Sinusitis: treatment, symptoms. Sinusitis in children: sinusitis, ethmoiditis, frontal sinusitis, sphenoiditis - what is it and what to do about it? How to treat sinusitis?

Viruses, bacteria and fungi entering our nasal cavity cause an inflammatory reaction. A runny nose is the simplest response to foreign organisms developing in the nose. Under unfavorable circumstances, for example, hypothermia, inadequate treatment, sinusitis or frontal sinusitis may occur. These diseases are complications of a runny nose and are no longer so easy to treat.

Paranasal sinuses or sinuses are cavities in the bones of the skull that communicate with the nasal cavity through openings. The inflammatory process in each of them has its own name: sinusitis - pathology of the maxillary (maxillary) sinus, frontal sinusitis - disease of the frontal sinus, sphenoiditis - inflammation of the sphenoid sinus, ethmoiditis - ethmoid labyrinth.

Causes and symptoms of sinusitis

Any disease has a cause. Frontal sinusitis and sinusitis are detected due to the following provoking factors:

untreated colds, ARVI, sore throat,
inadequate treatment of acute rhinitis,
history of adenoids,
immunity disorders,
chronic runny nose,
nasal injuries,
deviated nasal septum, etc.

The first signs of frontal sinusitis and sinusitis appear against the background of a prolonged runny nose. Pain is what makes you think about the development of serious complications. It can be dull, aching, paroxysmal, or occur after touching the face. Often the pain spreads to the temples, jaw or back of the head. Patients begin to complain of headaches that prevent them from relaxing and resting.

Along with pain, other symptoms of sinusitis and sinusitis arise:

temperature increase,
decreased or loss of sense of smell,
feeling of fullness and pressure in the nose, cheeks, forehead,
purulent green nasal discharge,
weakness, loss of appetite, lethargy.

Frontal sinusitis is also characterized by swelling of the upper eyelid and soft tissues above the eyebrows and forehead.

Frontitis: what it is, symptoms and treatment of frontal sinusitis

Among all types of sinusitis, frontal sinusitis is characterized by a particularly severe course of the disease and has quite dangerous consequences: tonsillitis, tonsillitis, bronchitis and even pneumonia.

Frontitis - what is it:

refers to a type of sinusitis;
a special type of inflammatory disease;
develops in the paranasal sinuses.

In the human nose there are sinuses, which have a mucous membrane.

This shell is extremely important because it performs a protective function: it blocks the possible penetration of infections and bacteria into the body, filters the air and warms it up. With frontal sinuses, these sinuses suffer the most; inflammation begins, which stops the normal functioning of the sinus defenses.

Special mention should be made of acute frontal sinusitis, when the illness can last up to three weeks. The mucous membrane is located next to the orbit and the anterior cranial fossa - such a proximity can provoke the development of complications with frontal sinusitis. It is extremely important to diagnose frontal sinusitis in time and begin treatment.

There are also two main forms of frontal sinusitis:

Unilateral, when inflammation of the sinus occurs on only one side.
Bilateral, when the sinus becomes inflamed on both sides.

According to official statistics, frontal sinusitis is a typical disease among men. The reasons explaining this phenomenon have not yet been established. The disease can occur at any age.

Frontitis can also be a consequence of congenital deformations of the nasal septum, curvature of the canal in the frontonasal area.

As a rule, frontal sinusitis develops against the background of a viral infection of the upper respiratory tract. There are often cases when frontal sinusitis occurs as a result of exposure to the body of rhinoviruses, coronaviruses, respiratory syncytial viruses or parainfluenza viruses. With polypous (cystic) frontal sinusitis, the mucous membrane grows in a pathological form, lining the sinus and forming a cyst. Parietal hyperplastic frontal sinusitis can form when a bacterial infection develops against the background of mucosal cell division.

The source of infection in the frontal sinuses may vary. The main ones are:

Rhinitis (runny nose).
An infectious pathogen that has penetrated the frontal sinuses.
Trauma to the skull in the area of the frontal sinuses.
Allergic reaction.
Previously suffered scarlet fever or diphtheria.
Incorrect ways of blowing your nose.
Reduced level of immunity.
Adenoids and polyps in the nose.

As a rule, the development of frontal sinusitis is provoked by staphylococci. Also, the cause of the disease can be streptococci, Haemophilus influenzae, and Maroxella cata. If frontal sinusitis occurs in a person with a weakened immune system, then the development of fungi and other harmful microorganisms is quite possible.

The following types of frontal sinusitis are distinguished according to the type of pathogen:

Allergic.
Bacterial.
Viral.
Fungal.
Mixed.

Depending on the type of causative agent of frontal sinusitis, the treatment of the disease will vary.

Key symptoms of this disease include:

Pain and pressure on the frontal sinuses, located behind the eyes.
Pain and swelling near the eyes and nose. If a person leans a little forward, the pain will intensify (this symptom is a distinctive sign of sinusitis: with sinusitis in a horizontal position, the patient’s pain begins to subside).
Swelling in the nasal passages.
Runny nose with yellow or green mucus.
Painful sensations in the ears.
Increase in temperature at night.
Development of a severe cough.
The appearance of toothache (pain in the upper jaw is especially pronounced).

In addition to the listed symptoms, others are possible if frontal sinusitis is very severe.

These symptoms include:

Decreased sense of taste, decreased sense of smell.
The appearance of a sore throat.
Bad breath.
The development of meningitis if the primary symptoms of frontal sinusitis are ignored and not treated. Meningitis is dangerous because it provokes inflammation of the meninges, and this can become a threat to the patient’s life.

It should be noted

At the initial stage of development of frontal sinusitis or in its chronic form, the disease can occur without a runny nose or fever.
If frontal sinusitis is not accompanied by nasal discharge, then there is cause for concern - swelling of the mucous membrane completely covers the frontal sinuses, so the pain becomes unbearable. In order to determine frontal sinusitis, what it is and how it manifests itself, it is necessary to know the characteristics of the symptoms of different types of the disease.

Catarrhal , which is characterized by nasal congestion, profuse nasal discharge, and a feeling of heaviness in the area above the eyebrows. If catarrhal sinusitis is not treated, it will move to the next stage when purulent inflammation begins.
Purulent , which is characterized by the accumulation of purulent discharge in the frontal sinuses. The headache manifests itself quite intensely, the patient’s condition is much worse than in the normal course of the disease.

The treatment of frontal sinusitis should be determined by the doctor after examining the patient. If frontal sinusitis is the result of an infection, then first of all you need to treat the infection, and only after that begin to restore the irritated sinus cavity. If the medications do not produce results, the patient is prescribed antibiotics (usually when purulent processes develop). As a rule, antibacterial drugs help within 3-5 days. If the pain of frontal sinusitis becomes unbearable, the doctor will additionally prescribe an anesthetic.

A good support for the main treatment will be anti-edema drugs , which can be bought at any pharmacy without a doctor's prescription. Such remedies will calm inflammation in the sinus cavities, narrowing the blood vessels, reducing pressure and restoring the ability to breathe normally. The drugs are taken no longer than 5-7 days, so as not to cause addiction. Decongestants are vasoconstrictor drops and sprays containing antibiotics and steroid hormones.

Treatment of frontal sinusitis in pregnant women should be carried out as soon as possible: the frontal sinus becomes a source of infection that can harm the child. Under no circumstances should you self-medicate. Frontal sinusitis is also dangerous for the baby during breastfeeding if the mother takes medications to treat this disease. If frontal sinusitis is detected on time, then it can be treated with mild medications.

If you have frontal sinusitis and you smoke, you will have to forget about cigarettes (at least for the duration of treatment of the disease).

You can additionally use folk remedies, but the treatment prescribed to you by your doctor should be paramount. For chronic frontal sinusitis, treatment is exactly the same as for the acute form.

How does sinusitis differ from sinusitis?

At first glance, these diseases have similar symptoms, but an experienced doctor will quickly make the correct diagnosis after listening only to the patient’s complaints. By assessing the nature and location of the pain, you can almost immediately determine which sinuses are inflamed.

If it is frontal sinusitis, then the pain is recorded at a point above the bridge of the nose. But with sinusitis, pain occurs on the sides of the wings of the nose or in the cheekbones.
When a patient develops frontal sinusitis, he often does not complain of nasal discharge. This is due to the fact that the anastomosis between the frontal sinus and the nasal passage almost immediately closes due to increasing swelling of the mucous membrane. With sinusitis the opposite is true. At a doctor’s appointment, the patient notes the fact that the exudate has turned from transparent to a greenish-gray color.
You can also distinguish sinusitis from frontal sinusitis by the localization of soft tissue swelling on the face. With inflammation of the maxillary sinuses, swelling is located in the area of the lower eyelid and cheek. If you press on these areas, the pain intensifies and causes muscle spasm.

Chronic rhinosinusitis (sinusitis, frontal sinusitis, ethmoiditis, sphenoiditis)

None of the patients like the word “chronic.” And this is easily explained, because when saying “chronic process,” the doctor most often means that he will not be able to completely cure the patient, which means, it seems, the responsibility for treatment is less. In fact, chronic sinusitis can be treated, although not always and not fully. However, it is, of course, necessary to know what and how to treat. What is chronic rhinosinusitis? As in the case of acute, the term “rhinosinusitis” implies inflammation of the mucous membrane of both the nasal cavity and the paranasal sinuses (maxillary, frontal, sphenoid, cells of the ethmoid labyrinth), on one or both sides. Well, the term “chronic” means that the main symptoms of the disease (nasal congestion and nasal discharge) last for at least 12 weeks, and in addition, the patient complains of headache or pain in the face or decreased/absent sense of smell. Well, is chronic rhinosinusitis associated with polyps? Yes, and quite often. In general, chronic rhinosinusitis is usually divided into sinusitis with polyps and sinusitis without polyps. Let's talk about the first one first. Polypous rhinosinusitis. The diagnosis of “polypous rhinosinusitis” is extremely unpleasant, although not fatal. A polyp is not a tumor: neither benign nor even malignant. This is an overgrown (hyperplastic) mucous membrane, which also contains a lot of glands that secrete mucus. This is why one of the main symptoms of this disease is persistent mucus discharge from the nose or mucus running down the back of the throat. Polyps most often grow from the cells of the ethmoid labyrinth, covering, first of all, the upper parts of the nasal cavity. This causes one of the very first symptoms – decreased sense of smell. Well, when the polyps become large enough, occupying the entire nasal cavity, then the most painful symptom appears - difficulty in nasal breathing or even its complete absence. This “classic” polyposis is most often bilateral and can be combined with bronchial asthma and allergies to non-steroidal anti-inflammatory drugs (aspirin and others). In this case, this disease is called the aspirin triad. The disease is serious, since there is no treatment as such. These polyps can be removed, but most often after removal, the growth of polyps in the nose and sinuses continues. Severe polyposis leads to attacks of bronchial asthma, which, in turn, increases the growth of polyps - a kind of vicious circle. The question of how to treat such polyposis is one of the most pressing at the moment. Nobody knows the reasons for the growth of polyps; accordingly, we can only influence the growth process itself. It has been proven that intranasal glucocorticosteroid sprays (mometasone, fluticasone, budesonide) slow down the growth of polyps, provided that the patient uses them regularly and in adequate dosage. How long should they be taken? After removal of polyps under endoscopic control, they should be used for at least six months, since at this time a relapse can occur most quickly, and most often these sprays must be used in the future. With the aspirin triad, taking such drugs often becomes lifelong. Now we have gradually approached the question: when and how should polyps be removed and is it necessary to do it at all? If the polyps are small in size and do not make breathing difficult, it is not necessary to remove them, but you must definitely use the above-mentioned sprays to slow down the progression of the process. What complications can occur with long-term use of glucocorticosteroid sprays? There are virtually no serious complications, with the exception of rare cases of perforation of the nasal septum and minor bloody discharge from the nasal cavity due to the development of atrophic rhinitis. If polyps make nasal breathing difficult, they certainly need to be removed. How? Until now, many doctors use the so-called “loop” method for this purpose - when a metal loop is inserted into the nasal cavity and polyps are blindly “pulled out” of the nose. This method, although seemingly simple at first glance, is quite dangerous - it can damage important anatomical structures in the nasal cavity, as well as disrupt the integrity of the orbital wall and the base of the skull, even damaging the membranes of the brain. A much safer method is to remove polyps under endoscopic control. In this case, the surgeon sees the structures of the nose on a large screen, which allows him to remove polyps in a targeted manner without damaging surrounding tissues. It should, however, be repeated that the endoscopic method of removing polyps is not in itself a guarantee that they will not grow after surgery. As well as the notorious laser removal of polyps. In fact, no removal method is permanent. The exception is single polyps, the so-called antrochoanal ones. This polyp grows only on one side, and not by itself, but from a cyst, which in turn is located in the maxillary sinus. It is in this situation that the problem can be finally solved - removal of the polyp and cyst using special instruments under the control of an endoscope leads to a cure for the patient. Well, what can we say about chronic rhinosinusitis without polyps? Chronic rhinosinusitis without polyps, or chronic purulent rhinosinusitis. This type of rhinosinusitis is not accompanied by the growth of polyps, but is often an equally difficult disease to treat. But first, let’s talk about what can be cured. It is possible and necessary to cure odontogenic maxillary sinusitis. This is a primarily chronic inflammatory process with a predominant localization in the maxillary (maxillary) sinus. It has a clear cause - filling material or a fragment of a tooth root that got into the sinus after treatment at the dentist. In 30% of cases, the roots of the teeth are in direct contact with the mucous membrane of the maxillary sinus, which can be detected by doing an orthopantomogram before visiting the dentist. One way or another, having entered the sinus cavity, a foreign body causes chronic inflammation in it, accompanied by the growth of fungus. Gradually increasing in size, the fungus occupies the entire sinus and even goes directly into the nasal cavity. Such a long-term inflammatory process is accompanied by incessant purulent discharge from the nose, as well as a feeling of heaviness in the projection of the affected sinus. Diagnosis of this condition is very simple: it is necessary to perform a computed tomography scan of the paranasal sinuses. Additional information can be provided by endoscopic examination, during which, in advanced cases, you can even see fragments of fungal masses in the nasal cavity. Treatment is definitely surgical. Priority is given to endoscopic surgery. Complete removal of the fungal body in the vast majority of cases leads to complete cessation of the inflammatory process and recovery of the patient. The situation is much more complicated with chronic purulent rhinosinusitis, which has no clear cause. Of course, it is very important to fully and correctly treat acute rhinosinusitis. Of course, it is extremely important to improve nasal breathing by performing surgery on a deviated nasal septum or enlarged turbinates. But, unfortunately, quite often this does not lead to a complete recovery of the patient. If you culture the discharge for bacteria from the nasal cavity or affected sinuses, then saprophytes are often sown - microbes that inhabit the normal mucous membrane. During an endoscopic examination or on a computed tomogram of the paranasal sinuses, it is also often possible to see an additional anastomosis of the maxillary sinus - in this case, endoscopic intervention with the combination of natural and additional anastomosis can lead to a reduction in the frequency of relapses of sinusitis, but rarely relieves the patient of complaints completely. The situation is even worse with chronic frontal sinusitis - inflammation of the frontal sinus. The frontal sinus connects to the nasal cavity in a very narrow, hourglass-like place. And surgical manipulations in this area, justified in case of constant headaches, unfortunately, often lead to scarring and recurrence of sinusitis, that is, again to recurrence of headaches. As for medicinal treatment methods, these primarily include constant rinsing of the nasal cavity with saline solutions or sea water solutions, which is an important and useful measure. In addition, both before and after surgery, the above-mentioned intranasal glucocorticosteroids, as well as antibiotics, are used. The latter should be used strictly as prescribed by a doctor and for at least 2 weeks (in some cases they are used continuously for several months). Thus, diagnosing chronic rhinosinusitis is not difficult - in most cases, it is enough to perform a computed tomography scan of the paranasal sinuses and collect an anamnesis. Treatment, both medicinal and surgical, most often is not a panacea - chronic rhinosinusitis recurs quite often, leading to a decrease in the patient’s quality of life.

Diagnosis of sinusitis

An x-ray of the skull bones prescribed by a doctor will help determine the exact location of the inflammatory process. In the resulting image, the maxillary or frontal sinus will be darkened, which indicates the accumulation of pathological fluid in it.

Additionally, a specialist may prescribe rhinoscopy, endoscopy, computed tomography or ultrasound examination of the paranasal sinuses.

Treatment of sinusitis and sinusitis

Drug therapy begins with testing to determine the sensitivity of bacteria to antibiotics. According to it, the doctor will choose a drug that will deal with pathogenic microbes as quickly and effectively as possible.

Amoxicillin is the first medicine for sinusitis and sinusitis. It is used in the form of tablets, injections and nasal sprays. In severe cases, the specialist resorts to prescribing two antibiotics of different groups, for example, Amclave orally and Cefazolin intramuscularly.

An important role is played by the use of vasoconstrictor drugs in the form of nasal drops. Naphthyzin, Xilin, Nazivin are the most common drops for frontal sinusitis and sinusitis. They facilitate nasal breathing and help reduce pathogenic mucus. To avoid addiction, such products are used only as needed for no more than 4-5 days.

Corticosteroids are prescribed to help them. These remedies restore the outflow of fluid from the sinuses, relieve swelling and reduce the severity of allergic reactions. You can put Rhinocort, Nazacort or Sintaris in your nose. However, you should definitely consult a doctor if you have concomitant systemic diseases.

Do not think that one antibiotic tablet or nasal drops can cure sinusitis or frontal sinusitis. Additionally, the doctor prescribes the following set of therapeutic measures:

nasal rinsing using the moving method (cuckoo, YAMIK),
instillation of vasoconstrictor drugs (nasal drops Naphthyzin, Xilin),
the use of physiotherapeutic procedures (UFO, UHF, phonophoresis),
massage of biologically active points,
breathing exercises with exercise therapy elements.

If drug therapy does not bring results, the otolaryngologist prepares for surgery. There are several methods for eliminating the inflammatory process in frontal sinusitis:

endoscopic sinus surgery,
trepanopuncture,
endonasal drainage,
open operation according to Jansen-Ritter.

The choice is made by the doctor after assessing the anatomical structure of the sinus, the severity of the disease and the characteristics of the patient’s body.

Prevention of sinusitis and sinusitis

Timely treatment of acute colds significantly reduces the risk of developing sinusitis. However, an important role in their prevention is played by hardening the body, nutritious nutrition with vegetables and fruits, additional intake of mineral complexes and an active lifestyle. Exercising in the fresh air helps strengthen the response of the nasal mucosa to subsequent temperature changes.

Unfortunately, sinusitis and frontal sinusitis lead to disastrous consequences if you do not consult a doctor in time. Meningitis, encephalitis, brain abscess, sepsis - this is only a small part of them, because in 5% of cases death can occur. Take care of yourself and listen to your body, which requires specialized help, not self-medication.

Reasons for the development of diseases

Acute forms of sinusitis and sinusitis often cause common colds. Viruses penetrate inside, resulting in inflammation. As soon as the microbe enters the nose, the body responds with an immune response. The nasal passages become narrowed and breathing becomes difficult. Inflammation affects the mucous membrane of the sinuses, and it swells. The outflow of mucus slows down, which allows bacteria to develop more and more, since for them this is an environment conducive to reproduction.

Fungi can also cause the inflammatory process. This often happens with allergies.

The chronic form of illnesses is caused by many reasons. This includes bronchial asthma, allergies, and inhalation of cold air. Even regular deodorant can cause sinusitis.

Many people suffering from chronic forms of sinusitis or frontal sinusitis live in damp climates or in areas with unfavorable environmental conditions. Often this provokes the development of the disease.

Immunodeficiency problems also influence the onset of disease, such as AIDS or cystic fibrosis. Causes sinusitis and nasal polyps.

There are cases where the development of sinusitis was facilitated by various medications taken by the patient in the treatment of completely different diseases.