Chronic sinusitis how to treat

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How to cure chronic sinusitis: symptoms, treatment

Chronic sinusitis is becoming more and more common in the modern world. A distinctive feature of this form of the disease is that the inflammatory process develops and lasts more than two months.

Table of contents:

Sinusitis itself is an inflammation of the sinuses located in the thickness of the wing of the upper jaw.

Chronic sinusitis, the symptoms and treatment of which we will consider, can develop from an acute form of the disease if sufficient attention has not been given to therapy. In addition, it can become a complication of diseases such as measles, influenza, rhinitis, scarlet fever and some other infectious diseases.

How the disease develops

When the infection enters the nasopharynx, it begins to spread into the maxillary sinuses, inflammation and, in severe cases, swelling may occur.

The mucous membrane connects the nasal cavity with the maxillary sinuses, and at the same time it swells very much, because of this, air flows poorly and mucus flows poorly. In the mucus that accumulates, various microorganisms begin to multiply, which intensify the inflammatory process.

Most often, only one sinus may be involved; very rarely, there may be bilateral chronic sinusitis.

Causes

When chronic sinusitis develops, the reasons lie in the violation of the body's protective properties, the penetration of infection into the upper respiratory tract as a result of pathological processes that occur in the pharynx, nasal cavity and mouth.

Most often, the development of chronic sinusitis is provoked by such pathologies as:

  • a consequence of acute inflammation, especially if unfavorable conditions are created for the outflow of pathological secretions from the maxillary sinuses;
  • deviated nasal septum;
  • too narrow nasal passages;
  • close contact of the lateral wall of the nose with the middle turbinate;
  • polyps and adenoids;
  • granuloma in the root of the tooth.

Contributing factors are unfavorable conditions that prevent the outflow of pathological secretions from the maxillary sinuses. Quite often, the inflammatory process, which is unilateral in nature, moves to the other sinus, in which case chronic bilateral sinusitis develops.

It is also known that chronic odontogenic sinusitis, as a rule, immediately develops in a chronic but sluggish form. Because of this, a person suffering from this type of sinusitis may not notice any symptoms for quite a long time, but if the inflammatory process activates, the patient will need to consult an otolaryngologist and a dentist.

Classification

There are several varieties of this disease:

  • Purulent - with this form, nasal discharge is thick, it has a yellowish-brown color and a rather unpleasant odor;
  • Catarrhal - characterized by copious and liquid discharge; in addition, with this form of the disease, pronounced local swelling of the face is observed;
  • Chronic polyposis - changes in the condition of the mucous membrane occur, as well as the growth of polyps;
  • Odontogenic - the reason for its development lies in inflammation in the jaw area or in the teeth area;
  • Allergic - characterized by serous or clear discharge and occurs as a result of the effect of an allergen on the patient’s body;
  • Mixed polyposis-cystic;
  • Caseous - with this form, fairly copious discharge of a cheesy nature is observed;
  • Necrotic - occurs quite rarely and is accompanied by necrotic changes;
  • Rhinogenic - begins as inflammation of the mucous membrane of the nasal passages;
  • Chronic hyperplastic - as a rule, occurs in a severe form and is difficult to treat.
Depending on the form of chronic sinusitis, the symptoms and aspects of treatment of the disease in adults will differ.

Symptoms of chronic sinusitis

In adults, during periods of remission of chronic sinusitis, the symptoms are mild; in most cases, the patient complains of:

  • nasal congestion;
  • impaired sense of smell;
  • change in voice timbre;
  • aching pain in the bridge of the nose.

In addition, general weakness, a feeling of fatigue, lethargy, decreased performance, and absent-mindedness are characteristic. During periods of remission of the disease, it may not be accompanied by pain.

Symptoms of exacerbation

In the chronic form of sinusitis, symptoms can be mild and only manifest themselves during periods of exacerbation of the disease. At this time, a person develops severe symptoms:

  • weakness, general malaise;
  • increased body temperature (usually up to 37.5 °C), chills;
  • pain in the head of a bursting nature, concentrated in the forehead, eyes and aggravated by
  • tilting the head forward when coughing, sneezing;
  • severe nasal congestion;
  • coughing (especially at night, when lying down);
  • swelling of the face;
  • increased sweating;
  • difficulty smelling;
  • restless sleep.
  • the appearance of thick nasal discharge, often purulent;
  • hoarseness, nasal voice;

With an exacerbation of chronic sinusitis, as a rule, there is a deterioration in health, severe headache, increased body temperature, the appearance of swelling on the cheeks and eyelids, and increased leakage of pus from the nasal passages when the head is tilted. Discharge from the nasal passages can provoke swelling and redness of the mucous membrane, its pathological growth and the appearance of polyps.

Diagnostics

As a rule, the doctor makes a diagnosis of chronic sinusitis based on symptoms and the results of an examination, which is carried out using an endoscope (allows you to examine the mucous membrane of the nose and nasal openings).

A thorough diagnostic examination should be performed to rule out any contributing factors, including allergies, asthma, and any immune problems. If the primary disease that provoked chronic sinusitis is not determined, then it is only possible to control the course of the disease. The patient’s recovery depends on the accuracy and time of diagnosis.

Puncture (puncture) of the maxillary sinus is the most reliable diagnostic method, but it does not always provide complete information about the process.

How to cure chronic sinusitis without surgery

In the case of chronic sinusitis, treatment differs from the treatment of a common disease in that even during a period of calm it should not be ignored. After all, the frequency and severity of the disease in the acute phase depends on how well the prevention and treatment is carried out.

To cure chronic sinusitis without surgery, you must completely adhere to a clear plan, which includes:

  • reducing inflammation in the sinuses;
  • restoration of patency of the nasal passages;
  • eliminating the cause of chronic sinusitis;
  • reducing the number of sinusitis occurrences.

During the period of remission, physiotherapeutic treatment is widely used:

  • speleotherapy (treatment with the microclimate of salt caves);
  • ultrasound on the area of ​​the maxillary sinuses;
  • electrophoresis with lidase on the sinus area;
  • UHF to the sinus area;
  • magnetic therapy on the pharynx area;
  • ultraphonophoresis with cortisone;
  • laser therapy.

If the disease is severe, a puncture of the maxillary sinus may be prescribed. This procedure allows you to remove pus in a short period of time. But it does not serve as a “substitute” for antibiotics and other medications, but it significantly facilitates the “work” of the tablets.

Antibiotics

Chronic sinusitis is treated with antibiotics when there is a bacterial infection. If sinusitis is caused by any other reasons, then the use of antibiotics will not bring any results.

The most commonly prescribed drugs are:

When using antibacterial drugs, it is extremely important to complete the entire course of treatment. In most cases, this means that the medication will have to be taken for a day or more, depending on when the patient's condition begins to improve. If you stop taking them after a few days, the symptoms will soon return.

Puncture of the maxillary sinus

Puncture of the maxillary sinus is one of the common methods of treating chronic sinusitis. During this procedure, you can pump out pus from the sinus with a syringe, rinse it with an antiseptic solution and inject an antibiotic or other drug into the cavity. Most often, a solution of furatsilin or physiological sodium chloride solution is used to rinse the maxillary sinus.

  • As an alternative to punctures, at this point in time there is such a procedure as installing a YAMIK catheter. This procedure is practically painless, as it is performed under local anesthesia, and there is no need to make a puncture.

Sometimes a puncture of the maxillary sinus is the only method of treating sinusitis. In addition, puncture of the maxillary sinus allows you to quickly eliminate pus, which is especially important during pregnancy, if the outflow of pus from the sinus is impaired and with existing concomitant diseases.

There is also an opinion that once a puncture has been made, they will have to be repeated for the rest of your life. This statement is absolutely not true - puncture is not one of the causes of sinusitis.

Prevention

If we talk about prevention, the most effective method is adequate and competent treatment of the disease at the initial stage, when a slight runny nose begins.

That is why it is important for people who know that they have a similar disease not to let its course take its course. The less hypothermia there is, the more regularly hardening procedures are carried out, the more balanced and rational the diet is, the easier the disease itself will progress.

Source: http://03-med.info/lor/kak-vylechit-khronicheskiy-gaymorit-si.html

Chronic sinusitis

Sinusitis is an inflammatory process that occurs on the mucous membrane of the maxillary sinus, which is otherwise called the maxillary sinus. This disease can develop at any age, including in children over 7 years of age. The likelihood of developing sinusitis increases sharply during the cold season.

Reasons for the development of sinusitis

Inflammation of the maxillary sinuses can be triggered by a number of factors unfavorable to the body. Very often, the disease develops against the background of previous infections of the upper respiratory tract, diseases of the pharynx, ear and nose. The development of sinusitis is most often preceded by acute rhinitis, which is complicated by sinusitis.

The main cause of inflammation of the maxillary sinuses is the penetration of pathogenic microflora into them, which begin to actively multiply, causing a violent inflammatory reaction.

There are common predisposing factors for the development of sinusitis:

  • pathological conditions that disrupt normal nasal breathing - allergic rhinitis, deviated nasal septum, adenoids;
  • weak immunity;
  • the presence of chronic foci of infections in the body;
  • untreated viral rhinitis, which becomes chronic;
  • staphylococcus bacteria carriage;
  • congenital changes in the anatomical structures of the nasal cavity;
  • viral respiratory infections;
  • carious teeth.

The main factor in the development of chronic sinusitis is a bacterial infection in the body - staphylococci, streptococci, chlamydia and mycoplasma.

In children, inflammation of the maxillary sinuses is most often caused by mycoplasmas and chlamydia. As a result, doctors must accurately diagnose the causative agent of the infection, since chlamydia and mycoplasma are not susceptible to penicillin or cephalosporin antibiotics, so even an intensive course of therapy will not have the expected effect. Treatment of chlamydial or mycoplasma sinusitis is carried out with antibiotics of the macrolide group, to which pathogens are most susceptible.

Diseases of the ENT organs play an important role in the development of the inflammatory process in the maxillary sinuses. The maxillary sinus (maxillary sinus) is anatomically connected to the nasal cavity in order to provide physiological drainage and self-cleaning of the sinus. During acute or chronic rhinitis, there is a blockage of the maxillary sinus outlet, which can lead to the penetration of pathogenic flora and the development of an inflammatory process. That is why doctors prescribe instillation of vasoconstrictor drops into the nose for acute rhinitis. They not only quickly eliminate a runny nose, but also prevent blockage of the maxillary duct with mucus, thereby protecting the maxillary sinuses from inflammation.

Chronic sinusitis develops against the background of an untreated acute inflammatory process in the maxillary sinuses. The chronic form of the disease is characterized by a long-term purulent inflammatory process in the maxillary sinuses.

Symptoms of chronic sinusitis

The main clinical manifestations of sinusitis are:

  • a feeling of pressure or fullness in the area of ​​the affected maxillary sinus;
  • severe pain in the affected area, which spreads to the forehead, cheekbones, temple and half of the face;
  • sensations of toothache that worsen when chewing;
  • violation of nasal breathing;
  • purulent discharge from the nose is yellow or greenish in color, with an unpleasant odor.

Clinical manifestations of chronic sinusitis are often not as pronounced as in the acute form of the disease. The main symptom is a chronic runny nose that cannot be treated with any medications. In this case, patients often complain of pain in the eyebrow area and headaches. Unpleasant sensations intensify when blinking and may go away if the patient lies down. Another characteristic sign of chronic sinusitis is swelling of the eyelids in the morning and frequent inflammation of the eyes (conjunctivitis).

Due to impaired nasal breathing, the patient's sense of smell significantly deteriorates. In addition, chronic sinusitis is characterized by the presence of a dry, persistent cough that does not go away even after treatment with expectorants and antitussives. The appearance of a dry cough is caused by the irritating effect of draining pus on the back wall of the pharynx.

Forms of chronic sinusitis

The clinical picture of sinusitis largely depends on the form of the inflammatory process. For example, with the exudative form of inflammation of the maxillary sinuses, the main clinical symptom of the disease is a long-lasting runny nose.

The nature of nasal discharge also depends on the form of the inflammatory process and the degree of damage to the maxillary sinuses. Purulent sinusitis is characterized by the discharge of mucus from the nose mixed with pus, which has a very unpleasant odor. In the catarrhal form of the inflammatory process, nasal discharge is viscous and mucous.

Difficulty in nasal breathing is characteristic of all types of sinusitis. Severe dryness of the pharynx, constant expectoration of sputum, discharge of pus and mucus in copious amounts during the day and vomiting are observed when the outflow of secretions from the maxillary sinus is disrupted anteriorly as a result of the presence of polyps in the nose or hypertrophy of the mucous membrane.

Complications of chronic sinusitis

If not treated promptly, chronic sinusitis can lead to a number of serious complications. Pus from the maxillary sinuses can easily penetrate into nearby tissues and organs, affecting teeth, nerve endings, the eye socket, and even the membranes of the brain in particularly severe cases.

Untreated chronic form of sinusitis can lead to the following complications:

In addition to damage to the brain and meninges, pathogenic microflora can cause damage to the tissue of the orbit and eyelids, thrombosis of the veins of the orbit, osteomyelitis of the upper jaw and inflammation of the middle ear.

The chronic form of sinusitis can cause frequent sore throats, laryngitis, and pharyngitis. Chronic inflammatory process often causes trigeminal neuritis. However, with proper treatment, the risk of complications is very low.

Diagnosis of chronic sinusitis

As with any other disease, a major role in the diagnosis of sinusitis is given to a thorough collection of the patient’s medical history. A correctly collected anamnesis allows you to quickly recognize the disease.

When interviewing the patient, the doctor should pay attention to the intensity and nature of the pain, as well as the location of the pain. The severity of difficulty breathing and impaired sense of smell is determined.

Examination of a patient with suspected sinusitis begins with palpation of the anterior wall of the maxillary sinus. The inflammatory process is characterized by pain in the sinus area. It is also possible to have such signs as unilateral swelling of the cheek, maceration of the skin above the upper lip.

The most reliable and frequently used method for diagnosing chronic sinusitis is x-ray examination. In order to clarify the severity of the inflammatory process, it is recommended to take pictures in different projections - frontonasal, chin-nasal and lateral.

Despite the fact that X-ray examination is a common method for diagnosing sinusitis, in children this method is not sufficiently informative. Similar changes in the condition of the maxillary sinus are observed in children with advanced rhinitis.

The most accurate and highly informative method for diagnosing chronic sinusitis is puncture of the maxillary sinus (puncture). The procedure is characterized by puncture of the maxillary sinus with a special thin needle, which allows the doctor to suck out the contents of the sinus with a syringe and detect the presence of pus and blood in the liquid. During puncture of the maxillary sinus, it is possible to wash the cavity with disinfectant anti-inflammatory solutions.

The procedure for puncturing and washing the sinus is not so complicated, and if performed correctly, it is quite easily tolerated by patients.

If a doctor violates the rules of asepsis and antisepsis, the following complications may occur:

  • emphysema of the cheek and orbit (a condition characterized by the entry of air from a syringe);
  • orbital abscess;
  • phlegmon;
  • blockage of blood vessels by air bubbles.

Despite the fact that the chance of developing such complications is quite small (if all rules and precautions are followed), doctors try to resort to puncture of the maxillary sinus as little as possible, and do this only when other diagnostic methods have not been effective.

Treatment methods for chronic sinusitis

The method of treating chronic sinusitis directly depends on the general condition of the patient, the severity of the disease, and the anatomical features of the structure of the nasal cavity.

Treatment methods for sinusitis can be divided into non-puncture treatment, puncture and surgical intervention. In combination with these methods, the patient is necessarily prescribed antibiotics, local rinsing of the sinuses with antiseptic solutions, antihistamines and vasoconstrictor nasal drops.

Puncture treatment

Puncture of the maxillary sinus is one of the effective methods of treating chronic sinusitis. During this procedure, you can pump out pus from the sinus with a syringe, rinse it with an antiseptic solution and inject an antibiotic or other drug into the cavity. Most often, a solution of furatsilin or physiological sodium chloride solution is used to rinse the maxillary sinus. The puncture of the maxillary sinus is performed under local anesthesia.

Very often, to effectively treat an exacerbation of chronic sinusitis, the patient undergoes several punctures over several weeks. In order not to further injure the patient, after the first puncture of the maxillary sinus, the patient is given special catheters (tubes) through which the sinus cavity can be washed and antibiotics administered. If one puncture is enough for the patient to treat sinusitis, then the catheter is not installed in the sinus cavity.

The puncture method is common in the treatment of chronic sinusitis, as it allows you to quickly identify the degree of the inflammatory process, remove pus from the maxillary sinus, rinse it with an antiseptic solution and administer the drug directly to the site of localization of the inflammatory process.

Like any other method of treating chronic sinusitis, the puncture method has its contraindications. Since the method is invasive (that is, penetrating inside), complications from the respiratory system, namely the lower respiratory tract, may occur. This is due to the close relationship between the organs of the respiratory system and each other.

That is why patients should inform the doctor about existing chronic diseases before starting treatment.

The disadvantage of the puncture method of treating chronic sinusitis is that the patient’s quality of life changes for the worse. Despite the fact that the procedure for puncture treatment of sinusitis is carried out under local anesthesia, the patient experiences very painful sensations.

Another disadvantage of puncture treatment of chronic sinusitis is the release of blood or ichor from the puncture site for quite a long time. After this treatment, the patient may have severe headaches and pain in the area of ​​the sinus puncture. In addition to the unpleasant sensations, it is almost impossible to combine this method of treatment with work, so most often the patient has to issue a sick leave.

Although the installation of catheters greatly simplifies the puncture treatment of sinusitis, it also has a number of disadvantages. Installation of the catheter itself is a painless procedure; in some patients it can only cause discomfort, but due to the need for a foreign object (tube) to be in the nose for a long time, pathological changes in the mucous membrane may begin, which lead to the development of an additional inflammatory process.

Many patients deliberately refuse to pierce the maxillary sinus, because they believe that having done such a procedure once, they will have to pierce the sinus constantly. This is a completely unfounded fear. Repeated sinusitis or exacerbation of the chronic form of the disease is often caused by a violation of the structure of the nasopharynx - a curvature of the nasal septum.

Sometimes a puncture of the maxillary sinus is the only method of treating sinusitis. In addition, puncture of the maxillary sinus allows you to quickly eliminate pus, which is especially important during pregnancy, if the outflow of pus from the sinus is impaired and with existing concomitant diseases.

Each patient should understand that the sooner he seeks medical help when symptoms of sinusitis appear, the greater the likelihood that a puncture of the maxillary sinus will not be required.

“Cuckoo”, or the Proetz method of sinus lavage

A non-puncture method for treating chronic sinusitis includes washing the maxillary sinus using the “cuckoo” method. It is allowed to perform such a procedure only in the absence of dysfunction of the sinus anastomosis and strong local immunity of the mucous membrane. This method of treatment is suitable only for those patients whose sinusitis is not complicated or advanced.

Very often, the non-puncture method of treatment is combined with laser therapy. Rinsing with a “cuckoo” removes pus from the sinus. And laser beams relieve swelling and inflammation of the nasal mucosa. “Cuckoo” is a painless method, so the patient does not require pain relief.

The procedure is as follows. The patient lies on his back, and the doctor inserts special catheters into the nose. Through the first catheter, an antiseptic solution is poured into the patient’s sinus cavity, and through the second, the contents of the sinus cavity are sucked out under vacuum.

The procedure was called “cuckoo” for a reason. While infusing the solution and suctioning it from the cavity, the patient must constantly say “ku-ku” so that the contents of the sinus cavity do not enter the lower respiratory tract.

As a rule, significant improvements in the patient’s condition are observed after 5-7 sessions of sinus lavage according to Proetz. After the first session, the patient’s breathing through the nose improves, the swelling of the mucous membrane goes away and the headache disappears.

In most cases, punctureless treatment of sinusitis is combined with oral administration of antibacterial drugs.

Prevention of sinusitis

The main method of preventing the development of sinusitis is timely treatment of diseases of the nasal cavity and respiratory system. A significant factor is the rehabilitation of foci of chronic infection - carious teeth, chronic tonsillitis and others.

Source: http://bezboleznej.ru/hronicheskij-gajmorit

Treatment of chronic sinusitis

Inflammation of the mucous membrane of the maxillary, or maxillary, paranasal sinuses, lasting more than 4 weeks, is called chronic sinusitis. According to statistics, this pathology accounts for exactly half of all inflammatory diseases of the sinuses (sinusitis). Chronic sinusitis occurs in waves - the remission stage is replaced by an exacerbation stage, after which remission occurs again. In the absence of adequate treatment, the pathological process also affects other organs adjacent to the maxillary sinuses and complications develop.

Causes of chronic sinusitis

The main cause of this disease is prolonged exposure to pathogenic microflora on the sinus mucosa. In the vast majority of cases, it is caused by bacteria; less often, viruses and fungi act as causative agents. There are often cases when, when examining the contents of the sinuses, several types of microorganisms are found in it.

Impaired nasal breathing due to congenital or acquired anatomical defects (for example, a deviated nasal septum, polyps) contributes to the onset of the pathological process in the sinus. Since the lower wall of the maxillary sinuses is very thin, infection can enter them from the oral cavity (for example, from teeth affected by caries, inflamed gums, etc.) - in this case, the disease is called chronic odontogenic sinusitis.

Factors predisposing to the development of the disease are:

  • frequent infectious diseases of the upper respiratory tract;
  • bad habits, in particular smoking;
  • cold season;
  • barotrauma;
  • hypovitaminosis;
  • severe concomitant diseases that have a negative impact on the immune system as a whole;
  • tendency to allergies.

The mechanism of development of sinusitis

The infection, entering the mucous membrane of the nasopharynx and maxillary sinus, causes local inflammation, one of the components of which is swelling. The mucous membrane of the anastomosis connecting the nasal cavity with the maxillary sinus also swells, which causes deterioration of air circulation in the latter and the outflow of mucus from it. Accumulated mucus is an excellent breeding ground for microorganisms, which further intensify inflammation.

In most cases, with this disease, only one sinus is involved in the pathological process, but there are also cases of bilateral chronic sinusitis.

Classification of chronic sinusitis

The main forms of chronic sinusitis are:

Allergic and odontogenic forms of this disease also often occur.

Symptoms of chronic sinusitis in adults

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

  • slight weakness, fatigue;
  • mild 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;
  • some swelling in the area of ​​​​the projection of the sinus onto the face.
When chronic sinusitis enters the acute stage, the patients’ well-being worsens: they note severe weakness, a slight increase in temperature (usually no more than 37.5–37.7 C); The headache becomes more intense, especially when tilting the head forward, and a feeling of heaviness appears in the head. Since during the inflammation stage the amount of mucus in the sinus increases, bursting pain may appear in this area. Complaints of sore throat, sore throat and coughing persist. Characterized by redness of the skin, cracks, swelling under the nose (due to constant irritation of this area with mucus). Complaints of swelling of the lower eyelid or the appearance of discharge from the eyes (conjunctivitis) indicate the spread of the inflammatory process to the eye sockets.

Complications of chronic sinusitis

Untreated chronic sinusitis can provoke the development of the following diseases:
  • phlegmon of the orbital tissue;
  • abscess of the lower eyelid;
  • otitis;
  • meningitis, brain abscess and sepsis should be noted among the serious complications;
  • diseases of the bronchopulmonary system (bronchitis, pneumonia);
  • kidney disease (pyelonephritis);
  • heart disease (myocarditis).

Diagnostics

Based on the patient’s complaints, medical history and life history, the otorhinolaryngologist will suspect a disease, which will be confirmed by rhinoscopy, as well as additional examination methods.

When visually examining the nasal mucosa, attention will be drawn to its hyperplasia (thickening), hyperemia (redness), swelling, and the presence of discharge in the form of viscous mucus or pus.

The leading methods used to confirm the diagnosis are:

  • bacteriological examination of material from a smear taken from the nasal cavity during rhinoscopy;
  • rhinoendoscopy (examination of the nasal mucosa and paranasal sinuses using a special device - a video endoscope);
  • X-ray of the paranasal sinuses.

Less often, for diagnostic purposes, puncture of the maxillary sinus is performed, and allergy tests are performed to determine the patient’s immune status - an immunogram.

How to cure chronic sinusitis

It is almost impossible to completely get rid of chronic sinusitis.

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.

To achieve an optimal treatment result, it is important to sanitize foci of chronic infection, which could cause an exacerbation of sinusitis, as quickly as possible. For this purpose, as well as to suppress the growth and reproduction of microorganisms in the sinus itself, antibacterial drugs from the group of cephalosporins (Ceftriaxone, Cefodox, Cefix) or fluoroquinolones (Ciprofloxacin, Gatifloxacin, Moxifloxacin) are prescribed.

The optimal solution is to prescribe, in parallel with systemic antibiotics, local antibacterial drugs, for example, Bioparox (available in the form of a spray).

Vasoconstrictor drops in the form of sprays or drops (Nazivin, Otrivin, Galazolin) will reduce swelling of the mucous membrane. It is worth remembering that drugs in this group cannot be prescribed for a long period of time, since addiction to them often develops.

It is worth mentioning separately about the combined drug, the components of which have a decongestant and mucolytic (mucus-thinning) effect - it is called Rinofluimucil and has a noticeable effect in the treatment of chronic sinusitis.

In order to wash pus from the sinuses and destroy pathogenic bacteria in them, a course of rinsing the cavities with disinfectant solutions (Dioxidin, Furacilin) ​​is carried out, followed by the introduction of antibiotics and enzyme preparations, such as Lidaza.

In order to strengthen the immune system, immunocorrectors (Ribomunil, sodium nucleinate, Imudon, IRS-19, immunoglobulin preparations) are prescribed on the recommendation of an immunologist.

If there is evidence of an allergic nature of sinusitis, antihistamines (Eden, Erius, Telfast) and topical hormonal drugs (Avamys, Nasonex) are prescribed.

During the period of remission, physiotherapeutic treatment is widely used:

  • speleotherapy (treatment with the microclimate of salt caves);
  • ultrasound on the area of ​​the maxillary sinuses;
  • electrophoresis with lidase on the sinus area;
  • UHF to the sinus area;
  • magnetic therapy on the pharynx area;
  • ultraphonophoresis with cortisone;
  • laser therapy.

Sometimes the severity of acute sinusitis requires immediate drainage puncture of the maxillary sinuses. This procedure restores the patency of the anastomosis, promotes the rapid removal of pus from the sinus, and makes it possible to administer locally antibacterial drugs. You should not blindly believe those who say that puncturing results in repeated sinusitis - this is nothing more than a myth.

In some cases, when chronic sinusitis is severe, the patient is recommended to undergo surgery - maxillary sinusotomy, during which the surgeon opens the affected sinus and sanitizes it.

Prevention of chronic sinusitis

Prevention of the development of chronic sinusitis is timely adequate treatment of acute inflammation of the sinus mucosa.

To maintain remission of a chronic process for as long as possible, it is necessary:

  • avoid acute infectious diseases;
  • promptly sanitize foci of chronic infection, especially those localized in the ENT organs and in the oral cavity;
  • monitor the patency of the nasal passages (remove polyps, straighten a deviated nasal septum, etc.);
  • lead a healthy lifestyle (this concept includes a nutritious diet rich in vitamins and microelements, healthy sleep, regular exercise, walks in the fresh air, giving up bad habits, in particular smoking).

Forecast

As mentioned above, it is impossible to get rid of chronic sinusitis. Timely initiation of comprehensive treatment and compliance with all preventive measures will help put the disease into stable remission and prevent possible complications.

About the treatment of sinusitis in the “Health” program by Elena Malysheva:

Source: http://otolaryngologist.ru/236

How to treat chronic sinusitis

Chronic sinusitis occurs during a complicated course of the acute phase of the disease, in which it is not possible to select the correct treatment or it was initially incorrect. In the chronic form of the disease, the same medications are used as in conventional treatment, but a special combined regimen can be selected that will avoid a large number of relapses in the future. When treating pathology, antibacterial drops are required; rinses and oral antibiotics may be prescribed. The use of vasoconstrictor drops is possible only as prescribed by a doctor, since they are not always well tolerated at the same time as other medications.

How to treat chronic sinusitis

Symptoms of chronic sinusitis

Among the symptoms of chronic sinusitis, the following points stand out:

  • severe weakness accompanied by a slight increase in body temperature;
  • the nose is constantly stuffy, mucous discharge comes out of it;
  • the voice acquires a characteristic tint of nasality, which develops against the background of a large amount of sputum;
  • there is constant pain in the nasal sinuses, which can radiate to the teeth, forehead and ears, and intensifies with a slight tilt of the head forward, when sneezing and coughing;
  • due to irritated mucous membranes, the patient often sneezes;
  • in the absence of proper treatment, the runny nose passes into the purulent stage, and the discharge becomes a characteristic yellow-brown color;
  • During the remission stage, the patient may experience symptoms such as heaviness in the cheeks, severe lacrimation, discharge of pus without signs of a runny nose.

Attention! Similar symptoms can also appear during a common cold. But such specific signs as pain in the sinuses, green discharge and a strong nasal voice should force you to consult a specialist to confirm or refute the diagnosis.

Oral antibiotics for chronic sinusitis

Azithromycin

A good third-generation antibiotic that can eliminate most pathogenic bacteria. It is used in adults and children, subject to correctly selected doses. Adult patients with the development of a chronic type of inflammation take 0.5 g of Azithromycin once a day without taking into account food. Treatment at the same dose is carried out for three days, after which the medication is completely discontinued.

Amoxicillin

Amoxicillin in tablet form

It can also be prescribed for the chronic type of sinusitis, but shows less resistance to bacteria, since they can develop resistance to the active substance of the drug. Taken in a minimum course of seven days, it rarely causes intestinal irritation or other side effects. The dosage of the active substance can be mg three times an hour after meals or an hour before it. Available in the form of tablets and capsules, the latter show a more noticeable result, since the active substance begins to disintegrate after entering the stomach.

Attention! Most experts agree that it is best to prescribe macrolide antibiotics to patients. They are the least dangerous and toxic even for weakened immunity; in addition, they additionally stimulate the body’s protective functions.

Antibacterial drops against chronic sinusitis

Polydexa

When treating chronic sinusitis, you should choose a drug that contains phenylephrine. It is allowed to use the medication from 2.5 years of age, but in childhood the doses are selected separately for each child. Adult patients, taking into account the intensity of the manifestation of sinusitis, make one injection into each nasal passage no more than five times a day. The product makes breathing easier, clears the passages of mucus and relieves swelling. You can take Polydex for 10 days, a longer course only with the permission of the ENT specialist.

Isofra

Isofra has a rapid antibacterial and anti-edematous effect

Available in the form of a spray, which is an analogue of Polydexa. Isofra also contains phenylephrine, which has a rapid antibacterial and decongestant effect. The drug is used up to 6 times a day in adult patients and up to three times a day in children. One spray is required in each nostril. The recommended course of therapy cannot exceed 7 days.

Framinazine

Available in spray form. It has a specific smell, the strength of the effect is slightly lower than Isofra and Polydexa. Framinazine can be used in children and adults when appropriate safe doses are prescribed. Patients over 15 years of age are recommended to take one injection of the active substance into each nasal passage no more than five times a day. The recommended course of treatment is 7-10 days.

Framinazine nasal spray

Attention! They are usually prescribed only at the stage of exacerbation of chronic sinusitis. If purulent discharge is observed during remission, rinsing is usually prescribed. You should not prescribe antibiotic drops on your own, so as not to provoke addiction to them.

Decongestant drops for chronic sinusitis

Leconil

Usually prescribed to patients only from the age of three. At the same time, in childhood, drops can be used only for three days, the dose is 1 drop in each nasal passage 2 times a day. At this dosage, Leconil is taken up to 12 years of age, but from 7 years of age the number of daily doses can be increased to three. Adult patients and children over 12 years of age take treatment three times a day, two drops in each nostril. The recommended course of therapy is 3-5 days. Longer treatment only with the permission of the attending physician.

Nazol Advance

Nazol Advance relieves swelling and suppresses phlegm production

A fast-acting drug that relieves swelling and suppresses phlegm production. Shows instant results when combined with Isofra or Polydexa. It is not recommended to take in the presence of chronic sinusitis complicated by allergic rhinitis. This may worsen the symptoms of a second chronic disease. The dosage of Nazol Advance depends on the age of the patient.

Oxymetazoline

Available in the form of drops and spray, it shows quick drying results. Due to severe drying of the mucous membrane, the problem of irritation may arise, so these drops should not be used for more than three days if there is severe sensitivity. The dosage of the drug is 1-2 drops in each nasal passage up to three times a day. In childhood, doses of the active substance are selected individually for each child. The duration of treatment with normal tolerability of the drug cannot be more than 7 days.

Attention! It is always worth remembering that vasoconstrictor drops can cause thinning of the vascular wall, which leads to constant runny nose and the need to use drops on an ongoing basis. To prevent this from happening, you should take decongestants only in weekly courses and in strict dosages. If your health allows, daily doses of vasoconstrictor drops can be reduced.

Sinupret against viral sinusitis

Chronic sinusitis is not always provoked only by bacteria, so it is important to choose a medication that can attack viruses. In case of a viral disease, antibiotics are absolutely useless and can even be dangerous. To eliminate such consequences, a good antiviral medication is prescribed, which includes Sinupret. It is available in the form of drops and tablets and has a completely natural composition. Most often, patients are prescribed a liquid form of the drug, since it is this that shows quick and noticeable results.

Release form of the drug Sinupret

When treated with Sinupret, the overall level of immunity rises, sputum is quickly separated and removed from the body. In addition, the walls of blood vessels are strengthened, toxins are removed and the activity of the virus is suppressed. Taking into account the patient’s age, Sinupret is prescribed in the following doses:

  • children from 2 to 6 years old, 15 drops three times a day;
  • children from 6 years to 12, 25 drops also three times a day;
  • adult patients take 50 drops of the drug three times a day.

The duration of treatment for each patient is determined individually, taking into account the complexity of the medical history and the response to the therapy.

Attention! When prescribing doses of the active substance, you should also focus on the patient’s weight, in particular this is done in childhood. If the patient's parameters are suitable for a different age group, other doses of Sinupret can be prescribed.

Mucolytics against chronic sinusitis

Bronchobos

The drug Bronchobos has a complex mucus-thinning and anti-inflammatory effect

A drug that has a complex mucus-thinning and anti-inflammatory effect. Bronchobos can be taken in the form of capsules and syrup. In adults, capsules and 5% syrup are prescribed. Taking into account the complexity of chronic sinusitis, patients after 15 years are prescribed 15 ml of syrup or 2 capsules three times a day. Therapy lasts no more than 10 days; a longer course of treatment is possible only with the permission of the attending physician.

Mukodin

Available in the form of syrup and tablets. Taking into account the complexity of the chronic form, Mucodin can be taken from 10 to 30 days. In the first days of treatment, adult patients are prescribed 750 mg of the active ingredient three times a day. Once the required therapeutic effect is achieved and the patient’s condition is stabilized, 1.5 g of Mucodin is taken in 4 divided doses.

Libexin Muco

Mucolytic agent Libexin Muco

A good remedy of mucolytic nature, which can be taken from the first month of the patient’s life. Adult patients are recommended to take 0.75 g of the active ingredient three times a day. In this case, if a dose is missed, it is not necessary to replenish the amount of the active substance. Chronic sinusitis using Libexin Muco can be treated for 4 to 30 days; the duration of therapy is influenced by the severity of symptoms.

Attention! Drugs in this group promote faster mucus discharge and easier breathing. It must be used for sinusitis in combination with drops and other highly specialized drugs. Monotherapy does not show any result, which leads to serious complications.

Video - How to cure sinusitis without punctures and pain

Additional treatment of chronic sinusitis

Taking into account the presence of other symptoms and associated complications, the following treatment methods may also be used:

  • prescribing vitamin complexes to strengthen the entire body and enhance protective functions;
  • take painkillers such as Paracetamol, Efferalgan and Ibuklin, which additionally relieve fever;
  • exposure to ultraviolet light, which helps create an additional disinfecting effect;
  • salt rinses; in severe cases, the procedure is carried out directly in the medical institution;
  • administration of antibiotics through injections or droppers is carried out in advanced cases of chronic sinusitis;
  • carrying out surgical interventions if sinusitis is provoked by injuries and congenital pathologies of the nasal cavity;
  • puncture and installation of a catheter to drain pus;
  • prescribing antiallergic drugs, they can also be prescribed without allergies to reduce swelling and remove mucus.

Nose piercing for sinusitis

Attention! For treatment to be more successful, it is important to identify the exact causative agent of the problem. This will not only allow for successful therapy, but will also reduce the risk of relapse in the future.

Treatment of chronic sinusitis should preferably be carried out under the supervision of the attending physician, who can assess the complexity of the disease and prescribe appropriate treatment. When using antibacterial agents, the simultaneous administration of oral and nasal medications is possible only in exceptional cases, when severe intoxication of the body is observed and the pus cannot be absorbed for a long time. If conservative treatment is ineffective, a puncture is prescribed to clear the sinuses.

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Source: http://med-explorer.ru/otolaringologiya/medicinskie-preparaty/kak-lechit-xronicheskij-gajmorit.html

How to cure chronic sinusitis?

Chronic sinusitis (sinusitis) is a fairly common disease in which inflammation of the voids around the sinuses occurs. The duration of the disease, depending on the correctness of treatment, is 12 weeks or more.

In addition, chronic sinusitis is often called chronic rhinosinusitis. The disease interferes with normal nasal passage due to the large secretion of mucus. With sinusitis, it is extremely difficult to breathe through the nose, and the face may be swollen. Throbbing headaches are common.

The cause of sinusitis can be infection, polyps (growths in the sinuses), or a deviated nasal septum. The disease is most often seen in middle-aged and young people, but can develop in anyone.

Symptoms of chronic sinusitis

Acute sinusitis and chronic sinusitis have many of the same signs and symptoms. But, at the same time, sinusitis is a temporary infection that affects the paranasal sinuses. To diagnose chronic sinusitis, at least two of the following symptoms must be present:

  • Nasal congestion and inability to breathe through the nose;
  • Yellow and greenish discharge from the nose and on the back of the throat;
  • Pain and swelling around the nose, forehead, cheeks;
  • Deterioration of sense of smell.

In addition, some symptoms may be expressed individually:

  • Ear pain;
  • Pain in the teeth and upper jaw;
  • Cough that gets worse at night;
  • Sore throat;
  • Bad breath;
  • Nausea;
  • General fatigue and fatigue.

The symptoms of chronic sinusitis are similar to those of acute sinusitis, but with sinusitis they are more pronounced and last quite a long time. A sign of the disease is not fever, which sometimes occurs with acute sinusitis.

When should you see a doctor?

Before chronic sinusitis begins to develop, a person may experience acute sinusitis several times over a period of 4-5 weeks. To treat the disease, you need to visit an otolaryngologist or allergist.

You need to visit a doctor if:

  • A person has had sinusitis several times, but still cannot cure it;
  • Symptoms of sinusitis lasting more than a week are observed;
  • Symptoms do not go away with proper treatment.

You should contact your doctor immediately if you develop symptoms that may be a sign of infection:

  • Swelling and pain around the eyes;
  • Swollen forehead;
  • Severe headaches;
  • Confusion;
  • Stiff neck;
  • Dyspnea;
  • Minor visual disturbances.

Causes of chronic sinusitis

Chronic sinusitis can develop for the following reasons:

1 Nasal tumors or polyps. Neoplasm tissue will partially or completely block the sinuses and nasal passages;

2 Allergic reaction. Allergic triggers often involve fungal infections affecting the paranasal sinuses;

3 Deviation of the nasal septum. In this case, the sinuses may be completely or partially blocked;

4 Respiratory tract infection. Such infections most often cause a cold, but also cause inflammation and growth of the sinus membrane, creating good conditions for the development of bacteria, blocking the drainage of mucus;

5 Facial injuries. Broken bones or cracks can cause sinus obstruction;

6 Obstruction of the nasal passages is also caused by complications in the gastrointestinal tract, cystic fibrosis, HIV and other immune diseases;

7 Specific allergies (eg hay fever). Inflammations that develop with allergies can block the sinuses;

8 Cells of the immune system. Immune cells (eosinophils) cause inflammation of the sinuses under some conditions.

Risk factors for chronic sinusitis

A person is at increased risk of developing recurrent or chronic sinusitis if he:

1 deviated nasal septum or nasal polyps;

2 High sensitivity to aspirin causing respiratory symptoms;

3 Specific immune system disorders (eg, HIV/AIDS, cystic fibrosis);

4 Obstructive chronic pulmonary disease;

5 Hay fever and other allergic disorders affecting the sinuses;

6 Bronchial asthma (2 out of 10 people suffer from both asthma and chronic sinusitis);

7 Chronic exposure to pollutants (eg, cigarette smoke or chemical fumes).

Complications of chronic sinusitis

Chronic sinusitis causes the following complications:

1 Asthma attacks. The disease quite often provokes an asthmatic attack;

2 Meningitis. An infection that causes inflammation of the membranes and fluid that surround the spinal cord and brain;

3 Vision problems. When the infection spreads to the eye sockets, vision deteriorates (in rare cases, it can lead to blindness);

4 Blood clots or aneurysms. The infection often causes problems in the veins that surround the sinuses, thereby preventing blood flow to the brain, increasing the risk of stroke.

Preparing before going to the doctor for chronic sinusitis

Before visiting a doctor, you need to carefully prepare for a sinus examination. The specialist will most likely examine the throat, nose, ears, and eyes. It is necessary to tell everything about the observed symptoms, even minor ones. The doctor will also need the following information:

  • What symptoms are observed and when did they begin?
  • Possible factors that, in the patient's opinion, worsen or improve symptoms;
  • Does the patient have a cold or other respiratory infection at the time of visiting the doctor? Have you had any similar illnesses during the month?
  • Are you allergic to anything?
  • Does the patient smoke, is exposed to passive smoking, or is constantly exposed to other atmospheric pollutants;
  • What medications does the patient take, incl. biological supplements and herbal medicines;
  • If you have any other health problems.

Preparing answers to these questions will save a lot of time when communicating with a specialist and diagnose the disease faster. When diagnosing chronic sinusitis, the doctor should ask the following questions:

  • What could be the cause of this condition and the symptoms that appear;
  • Are there any other possible causes for this condition and symptoms;
  • Do I need to take any tests?
  • What treatment program is best to follow;
  • What if there are additional factors? Can they be managed to improve the condition?
  • Are there any restrictions that must be strictly followed?
  • Should I contact other specialists?
  • Is there an alternative to the medications that were prescribed?

Don't be afraid to ask your doctor questions.

Tests and diagnosis of chronic sinusitis

To determine the cause of your symptoms, your doctor will likely test your sore throat and nose. To examine the nasal passages more thoroughly, the doctor will use special instruments to hold the nose open during the examination, use medications to narrow the blood vessels in the nasal passages, and use a lamp to better view the nasal passages to look for fluid or inflammation.

A visual examination will help rule out physical conditions that cause sinusitis (polyps and other disorders).

In addition, the doctor can use other methods to correctly diagnose chronic sinusitis:

1 Nasal endoscopy. A flexible, thin tube (endoscope) is inserted through the nose, allowing the specialist to visually examine the inside of the sinuses. The procedure is also often called rhinoscopy;

2 Graphic studies. MRI and CT images can help determine the condition of your nasal passages and sinuses. It will also help in identifying deep inflammation and physical obstructions that are difficult to see with rhinoscopy;

Treatment and medications for chronic sinusitis

The main goals of treatment of chronic sinusitis:

  • Reducing inflammation in the sinuses;
  • Restoring the patency of the nasal passages;
  • Elimination of the cause of chronic sinusitis;
  • Reducing the incidence of sinusitis.

How to relieve the symptoms of chronic sinusitis?

Your doctor may recommend special treatment to relieve the symptoms of sinusitis, which includes:

1 Nasal saline spray, which should be sprayed into the nose 4-5 times a day to flush out the nasal passages.

Antibiotics for chronic sinusitis

Chronic sinusitis is treated with antibiotics when there is a bacterial infection. If chronic sinusitis is caused by any other reasons, then the use of antibiotics will not bring any results.

Antibiotics that are used to treat illness caused by a bacterial infection should include the following drugs: doxycycline, amoxicillin, trimethoprim-sulfamethoxazole. If the infection does not go away or the disease soon develops again, the doctor will prescribe another antibiotic.

When prescribing antibiotics, it is extremely important to complete the entire course of treatment. In most cases, this means that the drugs will have to be taken for a day or more, depending on when the patient’s condition begins to improve. If you stop taking antibiotics after a few days, your symptoms will likely return soon.

Immunotherapy for chronic sinusitis

If the cause of chronic sinusitis is an allergy, then immunotherapy (allergy shots), which helps reduce the body's reaction to allergens, helps treat the disease.

Surgical treatment of chronic sinusitis

If chronic sinusitis continues to develop even after properly prescribed treatment, then endoscopic surgery may be the only effective remedy. For this procedure, doctors use an endoscope (a thin, flexible tube with a light source) to examine the sinuses. After this, special instruments will be used to remove polyps and tissues that may cause nasal congestion. To restore normal patency of the nasal passages, expansion of the sinus opening is also used.

Folk remedies for the treatment of chronic sinusitis

1 Rest helps fight inflammation. With its help, you can significantly speed up recovery after suffering from chronic sinusitis.

2 You need to drink a lot of fluids (juices, water). This helps to dilute mucous secretions, thereby improving the patency of the nasal passages. You should try to avoid drinking drinks that contain caffeine and alcohol because they cause dehydration. Alcohol also worsens swelling of the sinus lining.

3 Moisturize the sinuses. You need to hold the towel over your head while inhaling steam and hot water from the container. You should try to direct the steam onto your face. You can also take a hot shower, while inhaling moist and warm air. This will relieve pain and help in removing mucus.

4 You can apply a warm compress to your face. Place a damp, warm towel around your cheeks, eyes and nose. There will be less pain.

5 Rinse your nasal passages. To rinse the nasal passages with chronic sinusitis, it is recommended to use special devices, for example, a syringe with a spray can. If washing is done independently, at home. First of all, you need to make sure that sterile, distilled, pre-boiled water is used to prepare the solution, which must be pre-cooled and filtered using a filter with pores of 1 micron or less. In addition, be sure to clean the flushing device after each use with sterile and distilled water, leaving it open to dry afterwards.

6 It is recommended to sleep with your head slightly elevated, which will reduce congestion in your sinuses.

Prevention of chronic sinusitis

To reduce the risk of contracting chronic sinusitis, you must take the following steps:

1 No infections should enter the upper respiratory tract. Contact with people with colds should be minimized. Wash your hands often, especially before eating;

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