Symptoms of sinusitis often develop in patients after a cold. Especially often, this complication occurs in cases where the treatment of the infection was not given due attention. Today, this disease is extremely common. In otorhinolaryngology, sinusitis is called inflammation of the sinuses, which are located in the area of the nasal wings and upper jaw. They are called "maxillary sinuses", hence the name of the disease. There are few vessels and nerve endings. For this reason, patients may not notice the signs and symptoms of sinusitis for a long time. But the disease develops rapidly, and inflammation soon becomes chronic.
Causes of the disease
Chronic sinusitis is a disease of an infectious origin. Microorganisms enter the sinuses from the nasal passages, throat and oral cavity. With a decrease in the body's defenses, favorable conditions are created for the spread of infection. Symptoms of sinusitis in acute form are observed quite rarely. Usually the disease quickly becomes chronic. The pathological process most often affects one sinus, but bilateral sinusitis also occurs.
Various microorganisms cause the disease: streptococci, viruses, fungi, hemophilus bacillus, staphylococci. Sometimes the cause of inflammation becomes several different bacteria at once, which makes it difficult to choose a drug for the treatment of sinusitis symptoms.
However, in order for the infection to lead to a chronic inflammatory process, additional adverse factors are necessary. These include:
- Pathologies that prevent free breathing. These are the consequences of injuries and congenital abnormalities of the nose, allergic rhinitis, polyps. Respiratory disorders lead to the accumulation of mucus in the nasal passages and the multiplication of harmful microorganisms.
- Weakening of the immune system. Symptoms of sinusitis in a chronic form usually develop in often sick people. Often, sinus inflammation occurs in patients who abuse antibiotics or take cytostatics (immunosuppressants).
- Dental diseases. This is one of the common causes of sinusitis. The sinuses of the nose are located above the 4th, 5th and 6th teeth of the upper jaw. If there is chronic caries, pulpitis or periodontitis in this area, the infection can spread from the oral cavity to the paranasal areas.
- Viral diseases of the respiratory system. The sinuses of the nose are connected to the nasal passages using a small hole through which they are cleansed. 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 the maxillary sinuses to clear themselves of secretions.
- The focus of a chronic infection in the body. If a person is a bacteriocarrier (for example, staphylococcus or streptococcus), then the infection can be entered in the maxillary sinuses with a blood stream.
The causes, symptoms and treatment of sinusitis in children has its own characteristics. This disease practically does not occur in babies up to 4-5 years old, since at this age the sinuses are not yet formed enough. As for older children, chlamydia and mycoplasma are often the cause of sinusitis in them. This requires the use of special antibiotics.
Symptoms of pathology
Symptoms of chronic sinusitis are usually mild and inconsistent. This disease proceeds with periodic exacerbations. During remission, a person’s condition usually remains normal. Only slight signs of chronic inflammation (weakness, fatigue, slightly elevated temperature) can be observed, which a person usually does not associate with the disease.
Exacerbations occur as a result of hypothermia, weakening of the immune system, a cold or allergy. The following signs of pathology can be distinguished:
- a feeling of heaviness and pressure in the sinus;
- thick discharge from the nose;
- poorly treatable runny nose;
- headache;
- bursting sinus pain with radiation to the forehead, teeth, temples;
- difficulty breathing
- violation of smell due to constant nasal congestion (a person does not distinguish smells poorly);
- soreness in the upper jaw when chewing;
- signs of conjunctivitis;
- nasal, changes in the timbre of the voice;
- constantly open mouth during sleep (due to difficulty in nasal breathing);
- weeping skin lesions near the nostrils;
- dry cough due to throat irritation by nasal secretions.
A bursting sensation in the paranasal region is one of the main signs and symptoms of sinusitis. Where does the inflammation of the maxillary sinuses hurt? This question often worries patients.
Often during a cold, people have bursting pain in the frontal region. Many patients consider this a symptom of sinusitis. But it's not always the case. In medicine, there is the concept of "sinuses of the nose." These include all the sinuses: maxillary, ethmoid, frontal and wedge-shaped. Inflammation of these sections is collectively called sinusitis. Sinusitis is a special case of this disease.
Pain in the superciliary region is characteristic of 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, pain can be given to the forehead. In addition, both pathologies are often combined in patients: frontal sinus sinusitis and chronic sinusitis.
It is sometimes difficult for a patient to determine where it hurts. A sign and symptom of sinusitis is radiating pain, which gives in different parts of the face. The clinical picture of this disease may 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 more severe sinus inflammation 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.
Forms of the disease
The clinical picture of the pathology largely depends on the form of the disease. The following types of sinusitis are distinguished:
- Catarrhal. With this form of the disease, discharge in the form of transparent viscous mucus leaves the nasal passages. Often in patients, a swelling of the face can be noticed.
- Purulent. The discharge is thick, greenish or yellowish in color, have an unpleasant odor.
- Odontogenic. In this case, the cause of the symptoms of chronic sinusitis in adults and children are bad teeth. Inflammation always appears on the side where caries, periodontitis or other dental pathology is detected. Discharge from the nose is fetid, distressing pain in the upper jaw. Mandatory oral sanitation 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), and the discharge leaves the other nostril.
- Allergic. With this form, exacerbation of sinusitis symptoms in adults and children occurs after exposure to an allergen. Sneezing, lacrimation appears, clear liquid mucus is released from the nasal passages. This form of the disease can be complicated by polypous changes, which exacerbates the pathology.
- Fungal. It occurs in patients with sharply reduced immunity or after uncontrolled self-treatment with antibiotics. It is caused by fungi: aspergillus candida and various types of mold. Discharge from the nose has an unusual appearance. They may look like white curdled lumps, a yellowish jelly-like mass, or black-gray mucus.
If you find the listed symptoms of chronic sinusitis, you should immediately consult an otorhinolaryngologist. Permanent sinus inflammation 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. To launch such a disease is dangerous, since the nasal sinuses are in close proximity to the brain. Sinus infection can easily spread to nearby organs. The most dangerous complications of the disease include meningitis and meningoencephalitis, brain abscess, sepsis. Such pathologies can even be fatal. Therefore, the symptoms of sinusitis in adults and children should be the reason for immediately contacting a specialist. This disease does not go away on its own.
Sinus infection can enter the orbit, middle ear, or jaw bone. Otitis, osteomyelitis, phlegmon of the orbit. In addition, a patient with sinusitis becomes susceptible to diseases of the upper respiratory tract: tonsillitis, pharyngitis, laryngitis. Chronic inflammation of the sinuses can provoke a painful and unpleasant disease - neuralgia of the facial nerve.
However, with the timely detection of sinusitis symptoms 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 treatment methods.
Diagnosis of the disease
Symptoms and treatment of sinusitis in adults and children depend on the form and length of illness. However, first you need to diagnose the pathology. An experienced otorhinolaryngologist can suspect this disease already during the examination and history. But to confirm the diagnosis, additional studies will be required.
When palpating the area of the nasal sinuses, soreness and a feeling of fullness are usually felt. In some patients, a swelling of the face is noticeable. During the examination of the throat, you may notice 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 with the help of a rhinoscope. Sometimes an endoscopic examination of the sinus is prescribed. To do this, use a special probe with optics, which is introduced into the sinus cavity.
The most common and accurate way to diagnose the disease is a sinus x-ray. This study helps to determine not only the presence of an inflammatory process, but also the polypous-cystic changes that often accompany sinusitis. In some cases, a tomographic study is performed to clarify the diagnosis.
However, pregnant women and children X-ray is contraindicated. They undergo diaphanoscopy. The study is done in a darkened office. A special lamp is introduced into the mouth and its glow is monitored. The inflamed sinus of the nose is then 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 sinus wall, and washing is performed. 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, disinfectants are used when washing.
After the diagnosis is established, the doctor may prescribe 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 sinusitis symptoms without surgery? Modern antibiotics come to the rescue. If the disease is not started, then correctly selected antibacterial therapy can cope with the inflammatory process.
The use of antibiotics is indicated for the infectious form of chronic sinusitis, which occurs in most cases. If the disease is caused by an allergy, then antibiotic therapy will not help. In this case, the appointment of antihistamines is necessary: "Ebastina", "Chloropyramine."
In the treatment of sinusitis, penicillin and tetracycline drugs are most often used: Doxycycline, Amoxicillin, or the co-trimoxazole sulfonamide combination drug. They are able to affect a wide range of bacteria. The course of treatment takes about 14 days.
If sinusitis has a fungal 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. Immunomodulators are required to be prescribed, since a fungal infection in the sinuses is always a consequence of a drop 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 a chlamydial and mycoplasma infection. These microorganisms do not respond well to penicillins and tetracyclines. Therefore, antibiotics of the macrolide group are required: Clarithromycin, Azithromycin, Roxithromycin.
In the treatment of sinusitis symptoms in adults and children, antibiotic therapy is always combined with the appointment of nasal drops: "Dimetidine", "Naphazoline", "Oxymethazoline".
Drug treatment is supplemented with physiotherapeutic procedures for the sinus area:
- electrophoresis with antibiotics;
- UHF and microwave therapy;
- phonophoresis with drugs;
- 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 you interrupt treatment prematurely, then all signs of pathology may return.
It is quite possible to conduct a conservative treatment of sinusitis symptoms at home. This disease in most cases does not require the patient to be hospitalized. Hospitalization is necessary only in the presence of complications, in severe cases of exacerbation of purulent sinusitis and, if necessary, surgery.
Sinus flushing
Sinus lavage according to the Proetz method complements drug therapy. This is a painless treatment that does not require a sinus puncture. The people call this method "cuckoo."
Catheters are inserted into the nasal passages of the patient. One tube into the sinus cavity is supplied with a disinfectant solution. Purulent contents are aspirated from the other nostril through a catheter using a vacuum. During the procedure, the patient is recommended to say “cuckoo” so that the liquid does not get into the throat, hence the popular name of the method.
This method of treatment is quite effective. Usually, after just a few procedures, it becomes easier for the patient to breathe through the nose, headache and bursting in the sinuses disappear.
Surgery
Surgery is resorted to in advanced cases of chronic sinusitis. Under local anesthesia, a sinus puncture is made. Catheters are inserted into the nasal passages, through which the sinus cavity is washed with furacilin or saline. After surgery, the patient remains in the hospital for some time under the supervision of doctors.
This method is able to permanently rid the patient of sinusitis. However, puncture has its drawbacks. After a puncture, the patient may be disturbed by pain in the sinus and forehead, sometimes complications from the throat. For some patients with chronic pathologies of the internal organs, puncture is contraindicated.
Some patients fear surgical treatment. They mistakenly believe that having done a puncture once, it will have to be repeated in the future. This is the wrong opinion, such a surgical intervention can save the patient from sinusitis once and for all. Relapse of the pathology after a puncture occurs only when the nasal septum is curved. This requires additional plastic surgery.
In complex cases of sinusitis, a large surgical operation is performed. The sinuses of the nose are opened through the oral cavity, washed and removed the affected tissue. The postoperative scar remains invisible. 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, with the danger of developing brain complications.
Folk methods
Patients are often interested in alternative methods of treating sinusitis symptoms at home. It should be remembered that this cannot replace traditional drug therapy. Alternative recipes for sinusitis can only complement 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 slightly ease breathing and reduce nasal congestion. , . . , (, , ) .
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Prevention
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