Symptoms of sinusitis often develop in patients after suffering colds. Especially often this complication occurs in cases where the treatment of infection has not been given due attention. This disease is extremely common these days. In otorhinolaryngology, sinusitis is called inflammation of the sinuses, which are located in the region of the nasal wings and upper jaw. They are called "maxillary sinuses", hence the name of the disease. There are few blood vessels and nerve endings. For this reason, patients may not notice the signs and symptoms of sinusitis for a long time. But the disease progresses rapidly and the inflammation soon becomes chronic.
Causes of disease
Chronic sinusitis is a disease of infectious origin. Microorganisms enter the sinuses from the nasal passages, throat and mouth. With a decrease in the body's defensescreate favorable conditions for the spread of infection. Symptoms of sinusitis in acute form are observed quite rarely. Usually the disease becomes chronic very quickly. The pathological process most often affects one sinus, but bilateral sinusitis also occurs.
The disease is caused by various microorganisms: streptococci, viruses, fungi, Haemophilus influenzae, staphylococci. Sometimes several different bacteria become the cause of inflammation at once, which makes it difficult to choose a drug to treat the symptoms of sinusitis.
However, in order for the infection to lead to a chronic inflammatory process, additional adverse factors are needed. These include:
- Pathologies preventing free breathing. These are the consequences of injuries and congenital anomalies of the nose, allergic rhinitis, polyps. Breathing disorders lead to the accumulation of mucus in the nasal passages and the multiplication of harmful microorganisms.
- Weakened immune system. Symptoms of sinusitis in a chronic form usually develop in frequently ill people. It is not uncommon for sinus inflammation to occur in patients who abuse antibiotics or who take cytostatics (immunosuppressants).
- Dental diseases. This is one of the common causes of sinusitis. The sinuses are located above the 4th, 5th and 6th teeth of the upper jaw. If there is chronic caries, pulpitis or periodontitis in this area, then the infection can spread from the oral cavity to the paranasal areas.
- Viral respiratory diseases. The sinuses are connected to the nasal passages with a smallholes through which they are cleaned. In chronic and acute rhinitis, it becomes clogged, as a result, mucous secretions accumulate, and pathogenic microbes multiply. Therefore, with a runny nose, doctors recommend constantly using drops. This will help clear the sinuses of secretions.
- Focus of chronic infection in the body. If a person is a carrier of bacteria (for example, staphylococcus or streptococcus), then the infection can be brought into the maxillary sinuses with blood flow.
Causes, symptoms and treatment of sinusitis in children has its own characteristics. This disease practically does not occur in babies under 4-5 years old, since at this age the sinuses are not yet sufficiently formed. As for older children, they often have chlamydia and mycoplasma as the cause of sinusitis. This requires the prescription of special antibiotics.
Symptoms of pathology
The symptoms of chronic sinusitis are usually mild and intermittent. This disease occurs with periodic exacerbations. During remission, a person's condition usually remains normal. There may be only slight signs of chronic inflammation (weakness, fatigue, mild fever) that a person does not usually associate with the disease.
Exacerbations occur as a result of hypothermia, weakened immunity, a cold or an allergy. The following signs of pathology can be distinguished:
- feeling of heaviness and pressure in the sinus;
- thick nasal discharge;
- ill-treatable runny nose;
- headache;
- bursting pain in the sinus radiating to the forehead, teeth, temples;
- breathing difficulties;
- disturbances of smell due to constant nasal congestion (a person does not distinguish smells well);
- pain in the upper jaw when chewing;
- signs of conjunctivitis;
- nasiveness, changes in voice timbre;
- constantly open mouth during sleep (due to difficulty in nasal breathing);
- weeping skin lesions near the nostrils;
- dry cough due to throat irritation from nasal secretions.
The bursting sensation in the paranasal region is one of the main signs and symptoms of sinusitis. Where does it hurt with inflammation of the maxillary sinuses? This question often worries patients.
Often during the period of a cold, people experience arching pain in the frontal region. Many patients consider this a symptom of sinusitis. But it is not always the case. In medicine, there is the concept of "sinuses of the nose." These include all paranasal sinuses: maxillary, ethmoid, frontal and sphenoid. Inflammation of these areas is collectively known as sinusitis. Sinusitis is a special case of this disease.
Pain in the superciliary region is typical for sinusitis of the frontal sinuses (frontal sinusitis). With sinusitis, a feeling of fullness occurs near the nose, in the region of the upper jaw. However, the pain may radiate to the forehead. In addition, patients often combine both pathologies: sinusitis of the frontal sinuses and chronic sinusitis.
It is sometimes difficult for a patient to determine where it hurts. A sign and symptom of sinusitis is radiating pain that radiates to different parts of the face. The clinical picture of this disease can resemble the manifestations of many other ailments, such as trigeminal neuralgia.
Often the disease occurs in childhood, after frequent colds. A small child usually suffers inflammation of the paranasal sinuses more severely than a teenager, since his immunity is not yet fully formed. In general, the symptoms of sinusitis in children do not differ from the manifestations of this pathology in adults.
Disease forms
The clinical picture of the pathology largely depends on the form of the disease. There are the following types of sinusitis:
- Catarrhal. With this form of the disease, secretions in the form of transparent viscous mucus depart from the nasal passages. It is not uncommon for patients to notice facial swelling.
- Purulent. The discharge is thick, greenish or yellowish, and has an unpleasant odor.
- Odontogenic. In this case, the cause of symptoms of chronic sinusitis in adults and children are diseased teeth. Inflammation always appears on the side where caries, periodontitis or other dental pathology is found. The discharge from the nose is fetid, the pain in the upper jaw bothers. Mandatory sanitation of the oral cavity is required, otherwise such sinusitis is not amenable to therapy.
- Rhinogenic. This form of pathology occurs in more than half of patients. Inflammation of the sinuses is preceded by rhinitis. In this case, the patient has one nasal passage completely blocked (on the affected side), andsecretions coming out of the other nostril.
- Allergic. With this form, exacerbation of the symptoms of sinusitis in adults and children occurs after exposure to an allergen. There is sneezing, lacrimation, transparent liquid mucus is released from the nasal passages. This form of the disease can be complicated by polypous changes, which aggravates the pathology.
- Fungal. Occurs in patients with a sharply reduced immunity or after uncontrolled self-treatment with antibiotics. It is caused by fungi: candida aspergillus and various types of mold. Discharge from the nose has an unusual appearance. They may look like curdled white lumps, a yellowish jelly-like mass, or black-gray mucus.
If you find these symptoms of chronic sinusitis, you must urgently consult an otorhinolaryngologist. Constant inflammation in the paranasal sinuses can lead to serious complications.
Possible Complications
If the symptoms of sinusitis bother the patient for a long time, then this affects the condition of other organs. It is dangerous to start such a disease, since the nasal sinuses are in close proximity to the brain. A sinus infection can easily spread to nearby organs. The most dangerous complications of the disease include meningitis and meningo-ecephalitis, brain abscess, sepsis. Such pathologies can even lead to death. Therefore, the symptoms of sinusitis in adults and children should be the reason for an immediate visit to a specialist. itthe disease does not go away on its own.
A sinus infection can spread to the eye socket, middle ear, or jaw bone. There are otitis, osteomyelitis, phlegmon of the eye orbit. In addition, a patient with sinusitis becomes susceptible to diseases of the upper respiratory tract: tonsillitis, pharyngitis, laryngitis. Chronic inflammation of the paranasal sinuses can provoke a painful and unpleasant disease - neuralgia of the facial nerve.
However, with timely detection of symptoms of sinusitis in adults and children and correctly prescribed therapy, complications are very rare. Today, this disease has a favorable prognosis. It lends itself well to modern methods of treatment.
Diagnosis of disease
Symptoms and treatment of sinusitis in adults and children depend on the form and duration of the disease. However, it is first necessary to diagnose the pathology. An experienced otorhinolaryngologist may suspect this disease already during the examination and history taking. But further testing will be needed to confirm the diagnosis.
When probing the area of the nasal sinuses, pain and a feeling of fullness are usually felt. In some patients, swelling of the face is noticeable. During the examination of the throat, you can notice the discharge flowing down the back wall. These signs and characteristic complaints of the patient suggest chronic sinusitis. The doctor also conducts an instrumental examination of the nasal passages using a rhinoscope. Sometimes an endoscopic examination of the sinus is prescribed. To do this, use a special probe with optics, which is inserted into the sinus cavity.
The most common and accurate way to diagnose the disease is an x-ray of the sinuses. This study helps to determine not only the presence of an inflammatory process, but also polypous-cystic changes that often accompany sinusitis. In some cases, to clarify the diagnosis, a tomographic examination is performed.
However, X-rays are contraindicated for pregnant women and children. They undergo diaphanoscopy. The study is done in a darkened room. A special lamp is inserted into the mouth and its glow is monitored. The inflamed sinus of the nose turns out to be darkened.
An effective way to detect sinusitis is a sinus puncture. A special needle is inserted into the nostril, a puncture is made in the wall of the sinus and lavage is carried out. The liquid is sent for laboratory analysis. This method can be used not only for diagnosis, but also for the treatment of symptoms of chronic sinusitis in adults and children. In this case, when washing, disinfectants are used.
After the diagnosis is established, the doctor may order a bacteriological analysis of the contents of the sinus. This helps to choose the right antibiotic for therapy. With odontogenic sinusitis, consultation and treatment with a dentist is required.
Medication and physiotherapy
How to treat the symptoms of sinusitis without surgery? Modern antibiotics come to the rescue. If the disease is not advanced, then properly selected antibiotic therapy will be able to cope with the inflammatory process.
Applicationantibiotics are indicated for the infectious form of chronic sinusitis, which occurs in most cases. If the disease is caused by allergies, then antibiotic therapy will not help. In this case, it is necessary to prescribe antihistamines: Ebastine, Chloropyramine.
In the treatment of sinusitis, penicillin and tetracycline drugs are most often used: "Doxycycline", "Amoxicillin" or the sulfanilamide combination drug "Co-trimoxazole". They are able to act on a wide range of bacteria. The course of treatment takes about 14 days.
If sinusitis is fungal in nature, then Ketoconazole, Amphotericin B, Itraconazole are used. Drugs have to be taken for a long time, since this form of the disease is difficult to treat. Be sure to prescribe immunomodulators, since a fungal infection in the sinuses is always the result of a fall in the body's defenses.
As mentioned above, the symptoms and treatment of sinusitis in children have their own specifics. The cause of the disease in a child is often chlamydial and mycoplasma infection. These microorganisms are poorly affected by penicillins and tetracyclines. Therefore, the prescription of antibiotics of the macrolide group is required: "Clarithromycin", "Azithromycin", "Roxithromycin".
In the treatment of symptoms of sinusitis in adults and children, antibiotic therapy is always combined with the appointment of drops for the nose: "Dimetidine","Nafazolina", "Oxymetazoline".
Medicated treatment is supplemented with physiotherapy for the sinus area:
- electrophoresis with antibiotics;
- UHF and microwave therapy;
- medicated phonophoresis;
- magnetic and laser therapy.
Such an integrated approach to treatment in many cases allows you to get rid of chronic sinusitis completely. It must be remembered that the course of therapy must be completed. If treatment is interrupted prematurely, then all signs of pathology may return.
Conservative treatment of sinusitis symptoms at home is quite possible. This disease in most cases does not require the placement of the patient in a hospital. Hospitalization is necessary only in the presence of complications, in severe cases of exacerbation of purulent sinusitis and, if necessary, surgery.
Sinus Flushing
Proetz's sinus lavage complements medical therapy. This is a painless treatment that does not require a sinus puncture. People call this method "cuckoo".
Cathets are inserted into the patient's nasal passages. A disinfectant solution is delivered through one tube into the sinus cavity. Purulent contents are sucked out from the other nostril through a catheter using a vacuum. During the procedure, the patient is advised to pronounce "cuckoo" so that the liquid does not get into the throat, hence the popular name of the method.
This treatment is enougheffective. Usually, after a few procedures, the patient becomes easier to breathe through the nose, the headache and swelling in the sinuses disappear.
Surgical treatment
Surgical intervention is resorted to in advanced cases of chronic sinusitis. Under local anesthesia, a puncture (puncture) of the sinus is made. Catheters are inserted into the nasal passages, through which the sinus cavity is washed with furacilin or saline. After the operation, the patient remains in the hospital for some time under the supervision of doctors.
This method can permanently save the patient from sinusitis. However, the puncture has its drawbacks. After a puncture, the patient may be disturbed by pain in the sinus and forehead area, sometimes there are complications from the throat. For some patients with chronic pathologies of internal organs, puncture is contraindicated.
Some patients are afraid of surgical treatment. They mistakenly believe that, having made a puncture once, it will have to be repeated in the future. This is a wrong opinion, such a surgical intervention can save the patient from sinusitis once and for all. Relapses of pathology after puncture occur only when the nasal septum is deviated. This requires additional plastic surgery.
In difficult cases of sinusitis, a major surgical operation is performed. The sinuses of the nose are opened through the oral cavity, washed and the affected tissues are removed. The postoperative scar remains invisible. The intervention is carried out under general anesthesia. The operation lasts about 1-1.5 hours. This method of treatment is used only in extreme cases, withdanger of developing brain complications.
Folk methods
Patients are often interested in folk remedies for treating the symptoms of sinusitis at home. It should be remembered that this cannot replace traditional drug therapy. Folk recipes for sinusitis can only supplement the treatment prescribed by an otorhinolaryngologist.
It is impossible to completely eliminate the symptoms of sinusitis at home, since pathogens still remain in the sinuses. However, you can somewhat ease breathing and reduce nasal congestion. It is useful to use solutions with sea water, they can be purchased at pharmacy chains. They wash the nasal passages with a syringe or syringe. You can also use for this purpose a solution of propolis, decoctions of herbs (chamomile, calendula, St. John's wort) or silver water.
Often, patients are interested in whether it is possible to apply heat to the sinuses with sinusitis. Warming up with inflammation of the sinuses is not always indicated. The application of warm compresses is permissible only with the initial symptoms of sinusitis and the absence of purulent discharge. In other cases, warming up can lead to the growth of bacteria. It is especially not recommended to make such compresses with a fungal form of the disease. It is imperative to consult a doctor, only a specialist can decide whether warming procedures are appropriate.
Prevention
To prevent the occurrence of chronic sinusitis, it is necessary to eliminate its causes in time. Need to complete treatmentcolds, flu and other infectious diseases. You should regularly visit the dentist and carry out the sanitation of foci of caries.
If you have allergies, you should avoid contact with irritating substances that provoke an exacerbation of the disease. It is also important to maintain optimal humidity in the room, too dry air can provoke the development of sinusitis. It is useful from time to time to carry out preventive washing of the nasal passages with saline solutions, this prevents the accumulation of mucus and the growth of bacteria.
