Treatment of acute and chronic sinusitis has two main goals: eliminating the cause of the disease and combating the consequences of the inflammatory process. The first task is quite feasible thanks to a wide range of antibiotics that are able to overcome any infection. But with the second problem the situation is more complicated. It happens that efforts to ensure complete drainage from the inflamed maxillary sinuses do not lead to a positive result for a long time.
Pharmacotherapeutic drainage
We already know that all paranasal sinuses, including the maxillary sinuses, are connected by a system of passages to the nasal cavity. Why does mucus and pus accumulate in the sinuses during sinusitis? What interferes with the natural outflow of this pathological secretion?
It turns out that the main obstacle to the normal removal of mucus is swelling of the sinuses and the nasal cavity itself, which practically blocks the excretory ducts. In addition, the secretion itself has a very viscous consistency, which also makes it difficult to remove.
How to deal with this? There are two main ways: pharmacotherapeutic, basic, and surgical. Let's start with medications.
Vasoconstrictor drugs for sinusitis
In mild and moderate cases of sinusitis, drainage can be ensured by medicinal treatment of the root cause - swelling of the mucous membrane.
For this purpose, vasoconstrictor drugs are included in each treatment regimen. They stimulate alpha-adrenergic receptors located in arterioles - the smallest arteries - and cause their spasm, which is accompanied by vasoconstriction. As a result, local hyperemia (increased blood supply) and swelling decreases. The restoration of nasal breathing, which follows a few minutes after the use of alpha-adrenergic agonists (drugs that stimulate alpha-adrenergic receptors), is essentially a secondary process after the reduction of swelling.
However, with severe sinusitis, accompanied by severe swelling, vasoconstrictor drugs may not cope. In some cases, it is necessary to abandon this group of drugs altogether: for example, after 5–7 days of use, the drugs must be discontinued, because these are dangerous decongestants.
Cyclamen preparations for sinusitis
A relative alternative to alpha-agonists are herbal preparations containing cyclamen. The active substances of cyclamen tubers excite the receptors of the trigeminal nerve located in the area of the middle nasal passage, which stimulates the secretion of the nasal mucosa. The subsequent decrease in mucus viscosity is accompanied by a decrease in swelling. As a result, the natural flow of mucus from the sinuses is facilitated.
Other herbal and homeopathic medicines for sinusitis
There are some other herbal preparations that reduce swelling of the nasal mucosa and paranasal sinuses. However, their effectiveness has not been fully proven, and more often these drugs are used as auxiliaries.
The same can be said about the treatment of sinusitis with homeopathic remedies aimed at reducing swelling, improving drainage function and restoring nasal breathing.
Washing with solutions for sinusitis
Popular procedures for rinsing the nasal cavity are designed to reduce the viscosity of mucus and thereby improve its drainage properties, as well as “wash out” pus using liquid pressure. For this purpose, solutions of sea salt, isotonic sodium chloride solution, as well as infusions of various medicinal herbs are used. Local antiseptics are also used for rinsing, which immediately “kill two birds with one stone”, having an antimicrobial effect on pathogens and at the same time reducing the viscosity of mucus.
Washing is carried out both at home and using special equipment, which includes the popular “cuckoo”. The effectiveness of rinsing as an independent remedy is relatively low, and it is not worth using them as the main method of treatment.
However, rinsing as an additional treatment with an integrated approach to sinusitis shows good results. In addition, rinsing is mandatory after surgical treatment of sinusitis.
We advise you to study: Is herbal medicine always safe in the treatment of sinusitis?
AquaLor Clinic
Drainage of the paranasal sinuses with a sinus catheter is used to treat sinusitis.
Sinusitis is an inflammation of the mucous membrane of one or more paranasal sinuses. Occurs as a result of complications from acute runny nose, flu, other infectious diseases , as well as after injuries to the facial area. Sinusitis is caused by viruses and bacteria.
Symptoms of sinusitis
Heaviness in the paranasal or frontal area Pain with sudden movements of the head Thick discharge from the nose Fever
Localization of sinusitis
Sinusitis (sinusitis of the maxillary sinus) - inflammation of the mucous membrane of the maxillary paranasal sinus; Frontal sinusitis (sinusitis of the frontal sinus) - inflammation of the mucous membrane of the frontal paranasal sinus; Ethmoiditis - inflammation of the mucous membrane of the cells of the ethmoid bone; Sphenoiditis is inflammation of the mucous membrane of the sphenoid sinus.
To treat diseases of the paranasal sinuses (sinusitis), AquaLor Clinic doctors use an effective, atraumatic and virtually painless method - the application of a YAMIK sinus catheter.
The use of this device for the treatment of sinusitis is more preferable. The YAMIK method is successfully used in pediatric practice, where, taking into account the characteristics of the child’s body, local therapy for inflammatory diseases of the paranasal sinuses is preferable.
It should be noted that the pressure created in the nasal cavity using a sinus catheter does not significantly affect the transport function of the ciliated epithelium and does not lead to mechanical injury to the nasal mucosa . On the contrary, the YAMIK method helps to equalize the pressure in the paranasal sinuses in relation to the nasal cavity and restore the drainage function of the natural anastomoses of the paranasal sinuses.
In addition, the sinus catheter allows the delivery of drugs directly to the area of the ostiomeatal complex , thus this method can be considered pathogenetic.
The YAMIK method is used for wide clinical use in the treatment of acute sinusitis, exudative forms of chronic sinusitis, as well as for the treatment of relapse of a purulent process in the paranasal sinuses after endonasal surgical interventions.
Procedure
Drainage of the paranasal sinuses with a sinus catheter
The YAMIK procedure is performed under local anesthesia and anemia. The sinus catheter is inserted into the nasal cavity to the nasopharynx. The nasopharynx and nasal vestibule are blocked by inflating balloons. Positive and negative pressure is created in the nasal cavity, due to which the contents of the sinuses are evacuated, after which the sinuses are filled with a medicinal or diagnostic drug.
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Drainage of the paranasal sinuses with a sinus catheter – Section ENT doctor - see prices in the price list.
Surgical method of drainage
A more effective and, unfortunately, traumatic way to improve drainage is surgical. Using sinus puncture and irrigation techniques, purulent discharge can be quickly removed. At the same time, surgical drainage allows you to achieve two goals at once: to increase the mucociliary flow and to obtain material for further culture for the type of pathogen and sensitivity to antibiotics - more about the diagnosis of sinusitis.
As a rule, surgical drainage is resorted to only when drug therapy fails to control the infection and improve the drainage of mucus. In addition, this method is indicated for complications of sinusitis or a recurrent long-term inflammatory process, accompanied by a significant accumulation of secretions in the sinuses.
Puncture of the maxillary sinuses is also important in cases where the choice of antibiotics for the treatment of acute sinusitis is limited due to the individual sensitivity of the patient or empirical treatment does not bring results. In such a situation, it is necessary to establish sensitivity to antibiotics, which is only possible by culturing the nasal sinus discharge. This tactic is especially important in patients with weakened immune systems, as well as patients in intensive care units. In these categories of patients, banal sinusitis can cause sepsis - blood poisoning - and lead to a disastrous outcome.
Let us add that puncture is a pathophysiological method of drainage, used only in severe cases of sinusitis. However, if the doctor has decided that a puncture is necessary, you need to accept the situation, come to terms with it and not deviate from the path to recovery.
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Is it possible to have rhinoplasty if you have sinusitis?
Sinusitis is a disease associated with inflammation of the sinuses, which are located above the upper jaw. When left untreated, it becomes chronic.
If a person has an acute form of sinusitis (fever, weakness, pain in the forehead, the roots of the upper jaw teeth, severe headache, etc.), then rhinoplasty cannot be done. At this time, an inflammatory process occurs in the body. It, in some cases, leads to fatal diseases. For example, to meningitis, swelling of the meninges, and so on.
With chronic sinusitis, weakness, headache and malaise remain.
Before scheduling the day of surgery, the doctor will recommend treating sinusitis.
Drainage of the nasal sinuses for sinusitis
Home → OtolaryngologyThe drainage method of treating sinusitis significantly expands the therapeutic possibilities for this disease. In itself, drainage of the maxillary sinus during its inflammation is a purely pathogenetic intervention, since this achieves compensation for the function of the natural opening of the maxillary sinus disrupted by inflammatory edema of the mucous membrane.
Many doctors attach paramount importance to restoring ventilation of the maxillary sinus when it is inflamed; they believe that drainage of the maxillary sinuses increases the factors of local antimicrobial protection. Adequate drainage of the maxillary sinus can lead to normalization of even polypous mucosa, which is confirmed by observations.
The essence of the drainage method of treating sinusitis comes down to the fact that a tube is inserted into the maxillary sinus in one way or another, which is left for a long time. Through the drainage tube, the sinuses are washed and antibiotics and other medications are administered. Continuous drainage of the sinuses in the treatment of protracted acute and especially chronic sinusitis is very promising, as it saves the time of the doctor and the patient, allows you to rinse the sinus and administer medications many times during the day, eliminates the repeated use of anesthetic solutions, ensures constant outflow from the sinus, its aeration, and relieves the patient's feeling of fear before medical manipulation.
For drainage of the maxillary sinuses, polyvinyl chloride or polyethylene tubes are mainly used, which are inserted through the lumen of a Kulikovsky needle or together with the needle, inserting the tube from the outside.
Observations indicate that thin polyethylene tubing has significant disadvantages. The small lumen (0.8-1 mm) and large length (15-20 cm) of the tube impede the outflow from the sinus and its aeration. When pumped through such a tube, the washing liquid does not flow in a stream, but drop by drop, which cannot ensure complete washing. The introduction of larger diameter tubes through special trocars or placed on a Kulikovsky needle increases the invasiveness of the procedure. Long tubes protruding from the nasal cavity are unacceptable in an outpatient setting for aesthetic reasons.
A simpler set of instruments is used, which consists of a drainage needle-cannula, a guidewire and a decannulator. The drainage cannula needle is made from a needle for drawing blood. The length and diameter of the needle are quite suitable for the intended purpose. The quadrangular part of the needle cannula is removed, and a slot is sawn on the remaining metal collar, intended for fixing the cannula needle on the conductor in the desired plane. The sharp working end of the needle bends at an obtuse angle. A piece of soft rubber tube is placed on the collar, which significantly absorbs the pressure of the metal collar on the nasal mucosa and eliminates the possibility of bedsores. The cannula needle guide is a stainless steel rod with a handle at one end and a mandrel at the other. The diameter of the mandrel corresponds to the diameter of the cannula needle channel. Below the mandrin, the rod is flattened with two flats over a length of 1 mm. When the mandrin is inserted into the lumen of the cannula needle, the flattened part of the rod enters the slot of the collar, fixing the latter in the desired position. The decannulator is a two-pronged hook with a gap between the teeth equal to the outer diameter of the cannula needle. The puncture technique is no different from puncture of the maxillary sinus with a Kulikovsky needle. However, the cannula needle can also be inserted more or less successfully. Upon successful insertion, the cannula collar should be in contact with the anterior edge of the inferior concha. If the collar of the cannula remains in the vestibule of the nose or presses with its edge on the septum, then this position of the cannula should be considered unsuccessful. Some patients after the puncture note discomfort, which in almost all of them disappears on the 2-3rd day, and further wearing of the cannula does not cause any subjective disorders.
