Sinusitis is an inflammation that affects one or more paranasal sinuses. It can develop as an independent disease, and as a complication on the background of various infectious diseases. Acute sinusitis refers to one of the most common pathologies that the ENT doctor encounters in his work.
Sinusitis is divided into chronic and acute, such a division is caused by different duration of attacks on the body. Acute sinusitis - treatment takes up to 2 months, and then retreats, but chronic - can be cured for a long time, but with the slightest cold, it can return again. The chronic form is a problem of people with weakened immunity, immunodeficiency, and therefore the question of how to cure sinusitis is very, very serious.
In this article we look at the manifestations of sinusitis in adults, especially the first symptoms and effective methods of treatment at home.
What it is?
Why does sinusitis occur, and what is it? Sinusitis is an inflammation of the mucous membrane, which is localized in one or several paranasal sinuses simultaneously. One of the main reasons that causes the development of sinusitis is poorly cured or neglected rhinitis. In addition, acute respiratory viral infections (ARVI) can be the trigger for the development of sinusitis. A disease that develops against the background of respiratory infections of the upper respiratory tract is usually called community-acquired forms.
Depending on its location, sinusitis can be of several types:
- antritis is an inflammation of the maxillary sinus, which is a complication of the flu, acute cold, scarlet fever, measles and many other infectious diseases.
- frontal sinusitis is an inflammation of the paranasal frontal sinus, which is much more severe than other types of sinusitis.
- ethmoiditis - manifested as inflammation of the cells of the ethmoidal labyrinth and is the most common type of sinusitis.
- sphenoiditis - inflammation of the sphenoid sinus, which is quite rare.
The first sign of acute sinusitis is a prolonged rhinitis. It should pay attention to the discharge from the nose. If they become yellowish-greenish, this indicates the bacterial nature of the inflammation. In such a situation, bacteria can at any time get into the maxillary sinuses and sinusitis begins.
Also, sinusitis is unilateral or bilateral, with the defeat of all the paranasal sinuses on one or both sides. Acute sinusitis often occurs during acute rhinitis, flu, measles, scarlet fever and other infectious diseases, as well as due to a disease of the roots of the four back upper teeth.
Symptoms of sinusitis
Symptoms of sinusitis in adults depend on what kind of sinus is inflamed. In general, the clinical picture of all sinusitis consists of several permanent and variable symptoms:
- difficulty in nasal breathing, nasal voices;
- copious nasal discharge (mucous or purulent);
- discomfort in the nose, paranasal region, or above the eye;
- fever of a low-grade or febrile character;
- reduced sense of smell;
Depending on the type of sinusitis, the symptoms in adults will differ:
- Sinusitis The disease begins acutely. The patient's body temperature rises to 38-39C, signs of general intoxication are expressed, chills are possible. In some cases, the patient's body temperature may be normal or subfebrile. A patient with sinusitis is worried about pain in the area of the affected maxillary sinus, zygomatic bone, forehead and root of the nose. The pain increases with palpation. Irradiation to the temple or the corresponding half of the face is possible. Some patients have diffuse headaches of varying intensity. Nasal breathing on the affected side is impaired. With bilateral antritis, nasal congestion forces the patient to breathe through the mouth. Sometimes due to blockage of the lacrimal canal, tearing develops. Nasal discharge is serous at first, fluid, then becomes viscous, turbid, greenish.
- Frontline In acute frontal sinusitis, the patient is worried about sharp pains in the forehead, aggravated by pressing or tapping on the brow, headache of a different location, difficulty in nasal breathing, heavy discharge from the corresponding half of the nose (initially serous, then serous-purulent), pain in the eye, tearing, photophobia. Body temperature rises to fibril level (up to 39 ° C), but it can be subfebrile. The clinical picture of chronic frontitis is less pronounced than acute. Headache is usually aching or pressing, often localized in the area of the affected frontal sinus. Nasal discharge is especially abundant in the morning, purulent, often with an unpleasant odor.
- Etmoiditis. As a rule, the inflammatory process in the anterior sections of the ethmoid labyrinth develops simultaneously with frontal sinusitis or sinusitis. Inflammation of the posterior parts of the ethmoid labyrinth is often accompanied by sphenoiditis. A patient with ethmoiditis complains of headaches, pressing pain in the nose and root of the nose. In children, pain is often accompanied by conjunctival hyperemia, edema of the internal divisions of the lower and upper eyelids. Some patients experience neurological pain. Body temperature usually rises. Discharge in the first days of the disease serous, then becomes purulent. Smell sharply reduced, nasal breathing is difficult. With the rapid course of sinusitis, inflammation can spread to the orbit, causing protrusion of the eyeball and marked swelling of the eyelids.
- Sphenoiditis. The main symptoms of chronic sphenoiditis - pain in the parietal (and sometimes in the occipital) region, the feeling of an unpleasant smell. An important clinical sign of chronic sphenoiditis is swelling of the discharge along the anterior wall of the sphenoid sinus along the arch of the nasopharynx and posterior pharyngeal wall. The process may spread into the cranial cavity, the other paranasal sinuses, into the orbit. Sphenoiditis can be a complication of the organs of vision (retrobulbar neuritis).
With acute sinusitis in adults, the temperature rises, the head starts to ache, it becomes difficult to breathe, as the nose is filled with mucus (from time to time the congestion changes from one nostril to another), nasal discharge with purulent, sometimes with blood. In the place where the inflamed sinus is located, pain is felt, and swelling of the soft tissues of the face may also occur. At night, there are bouts of dry cough. The sense of smell with sinusitis is reduced or absent altogether.
Symptoms of sinusitis in the chronic stage can include all the signs of the disease or only some of them. Signs of illness do not go away even after two weeks. What is sinusitis with chronic inflammation is best known to patients with asthma, seasonal or food allergies. Treatment in this case should be accompanied by the exception of allergens and products that cause the manifestation of rhinitis.
The diagnosis of sinusitis is made on the basis of patient complaints, clinical symptoms, laboratory and instrumental studies. In order to confirm the final diagnosis, a complete blood count (showing the presence of an inflammatory process in the body), radiography or computed tomography are used.
How to treat sinusitis?
When symptoms of sinusitis occur, the treatment in adults consists in the use of special preparations, they effectively suppress the causative agent of the disease and eliminate unpleasant symptoms.
- To reduce the temperature prescribed antipyretic drugs: paracetamol, nurofen.
- In the presence of allergies, antihistamine medications are prescribed: tavegil, claritin.
- To eliminate edema of the mucous membranes of the nose, prescribe vasoconstrictor drugs or aerosols.
- If you suspect sinusitis, antibiotics are prescribed.
- When rhinitis in children nasal sprays are prescribed: triamcinolone, mometasone furoate, fluticasone, beclomethasone.
The main objectives of the treatment of sinusitis:
- Eradication (complete destruction) of the pathogen if the inflammation is caused by an infectious agent;
- Elimination of other provoking factors, such as deformation of the structures of the nose;
- Relief of symptoms of sinusitis;
- Restoration of normal drainage of the sinuses;
- Prevention of complications;
- Preventing acute sinusitis from becoming chronic.
In case of chronic sinusitis, physiotherapy (magnetic therapy, heating) and sanatorium treatment are additionally used. Surgical treatment is a puncture (puncture) of the sinus, in the presence of pus in it. Also in case of chronic antritis, plastic surgery of the maxillary sinus is performed to improve the outflow (drainage) of its contents.
Antibiotics for sinusitis in adults
At home, effective treatment with antibiotics for acute and chronic sinusitis in adults. The decision on the appointment of antibacterial drugs takes only a doctor. The course of treatment is usually 10-14 days.
Antibiotics for sinusitis is indicated in cases where the bacterial nature of the disease has been proven. The doctor may suspect purulent sinusitis, if the discharge from the nasal passages is purulent, headache and pain in the projection of the sinuses does not decrease after a week against the background of the therapy. Antibiotic therapy can be started earlier in the severe course of the disease, regardless of its duration.
In the mild form of sinusitis, priority is given to macrolide and cephalosporins antibiotics. In severe cases of the disease, penicillins of the second and third generation or cephalosporins are prescribed. In the case of chronic sinusitis, the use of protected penicillins is preferable.
For the treatment of acute and chronic sinusitis in recent years, a three-day course of azithromycin is often recommended, which is especially effective for mycoplasmal sinusitis. This type of sinus disease is often seen in children, and is not amenable to treatment with other antibiotics.
In acute sinusitis, in some cases, local effective antibiotics (bioparox) are used.
Physiotherapy procedures include:
- Sinus washing with cuckoo method;
- Puncture and further drainage of cavities with antiseptic agents;
- Phonophoresis with ointments with antiseptic effects;
- Inhalation with antibiotic solutions, herbal decoctions;
- UHF sinuses;
- Laser treatment with endonasal method;
- The use of quantum rays.
In the late stages of sinusitis, classical nasal rinsing at home or inpatient conditions (the so-called "cuckoo") does not help to remove stagnant pus from the cavities of the sinuses: in this case, it prescribes a very unpleasant, painful, but effective procedure called puncture and puncture.
Here, the doctor punches through the nose the soft cartilage tissue with a special surgical spatula? Then he introduces a catheter, connects a syringe with a disinfectant solution to the system, and injects fluid under pressure, thus, through the nose, washing out all the pus accumulated in the cavity. If necessary, leave the catheter in the cavity and repeat the washout procedure several times.
The first thing you should pay attention to the prevention of sinusitis - the timely treatment of colds, the common cold and the flu. Often, these diseases become triggers for sinusitis. Treat a runny nose or cough need at home. After consulting with your doctor about the choice of effective means.
In addition, follow these guidelines:
- It is mandatory to undergo a preventive dental checkup: infections with pulpitis, stomatitis, etc., can very quickly overcome the bone barrier and cause inflammation of the paranasal sinuses;
- Do not self-medicate: for a cold, fever and general malaise, which does not pass within 2-3 days, consult a doctor;
- Systematic tempering procedures significantly increase immunity, which will reduce the incidence of viral diseases and, accordingly, eliminate the risk of sinusitis.
If you suspect this disease should not tempt fate and self-medicate at home. Should immediately seek qualified assistance. Effective and rapid recovery is possible with proper treatment.