue and decreased performance.

In some cases, the disease can occur without pronounced symptoms, but usually it is accompanied by:

rise in temperature;

strong secretion of mucus, mixed with pus, from the nose;

the appearance of swelling;

difficult breathing;

sleep disturbance;

the appearance of pain during palpation of the maxillary sinus area, etc.

Become the cause of the development of this disease can:

congenital defects of the nasal septum;

mechanical damage to cartilage and bone tissue in the nose;

viral and infectious diseases transferred on the legs;

tendency to allergic reactions to any external stimuli, etc.

Treatment of the acute form of sinusitis takes several weeks and includes constructive drug therapy.

Odontogenic sinusitis

Odontogenic sinusitis often develops against the background of an acute inflammatory process in the maxillary sinuses. The causative agents of this form of the disease are: staphylococci, mixed infection, streptococci. Poor dental health and poor daily oral hygiene can also cause odontogenic sinusitis.

With the progression of this form of the disease, immunity decreases in patients, bone tissues can be damaged, pain appears, etc. To prescribe effective therapy, it is very important to correctly determine the focus of the disease and identify its pathogen. After that, a group of antibiotics, antihistamines and other medications is selected.

Sinusitis is a very complex disease, with proper treatment of which patients can face serious consequences:

the appearance of swelling of the maxillary sinuses;

inflammation of the mucous membrane;

violation of nasal breathing;

strong discharge of mucus from the nose;

accumulation of pus in the maxillary cavities, etc.

After treatment of sinusitis, some patients experience various complications:

very often the acute form of sinusitis passes into the chronic stage, which requires a longer constructive treatment;

inflammatory processes of the bronchopulmonary system, tonsils of the pharynx and other organs develop;

against the background of the inflammatory process, otitis media appears.

Patients who have been diagnosed with an advanced stage of sinusitis may face more serious complications, in which appear various diseases:

organs of vision;

brain, etc.

When complications go beyond the boundaries of the bronchopulmonary system and damage to other internal organs, patients may encounter. In the case when the patient, upon identifying the primary symptoms of sinusitis, immediately turns to medical institution and will undergo medical and physiotherapeutic treatment, he will be able to avoid any consequences and complications of this disease.

Warming up the nose is strictly prohibited in the acute form of sinusitis, since under the influence of a high temperature regime, a rapid spread of infection throughout the body can occur. It is possible to warm the nasal area in those cases when the maxillary sinuses are already almost completely freed from pus and the patient is at the stage of recovery.

To date, there are various methods warming up the nose with sinusitis:

heating with salt. This method is familiar to many people since childhood, when parents applied a hot bag of salt with a stuffy nose. To prepare such a hot “compress”, you need to heat a glass of rock salt in a frying pan and put it in an ordinary clean sock. Such a hot pad should be applied to the bridge of the nose and kept for 10-15 minutes;

heating with chicken eggs. To use this method, you need to hard-boil two eggs. After the eggs are removed from the boiling water, they should be immediately wrapped in a towel. A hot towel is applied in the area of ​​​​the maxillary sinuses and is held until the moment of partial cooling;

warming up the nose with inhalation. To do this, boil the potatoes in their skins, drain the water from it. Leaning over the pan with steaming potatoes, you should cover yourself with a blanket so that the desired temperature regime is maintained inside. Within 10 - 15 minutes it is necessary to take deep breaths through the nose or mouth;

warming up the nose with a blue lamp. The action of this device is aimed at the destruction of bacteria and infections. Blue lamps are actively used to disinfect rooms in which there were sick people. In most cases, blue lamp warming procedures are part of complex drug therapy.

Before using any of existing methods warming up the nose with sinusitis, each patient should consult his doctor. The specialist will foresee any side effects and help you choose the safest method for your patient.

Is it possible to go to the bath with sinusitis?

Many patients who have been diagnosed with sinusitis are interested in the question of visiting the Russian bath and the Finnish sauna. With the progression of this disease, people need to take any water procedures with caution. Doctors recommend that their patients refrain from visiting steam rooms with acute sinusitis. At this stage of the development of the disease, patients are advised to soar their feet by adding mustard or various essential oils to the water.

To prevent the development of sinusitis, it is necessary to regularly carry out a number of preventive measures:

when visiting the street, dress according to the season;

strengthen your immune system folk remedies and special medicines;

take vitamins and mineral complexes;

exercise regularly (you can visit Gym, swimming pool, fitness club, etc.);

take long walks in the fresh air (preference is given to park and forest areas);

do breathing exercises that help normalize nasal breathing;

with the manifestation of the primary symptoms of rhinitis, it is necessary to take measures (massage, rinse the nasal passages, use special drops and other medications);

Go to healthy eating, review your daily diet and introduce into it only healthy foods;

completely abandon bad habits that cause irreparable harm to the human body;

timely treat any diseases against which sinusitis may develop;

take care of your health, try not to expose the body to hypothermia;

• at primary manifestations you should immediately consult a doctor and undergo a course of medical treatment;

The maxillary sinuses are lined with a mucous membrane that normally drains into the nasal cavity through small openings. When this drainage system becomes blocked due to swelling caused by inflammation, infection, or allergies, sinusitis develops.

First aid for sinusitis

Most cases of acute sinusitis are caused by viral infections that resolve without medication. However, many people are interested in what to do when sinusitis begins.

One of the simplest, cheapest and most effective ways to treat sinusitis at any stage of development is. This relieves symptoms, reduces dependence on nasal sprays and antibiotics, and improves patients' quality of life.

Do the following several times a day:

• Dissolve 1/2 teaspoon non-iodized table salt and 1/2 teaspoon baking soda in 2 cups of boiled or distilled water.
• Fill a small syringe or bulb with this saline solution.
• Bend over the bathtub or sink, insert the tip of the device inside the nose through one nostril and gently squeeze out the solution. Repeat several times with both nostrils.
• Wash the syringe or bulb thoroughly and dry.

In addition to rinsing the nose, the following are helpful in the early stages of acute and chronic sinusitis:

• Drink plenty of water. Good hydration keeps the mucus fluid, which improves its drainage from the inflamed maxillary sinus.
• Steam inhalation. To do this, you can linger longer in the shower. In addition, you can boil water in a saucepan, tilt your head over it, cover yourself with a towel and inhale the steam. Can be added to water essential oil eg pines. This method must be used with care to avoid burns.
• Dry environmental conditions should be avoided. Using a humidifier at home and at work can prevent nasal passages from drying out. It is very important to regularly clean humidifiers from bacteria and mold.
• Sleep with head up. When the head is lowered during sleep, mucus accumulates in the maxillary sinuses, which worsens the course of the disease.
• Blow your nose gently, one nostril at a time. Blowing too hard can irritate your nasal passages and send mucus and bacteria back into your sinus.
• Warm compresses on the face.
• Do not take antihistamines without a doctor's prescription. These drugs increase the viscosity of the mucus, which interferes with its drainage. However, if sinusitis is caused, doctors prescribe antihistamines in combination with other drugs.
• You need to be careful with the use of decongestants. Tablets and nasal sprays containing these drugs reduce mucosal swelling and improve drainage of the maxillary sinuses. But the frequent use of nasal sprays leads to the development of addiction, and taking tablets is accompanied by a risk of increasing blood pressure.

What to do with sinusitis?

Often patients are interested in what to do if their forehead hurts with sinusitis. In this case, you can take an Ibuprofen or Paracetamol tablet.

Acute sinusitis usually starts with a cold caused by viruses rather than bacteria. But when a cold turns into sinusitis, a bacterial infection can join. In this case, the patient may need

If the symptoms become severe and last more than a week, you should definitely visit a doctor. He will establish the diagnosis and prescribe the appropriate treatment. If necessary, the course antibiotic therapy lasts 10-14 days, most often use or.

- a more complex disease, the treatment of which should be under the supervision of an otorhinolaryngologist. For effective treatment, it is necessary to identify and eliminate the cause of the disease. For this purpose, a survey is carried out, which may include computed tomography sinuses and nasal cavity, endoscopic examination of the nasal cavity, blood and allergy tests, blood cultures for bacterial culture.

Nasal rinsing and the use of decongestants can improve drainage of the maxillary sinuses. Another drug used for this purpose is Guaifenesin.

To combat the inflammatory process, corticosteroids are prescribed in the form of nasal drops or sprays. In the presence of large, causing chronic sinusitis, oral corticosteroids are more effective. Also, with this disease, there is a high risk of a bacterial infection, which requires a longer and more intensive antibiotic therapy.

What can not be done with sinusitis?

Many patients are interested in what can not be done with chronic sinusitis.

• Dairy products, eggs, wheat and corn products (including corn derivatives - maltodextrin, corn syrup, modified starch, corn starch, corn oil). Chronic sinusitis can be caused by a food allergy or an intolerance to certain foods.
• All simple or refined carbohydrates (white flour, white rice, white bread, pasta, cookies, cakes, crackers, etc.).
• All products containing refined sugar or artificial sugar substitutes such as aspartame.
• It is forbidden to abuse alcohol, as they disrupt the functioning of the immune and digestive systems.
• It is necessary to limit the use of cheeses and wine.
• Mushrooms.
• Marinated products.
• Sweet fruit juices - they dramatically increase blood sugar levels.
• Carbonated drinks, which can cause a drop in blood pH.
• Some seafood (eg oysters, mussels, lobster, tuna, mackerel) which may contain toxic levels of mercury.
• Sodium nitrite - found in processed foods (hot dog, bacon).
• Monosodium glutamate is found in many foods as a flavor enhancer.
• Hydrogenated or partially hydrogenated oils found in many processed foods.
• Limit your intake of caffeinated foods and drinks.

Other helpful tips, which can reduce the risk of exacerbations in chronic sinusitis and alleviate the condition in acute:

• Smoking cessation - tobacco smoke irritates the mucous membrane of the nose and paranasal sinuses.
• Use of a humidifier to keep mucous membranes moist.
• Do not swim in chlorinated pools or contaminated water.
• It is necessary to identify the cause of the allergy and avoid it.
• Should be held effective treatment fungal infections, if any.
• Avoid contact with feathers, old and moldy pillows, which are often the cause of allergies.
• If a person has silver dental fillings, they may need to remove the mercury amalgam fillings. Mercury in the body damages immune cells, which then lose their ability to fight infections.
• Physical exercise. Despite pain and throbbing in the head, with sinusitis physical exercise contribute to the restoration of health. Just remember that excessive exercise can worsen the symptoms of the disease.

When is a puncture necessary?

Not so long ago, puncture of the maxillary sinus was the main method of treatment of sinusitis in the CIS countries.

Currently, it is carried out in the following cases:

• When the maxillary sinus is filled with pus and its drainage is difficult, despite the ongoing complex conservative treatment. In this case, even several punctures are possible, taking into account the dynamics of the disease.
• For diagnostic purposes - to obtain material for bacterial culture. This allows you to identify the causative agent of sinusitis and determine its sensitivity to antibiotics.

Most often, a puncture of the maxillary sinus has to be done with recurrent chronic sinusitis.

If the combination of conservative treatment and maxillary sinus puncture fails, it is necessary to surgical intervention aimed at improving its drainage. One of the most modern methods is functional endoscopic surgery on the paranasal sinuses, which is carried out using a special endoscope inserted through the nose of patients. During this operation, the surgeon can see the opening of the maxillary sinus and insert tiny instruments into it.

Then he:

• Removes any tissue (such as nasal polyps) that is blocking the maxillary sinus.
• Inflates a small balloon in the drainage hole of the maxillary sinus, expanding it.

Potential complications of such an operation include temporary pain and discomfort in the nose, bleeding, and infection.

Sinusitis is a common disease. In most cases of an acute process, it is caused viral infection, the treatment of which is purely symptomatic. In chronic sinusitis, more serious treatment is most often needed, including long-term antibiotics, and sometimes a puncture and surgery. What to do with sinusitis in each case, the doctor will tell.

Useful video about the treatment of sinusitis

Sinusitis (Highmoritis) is one of the common diseases of the internal nose. It accounts for 25-30% of all inpatient pathology of the ENT profile. It ranks fifth on the list of conditions requiring antibiotic therapy. It is more common in children and immunocompromised patients with recurrent infections of the upper respiratory tract. Leads to a deterioration in the quality of life. According to the Russian Society of Rhinologists, in 26% the disease in an advanced form becomes the cause of mental depression. Acute sinusitis code for microbial 10 - J 01.0, J 32.0 - for the chronic form.

What is sinusitis

This is an episodic or chronic inflammation of the maxillary sinuses. It can occur in various pathological configurations. Leads to persistent respiratory failure, headaches, general toxic syndrome. Influencing factors:

• Congenital or acquired anomalies in the structure of the respiratory system.
• Violation of transport and secretory function mucociliary apparatus.
• Weakening of immune mechanisms of any etiology.
• URT infections (runny nose).
• Dental diseases (primarily apical granuloma of the second premolar and first molar).

Has an infectious nature. The causative agents are Escherichia coli, hemolytic streptococcus, pneumococcus, less often - viruses and fungi. With odontogenic varieties, anaerobic flora is sown. Acute sinusitis - a disease that lasts for 12 weeks, is cured without residual changes. Recurrent variety - 1, 2, 3 or 4 episodes per year, the interval between which is 8 weeks. During periods of remission, there are no signs, treatment is not required. Chronic course - continuous symptoms for 12 weeks.

Types of disease

Seven principles for classifying sinusitis apply. Distinguish between acute, chronic and recurrent forms; bacterial and viral varieties; primary and secondary inflammatory processes. The modified B.S. system is in demand. Preobrazhensky, where the division is made according to the morphological features of the disease.

Exudative

Consistently goes through three stages of development: catarrhal, serous, purulent. Initially, inflammation is characterized by swelling and hyperemia of the mucous membrane, there is no discharge. There is a bursting headache, nasal breathing is disturbed. If a person ignores these signs, the process goes into a serous form, in which exudate accumulates in the sinus. Subsequently, it becomes purulent, begins to stand out through the external nasal passages. The color of the snot is yellow-green, the smell is fetid. Systemic phenomena develop, a general toxic syndrome occurs. The exudative variety of sinusitis can be left-sided, right-sided or bilateral. In the latter case, the disease is severe.

Productive

Another name: parietal-hyperplastic or polypous variety - the mucous membrane thickens. Polyps are growing organic disturbance nasal breathing. In this case, there is no separable. Often occurs against the background of chronic exudative sinusitis, in the absence of treatment. Operative removal of neoplasms is shown.

Alternative

Has several forms:

• Atrophic - a decrease in the volume and mass of the mucous membrane.
• Necrotic - areas of necrosis.
• Cholesteatoma - in the sinus of the tumor, consisting of layered on top of each other torn layers of the mucous membrane.
• Caseous - the release of exudate in the form of curdled masses.

allergic

It is characterized by an undulating course, abundant serous discharge. When a bacterial infection is attached, it can become purulent. Accompanied by other symptoms of hypersensitivity, it is relatively easy to stop with the help of antihistamines. Occurs rapidly, shortly after contact with the trigger.

Symptoms of sinusitis

There are a number of general and local features that are characteristic of all acute varieties. The local ones include:

• Unilateral or bilateral respiratory failure.
• Pain on the affected part, radiating to the temple.
• Increased negative sensations when the head is tilted forward.
• Profuse or scanty nasal discharge.

There is infiltration and edema of the area of ​​the external projection of the sinus. In the blood, signs of an intense inflammatory process are revealed: leukocytosis, an increase in ESR. The patient complains of fever, general deterioration of health, headaches, loss of appetite. With proper treatment, it is possible to completely get rid of the “clinic” of the disease within 2 weeks.

Chronic sinusitis has a lubricated course. Patients note the presence of scanty discharge from the nose, which is present for several weeks. Headaches are intermittent, diffuse, they can not always be associated with ENT pathology. There is a decrease in the sense of smell up to its complete loss. This often occurs when polyps form in the nasal cavity. big size. Possible hearing loss, ear congestion. During the period of remission clinical manifestations weaken, but do not always disappear completely. Certain pathological signs persist, regardless of the stage of the disease.

Accurate diagnosis

The diagnosis is made on the basis clinical symptoms, complaints and anamnesis of the patient. For confirmation, an x-ray of the maxillary voids is prescribed. The images show darkening with a horizontal level, which indicates the accumulation of exudate. In the catarrhal form, the changes are parietal, there is no fluid in the cavity. During endoscopic examination, the sinus mucosa is infiltrated, edematous, and may be covered with purulent films. In chronic forms, the presence of polyps, thickening or atrophy of the mucous membrane is noted. In the latter case, the inner layer of the sinus is pale, with a well-visible vascular network.

If a neoplasm of the nose is suspected, a biopsy is used. During the study of the obtained biomaterial, atypical, degenerated cells are detected. An antibiotic susceptibility test is used to select an antibiotic regimen. Material - discharge from the nose. During the study, it is determined to which antimicrobial agents the pathogen is sensitive. In the presence of diagnostic difficulties, computed tomography or magnetic resonance imaging, radiography using a contrast agent are indicated.

What Not to Do

There are a number of factors that can worsen the course of sinusitis. One of them is smoking. Tobacco smoke complicates the already impaired nasal breathing, impairs the function of the ciliated epithelium, indirectly contributes to the accumulation of purulent discharge in the cavity of the maxillary sinuses. In addition, nicotine and other toxic substances formed during the combustion of tobacco weaken the immune mechanisms, reduce the level of the body's natural defenses. Swimming in chlorinated artificial reservoirs and pools is prohibited. The ingress of contaminated liquid on the mucous membrane irritates it, contributes to increased edema, hyperemia.

Purulent forms of sinusitis - a contraindication to heating the sinuses. A slight increase in local temperature creates favorable conditions for the reproduction of pathogenic flora, the intensity of the inflammatory process increases many times. With catarrhal varieties, warming up is permissible. They help to strengthen local immunity and stop inflammatory phenomena. Frequent blowing is not recommended, especially with clamping of one nasal passage. This contributes to the entry of exudate into the maxillary cavity. At allergic forms disease, contact with a trigger that causes a hypersensitivity reaction should be avoided.

Classical folk method treatment - a visit to the bath with a mandatory visit to the steam room. It is impossible to do this before identifying the form of sinusitis. Impact high temperatures admissible only in the catarrhal variety. Exudative types - a limitation for warming up.

Treatment of sinusitis

Therapy is carried out with the use of vasoconstrictor, antibacterial, anti-inflammatory drugs. To remove purulent contents, a puncture or a non-puncture method with the introduction of a sinus catheter "Yamik" is used. With the ineffectiveness of conservative treatment, maxillary sinusectomy and surgical sanitation of the cavity are performed. Specialists traditional medicine trying to exploit methods based on the use of herbal ingredients, but they are ineffective and rarely lead to recovery.

Medicines

Quickly cure sinusitis in an adult with medication succeeds only with its catarrhal variety. The patient is prescribed vasoconstrictors that reduce swelling and exudation, facilitate nasal breathing, and improve sinus ventilation. Naphthyzin, Galazolin, Tizin are chosen as the drug. The introduction is made three times a day, 5 drops in each stroke. The course of treatment is 7–8 days. Long-term use is contraindicated, as they cause drug-induced rhinitis - mucosal edema in response to drug withdrawal. In addition to drugs of this group, local mucolytic substances are prescribed - Rinofluimucil, Sinupret. They transform the consistency of the discharge, make the exudate more liquid, and facilitate its removal.

The basis of the treatment of purulent processes is antibiotics. The choice of the first-line drug is made empirically. Means for initial therapy: Amoxiclav, Cefazolin or Ceftriaxone, Sumamed. In the absence of a visible result on the 3rd day of treatment, the agent is replaced with an antimicrobial drug of another group, material is taken to determine the sensitivity of the pathogen to etiotropic drugs. Further antibiotic therapy - according to the results of the test. The course is 10-12 days. In parallel with this, symptomatic drugs are prescribed - analgesics (Ketorol), anti-inflammatory (Paracetamol), antihistamines (Zirtek). It is possible to use first-generation antiallergic drugs (Suprastin, Diphenhydramine) in cases where there are negative psycho-emotional phenomena: fear, anxiety. These drugs have a pronounced sedative and hypnotic effect, can reduce the level of anxiety of the patient.

Nasal lavage

Most effective way removal of pus is considered a sinus puncture. The puncture is made at the point of minimum thickness of the lateral bone wall, at the upper fornix of the lower nasal passage. Before the intervention, the patient is instilled with vasoconstrictor drugs, local anesthesia is applied using 10% lidocaine or 2% dicaine. The Kulikovsky needle is passed through the bone until it enters the sinus. Then, using a syringe, the existing contents are removed from the cavity, washed with antiseptic solutions (Chlorhexidine, Octenisept), and an antibiotic is administered.

Introduction medicines and removal of pus can be carried out without puncture, using an intranasal three-lumen catheter. This device provides low-impact access to the maxillary sinus. Sanitation is implemented by creating negative pressure in the affected area. Sealing - due to balloons inflated with a syringe. The use of the "Yamik" catheter is preferable, since it minimizes discomfort in the patient, reduces the risk of complications, and eliminates the difficulties associated with passing the puncture needle through the bone.

Surgery

Surgical intervention is indicated for persistent morphological changes and the ineffectiveness of washings performed more than 8 times. A common procedure is performed according to the Caldwell-Luc method, radical operation with a slit under the upper lip. The sinus is opened using a chisel and bone forceps, under local or general anesthesia. The mucosa is scraped with a raspator with the removal of all pathologically altered tissues. After the intervention, the patient is hospitalized for 1 week. At this time, he receives analgesic and antibacterial drugs.

A sinusectomy is a painful operation. Its implementation in patients childhood performed under general anesthesia or under local anesthesia, supplemented by the introduction of hypnotics. Otherwise, there is a risk of causing serious psychological trauma to the child, and the work of the surgeon will be hampered by the restless state of the patient.

Folk methods

At home, they try to treat sinusitis in unscientific ways. For introduction into the nose on turunda, a composition of aloe juice, onion and Vishnevsky ointment is used. The skin over the affected area is rubbed with garlic. For instillation into the nose and inhalations, infusions of chamomile, St. John's wort, cudweed, propolis are used. Another method is the use of prickly tartar juice as drops for intranasal administration. The reliability of such methods of treatment is extremely low. The person using them is at risk of chronicity of the process due to the lack of effectiveness of non-traditional means. The possibility of application is discussed with the doctor.

What happens if sinusitis is not treated

Sinusitis of the maxillary sinuses is a source of chronic infection. The causative agent can spread with the blood stream, seeding other tissues and organ systems. A frequent complication is infection of the soft materials of the face, eye sockets, and the formation of abscesses. In addition, the disease can lead to the development of osteoperiostitis, tonsillitis, pneumonia.

In severe cases, the pathogenic flora enters the zone of the meninges, meningitis develops. Common processes cause sepsis - generalized infection associated with massive blood infection. Acute sinusitis, not cured in time, turns into chronic form. Complications are most susceptible to infants, the elderly and patients suffering from immunodeficiency conditions.

Prevention

Prevention is timely treatment infectious diseases of the upper respiratory tract, maintaining the immune status at an acceptable level, the use of vitamins. You should eat well, avoid hypothermia, play sports. All this allows you to activate the body's defenses and avoid the development of pathogenic flora. Prevent chronization acute forms It is possible by the timely initiation of therapy and the fulfillment of all prescriptions of an otolaryngologist. It is unacceptable to warm the nose on your own and take medication.

Sinusitis and sinusitis - what's the difference

Sinus is a cavity present in human bone tissue. There are several similar sinuses in the skull: frontal, maxillary, sphenoid. The common name for the inflammatory process in any of them is sinusitis. Sinusitis is a narrower term. It denotes the pathology of the maxillary cavity. Simply put, it is one of several varieties of sinusitis. The latter is a broad concept.

Sinusitis is contagious or not for others

It is not transmitted to other people in the form of this particular pathology. However, the process is infectious. The causative agent is spread by airborne droplets when sneezing or coughing, by contact-household method. Depending on where exactly the ingested healthy person causative agent that develops a disease. Often there is laryngitis, bronchitis, pneumonia. With a safe immune system pathology may not occur, as the body suppresses bacteria and viruses that have got inside.

Doctor's conclusion

Sinusitis is a serious disease associated with inflammation of the sinuses. Treatment in adults takes 1-2 weeks, in young children the period of convalescence may be increased. At the initial stage, the process proceeds without a runny nose (catarrhal form). Subsequently, exudate begins to stand out. Get rid of unpleasant symptoms seeking help from the clinic will help. The disease can be cured on an outpatient basis, without hospitalization. If there is a running and complicated sinusitis, the patient is sent to the hospital.

- inflammation of the maxillary (maxillary paranasal) sinuses. It is accompanied by difficulty in nasal breathing, mucopurulent discharge from the nasal passages, intense pain in the bridge of the nose and at the wings of the nose, swelling of the cheeks and eyelids on the side of the lesion, and a rise in body temperature. Timely treatment will help to avoid serious complications: otitis media, meningitis, brain abscess, orbital phlegmon, osteomyelitis, myocardial and kidney damage.

General information

Sinusitis can be acute or chronic. According to international medical statistics, about 10% of the population of developed countries falls ill with acute sinusitis and other sinusitis every year. The disease affects people of all ages. In children under 5 years of age, sinusitis almost never occurs, since at this age the paranasal sinuses are not yet sufficiently developed. Timely treatment of sinusitis avoids serious complications: otitis media, meningitis, brain abscess, orbital phlegmon, osteomyelitis, myocardial and kidney damage.

Causes of sinusitis

Diagnosis of sinusitis

The diagnosis is made on the basis of the patient's complaints, external examination data (reflex expansion of the skin vessels of the infraorbital region is determined), examination of the nasal mucosa (inflammation, swelling, purulent discharge from the sinus opening). On the x-ray of the maxillary sinus, darkening is detected. With insufficient information content of other research methods, a puncture of the maxillary sinus is performed.

Treatment of sinusitis

acute form

To reduce mucosal edema and restore normal sinus ventilation, apply vasoconstrictor drugs local action (naphazoline, naphazoline, xylometazoline hydrochloride) for a period not exceeding 5 days. With significant hyperthermia, antipyretic drugs are prescribed, with severe intoxication - antibiotics. Avoid adverse side effects and it is possible to achieve a high concentration of the drug in the focus of inflammation by using topical antibiotics. After normalization of the temperature, physiotherapy (Solux, UHF) is recommended.

Chronic sinusitis

To achieve a sustainable effect of therapy in chronic sinusitis, it is necessary to eliminate the causes that contribute to the development of inflammation in the maxillary sinus (adenoids, chronic diseases of the upper respiratory tract, deviated nasal septum, bad teeth, etc.). During the period of exacerbation, local vasoconstrictors are used in short courses (to avoid mucosal atrophy).

With purulent-polypous, polypous, caseous, cholesteatoma and necrotic form of chronic sinusitis, surgery. Produce an autopsy of the maxillary sinus -