The disease frontitis is diagnosed quite often in adults and children. The symptoms of this disease are mostly manifested in isolation, however, they can be combined with symptoms of inflammation of adjacent sinuses. This is typical for children over 12 years of age and adults, since the paranasal sinuses are already fully formed during this period.
ICD 10 frontitis is assigned the code J01.1, it is an inflammation of the mucous membranes in the frontal sinuses. At the same time, overall well-being worsens significantly, purulent discharge forms, and without treatment dangerous complications can develop. Frontitis in children, especially in small ones, is quite rare, since they still have insufficiently formed frontal sinuses.
Main classification
Among the main types of frontitis, an acute and chronic type of course of the disease can be distinguished. Depending on the form of the disease, the symptoms vary. Acute frontal sinusitis occurs as a result of the penetration of bacteria into the nasal cavity, which, with weakened immunity, leads to the formation of an inflammatory process.
The clinical picture consists of local and general symptoms. In addition to an increase in body temperature, severe weakness and general malaise are noted. Among the local symptoms of acute frontitis, there are:
- complicated nasal breathing;
- headache;
- discharge from the nose;
- violation of smell.
Painful sensations are observed mainly in the morning, amplified by dinner, and then gradually pass. The intensity of pain in frontitis can be very different, ranging from a feeling of pressure in the forehead to sharp, unbearable attacks around the entire circumference of the head.
In the presence of bilateral inflammation, pressure is felt mainly in the forehead. Breathing through the nose is quite difficult on both sides. Purulent discharge from the sinuses is noted. The sense of smell may be completely absent.
With a unilateral lesion, pain is mainly observed in the forehead and is concentrated only in one half of it, at the site of localization of the inflamed sinus. On the same side, nasal congestion and discharge are noted. Purulent frontal sinusitis is considered the most dangerous, since it is often accompanied by various complications. Pathogens can enter the cranial cavity, causing an abscess.
Chronic frontal sinusitis in adults can occur for several months. The most basic reason for the transition to a chronic form is not fully cured acute process. The provoking factors include the prolonged absence of full sinus drainage, anatomical abnormalities, and the presence of polyps. All the signs that are observed in acute lesions are also characteristic of the chronic form, but they are not so pronounced and do not differ in the constancy of the course.
Causes of the disease
Frontitis very rarely arises as an independent disease, mainly acute rhinitis precedes it. By its nature, it is viral, bacterial or fungal. Among the main causes of frontitis can be identified such as:
- infectious or allergic rhinitis;
- tonsil hypertrophy;
- curvature of the nasal septum;
- the presence of chronic foci of infection;
- decreased immunity;
- injuries to the nose and sinuses.
The factors that lead to violations can be very different. First of all, it is a bacterial or viral infection. Their penetration into the cavity of the frontal sinus leads to inflammation of the nasal mucosa.
The allergic cause of frontal sinusitis is much less common. In this case, there is an allergic predisposition of the body. Often, the symptoms of conjunctivitis also join the main symptomatology.
Among the main causes can be identified injuries of the nose and bones of the skull. In such cases, there is a violation of the integrity of the frontal sinuses, which leads to the penetration of pathogens into the sinuses.
Symptoms of the course
Acute frontal sinusitis generally begins very sharply and with vivid clinical manifestations. Among the main features can be identified such as:
- sharp pain in the forehead;
- headache;
- photophobia, tearing;
- difficulty in nasal breathing;
- copious discharge from the sinuses;
- swelling of the tissues near the eyes;
- a sharp increase in temperature.
During the examination, the doctor notes the presence of severe edema and redness of the mucous membrane of the nasal concha. When removing purulent contents from the sinuses, there is some relief and relief of pain. With the occurrence of chronic frontitis, clinical manifestations are less pronounced, but they continue for a long time. Among the main symptoms can be identified such as:
- aching or pressing headaches;
- sharp pain when pressing on the eyes;
- the presence of discharge of pus from the nose with an unpleasant odor;
- the occurrence of cough with sputum;
- the nasal mucosa becomes swollen and reddened.
Despite the fact that the symptoms of chronic frontitis are not pronounced enough, however, treatment must be carried out necessarily to prevent the occurrence of serious complications.
Diagnostics
If you experience complaints of pain in the forehead, significant discharge from the nose, fever, you should immediately consult a doctor. Diagnosis is based on a survey and examination of the patient to obtain all the data required for an additional examination. The doctor should find out the complaints and the nature of the course of the disease. In addition, rhinoscopy may be necessary with simultaneous sampling of the contents of the nasal sinuses to test for the sensitivity of microflora to antibacterial drugs.
When conducting a blood test, it is possible to determine the course of the inflammatory process, in particular, an increase in the number of leukocytes, ESR levels, as well as a violation of the leukocyte formula. X-ray examination and diaphanoscopy are required. To clarify the diagnosis, ultrasound and computed tomography are prescribed. The faster and more accurately the diagnosis is carried out, the more chances there are to start treatment in a timely manner and achieve a good result.
Be sure to distinguish the course of frontal sinusitis from inflammation of other sinuses, for example, neuralgia or sinusitis.
Treatment feature
Treatment of frontal sinusitis should be carried out comprehensively, as this is a rather dangerous disease that threatens to cause complications. Therapy should be started as soon as possible, as this guarantees the success of the cure. It is very important to eliminate not only the inflammation itself, but also the provoking factor, since this will achieve a very good result. That is why antibacterial therapy plays the main role in the treatment.
From the very first day of the disease, while an analysis to determine the sensitivity of microflora has yet been carried out, the use of broad-spectrum antibiotics is required to treat frontitis. The mild form is easily treated with antibacterial sprays, in particular such as Isofra or Polydex. For the treatment of moderate inflammation and severe damage, oral or intramuscular administration of tetracycline antibiotics, such as Doxacin, Isodox or Ampicillin, will be required.
Upon receipt of results regarding the sensitivity of bacteria to antibiotics for frontal sinusitis, if necessary, correction of therapy is performed. The duration of the course is determined by the strictly treating doctor. Mostly it is 7-10 days.
In addition, treatment of frontal sinusitis can be symptomatic, aimed at reducing the amount of contents in the frontal sinus and improving the process of its excretion. For this, drops or vasoconstrictor sprays are used, antihistamines. Very good results in cleansing the nasal sinus from the purulent contents are exerted by washing the nose with furacilin, electrophoresis, inhalation, and UHF.
Symptomatic therapy consists in eliminating the pain syndrome and normalizing the temperature. For this, Aspirin, Analgin, Paracetamol are prescribed. If drug treatment did not bring the desired result, then surgery is performed. It implies the restoration of the nasal canal using an endoscope. In rare cases, a sinus wall is punctured through the orbit or frontal bone. At the same time, cleaning and treatment with medications is carried out.
Frontitis treatment is carried out using decoctions of medicinal plants and juices. Similar remedies can be used for a variety of forms of inflammation. They relate to auxiliary methods of treatment. For effective cleansing of the sinus, a salt solution is used. There are many different methods of alternative therapy, however, in order to bring the best possible result, their application must first be agreed with the doctor.
Treatment must be comprehensive and carried out under the supervision of the attending doctor. Incorrectly selected therapy can cause serious harm to the body and provoke many complications.
Medications
Often, treatment of frontal sinusitis is carried out by conservative techniques in a hospital setting. The patient is prescribed a course of vasoconstrictor drugs in the nose, in particular, such drops as "Tizin", "Galazolin", "Farmazolin", "Naphthyzin". Their use is shown in 3 drops in each nostril about 3-4 times a day. After each instillation, it is recommended to additionally use an aerosol, for example, Bioparox, Cameton, Proposol.
With the course of the acute form, antibiotics are prescribed for frontitis. Very good remedies are considered such as Cefazolin, Sumamed, Ampioks, Augmentin. Intramuscular administration of antibiotics is most effective. In some cases, an intravenous administration of the drug may be prescribed.
Together with antibacterial therapy, the doctor additionally prescribes antihistamines, in particular, such as Tavegil, Diphenhydramine, Suprastin. 1 tablet is prescribed 3 times a day. These drugs help reduce swelling and eliminate allergic symptoms.
If the cause of frontitis is a hemophilic bacillus, then treatment is carried out using such drugs as Amoxiclav or Ampicillin. These funds are administered intramuscularly or intravenously. If the causative agent is pneumococcus, then tetracycline antibiotics are prescribed, in particular, such as Doxacin, Isodox, Doxilin, Abadox. If pus has accumulated in the sinus, then the patient is prescribed 1 tablet of “Atz-Long” per day.
You can also use homeopathic medicines, such as Sinuforte, Sinupret, Cinnabsin. They help reduce pain and inflammation. When using antibiotics, intestinal motility can be significantly impaired. To maintain it, Bifikol, Lineks, Laktobakterin are prescribed. To reduce headaches, "Analgin", "Nurofen" are used.
Folk remedies
Folk remedies are widely used to treat frontitis. The easiest way is to heat rice. To do this, you need to take a clean sock or cloth, fill them with rice and warm them in the microwave for several minutes. When the rice is heated, it must be applied to the nose and held for 10-15 minutes. Rice retains heat for a long time, helping the thick mucus accumulated in the sinuses to come out much faster and easier. In addition, such a tool will help reduce pain. A similar methodology for conducting therapy, despite the fact that it looks quite simple, has a very high degree of effectiveness.
A sick person throughout the entire period of treatment should be in a room with high humidity. To do this, you can use the most common humidifier. Humid air helps to remove accumulated sputum from the sinuses, while facilitating the course of the disease and accelerating the healing process.
When conducting therapy at home, washing the nose with tea tree oil, soda and salt is indicated. With a small syringe, you need to rinse first one and then the other nostrils above the sink. The solution should exit the nostrils along with mucus and pus. You need to stand upright and do not throw your head back. A similar procedure should be carried out 2-3 times a day.
A good remedy is considered to be inhalations with frontal sinusitis, which are carried out using a decoction of bay leaves. To do this, boil a bay leaf for several minutes, reduce heat and breathe over steam for 5-7 minutes. A similar procedure should be carried out in the morning and in the evening.
You can also cook potatoes in their skins, drain the water and knead it with a fork. Breathe over the steam, covering your head with a towel. As drops, you can use Kalanchoe juice. To do this, pick a few leaves and put them in the refrigerator for several days. Then squeeze the juice from the plant, dilute it with water in a ratio of 1: 1 and instill in the nose several times a day. This tool helps very well with a common cold.
For warming, you can use warm sand or a boiled egg. To do this, you need to warm up a little sand in a pan, then pour into a prepared bag and apply to the nose for about 20 minutes. After the warm-up procedure, you can put on a woolen bandage on your forehead to keep the heat inside the sinuses much longer after the heat procedure.
Operation
With insufficient effectiveness of drug therapy for frontitis, surgery is indicated. Depending on the age and general well-being of the patient, the doctor makes a decision regarding anesthesia. Surgery may be performed under general or local anesthesia.
Initially, a small incision is made in the area of the eyebrow, which extends to the lower edge of the nasal bone. Then, trepanation of the inner corner of the eye is performed, the sinus is opened and its purification from the accumulated purulent contents is carried out. Partially carry out the removal of the frontal process, while further cleaning the main sinus. After this, sinus drainage is performed, sutures are applied, leaving drainage literally for 2-3 weeks. In adults and older children, you can open the frontal sinus, using the endonasal method for this.
Possible complications
Complications of frontitis that occur during the course of an acute and chronic inflammatory process can be quite dangerous. The main violations include such as:
- intraocular
- intracranial;
- sepsis.
Intraocular complications include phlegmon of the eye, eyelid abscess , purulent fistula. In addition, intracranial complications are often observed, manifested in the form of meningitis, frontal bone osteomyelitis, and brain abscess.
With uncomplicated course, the prognosis is positive, since a complete cure is possible. In more advanced cases, the transition of inflammation to the chronic stage with the occurrence of periods of exacerbation and remission is possible.
Prophylaxis
Comprehensive prevention of frontal sinusitis is required to prevent the frequent occurrence of inflammation, as well as to prevent the transition to the chronic stage. Among the main preventive measures, it is necessary to highlight such as:
- prevention of hypothermia, colds and frequent infectious diseases;
- avoidance of head and nose injuries;
- timely treatment of allergies;
- strengthening the immune system;
- hardening of the body.
Be sure to prevent the penetration of foreign objects into the sinuses. Special control is needed for children. At the first signs of the disease, you should definitely consult a doctor.
Frontitis can provoke many different complications with improper or untimely treatment, which is why it is important to conduct therapy and preventive measures in a timely manner.