The sinuses are constantly inflamed. Treatment of sinusitis with a laser. Acute course has such symptoms

The sinuses, or sinuses, provide warming and purification of the inhaled air. Due to their proximity to the external environment, they are prone to the development of inflammatory processes - sinusitis. A person has four paranasal sinuses - maxillary, frontal, ethmoid and sphenoid. The first three are paired, and the last is unpaired. The occurrence of inflammation of their mucous membrane is respectively called sinusitis, frontal sinusitis, ethmoiditis and sphenoiditis. The most common sinusitis is sinusitis, it is he who becomes the reason for seeking help from an ENT doctor.

The mechanism of development of sinusitis

The main sinus, which most of inflammatory processes - this is maxillary. The rest are affected much less frequently.

Fistula of sinuses with nasal passages

An important role in the development of sinusitis belongs to the anatomical formations in the nasal cavity - fistulas. They connect the paranasal sinuses with the nasal passages, through which drainage is carried out.

On hit various kinds infections develop inflammatory process, which entails swelling of the mucous membrane and an increase in secretion production. At the same time, the edematous mucosa blocks the fistulas, the ventilation of the paranasal sinuses stops. The sinuses become pneumatized due to residual air in their cavity, due to inflammation, a secret begins to stagnate inside, which is a breeding ground for pathogenic microorganisms. As a result, the infectious process from the nasal cavity passes into the paranasal sinuses. If you do not start therapy, the sinuses will be completely clogged, surgery will be required.

Fistula blockage can also occur due to past injuries, congenital deformities of the bones of the skull or curvature of the nasal septum. Availability similar pathologies is a factor in the development of chronic inflammation of the sinuses.

Causes of inflammation in the sinuses of the nose

sinusitis

Sinusitis can occur due to a bacterial, viral or fungal infection, or due to allergic reactions. Most often, the disease appears due to SARS. The development of the disease occurs according to the mechanism described above, and then, against the background of increased secretion of mucus, a bacterial infection occurs, due to which the usual inflammation turns into a purulent process.

Sometimes the disease occurs due to only a bacterial infection, but this happens much less often. Fungal sinusitis develops in people with reduced immunity - in patients with HIV infection or hemoblastoses.

Contributing factors are:

• Hypothermia.
• Decreased general and local immunity.
• Recent infectious diseases.
• The presence of concomitant pathologies - immunodeficiency states, diabetes, leukemia.

Along the course, the disease can be acute and chronic, serous, catarrhal and purulent processes are distinguished according to the type of inflammation. paranasal sinuses nose. A separate group is sinusitis with a predominance of hyperplastic signs, for example, a polyposis form.

Symptoms of sinusitis

The main symptoms of sinusitis

Most often in adults there are acute forms of sinusitis, which are characterized by general and local manifestations. The first signs include fever, severe headache, weakness, malaise, chills. These symptoms develop with any infectious process, therefore, it is impossible to judge by them the presence of inflammation in the paranasal sinuses.

Local manifestations include:

• Redness in the sinus area.
• Swelling, soreness in the projection of the sinus, aggravated by pressure and tilting the head forward.
• Runny nose with discharge copious amounts mucus - with a purulent process it is green, with a serous process it is white, with a catarrhal it is transparent.
• Violation of the perception of smells.
• Difficulty breathing through the nose.
• Feeling of fullness over the localization of the sinus.

According to the place of sensation of pain, one can judge which sinus is involved in inflammation:

1. AT more cases pathological process the maxillary, or maxillary sinus is exposed. Soreness in this case is localized in the area of ​​​​the wings of the nose, zygomatic bone, under the lower eyelid and upper jaw above the dentition.
2. With frontal sinusitis (frontal sinus) - there is discomfort at the location of the superciliary arches, above the bridge of the nose and extends to the entire forehead area.
3. Ethmoiditis (lattice) is defined by pain from the root to the tip of the nose, over the bridge of the nose and at inner corner eyes.
4. Sphenoiditis (sphenoid sinus) is located inside the head, its inflammation is characterized by strong unpleasant sensations in the occipital region, and sometimes in the parietal, temporal and frontal.

For the ruling accurate diagnosis must pass x-ray examination, which will show which sinus is affected and give an idea of ​​the severity of the course of the disease.

Symptoms also depend on the severity:

• With a mild course, there are no radiological signs of sinusitis or they are minimally expressed, but there are symptoms of intoxication - headache and slight local pain over the affected sinus. The temperature will rise to +38 degrees Celsius.
• With sinusitis of moderate severity, there are also common manifestations in the form of headache, discomfort in the area of ​​the affected sinus. Body temperature rises to +39 degrees Celsius, and from local symptoms a slight edema develops over the projection of the sinus.
• The severe form is characterized by a pronounced intoxication syndrome with unbearable headache and temperature up to +39 ... +40 degrees Celsius, weakness and malaise. Edema and hyperemia of the face occur, as well as severe discomfort in the sinus area. Such patients in 100% of cases should be treated in a hospital, it is possible to prescribe a surgical intervention to remove purulent contents from the paranasal sinuses.

Symptoms of chronic sinusitis

The occurrence of sinusitis

Often patients do not pay attention to nasal congestion and long time treat it with vasoconstrictor drugs, despite the fact that you need to undergo antibiotic therapy to eliminate the focus of infection located in the paranasal sinuses. Therefore, with a long runny nose, it is necessary to visit an ENT doctor and exclude the presence possible inflammation sinuses.

If you do not remove the infection from the sinuses, acute process turns into chronic. Because of this, a runny nose will persist for a long time, and inflammation can move from the mucous membrane to the soft tissues and bones of the skull.

Chronic sinusitis has the following manifestations:

• prolonged runny nose with the release of greenish mucus;
• pain in the teeth;
• bad breath;
• pain in the sinus area is moderate or absent at all;
• difficulty in nasal breathing;
• feeling of pressure over the projection of the sinuses.

These signs in chronic inflammation have a blurred course and appear periodically, the intoxication syndrome is practically not expressed. Patients come to the doctor when the situation worsens and symptoms similar to acute sinusitis appear.

Symptoms of the disease in children

Inflammation of the paranasal sinuses in children occurs with some features. At the age of 3 years, they suffer from sinusitis, which develops only with general manifestations, and the causes of the disease are adenoid growths and viral infections. In children preschool age the symptoms of the disease will be similar to adults, but an isolated lesion of one sinus is very rare. Usually, several sinuses or all at once are involved in inflammation at the same time.

For children under 3 years of age and preschool age, a combination of sinusitis with otitis media is typical. This is due to the anatomical features of the child's canal connecting the nasopharynx and middle ear. At an older age (from 7 years and above), the disease occurs with the same symptoms as in adults, the distinguishing feature is that intoxication is more pronounced in children.

Treatment

The occurrence of the disease is associated with the presence of a bacterial infection, so the basis of therapy will be the appointment of antibacterial agents. Antibiotics are the drug of choice for sinusitis. penicillin series, such as amoxicillin with clavulanic acid (Augmentin, Flemoclav), as well as 2nd and 3rd generation cephalosporins - Ceftriaxone, Cefalexin, Cefoperazone and others. For adults with mild and moderate prescribe antibiotics in the form of tablets with the use of a therapeutic dose 2 times a day. At severe course carry out injection antibiotic therapy (drugs are administered intramuscularly and intravenously).

Children are prescribed drugs in the form of a suspension with a dose-by-weight calculation and two or three doses. In severe cases and involvement of the middle ear or all sinuses in the process, injection therapy is carried out.

Prescribe antibacterial drugs local action in the form of aerosols. good effect has such combined remedy, like Isofra, it has antimicrobial, anti-inflammatory and anti-edematous effects on the nasal mucosa and paranasal sinuses.

With severe intoxication and high body temperature, detoxification therapy is carried out. It is necessary for the excretion of products formed due to inflammatory response. For this purpose, a solution of Rheosorbilact is used (it contains physiological, 5% glucose, 4% sodium bicarbonate).

As local treatment use drops with a vasoconstrictor effect. They reduce swelling of the mucosa and open fistulas, thereby restoring the drainage of the paranasal sinuses. With sinusitis, it is important to observe the toilet of the nasal cavity, for which saline solutions are prescribed in the form of drops or aerosols. They flush out mucus and pus, and high concentration salt denatures bacterial proteins, thereby exhibiting a bactericidal effect. From this group, the most famous drugs are Aquamaris, Humer, No-salt and others. To reduce puffiness as systemic therapy using antihistamines. They are especially effective for allergic sinusitis.

Surgery and physiotherapy

Drainage of the sinuses advanced cases and at large cluster exudate is carried out using a surgical method. It consists in the fact that a special puncture needle enters the sinus and pumps out the contents, then a catheter is installed through which the cavity is washed antiseptics, such as Miramistin, Dioxidin. With viscous and thick secret add drugs with proteolytic activity - Trypsin, Lidaza, Chymotrypsin. A non-invasive way to eliminate exudate from the sinuses is the cuckoo method - with the help of suction, negative pressure is created in the nasal passages, due to which the mucus is pulled out of the sinuses. After that, antiseptic solutions are poured into the nasal cavity, which fill the sinuses and have anti-inflammatory and antimicrobial effects.

In chronic and acute sinusitis, in addition to medical and surgical treatment, effective methods are physiotherapy. Patients are prescribed a course of UHF (ultra-high-frequency therapy), laser therapy, a good result is the use of modulated and sinusoidal comrade. Before carrying out these procedures, the paranasal sinuses must be freed from exudate by the puncture method or the cuckoo method.

To avoid complications and the transition of inflammation to the surrounding tissues and bones of the skull, it is necessary to eliminate the focus of infection in time. Modern methods of treatment allow you to completely get rid of the disease, but you should never prescribe drugs on your own. Only an otolaryngologist can fully assess the condition and choose the right therapy.

The nasal mucosa becomes inflamed when various diseases. Characteristic symptoms- congestion, it becomes difficult to breathe, a discharge is formed. To quickly cure a runny nose, it is necessary to determine its cause and type. An early and correct diagnosis can help prevent undesirable consequences, the course of the disease will be less severe.

What is a runny nose

As a rule, it is necessary to think about the treatment of a runny nose (rhinitis) when the mucous membrane of the upper respiratory tract swells.

Often the cause is the penetration of mechanical or chemical irritants. Some people get stuffy nose and want to sneeze when dust gets in, in a draft, in too bright light.

Runny nose, caused by the above reasons, in adults and children does not go away for several days, treatment is not required.

The common cold itself is not contagious, its causative agent is unknown.

But the symptoms of a runny nose are characteristic of many diseases - for example, for initial period SARS, influenza.

AT Everyday life the need to cure a runny nose is associated with nasal congestion. Others consider heavy discharge to be an obligatory symptom. Still others are looking for a cure for a runny nose when they start to sneeze.

For many, the mucous membrane swells with a change in temperature, under the influence of alcohol, a strong odor, and for other reasons.

Types of runny nose

The vasomotor variety is associated with watery compartments. Congestion appears alternately in one nostril, then in the other. I want to sneeze, tears flow, my head hurts.

The reason is tobacco smoke, hormonal disorders, emotional experiences. This type of rhinitis is correctly considered a disease of a neuro-reflex nature.

The condition is accompanied by weakness, increased fatigue, irritability, insomnia.

The allergic variety manifests itself seasonally or as a reaction to certain foods, dust, animal hair, substances that make up detergents or cosmetics.

I want to sneeze, my nose itches, tingles.

To avoid bronchial asthma, allergic rhinitis must be treated, and not relieve symptoms with medications or ointments.

With vasomotor and allergic rhinitis the nasal cavity is not inflamed.

The infection occurs when colds. The cause is viruses, bacteria, fungus. Symptoms - burning and dryness in the nasopharynx. It is advisable to start treatment immediately so that the virus does not penetrate the throat and bronchi.

Acute rhinitis manifests itself or as a symptom of acute respiratory diseases.

The nose is slightly itchy, there is dryness, general lethargy and weakness. It is difficult to breathe through both nostrils, I want to sneeze, tears flow.

The condition is accompanied by a deterioration in the sense of smell, abundant mucopurulent discharge from the nose, which, if the vessels are damaged, become bloody (snot with blood).

Acute coryza lasts a week or more. Maybe 37C or higher.

Chronic rhinitis in a simple form is manifested by profuse discharge, often unilateral congestion. It often develops as a complication of an acute form in case of circulatory disorders in the mucosa, diseases of the paranasal sinuses.

If you do not treat a simple chronic rhinitis, as well as under the influence abrupt change climate, the development of the inflammatory process in the paranasal sinuses, the adenoid, it passes into a hypertrophic form.

Headache, stuffy nose, constant discharge, impaired sense of smell.

Chronic atrophic rhinitis develops with a weakened, after suffering infectious diseases With acute runny nose as a result of surgical intervention in nasal cavity, as a result of adverse climatic conditions, harmful substances.

The nasal cavity is dry, the sense of smell is reduced, it is difficult to completely blow your nose, periodic bleeding from the nose.

If you do not get rid of a runny nose, over time it becomes chronic, which can lead to inflammation of the maxillary sinuses -. Complications may be associated with inflammation of the paranasal sinuses, middle ear.

Treatment of acute rhinitis

The disease begins with dryness in the nose, a feeling of heat. After 1-2 hours, the nose is blocked, the head hurts, profuse discharge begins, you often have to sneeze, and the temperature rises. After a week, the discharge becomes thick, purulent.

Acute rhinitis is treated with bed rest. You can put mustard plasters on the calves, warm your feet in hot water with the addition of mustard (1 tsp per 8 l of water).

They instill or wash it in the nose with a collection of coltsfoot, or a collection of eucalyptus,.

• Mix vegetable raw materials in equal quantities. Brew 1s.l. mixture with a glass of boiling water, simmer for 5 minutes, insist in a sealed container for 1 hour.

• Grind 5g of propolis, add a little butter, up to 50g sunflower oil, to stir thoroughly.

Having soaked cotton swabs, lay them in the morning and evening in each nostril for 10 minutes.

Soak tampons with propolis ointment and insert into the nostrils. Lie down without a pillow for 5 minutes on the left side, 5 minutes on the right side.

Onion, garlic, horseradish - medicines for the common cold

Cut the onion, rub the wings of the nose with it, put small pieces through gauze into the ear canals. The tool allows you to quickly get relief. Some people manage to get rid of a runny nose for three days in this way.

Cold juices

Bury children in each nostril 5 drops of fresh beetroot juice. Can be mixed with honey at the rate of 1 tsp. honey for 2.5 tsp juice.

In case of thick discharge, rinse the nose with boiled juice.

Moisturize beetroot juice cotton swabs and place them in the nose for 10 minutes, repeat 3-4 times a day.

Kalanchoe juice helps to quickly get rid of a runny nose. Lubricate nostrils 1-2 times a day fresh juice, which is why mucus begins to intensively separate.

Bury aloe juice 2-4 drops 4 times a day.

Put tampons moistened with radish juice into the nostrils.

For the treatment of chronic rhinitis, mix 50 g of grated and juice. Take on an empty stomach twice a day for 1/2 teaspoon.

Mix fresh ginger juice with the same amount of water, bury children three times a day and at bedtime.

At constant runny nose instill juice from the leaves of the mother and stepmother, as well as yarrow juice.

Oils for colds

To quickly get rid of congestion, instill 2-3 drops of oil or. Can be placed in the nostrils gauze swabs impregnated with one or another oil.

Eucalyptus oil helps to cure a runny nose:

• Heat 100 ml of vegetable oil, add 0.5 tsp. dry eucalyptus leaves, simmer over low heat for 10 minutes, insist in a sealed container for 5 hours, strain.

Bury warm up to 6 times a day.

• chop the leaves, pour a glass of water, simmer for 3 minutes, let cool. Add 1 tsp. salt and 0.5 tsp honey, mix.

To cope with sneezing with a runny nose, instillation of a weak solution of starch helps.

In Tibet, when you have a cold, you tickle your nose with a match, at the end of which is cotton wool. Sneezing causes copious excretion mucus.

How to cure a runny nose

At the beginning of the disease, some people are helped by instillation of a 3% solution (3-6 drops per 1 tsp. warm water). After a copious discharge of mucus, the congestion disappears.

After half an hour, sniff the ammonia in turn with each nostril.

Heat in a frying pan or rye cracker until smoke appears, inhale through the nose. Treat runny nose several times a day.

At prolonged runny nose sniff oregano herb powder.

Allergic rhinitis to treat. Mash a green leaf, inhale the aroma for 3 minutes several times a day.

Warm up the body in a bath or bath, rub the sacrum with grated radish, mixed with the same amount of grated horseradish, where to add a little honey and table salt. After drinking tea with raspberries, mint. The next morning manages to get rid of the common cold.

Acute sinusitis is inflammation of the paranasal sinuses. Depending on the localization of inflammation, there are: maxillary sinusitis, or sinusitis (inflammation of the maxillary sinuses), ethmoiditis (inflammation of the mucous membrane of the cells of the ethmoid labyrinth), frontal sinusitis (inflammation of the frontal sinus), sphenoiditis (inflammation of the sphenoid sinus). The causative agents of the disease are viruses or bacteria. Since the sinuses are located near the brain, it is necessary to timely treatment to avoid serious complications.

Inflammation of the sinuses: diagnosis and treatment

Depending on the location, sinusitis can be:

• maxillary sinusitis;
• ethmoiditis (inflammation of the mucous membrane of the cells of the ethmoidal labyrinth);
• frontal sinusitis (inflammation of the frontal sinus);
• sphenoiditis (inflammation of the sphenoid sinus)

If the inflammatory process has affected all the sinuses, then it is diagnosed as acute pansinusitis. If inflammation has captured one half of the head (right or left frontal and maxillary sinuses), then given state called hemisinusitis. If more than one is inflamed, but not all of the paranasal sinuses, then this process called polysinusitis (poly - from the word a lot).

Causes and course of the disease

sinusitis by etiological factor are divided into viral and bacterial, according to pathophysiological - purulent and catarrhal. Most often, the viral form corresponds to the catarrhal form, and bacterial - purulent.

Unfavorable environmental factors, decreased immunity, stress, overwork, monotonous and meager food, as well as individual characteristics of the body are related to common factors causing sinusitis.

Local causes include violation of ventilation and drainage functions in the paranasal sinuses. They can occur with allergies of the nasal mucosa, true hypertrophy (enlargement) of the inferior turbinates, vasomotor disorders of the neurovegetatives of the inferior turbinates, congenital enlargement of the middle or middle turbinates (conch bullosis), the presence of ridges and spikes on the nasal septum, polyps of the nasal cavity and paranasal sinuses, as well as the curvature of the nasal septum.

But still, in the occurrence of acute sinusitis, the main role is played by infection, mainly coccal (streptococcus, staphylococcus, pneumococcus).

When an acute inflammatory process occurs, the functions of the glands of the mucous membrane are disrupted. This leads to a lack of secretion or to its excessive accumulation. The direction of the jet of inhaled and exhaled air changes, which leads to disruption of gas exchange, the function of the ciliated epithelium is inhibited. Violation of ventilation causes swelling of the mucous membrane, natural fistulas close, and secretion stagnates, metabolism is disturbed.

At the beginning of the disease, the exudate (fluid sweating from the blood vessels at the site of inflammation) has a serous character, then muco-serous. And with the addition of a bacterial infection, it becomes purulent, it contains big number leukocytes. Blood vessels at the same time, they are dilated, the capillaries are excessively permeable, the mucous membrane is edematous.

Clinical picture

In acute sinusitis, weakness, headache, and malaise are observed. Fever may occur, there are inflammatory changes in the general blood test. Highest value in the diagnosis of this disease local manifestations inflammation.

All forms have:

1. Difficulty in nasal breathing. It can be permanent or intermittent, one or two-sided, may occur due to obstruction (blocking of the lumen) of the nasal openings by edema.
2. Discharge from the nose. There are permanent and temporary, on two or one side. Due to swelling of the mucous membrane of the nasal cavity or fistula, there may be no discharge. The flow of secretion into the nasopharynx is often noted.
3. Headache.

In severe sinusitis, swelling of the soft tissues of the face is possible in the projection of the maxillary and frontal sinuses. In some cases, periostitis (inflammation of the periosteum) occurs.

Diagnostics

When diagnosing acute sinusitis, rhinoscopy (examination of the nasal cavity), endoscopy of the nasal cavity, X-ray examination and, if necessary, diagnostic puncture maxillary sinus with bacteriological research washed content. If necessary, studies are prescribed using pulsed ultrasound, thermal imaging, computed (CT) and magnetic resonance imaging (MRI). It is imperative to carry out a differential diagnosis of acute sinusitis and distinguish it from neuralgia of the first and second branches of the trigeminal nerve.

Treatment

Inflammation of the sinuses of the nose - treatment is aimed at eliminating the focus of infection, the phenomena of the inflammatory process and the evacuation of the discharge. In addition, it is necessary to achieve the restoration of ventilation and drainage functions. This is important from the point of view of preventing relapses (repetitions) of this disease.

The disease is usually treated with outpatient settings. With catarrhal rhinosinusitis, local antibacterial and anti-inflammatory treatment is prescribed. It is necessary to carry out the so-called "unloading" therapy (rinsing the nose by the method of moving fluid, YAMIK catheterization, washing the nose along the Pass, puncture of the maxillary sinus). It is necessary to prescribe secretomotor (expectorant) and secretolytic (thinning viscous mucus) drugs with caution and according to indications.

In severe form, as well as in case of suspicion of development possible complications acute sinusitis (often rhinogenic meningitis), in the presence of concomitant severe pathology, also if it is impossible to carry out specialized ENT manipulations on an outpatient basis, the patient is sent to treat acute sinusitis in the ENT department of the hospital.

At purulent sinusitis antibacterial drugs are necessarily prescribed simultaneously with anti-inflammatory drugs. Be sure to carry out one of the washing methods. With difficult evacuation of the mucopurulent discharge from the maxillary sinus, and this happens when the maxillary fistula is blocked, a puncture is performed. Sometimes it is carried out several times, until the so-called "clean wash water".

What is sinusitis and how is it treated? We are talking about inflammation of one or more paranasal sinuses, which is caused by viral, fungal, allergic and some other pathogens. Sinusitis can act as an independent disease or be a complication of influenza, rhinitis, colds, measles and other infectious diseases.

The treatment regimen involves the use of medication, physiotherapy, and in especially advanced cases - operational methods. Self-medication is strictly prohibited. This can further worsen the clinical picture and lead to severe intracranial and orbital complications (up to death).

How does sinusitis develop in adults?

If an infection becomes the cause of the inflammatory process of the paranasal sinuses, severe swelling mucous membrane. There is an active production of mucus. The fistula, which connects the nasal cavity and sinuses, narrows significantly. Natural ventilation and drainage (cleansing) of the sinuses is disturbed. As a result, mucus accumulates within the paranasal sinuses, thickens and becomes an ideal breeding ground for pathogenic microflora.

In the early stages of the development of the disease, nasal discharge is serous in nature. But then they quickly turn into muco-serous. If the treatment of sinusitis in adults does not occur, the mucus penetrates bacterial pathogens. As a result, the permeability of the capillary walls decreases, extensive purulent foci appear with high content leukocytes and detritus.

Delay with therapy promotes the appearance dangerous consequences or risk of relapse. The duration of acute sinusitis does not exceed two months.

The root causes of the disease

Most clinical cases(about 50 percent) such an ailment is caused by Pfeiffer's bacillus and pneumococci. Slightly less inflammation provokes hemolytic streptococcus, moraxella and other bacterial, viral and fungal agents. The main causes of sinusitis will be the following:

Types and forms

Sinusitis, the treatment of which always begins with an accurate diagnosis, can be divided into 4 main types. AT this case The classification is based on the localization of the inflammatory process.

• The first type is sinusitis. Pathological changes occur within the maxillary sinuses, which are located on the sides of the nasal wings. Sinusitis occurs most often, which is easily explained by the low location of the sinuses and the difficulty in passing mucus.
• The most dangerous and insidious type of sinusitis can be called frontal sinusitis. Inflammation of the frontal sinuses, in the absence adequate therapy, may have far-reaching Negative consequences in the form of a decrease in the acuity of hearing and vision, a complete loss of smell and a number of complications. Frontitis is dangerous because the frontal sinuses are located very close to such vital important bodies like ears and eyes.
• With ethmoiditis, the inflammatory process is concentrated in the cells of the ethmoid labyrinth. For this reason, the pain sensation is concentrated in the region of the nose. Often this kind of sinusitis is complicated by sinusitis.
• Sphenoiditis is the least common. In this case, inflammation begins in the sphenoid sinus, which is located slightly deeper than the ethmoid bone.

To quickly and safely get rid of sinusitis, it is necessary to accurately determine its form - acute or chronic. For acute form clinical symptoms appear quickly and clearly. Body temperature instantly rises, severe headaches occur. Nasal congestion prevents the patient from breathing normally. There is a clear nasal discharge, which very quickly transforms into purulent.

In addition, on front side of the affected sinus on palpation (palpation) are clearly visible pain. The patient may be disturbed by bouts of dry cough, aggravated at night. After sleep, swelling of the soft facial tissues is often noticeable. The sharpness of smell is reduced, and in some cases the patient may not distinguish smells at all.

As for the chronic form of sinusitis, in this case the symptoms are similar. However, the manifestations will be blurred and dimly expressed. Symptoms manifest themselves during exacerbation, and during the period of remission they fade or completely disappear.

The main reasons for the transition of the acute form to the chronic one are long-term ignorance of the problem, lack of treatment, frequent contact with allergens.

Therapy

If you want to know how to cure sinusitis, you need to decide on priority areas therapy. The key tasks are the following.

How to quickly cure sinusitis? For this, we do not recommend delaying the visit to the doctor. At the initial stage, treatment in adults can be performed with medication. To get rid of the symptoms of the disease and eliminate the causative agent of the disease, the following drugs are used:

1. Lower body temperature to optimal values antipyretic drugs - Nurofen, Paracetamol and some others will help.
2. For the treatment of sinusitis allergic nature you can not do without antihistamines - "Claritin", "Tavegil" and so on.
3. Aerosols for vasoconstriction will help to quickly eliminate the swelling of the nasal cavity and organize the discharge of mucus (but do not forget that their excessive use leads to addiction, as well as excessive dryness of the mucosa).
4. Bacterial sinusitis, which must be treated under the supervision of a physician, is treated with antibiotics.
5. Furoat, Beclomethasone, Triamcinolone and some other nasal sprays will help reduce the intensity of a runny nose in children.

Antibiotics

How to treat sinusitis bacterial type at home? For these purposes, it is assigned antibiotic therapy. We note right away that only the attending physician selects the optimal type and group of antibiotics. Doing it yourself is not recommended. Otherwise, you can further worsen the clinical picture.

The use of antibiotics will be justified if it is definitely established that the sinusitis has a bacterial origin. In addition, such medicines are indicated in case of detection of purulent exudate (mucus).

Foci of pus are an ideal place for the active reproduction of pathological microflora. To stop such a process, the use of antibacterial agents is justified.

If diagnosed mild form sinusitis, preference is given to antibiotics from the group of macrolides, as well as cephalosporins. In especially severe cases, drugs from the penicillin group (second or third generation) are used. Protracted chronic forms of the disease are treated with protected penicillins.

Acute and chronic inflammation of the sinuses, the treatment of which with antibiotics is justified, can be eliminated with a three-day course of Azithromycin. This option is best suited for children and is gentle. Often in demand antibacterial agents local action, for example, Bioparox.

Physiotherapy procedures and puncture (puncture)

as effective therapeutic methods the following appear:

• washing the nose with sinusitis using the "cuckoo" method;
• puncture of the nasal sinus with its subsequent cleaning from pus;
• laser treatment of sinusitis;
• electrophoresis;
• UHF of the affected sinus;
• inhalations based on decoctions of medicinal herbs;
• phonophoresis and so on.

To get rid of sinusitis in the later stages, it is not enough to rinse the nasal cavity antiseptic solutions. The doctor prescribes a puncture (puncture) of the wall of the inflamed paranasal sinus. How does this happen?

With the help of a special tool, penetration into the sinus cavity is carried out through soft cartilage tissue. Next, a catheter (a small hollow tube) is inserted into the resulting hole, through which a disinfectant solution is supplied under a certain pressure. It disinfects the sinus cavity and removes the accumulated pathological contents. In some cases, the procedure is repeated several times, which helps to eliminate recurrence.

Preventive actions

Now we know how to get rid of sinusitis. But it is always easier to prevent any disease than to treat it for a long time and hard, so let's pay attention to prevention. Not fully cured runny nose, flu, colds and other ailments cause various kinds sinusitis.

Therefore, the most important task in the process of prevention is to treat them correctly. Believe me, it is better to spend time and cure a runny nose than to fight acute or chronic sinusitis for weeks.

Don't forget these helpful tips:

Healthy lifestyle, regular physical activity and proper nutrition- that's what is able to completely replace tablets and sprays. Sinusitis develops more readily in a weakened body. Follow the above tips, live happily ever after!

The sinuses are cavities located in the bones of the upper jaw. They are filled with air and connect to the nasal cavity through natural openings. The paranasal sinuses provide mechanical and thermal protection eyeballs and the brain, in addition, thus increasing the strength of the bones of the skull. The sinuses of the nose are involved in the process of voice formation and the formation of sounds when talking. But these formations are most important for normal breathing. Due to the sinuses, the air inhaled by a person is warmed, cleaned and moistened.

The following nasal sinuses are distinguished: maxillary, sphenoid, frontal and ethmoid sinuses, which are divided into posterior and anterior.

Types of inflammation of the sinuses

Inflammation of the sinuses is called a mucosal diseasecharacterized by inflammatory processes and affecting one or more nasal sinuses. Such a pathology appears against the background of rhinitis.

There are three forms of the course of the disease:

1. Acute inflammation. All symptoms of inflammation of the sinuses are very pronounced, with proper treatment, the disease goes away without leaving any traces.
2. relapse of inflammation. Outwardly, this species is similar to the previous one, but the signs of the disease are more blurred. If the treatment is started on time and is carried out in full, then the changes in the mucosa quickly disappear.
3. Chronic inflammation. This pathology is quite difficult to cure, this will require more thorough and thoughtful treatment.

Causes of sinus inflammation

In adults, inflammation of the sinuses is often associated with a viral infection. Most often, the spread of the disease occurs through the mucous membranes of the nasal cavity, in more rare cases the cause is the condition of the teeth or blood. Viral pathology is milder, but it can cause a bacterial infection to join.

Of the microorganisms, staphylococci most often become the cause of inflammation of the sinuses. Infections of other types can also affect this area, but this usually occurs when the immune system malfunctions. Sometimes the inflammatory process can be caused by the spread of infection with bone tissue or teeth. Then only the maxillary sinuses are affected. But this is more of a special case, usually infectious inflammation covers all or almost all nasal sinuses.

The mechanism of development of such a disease is as follows. Otolaryngologists quite often face the transition of inflammation to the sinuses with the affected mucosa of the upper organs. respiratory system. In this case, not one sinus is usually affected, but several. The reason for this lies in their proximity to each other.

When air is inhaled, various small particles and microorganisms enter the nasal cavity, and then into the sinuses. AT normal condition here the air is cleared of unnecessary elements, this happens due to the ciliated epithelium, which is lined with the sinus, and special mucus. The mucus collects microbes and polluting particles and, with the help of the cilia of the epithelium, moves towards the mouth of the sinus. Next, she gets to back wall nose and excreted from the body.

If this mechanism is violated for any reason, then this can lead to the development of inflammation of the sinuses. There is a group of predisposing factors for the onset of the disease. These include the curvature of the conchas of the nose or the nasal septum, the incorrect anatomical location of the mouths of the sinuses, and so on. Some pathologies or genetic characteristics can contribute to the disruption of the sinus cleansing mechanism, and, consequently, the development of inflammation. Unfavorable factors disrupt normal work cilia, due to which microorganisms are delayed or not removed from the sinuses at all, becoming the cause of their defeat. Among such factors are injuries of the nose, fever, exposure to tobacco smoke or any other harmful substances, hormonal changes, dry indoor air and others.

Inflammation of the sinuses: symptoms

The most characteristic signs of inflammation of the sinuses are:

1. Rhinitis, or runny nose.
2. Headache, aggravated by pressure drop, pressure on the area near the sinuses and head tilts.
3. Constant feeling of stuffy nose.
4. Rise in temperature to about 38 0 .
5. Violent discharge from the nose, having a thick consistency and becoming greenish in color.
6. Cough, especially at night and in the morning.
7. Feeling of pressure and pain in the forehead, nose and upper jaw.
8. Breathing through the mouth.
9. Discharges with an admixture of pus from the nasal passages.
10. Appearance bad smell from mouth.
11. Kind of raspy voice.

Usually acute inflammation sinuses resolves on their own in about two weeks, the chronic form can be delayed for a long time, while periods of recovery alternate with relapses of the disease.

Diagnosis of inflammation of the sinuses

Complex diagnostic procedures to determine the presence of inflammation of the sinuses, the patient is prescribed by a doctor after collecting an anamnesis and examining the patient. With this disease laboratory research blood may show marked leukocytosis, usually indicating acute inflammation.

The most complete information about the state of the sinuses can give CT scan. When it is carried out, such violations as the presence of fluid in the sinus cavity, polyps of the mucous membranes, loss of patency of the mouth and others may be revealed. pathological changes. AT last years X-ray methods for examining the sinuses of the nose began to be used much less frequently, since they are less informative than tomography. They are used mainly in acute forms of inflammation of the sinuses. In some cases, a sinus puncture is indicated to take and remove pus from it, as well as to administer a drug.

During this procedure, the patient is sitting position. For local anesthesia, a certain drug is injected into the lower nasal canal. Then, a puncture needle pierces the central wall of the sinus in the region of the lower nasal canal. After that, a 0.9% solution of sodium chloride is poured inside, previously brought to room temperature. This remedy washes the sinus and disinfects it. The final stage of the procedure is the administration of antibiotics, steroids, or drugs that stimulate the removal of mucus from the sinus, at the discretion of the doctor.

Features of inflammation of the sinuses in children

AT childhood inflammation of the sinuses - quite frequent illness, while in 9 cases out of 10 it is bacterial in nature. Some of the difficulties of diagnosis at this age are in a wide range possible manifestations pathology. It is most difficult to diagnose newborns and young children. Older children with inflammation of the sinuses complain of nasal discharge of a purulent-mucous nature, nasal congestion, shortness of breath, pain and a feeling of fullness in the eye area. In the acute course of the disease, an increase in temperature is also usually noted, sometimes above 38 0. In babies, the inflammation of the sinuses of the nose acquires a long course and is manifested by breathing through the mouth, coughing, bad breath, clogged nasal passages.

In the youngest children, the disease is accompanied common symptoms such as lack of appetite, moodiness, weight loss, tearfulness, bad dream and others. Often there is also swelling of the eyelids or movement towards the eyeball. The latter is due to the fact that the ethmoid sinus is located in close proximity to the eye sockets, and in newborns, the wall between them is still not sufficiently formed. To confirm the diagnosis in children, they may be prescribed computed tomography, it is carried out on the basis of the collected history, examination and laryngological examination.

Treatment is determined by a specialist depending on the age of the child, the form and severity of the disease. Often it consists in carrying out a certain complex, it includes taking antibiotics for 2-3 weeks according to the scheme, drugs whose action is aimed at narrowing the sinus mucosa, antipyretics, antihistamines, moisturizers, painkillers and other drugs at the discretion of the attending physician.

If a conservative treatment does not improve, and bone destruction begins, then there is a need for surgical methods. The danger of acute inflammation of the sinuses in children is that, if left untreated, they often lead to complications, therefore, with such a diagnosis, the child is often hospitalized.

Chronic inflammation of the sinuses

The chronic form of the disease is characterized by a long course. That is, signs of inflammation of the sinuses of the nose can persist for up to 2-3 months, even with the necessary therapeutic measures. This form of the disease occurs in both adults and children. The maxillary sinuses are most often affected, the frontal sinuses are somewhat less common.

Signs of chronic inflammation are discharge from the nasal passages, having a purulent, mucous, watery or mixed character, difficulty breathing due to nasal congestion, coughing, pain and sore throat caused by mucus flowing down the back of the throat. Perhaps the appearance of headaches, localized mainly in the forehead, eyes and nose. Quite often at patients the sense of smell is broken or vanishes. Chronic inflammation of the sinuses can cause the growth of mucosal polyps and fill them with the entire nasal cavity. This form of the disease is more susceptible to people who have problems with the immune system or poor condition of the teeth and oral cavity. Acute inflammation of the sinuses can also go into the chronic stage, if treatment is not started in a timely manner or it is carried out incorrectly and not fully.

play an important role in the development and progression of the disease pathogenic microorganisms, as well as the anatomical features of the location of the mouth of the sinus. To diagnose the chronic form of inflammation of the sinuses, an examination of the patient and his questioning are used. specialized methods- computed tomography.

Often there is a need to puncture the affected sinus. Treatment of chronic inflammation of the sinuses often includes the removal of the pathologically altered sinus mucosa and the expansion of its mouth. Of the drugs, glucocorticosteroids, antibiotics, agents that reduce the volume of the mucous membrane and remove mucus from the nose and sinuses can be prescribed. If the cause of the inflammation is affected teeth (in such cases, the maxillary sinuses are usually affected), then the teeth should be removed.

Fungal inflammation of the sinuses

Inflammation of the sinuses caused by fungi is quite common. In this case, only one

or several sinuses. The most prone to the occurrence of this type of disease are people who undergo local steroid therapy, often take antibiotics, are treated with drugs that depress immune system, as well as in patients with oncology and who have undergone a course of radiotherapy or chemotherapy.

The disease caused by fungi can occur in HIV carriers and in people with diabetes. The cause of inflammation of the sinuses, most often, are fungi belonging to the genus Candida, mucor, rhizopus and aspergillus. Symptoms fungal infection paranasal sinuses are identical to the signs of a disease caused by bacteria.

The course of the disease can vary considerably, ranging from mild and gradual to rapid and severe. A preliminary diagnosis is made on the basis of radiological images. In the future, it is confirmed by the results of histology or mycological analysis, in which pathogens are detected.

Treat fungal inflammation of the sinuses surgical method, which involves the removal of polyps and fungal masses from the lumen of the sinus. Additionally, antifungal drugs are prescribed.

Sinus inflammation: treatment

Treatment of inflammation of the sinuses can be carried out by two methods: conservative and surgical. The first of these is to relieve tissue edema, combat the reproduction of microorganisms, facilitate the removal of mucus from the nasal passages and sinuses, and restore normal patency of the sinus mouth. For effective fight With bacterial infection antibiotics may be used. The lack of visible improvement after the use of these drugs may indicate wrong choice antibiotic, too low a dose of the drug, insufficient treatment time, neglect of other therapeutic measures, as well as a different nature of the disease, for example, viral. Additional methods the treatment required for inflammation of the sinuses is the use of drugs that narrow the nasal mucosa and mouths of the grooves. These drugs can be used topically or as general remedy. For this purpose, ephedrine or pseudoephedrine is often used in conjunction with antihistamines.

Surgical treatment for inflammation of the sinuses is aimed at restoring the patency of the nasal passages, removing mucus and establishing normal ventilation of the sinuses. The indication for intervention is the chronic form of the disease, foreign objects in the sinus or education soft buds. Classically, the operation is performed according to the Goldwell-Look method and consists in opening the maxillary sinus through the nose. modern medicine involves the use of a new operating room endoscope

ic technology. During the operation, all polyps are removed and nasal patency is restored, the mouths of the sinuses (ethmoid, frontal, maxillary and sphenoid) open and expand, and areas of pathologically altered mucosa inside the sinus are also removed.

To perform the procedure, you will need a special set of instruments and endoscopes. The decision on the need for surgical intervention can only be made by a specialist after all diagnostic measures and confirmation of the diagnosis special role here it is given to such a method as computed tomography.

Possible complications of inflammation of the sinuses

It must be understood that incompletely cured inflammation of the sinuses can cause the development of some serious complications. The reason for them often lies in the incorrect or inappropriate use of antibiotics, a decrease in the protective properties of the body and an increase in the resistance of microorganisms.

The most typical complications are damage to the eyes and eye sockets, the transition of the inflammatory process to Bone marrow skull and intracranial complications. Eye lesions that appeared as a complication of inflammation of the sinuses of the nose include swelling and inflammation of the eyelids, phlegmon of the eye socket, inflammatory processes that affect the soft tissues of the eye socket or optic nerve, periosteal abscess, and others. From intracranial complications inflammation of the sinuses of the nose, most often thrombosis of the upper longitudinal sinus or cavernous body, an abscess meninges internal or external, inflammation of the pia mater.

Starting the treatment of complications of inflammation of the sinuses of the nose, they usually carry out a procedure for cleaning the affected sinus and removing the altered mucosa, polyps and complications. Often, this is followed by a course intravenous administration chemotherapeutic agents that have wide range actions.

The earlier the decision to start treatment is made and the set of necessary therapeutic measures, the more likely it is to quickly and without consequences to cope with complications. To do this, it is necessary to diagnose the disease at an early stage, so it is worth knowing the signs and course of the most frequent and dangerous complications inflammation of the sinuses.

Phlegmon of the eye cavity occurs during the transition purulent inflammation from the sinus to the eye cavity or as an unfavorable consequence of inflammation of the soft tissues. This disease is manifested by swelling and blueing of the connective membranes of the eyelids and eyes, an increase in temperature to high numbers and serious condition sick. In some cases, there is a backache, which results in drooping of the eyelids, and the eyeball loses mobility. Of particular danger is the development of

aleniya and its promotion inside the eyeball and on optic nerve, it can lead to blindness. Since the trochlear, trigeminal, oculomotor and abducens nerves pass in close proximity to each other, symptoms of their defeat may be noted with eye socket phlegmon.

Phlegmon is treated surgically. The affected sinus opens and purulent contents are removed from it. As additional funds antibiotics and drugs that prevent thrombosis are prescribed.

Another severe complication inflammation of the sinuses - thrombosis and inflammation of the cavernous body. The cause of such processes can be not only acute, but also chronic illness. Inflammation spreads in most cases from the frontal, ethmoid and sphenoid sinuses, as they are anatomically located close to the base of the skull. But the transition of the inflammatory process from the maxillary sinuses is also possible.

There are a number of factors that increase the likelihood of developing intracranial complications. These include a decrease in immunity, increased virulence of microorganisms, acquired or congenital defects in the bone tissue of the base of the skull. Thrombotic inflammation of the cavernous body occurs when inflammation passes to the veins of the eye sockets. The manifestations of such a disease are an increase in the sensitivity of the skin of the face to touch, exposure to light, cold, heat, recurrent dizziness, a rise in temperature to high values chills, sensitivity to bright light.

Inflammation spreads very quickly throughout the body with blood flow, resulting in sepsis. There are symptoms of damage to the block, trigeminal, visual, efferent and oculomotor nerves. There is a noticeable swelling of the connective membranes of the eyes, immobility of the eyeballs, sharp deterioration vision, sometimes to complete blindness. To characteristic manifestations can be attributed to the blue of the skin of the forehead, which take on the appearance of marble. The above external signs can be supplemented by symptoms of a lesion. nervous system such as limited neck movement.

This complication of inflammation of the sinuses requires the immediate initiation of treatment, including broad-spectrum drugs and antibiotics. It is important to take timely measures to treat cerebral edema. Often carried out surgical intervention, which consists in cleaning the sinuses and removing pathological tissues.

Even with the current level of medicine, effective drugs and methods of treatment, thrombotic inflammation of the cavernous body remains a deadly disease, from which almost every third patient dies.