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 the ENT doctor, because inflammation of the nasal sinuses is found in both adults and children.
The severity of symptoms depends largely on the severity of the disease. During the diagnosis of sinusitis, otolaryngologists carefully study the patient’s life history, conduct an examination and instrumental procedures. Usually, X-ray, ultrasound is enough to confirm inflammation in the sinuses, in some cases they resort to puncture. The treatment of sinusitis is carried out by 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, indisputable leadership are:
- viral infections;
- prolonged exposure to cold, freezing of the body;
- inflammation of the oral cavity;
- diseases of the upper respiratory tract;
- allergic rhinitis;
- chronic runny nose;
- curvature of the nasal septum;
- adenoiditis;
- complex surgical treatment of upper teeth;
- injuries and bruises of the nose;
- weakened immunity;
- HIV infection.
The causes of the progression of acute maxillary sinusitis and its exacerbation can confidently be considered an incorrect lifestyle, alcohol abuse and drug use. The corresponding genetic abnormalities, intrauterine abnormalities are also capable of influencing the development of sinusitis. In the end, environmental quality and environmental pollution play a huge role. Symptoms of acute maxillary sinusitis can be caused by one or more provoking factors at the same time.
Disease classification
Thousands of people turn to doctors every day with sinusitis. Moreover, all patients may have a different type of acute maxillary sinusitis. ICD-10 code, corresponding to sinusitis, J32.0 - inflammation in the upper sinuses of the nasal cavity. In addition, experts divide the disease into several types, depending on the etiology:
- Rhinogenic. A chronic runny nose, fungal infections can provoke this type of sinusitis .
- Hematogenous. Pathology develops when an infection that is previously present in the body enters the bloodstream.
- Traumatic. It is a consequence 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 go 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 sinusitis in patients, their health can significantly worsen, headaches appear.
Any of the varieties of sinusitis can be unilateral or bilateral.
What is the manifestation of inflammation of the paranasal sinuses
The symptoms of sinusitis deserve special attention. The main signs of acute maxillary sinusitis are:
- nasal congestion;
- labored breathing.
The remaining symptoms, which are attributed to various forms of sinusitis, will manifest themselves depending on the nature of the course of the disease. In acute sinusitis, it is most often observed:
- low-grade body temperature;
- first, the release of transparent mucus, and later - purulent infiltrate;
- frequent sneezing
- headache;
- nasal;
- lack or dullness of smell;
- discomfort and pain in the upper part of the face.
Symptoms may intensify during moments of sudden movements, sneezing, and coughing. Increased lacrimation and conjunctivitis are added to acute bilateral maxillary sinusitis. By the way, with the chronic form of maxillary sinusitis, similar manifestations are observed.
What can be the complications
Diagnosed sinusitis requires treatment. It is impossible to ignore a disease that, it would seem, does not pose a serious threat to health. Inaction is fraught with dangerous complications. Most of them require urgent surgical treatment:
- inflammation of the laryngeal mucosa;
- oxygen deficiency;
- apnea;
- blood poisoning;
- damage to the cranial bones and brain.
Sinusitis in childhood
Unlike adults, the sinuses in babies are poorly developed, so mucus stagnation rarely occurs in them. At 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. At the same time, recurrence of a chronic runny nose 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 of pain and describe their well-being prevents parents from recognizing the problem. But despite this, you can guess about the sinusitis in the baby. Toddlers who have acute sinusitis breathe heavily. Breasts become restless and capricious, sleep poorly, often refuse to eat and drink - a stuffy nose prevents them from sucking their breasts or nipples normally.
Older children are already able to tell what worries them and to characterize their condition. Toddlers of preschool and preschool age often suffer from inflammation of several sinuses at the same time. With a general defeat of sinusitis in the purulent-mucous secretions, blood impurities may appear.
Other common symptoms of acute sinusitis in childhood, in addition to nasal congestion, can be called:
- photophobia;
- decreased odor sensitivity;
- dryness and sore throat;
- frequent coughing at night;
- high body temperature;
- increase in irritability in the evening.
Children are difficult to tolerate exacerbation of maxillary sinusitis. During illness, attention worsens, memory and learning ability decreases. The baby does not sleep well at night, can snore.
Diagnosis of maxillary sinus sinusitis
Any specialist otolaryngologist can easily determine sinusitis, but to clarify the diagnosis, the patient still has to go through several research procedures. Before referring the patient for diagnosis, the doctor will familiarize himself with his medical history and try to find the causes of the disease. In addition, for the successful treatment of an ailment, it is important to clarify the nature of its course - chronic or acute. To do this, find out the degree of intensity of the symptoms.
Diagnosis of maxillary sinusitis involves the use of instrumental methods of research:
- radiography;
- Magnetic resonance imaging;
- rhinoscopy;
- endoscopy of the nasal cavity;
- Ultrasound
- puncture.
In addition to ENT examinations, 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 medical history, the doctor writes down the optimal therapeutic tactics, which may be subject to adjustment depending on the individual characteristics of the body and the rate of recovery.
Principles and tactics of disease therapy
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 can increase the physical and chemical activity of the active components. But experts have become increasingly skeptical about taking pills - in their opinion, the effectiveness of such drugs cannot be maximum due to poor blood supply to the paranasal sinuses.
The second popular method for the treatment of sinusitis is the use of electrophoresis, which implies the introduction of minimum doses of the drug in ionized form. Medications arrive at 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, local drugs penetrate the sinuses through the pores, directly to the tissues.
In the treatment of acute sinusitis, the doctor has the following tasks:
- relieve swelling of the patient’s mucosa;
- to free the nasal passages for the outflow of infiltrate from the maxillary sinuses;
- the fight against a bacterial or viral pathogen;
- elimination of symptoms and treatment of secondary diseases.
Unlike rhinitis, the flow of the secretion from the sinus cavity during sinusitis is impaired, and in order to prevent infection by pathogenic microflora, the patient is prescribed local antimicrobial drugs that are administered by inhalation.
All drugs that are used today in otolaryngology in the treatment of sinus infections are conventionally divided into:
- mucolytic;
- decongestants;
- antibacterial;
- anti-inflammatory.
In acute bilateral maxillary sinusitis, immunomodulators, most often of homeopathic origin, must be used. The most effective are tinctures of eleutherococcus, ginseng, calendula. These herbal remedies not only increase the body's defense, but also prevent the growth of pathogenic bacteria in the sinus cavity. Immunomodulators should be treated under the strict supervision and supervision of a physician.
The use of herbal remedies to combat sinusitis shows good results. If the course of sinusitis is not complicated by a bacterial infection, the treatment is built without antibiotics. Good results are demonstrated by the use of inhalers along with antiseptics and vasoconstrictive 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, they resort to the use of the “shock” power drug complex for its treatment. Most often, with this sinusitis, the key role is played by a correctly selected combination of antibiotics (sometimes they are administered intravenously) and antiseptics. In some cases, against the background of a weakened immune system, the disease can lead to the melting of surrounding tissues and, as a result, damage to the brain, sepsis. These are very dangerous pathologies that, in a predominant number of cases, end up for the patient with a disability or death.
Drugs for the treatment of acute sinusitis
If you approach the issue of treatment of acute maxillary sinusitis in detail, you should pay attention to the most popular drugs that are prescribed by doctors. It is impossible to self-medicate with sinusitis, as you might have guessed. In addition, the same drug can affect patients in different ways. That is why only the attending doctor should select medicines.
With mild and moderate severity of sinusitis, right-side and left-sided acute maxillary sinusitis, the German "Sinupret" has established itself well. It contains only plant components that relieve inflammation 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:
- It has both an antiviral and immunomodulating effect;
- regulates sputum viscosity;
- struggling with 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 sinus puncture. This unpleasant procedure will allow you to find out about the type of pathogen and select the active antibiotics. After taking the biomaterial, it will take several days to find out to which antibacterial substances the pathogenic microflora is sensitive. With sinusitis, such drugs are prescribed:
- "Cefuroxime";
- "Amoxicillin clavulanate";
- Amoxicillin;
- Trimethoprim.
If the diagnosed acute maxillary sinusitis has a viral origin, the treatment is built on a different principle. Unfortunately, while there are no sufficiently effective drugs that are able to 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 "classical" scheme:
- Antiseptic inhalation.
- Vasoconstrictors (no longer than a week).
- Broad-spectrum antibiotics until puncture results are obtained (Ceftriaxone, Nafcillin).
- Antihistamines (with a tendency to allergic reactions).
On average, treatment for acute sinusitis lasts about 2-4 weeks. If sinusitis has become a secondary disease, puncture and bacteriosis are necessary.
How to prevent the disease
Prevention of acute maxillary sinusitis comes down to a simple rule - treat rhinitis in a timely manner, including a runny nose of an allergic etiology, respiratory tract disease, and also monitor the condition of the oral cavity. The chances of developing sinusitis are minimal if the patient eats properly and leads a healthy lifestyle. Remember that any disease is easier to prevent than to treat.