Diagnosis of sinusitis

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Sinusitis

Sinusitis is called inflammation in the area of ​​the maxillary sinus; it can occur acutely or have a chronic course.

Sinusitis occurs in older children and adults, manifesting itself as pain in the maxillary sinuses, accumulation of pus inside them and symptoms of intoxication.

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Typically, sinusitis does not occur in isolation, but in a complex of inflammation of several nasal sinuses, but the symptoms of damage to the maxillary sinuses predominate. In mild cases, the inflammation process involves the mucous membrane; in case of complications, inflammation can spread to the area of ​​the periosteum and bones.

Odontogenic sinusitis

A special case is the so-called odontogenic sinusitis with the penetration of infection from the carious cavity of the teeth (usually in the upper jaw). Usually provoked by opportunistic oral flora.

With odontogenic sinusitis, the infection usually penetrates

  • with the development of periodontitis and osteomyelitis of the upper jaw
  • with deep dental damage,
  • when cysts suppurate in the area of ​​​​the roots of the teeth,
  • in case of unsuccessful tooth extraction.

Odontogenic sinusitis occurs as an acute and chronic process, with stages of remission and exacerbation.

Purulent sinusitis

Purulent sinusitis is an inflammation of the sinus with the accumulation of yellow-green purulent contents inside it with an unpleasant odor. In this case, the outflow of pus can be difficult due to tissue swelling, which leads to a sharp deterioration of the condition - severe fever and toxicosis with painful headaches occurs. When the position of the head changes, the pain increases sharply.

The greatest danger of purulent sinusitis is the breakthrough of pus into the cavity of the orbit of the eye or into the area of ​​the brain skull with the formation of intracerebral abscesses, periostitis (inflammation of the periosteum and bones of the skull), diseases of the orbit of the eye, and sepsis.

Symptoms of sinusitis

In acute sinusitis, the following symptoms appear:

  • feeling of heaviness in the sinus area,
  • bursting and pressing pain, sometimes simulating toothache,
  • increased pain when tilting the head forward or when pressing on the upper jaw area,
  • purulent nasal discharge, difficult to discharge,
  • unpleasant smell of discharge,
  • fever, general malaise with symptoms of toxicosis.

When acute sinusitis is neglected or improperly treated, a chronic form of the disease develops. This is facilitated by the presence of a persistent infection in the nasopharynx or a deviated nasal septum. In this case, only the mucous layer may be affected, or polyps and purulent discharge may form.

The main manifestations of chronic sinusitis are:

  • fatigue, constant weakness,
  • frequent headaches of a pressing nature,
  • constant runny nose,
  • impaired sense of smell,
  • absence or extreme difficulty of free nasal breathing, weak effect of vasoconstrictor drugs,
  • mucous or purulent nasal discharge.
  • unpleasant smell from the nose.

Diagnosis and treatment of sinusitis

Sinusitis is diagnosed and treated by ENT doctors; the diagnosis is made on the basis of complaints and examination, as well as x-rays of the paranasal sinuses. Sometimes, in case of purulent sinusitis, nasal discharge is cultured for flora and sensitivity to antibiotics is determined.

Treatment at home

The basis of conservative treatment is broad-spectrum antibiotics or those to which the microflora is sensitive.

  • Usually penicillins (amoxiclav, amoxicillin), cephalosporins (cephalexin) or macropen, zitrolide are used. It is necessary to take one or two courses of antibiotics, depending on the severity and condition of the sinuses.
  • In addition to this, vasoconstrictor drugs are prescribed to help relieve swelling in the mucous membranes, as well as drugs that dilute the contents of the sinuses (ASC) and drugs that help the outflow of pus.
  • Antiallergic drugs (suprastin, tavegil) are used - they reduce swelling.
  • Thermal procedures are applied to the sinus area - a solux lamp, UHF or laser therapy.
  • To rinse the sinuses when treating sinusitis, the “cuckoo” method is used: an antiseptic solution is poured into one nostril, and it is pumped out of the second with a soft catheter. To prevent the patient from choking on liquid during the procedure, it is necessary to constantly pronounce “ku-ku-ku-ku”. With this sound, the cavity of the pharynx and throat closes.

Sinus piercing

If these measures are ineffective and the outflow of pus is impaired in complicated sinusitis, a puncture of the sinuses is indicated, rinsing them with antiseptic solutions and removing the pus. After washing the sinuses, solutions of antibiotics and proteolytic enzymes are injected into them, removing inflammatory tissue and cleansing the sinuses (trypsin or chymotrypsin). This procedure significantly alleviates the condition, as it relieves pressure on the walls of the sinuses and pain, and eliminates the source of infection.

Sinusitis during pregnancy

The development of sinusitis during pregnancy is especially dangerous; due to the accumulation of pus, there is a danger for the woman and the fetus, and it is necessary to quickly eliminate the source of infection.

Antibiotic use during pregnancy is limited, and sometimes the only treatment is to puncture the sinuses and pour topical antibacterial solutions inside. In parallel with this short course, vasoconstrictors are prescribed. “Cuckoo” and local irrigation of the nasal cavity with antimicrobial agents are also applicable.

Prevention of sinusitis

In the summer, in the presence of chronic sinusitis, it is necessary to work on hardening and strengthening the immune system, restoring nasal breathing. This is important because sinusitis tends to worsen against the background of colds, which affect people with reduced immunity. It is necessary to heal all carious teeth, rinse the nasal cavity and throat with herbal decoctions (chamomile, sage).

If all these measures are ineffective, an operation to plasticize the nasal septum, open the maxillary sinus, remove destroyed tissues and polyps, and rinse the cavities is indicated.

Causes

For the development of sinusitis, penetration of microbes into the area of ​​the maxillary sinus is necessary. This usually occurs as a result of a complication of a viral infection.

For the development of chronic sinusitis, an important factor is the lack of adequate treatment in the acute process or a decrease in immunity, with the transition of the infection to a sluggish, chronic phase.

Also, sinusitis can develop as a result of trauma to the nasal cavity with infection penetrating inside.

Predisposing factors to it are hypothermia of the legs and the whole body, decreased immunity, allergization of the body, foci of chronic infection in the pharynx and other parts of the body.

Complications of sinusitis

The main complications include destruction of the nasal sinus with the spread of infection deep into the skull - the formation of abscesses, periostitis, diseases of the orbit of the eye, and sepsis.

Diagnosis by symptoms

Find out your probable illnesses and which doctor you should go to.

Source: http://www.diagnos.ru/diseases/lorr/haimorytis

Diagnosis of sinusitis

To make a diagnosis of sinusitis, only characteristic clinical symptoms are not enough. They must be confirmed using functional diagnostic methods, which are sometimes supplemented by laboratory tests. All over the world there is a fairly standard scheme for diagnosing acute sinusitis. Let's consider its main stages.

>> The site presents an extensive selection of medications for the treatment of sinusitis and other nasal diseases. Enjoy it for your health! <

Functional diagnostics of the maxillary sinuses. X-ray

In Russia and the CIS countries, the main technique that allows you to quickly and accurately establish the diagnosis of sinusitis is radiography. Ideally, it is necessary to visualize not only the maxillary sinuses, but also the frontal paranasal sinuses, as well as the ethmoidal labyrinth - after all, the inflammatory process is often generalized. To do this, an x-ray is taken in three projections:

  • nasomental, visualizing the maxillary sinuses;
  • chin.

In this projection, the same maxillary sinuses are visible, however, unlike the nasomental projection, the shadows of the pyramids of the temporal bones are not superimposed in it. This allows a more correct assessment of the condition of the maxillary sinuses;

  • nasofrontal.

    • X-ray findings in patients with acute sinusitis include diffuse opacification, thickening of the mucous membrane of the paranasal cavities and other characteristic indicators (detailed information is presented in the article X-ray of the sinuses with sinusitis). These data, combined with clinical signs of acute sinusitis (sinusitis), play a vital role in confirming the diagnosis.

    CT scan

    Computed tomography (CT) is considered the method of choice when simultaneous sinusitis and rhinitis are suspected. Experts recommend using this study in cases where rhinosinusitis takes a chronic course or adequate treatment of the disease does not lead to the desired result.

    If doctors have reason to suspect more serious pathologies of the paranasal sinuses, for example, benign or malignant tumors, a full scan of the nasal sinuses is performed in frontal and coronal projections. In addition, CT is an ideal technique for assessing the condition of the ethmoid sinuses, as well as monitoring the condition of the nasal cavity and paranasal sinuses before planned surgical treatment.

    In acute sinusitis, not complicated by rhinitis and inflammatory processes in other sinuses, computed tomography has very mediocre specificity. Thus, in 87% of patients with simple respiratory tract infections and in 40% of patients who do not have respiratory symptoms at all, CT reveals an increased level of fluid in the maxillary sinuses. However, in some situations, for example, if other research methods can cause unwanted complications, as well as during preoperative preparation of patients, doctors choose computed tomography.

    Computed tomography can provide valuable information about the anatomical features of the structure or mechanical changes in the paranasal sinuses that make a significant contribution to the development of acute sinusitis. Layer-by-layer images in a coronal projection make it possible to assess the condition of all paranasal sinuses, as well as the ostiomeatal complex. Let us recall that the slightest changes in the structure of the ostiomeatal complex can become one of the most important risk factors for acute sinusitis.

    Experts recommend performing a CT scan after the acute inflammatory process can be extinguished with the help of antibiotics. This means that a CT scan of the paranasal sinuses is best done when the antibiotics have already been taken and the acute phase of sinusitis is over. This practice allows you to correctly diagnose chronic inflammation, which is not controlled by antibacterial drugs.

    Magnetic resonance imaging

    MRI is prescribed, as a rule, in the case of a fungal infection (if allergic fungal sinusitis is suspected). In addition, this study is used if there is a suspicion of a tumor in the area being examined. MRI is excellent for diagnosing soft tissue disease of the paranasal sinuses, but the value of this technique for establishing the classic diagnosis of “acute sinusitis” is very limited.

    We add that MRI cannot visualize bone pathologies. Magnetic resonance imaging is typically used to detect intracranial pressure and may be used as an adjunct to computed tomography in patients with suspected allergic fungal sinusitis.

    Ultrasonography

    Ultrasound has limited use in the diagnosis of acute sinusitis. Two-dimensional B-mode ultrasound (a standard technique used in most clinics and private offices) can be useful in detecting fluid in the sinus cavity, as well as in assessing mucosal thickening or soft tissue mass in the maxillary sinus.

    Biopsy

    A biopsy of the paranasal sinuses is indicated in cases where the doctor has reason to suspect the development of malignant neoplasms, fungal infection or granulomatous diseases against the background of sinusitis.

    Fiberoptic endoscopy

    This technique is used to clearly visualize all sinuses and anatomical structures of the nose. Endoscopy is useful to exclude structural lesions (congenital or acquired anatomical disorders), fungal and granulomatous diseases.

    Diagnosing sinusitis in the laboratory

    In addition to functional methods, laboratory tests are also used to diagnose sinusitis.

    Blood tests

    Some doctors, as an additional research method for sinusitis, prescribe a blood test to determine the erythrocyte sedimentation rate - ESR. This indicator is known to serve as a marker of nonspecific inflammation in the body. In addition, a test for C-reactive protein levels is sometimes prescribed. It, like ESR, serves as an indicator of an acute inflammatory process.

    It is worth considering that the determination of both erythrocyte sedimentation rate and C-reactive protein is not specific. After all, the inflammatory process can be caused not only by acute sinusitis, but also by many other diseases.

    Tests for immunodeficiency

    These studies are carried out for recurrent acute sinusitis. Let us recall that such development is indicated by regularly occurring episodes of the disease (from one to four or even more episodes per year). If an immune response is suspected, several tests are performed, including:

    • immunoglobulin tests;
    • serological tests for HIV infection.

    Cytological examination of nasal discharge

    This analysis allows you to determine the exact cellular composition of nasal mucus. Deciphering a cytological examination can provide a lot of useful information that will help establish the origin of sinusitis:

    • the predominance of basophils and eosinophils in the nasal discharge indicates the allergic origin of the inflammatory process, that is, most likely, the cause of sinusitis lies in allergic rhinitis;
    • detection of a large number of neutrophils in a smear is characteristic of an acute infection (acute sinusitis);
    • the combination of an increased number of eosinophils and neutrophils most likely indicates infectious inflammation against the background of a primary allergic reaction;
    • an increased content of lymphocytes is characteristic of chronic infectious lesions of the nasal mucosa - acute rhinitis;
    • the insignificant content of neutrophils and eosinophils speaks in favor of ordinary vasomotor rhinitis and completely refutes the diagnosis of acute sinusitis.

    Sweat test

    A study with a somewhat unusual and strange name is one of the most informative tests for diagnosing cystic fibrosis. The sweat test is based on the fact that with this hereditary pathology, the concentration of sodium chloride in the sweat fluid increases. As you know, cystic fibrosis is a risk factor for inflammatory diseases of the paranasal sinuses, so if sinusitis or other types of sinusitis persist, it makes sense to exclude this pathology.

    Nasal discharge: to sow or not to?

    I would like to pay special attention to such a common type of research as culture of nasal discharge. Domestic ENT doctors prescribe this test frequently and extensively. Numerous patients with suspected chronic infections of the nose or paranasal sinuses are storming the laboratories. Moreover, completely healthy pregnant women are joining the army of patients, and they are also trying to identify the infection just in case of emergency.

    Meanwhile, Western experts believe that culture of nasal discharge is a completely useless analysis that does not carry any information load. This is due to the fact that the nasal mucosa is contaminated with a wide variety of non-pathogenic and opportunistic bacteria.

    As an alternative to examining the nasal mucosa, analysis of the mucous membrane of the maxillary sinuses is used. But even in this case, experts are very reserved about the diagnostic value of the study. In the vast majority of cases, it is almost impossible to accurately sow a crop and determine the pathogen, again due to contamination with normal flora.

    However, in some cases, seeding is still prescribed, namely:

    • patients in the intensive care unit;
    • patients with a reduced immune response;
    • children who do not respond to correct treatment;
    • patients with complications of sinusitis.

    When assessing the results of the analysis, the doctor must exercise special caution, which is associated with significant colonization of the mucous membrane by numerous bacteria. A specific microorganism is considered pathogenic (that is, disease-causing) when more than 10 colony-forming units of microbes are isolated in culture.

    Let us add that the only sure way to take a scraping is to perform a direct antral puncture. Considering the additional difficulties in collecting a sample of material, this technique is resorted to in domestic medicine only in extreme cases.

    Share with others.

    Good articles to follow:

    Class! Why does a clinic in St. Petersburg (not in a distant village) only have X-rays and blood tests out of ALL of the above?

    Why does the doctor, not knowing what to say, send him to the hospital for a puncture, they do it there without even looking, and then everything repeats all over again. And no one knows what’s the matter, because... Does the doctor have to determine the recurring cause of frequent inflammation (or no inflammation at all) “by eye”?!

    However, thank you very much for the information. It is clear that doctors are powerless and not freeloaders. It is clear that there are paid clinics. But ALL of the above. I think, for example, I don’t have enough money. Alas!

    Source: http://gaimoriti.ru/o-gaimorite/diagnostika-gajmorita.html

    Sinusitis - signs, symptoms and treatment in adults, causes, exacerbation of the disease

    Sinusitis is a type of sinusitis that is characterized by inflammation of the maxillary sinus (maxillary sinus). The name of the disease comes from the name of the sinus, the defeat of which causes the disease (the maxillary sinus in medicine is called the maxillary sinus; these sinuses are located on both sides of the nose, just below the eyes). The inflammatory process affects one or both maxillary sinuses.

    Sinusitis can develop at any age, including in children. The incidence of sinusitis increases significantly during the cold season and can occur in various forms. When the disease develops, the inflammatory process covers both or one maxillary sinus. In this article you will learn about what the symptoms of sinusitis may be and how to treat it.

    Causes

    Experts believe that the main reason for the formation of pathology is the presence of bacterial or viral agents in the maxillary sinuses. During the autumn-winter period, the immune system is weakened and the body is susceptible to the penetration of bacteria that can provoke illness.

    The maxillary sinuses are located in the thickness of the bones of the upper jaw closer to the nasal passage and have a volume of about 30 cm³. They secrete a secretion that moisturizes the nasal passages, protecting them from dust, allergens and pollution.

    The causes of sinusitis can be different. For example:

    • congenital disorders of the anatomy of the nasal cavity (deviated septum, enlarged nasal turbinates);
    • allergic diseases;
    • prolonged stay in a room where the air is too dry and heated to a high temperature;
    • being in a draft;
    • previous influenza or acute respiratory viral infection;
    • weakening of the immune system;
    • mechanical damage to the nasal septum (any physical impact, trauma, etc.);
    • growth of polyps and adenoids;
    • dangerous diseases such as tuberculosis, fungal infection of the mucous membrane, radiation sickness, tumors, etc.

    The incidence of sinusitis is very high. Among diseases of the ENT organs they occupy first place. According to statistics, about 10 million people get sick in Russia every year.

    Types of sinusitis

    Sinusitis can be catarrhal or purulent. In catarrhal sinusitis, the discharge from the maxillary sinus is aseptic in nature, while in purulent sinusitis it contains microflora.

    In the photo you can see: unilateral and bilateral sinusitis

    Depending on what caused the onset of sinusitis, there are several types:

    • Varieties according to the degree of coverage distinguish between unilateral and bilateral sinusitis;
    • depending on the presence of inflammation in one maxillary sinus or both;
    • according to the nature of the disease: acute, subacute and chronic sinusitis;
    • Depending on the cause, sinusitis can be: viral, bacterial, fungal, traumatic.

    Most often, both sinuses become inflamed, so bilateral sinusitis is most common. However, there are cases when the left or right sinus becomes inflamed, depending on this they distinguish between left-sided and right-sided.

    Any type of sinusitis is dangerous to human health. Because it can become chronic or cause a more serious illness. If characteristic symptoms of sinusitis occur, it is necessary to begin treatment to avoid serious consequences.

    Symptoms of sinusitis in adults

    Often adults exhibit the following symptoms of sinusitis:

    • Weakness;
    • Constant nasal congestion;
    • Cough;
    • Chills;
    • Chronic courses of tonsillitis, rhinitis, pharyngitis;
    • Fever;
    • Pain syndromes that radiate to the forehead, teeth, nose. Pain sensations depend on which side the maxillary sinus is inflamed and filled with pus. The head may hurt on the right side or on the left.

    One of the symptoms of sinusitis is inflammation of the mucous membrane. The photo above shows how the air circulation in the sinuses is blocked due to the swollen mucous membrane.

    Signs of acute sinusitis

    Acute sinusitis indicates that the infection develops quickly (over several days) and spreads throughout the body in a short time. Characteristic clinical symptoms of mild acute sinusitis are:

    • difficulty breathing through the nose;
    • mucous discharge, in rare cases mucopurulent;
    • impaired sense of smell;
    • slight pain in the forehead or projection of the maxillary sinuses.

    Acute sinusitis of moderate and severe course is characterized by:

    • general intoxication;
    • fever of 38ᵒC and above;
    • intense headache;
    • severe pain in the projection of the sinuses;
    • swelling of the eyelids and soft tissues of the face.

    In moderate and severe cases of the disease, there is a risk of developing intracranial complications.

    Symptoms of the chronic form

    Chronic sinusitis in remission occurs with mild symptoms. Patients are usually concerned about:

    • slight weakness, fatigue;
    • intermittent headache without clear localization;
    • nasal congestion, as a result of which the sense of smell is impaired;
    • pain and sore throat when swallowing, caused by the irritating effect of mucus flowing from the inflamed sinus along the back wall of the throat;
    • Often, especially in the morning, patients' eyelids swell and conjunctivitis appears.
    • some swelling in the area of ​​​​the projection of the sinus onto the face.

    When chronic sinusitis enters the acute stage, the patient’s well-being worsens:

    • they note severe weakness,
    • slight increase in temperature (usually no more than 37.5–37.7 C);
    • The discharge changes its color most often a week after the exacerbation of the disease, it becomes yellow and sinusitis turns into a purulent form.
    • The headache becomes more intense, especially when tilting the head forward, and a feeling of heaviness appears in the head.

    Due to blockage of the mucous glands in chronic sinusitis, true cysts and small pseudocysts of the maxillary sinus often form.

    Allergic sinusitis

    It is characterized by a paroxysmal course with unexpected nasal congestion, itching, frequent sneezing and copious discharge. Quite often the disease occurs as a bilateral lesion. The following symptoms are characteristic of allergic sinusitis:

    • headache;
    • copious nasal discharge;
    • chills, as well as a general deterioration in health;
    • tension and pain in the sinus area;
    • purulent mucous discharge from the nose is noted;
    • Photophobia may occur;
    • itching in the nose.

    Viral

    The disease is asymptomatic in most cases (or rather, mixed with the symptoms of the underlying viral infection), although in some cases the following are noted:

    • Headache;
    • Putrid odor from the mouth;
    • Cough with mucous discharge;
    • Fever;
    • Toothache (upper jaw);
    • Decreased sense of taste or smell.

    Bacterial

    Bacterial sinusitis usually begins after a cold or runny nose. Feeling worse, weakness occurs, and temperature rises. Pus or light yellow mucus with an unpleasant odor is discharged from the nasal passage on the affected side. There is a feeling of nasal congestion and heaviness inside it. These symptoms are especially aggravated when tilting or turning the head.

    Fungal

    Usually occurs as a result of colonization of the mucous membrane by bacteria such as pneumococcus, streptococcus, staphylococcus against the background of weak body resistance. Depending on the type of inflammatory agent, the color of nasal discharge can vary from yellow to dark green. The main symptoms that accompany it:

    • the appearance of white-yellow, white cheesy, jelly-like or even brown and black nasal discharge;
    • sometimes - bloody streaks in the discharge;
    • cyanosis of the nasal mucosa;
    • swelling of the nose;
    • severe difficulty in nasal breathing;
    • nasal congestion becomes permanent;
    • recurrent headaches;
    • pain in the teeth, in the upper jaw;
    • loss of smell.

    The appearance of temperature during sinusitis

    A prerequisite for the development of sinusitis is the addition of bacterial flora (most often it is Haemophilus influenzae and pneumococcus), so with sinusitis there is almost always a temperature.

    A high temperature during sinusitis is an indicator of the characteristics of its form, and not just a sign of the disease itself.

    Temperature usually indicates the presence of an inflammatory process. To eliminate the source of infection, it is necessary to destroy the environment favorable for the proliferation of pathogenic organisms. Thus, a mandatory stage of restorative therapy is the removal of purulent mucus, which is carried out mainly by rinsing.

    Basically, the temperature will depend on the stage of the disease, its etiology and the body's resistance.

    1. With acute purulent sinusitis, in most people the temperature rises to degrees. That is, the rise figures depend on the severity of the disease and the body’s immune response.
    2. With an exacerbation of chronic sinusitis, the temperature, if it rises, is not very high. It can stay at 37-37.5 degrees.

    You should try to normalize the temperature when it has reached 38-38.5 degrees, which can already harm the body. If the fever is lower, the body should be given the opportunity to devote its strength to fighting the infection, which begins to die during such a temperature.

    In any case, remember that antipyretic drugs, like any other, for sinusitis should be prescribed exclusively by a doctor. Only well-chosen treatment will achieve eradication of the pathogen and complete recovery.

    Exacerbation

    The fact that this is sinusitis cannot be immediately understood, since the disease tends to be hidden behind various other diseases. Characteristic symptoms most often make themselves felt when the disease worsens. The main complaints of patients with exacerbation of inflammation are:

    • Pain in the sinus area, which intensifies when chewing, tilting the head sharply, or sneezing.
    • Discharge from the nose mixed with pus.
    • Severe nasal congestion, which can cause headaches and fatigue.
    • A slight swelling of the skin over the jaw, which is accompanied by pain when pressed.
    • Increase in body temperature to 38 degrees.
    • Change in voice timbre, nasality.

    Diagnostics

    Sinusitis is diagnosed and treated by ENT doctors; the diagnosis is made based on complaints and examination, as well as x-rays of the paranasal sinuses. Diagnosis of sinusitis begins with a general examination, including:

    1. studying the patient’s medical history (previous colds, results of recent laboratory tests, etc.);
    2. examination of the nasal cavity;
    3. physical examination, in which the doctor palpates the area around the nose, above and below the eyes to determine the presence of tenderness and its intensity.
    4. general blood test, which includes counting all types of blood cells (erythrocytes, leukocytes, platelets), determining their parameters (cell sizes, etc.), leukocyte formula, measuring hemoglobin levels, determining the ratio of cell mass to plasma
    5. X-ray of the paranasal sinuses. To clarify the diagnosis, as a rule, an X-ray examination is prescribed. With sinusitis, the image shows a darkening in the area of ​​the maxillary sinuses - the accumulation of mucus in the cavities does not allow x-rays to pass through.
    6. CT scan of the sinuses. The situation is more complicated in the chronic form of the disease: computed tomography of the paranasal sinuses is needed to identify a foreign body, polypous process, cysts and other changes. The examination of the sinuses is carried out within 5 minutes and is absolutely painless. This method involves the use of X-rays on the area being examined.

    How to find out whether you have sinusitis or not on your own? Try to tilt your head down and hold for 3-5 seconds; usually with sinusitis there is a strong feeling of heaviness, pressing on the bridge of the nose and the eye area. Raising your head, the discomfort usually subsides, disappearing completely after a while. Of course, this is an approximate diagnosis; only an ENT doctor can establish the correct diagnosis.

    Treatment methods for sinusitis

    In the treatment of sinusitis, the most effective is an integrated approach. Its goal is to suppress the infectious focus in the sinus and improve its drainage. Non-invasive, painless methods of treatment in combination with drug treatment lead to complete recovery and prevent the transition of inflammation to a purulent, acute, chronic stage.

    When the process worsens, comprehensive treatment should be carried out, the goals of which are to restore normal nasal breathing and destroy the causative agent of the disease. Mild acute sinusitis tends to resolve on its own. No special treatment regimens are used. Treatment is symptomatic. Apply:

    1. Anti-inflammatory medications – to combat common symptoms of inflammation.
    2. Vasoconstrictor drugs - to improve the natural communication of the sinuses with the nasal cavity.

    To reduce swelling of the mucous membrane and restore normal ventilation of the sinuses, local vasoconstrictor drugs (sanorin, galazolin, naphthyzin, otilin, nazivin) are used for a period of no more than 5 days. In case of significant hyperthermia, antipyretic drugs are prescribed; in case of severe intoxication, antibiotics are prescribed. You can avoid adverse side effects and achieve a high concentration of the drug at the site of inflammation by using topical antibiotics.

    With advanced inflammation, the outlet of the maxillary sinus is blocked by thickened accumulations of mucus and pus. Depending on the severity of the inflammation, the patient may only need one puncture of the maxillary cavity, followed by cleansing of pus and washing the sinuses with medicinal solutions.

    • Treatment for chronic sinusitis

    The main goals of treatment are aimed at:

    1. Reducing inflammation in the sinuses;
    2. Restoring the patency of the nasal passages;
    3. Elimination of the cause of chronic sinusitis;
    4. Reducing the incidence of sinusitis.

    The patient must be prescribed antibiotics, local rinsing of the sinuses with antiseptic solutions, antihistamines and vasoconstrictor nasal drops.

    It is very important to get rid of the proliferation of microorganisms; for this, antibacterial drugs are used - Cefix, Cefodox, Ceftriaxone, Moxifloxacin, Ciprofloxacin, Gatifloxacin.

    If a doctor prescribes antibiotics, it is important to complete the entire course. Typically, this means that you will have to take them for a period or more - even after the sinus symptoms have gone away. If you stop taking them early, symptoms may return.

    Drug therapy

    Bacteria that provoke the development of sinusitis are quickly suppressed by tetracycline and penicillin antibiotics. They cause the death of bacteria. Next, you will learn about tablets that help with sinusitis.

    Basically, for sinusitis, doctors prescribe the best antibiotics of the tetracycline and penicillin groups, which can destroy the walls of bacterial cells, causing their death. Their advantages include:

    • Wide spectrum of action;
    • Stability in the stomach environment;
    • A small number of side effects;
    • Minimum side effects.

    Effective antibiotics include:

    You need to remember that if a large amount of pus has accumulated in the maxillary sinuses (purulent sinusitis occurs) and it is not removed, the effect of the antibiotic will be weakened. In addition, the effectiveness is slightly reduced if there is swelling of the sinuses.

    It is important to know that all of the above remedies relieve symptoms within 1-2 days after the start of treatment. But you should not stop taking antibiotics just because the patient feels much better. This way, sinusitis can become chronic, and antibiotics will lose their ability to destroy or inhibit infectious bacteria.

    It should be remembered that throughout the entire period of treatment (especially if sinusitis is contracted during the cold season), the patient should wrap his face high with a scarf to prevent hypothermia. The full course of therapy for an acute process can last up to 2 months.

    Nasal drops

    Only a doctor who constantly monitors the patient should decide which drops to treat sinusitis. There is no need to use drops for sinusitis and sinusitis for more than 6 days. According to doctors, they are addictive if used longer than the specified time.

    There are several types of nasal drops for the treatment of sinusitis. These groups include:

    1. Vasoconstrictors
    2. Anti-inflammatory Drops with antibacterial action
    3. Herbal nasal preparations
    4. Antihistamine drops
    5. Sea water drops
    6. Complex drops.
    • for patients with sinusitis over 12 years of age, the dosage is increased to 2 drops into the nasal passage, also three times a day;
    • spray 0.1% is used for children over 6 years of age, as well as for adults - in each nasal passage up to 3 times a day.

    Puncture of the maxillary sinus

    In advanced cases, when traditional methods do not help, a puncture is performed. Puncture of the maxillary sinus is considered an operation, although not a particularly complicated one. Piercing the nose for sinusitis helps not only to alleviate the patient’s well-being, but also to finally recover from such an unpleasant illness

    Indications for puncture for sinusitis are as follows:

    • Traditional treatment methods have not produced a therapeutic effect and the patient’s condition is only getting worse.
    • Nasal congestion is accompanied by severe headaches, aggravated by tilting the head forward.
    • An unpleasant odor emanates from the patient's nose.

    Puncture of the nasal sinuses for sinusitis is carried out using a special Kulikovsky needle. Before this, the patient is given a fairly strong painkiller. A syringe is attached to the needle and the sinus is washed with it, thus removing its contents (pus, blood or mucus).

    Washing is done with several types of solutions: antiseptic and decongestant. Then a special long-term medication is injected into the sinus to further combat the disease.

    The selection of postoperative treatment must be carried out by the attending physician, and strictly individually.

    Surgical treatment of sinusitis

    In severe cases, surgery is necessary. But surgery is only recommended in cases where other treatment options have failed. These methods include:

    • Correction of the nasal septum (septoplaty) is a surgical operation to correct a deviated nasal septum. The purpose of the operation is to improve nasal breathing;
    • Radioturbation of the nasal concha;
    • Partial or complete removal of the nasal mucosa (conchotomy) is an operation that involves removing the nasal turbinates. Another name for this operation is turbinectomy. Surgery is necessary when it is determined that enlarged turbinates are the cause of impaired nasal breathing, chronic rhinitis and inflammation of the paranasal sinuses (chronic sinusitis);
    • Removal of nasal polyps (polypotomy). The essence of the method is that the structure of the polyp sharply loses fluid under the influence of the laser. “Evaporation” of polypous tissue occurs, i.e. its reduction.

    The surgical intervention aims to create a permanent connection between the nose and the maxillary sinus. Radical surgery is used for severe forms of sinusitis.

    Nutrition for sinusitis

    Products that should be in the diet for sinusitis:

    • Freshly squeezed juices especially from carrots, beets, spinach and cucumber. Juices from these vegetables can be drunk either individually or in the form of a cocktail. For example, in proportions 3:1:2:1.
    • Herbal teas based on chamomile, string, St. John's wort, tea rose and others. Warm drink and steam from a cup moisturize the mucous membranes, facilitate the outflow of mucus and breathing through the nose.
    • Natural mineral water - maintains normal mineral-water balance in the body, improves blood composition, increases the body's resistance.

    As the severity of clinical symptoms decreases (with successful treatment of acute sinusitis), a three-component basic diet is recommended. The diet should consist of three food groups: seeds, nuts and grains, vegetables and fruits.

    Washing

    The procedure for cleansing the sinuses and nasal cavity significantly reduces swelling of the mucous membrane, tones the capillary system, and also improves the immune functions of the epithelium, which in turn begins to fight the problem on its own. The main function of nasal rinsing is not only to remove stagnant mucus, but also to restore the full natural process of its removal.

    1. Before you start rinsing your nose with the solution, you need to relieve congestion with vasoconstrictor agents. After 10 minutes, you can begin rinsing;
    2. A popular method of rinsing is using a syringe or syringe without a needle. But it is more convenient to rinse the nose with a special device called a jala neti teapot, or using a special nasal syringe purchased at a pharmacy;
    3. Tilting your head to the side, you need to insert the device into the nostril and begin to pour liquid into it. Then you need to slowly tilt your head to the other side for the solution to come out. The same action is repeated with the second nostril.

    The most common are rinses with drugs - saline solution and sea water; also often used:

    Is it possible to warm your nose if you have sinusitis?

    Sinusitis does not go away on its own or just from warming up, so under no circumstances should it be started. And even a common runny nose must be treated, since the likelihood of it turning into acute and then chronic sinusitis is quite high.

    Sinusitis should not be treated with heating at the acute stage of its development. Heat leads to increased swelling, congestion will not go away, it will only increase. It is heat, acting on purulent inflamed areas, that activates the process of pus coming out. But the sinuses are blocked, and the movement of pus will be in a completely different direction: the infection will spread to the teeth, ears, eyes, and brain.

    As you can see, the possibility of using warming depends on the stage of the disease and the characteristics of its course in a particular patient.

    In general, if you are not sure whether it is possible to warm your nose during sinusitis at your stage, you should contact a specialist to avoid various kinds of complications. After all, prompt and correctly selected treatment will give extremely positive results.

    What happens if sinusitis is not treated: consequences and complications for humans

    This disease should be considered a very insidious disease. Symptoms begin suddenly. The patient complains of poor general health: weakness, drowsiness, high body temperature. The main complaint is headache and purulent nasal discharge, so you definitely need to understand that sinusitis is dangerous.

    Complications after sinusitis can be divided into two large groups. The first group includes negative consequences that are associated with the ENT organs and the respiratory system.

    Among them we can distinguish such pathological processes as:

    • Transition from acute to chronic;
    • Inflammatory phenomena in the pharynx and tonsils;
    • Bronchitis and pneumonia;
    • Spread of sinusitis to other sinuses;
    • Inflammation of the middle ear (otitis).

    Complications from other organs:

    1. Meningitis. A very serious complication of chronic sinusitis is inflammation of the soft membranes of the brain and spinal cord, i.e. meningitis. The disease can be acute (symptoms appear within a couple of hours from the onset of the disease) or be sluggish.
    2. Sepsis. Sinusitis can lead to sepsis. When too much pus accumulates, it leaks out of the sinuses and spreads throughout the body. It often enters the bloodstream, which causes sepsis.
    3. Osteoperiostitis. Limited inflammation of the bone and periosteum of the orbit, clinically usually diagnosed as periostitis. It can be located in any department and can be either non-purulent or purulent in nature, up to the formation of an abscess.

    Always treat illnesses on time, consult a doctor and do not forget about an annual preventive examination.

    Prevention

    Immunologists say that it is imperative to prevent sinusitis during a runny nose, since people with this symptom are especially susceptible to developing this disease.

    For this reason, experts strongly recommend that during the autumn-winter period, people with weakened immune systems consume as many vitamins as possible, and sometimes the use of special medications, mainly vitamin complexes, is allowed to prevent sinusitis in adults.

    Sinusitis in adults often occurs against the background of other diseases, so to prevent it, you should be treated in time and avoid factors that provoke colds:

    1. Treat teeth immediately when signs of a problem appear.
    2. Brush your teeth 2 times a day.
    3. Treat allergies.
    4. Wash your hands after going outside and before eating.
    5. Don't get too cold.
    6. Carry out wet cleaning regularly.
    7. Get vaccinated.

    On frosty days, make sure that the indoor air is not only warm, but also humidified. It is recommended to place a vessel with water next to the battery - this will be enough to prevent the climate from becoming dry. After all, this can lead to drying of your nasal mucous membranes, which can trigger the onset of the disease, because in winter we suddenly go from a warm room into the cold.

    If it is still not possible to avoid sinusitis, it is necessary to begin treatment immediately so that the disease does not become chronic. It is extremely difficult to cure chronic sinusitis: the disease will return again and again after any cold or the slightest hypothermia. To prevent this from happening, acute sinusitis should be completely cured.

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    Sinusitis

    Sinusitis is inflammation of the maxillary (maxillary) sinuses. It is accompanied by difficulty in nasal breathing, mucopurulent discharge from the nasal passages, intense pain in the bridge of the nose and at the wings of the nose, swelling of the cheek and eyelid on the affected side, and a rise in body temperature. Timely treatment will help avoid serious complications: otitis media, meningitis, brain abscess, orbital phlegmon, osteomyelitis, myocardial and kidney damage.

    Sinusitis

    Sinusitis is inflammation of the maxillary (maxillary) sinuses. It is accompanied by difficulty in nasal breathing, mucopurulent discharge from the nasal passages, intense pain in the bridge of the nose and at the wings of the nose, swelling of the cheek and eyelid on the affected side, and a rise in body temperature. Timely treatment will help avoid serious complications: otitis media, meningitis, brain abscess, orbital phlegmon, osteomyelitis, myocardial and kidney damage.

    Sinusitis can be acute or become chronic. According to international medical statistics, about 10% of the population of developed countries falls ill with acute sinusitis and other sinusitis every year. The disease affects people of all ages. In children under 5 years of age, sinusitis almost never occurs, since at this age the paranasal sinuses are not yet sufficiently developed.

    The mechanism of development of sinusitis

    The maxillary sinus is an air-filled cavity in the maxillary bone. The maxillary sinus has common bone walls with the following anatomical formations: above - with the orbit, below - with the oral cavity, from the inside - with the nasal cavity.

    Along with other paranasal sinuses (two frontal, two ethmoid and one sphenoid), the maxillary sinuses perform the following functions:

    • participate in equalizing pressure in the cavity formations of the skull in relation to external atmospheric pressure;
    • warm and clean the inhaled air;
    • form the individual sound of the voice.

    All sinuses communicate with the nasal cavity through small openings. If these openings become closed for some reason, the sinuses stop being ventilated and cleaned. Microbes accumulate in the cavity and inflammation develops.

    Causes and risk factors for developing sinusitis

    Sinusitis can be caused by streptococci, staphylococci, chlamydia, Haemophilus influenzae, fungi, viruses and mycoplasma. In adults, sinusitis is most often caused by viruses, Haemophilus influenzae and Streptococcus pneumoniae. In children, the causative agents of sinusitis are often chlamydia and mycoplasma. In weakened patients and patients with impaired immunity, sinusitis can be caused by fungal and saprophytic microflora.

    Risk factors include diseases and conditions that impede normal ventilation of the maxillary sinus and contribute to the penetration of infection into the sinus cavity:

    The risk of developing sinusitis increases in winter and autumn due to the natural seasonal decrease in immunity.

    Classification of sinusitis

    Sinusitis can be catarrhal or purulent. In catarrhal sinusitis, the discharge from the maxillary sinus is aseptic in nature, while in purulent sinusitis it contains microflora. Depending on the route of infection, hematogenous (usually in children), rhinogenic (usually in adults), odontogenic (microbes enter the maxillary sinus from adjacent molars) and traumatic sinusitis are distinguished.

    Depending on the nature of the morphological changes, the following forms of chronic sinusitis are distinguished:

    • Exudative (catarrhal and purulent chronic sinusitis). The predominant process is the formation of pus.
    • Productive (purulent polypous, polypous, necrotic, atrophic, parietal hyperplastic sinusitis, etc.). The predominant process is a change in the mucous membrane of the maxillary sinus (polyps, atrophy, hyperplasia, etc.).

    Due to blockage of the mucous glands in chronic sinusitis, true cysts and small pseudocysts of the maxillary sinus often form.

    Polypous and polypous-purulent forms of chronic sinusitis are widespread. Less common are parietal-hyperplastic and catarrhal allergic forms, very rarely – caseous, cholesteatoma, oseotic and necrotic forms of chronic sinusitis.

    Symptoms of sinusitis

    • Symptoms of acute sinusitis

    The disease begins acutely. The patient's body temperature rises to 38-39C, signs of general intoxication are expressed, and chills are possible. In some cases, the patient's body temperature may be normal or subfebrile. A patient with sinusitis is bothered by 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 experience diffuse headaches of varying intensity.

    Nasal breathing on the affected side is impaired. With bilateral sinusitis, nasal congestion forces the patient to breathe through the mouth. Sometimes, due to blockage of the tear duct, lacrimation develops. Nasal discharge is initially serous and liquid, then becomes viscous, cloudy, and greenish.

    As a rule, chronic sinusitis is the outcome of an acute process. During the period of remission, the patient's general condition is not impaired. With an exacerbation, signs of general intoxication appear (weakness, headache, weakness); the temperature may rise to febrile or subfebrile.

    Exudative forms of chronic sinusitis are characterized by discharge, the amount of which increases during the period of exacerbation and becomes insignificant when the patient’s condition improves. With catarrhal sinusitis, the discharge is liquid, serous, with an unpleasant odor. In the purulent form of the disease, the discharge is thick, yellowish-green. Abundant viscous mucous discharge appears, which dries out and forms crusts in the nasal cavity.

    Headache, as a rule, appears only during periods of exacerbation of chronic sinusitis or when the outflow of discharge from the maxillary sinus is disrupted. The headache is pressing or bursting; according to patients, it is often localized “behind the eyes” and intensifies with lifting of the eyelids and pressure on the infraorbital areas. Decreases during sleep and in a lying position (relief is explained by the resumption of the outflow of pus in a horizontal position).

    Often, patients with chronic sinusitis complain of a night cough that does not respond to conventional treatment. The cause of cough in this case is pus flowing from the maxillary sinus along the back wall of the pharynx.

    In patients with chronic sinusitis, skin lesions in the vestibule of the nasal cavity (cracks, swelling, maceration, oozing) are often detected. Many patients develop concomitant conjunctivitis and keratitis.

    Diagnosis of sinusitis

    The diagnosis is made based on the patient's complaints, external examination data (reflex dilation of the skin vessels in the infraorbital region is determined), examination of the nasal mucosa (inflammation, swelling, purulent discharge from the sinus opening). An x-ray of the maxillary sinus reveals darkening. If other research methods are insufficiently informative, a puncture of the maxillary sinus is performed.

    Treatment of sinusitis

    • Treatment of acute sinusitis

    To reduce swelling of the mucous membrane and restore normal ventilation of the sinuses, topical vasoconstrictor drugs (naphazoline, naphazoline, xylometazoline hydrochloride) are used for a period of no more than 5 days. In case of significant hyperthermia, antipyretic drugs are prescribed; in case of severe intoxication, antibiotics are prescribed. You can avoid adverse side effects and achieve a high concentration of the drug at the site of inflammation by using topical antibiotics. After normalization of the temperature, physiotherapy (Sollux, UHF) is recommended.

    To achieve a sustainable effect of therapy for chronic sinusitis, it is necessary to eliminate the causes that contribute to the development of inflammation in the maxillary sinus (adenoids, chronic diseases of the ENT organs, deviated nasal septum, diseased teeth, etc.). During an exacerbation, local vasoconstrictors are used in short courses (to avoid mucosal atrophy).

    The maxillary sinus is drained. Sinus lavage is carried out using the “cuckoo” or sinus evacuation method. For this purpose, disinfectant solutions are used (firacilin, potassium permanganate). Proteolytic enzymes and antibiotic solutions are injected into the cavity. Physiotherapeutic techniques are used (inhalations, diathermy, ultraphonophoresis with hydrocortisone, UHF). Patients with sinusitis benefit from speleotherapy.

    For purulent polyposis, polyposis, caseous, cholesteatoma and necrotizing forms of chronic sinusitis, surgical treatment is indicated. The maxillary sinus is opened - a maxillary sinus.

    Sinusitis - treatment in Moscow

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