For some people, sinusitis is associated with a trivial runny nose, medically called rhinitis. Indeed, these two different diseases have one common symptom - discharge from the nose, or popularly snot. When they appear, many rush to solve the problem with the help of widely advertised sprays and drops, not suspecting that such therapy is only making new problems for themselves. And all because the treatment of acute sinusitis, unlike rhinitis, must take into account the causes that caused it. In other words, if sinusitis is caused by an injury, such as after a visit to the dentist, the treatment is very different from sinusitis caused by a bacterial infection. And the treatment of acute sinusitis caused by pathogenic fungi cannot be carried out by the same methods as allergic sinusitis.
Only otorhinolaryngologists can determine what exactly happened to your nose. They prescribe a series of studies, and on the basis of their results prescribe medications. If you try to get rid of the annoying runny nose on your own,you can stop it for a while, and drive the disease deeper. Then, at best, a runny nose will appear with tedious regularity, and at worst, sinusitis will develop into a more dangerous disease, such as meningitis or a brain abscess.
The concept and characteristics of sinusitis
To understand how effective treatment of acute sinusitis should take place, you need to clearly understand what it is. Not everyone knows that sines are not only in geometry. The same term refers to the special sinuses of our nose, and their inflammation, respectively, sinusitis. In total, people have four pairs of sinuses (paranasal sinuses), the diseases of which have specific names:
1. Frontit. In the frontal part of the skull, approximately above the eye sockets, there are two sinuses, similarly to the frontal ones. In newborns, they are absent and are formed only after reaching the age of 7 years and older, and in some people they do not form at all. Their rear walls border on the frontal lobes of the brain, and the lower ones - on the walls of the orbits. The sinuses are lined with a thin mucous membrane connected by special fibers to the supraocular and facial nerves. Inflammation of these frontal sinuses is called frontitis. Treatment of acute sinusitis in adults and schoolchildren must necessarily begin with the localization of inflammation and the exclusion of frontal sinusitis, as it is one of the most serious forms of the disease.
2. Etmoiditis. Approximately in the region of the bridge of the nose, or rather between the frontal, lacrimal, palatine and maxillary bones, there iscalled the ethmoid bone. In cross section, it resembles a figured labyrinth of cells of various shapes and sizes. From the inside, the sinuses of the ethmoid bone are also lined with mucous. Their inflammation is called "ethmoiditis".
3. Sinusitis. There are sinuses in the maxillary bone, known to many as the maxillary sinuses. Schematically, they are located on both sides of the nose, approximately from the eye sockets to the nasolabial fold, and are the largest in size. The maxillary sinuses are lined with mucosa, very poor in nerves. Therefore, her inflammation does not immediately make itself felt. In a he althy state, they are filled with air. Their lower walls are too thin, which creates the risk of infection and even filling material penetrating into them, for example, during poor-quality work of dentists. This greatly complicates the treatment of acute sinusitis of the maxillary sinuses, also called sinusitis, since it is necessary to simultaneously sanitize the oral cavity and treat dental diseases.
4. Sphenoiditis. In the sphenoid bone there are small sinuses, called by analogy sphenoid. Their inflammation is sphenoiditis.
If several sinuses are inflamed at the same time, pansinusitis is diagnosed.
Reasons
Treatment of acute sinusitis in adults and children is correct to begin with the establishment of the causes that caused it. They can be:
- various diseases of infectious etiology (tonsillitis, rhinitis, pulpitis, tuberculosis, as well as tumors and radiation);
- allergic reactions;
- dental treatment (root resection, canal filling);
- injuries of the nose and sinus membranes;
-polyps that appeared in the sinuses;
- toxins;
- uncontrolled use of drops from the common cold, as a result of which a large amount of mucus accumulates in the sinuses (especially in the maxillary sinuses);
- drafts;
- long stay in places with dry and hot air;
- hypothermia;
- adenoids and polyps;
- problems with teeth and oral cavity (in case of sinusitis).
But most often it is because of the penetration of pathogenic microorganisms into the sinuses that acute sinusitis begins. Symptoms and treatment in adults depend on the type of microbe that has entered the mucous membranes. These could be:
- staphylococci;
- mushrooms;
- streptococci and others.
Classification
Differentiate not only by the localization of inflammation, but also by other signs of acute sinusitis. Symptoms and treatment, depending on the type diagnosed, may be similar, but may differ significantly.
For the causes of sinusitis, the classification is as follows:
- traumatic;
- viral;
- allergic;
- mycosis (caused by parasitic fungi);
- bacterial;
- medication;
- mixed.
According to the type of mucus formation, the classification is as follows:
- exudative sinusitis (serous, purulent, catarrhal);
- productive (polypous, parietal-hyperplastic).
Chronic sinusitis
Acute andchronic sinusitis. In the acute form, the disease lasts no more than two weeks. In chronic it lasts for years, in remission almost without showing symptoms. When there are factors that provoke exacerbations, acute chronic sinusitis is diagnosed. Treatment in such cases is the same as in the acute form. Causes of Chronic Sinusitis:
- untreated diseases (ARI, flu, bronchitis and others);
- improper treatment (inappropriate antibiotics, etc.);
- adenoids and polyps in the nasal cavities;
- reduced immunity;
- smoking;
- chronic diseases;
- cystic fibrosis;
- bronchial asthma;
- HIV and others
During remission, chronic sinusitis can only bother you with mild headaches, fatigue, lethargy and not attract attention. Its treatment is complicated by the fact that the microorganisms parasitizing in the sinuses have time to adapt to the drugs used by the patient. Therefore, therapy is carried out only in combination: antibiotics, to which pathogens are susceptible, anti-inflammatory and immune-correcting drugs, methods that strengthen the body as a whole.
Acute sinusitis symptoms
Each kind and type of sinusitis has its own characteristic symptoms. However, there are a number of common signs that help to suspect this insidious disease. Why suspect rather than diagnose? Because the symptoms of sinusitis, especially at the initial stage, are observed in many other diseases. This is:
- general weakness;
- loss of appetite;
- moderate headache, relieved by analgesics (if the inflammation is one-sided, then the head hurts on the same side);
- temperature.
Also may be present:
- runny nose;
- sneeze;
- nasal congestion;
- pain in the nasal sinuses;
- decreased sense of smell;
- sleep disturbance;
- sometimes sore throat.
In addition, patients with different types of sinusitis experience some characteristic symptoms.
So, sinusitis or acute maxillary sinusitis, the treatment of which in no case should be carried out without consulting a doctor, is characterized by the following symptoms:
- tearing;
- chills;
- memory impairment;
- pain in the gums when turning the head.
With frontal sinusitis, characteristic symptoms:
- feeling of pain and heaviness above the eyes;
- pain in the eyes, aggravated by bending over and decreasing in the supine position.
When ethmoiditis, the symptoms are:
- feeling of pressure in the eye sockets;
- tearing;
- heaviness in the cheek from the inflamed sinus;
- signs of toxicosis.
For sphenoiditis:
- feeling of heaviness, fullness in the nasopharynx;
- aching headache, mainly in the back of the head (prevailing symptom);
- double vision;
- pain radiating to the ears.
To clarify the diagnosis, the doctor prescribes a blood test (general), X-ray, rhinoscopy, and evencomputed tomography.
So, you already know what the symptoms of acute sinusitis are. And treatment in adults will be brought to your attention later. In the meantime, let's talk about the features of the disease in young patients.
Sinusitis in children
About one in five children are diagnosed with acute sinusitis. Symptoms and treatment of all types of the disease are about the same as in adults. The differences are that babies do not have frontal sinusitis, since they do not have frontal sinuses. The causes of sinusitis in children are almost the same as in adults, but they are predominant:
- infection with pathogenic microorganisms;
- adenoids;
- hypothermia;
- weakened immune system;
- allergic reactions;
- congenital pathologies in the structure of the nasal septa;
- incorrect treatment of acute respiratory infections, influenza, bronchitis preceding sinusitis.
In addition to the main symptoms of sinusitis, parents may be alert:
- the appearance of blue circles under the baby's eyes;
- complaints of pain in the ears;
- refusal to eat;
- capriciousness;
- heavy breathing;
- deterioration of the child's condition in the evening and improvement in the morning;
- prolonged (more than two weeks) cough, runny nose.
Acute sinusitis in children should never be treated alone. The ENT doctor is obliged to prescribe a number oftests (blood, swab from the nose), in especially difficult cases, an MRI or CT scan is performed. At home, you can perform the following therapies:
1. Instillation of the nose with one of the vasoconstrictor drugs: Nazivin, Sanorin, Xylo, and after that with one of the antiseptic drugs: Ekteritsid, Protargol. Nasal irrigation is not recommended for very young children.
2. Treatment with antibiotics: "Amoxiclav", "Augmentin" or their analogues.
3. Treatment with antiallergic drugs: Claritin, Tavegil.
Inhalations can be performed on the recommendation of a doctor. Usually use decoctions of chamomile, calendula. Also, after agreeing with the doctor, you can give the child homeopathic medicines and use physiotherapy. Acupressure and gymnastics give a good effect.
Degrees of severity
Regardless of location and type, acute sinusitis can be mild or extremely severe. Symptoms and treatment for different degrees of severity differ significantly:
1. Light form. The patient feels a slight malaise, slight weakness, although he remains efficient. Symptoms that give the right to suspect sinusitis:
- runny nose;
- sniffing when breathing;
- not particularly severe headaches;
- nasal congestion;
- slight increase in temperature (not always).
If the patient is x-rayed, the x-rays may not show signs of sinusitis.
2. Medium form. There is marked malaise. Other symptoms:
- quite noticeable headaches;
-high temperature (over 38 °C);
- nausea, sometimes vomiting;
- puffiness of the eyelids;
- soreness of the sinuses;
- swelling of soft tissues near the sinuses.
3. Severe form. The patient is weakened, indifferent, complains of soreness throughout the body. Other symptoms:
- high temperature;
- lack of appetite;
- nausea, often with vomiting;
- sometimes diarrhea;
- severe headaches;
- the temperature has increased significantly, sometimes to critical levels.
Rhinosinusitis
The mechanism of development of sinusitis in a simplified form is as follows: the openings (orifices), through which all nasal sinuses communicate, in fact, with the nose, narrow or close completely due to inflammation of the mucosa. Because of this, excess pressure arises in the sinuses, which, in turn, provokes a new formation of mucus. Since the exit is blocked for her, she stagnates. This leads to a change in the acidity of the flora in the nose, and the cilia of the epithelium wrapped in mucus stop moving. All this creates heavenly conditions for pathogenic microorganisms. They begin to multiply at an accelerated pace, destroy the membrane of the mucous membranes and penetrate into their cells.
In the initial stages, the discharge from the nose is serous in nature (transparent color, low specific gravity). The body sends armies of leukocytes to the area of inflammation to fight uninvited guests. When they die, they form a cloudy greenish-yellow liquid of higher density, called pus, and the disease is already diagnosed as rhinosinusitis or acute purulent sinusitis. Treatment of the disease should be carried out only professionally, otherwise you can get complications such as meningitis, subdural empyema, orbital abscess.
Purulent sinusitis, like any other, occurs in three stages. Mild and moderate can be treated according to the general rules, but it is imperative to take a swab from the nose to determine the type of pathogen and choose the right antibiotic. Also, the complex of treatment includes drugs that thin the mucus, constrict the vessels of the mucosa, antiseptics, anti-inflammatory, antihistamines and strengthen the immune system. In the third stage of the disease, such conservative measures may not be enough, so sinus punctures are performed. Such measures are also taken in cases where other methods of treatment do not work.
Acute sinusitis: treatment. Drugs
The meaning of the therapy of any sinusitis is to relieve inflammation of the mucous membrane, ensure the removal of exudate from the sinuses and the destruction of pathogenic pathogens.
When polyps or adenoids are found in a patient, they are surgically removed.
In case of allergic etiology of sinusitis, they find out what exactly provokes it, conduct anti-allergic therapy, at the same time restore breathing with special exercises and prescribe drugs that increase immunity.
With advanced sinusitis, a puncture of the maxillary sinuses is prescribed with the removal of accumulated masses from them, washing them with saline and injecting antibiotics and anti-inflammatory drugs inside. However, this procedure can cause complications such asotitis media, edema, vascular embolism, meningitis. Therefore, if possible, you should not start the disease.
Drugs of choice in the treatment of acute sinusitis are prescribed based on the condition and age of the patient, the presence of chronic diseases, and also on the basis of the results of a study of pathogenic microflora in the nose. For mild to moderate sinusitis, medications are taken orally. In severe cases, some drugs are given by injection.
Treatment algorithm:
1. Nose instillation. Most people, when snot appears, immediately run to the pharmacy for vasoconstrictor drops from the common cold. It is advisable to use them only during acute attacks and, as a rule, at night to ensure restful sleep. But even if this is not adhered to and the nose is instilled according to indications, such treatment can be carried out for no more than 5 days. Popular drugs are Protargol, Ingaron, Derinat, Grippferon, Pinosol, Euphorbium (suitable for children).
2. Washing the nose. This technique provides an outflow of mucus from the sinuses and sanitizes the nasal cavity. Recommended drugs are Dioxidin, Miramistan, Furacilin, Chlorophyllipt. According to many patients, such a simple technique as washing the nose can not only get rid of the disease, but also prevent acute sinusitis. An effective treatment, reviews of both doctors and patients about which are only positive, is the use of bacteriophage solutions for washing the nose. Using them, you can do without antibiotics, which is fundamentally important for some categories of patients. The only condition without which the method does not work isbefore preparing a solution of bacteriophages, it is necessary to determine the type of bacteria that have occupied the sinuses.
3. Antipyretic. At a temperature, the drugs "Paracetamol", "Aspirin", "Ibuprofen", "Nalgezin" are prescribed. Anti-allergic drugs "Loratadin", "Cetirizine" are also used.
4. mucolytic drugs. Be sure to include in the complex therapy "Libeksin", "Mukodin", "Flyuditek". They thin the mucus, which helps to expel it faster.
5. Antibiotics and antivirals. They are prescribed for almost all types of sinusitis. The following groups are used:
- penicillins: "Amoxilav", "Unazin", "Ampisid";
- cephalosporins: Cefixime, Pancef, Suprax (have a large number of adverse reactions);
- macrolides: "Josamycin", "Clarithromycin" (use period - up to 3 days);
- fluoroquinolones (adults only): Ciprofloxacin, Levofloxacin, Ofloxacin and others.
6. Physiotherapy - treatment with laser, UHF, microwaves and pulsed currents.
Folk remedies
Treatment of acute sinusitis with folk remedies is quite possible, provided that the disease is at the very beginning or as an additional remedy to the main course.
1. Washing the nose with a solution of s alt, especially sea s alt. For adults, put a teaspoon without a slide of s alt in half a liter of water, and for children - per liter, stir thoroughly so that all the crystals dissolve. In severe cases, a drop of iodine can be added to the solution and baking soda on the tip of a knife. Prepared solutioncan be used for a kind of mask. They moisten gauze in it, wring it out slightly and cover their face with it for a quarter of an hour.
2. Tui oil. It is used as an antiseptic, immunomodulator, remedy for inflammation of the mucosa and as a prevention of polyps. Thuja oil can be instilled into the nose or inhaled. For instillation, the nose is first washed with saline, then 3 drops of purified (distilled) water are instilled into each nostril, and only then 2 drops of oil. Nostrils pinched.
3. Cyclamen. One of the most effective remedies for acute sinusitis. Treatment at home with this method is long, at least 2 months every day, but it eliminates the disease forever. Cyclamen root is washed, rubbed on a grater, squeezed out the juice and diluted with water (1:1). Store the product in the refrigerator. They instill 2 drops in each nostril.
4. A mixture is prepared from cyclamen, aloe, kalanchoe and onion juices, Vishnevsky ointment is added. The resulting ointment is placed with ear sticks in each nostril.
5. Laurel. Three large bay leaves are poured with water and brought to a boil. In the resulting solution, moisten a rag, squeeze it a little, put it on the forehead and bridge of the nose, and hold it until it cools. Repeat the process 3 times.
Some people try to treat sinusitis by heating their sinuses with a hot egg or other objects, which is a mistake. If there is an accumulation of mucus in the sinuses, especially purulent, warming up will contribute to the rapid reproduction of microorganisms and the further spread of the infection. You can warm up the nose only when the recovery phase has begun andsinuses already cleared.
There are dozens of other folk recipes for sinusitis, it is impossible to cover them all in one article.
