Acute and chronic sinusitis (sinusitis, sinusitis, ethmoiditis)

The ENT organs, being an outpost of the immune system on the path of infection into the body, are the first to encounter the effects of various pathogens. That is why inflammatory processes often begin in them. Inflammation of the paranasal sinuses is called sinusitis . In total, a person has 4 pairs of paranasal sinuses, these are cavities filled with air. As a result of inflammatory processes, pus is formed in the sinuses, and the person begins to feel weak and unwell.

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Nasal endoscopy in MedicCity

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Symptoms of sinusitis

There are acute and chronic forms of sinusitis, which differ in their symptoms.

Acute sinusitis. Symptoms:

• Runny nose lasting more than 7-10 days, without signs of improvement;
• nasal congestion, mucous or purulent discharge from the nose;
• mucus running down the back of the throat, copious discharge of purulent sputum in the morning;
• headache, heaviness and pain in the inflamed sinus area. Sometimes pain in the teeth, eyes, cheekbones, cheeks;
• increased sensitivity of the facial skin in the projection of the affected sinus;
• increase in body temperature (up to 38°C and above). As a rule, this symptom is observed in an acute case. In a chronic process, body temperature rarely rises or remains at subfebrile levels (37-37.50°C);
• weakness, fatigue, irritability. Photophobia, lacrimation, loss of appetite, sleep disturbance;
• weakened or absent sense of smell;
• swelling of the cheeks and eyelids.

Chronic sinusitis. Symptoms:

Symptoms of chronic sinusitis depend on the form of the disease. Outside of an exacerbation, symptoms may be very mild or absent. The most common symptoms of concern are:

• nasal congestion, difficulty in nasal breathing;
• scant mucous or purulent discharge from the nose, may be in the form of drying crusts;
• constant leakage from the nose, causing cracks and abrasions at the entrance to the nose;
• mucus running down the back of the throat;
• dry throat;
• headache;
• bad breath.

As the disease worsens, symptoms characteristic of acute sinusitis may appear.

What to do if you have pain?

What to do if you have severe pain in the head during a runny nose? There is no time to wait for diagnostic results, because suffering a severe migraine is harmful. You need to start improving your health on your own:

• Blow your nose thoroughly. The nasal passages must be clear.
• Drink from the group of antispasmodics: Analgin, No-shpa, Citramon.
• Lie down in bed, open the window. Be in a state of peace. Turn off the TV, put gadgets aside.
• If you have a humidifier, don't forget to turn it on.
• The room must be ventilated.
• You can use “Star” balm or its analogues.

Sinusitis in children

Sometimes sinusitis in children is more difficult to see than sinusitis in adults. The disease usually develops after an infection: influenza or sore throat, and is often accompanied by otitis media. The symptoms are somewhat blurred and appear weaker than in adults. Here are the main ones:

• purulent or mucous discharge from the nose;
• general weakness, malaise;
• pungent odor from the mouth.

With sinusitis in children, one side of the face is often inflamed. While sinusitis in adults is often accompanied by headaches, headaches in children are extremely rare.

How do the paranasal sinuses work?

The nose is one of the most important human organs. This system is complex and quite fragile, which leads to frequent illnesses. But without the maxillary sinuses, normal nose function would be impossible. They perform the following functions:

• provide full breathing;
• warm and humidify the inhaled air;
• clean the inhaled air from dust and allergens;
• allow you to recognize many aromas and smells;
• form an individual timbre and other voice parameters.

The sinuses have other tasks as well. For example, they quickly respond to changes in environmental pressure (act as baroreceptor organs) and reliably protect the eyeballs, tooth roots and skull bones from injury.

Types of sinusitis

There are several types of sinusitis:

• sinusitis;
• frontal sinusitis;
• ethmoiditis;
• sphenoiditis, but the latter type of sinusitis is extremely rare and almost always together with ethmoiditis.

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Sinusitis

Sinusitis is one of the most common types of sinusitis. This disease is accompanied by inflammation in the maxillary and maxillary cavities. During inflammation, swelling of the mucous membrane occurs, which blocks the opening from the sinus to the nasal cavity. Mucus begins to accumulate in the sinus space, pathogenic bacteria multiply, and pus appears. Inside the cavity, pressure occurs on the vessels, and the person begins to feel pressing pain at the site of accumulation of pus.

Chronic sinusitis is the result of a long inflammatory process, when a person has had sinusitis for more than 2 months. The patient develops general weakness, nasal discharge has an unpleasant odor, the sense of smell is impaired, and a night cough appears. Chronic sinusitis is characterized by inflammation of only one sinus, right or left. Pressure in the sinus can cause a deviated nasal septum.

Symptoms of sinusitis

The following symptoms are characteristic of sinusitis:

• increased body temperature;
• copious discharge, nasal congestion;
• disturbances of smell;
• weakness;
• headache radiating to the forehead, bridge of the nose, teeth;
• pain that intensifies when tilting the head and pressing on the sinus;
• constant, intense pain;
• a feeling of fullness in the forehead and cheeks, aggravated by tilting the head, coughing and sneezing;
• photophobia and lacrimation.

Signs of sinusitis

If after a flu or cold the temperature rises again, your health worsens, severe pain appears when tilting your head and when pressing on the sinuses, then you need to urgently consult an otolaryngologist. These could be manifestations of sinusitis! Sinusitis in adults is often advanced, since adults are usually in no hurry to see a doctor.

Treatment of sinusitis

Antibiotics for sinusitis are used only after a complete examination of the patient, based on the characteristics of his body and possible allergic reactions.

Antibiotics are not advisable in case of sinusitis of allergic or fungal origin. For mild sinusitis, inhalations, rinses and immunotherapy are also sufficient.

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Causes of the disease

The causative agents of the purulent form of the disease are bacteria (streptococcal, staphylococcal infections, Haemophilus influenzae, etc.). In order for an inflammatory process to start in the maxillary sinus, the body must have favorable conditions for the reproduction and activation of bacterial flora. Such provoking factors contributing to the development of inflammation are:

• complicated colds and acute respiratory viral infections;
• mechanical injuries of the nose (fractures, bruises);
• chronic diseases of the nasopharynx (rhinitis, tonsillitis, adenoids);
• allergic rhinitis;
• carious teeth of the upper jaw;
• deviated nasal septum;
• the presence of cysts, polyps and other formations in the nose;
• hypothermia;
• poor working conditions (working in “harmful” industries, when a person is constantly in contact with dust and toxic substances);
• poor hygiene of the nasal cavity at the onset of an infectious disease.

If the cause of purulent sinusitis is correctly identified and eliminated, treatment of inflammation will be more effective.

Frontit

Frontal sinusitis (frontal sinusitis) is an inflammatory disease of the frontal paranasal sinus. This type of sinusitis is the most severe. There are forms of acute and chronic frontal sinusitis.

Symptoms of sinusitis

Acute frontal sinusitis, symptoms:

• pain and swelling around the nose and eyes;
• increased pain when tapping in the projection area of ​​the inflamed sinuses;
• heavy breathing due to inflammation of the nasal passages;
• runny nose with thick yellow or green mucus;
• increase in body temperature to 38-39 degrees;
• severe headache (minor relief occurs when lying down);
• pain radiating to the ears and teeth;
• fear of light;
• severe weakness;
• sometimes sore throat, difficulty identifying odors, decreased pungency of taste.

Chronic frontal sinusitis, symptoms:

• aching headache;
• purulent, unpleasant-smelling nasal discharge in the morning;
• slight increase in temperature;
• difficulty breathing through the nose;
• sputum discharge in the morning.

Causes of frontal sinusitis

The following reasons for the development of frontal sinusitis are distinguished:

• viral, bacterial or fungal infection;
• complication after influenza, ARVI, etc.;
• getting foreign objects into the nose;
• long-term infectious or allergic rhinitis (rhinitis);
• deviated nasal septum;
• adenoids;
• allergy;
• nasal polyps.

Treatment of frontal sinusitis

How to treat frontal sinusitis? Definitely under the supervision of an otolaryngologist! The disease is not only difficult for many patients to tolerate, but also has dangerous complications, including orbital abscess, meningitis, sepsis, etc.

Treatment of sinusitis is aimed at eliminating infection in the sinuses and stopping inflammation. Medicines will help relieve swelling, improve ventilation of the sinuses and lead to the discharge of contents from them. If the disease is viral in nature, then antibiotics for frontal sinusitis are mandatory!

The following antibiotics are used to treat sinusitis:

• penicillin antibiotics (semi-synthetic or synthetic amoxicillin preparations);
• cephalosporin antibiotics;
• macrolide antibiotics (they do not affect the intestinal microflora);
• local antibiotics in the form of nasal drops, nasal spray, aerosol;
• homeopathic medicines;
• symptomatic remedies for frontal sinusitis in the form of vasoconstrictor nasal drops, antipyretics and anti-inflammatory drugs.

In case of severe frontal sinusitis and insufficient effectiveness of conservative treatment, sinus lavage using the method of displacement and puncture is prescribed.

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Prevention of frontal sinusitis

To prevent frontal sinusitis, you need to monitor the state of your immune system, promptly eliminate foci of inflammation in the ENT organs, harden your body, and lead a healthy lifestyle.

Prevention

The simplest thing you can do is to avoid hypothermia and drafty air. In cold and dank weather, you need to wear a hat, protect your neck from the wind, and wear warm shoes.

Prolonged stay in stuffy rooms with poor ventilation leads to the development of viral diseases. It is important to regularly ventilate your home, workplace, and take walks in the fresh air.

In an overtired state, a person is more susceptible to infection with viral, infectious and respiratory diseases that lead to a runny nose.
For prevention, it is enough to establish a sleep schedule. It is advisable for people with weak immunity and a tendency to catch colds to be vaccinated with an antiviral drug 2-3 weeks before the start of the flu and acute respiratory infections season. In the midst of morbidity, reduce visits to public places, take immunostimulating drugs, vitamins and dietary supplements.

Ethmoiditis

Ethmoiditis is an acute or chronic inflammation of the mucous membrane of the cells of the ethmoid labyrinth (anatomical labyrinth in the bridge of the nose). Ethmoiditis is bacterial or viral in nature.

There are acute and chronic ethmoiditis. Acute ethmoiditis accompanies influenza, rhinitis and is complemented by inflammation of the paranasal sinuses.

Ethmoiditis in adults affects both the frontal and maxillary cavities. With weak immunity, the acute form of ethmoiditis turns into long-term chronic ethmoiditis with periods of exacerbation and remission.

Polypous ethmoiditis is characterized by the appearance of polyps in the mucous membrane of the ethmoid labyrinth of the forehead. Polypous ethmoiditis may appear after chronic, allergic rhinitis.

Catarrhal ethmoiditis occurs due to the activity of viruses. It is characterized by increased lacrimation, weakness, nausea, dizziness, swelling in the bridge of the nose, and fever.

Ethmoiditis in children is a very serious disease. The infection spreads very quickly due to the anatomical structure of the ethmoid labyrinth. The development of ethmoiditis in children requires urgent hospitalization.

Symptoms of ethmoiditis

Acute catarrhal ethmoiditis. Symptoms

• pain in the bridge of the nose and at the wings of the nose;
• heavy breathing through the nose;
• loss of smell;
• headache, weakness;
• profuse nasal discharge, which gradually becomes purulent;
• temperature rises to 38 degrees;
• In children, the inner corner of the eye socket also swells and turns red.

In the acute form, primary and secondary ethmoiditis are distinguished.

With primary ethmoiditis, anxiety, vomiting, dyspepsia and toxicosis appear, the temperature is 39-40 degrees.

Secondary ethmoiditis is more severe and develops faster. The patient is in extremely serious condition with pronounced septic symptoms. The eyelids become swollen and cyanotic, swelling of the conjunctiva and noticeable protrusion of the eyeball are observed, and nasal breathing becomes difficult.

Chronic ethmoiditis. Symptoms

• headaches that are difficult to register by localization;
• weakness, rapid fatigue of the patient;
• soreness in the bridge of the nose when pressed and painful points at the wings of the nose;
• purulent discharge with a nauseating odor;
• extensive mucus in the nasopharynx, which is difficult to spit out;
• emerging polyps.

Complications after ethmoiditis:

• meningitis;
• encephalitis,
• intraocular and intracranial pressure;
• destruction of the ethmoid bone.

Treatment of ethmoiditis

Treatment of ethmoiditis in acute form is predominantly conservative. It is necessary to ensure the outflow of mucus with the help of vasoconstrictors and physiotherapeutic procedures.

Treatment of ethmoiditis in chronic form is predominantly surgical.

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These are two completely different pathologies that require their own treatment regimens. Therefore, when characteristic symptoms appear, you need to think about whether you may be allergic to anything. Often such pathologies are familial, that is, among relatives there are people with similar diseases.

If the condition is accompanied by fever or characteristic swelling of the face in the sinus area, sinusitis can be suspected. In this case, urgent medical intervention is required. Delaying a trip to the doctor risks spreading the infection to the brain, which causes serious complications.

Diagnosis of sinusitis using modern techniques

To confirm the diagnosis of sinusitis, the following types of examination are used:

• Video endoscopy of the nasal cavity and nasopharynx to identify features of the anatomical structure and determine predisposing factors for the development of sinusitis;
• radiography of the paranasal sinuses;
• Ultrasound examination of the paranasal sinuses is a safe method with no contraindications, used to diagnose sinusitis and monitor the treatment process;
• CT, MRI - according to indications;
• laboratory diagnostics according to indications in full.

Treatment of sinusitis at MedicCity

Conservative methods of treating sinusitis

If you are concerned about how to treat sinusitis in Moscow, be sure to contact the MedicCity specialists! Our clinic provides treatment for sinusitis without puncture and without pain. However, non-surgical treatment of sinusitis is possible only at the initial stage. Don't waste time!

In the vast majority of cases, treatment of sinusitis in our clinic is carried out without a puncture.

• Using YAMIK (sinus catheter). The YAMIK method is the use of a device called the “YAMIK sinus catheter.” Using the YAMIK sinus catheter, controlled pressure is created in the nasal cavity and the purulent contents of the sinus are pumped out through the natural anastomosis (openings), and then a medicinal substance (antibiotics, mucolytics) is administered.
• Rinsing the nose and paranasal sinuses using the moving method (“cuckoo”). It is carried out using a special suction - an aspirator; in the process, pathological contents are removed from the nasal cavity and sinuses and the drug is injected into the sinuses.
• Inhalation therapy using a special inhaler PARI SINUS. This method is based on the introduction of microparticles of the drug into the affected paranasal sinuses through a pulsating supply of an aerosol. In this case, the aerosol of the medicinal substance is deposited in the sinuses and has an effect directly at the site of inflammation.

All proposed methods for treating sinusitis are painless and effective.

When using combined treatment, complete recovery in case of acute sinusitis is achieved within 7-10 days.

If puncture treatment is necessary, it is possible to install special catheters in the sinus, which eliminate the need for repeated punctures.

Folk remedies

The basic treatment of various forms of sinusitis can be supplemented with some folk remedies, but before using them it is also recommended to consult with your doctor. Among the effective means are the following:

1. Aloe juice. The most effective treatment is considered to be leaves that have been left in the refrigerator for at least 3 days. Next, the plants are washed, the juice is squeezed out and instilled for a runny nose, 3 drops 3 times a day. The course of treatment is 4-14 days.

2. Ointment based on laundry soap. To prepare the medicine, you need to put 1 teaspoon of grated soap in a metal container and place it in a water bath. Next, add a little propolis and 1 teaspoon each of honey, onion juice and aloe. After obtaining a mixture of homogeneous consistency, it is cooled. The resulting ointment is applied to cotton pads and inserted into the nostrils for 15 minutes, once a day.
3. Beetroot drops. To treat a runny nose, instilling fresh beet juice in the amount of 3 drops 3 times a day is effective. The juice is first diluted with boiled water 1 to 3. The course of treatment is 7 days. For burning in the nostrils, you can use boiled vegetables.