Chronic sinusitis symptoms and treatment in adults

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Chronic sinusitis - symptoms and treatment in adults

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.

Good to know:

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One comment

Of course, it never came to that. A long time ago, an ENT specialist said to take Morenazal with chamomile if you have a runny nose or a cold, and the runny nose immediately goes away and the inflammation goes away.

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Chronic sinusitis: a death sentence or a way out?

Currently, there is a large percentage of people suffering from sinusitis in the world. According to statistics, the frequency of continuously ongoing inflammation is 146 cases per 1 thousand population. Of these, sinusitis accounts for 65–73%. Unfortunately, modern people do not always pay due attention to the first signs of pathology, as a result of which the acute process takes on a protracted course. Another reason for the continued high incidence of chronic sinusitis is the increase in the number of hay fevers, which are accompanied by increased secretion of mucus from the nose. A person who encounters an allergy for the first time often does not recognize the cause of his painful condition and continues to “endure” seemingly harmless symptoms. Difficult nasal breathing in combination with abundant mucus formation quickly leads to inflammation of the paranasal sinuses, the most vulnerable of which are the maxillary (maxillary) sinuses.

Features of chronic sinusitis

Sinusitis is an inflammation of the mucous membrane of the maxillary sinuses. The chronic process is characterized by a sluggish course with vague symptoms (no increase in temperature and pain in the cheekbones, upper jaw, head, etc.). Its intensification occurs during periods of exacerbation of the disease. Despite the absence of unpleasant manifestations, the mucous membrane lining the sinuses remains constantly inflamed, and any slightest stress on the body (hypothermia, overwork, etc.) will lead to an aggravation of the pathology.

When talking about chronic sinusitis, most often a more general term is meant - polysinusitis. The fact is that a protracted disease of the nasal mucosa and sinuses, as a rule, does not occur locally in one cavity, but spreads to several sinuses.

Along with damage to the maxillary sinuses, the inflammation process can involve the frontal (frontitis), ethmoidal (ethmoiditis), and sphenoid (sphenoiditis) cavities.

Chronic sinusitis most often occurs simultaneously with inflammation of the remaining paranasal sinuses

Main types of pathology

Sinusitis can be unilateral, if inflammation occurs in one of the maxillary sinuses, and bilateral, when both sinuses are affected.

Depending on the route of infection in the maxillary sinuses, the disease is distinguished:

  1. Rhinogenic. An infection caused by bacteria, viruses or fungi enters the mucous membranes of the paranasal sinuses from the nasal cavity during prolonged rhinitis or during breathing.
  2. Hematogenous. If there is even a distant focus of inflammation in organs and tissues, there is a risk that the infection will enter the sinuses through the bloodstream, resulting in the development of sinusitis. Such processes are characterized by a low level of the body's defenses.
  3. Traumatic. Develops after injury. Stagnation of mucus as a result of edema is also a favorable environment for infection. In addition, displacement of the nasal septum causes uneven entry of air into the upper respiratory tract, which leads to injury to the membrane lining them in certain places and, as a consequence, to its growth. Hypertrophy of the mucosa leads to a delay in natural secretions and the creation of favorable conditions for the proliferation of harmful microorganisms.
  4. Odontogenic. Occurs when teeth become inflamed. In this case, the primary source of infection is the roots of the teeth located close to the maxillary sinuses.
  5. Allergic. Appears with the development of edema of the mucous membrane against the background of profuse mucus production due to allergies.
  6. Vasomotor. In some cases, the tone of the vessels lining the inner lining of the sinuses decreases, which leads to swelling of the mucous membrane and difficulty in the outflow of secretions from the sinus. Sometimes this condition occurs during hormonal changes, in particular during pregnancy.

Sinusitis can develop in one of the maxillary sinuses, or in both at once

Based on the nature of changes in the mucous membranes, sinusitis is distinguished:

  1. Exudative. In this case, the presence of nasal discharge is noted. They are divided into 2 types:
    • Catarrhal. The discharge is mucous and transparent, swelling of the inner membranes of the sinuses and nose is noted, and the outflow of secretions is difficult. This course is typical for the acute stage of sinusitis.
    • Purulent. Nasal discharge contains dense purulent clots (discharge may be green, yellow, streaked with blood). Such sinusitis may also be preceded by catarrhal sinusitis, which passes into the next stage when a bacterial infection is attached due to stagnation of mucus, resulting in the creation of a favorable environment for the proliferation of bacteria. This type of pathology most often develops acutely, but sometimes it can also have a chronic course.
  2. Productive. Occurs with impaired nasal breathing. They also have several types:
    • Hyperplastic. It is characterized by thickening of the mucosa as a result of long-term inflammation, which is typical for the chronic stage of the disease. Due to the proliferation of the internal membranes, the entrance openings of the sinuses narrow, nasal breathing remains difficult (and may be completely disrupted) even in the absence of inflammation.
    • Polypous. It is characterized by the proliferation of mucous membranes in the form of polyps, which is characteristic of the chronic course of the disease.
    • Cystic. It occurs when cysts form in the maxillary sinus (usually only one), which are round in shape and filled with fluid. The reasons for their formation may be diseases of the roots of the teeth and blockage of one of the many glands on the mucous membrane. Polyps can also become activators of the growth of cysts in the maxillary sinus. The presence of the formation complicates normal air exchange in the accessory cavity and leads to periodic inflammation.
    • Atrophic. It is characterized by scanty discharge (sometimes with an unpleasant odor) as a result of atrophy of the mucosal glands.
    • Fibrous. It is characterized by the formation of thickenings on the inflamed mucous membranes of the maxillary sinuses, as a result of which the drainage of the sinuses worsens and the removal of mucus and pus becomes more difficult.

Causes and development factors

The development of sinusitis is promoted by many factors, the main of which are:

  • past infections (ARVI, influenza and others);
  • hypothermia;
  • allergy;
  • violation of the tone of the walls of mucous vessels;
  • hormonal disorders;
  • foci of infection in the oral cavity;
  • injuries and anatomical features;
  • unfavorable environmental conditions;
  • severe concomitant diseases;
  • certain medications (especially those used off-label).

In the absence of timely and effective therapy, the inflammatory process is prolonged, as a result of which it can spread deep into the mucous membrane, into bone tissue, other sinuses and the bloodstream, thus becoming chronic, difficult to treat.

Colds can trigger the development of sinusitis

Symptoms and signs of chronic sinusitis

Particular attention should be paid to the fact that in the chronic course of the pathology, pronounced symptoms (runny nose, fever, etc.) may be absent, but the patient is often bothered by the following manifestations of the disease:

  • general intoxication: lethargy, apathy, sleep disturbances, body aches;
  • severe paroxysmal cough;
  • the appearance of crusts in the nose, unpleasant odor from the nose and mouth, deterioration of the sense of smell;
  • constant nasal and ear congestion, heaviness and pressure in the eye area;
  • persistent runny nose;
  • periodic pain in the face, upper jaw, head, neck, temples.

The main symptom of the onset of chronic sinusitis in adults is cough. Most often it occurs at night or in the morning due to the drainage of secretions from the affected sinuses along the back wall of the pharynx and their entry into the middle respiratory tract.

A long-lasting runny nose (or cough) may indicate a chronic process

Features during pregnancy, breastfeeding and childhood

Often sinusitis develops against the background of a decrease in the body's defenses. First of all, pregnant and lactating women, whose support resources are shared between two, fall into the risk category. In addition, during the period of bearing a baby, almost every third representative of the fair sex, under the influence of hormones, develops vasomotor rhinitis (rhinitis of pregnant women), which is a good soil for the development of sinusitis.

Normally, rhinitis in pregnant women goes away within the first hours after birth.

Diagnosis and treatment of sinusitis in a pregnant woman will be very gentle, and therefore less effective, because most procedures are extremely undesirable or prohibited, and medications are selected with extreme caution.

The course of treatment depends on the duration of pregnancy and the degree of neglect of the process. Therapy should be carried out under the strict supervision of a specialist, since incorrect actions can cause significant harm to the baby. In addition, there is a risk of infection of the fetus as a result of infection passing through the placenta.

Sinusitis during pregnancy is dangerous for infecting the fetus

In children, the peak incidence of sinusitis occurs in the autumn-winter period, when immunity decreases. Diagnosis and treatment follow the same scheme as in adults. However, the size of children's paranasal sinuses is much smaller, and their formation ends only by 15–20 years. In this regard, the main location of inflammation is the maxillary sinus and ethmoid cells.

It is worth paying special attention to the features of the anatomical structure of the Eustachian tube in children. In children under three years of age, it is quite wide and short, which requires caution when organizing the position of the head during sleep with a runny nose and when rinsing the nose. It is important to prevent the infection from spreading to the ears and the development of otitis media.

The final formation of the paranasal sinuses occurs at the age of 15–20 years

Diagnosis of the disease

Diagnosis of sinusitis includes:

  1. Examination by an otolaryngologist. This is the main diagnostic method in which the doctor assesses the nature of nasal discharge and swelling of the mucous membrane. However, this does not allow us to say unambiguously whether the paranasal sinuses are involved in the process.
  2. X-ray. An x-ray allows you to see inflammation and pathological contents in the sinuses. The downside is that the sphenoid sinus is poorly visible, and the method itself is associated with exposure to ionizing radiation on the body, which is extremely undesirable, for example, during pregnancy.
  3. Computed tomography (CT). The most informative method of visualizing the contents of all paranasal sinuses, which allows you to obtain many photographic sections. Associated with exposure to x-ray radiation, therefore not used during pregnancy.
  4. Magnetic resonance imaging (MRI). The method is based on the effect of a magnetic field on the body. It also allows you to obtain many photographic sections without the influence of x-ray radiation. Unlike CT scans, MRI images are less clear and not as informative. In addition, MRI is impossible when there are metal objects in the body (implants, stents, pacemakers, etc.), and the duration of the procedure with the requirement not to move makes it unsuitable for studying children. During pregnancy, MRI is more preferable than CT or X-ray, but still undesirable.
  5. Ultrasound examination (ultrasound) of the sinuses. Another method of visualizing the contents of the sinuses using ultrasound (relatively harmless and allowed for pregnant women). It is rarely used, since not all sinuses are visible and it is not always possible to judge the nature of their contents (pus or mucus).
  6. Endoscopic examination. Allows you to assess the condition of the mucous membrane, partially see the contents of the sinuses and the source of inflammation in them. However, this method is less informative than CT, MRI and X-ray.
  7. Biopsy. Allows you to exclude malignant neoplasms, fungal infection or granulomatous diseases.
  8. Laboratory methods. They include a blood test, secretion culture, immunodeficiency test, and sweat test. The use of these diagnostic methods provides a more accurate approach to the choice of therapy.

Diagnosis of sinusitis can combine various methods. Most often, the initial studies are an examination by a specialist and a CT scan, after which a diagnosis is made and treatment begins.

Pregnant and lactating women are recommended to undergo endoscopic examination or MRI diagnostics instead of CT for an accurate diagnosis. In addition to being examined by a specialist, children are given an x-ray, which does not involve standing still for a long time during the examination, like an MRI. This is sufficient to visualize all the most developed sinuses.

Examination by an otorhinolaryngologist is the initial and most important stage in diagnosing sinusitis.

How can pathology be cured?

Treatment of chronic sinusitis requires an integrated approach and a long time. As a rule, elimination of the main cause of the disease and the source of inflammation, as well as a number of preventive measures after the main course of therapy, give a stable positive result.

The main approach to conservative treatment of sinusitis consists of the following components:

  • ensuring air exchange in the sinuses;
  • eliminating the source of infection;
  • physiotherapy;
  • prevention.

Drug therapy

Ensuring proper air exchange and eliminating the source of infection is achieved by using a number of medications:

  1. Vasoconstrictors. They increase the tone of the capillary walls, narrow their lumen, as a result of which the swelling of the mucous membrane subsides and breathing is restored. The main disadvantage is that their use for more than one week is addictive, which can cause the opposite effect - after use it does not get better, sometimes the condition even gets worse. Of these, the most commonly used are nasal sprays or drops based on the following substances:
    • phenylephrine (Vibrocil, Nazol Baby, Nazol Kids), acting for 2 to 4 hours, most suitable for children;
    • xylometazoline (drugs: Otrivin, Galazolin, Xymelin) - lasts up to 8 hours;
    • oxymetazoline (drugs: Nazivin, Nazol, Rinazolin) - lasts up to 10 hours;
    • naphazoline (drugs: Naphthyzin, Sanorin) - acts from 4 to 8 hours;
    • sea ​​water (Marimer, Solin, Physiomer) - has not only a vasoconstrictor effect, but also helps to flush the nasal passages from accumulated mucus.
  2. Hormonal drugs (corticosteroids). Most effective if nasal congestion is caused by an allergic reaction. Among the local drugs used: Avamis, Flixonase, Nasonex, Tafen nasal. Do not be afraid to use them, as they act locally and provide highly effective treatment.
  3. Antiseptics. In addition to the disinfecting effect, they have drying properties. Protargol, Sialor and so on are often used.
  4. Antibiotics. Before using them, it is necessary to determine the pathogen by inoculating the pathological contents of the sinus, but in this case a puncture is required. In addition, the microflora on the mucous membrane of the sinuses and nose is extremely diverse and in laboratory conditions can grow unevenly; for example, Staphylococcus aureus often displaces other pathogens, even if the sinus contents are collected cleanly. In addition, culture results have to wait from 3 to 5 days. Therefore, some specialists select the drug without waiting for them. If the prescribed antibiotic does not lead to an improvement within 2–3 days, then you should consider selecting a different antibacterial agent. Mainly prescribed:
    • Local remedies. They act exclusively at the site of inflammation. These include drugs such as Isofra, Polydex with phenylephrine, Bactroban ointment and others. In addition, you can use broad-spectrum antiseptics to rinse the nasal passages (Miramistin, Chlorhexidine, Furacilin and others).
    • Systemic drugs. Mainly used in complicated cases. The following groups of these funds are most effective:
      • penicillins (most preferred);
      • macrolides (used for allergies to penicillins);
      • cephalosporins (allowed during pregnancy, administered intramuscularly, used when penicillins or macrolides do not work);
      • fluoroquinolones (a synthetic substance that has not yet caused addiction in most modern bacteria);
      • aminoglycosides (used if others do not work).
  5. Herbal medicines. Made from medicinal plants with the addition of chemical components. They gently relieve inflammation, promote the removal of mucus, restore mucous membranes and normalize breathing (Pinosol, Sinupret, and so on).
  6. Mucolytics. They contain plant components. These agents help to liquefy thick secretions and remove them from the sinus cavity (Mukaltin, Acetal S and others).

The most commonly used medications - photo gallery

Physiotherapeutic methods

Physiotherapy is aimed at activating metabolic processes in the lesion and deeper action of medications. Each method requires on average 10 to 15 sessions, performed every other day or daily. Most of them are prohibited during pregnancy, except for inhalation using a nebulizer. Most often doctors prescribe:

  • Ultrasonic exposure. Promotes massage, warming and blood flow to the epithelial tissues, thus stimulating metabolic processes in them and increasing the production of beneficial enzymes.
  • Inhalations with medications. They help thin thick secretions (mucolytics), relieve swelling, and eliminate inflammation (antibiotics). Spraying medications into small particles and directing them into the affected area is more effective than using them in the form of drops, ointments and sprays.
  • Electrophoresis. Medicines enter the problem area in the form of active ions. This helps improve blood supply to the sinuses and warm them up.
  • Phonophoresis. It combines the supply of medication and the effects of ultrasound, resulting in a deeper, targeted effect of the drug in combination with warming, improving metabolic processes and increasing blood flow.
  • UHF and microwave (electromagnetic therapy). Ultrashort and ultra-frequency electromagnetic waves cause instant expansion of capillaries in the tissues of the sinuses, resulting in increased blood flow with good fluid outflow. The procedure increases vascular permeability, enhances metabolism, accelerates the removal of metabolic products, and resolves swelling. UHF acts mainly on surface structures, and microwaves have an effect at a depth of 4–6 cm.
  • Mud therapy. Pies are made from medicinal mud, rich in minerals, and applied to the area of ​​the maxillary sinuses. A thermal effect is created that promotes deep penetration of its medicinal components, eliminating inflammation and liquefying thick mucus in the sinuses.
  • Diadynamic pulse currents. This procedure allows you to eliminate pain without the use of analgesics.

Inhalations help to liquefy thick secretions and penetrate medicinal substances into the mucous membrane

Preventive diet

A special diet for the treatment of sinusitis has not yet been invented, however, there are a number of general recommendations that will allow you to quickly cope with the infection:

  • drinking plenty of warm water to dilute and remove pathological secretions;
  • eating alkaline foods such as whole milk, greens, bananas, spinach;
  • introducing into the diet foods rich in vitamin A, a “builder” of the mucous membranes of the nasopharynx (egg yolk, yogurt, pumpkin, carrots, tomatoes, carrot and beet juice, cucumbers, spinach);
  • consumption of garlic and horseradish root, which help relieve inflammation and thin the secretions of the sinuses;
  • drinking mineral water, which will help replenish minerals;
  • limiting the consumption of salt, which retains moisture and contributes to the preservation of swelling;
  • reducing the consumption of fried, sweet, flour, fatty, marinades, alcohol - these products help slow down metabolism, reduce the body's immune defense, and help lower blood pH (acidification).

Drinking plenty of fluids helps thin out thick mucus accumulated in the sinuses.

Operation

When conservative therapy methods do not help, or the cause of sinusitis is a foreign object entering the sinus, it is advisable to use the most radical and effective approach to treatment - surgical intervention. Modern techniques make it not only painless, but also minimize contraindications and the development of complications. In some cases, surgery causes less damage to the body than medication. For example, during pregnancy, long-term use of vasoconstrictor drugs and antibiotics is extremely undesirable, while non-puncture methods or even a puncture imply only a single local anesthesia and the injection of antiseptic solutions into the sinus.

The main types of surgical treatment of sinusitis are:

  1. Puncture, or puncture of the nose. This is a therapeutic and diagnostic procedure, during which you can take the contents of the paranasal sinus for examination, determine the causative agent of the disease and its sensitivity to antibiotics. The operation is performed both under local anesthesia and general anesthesia, depending on the general condition of the patient.
  2. Balloon sinuplasty. It is a new, low-traumatic method in which a flexible catheter is inserted into the maxillary sinus through the natural nasal passages and strengthened there by inflating the cuff, thereby expanding the area of ​​the anastomosis. The sinus is then flushed with a medicinal solution, resulting in the removal of its contents.
  3. Yamik sinus catheter. Also a non-puncture method of aspiration of the contents of all paranasal sinuses by creating negative pressure in them. The sinus catheter consists of three tubes, two of which are equipped with cuffs. By swelling, they delimit the area where the anastomosis exits into the nasal cavity from its communication with the pharynx and the entrance to the nose. Then a vacuum is created in the resulting small space, which facilitates the evacuation of the accumulated purulent secretion from the maxillary cavity.
  4. Endoscopic surgery. It is carried out through an endoscope, which is a fiber optic tube equipped with channels through which additional instruments can be inserted. A special feature of the operation is visual control with good lighting of the nasal cavity.
  5. Laser treatment. It is also carried out using an endoscope, but the main working tool here is a laser. Its radiation is absorbed by the cells of the mucosa and leads to a microburn of its surface, thereby relieving swelling, accelerating metabolic processes, increasing local immunity and increasing blood flow.
  6. Caldwell-Luke operation. The most radical surgical intervention, which is used when all less traumatic methods fail. The operation is performed under general anesthesia and involves cleaning the cavity from pathological contents and removing altered areas of the mucosa through the hole under the upper lip.

Puncture is most often used for sinusitis in outpatient practice

Traditional methods

Traditional recipes can be combined with traditional treatment methods or used to prevent relapses. Widely used:

  1. Hot soda inhalations. You should pour 2 tbsp into a glass. l. soda, which needs to be poured with half a glass of boiling water. It is necessary to breathe the fumes. Baking soda helps thin out thick sinus secretions and relieves swelling.
  2. Instillation of beet juice. To prepare it you need to mix 1 tsp. beet juice and 1 tsp. olive oil. It is necessary to instill 3 drops into each nasal passage in the morning. Beetroot juice has an anti-inflammatory effect.

There are cases when, after unsuccessful traditional therapy, chronic sinusitis was treated with beetroot juice and massage, which led to complete recovery within 3–4 months.

Remedies for the treatment of sinusitis at home - photo gallery

Homeopathy

Despite many disputes about the effectiveness of homeopathic medicines, many doctors still prescribe remedies from this group. They gently relieve the inflammatory process, stimulate local immune defense, dilute the viscous pathological secretion accumulated in the cavities and improve its removal from the paranasal sinuses. Such medications are used both internally and locally (they exist in the form of tablets, nasal drops and sprays). The most commonly used drugs are Cinnabsin, Euphorbium compositum Nazentropfen S and Delufen.

Homeopathy for sinusitis - photo gallery

Treatment prognosis and possible complications

The sooner treatment for acute sinusitis or its chronic stage begins, the more favorable the prognosis. Even in advanced cases, a combination of conservative and radical treatment methods allows you to achieve a sustainable positive result (recovery).

If complex therapy is absent for a long time, then the risk of complications is high, namely:

  • orbital abscess;
  • meningitis;
  • acute otitis;
  • sepsis (blood poisoning);
  • bronchitis and pneumonia.

To prevent relapse and serious consequences of the chronic process, immediately after treatment, a long recovery with many preventive procedures is required.

Orbital abscess is one of the dangerous complications of sinusitis

Prevention of chronic sinusitis and the development of exacerbations

Preventive measures include:

  • timely elimination of viral infections (use of oxolinic ointment during disease outbreaks, drugs containing interferons at an early stage of infection);
  • rinsing with saline solutions before going to bed (at the first sensation of discomfort in the nose, you should increase the frequency of the procedure or have a deeper cleansing of the sinuses - “cuckoo” - by an otolaryngologist);
  • active lifestyle;
  • frequent exposure to fresh air;
  • healthy eating.

Video about the disease

Coping with such a serious disease as chronic sinusitis is difficult, but possible. It is important to visit a doctor on time, act comprehensively and not be afraid of radical measures if conservative treatment is ineffective.

  • Author: Maria Putyrskaya
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Chronic sinusitis - symptoms, complications, how to cure it in adults

Chronic sinusitis is a long-term inflammatory process of the maxillary sinus, which, depending on the form and stage, manifests itself in a varied clinical picture. Statistics show that the proportion of chronic sinusitis in adults among all nasal pathologies reaches 50%. It is diagnosed equally often in both men and women in all age categories. In Russia, there are 12 cases of the disease per 100 inhabitants. In Europe, this figure is half as much – 6 people out of 100 get sick.

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

The main causes of the chronic form

Inflammation of the maxillary sinus occurs due to the impact of infection or allergen on the mucous membrane. If the disease is not completely cured and is protracted, then sinusitis becomes chronic. In adults, it is most often caused by a bacterial infection; the cause of the disease is infection with Streptococcus pneumonia, Haemophilus influenza. The cause of sinusitis can be viruses, anaerobic bacteria, yeast-like, mold fungi.

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.

Key risk factors causing chronic disease:

  • Previously suffered an acute form of sinusitis that was not treated;
  • persistent infections of the nasopharyngeal region - tonsillitis, rhinitis, etc.;
  • a disease or deficiency that interferes with the outflow of mucus, for example, a deviated nasal septum;
  • cysts, polyps in the maxillary sinus;
  • diseases of the upper teeth;
  • interventions in the upper jaw;
  • bad habits – smoking, alcohol abuse;
  • tendency to allergic reactions.

The main forms of chronic sinusitis are:

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.

Regardless of what caused the development of the disease and whatever subtype it belongs to, chronic sinusitis can be either unilateral or affect both sinuses.

Symptoms of chronic sinusitis

Chronic sinusitis in adults can last for years, worsening when the patient’s immunity decreases or unfavorable external conditions. Exacerbation of the chronic form occurs in exactly the same way as acute sinusitis. The patient is concerned about the following symptoms:

  • headache;
  • nasal discharge;
  • temperature increase;
  • sinus pain and nasal congestion;
  • violation of nasal breathing;
  • purulent discharge from the nose is yellow or greenish in color, with an unpleasant odor.

Chronic sinusitis occurs in waves: remission is replaced by exacerbation. An exacerbation is accompanied by a more pronounced manifestation of symptoms:

  • The temperature rises to 37.5 o C;
  • the patient feels chills and general malaise;
  • sneezing appears;
  • the pain becomes more pronounced, especially when a person tilts his head, coughs and sneezes, it radiates to the teeth and the root of the nose.

Provokes exacerbation: hypothermia, high humidity, colds, allergic reaction, runny nose, flu.

Sinusitis is considered chronic if its duration exceeds 6–8 months.

During the period of remission (the period of absence of symptoms of the disease), various symptoms may be observed, less pronounced, inconsistent:

  • nasal congestion;
  • constant runny nose that cannot be treated, periodic purulent discharge;
  • mucus flowing down the back wall of the throat (a feeling that mucus is flowing from the nasopharynx, a constant desire to swallow, sometimes there is a feeling of a lump of mucus in the throat that cannot be swallowed);
  • headaches, mainly in the orbital area. The pain becomes more intense when blinking, and goes away when lying down;
  • heaviness in the face, cheeks, feeling of pressure, fullness;
  • a characteristic symptom is swelling of the eyelids in the morning;
  • conjunctivitis (inflammation of the mucous membrane of the eye, accompanied by tearing, sensation of a foreign body in the eyes);
  • nasality;
  • due to impaired nasal breathing, the patient’s sense of smell significantly deteriorates;
  • lacrimation.

The nature of nasal discharge also depends on the form of the inflammatory process and the degree of damage to the maxillary sinuses. Chronic 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.

In addition to specific complaints, patients are concerned about unmotivated weakness, disordered sleep and wakefulness, decreased performance, and irritability.

Possible complications and health consequences

It should be understood that any form of sinusitis, and, in particular, purulent one, can cause quite serious complications. This is due to the location of the infection, and the close proximity of the maxillary sinuses to the brain. That is why competent and qualified treatment of the disease is necessary, both during exacerbation and during remission.

Chronic sinusitis can have the following complications:

  • inflammation of the membranes of the brain;
  • brain abscess;
  • purulent inflammation of the soft tissues of the orbit;
  • sepsis.

Diagnostics

First of all, the doctor collects anamnesis, specifying the patient’s symptoms, duration of the disease and previous treatment regimen. Then proceeds to external examination, palpation of the sinus and anterior rhinoscopy.

The main method for diagnosing chronic sinusitis is fluoroscopic examination. An x-ray allows you to confirm the inflammatory process in the sinus and detect cysts and polyps in the maxillary cavity. Accurate data on the degree of pathology can be obtained using computed tomography.

You need to visit a doctor if:

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

To eliminate the risk of complications and progression of ENT diseases into a chronic form, it is important to diagnose them in a timely manner.

Treatment of chronic sinusitis in adults

Chronic sinusitis is a long-term inflammatory process of the maxillary sinus, which, depending on the form and stage, manifests itself in a varied clinical picture. The danger is that in the absence of treatment and erased signs, the disease causes constant intoxication of the body.

Conservative treatment includes a wide range of measures. They are carried out both during exacerbation and during remission.

The key principles for the treatment of chronic forms of sinusitis are:

  • The choice of antibiotic is strictly taking into account the sensitivity of the pathogen;
  • Exacerbation of sinusitis is treated in the same way as the acute form;
  • In adults, treatment of chronic sinusitis in remission is carried out conservatively (sinus lavage, physiotherapy, mucolytics, antihistamines and restorative therapy);
  • If necessary, corrective operations are performed to restore sinus aeration and normal nasal breathing: septoplasty, removal of adenoids, conchotomy, polypotomy, etc.;
  • In the absence of a positive effect from conservative therapy and the development of complications, chronic sinusitis is subject to full surgical treatment.

Antibiotics for chronic sinusitis

Antibiotics for chronic sinusitis are used in cases of prolonged, incessant runny nose, fever, fever, general malaise and pain in various parts of the face, which can be permanent or appear sporadically. In such cases, the treatment of the chronic form requires a special approach, depending on the specific symptoms of the disease.

Doctors generally prescribe the following antibiotics to patients:

The best results are achieved when using new generation antibacterial agents - Augmetin, 3rd generation Cephalosproin, Azithromycin, Bioparox, etc.

Systemic antibiotic therapy is necessary for moderate and severe forms, as well as when establishing the streptococcal nature of the inflammatory process. The course of treatment is strictly individual in each specific case.

Vasoconstrictor drops

For chronic sinusitis, adults are prescribed mild vasoconstrictor drops - naphazoline, oxymetazoline. They do not dry out the mucous membranes, they can be used for a week, like other medications, under the supervision of a doctor.

  • Vasoconstrictors - Xylometazoline, Galazolin, Rinonorm, Ximelin, Rinorus, Rinotaiss, Tizin.
  • Drops with antibiotics - “Isofra”, “Polydex”, “Sofradex”, “Garazon”, “Vibrocil”.

Physiotherapy

In case of exacerbation, physiotherapy methods are aimed at stabilizing the patient’s condition, in case of remission - at stopping (suppressing) the syndrome. Physiotherapy is prescribed when the contents of the maxillary sinus are freely separated.

  • Sollux – light therapy procedure;
  • diathermy - a method of electrotherapy;
  • ultra-high frequency currents;
  • inhalation.

Sinus rinsing

Nasal rinsing can be done either independently or in the otolaryngologist's office. This depends on the severity of the disease. To achieve this goal, both antiseptics and saline solutions are used.

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.

Proetz flushing, popularly called “cuckoo”, involves the movement of liquid under the influence of vacuum. Using a catheter, an antiseptic solution is poured into one nostril, and the liquid with pus is drained from the other nostril using an electric suction.

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.

Puncture of the maxillary sinus

The puncture for chronic sinusitis is done under local anesthesia. Lidocaine is used for this. They moisten tampons and insert them deeply into the nasal passage. The puncture is made with a very sharp needle after freezing. The patient does not feel any pain.

If you don’t start the disease, you can get by with just one puncture, and there are many examples of this. And if you come to the doctor at the earliest stage of sinusitis, treatment may well be limited to prescribing medications and rinsing the nose.

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.

In uncomplicated chronic sinusitis, the prognosis depends on the individual characteristics of the body and the viability of the immune response; generally favorable. The prognosis worsens when complications arise and there is no effect from conservative therapy.

How to cure chronic sinusitis with folk remedies?

According to statistics, comprehensive treatment promotes a speedy recovery. Simultaneous use of medications and the use of folk recipes will help get rid of chronic sinusitis in less time.

You should know that without first consulting a doctor, traditional recipes are not only useless, but also dangerous to health!

  1. Cyclamen root. It contains saponins - substances that cause increased mucus secretion, as a result of which tissue swelling disappears. To prepare drops with cyclamen juice, the root of the plant is grated and squeezed through cheesecloth. The resulting liquid is diluted with a solution of furatsilin 1 to 4 and one drop is instilled into the nostril on the side of which inflammation is observed. The procedure is repeated three times a day for a week. Contraindications are pregnancy and lactation.
  2. Honey dam. This beekeeping product is extremely effective against bacterial and inflammatory diseases of the nasopharynx. And using it is as easy as shelling pears – you just need to chew one tablespoon of zabrus six times a day. Tasty and healthy!
  3. To relieve swelling at home, you can use decoctions of St. John's wort, propolis, Kalanchoe, eucalyptus drops and other medicinal plants.
  4. For this method of treatment, it is advisable to choose wild chestnut. It should be soaked for several hours and, when it becomes soft, peeled. You need to scrape off the shavings from the white kernel and carefully insert them into both nostrils. You can also make small candles from chestnuts and insert them into the nose as turundas. Chestnut should be used within a week.
  5. Rinsing the maxillary sinus is an integral step in the treatment of chronic sinusitis at home. Sea salt is best suited for rinsing, as it makes the water softer. Sea salt also provides an antiseptic effect, which is especially valuable at the early stage of development of the disease. In order to properly carry out the washing procedure, it is necessary to prepare a solution of sea salt. It is recommended to add one teaspoon of sea salt to two glasses of warm water (approximately a degree).
  6. Thuja oil copes well with many ailments, including sinusitis. It is made from the cones and needles themselves. This remedy has an excellent antibacterial effect, is a good preventive measure against infectious diseases, and strengthens the immune system.
  7. Sea buckthorn oil or rosehip oil will soothe the mucous membrane if you drop 2 drops into each nostril up to three times a day.

Prevention

Prevention of chronic sinusitis for adults comes down to the following measures:

  • 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.
  • Treat colds under medical supervision. Carry out the therapeutic course to completion. If it is said that you need to take antibiotics for 2 weeks, then you cannot stop taking them, even if you feel significant relief on the 3rd day.
  • Use a humidifier. If the air in your home is quite dry, then there is a certain risk of sinusitis. Therefore, it is recommended to use a humidifier. Remember to clean the appliance regularly to remove accumulated dirt and mold.

The best way to prevent is to prevent colds. This requires timely detection and proper treatment of ARVI and influenza.

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