With exudative sinusitis in people, the maxillary sinuses, which are also called maxillary sinuses, become inflamed. This disease can take place in various forms; complications are possible against its background. This ailment is the main type of inflammatory processes in the maxillary sinuses, it threatens with serious consequences.
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. Jaw 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 opening swells, due to which gas exchange with the environment is disturbed. As a result, an inflammatory fluid appears in the sinus, which, if untreated, can become purulent.
Forms of the disease
Exudative sinusitis is very common and consists in the gradual course of the following stages:
- Catarrhal stage of the development of the disease.
- Serous stage.
- Purulent stage.
The catarrhal stage is considered the easiest, in which inflammatory edema is formed in the maxillary sinuses. If treatment is not started, then abundant mucous discharge appears from the nose, and after them a purulent type of right-sided or left-sided exudative sinusitis forms. 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 quite vivid symptoms with varying degrees of intoxication.
What are the main causes of the disease
The causes of exudative sinusitis in a healthy person, which does not suffer from chronic pathologies of the nose, usually lie in the infection of 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 of them 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 a background of tonsillitis, pharyngitis, chronic tonsillitis, acute bacterial rhinitis, dental disease, and so on.
A viral infection can provoke only acute exudative sinusitis, and its chronic type appears after colonization of the mucosa with bacteria against a background of weakened immunity. 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:
- The presence of a curved nasal septum.
- Various anomalies in the structure of the sinuses.
- Untreated teeth and gums.
- Exposure to frequent allergies.
- Activities in hazardous industries.
- The presence of injuries or foreign bodies in the sinuses.
- The presence of somatic diseases of the body.
- The use of medicines that weaken the immune system.
How does left-sided or right-sided exudative sinusitis manifest itself?
Symptoms of this unpleasant disease
As a rule, at first, the patient against the background of this disease develops symptoms of viral pathology. For example, body temperature may rise, possibly mucus separation from the nose along with sore throat, nasal congestion and weakness. The most common symptoms of acute sinusitis are the following manifestations:
- Discomfort in the nose, near it and in the nose.
- The 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.
- Strengthening pain when the head is tilted down.
- The presence of nasal congestion, along with their inability to breathe, as well as a nasal voice.
- The appearance of transparent discharge from the nose.
- Runoff 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.
- Decreased 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 copious mucous secretions. They can dry out in the nose and form crusts. If untreated, catarrhal sinusitis can turn into purulent, while the color of the mucus will change and turn yellow, and its consistency will be thicker, in addition, an unpleasant odor is observed. With a favorable outcome, the disease ends four weeks later with a complete recovery. But often, exudative sinusitis acquires a chronic form, and its symptoms are erased and subtle:
- The presence of chronic runny nose, poorly treatable.
- The presence of nasal congestion, often alternating or unilateral.
- The appearance of periodic pain in the orbit.
- Increased pain during blinking.
- The development of chronic conjunctivitis.
- The occurrence of headaches.
- The appearance of a dry cough against a background of mucus draining down the throat.
- Disturbed sense of smell.
The chronic form of exudative sinusitis is often combined in patients with proliferation of polyps, and then in this case the disease is recognized as mixed.
Diagnosis of sinusitis
The diagnosis is made on the basis of a complete medical history, as well as starting from examination, assessment of severity and localization of the clinical manifestation. If you suspect sinusitis, a radiography or computed tomography of the paranasal sinuses is mandatory. Against the background of rhinoscopy, edema is usually detected along with inflammation, mucous or purulent discharge, and the presence of polyps in the nose can also be noticed.
Endoscopy and Puncture
A very informative method of examination for this disease is endoscopy of the nose, as well as puncture of the maxillary sinuses. With a puncture by a doctor, the sinus wall is punctured and its contents are pumped out. In the future, therapeutic measures begin in the form of washing the sinus and injecting antibiotics into it. In pregnant women, the diagnosis is facilitated by diaphanoscopy, since CT and radiography can harm the developing fetus.
Treatment of exudative sinusitis
What is the treatment of the disease?
The most important goal of treatment is the prevention of complications, for which it is necessary to completely eliminate the infectious processes. This is achieved by restoring sinus drainage and eliminating the pathogen. It is mandatory to provide non-pharmacological measures in the form of heavy drinking, giving up bad habits, humidifying indoor air and diet food. To relieve edema, and, in addition, to improve sinus drainage, the following methods of therapy are performed:
- They take antihistamines in the form of Zirtek, Desloratadine, or Erius.
- Instill vasoconstrictors in the form of "Klisen", "Oksimetazolin", "Rinonorm" and the like.
- They wash their nose with sea salt solutions, for example, Aquamaris is suitable for this along with Aqualor, Physiomer and No Salt.
- Irrigate the nose with drugs designed to thin out pus and mucus, for example, with the help of Rinofluimucil and Sinuforte.
- They inject drugs into the nose to reduce rhinorrhea, for example, ipratropium bromide.
To eliminate infectious processes, the patient is prescribed antibiotics. Typically, penicillins with macrolides in tablets in the form of Azitrox, Flemoklav, Augmentin and Erythromycin are used to treat exudative sinusitis. 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 medications 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 Kagocel.
- Irrigation with local antiseptics and antibiotics in the form of Miramistin, Bioparox, Albucid, Protargol and Isofra.
- The use of nasal glucocorticosteroids in the form of Nazonex and Avamis.
- Conducting physiotherapy. In this case, laser treatment, UHF, blue light and the like are performed.
Surgical treatment is often shown against the background of catarrhal exudative sinusitis of a chronic type or purulent. A puncture is done to remove thick pus from the sinus. This procedure is also performed for targeted administration of antibiotics. After a puncture, a catheter is inserted into the sinus, through which rinsing is done every day with the help of antiseptics and proteolytic enzymes. Against the background of allergic sinusitis , special antihistamines and glucocorticosteroids are introduced into the sinus cavity.