Exudative sinusitis: symptoms, diagnosis, treatment

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Exudative sinusitis: symptoms, diagnosis, treatment
Exudative sinusitis: symptoms, diagnosis, treatment

Video: Exudative sinusitis: symptoms, diagnosis, treatment

Video: Exudative sinusitis: symptoms, diagnosis, treatment
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With exudative sinusitis, people inflame the maxillary sinuses, which are also called maxillary sinuses. This disease can take place in different forms, against its background, complications are possible. This disease is the main type of inflammatory processes in the maxillary sinuses, it threatens with serious consequences.

exudative sinusitis treatment
exudative sinusitis treatment

Features of this pathology

Exudative sinusitis can occur on the left, on the right, or it can also spread to both sinuses at the same time. The maxillary sinuses are voids in the bones of the skull. Their purpose is to equalize the pressure inside the skull. Normally, these sinuses are filled with air and can freely communicate with the nasal cavity, but during the inflammatory process, their outlet swells, which disrupts gas exchange with the external environment. As a result, an inflammatory fluid appears in the sinus, which, if left untreated, can become purulent.

Disease forms

Exudative sinusitis is very common and consists in a gradual coursefollowing steps:

  • Catarrhal stage of disease development.
  • Serous stage.
  • Purulent stage.

The catarrhal stage is considered the easiest, at which inflammatory edema is formed in the maxillary sinuses. If treatment is not started, then abundant mucous discharges appear from the nose, and after them a purulent type of right-sided or left-sided exudative sinusitis is formed. This disease often becomes chronic, which lasts for months or even years, periodically provoking relapses. The acute type of such sinusitis lasts no more than a month and is characterized by pronounced and rather vivid symptoms with varying degrees of intoxication.

left-sided exudative sinusitis
left-sided exudative sinusitis

What are the main causes of the disease

The causes of exudative sinusitis in a he althy person who does not suffer from chronic pathologies of the nose usually lie in a viral infection. Quite often, this pathology appears against the background of serious infectious diseases, such as measles and scarlet fever, and sinusitis acts as a complication or as one of the leading symptoms. Reduced immunity and the presence of somatic diseases cause the development of exudative sinusitis. Thus, they can get sick against the background of tonsillitis, pharyngitis, chronic tonsillitis, acute bacterial rhinitis, dental disease, and so on.

Viral infection can only provoke acute exudative sinusitis, and its chronic type appears after the colonization of the mucosabacteria in a weakened immune system. Pathology can also occur as a result of exposure to allergens and various irritants that can provoke serous inflammation.

Bilateral exudative sinusitis is dangerous, it most often leads to the development of complications.

Risk factors

The following factors increase the risk of developing this disease:

  • Having a deviated nasal septum.
  • Various sinus anomalies.
  • Untreated teeth and gums.
  • Susceptibility to frequent allergies.
  • Activity in hazardous production.
  • Presence of injuries or foreign bodies in the sinuses.
  • Presence of somatic diseases of the body.
  • Using drugs that weaken the immune system.

How does left-sided or right-sided exudative sinusitis manifest itself?

bilateral exudative sinusitis
bilateral exudative sinusitis

Symptoms of this unpleasant disease

As a rule, in the beginning, the patient develops symptoms of a viral pathology against the background of this disease. For example, body temperature may rise, mucus may be discharged from the nose, along with sore throat, nasal congestion, and fatigue. The most common symptoms of acute sinusitis are the following manifestations:

  • The appearance of discomfort in the nose, near it and in the bridge of the nose.
  • Presence of pressure and pain under the eye, as well as swelling of the eyelids.
  • The occurrence of a headache covering the forehead and temples.
  • Increased pain when tilting the head down.
  • Presencenasal congestion along with the inability to breathe, as well as nasal voice.
  • Occurrence of clear discharge from the nose.
  • Drainage of pathogenic mucus along the posterior pharyngeal wall.
  • Another increase in body temperature, even if it has already returned to normal.
  • The presence of malaise and high fatigue, as well as weakness.
  • Loss of appetite and insomnia.

Catarrhal type of sinusitis of this form

The catarrhal type of exudative sinusitis passes more easily. Usually it is accompanied only by swelling of the nose and scanty or profuse mucous secretions. They can dry up in the nose and form crusts. If left untreated, catarrhal sinusitis can turn into purulent, while the color of the mucus will change and become yellow, and its consistency is thicker, in addition, there is an unpleasant odor. With a favorable outcome, the disease ends after four weeks with a complete recovery. But often exudative sinusitis becomes chronic, and its signs are erased and hardly noticeable:

right-sided exudative sinusitis
right-sided exudative sinusitis
  • Having a chronic cold that is difficult to treat.
  • Presence of nasal congestion, often alternating or unilateral.
  • The appearance of periodic pain in the orbit.
  • Increased pain when blinking.
  • Development of chronic conjunctivitis.
  • The occurrence of headaches.
  • The appearance of a dry cough against the background of mucus running down the throat.
  • Disturbedsmell.

The chronic form of exudative sinusitis is often combined in patients with the growth of polyps, and then in this case the disease is recognized as mixed.

Diagnosis for sinusitis

Diagnosis is made on the basis of a complete history, as well as starting from the examination, assessment of the severity and localization of the clinical manifestation. If sinusitis is suspected, an x-ray or computed tomography of the paranasal sinuses is mandatory. During rhinoscopy, edema is usually detected along with inflammation, mucous or purulent discharge, and the presence of polyps in the nose can also be noticed.

Nasal endoscopy and puncture

A very informative examination method for this disease is nasal endoscopy, as well as puncture of the maxillary sinuses. During the puncture, the doctor punctures the wall of the sinus and pumps out its contents. In the future, therapeutic measures begin in the form of washing the sinus and introducing antibiotics into it. In pregnant women, determining the diagnosis facilitates diaphanoscopy, as CT and radiography can harm the developing fetus.

acute exudative sinusitis
acute exudative sinusitis

Treatment of exudative sinusitis

What is the therapy of the disease?

The most important goal of treatment is the prevention of complications, which requires the complete elimination of infectious processes. This is achieved by restoring sinus drainage and eliminating the pathogen. It is mandatory to provide non-drug measures in the form of plentiful drinking,giving up bad habits, humidifying the air in the room and dietary nutrition. To relieve swelling, and, in addition, to improve the drainage of the sinuses, the following therapy methods are performed:

  • Taking antihistamines in the form of Zyrtec, Desloratadine, or Aerius.
  • They instill vasoconstrictors in the form of Klisen, Oxymetazoline, Rhinonorm and the like.
  • Rinse the nose with solutions of sea s alt, for example, Aquamaris is suitable for this along with Aqualor, Physiomer and No-S alt.
  • Irrigate the nose with preparations designed to thin pus and mucus, for example, with the help of Rinofluimucil and Sinuforte.
  • Drop in the nose drugs to reduce rhinorrhea, for example, ipratropium bromide.
catarrhal exudative sinusitis
catarrhal exudative sinusitis

To eliminate infectious processes, the patient is prescribed antibiotics. Usually, for the treatment of exudative sinusitis, penicillins with macrolides in tablets in the form of Azitrox, Flemoclav, Augmentin and Erythromycin are used. And in severe cases, fourth-generation cephalosporins in the form of Suprax and Ceftriaxone in the form of pills are more suitable, but it is better to use these drugs in the form of intramuscular injections. Additional therapeutic methods that are selected for the treatment of this pathology can be:

  • Treatment with anti-inflammatory drugs for fever and malaise in the form of Ibuprofen, Nurofen and Nimesil.
  • The use of antiviral drugs in the form of drugs such as "Viferon" along with "Cycloferon" and"Kagocele".
  • Irrigation with local antiseptics and antibiotics in the form of Miramistin, Bioparox, Albucid, Protargol and Isofra.
  • Use of nasal glucocorticosteroids in the form of Nasonex and Avamys.
  • Physiotherapy. In this case, laser treatment, UHF, blue light, and the like are performed.
exudative sinusitis on the left
exudative sinusitis on the left

Surgical treatment is often indicated against the background of catarrhal-exudative sinusitis of a chronic type or purulent. A puncture is done to remove thick pus from the sinus. Also, this procedure is performed for targeted administration of antibiotics. After a puncture, a catheter is placed in the sinus, through which washing is done every day with the help of antiseptics and proteolytic enzymes. Against the background of allergic sinusitis, special antihistamines and glucocorticosteroids are injected into the sinus cavity.

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