Acute maxillary sinusitis is an inflammatory process that occurs in the maxillary sinuses. It is easy to guess why the second name of this disease is sinusitis. The disease quickly spreads to the submucosal layer, periosteal and bone tissue of the upper dentition. According to statistics, this pathology is the most common reason for a visit to an ENT doctor, because sinus inflammation occurs in both adults and children.
The severity of symptoms largely depends on the severity of the course of the disease. During the diagnosis of sinusitis, otolaryngologists carefully study the patient's life history, conduct an examination and instrumental procedures. Usually, X-rays, ultrasound are enough to confirm inflammation in the sinuses, in some cases they resort to puncture. Sinusitis is treated with conservative and surgical methods.
Causes of sinusitis
If you know firsthand what it is - acute maxillary sinusitis (in the photo presented in the article, you can clearly see the location of the paranasal sinuses), you probably heard about the reasons for its formation. Among the factors that could provoke the development of sinusitis, the undisputed leadership is occupied by:
- viral infections;
- prolonged stay in the cold, freezing of the body;
- inflammation of the oral cavity;
- diseases of the upper respiratory tract;
- allergic rhinitis;
- chronic runny nose;
- deviated septum;
- adenoiditis;
- complicated surgical treatment of upper teeth;
- injuries and bruises of the nose;
- compromised immunity;
- HIV infection.
The causes of the progression of acute maxillary sinusitis and its exacerbation can be confidently considered an unhe althy lifestyle, alcohol abuse and drug use. Corresponding genetic abnormalities, intrauterine anomalies are also capable of influencing the development of sinusitis. In the end, the quality of ecology and environmental pollution play a huge role. The symptoms of acute maxillary sinusitis can be caused by one or more triggers at the same time.
Disease classification
Thousands of people turn to doctors every day with sinusitis. However, all patients may have a different type of acute maxillary sinusitis. ICD-10 code,corresponding to sinusitis, J32.0 - inflammation in the upper paranasal sinuses of the nasal cavity. In addition, experts divide the disease into several types, depending on the etiology:
- Rhinogenic. Chronic runny nose, fungal infections can provoke this type of sinusitis.
- Hematogenous. Pathology develops when an infection that was previously present in the body enters the bloodstream.
- Traumatic. Is the result of a fracture of the upper jaw or nasal septum.
- Vasomotor. It is formed due to an incorrect reaction of the body to external stimuli (cold air, chemicals, etc.).
- Odontogenic. Acute maxillary sinusitis of this type is the result of the influence of pathogenic bacteria localized in the carious cavities of the upper teeth.
- Allergic. This type of sinusitis is a complication of allergic rhinitis.
Forms of maxillary sinusitis
There is another classification of paranasal sinus disease - symptomatic. Depending on the nature of the course, the disease is divided into:
- Acute catarrhal maxillary sinusitis. As a rule, such sinusitis is not much different from the common cold in our understanding, since it is expressed by congestion and mucous discharge from the nose. Catarrhal sinusitis can be cured and complications avoided. If you start the disease, it can turn into a purulent form.
- Acute purulent maxillary sinusitis. Unlike the previous one, it is characterized by the presence of exudative contents in the sinuses. With purulent sinusitispatients may feel significantly worse, headaches appear.
Any type of sinusitis can be unilateral or bilateral.
What is inflammation of the paranasal sinuses
Special attention deserves the symptoms of sinusitis. The main signs of acute maxillary sinusitis are:
- nasal congestion;
- shortness of breath.
The rest of the symptoms that are attributed to various forms of sinusitis will appear depending on the nature of the course of the disease. Most common in acute sinusitis:
- subfebrile body temperature;
- first secretion of clear mucus, and later - purulent infiltrate;
- frequent sneezing;
- headaches;
- nasiveness;
- absence or dullness of smell;
- discomfort and soreness in the upper part of the face.
Symptoms can intensify at moments of sudden movements, sneezing, coughing. Acute bilateral maxillary sinusitis is accompanied by increased lacrimation and conjunctivitis. By the way, in the chronic form of maxillary sinusitis, similar manifestations are observed.
What could be the complications
Diagnosed sinusitis requires treatment. It is impossible to ignore a disease that does not seem to pose a serious threat to he alth. Inaction is fraught with dangerous complications. Most of them require urgentsurgical treatment:
- inflammation of the mucous membrane of the larynx;
- oxygen deficiency;
- apnea;
- blood poisoning;
- damage to the cranial bones and brain.
Sinusitis in childhood
Unlike adults, the sinuses of babies are poorly developed, so mucus stagnation rarely occurs in them. Under the age of 3 years, sinusitis is most often bacterial in nature. In addition, acute maxillary sinusitis is much less common in children than in adults. In this case, the recurrence of chronic rhinitis is often accompanied by inflammation of the middle ear.
Sinusitis in young children is difficult to diagnose. The inability of the child to clearly complain about the pain and describe his state of he alth prevents parents from recognizing the problem. But despite this, you can guess about sinusitis in a baby. Babies with acute sinusitis have difficulty breathing. Babies become restless and capricious, sleep poorly, often refuse to eat and drink - a stuffy nose prevents them from sucking normally at the breast or pacifier.
Older children are already able to tell what worries them and describe their condition. Toddler and preschool children often suffer from inflammation of several sinuses at the same time. With a general lesion of sinusitis, blood impurities may appear in the purulent-mucous discharge.
Other common symptoms of acute sinusitis in childhood, in addition to nasal congestion, include:
- photophobia;
- desensitization to odors;
- dry and scratchy throat;
- frequent cough at night;
- high body temperature;
- growing irritability in the evening.
Children have a hard time with exacerbation of maxillary sinusitis. During illness, attention deteriorates, memory and learning ability decrease. The baby does not sleep well at night, may snore.
Diagnosis of sinusitis of the maxillary sinuses
Any otolaryngologist can easily determine sinusitis, but to clarify the diagnosis, the patient will still have to undergo several research procedures. Before referring the patient for diagnosis, the doctor will get acquainted with his medical history and try to find the causes of the disease. In addition, for the successful treatment of the disease, it is important to clarify the nature of its course - chronic or acute. To do this, find out the degree of intensity of symptoms.
Diagnosis of maxillary sinusitis involves the use of instrumental research methods:
- radiography;
- magnetic resonance imaging;
- rhinoscopy;
- nasal endoscopy;
- ultrasound;
- puncture.
In addition to an ENT examination, patients are usually advised to consult a dentist about the condition of the upper jaw and teeth on it. Treatment begins only after the results of all studies, making sure that the patient has acute maxillary sinusitis. In the history of the disease, the doctor describes the optimal therapeutic tactics that cansubject to adjustment depending on the individual characteristics of the organism and the rate of recovery.
Principles and tactics of disease therapy
The current trends in the treatment of sinusitis are based on inhalation procedures. Today, many experts are confident that the introduction of drugs by aerosol method allows you to increase the physical and chemical activity of the active ingredients. But experts have become increasingly skeptical about taking pills - in their opinion, the effectiveness of such drugs cannot be maximum due to the poor blood supply to the paranasal sinuses.
The second popular way to treat sinusitis is the use of electrophoresis, which involves the introduction of minimal doses of the drug in ionized form. Medicines come to the site of the immediate focus of inflammation and have a powerful sanitizing effect. The combined use of aerosols and electrophoresis gives good results. Unlike systemic drugs, whose action is blocked by inflamed vessels, topical drugs penetrate into the sinuses through the pores, directly to the tissues.
When treating acute sinusitis, the doctor faces the following tasks:
- relieve swelling of the patient's mucosa;
- free the nasal passages for the outflow of infiltrate from the maxillary sinuses;
- fight against a bacterial or viral pathogen;
- treatment of symptoms and treatment of secondary diseases.
Unlike rhinitis, the flow of secretion from the cavity of the sinuses with sinusitis is disturbed, andin order to prevent infection with pathogenic microflora, the patient is prescribed local antimicrobials, which are administered by inhalation.
All medicines that are currently used in otolaryngology in the treatment of sinuses are conditionally divided into:
- mucolytic;
- decongestants;
- antibacterial;
- anti-inflammatory.
In acute bilateral maxillary sinusitis, immunomodulators are necessarily used, most often of homeopathic origin. The most effective are tinctures of Eleutherococcus, ginseng, calendula. These herbal remedies not only increase the body's defenses, but also prevent the growth of pathogenic bacteria in the sinus cavity. It is necessary to be treated with immunomodulators under the strict supervision and control of a doctor.
The use of herbal remedies to combat sinusitis shows good results. If the course of sinusitis is not complicated by a bacterial infection, treatment is lined up without antibiotics. Good results are demonstrated by the use of inhalers along with antiseptics and vasoconstrictor sprays, thanks to which it is possible to suppress the inflammatory process in the sinuses.
Since acute purulent maxillary sinusitis is considered the most severe form, for its treatment they resort to the use of a medicinal complex of "shock" force. Most often, with such sinusitis, a correctly selected combination of antibiotics (sometimes administered intravenously) and antiseptics plays a key role. In somecases, against the background of weakened immunity, the disease can lead to the melting of surrounding tissues and, as a result, brain damage, sepsis. These are very dangerous pathologies, which in the majority of cases end in disability or death for the patient.
Drugs for the treatment of acute sinusitis
If you approach the issue of treatment of acute maxillary sinusitis objectively, you should pay attention to the most popular drugs prescribed by doctors. To self-medicate with sinusitis, as you might have guessed, is impossible. In addition, the same drug can have different effects on the body of patients. That is why only the attending doctor should select medicines.
With mild and moderate severity of sinusitis, right-sided and left-sided acute maxillary sinusitis, the German "Sinupret" has proven itself well. It contains only herbal ingredients that relieve inflammation that occurs in the upper respiratory tract (sorrel, verbena, gentian, elderberry, primrose). Sinupret has no analogues with identical content. This medicine is unique in its kind because:
- has both antiviral and immunomodulatory effects;
- regulates the viscosity of sputum;
- fights mucostasis;
- improves the natural discharge of infiltrate from the sinuses;
- restores normal functions of the epithelium.
If herbal medicine does not produce the expected effect, the doctor may prescribe the patient to undergo a nasal puncturesinuses. This unpleasant procedure will allow you to find out about the type of pathogen and select effective antibiotics. After taking the biomaterial, it will take several days to find out which antibacterial substances the pathogenic microflora is sensitive to. With sinusitis, the following drugs are prescribed:
- Cefuroxime;
- "Amoxicillin clavulanate";
- "Amoxicillin";
- "Trimethoprim".
If the diagnosed acute maxillary sinusitis has a viral nature of origin, the treatment is built according to a different principle. Unfortunately, there are no sufficiently effective drugs that can completely eliminate the pathogen from the body. Antiviral drugs only inhibit the activity of pathogens. The main emphasis in therapy is on strengthening the immune system.
Puncture is not done to patients in uncomplicated cases of sinusitis. Then the treatment of sinusitis is carried out according to the "classic" scheme:
- Antiseptic inhalation.
- Vasoconstrictors (no longer than a week).
- Broad-spectrum antibiotics pending puncture results (Ceftriaxone, Nafcillin).
- Antihistamines (if prone to allergic reactions).
On average, the treatment of acute sinusitis lasts about 2-4 weeks. If sinusitis has become a secondary disease, a puncture and bakposev are mandatory.
How to prevent disease
Prevention of acute maxillarysinusitis comes down to a simple rule - timely treat rhinitis, including a runny nose of allergic etiology, respiratory diseases, and also monitor the condition of the oral cavity. The chances of developing sinusitis are minimal if the patient eats properly and leads a he althy lifestyle. Remember that any disease is easier to prevent than to cure.
