Acute sinusitis: frontal, purulent and catarrhal. Why is sinusitis dangerous? How to treat acute sinusitis: antibiotics and other drugs

Everyone has a runny nose and nasal congestion at least a few times a year, and the number of episodes of headaches is difficult to count, but most people do not pay any attention to it. Nevertheless, a very dangerous ailment frontitis can begin to manifest itself, the symptoms and treatment of which have a number of features.

What is frontitis and why is it dangerous?

Often found in professional athletes, frontal sinusitis is the most severe type of sinusitis, manifested by inflammation of the mucous membrane of the frontal sinus. It causes a violation of the general condition of the body, so many patients lose their ability to work and are forced to undergo long-term treatment.

If you ignore its signs for a long time, this can cause the development of severe complications, including:

• meningitis;
• pneumonia;
• sepsis;
• osteomyelitis;
• phlegmon of the orbit, etc.

Thus, when symptoms of frontal sinusitis appear, you should immediately contact the ENT and begin treatment. Otherwise, the patient may require serious surgical intervention, and developing complications can cause death.

Varieties of frontal sinusitis

Traditionally, the disease can occur in acute and chronic forms. Depending on the symptoms accompanying it, the following types of frontal sinusitis are distinguished:

• catarrhal;
• purulent;
• polyposis;
• polyposis-purulent;
• complicated.

Also inflammation can be:

• left-sided;
• right-handed;
• bilateral.

Spicy

Acute frontal sinusitis in many (more often in young men) begins against the background of a common cold or flu. It is typical for him:

• an increase in body temperature up to 39 ° C;
• malaise;
• severe headaches;
• cough;
• a feeling of fullness in the mid-eyebrow;

An acute inflammatory process is accompanied by the production of a large amount of secretion and a significant decrease in the rate of its outflow. Therefore, acute frontal sinusitis without discharge from the nose is often observed. In this form, the process persists only for 3 weeks, after this time the disease is considered chronic.

Chronic

Chronic sinusitis is called inflammation that persists for a long time in the paranasal sinuses, which does not appear too pronounced. Often it develops in the absence of acute treatment, but it is much more difficult to diagnose it. Chronic frontal sinusitis in most cases is unilateral, and is typical for it:

• periodic aching pain in the corresponding part of the forehead;
• the constant presence of mucous discharge from the nose;
• thickening of the mucosa;
• the formation of granulomas and polyps;
• morning cough with the separation of a large amount of sputum with impurities of pus.

left hand

For the left-sided process, a dull pressing pain in the left half of the forehead is typical. It worsens in the evenings, after physical exertion, long reading, computer work, or other activity that requires the head to be tilted.

In addition, she can give to the right eyebrow or temple, as well as the crown. As a rule, it is constant, but sometimes it can become pulsating. In addition, discharge and congestion are also observed only on the left. Source: website

Right handed

Inflammation of the right frontal sinus is accompanied by almost continuous discomfort in this part of the forehead, which increases significantly when pressed. There was also an increase in discomfort in the evening, after physical exertion and work with the head bowed. By analogy with the left-sided lesion, discomfort can be felt in the left temple and brow, sometimes in the crown, and nasal congestion and discharge are present only in its right side.

What are the symptoms and complaints of frontal sinusitis?

For frontal sinusitis, both local and general clinical manifestations are characteristic, the intensity of which is directly dependent on its form and the age of the patient. The first ones include:

• difficulty in nasal breathing;
• sudden headaches in the brow from the infected paranasal sinus, often aggravated in the morning or when pressing on the corner of the eye or between the eyebrows;
• runny nose;
• a feeling of fullness in the bridge of the nose, growing during the day;
• feeling of heaviness behind the eyes;
• swelling of the eyelids and soft tissues between the eyebrows.

The most specific feature is frontal headaches. If the pathology has managed to become chronic, it can be diffuse, and not clearly localized.

This is a consequence of a violation of the cerebral lymph and blood circulation, a deterioration in the outflow of contents from the frontal sinuses, mechanical irritation of the endings of the trigeminal nerve, poisoning of the body with the waste products of pathogens, etc.

Attention

With an exacerbation of this type of sinusitis, arching pain occurs in the forehead, which increases significantly during eye movements or when the head is tilted forward. But applying cold usually brings relief.

The discharges present are viscous, thick and have an unpleasant odor, and the use of traditional remedies for the common cold usually does not work. Initially, they are transparent, but as the disease progresses, they acquire a yellow or greenish color, which indicates the beginning of a purulent process. Although often there is frontal sinusitis without discharge from the nose.

This occurs with a serious violation of the outflow from the affected sinuses. In such cases, the main symptom of the pathology is severe headaches, and a visual examination of the nasal cavity reveals deformations of the anatomical structures provoked by the pressure of accumulated pus.

Sometimes patients note that the symptoms that characterize frontal sinusitis disappear. , and treatment is unreasonably stopped. This is a huge mistake, as the disappearance of typical symptoms does not always indicate recovery. After all, they may be absent when the outflow from the sinuses is normalized, despite the preservation of their purulent lesion.

Also, patients suffer from violations of the general condition, in particular:

• temperature increase;
• weaknesses;
• dizziness;
• sleep problems;
• apathy;
• loss of appetite, etc.

In rare cases, there is:

• decrease or even disappearance of smell;
• lacrimation;
• photophobia;
• deterioration of vision.

Causes of Frontal Sinusitis

The causative agents of sinusitis are various types of staphylococci and streptococci, which can live on the mucous membranes even in absolutely healthy people. But with the development of various diseases, immunity decreases, as a result of which bacteria get the opportunity to actively multiply and, therefore, provoke the development of frontal sinusitis.

In recent years, data have also appeared that Haemophilus influenzae, some fungi, etc., can become pathogens of pathology. There is also a clear connection between its development and environmental pollution with dust, toxins, etc.

As an impetus to the onset of the disease can be:

• untreated rhinitis;
• injuries and anomalies in the structure of the nose, causing difficulty in breathing;
• infectious diseases, in particular, tonsillitis, scarlet fever, diphtheria;
• proliferation of tissues of the pharyngeal tonsil.

They create good conditions for the formation of inflammation and diseases such as:

• the presence of polyps, tumors and other neoplasms in the nose;
• violation of the culture of blowing your nose;
• immunodeficiencies of various nature.

Features of the disease

Frontitis, especially purulent, is very often combined with sinusitis or damage to the cells of the ethmoid labyrinth. For this reason, the pathology is difficult and gives patients a lot of trouble.

Indeed, the symptoms of frontal sinusitis are joined by signs of these ailments, and patients suffer from severe discomfort not only in the forehead and eyebrows, but throughout the face. Also, the disease often provokes the occurrence of conjunctivitis and a persistent cough that cannot be treated.

It is especially difficult to timely diagnose frontal sinusitis in children, which is quite dangerous for them. Moreover, it is in children that, due to the excessive use of various medicines, the disease imperceptibly becomes chronic and, due to the specifics of the anatomy, often provokes the development of otitis media. And one of the reasons for its formation may be the ingress of foreign bodies into the nose.

The main methods for diagnosing frontal sinusitis

A significant role in identifying the disease is given to the questioning of the patient and palpation. To confirm the diagnosis allow:

• rhinoscopy;
• radiography;
• diaphanoscopy (more often used when examining pregnant women and children);
• sinoscopy;
• thermography;
• scintigraphy (used to detect complications and diagnose a latent form of pathology);

What does frontal sinusitis look like on an x-ray? The radiograph helps to establish the presence of pathological formations, fluid, and deformation of the structure of the frontal sinuses. This is one of the most reliable ways to detect pathology at an early stage. Flaw- radiation exposure. An x-ray of the frontal sinuses shows:

• nature of inflammation (presence of fluid and its amount)
• any darkening indicating any formation in the frontal sinuses
• cushion-like protrusion in chronic hyperplasia.
• absence of cysts

To avoid the development of such an unpleasant pathology, you should be attentive to the treatment of acute rhinitis, various acute respiratory viral infections, influenza. It is also necessary to restore the normal anatomy of the nasal structures in the presence of septal deformities, etc. And if, nevertheless, it was not possible to avoid its occurrence, it is necessary to immediately begin treatment.

How should frontitis be treated?

Frontitis can greatly reduce a person’s ability to work and disrupt the usual course of his life, but the main danger of the disease is the appearance of complications. Therefore, the diagnosis of pathology should be carried out as early as possible, and treatment should begin just as early.

When the first symptoms of frontitis appear, you should seek medical help. Only a specialist, taking into account the stage, severity and all the characteristics of the patient, will be able to prescribe a correctly justified therapy.

Rationale for treatment directions

Treatment of frontal sinusitis in adults and children after 12 years of age (up to 12 years of age, the frontal sinuses are not formed anatomically) is based on the etiology and pathogenesis of the disease. That is, each medication or procedure is aimed either at eliminating the provoking factor of the pathology, or at stopping its symptoms.

The vast majority of cases of the disease occur due to the introduction of bacterial microflora into the mucous membrane, leading to inflammation of an infectious origin. Much less often - due to sensitization of the body to a certain antigen, which is the cause of inflammation of allergic origin.

Having diagnosed an infectious or allergic frontal sinusitis, the ENT doctor determines the main direction of therapy - etiological. In case of bacterial inflammation, antibacterial agents are prescribed.

With the allergic nature of the pathology, antihistamine, hormonal, barrier drugs, as well as cell membrane stabilizers are necessary.

The pathogenesis of inflammation of the frontal sinuses develops in the following areas:

• expansion of the capillaries of the mucous membrane of the sinuses and excretory channels;
• the release of blood plasma into the intercellular space with the formation of a significant edema of the membrane;
• blockage of the drainage channels increased in volume by the mucous membrane;
• increased production of mucopurulent contents in the frontal cavities;
• impaired drainage of discharge into the nasal passages.

The appointment of medications or procedures that can stop the development of the inflammatory process at these stages is symptomatic therapy.
It includes:

• the use of vasoconstrictor drugs;
• restoration of drainage function, cleansing the sinuses from purulent contents and treating them with antiseptics;
• normalization of local immunity of the mucous membrane, acceleration of the regeneration of the destroyed epithelium.

Early seeking help, as well as the appointment of competent therapy, allow the treatment of frontal sinusitis without a puncture, which can be carried out both through the nasal cavity and directly through the frontal bone.

A complex of medications, optimally selected for each patient, is able to cure acute inflammation in 7-10 days, and in the case of chronic inflammation, to lengthen the remission as much as possible.

How to treat sinusitis with antibiotics?

Treatment of bacterial infection is the mainstay of therapy. Antibacterial drugs are presented in an extensive range, it is necessary to choose the most effective of them in each case.

The best option is to inoculate the detachable frontal sinus on a nutrient medium, followed by determining the sensitivity of the pathogen to antibiotics. This method will give results in 24 hours and will avoid the appointment of ineffective funds.

But in practice, in medical institutions it is often not possible to carry out such a study at all in the first days of the disease. Or the material is taken, but sent to distant laboratories.

Therefore, the medical tactic is as follows: a broad-spectrum antibiotic is prescribed as the first course; if recovery does not occur, then a narrow-spectrum antibiotic is used in the second course (a strictly defined remedy is prescribed upon receipt of results from the laboratory).

Antibiotics for frontitis, prescribed in the first course, take into account the fact that the disease is most often caused by Haemophilus influenzae or pneumococcus. Therefore, from a wide range of funds, preference is given to the penicillin group, macrolides and cephalosporins.

From penicillins more often amoxicillin derivatives (Amoxiclav, Augmentin, Doxycycline) are used in the form of tablets or injections, the dosage is calculated depending on the patient's weight.

From cephalosporin antibiotics of the latest generation are prescribed Cefaclor, Cefotaxime, Ceftriaxone.

Funds from the group macrolides can be used not only in the first course, but also in the second, with a low effectiveness of penicillin or cephalosporin antibiotics. An example of macrolides is Sumamed containing azithromycin.

It has a bactericidal effect on streptococci, pneumococci, Haemophilus influenzae, fusobacteria, clostridia, and some protozoa. The drug is used for intramuscular or intravenous administration.
There are antibacterial agents for topical use. This is Bioparox nasal spray containing fusafungin, which is very effective in acute and chronic frontal sinusitis, as well as Isofra and the combined preparation Polydex (a complex with a vasoconstrictor and hormonal component).

Symptomatic treatment of frontitis

Etiological therapy should be supplemented with symptomatic treatment. To reduce swelling of the mucous membrane, vasoconstrictors (vasoconstrictors) are needed for topical application.

Their choice, the appointment of the dosage and the duration of the course must be carried out by the doctor, since any violation can lead to damage to the epithelium.

The drug is selected from the groups of short, medium or long-acting. Examples:

1. Galazolin
2. Nazol
3. Rinostop
4. Nazivin
5. Polydex is very effective.

Treatment of frontal sinusitis can be carried out using homeopathic remedies, for example, Sinuforte. This preparation, produced on the basis of the active substances of cyclamen, is an absolutely natural herbal medicine. Sinuforte, as well as Echinacea, Traumeel or Engystol, has a complex effect (antimicrobial, vasoconstrictor and immunomodulatory).

The most important direction of therapy is hot or cold inhalations and washing the sinuses with special solutions. At home, this is easy to do, but it must be remembered that the procedures are not carried out at elevated body temperature. To reduce it, you can use antipyretics based on Paracetamol.

Inhalations are carried out both through a nebulizer and with the help of ordinary hot decoctions (chamomile, calendula, boiled potatoes, sage). Washing is carried out with a saline solution (2 teaspoons of salt per 2 liters of water) or pharmaceutical preparations

1. Dolphin
2. Aqua Maris
3. Marimer
4. Physiomer
5. Otrivin Sea
6. Quicks

In the conditions of a medical institution, the “cuckoo” procedure is carried out, or the supply of a solution under pressure through one nostril, and the removal of wash water through the other. In this case, drainage and cleansing of all paranasal sinuses occurs. Very effective and the use of the Yamik sinus catheter

Inflammatory processes that form in the paranasal sinuses are called sinusitis. Sinusitis and frontal sinusitis are varieties of sinusitis that occur under the influence of microorganisms or viruses. Most often, with sinusitis, sinusitis appears, and in the second place in terms of the frequency of inflammation of the mucous membrane of the sinuses is frontal sinusitis. These two types of the disease have a number of similar symptoms, which can be used to determine which of the sinuses is inflamed. In addition, frontal sinusitis and sinusitis sometimes appear simultaneously.

The main causative agents of sinusitis are Haemophilus influenzae, pneumococci. Complications after a runny nose, infectious and colds can provoke inflammation in the paranasal sinus. The most common cause of sinusitis is the common cold. Inflammation in sinusitis leads to swelling, contraction of the capillaries, which prevents the accumulated contents of the sinuses from escaping. Regularly producing mucus stagnates in the cavities, and this leads to the development of pathogenic microflora. Due to inflammation of the mucous walls of the sinuses, frontal sinusitis and sinusitis often occur. Diseases are of 2 types: acute, chronic. What is the difference between these two diseases?

Frontitis - an inflammatory process of the frontal sinus, appears due to a bacterial infection (very rarely viral, fungal) in the paranasal sinuses. The development of infectious inflammation appears due to weak immunity, adenoids, nose injuries.

Sinusitis is an inflammation of the maxillary (maxillary) mucous membrane of the sinuses located around the nose. Inflammation of the maxillary sinuses is often due to diseased teeth. Microorganisms that live in damaged teeth lead to suppuration. Adenoids can also cause sinusitis (more often in children, because they have inflammation of the nasopharyngeal tonsils much more often).

Similarity of symptoms

A runny nose is the main symptom of sinusitis and frontal sinusitis. It is worth noting that not all nasal discharge is inflammation of the paranasal sinuses.

Similar symptoms of both sinusitis:

• microorganisms multiplying in the inflamed focus secrete toxins, they enter the bloodstream and lead to intoxication of the body;
• accumulated pus, which does not completely come out of the sinuses, contributes to the expansion of the cavity, as well as irritation of the nerve endings;
• signs of intoxication are manifested with sinusitis, and with frontal sinusitis: headaches, fever are possible; weakness, lethargy; decreased appetite.

With a mild course of diseases, signs of intoxication may not be noticeable, only fatigue is felt. But with inflammation accompanied by pus, intoxication will be quite pronounced.

Frontitis or sinusitis are characterized by the separation of mucus and difficulty in breathing. Due to damage to the ventilation in the inflamed sinuses, there is no free passage of air, and the accumulated purulent secret comes out of the nasal passages.

difference in symptoms

Although these two pathologies have common similarities, they also have some differences by which the attending physician can determine the correct diagnosis.

Features:

1. Headache. Pain with frontal sinusitis is felt in the forehead area, especially severe pain, manifests itself just above the bridge of the nose. Pain with sinusitis is felt on the sides of the nose, as well as in the area of ​​​​the cheekbones and gives to the temples. If the maxillary sinuses are inflamed, then the pain increases markedly when the head is tilted down. The pathology of the frontal sinuses causes pain during vibration (travel in transport) or head movements.
2. The appearance of external edema. Inflammation in sinusitis causes swelling under the eyes, the lower eyelid may swell. And with frontal sinusitis, puffiness appears on the upper eyelid, in the forehead or above the eyebrows.
3. Discharge from the nasal passages. The mucus is initially transparent, then becomes yellowish due to the accumulation of pus. In patients with sinusitis, the nose is completely blocked, and the mucus cannot be separated (swelling of the connection between the frontal sinus and the nasal passage is blocked).

It is worth noting that frontal sinusitis is more difficult, since the outflow of mucus is difficult due to anatomical changes in the frontal sinuses. There are risks of complications that are associated with the brain.

You can distinguish these two sinusitis yourself.

1. For sinusitis:

• formed nasal voice, loss of smell;
• appetite is noticeably reduced (especially if the inflammation has passed to the ethmoid sinuses);
• when turning or tilting the head, the pain increases;
• headaches appear, radiating to the bridge of the nose, forehead, teeth.

1. For frontal:

• pains appear when pressing on the area located above the eyebrow (if there is inflammation, then the resulting pain will last for a long time);
• if you look at a bright light, lacrimation, photophobia, and partial visual impairment appear.

Often, a combined inflammatory process of the maxillary and frontal sinuses is formed, which leads to frontal sinusitis.

Treatment of sinusitis and frontal sinusitis

There are two methods of therapy: conservative, surgical. The main in the treatment of sinusitis is systemic antibacterial and local therapy.

Conservative treatment of sinusitis

Conservative therapy of sinusitis practically does not differ from the treatment of frontal sinusitis and is carried out in the same way:

• treatment with antibacterial agents, antibiotics for frontal sinusitis, as well as sinusitis are selected individually for each patient (the choice depends on the causative agent of the disease, intolerance to any of the constituent components of the drug, allergic reactions, etc.);
• the use of sprays, nasal drops with a vasoconstrictive effect, irrigation is also effective, washing the nasal passage with a salt solution (Nafthyzin, Nazivin);
• to reduce swelling, anti-inflammatory, antihistamines (Zirtek, Zodak) are used;
• the use of drugs to thin and outflow of mucus;
• drugs that increase immunity (synthetic, plant origin);
• at elevated temperatures take antipyretics;
• physiotherapy (inhalation, UHF, phonophoresis).

Conservative treatment with antibiotics and other drugs for sinusitis or frontal sinusitis can be used at home, but before that it is advisable to visit a specialist.

Surgical therapy

Surgery is performed when conservative treatment has not brought any results. With polyps or formations in the nose, paranasal sinuses, a puncture (puncture) is made.

The purpose of any operation is to clean the sinuses from the existing pathogenic content: fungi, polyps, foreign bodies, etc. During the procedure, the natural canal between the nasal passage and the sinus is expanded, which improves drainage in the nasal cavity. You can also remove the pathological secret using a special catheter. There are other methods of therapy: according to Riedel, according to Jansen-Ritter, according to Killian, etc. These methods are suitable for the treatment of frontal sinusitis and sinusitis.

Frontitis is an inflammatory process that affects the mucous membrane of the frontal sinus. Although it occurs less frequently than ethmoiditis, it proceeds more severely, with severe headache, intoxication. With frontal sinusitis, general well-being is disturbed, purulent discharges are formed, and without treatment, the risk of serious complications is high.

If you do not consult a doctor in a timely manner and do not undergo an examination, there is a high probability of the transformation of the acute form into a chronic one. Inflammation of the frontal sinuses of the chronic type is fraught with many dangerous complications and can even lead to death.

Frontit: what is it?

Frontitis is an inflammation of the mucous membrane of the frontal sinuses, which are the paranasal sinuses. The formation of inflammation is carried out in the mucous membrane, which is located in the frontal sinus. This disease has another name - frontal sinusitis. Of all types, it has the most severe form of flow.

ICD code:

• ICD-10: J01.1
• ICD-9: 461.1

The development of frontal sinusitis begins as an acute process with a viral or microbial infection, or as an inflammation as a result of trauma to the fronto-nasal canal and frontal bone.

Types of disease

By localization:

• left hand
• Right handed
• Bilateral

With the flow:

• Acute sinusitis
• Chronic sinusitis

By form:

Exudative:

• Catarrhal frontitis;
• Purulent sinusitis

Productive frontal:

• polyposis, cystic
• Parietal-hyperplastic

By etiology:

• Allergic
• Traumatic
• Viral sinusitis (influenza, measles, adenoviruses, etc.),
• Bacterial (, staphylococcus, streptococci, hemophilic infection, other microbial flora),
• Fungal
• Mixed
• Medical.

The reasons

Frontitis causes inflammation of the mucous membrane that lines the sinus. The reasons can be various, often the form and severity of the disease depends on them.

There are the most common causes of the formation of this pathology:

• Prolonged infectious or allergic nature.
• Curvature of the nasal septum, congenital or acquired form.
• The focus of infection formed due to infection with staphylococci, streptococci and other bacteria.
• Allergic reaction - bronchial asthma and contribute to the formation of mucosal edema. The result of this process is the overlap of the hole, which contributes to the entry of fluid from the frontal sinus.
• Polyps in the nose.
• Foreign bodies.

The most common causative agents of viral frontal sinusitis are:

• adenoviruses
• coronaviruses
• rhinoviruses
• respiratory syncytial viruses

Frontitis symptoms in adults

Frontitis is a serious disease that is more severe than other forms of sinusitis. According to the nature of the course, two forms are divided: acute and chronic. Each of them has its own characteristics and characteristics.

Frontitis photo on x-ray

The first signs of a general condition occur as a result of blood flow disorders in the human body or intoxication of the body. Common features include:

• pain in the forehead, sometimes eyes, temples, most often manifested in the morning;
• difficulty breathing through the nose;
• discharge from the nose, often with an unpleasant odor, transparent in the initial stages, then purulent;
• morning expectoration of sputum.

Acute sinusitis

Pathogenic microorganisms multiply in the nasal cavity and frontal sinuses. In an acute course, the inflammatory process is localized in the mucous membrane, disappears on its own or in the process of adequate treatment after 10-14 days.

Symptoms of chronic frontal sinusitis are somewhat less pronounced than acute:

• aching or pressing pain in the frontal sinus, which is aggravated by tapping
• sharp pain in the inner corner of the eye when pressed
• copious purulent discharge from the nose in the morning, having an unpleasant odor
• a large amount of purulent sputum in the morning

The fact that the symptoms have become weaker does not mean that there has been an improvement. On the contrary, chronic sinusitis can lead to serious consequences and life-threatening complications.

Chronic sinusitis

In the chronic form of frontitis, only one nasal sinus is affected. In the nasal cavity, deformation processes caused by the pressure of pathogenic contents can be observed. When the disease has become chronic, the clinical picture is much less pronounced. Symptoms may appear and then disappear.

The following signs of frontal sinusitis of a chronic course are distinguished:

• reduced sense of smell, sometimes the patient cannot recognize smells at all;
• conjunctivitis;
• there may be no discharge from the nose;
• in the morning, the eyelids are slightly swollen, which indicates the spread of inflammation to the walls of the orbits;
• persistent cough, which cannot be stopped by any antitussive and expectorant drugs;
• severe weakness that does not allow you to perform ordinary household chores;
• in chronic frontal sinusitis, polyps and neoplasms grow in the nasal cavity, which cause breathing problems.

In medical practice, frontal sinusitis without discharge from the nose refers to a chronic type of disease.

Complications

Complications of frontal sinusitis that occur in both acute and chronic processes can be dangerous.

These include:

• the transition of infection to the bone walls of the sinus, necrosis and the formation of a fistula with the release of fluid,
• the transition of infection to the region of the orbit with the formation of abscesses and phlegmon,
• the transition of inflammation to the back wall with the formation of a brain abscess or meningitis,
• sepsis.

Lack of optimal treatment leads to partial or complete loss of smell. The inflammatory process can impair eye function and significantly reduce visual acuity. Within the frontal sinuses, granulations and polyps are formed. This is fraught with the appearance of fistulas in the region of the orbit and a violation of the integrity of the bony septa of the sinus.

Diagnostics

Often, frontal sinusitis begins without discharge from the nose, so it is possible to diagnose the onset of the disease only on examination by an otolaryngologist. An experienced otolaryngologist (ENT) will quickly make the correct diagnosis based on the patient's complaints. Additional studies are needed to clarify the severity of the disease and the correct selection of the treatment regimen.

Diagnosis of frontitis includes the following methods:

• Collection of anamnesis;
• X-ray of the sinuses;
• Rhinoscopy;
• Ultrasound of the paranasal sinuses;
• nasal endoscopy;
• Computed tomography (CT);
• Diaphanoscopy (transillumination);
• Thermal imaging (thermography);
• Bacteriological examination of the secret from the nasal cavity;
• Cytological examination of the contents of the nasal cavity.

Frontitis treatment

Treatment must be entrusted to a qualified medical professional. However, at the initial stage, frontitis can be cured on its own. In most cases, at the initial stage, there is no need to take special drugs. It is enough to wash the nasal cavity several times a day. Washing will clear the cavity of mucous formations. However, it is far from always possible to determine frontitis at the initial stage. Few people pay attention to a headache.

How to treat acute frontitis?

For the treatment of an acute form of frontal sinusitis, if its corresponding symptoms occur, drugs are prescribed to narrow the vessels. Basically, these are nasal sprays. They provide a qualitative elimination of swelling of the nose, as well as restore the full outflow of the contents of the nasal sinuses. For such purposes, medications based on phenylephrine, oxymetazoline, and xylometazoline are used.

Basic principles of treatment of acute frontal sinusitis:

• Creating conditions for normal drainage of the sinus.
• Antibacterial and anti-inflammatory treatment.
• Increasing the body's defenses.
• Prevention of relapses.

How to treat chronic sinusitis?

With chronic frontal sinuses, they carry out:

• rinsing the nose with saline solutions;
• nasal sprays with steroid hormones (substances that have an anti-inflammatory effect). The drugs have proven their effectiveness and safety in numerous studies around the world: they are practically not absorbed into the blood and do not affect the hormonal background;
• long courses of macrolide antibiotics in low doses (drugs of the group of antibiotics, the least toxic to the human body, have antimicrobial, anti-inflammatory, and immunomodulatory properties)
• Complete treatment of other inflammatory/infectious diseases;
• Find out the causes of the development of allergies and get rid of the irritant - only in the case of the development of chronic frontal sinusitis against the background of an allergic rhinitis.

Medications

Before using any drug, be sure to consult with an ENT doctor.

Antibiotics for frontitis

If there are indications for taking antibiotics, then the drug of first choice is Amoxicillin in combination with Clavulanic acid. Preparations that contain such a combination: "Augmentin", "Amoxiclav". If the patient is allergic to antibiotics of the penicillin group, then it is better to use -

• antibiotics of the fluoroquinolone group (for example, "Ciprofloxacin"),
• macrolides ("Clarithromycin", Azithromycin).

Antibiotics for frontal sinusitis are prescribed for about 10-14 days. However, after 5 days from the start of administration, it is necessary to evaluate the effectiveness of therapy. If significant improvement is not achieved, then it is best to prescribe a more potent antibiotic.

Swelling medications

In the treatment of sinusitis, homeopathic remedies are also used.

• Sinupret: used to relieve inflammation, liquefies the contents of the sinuses.
• Sinuforte: relieves inflammation, promotes ventilation and opening of the sinuses.
• Cinnabsin: relieves swelling, makes breathing easier and helps to strengthen the immune system.

To reduce mucosal edema, antihistamines are also prescribed - Suprastin, Tavegil, Cetirizine.

Antipyretics are used at elevated temperatures, many drugs have analgesic and anti-inflammatory effects. Reduce the temperature of the drug with paracetamol (Efferalgan and Panadol), ibuprofen (Nurofen).

Drops

To relieve swelling and improve the drainage of the affected sinus, the mucous membrane under the middle nasal concha is lubricated with vasoconstrictors - adrenaline, ephedrine, naphazoline, xylometazoline. For the same purpose, instillation of drops with a similar effect is prescribed 3-4 times a day. These are well-known drugs Naphthyzin, Sanorin, Galazolin, Nazivin, Nazol and others.

Physiotherapy

UHF therapy

Treatment with an electromagnetic field with a wavelength of 1–10 nm. The plates are superimposed on the region of the frontal sinuses. The UHF field acts with heat, reduces puffiness, and activates regeneration processes.

cuckoo method

It involves the introduction of a thin tube into one nasal passage, through which special thinning and antibacterial drugs are supplied. Another tube is inserted into the second passage to pump out purulent mucus. Washing of the sinuses is carried out using solutions such as "Chlorophyllipt" and "Furacillin".

Washing with inflammation of the frontal sinuses, carried out at home, is less effective than similar procedures in a medical institution. But, nevertheless, they should not be abandoned.

Washing the nasal passages is carried out:

• Salt solution. To prepare it, a small spoonful of salt must be diluted in a glass of warm water. In case of acute frontal sinusitis, it is recommended to add 3-5 drops of tea tree ether to this solution.
• Decoctions of herbs - calendula, sage, chamomile flowers.

Puncture

Often, a puncture with frontal sinusitis is used if treatment with medication has not helped. Also, when the disease is accompanied by headaches, there is a pathological cavity in the tissues and suppuration. Initially, an x-ray is required to determine the puncture site. The procedure can be performed through the nose or forehead under local anesthesia.

With an uncomplicated course, the prognosis is favorable, a complete cure is possible, in advanced cases, a transition to a chronic course with periods of exacerbation is possible.

Folk remedies for frontitis

It is not always possible to completely cure frontitis with folk methods, however, it is possible to significantly speed up the healing process at home, additionally using medications.

1. Dissolve in 500 ml. warm boiled water a tablespoon of alcohol solution of chlorophyllipt. It has an antibacterial effect and fights even those microorganisms that have developed resistance to antibiotics. The solution is used for washing 3-4 times a day.
2. Take equal amounts of aloe juice, onion juice, honey, cyclamen root juice, Vishnevsky ointment. Mix everything well and keep in the refrigerator in a sealed jar. Before use, steam until a temperature of thirty-seven degrees is reached. Apply the ointment on cotton flagella and inject for half an hour in both nasal passages. Course 3 weeks.
3. Frontitis can be treated with a cyclomen plant. The juice of this plant is diluted with boiled water in a ratio of 4: 1, the solution is dripped three times a day, two drops.
4. Rosehip decoction(2 tablespoons per glass of water, boil for 10 minutes, leave for 20 minutes), add viburnum juice or raspberry syrup / jam to regular tea. You can make the following mixture with a general strengthening effect - take 3 walnuts, hazelnuts and cashews in a glass of honey, insist for a day and use half a teaspoon three times a day.
5. Bay leaf . Throw a few leaves into boiling water, sweat for 10 minutes, and then breathe over the steam. Perform the procedure in the morning, and in the evening you can leave the same decoction, warm it up and breathe again.

Prevention

High-quality prevention of frontal sinusitis in humans involves the treatment of the primary disease. Of great importance is the overall strengthening of the immune system, which involves hardening and water procedures, eating vitamins, as well as fresh fruits and vegetables.

The main goal of the prevention of frontal sinusitis is to increase the protective properties of the body, treat viral diseases, as well as regularly visit an otolaryngologist.

Sinusitis is a disease characterized by acute or chronic inflammation concentrated in the area of ​​the sinuses (paranasal sinuses), which, in fact, determines its name. Sinusitis, the symptoms of which we will discuss below, mainly develops against the background of an ordinary viral or bacterial infection, as well as allergies and, in some cases, against the background of a microplasma or fungal infection.

general description

Let us dwell, first of all, on what the sinuses are as an area of ​​interest to us in the context of the disease in question. Sinuses are small cavities that are concentrated within the thickness of the bones of the skull. Each person has seven sinuses (paranasal sinuses): frontal sinuses (2), maxillary sinuses (2), ethmoid sinuses and sphenoid sinus.

Each of the sinuses is lined with a mucous membrane, while all of them communicate with the nasal cavity. Note that the possibility of such a message plays an extremely important role in ensuring a normal state for the paranasal sinuses. In the event that, as a result of the influence of certain factors, the channel that unites the nasal cavity and the paranasal sinus closes (which, in particular, can occur, for example, due to swelling of the nasal mucosa due to a runny nose), this leads to the absorption of air into the blood from a generally tight sinus. The sinus itself in this case begins to fill with an inflammatory fluid, in which, in turn, bacteria begin to multiply rapidly.

The paranasal sinuses perform extremely important functions, and they are as follows:

• formation of the facial skeleton, facial features and voice timbre;
• warming the air properly for its subsequent passage through the nose.

It is noteworthy that the sinus mucosa is just as prone to infection by various types of infection as the nasal mucosa, this predisposition and the possibility of inflammation are related. Actually, inflammation of the mucous membrane of the paranasal sinuses, which we noted earlier, is sinusitis.

Forms of sinusitis

With sinusitis, compared with the usual one, accompanied by the involvement of predominantly the entire nasal mucosa in the inflammatory process, infection mainly affects one paranasal sinus or several sinuses. Based on the specific sinus subjected to inflammation, the specific form of sinusitis is determined, in turn.

• – accompanied by predominant inflammation of one of the maxillary sinuses (in some cases, inflammation of both sinuses becomes a possible option);
• – the inflammatory process is concentrated in the region of one frontal sinus or both sinuses;
• – the inflammatory process is concentrated in the region of the sphenoid sinus;
• – the inflammatory process is concentrated within the framework of the ethmoid sinuses (cells).

Acute sinusitis can provoke development, which, in turn, is accompanied by extremely pronounced pain sensations in the facial area.

Often, a complication of chronic sinusitis is the formation of an abscess in the form of a closed cavity, inside which there is pus.

When sinusitis occurs against the background of a chronic form, atrophy of the nasal mucosa can occur, which, in turn, leads to a loss of smell.

As a rule, patients with sinusitis, and especially with its chronic form, unsuccessfully and for a long time undergo treatment for other diseases / causes that provoke a constant (chronic) cough.

Frontitis (frontal sinusitis): symptoms

With frontal sinus inflammation, the frontal paranasal sinus is exposed, in particular, the process is concentrated within the mucosa that lines the frontal sinus. The course of frontal sinusitis is possible in acute or chronic form.

The acute form of frontal sinusitis is accompanied by sharp pain sensations that occur in the forehead. In addition, there is a headache (of a different area of ​​localization), lacrimation, pain in the eyes, difficulty in nasal breathing, photophobia. From the corresponding half of the nose, copious, odorless discharge is noted. The temperature is about 39 degrees, but it can be lower (subfebrile). There may be swelling in the soft tissues.

Chronic frontitis is expressed somewhat weaker in its manifestations. So, the headache in this case is aching or pressing, it is mainly localized from the affected sinus. With difficulty in the outflow of exudate, as well as with increased pressure noted in the sinus, the pain, respectively, increases, pressure on the orbit (its inner corner or inner wall) may be accompanied by sharp pain. As for the actual symptom for this disease in the form of nasal discharge, they are especially plentiful in the morning, they are often characterized by an unpleasant odor. In a dream, they drain during sleep to the nasopharynx, as a result of which a significant amount of sputum is expectorated in the morning.

Complications of frontal sinusitis (mainly in a chronic form) are often reduced to the transition of inflammation to the frontal sinus, that is, to its anterior bone wall, resulting in its subsequent necrosis, sequestration and fistula formation. Somewhat less often, the spread of the process passes to the lower wall, as a result of which the tissues of the orbit are subject to inflammation, and due to the involvement of the posterior wall in such a process, intracranial complications (, extradural abscess or meningitis) develop, respectively. It may also develop.

Sphenoiditis (sphenoidal sinusitis): symptoms

This disease implies inflammation of the mucosa, affecting, this time, the sphenoid sinus, which, as in previous versions of sinusitis, develops against the background of exposure to a bacterial or viral infection. This disease occurs infrequently in practice and, as a rule, is caused by the prevalence of inflammation from the posterior cells of the ethmoid labyrinth.

Sphenoiditis can occur in the form of acute or chronic. Acute sphenoiditis is accompanied by nasal discharge and a headache characteristic of sinusitis, which, as a rule, is concentrated in the occipital part (much less often in the parietal, temporal, or frontal). A symptom such as a disorder of smell is also manifested, there is an increase in temperature and general weakness. As a possible complication, as noted earlier, the possibility of inflammation spreading to the orbit and to the skull is determined, as a result of which the optic nerve is damaged, meningitis, abscess and other related processes develop.

The transition to the chronic form in sphenoiditis occurs against the background of the acute form of this disease. Its main symptomatology is reduced to the appearance of a headache (parietal, in some cases - occipital). There may also be a sensation of an unpleasant odor to patients due to the opening of the aperture of the sphenoid sinus to the olfactory nasal part.

Etmoiditis (ethmoid sinusitis): symptoms

Ethmoiditis is an inflammatory process that is concentrated in the area of ​​\u200b\u200bthe mucous membrane of the ethmoid bone (the shell of its cells). A disease occurs against the background of a bacterial or viral effect, it can proceed in an acute or chronic form.

Symptoms of acute ethmoiditis often occur with normal, rhinitis, etc. diseases. The main symptom is a headache, as well as pain in the region of the bridge of the nose and the root of the nose. If pain occurs in its main part from the inner edge of the orbit, as well as the root of the nose, then in this case we can talk about damage to the posterior cells of the indicated bone, which is directly affected by the disease in question.

Nasal breathing is often difficult, there may be a violation or complete absence of nasal breathing. Gradually, the general condition only worsens, which is accompanied by an increase in temperature of the order of up to 38 degrees.

The first days of the course of the disease are characterized by the appearance of copious nasal discharge, as a rule, at this time they are odorless, but later a change in their character is noted - they become serous-purulent or purulent, which is accompanied by a change in color and the acquisition of a certain smell.

Etmoiditis in children is often accompanied by hyperemia and swelling from the inner corner of the orbit, as well as the inner part of the lower and upper eyelids.

Primary acute ethmoiditis is accompanied by the most pronounced changes in the general condition of patients. The onset of the disease is accompanied by a sudden rise in temperature to 40 degrees, regurgitation and vomiting, and general anxiety.

Acute secondary ethmoiditis is characterized by an increase in the severity of manifestations and its gradual progression. Already by the third day, complications of this disease are noted. These include, in particular, destruction that occurs in part of the bone walls, the formation of empyema, as a result of which pus can break through to the fiber of the orbit (in some cases, into the cranial cavity). When the process spreads to the orbit, visual disturbances are noted, in which the field of view narrows, its sharpness decreases, etc. If we are talking about intracranial complications during a breakthrough of pus, then they are meningitis, brain abscess,.

As for the chronic form of ethmoiditis, but it occurs against the background of an acute form of the disease, developing, as a rule, in those patients who have significantly reduced body resistance forces and those for whom the effectiveness of treatment is determined as insufficient. Symptoms of the chronic form are identified based on the overall degree of inflammation activity. Patients are faced with increased fatigue and deterioration in general, performance is reduced. An exacerbation of the chronic form proceeds with symptoms that are relevant for the acute form.

Acute sinusitis: symptoms

The clinic of the acute form of sinusitis is characterized by signs of an inflammatory process of a general and local scale. As manifestations of a general reaction, symptoms in the form of headache, general malaise, fever and weakness can be identified. When analyzing the blood, the corresponding changes in the blood are determined. The listed symptoms are generally not specific, and therefore the diagnosis of the disease occurs on the basis of manifestations of the disease on a local scale.

The most common complaints that are relevant in acute sinusitis are difficulties associated with nasal breathing, headache, abnormal nasal and nasopharyngeal discharge, as well as a disorder of smell.

Most often, the headache is concentrated in the area of ​​the frontotemporal regions, and its intensification is not excluded during head tilts. If the sphenoid sinus is affected, then a very characteristic symptom appears, which is expressed in the so-called nocturnal headaches, which determines their nature, as well as localization - in this case, it lies in the center of the head, as well as in the back of the head. In some situations, there are no complaints about the appearance of headaches.

As for the difficulty of nasal breathing in the disease under consideration, it develops against the background of actual obstruction of the nasal passages, which occurs against the background of hyperplasia or edema of the mucosa and due to the formation of a pathological secret in the nasal passages. As a rule, the defeat of nasal breathing on a particular side corresponds to the same side of the lesion of the sinuses.

Based on the severity of symptoms characteristic of acute sinusitis, the peculiarity of the course of the disease as a whole is also determined - in particular, acute sinusitis can be mild, moderate and severe.

O easy course diseases can be said in the absence of radiological and local signs indicating sinusitis, or with a minimal degree of severity of signs of intoxication in combination with headache and localization of pain from the sinuses that have undergone inflammatory damage. This form of the disease is accompanied mainly by normal or subfebrile temperature.

Moderate course acute sinusitis is accompanied by moderate manifestations of intoxication with simultaneous moderate manifestation of pain syndrome, which, again, is concentrated in the area of ​​the affected sinuses in combination with headache. The temperature in this state rises to 38-38.5 degrees, slightly pronounced reactive phenomena are also possible in the variants of eyelid edema, swelling in the paranasal sinuses, affecting soft tissues.

For severe form sinusitis is characterized by phenomena in the form of intoxication, severe headache and pain from the affected walls of the sinuses. The temperature during this period exceeds the mark of 38.5 degrees. The urgency acquires the possibility of developing complications.

Chronic sinusitis: symptoms

The transition to chronic sinusitis occurs in the case of unfinished acute inflammatory processes, their undertreatment or complete lack of treatment. In particular, the transition to such a flow is relevant in case of violation of one of the functions of the sinuses, as well as under unfavorable conditions that affect their ability to aerate and to outflow a pathologically formed secret.

It is noteworthy that the microflora that provokes the chronic course of the inflammatory process of the paranasal sinuses can have a very different character, being both highly pathogenic and conditionally pathogenic or saprophytic.

Chronic sinusitis also has its own classification, built on the basis of their histomorphological features in combination with the inherent clinical manifestations.

• Exudative form:
• catarrhal chronic sinusitis;
• serous chronic sinusitis;
• purulent chronic sinusitis.
• productive form:
• parietal-hyperplastic chronic sinusitis;
• polyposis sinusitis.
• Alternative form:
• atrophic chronic sinusitis;
• cholesteatoma chronic sinusitis.
• The form is mixed (or polyposis-purulent).

In general, considering chronic sinusitis, it can be noted that the disease in this form is mainly affected by children. Chronic sinusitis in children, as a rule, occurs against the background of the course of diseases such as acute rhinitis, influenza, etc.

The main danger of the course of this disease in the chronic form is that it leads to a significant decrease in protective forces, as a result of which small patients become even more susceptible to a number of diseases, of which, first of all, respiratory diseases can be distinguished (, pharyngitis, etc.). ). In general, chronic sinusitis in children has its own characteristics for each of the individual age groups.

So, for example, children of the category of early and preschool age are faced with a fairly pronounced symptomatology of a general type, prevailing over local symptoms. In particular, subfebrile temperature can be distinguished here, which is maintained within a long time period. In addition, lethargy and weight loss are noted, sleep and appetite worsen. Children quickly get tired, they develop cervical lymphadenitis, blue appears under the eyes, in addition, there is a cough. Against the background of the general condition, irritability and capriciousness appear, in frequent cases keratitis and recurrent conjunctivitis develop. As a result of these symptoms, the condition of patients is defined as chronic sinusogenic intoxication.

The clinic of sinusitis in older children is slightly different from the course of this disease in adults. Manifestations of a subjective scale are expressed in this case somewhat less than in the case of acute sinusitis. The duration of the course with frequent exacerbations is also characteristic of the disease. There are complaints about difficulty in nasal breathing, headaches of various types and occurring mainly in the second half of the day. Nasal secretion increases, the sense of smell decreases, patients quickly get tired.

Diagnosis and treatment of sinusitis

Diagnosis of the form and features of the course of the disease is carried out on the basis of a general medical history, as well as the results of examinations carried out in combination with radiography, tomography of the facial part and sinuses in particular.

Treatment may include conservative or surgical therapy.

Conservative therapy consists in taking drugs aimed at reducing the swelling of the nasal mucosa, as well as improving the outflow from the paranasal sinuses. This includes local vasoconstrictor drugs (lasting no more than a few days). Antibacterial medications, antihistamines are also used. Nasal lavages are carried out using antiseptic solutions. Relevant is the use of physiotherapy procedures.

As for surgical treatment, it comes down to washing the nasal cavity, followed by a puncture (puncture) of the maxillary or frontal sinuses. Through the puncture, the pressure in the sinuses is reduced, as a result of which material for seeding can also be obtained. Subsequently, anti-inflammatory drugs and antibiotics are injected into the sinus.

If the above measures were also ineffective, which is accompanied by corresponding complications in the form of meningitis, etc., then surgical intervention is performed in a more active way.

Sinusitis(from Latin "sinus" - sinus) is an inflammation paranasal sinuses- cavities in the bones of the skull, which communicate with the nasal cavity through holes. Sinuses exist in the maxillary bones ( maxillary sinuses ), in the frontal bones ( frontal sinuses ), in the ethmoid bone ( ethmoid sinuses ). In addition to them, there is also a wedge-shaped ( sphenoidal sinus ), located behind the ethmoid sinuses in the upper part of the nose.

Based on this, there are several types of sinusitis. - inflammation of the maxillary (maxillary) sinus, frontitis- inflammation of the frontal sinus, ethmoiditis- inflammation of the ethmoid labyrinth and sphenoiditis- inflammation of the sphenoid sinus. Sinusitis can be unilateral or bilateral, affecting one or all of the sinuses. The most common types of sinusitis are sinusitis and sinusitis.

There are two types of sinusitis - acute, which occurs as a result of acute, and lasts 2-3 weeks, as well as chronic, which occurs as a result of insufficiently cured sinusitis. There are also 3 forms of inflammation of the sinuses - purulent when the sinuses contain pus, catarrhal when inflammation affects the surface of the mucosa, and discharge in the form of mucus is observed, as well as mixed form .

Diagnosis of sinusitis determines the main causes of sinusitis, which are:

• not fully cured cold, acute rhinitis, ( flu , , );
• chronic runny nose;
• diseases of the roots of the 4 upper back teeth;
• sick;
• immune disorders, which can lead to long-term chronic diseases;
• hypertrophied rhinitis;
• congenital disorders in the development of the anatomical features of the nose;
• nose injury.

During a decrease in immunity or hypothermia, the body cannot fight back pathogenic bacteria, which leads to their entry into the nasal mucosa. The arising leads to a violation of the ventilation of the sinus, which is isolated from the nasal cavity, and in which mucus begins to secrete, filling the sinus. Bacteria multiply in the mucus, pus is formed, which, entering the bloodstream, sends the body. If sinusitis is left untreated, it becomes chronic and complications of sinusitis occur.

Symptoms of sinusitis

The symptoms of sinusitis are:

• and pain in the cheekbones, cheeks, teeth, increasing in the evening;
• a feeling of fullness, pressure in the forehead, nose, cheeks;
• nasal congestion, alternating congestion of both nostrils is possible, mucous or purulent discharge from the nose;
• increase in body temperature;
• the appearance of heightened sensitivity of a part of the face;
• night cough;
• weakness, fatigue, irritability;
• weakening of the sense of smell.

One of the most common variants of sinusitis is sinusitis. It usually occurs against the background of a runny nose and other diseases, and also as a result of inflammation of the roots of the 4 rear upper teeth.

The main symptoms of sinusitis are a feeling of pressure in the area of ​​​​the inflamed sinus, as well as headaches in the forehead, cheekbones, pain that captures half of the face, and also with pressure on the cheeks. The pain may increase with a change in the position of the head. There may also be toothache, which is aggravated by chewing. In patients with sinusitis, nasal breathing is disturbed, a nasal voice appears, as well as clear or purulent discharge from the nose. Patients may complain of lacrimation, photophobia, decreased sense of smell. Sometimes the body temperature rises and the general condition worsens, the person becomes lethargic, unable to concentrate. There may be swelling of the cheek on the side of the affected sinus, swelling of the lower eyelid, discomfort in the ears.

The acute form of sinusitis usually lasts 2 weeks, and if it is not treated, then the sinusitis becomes chronic. There are also rhinogenic , odontogenic , hematogenous and traumatic sinusitis.

Frontit is an inflammation of the frontal paranasal sinuses. When suffering from frontal sinusitis, there is pain in the forehead, which increases with pressure and during bending, impaired nasal breathing, discoloration of the skin over the sinuses, and swelling in the forehead. Chronic sinusitis is accompanied hypertrophy of the nasal mucosa and polyps .

Ethmoiditis has the following symptoms:

• swelling of the soft tissues around the eyes and eyelids;
• pain between the eyes;
• partial loss of smell.

Symptoms sphenoiditis:

• ear pain;
• pain around the neck.

All of these symptoms of sinusitis are aggravated by tilting the head forward.

Diagnosis of sinusitis

ENT diagnoses acute catarrhal and purulent sinusitis on the basis of a patient interview, examination of the nasopharyngeal cavity and the results of an x-ray of the paranasal sinuses. Swelling of the mucous membranes leads to darkening of the sinuses on the x-ray, and the accumulation of exudate (pus) looks like a fluid level.

To diagnose chronic sinusitis, the doctor prescribes computed tomography of the paranasal sinuses, which will reveal cysts, polyps and other changes.

Sinusitis treatment

In the case of allergic sinusitis, it is prescribed antihistamine therapy( , ). For people prone to allergies, prevention of sinusitis is important in order to avoid relapses of the disease.

Nasal irrigation is an important element in the treatment of sinusitis. antiseptic solutions(moving method or "cuckoo"), due to which the nasal mucosa is cleared of germs, dust, and inflammation is also reduced.

If the inflammation of the sinuses has become purulent, then . The choice of antibiotics depends on the infectious agent, and is usually given loracarbef , axetil . These drugs are used both inside in the form of tablets, and intramuscularly and intravenously for 1-2 weeks. Alternative drugs are macrolides , cephalosporin , .

Complex treatment of sinusitis is used, including homeopathic preparations (, ), which help reduce pain and inflammation in the sinuses.

Corticosteroids contribute to the restoration of outflow from the sinuses and reduce the severity of allergic reactions. However, they are not prescribed for purulent sinusitis. If sinusitis occurs against the background of allergic rhinitis or, then the treatment of the underlying disease is mandatory.

If drug treatment of sinusitis is not effective, then sinus cavity lavage and puncture (puncture) of the maxillary and frontal sinuses are prescribed. In this case, the sinuses are cleaned of pus accumulated there, the sinuses are washed and antibiotics, anti-inflammatory and antiseptic drugs are administered ( , , angina), as well as the elimination of factors that are predisposing to the development of inflammation in the sinuses. It is important to harden the body, exercise regularly, do not overcool, often be in the fresh air, take vitamins and immune-supporting drugs. Avoid swimming in pools, as chlorine irritates the mucous membranes of the nose.

Complications of sinusitis

Complications of sinusitis can be diseases such as meningitis , swelling of the meninges , eyelid thrombosis , i.e. various intraorbital and intracranial diseases, as well as pneumonia , otitis media .