Parietal thickening of the maxillary sinus mucosa: how to treat

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Parietal thickening of the mucous membrane of the maxillary sinus, what is it?

Many patients who came to see an ENT doctor, after the examination, hear that they have been diagnosed with thickening of the mucous membrane of the maxillary sinus.

Table of contents:

This situation is very common and requires increased attention, because it can indicate a serious pathology. Why this happens, what the symptom indicates, and how disorders in the maxillary sinus can be eliminated - it is not possible to deal with these questions on your own.

General information

All paranasal sinuses are covered with mucous membrane. It is a columnar epithelium with cilia, goblet cells and mucous glands, which is fairly well supplied with blood. The main function of this layer is to cleanse the sinuses and warm the air in them. The mucous membrane of the maxillary sinus can be determined by the results of an x-ray examination. And if previously a thickness of less than 5 mm was considered the norm, now they say that the healthy epithelial lining is not visible at all - only the smooth contour of the bone walls.

Causes and mechanisms

If the mucous membrane thickens, it means pathological processes are occurring in it. They are manifested by edema, increased vascular permeability, infiltration and increased division of cellular elements. Therefore, the mechanism of violations can be different:

  • Inflammation (sinusitis).
  • Tissue hypertrophy.
  • Allergic reaction.
  • Neurovegetative disorders.

The infection enters the sinuses from the nasal cavity, and its further development is facilitated by a violation of the outflow of physiological secretions. The mucus stagnates and becomes a favorable environment for the proliferation of microbes. But parietal swelling of the mucous membrane can occur not only with sinusitis, but as a result of acute respiratory viral infection or another cold, persisting even during the recovery period. And additional factors are:

  • Smoking.
  • Dry and polluted air.
  • Injuries and nasal polyps.
  • Deviation of the nasal septum.

Allergic reactions, like inflammation, are accompanied by swelling. But it has a different origin. An increase in vascular permeability is initiated by allergy mediators (histamine, serotonin). The latter are secreted by mast cells in response to the binding of the allergen to immunoglobulins E absorbed on their surface.

A reaction with swelling of the mucous membrane can also occur with neurovegetative disorders. A decrease in vascular tone leads to expansion of the corpora cavernosa and thickening of the walls of the sinuses. This is facilitated by hormonal disorders and long-term use of nasal decongestants. And hyperplasia of the mucous membrane of the maxillary sinuses is a sign of a chronic process when long-term cellular infiltration develops into tissue disorders akin to tumors.

The mucous membrane of the maxillary sinuses can thicken for various reasons. But to establish the source of the pathology, diagnosis is necessary.

Symptoms

The clinical picture of the condition in question is variable. With slight thickening, there may be no symptoms. But even swelling of about 3 mm in the area of ​​the sinus openings can lead to a deterioration in aeration and outflow of secretions. And with more pronounced changes, the symptoms will become obvious:

  • Difficulty in nasal breathing.
  • Nasal discharge.
  • Sneezing.
  • Decreased sense of smell.
  • Feeling of pressure in the sinus area.

Acute sinusitis in case of untimely diagnosis transforms into a chronic inflammatory process (including hypertrophic). In addition to the above symptoms, it is characterized by a feeling of heaviness in the projection of the maxillary sinuses and periodic headaches. Due to impaired nasal breathing, the mucous membrane of the oropharynx dries out, sometimes the ears become blocked, sleep is disturbed and work capacity is reduced. And during periods of exacerbation, the temperature rises, malaise and weakness occur.

Atopic rhinitis is accompanied by profuse rhinorrhea, paroxysmal sneezing, itching in the nose and lacrimation. Such patients are likely to develop concomitant diseases (conjunctivitis, dermatitis, bronchial asthma). Neurovegetative runny nose has similar symptoms, but it is not associated with allergens. If the examination was carried out during the recovery period from ARVI, then among the probable signs there may be only minor nasal discharge and coughing.

Additional diagnostics

The thickening of the mucous membrane of the maxillary sinuses itself is determined using conventional radiography or computed tomography. But these studies are not enough to establish the reasons. Patients are prescribed additional diagnostic procedures:

  • General blood analysis.
  • Analysis of nasal discharge.
  • Allergy tests.
  • Rhinoscopy.
  • Sinus endoscopy.
  • Biopsy with histology.
  • Puncture of the paranasal sinuses.

Based on the results obtained, it is possible to form a complete picture of what is happening. And having made a diagnosis, you can proceed to the next stage of medical care - treatment.

X-ray methods alone do not allow us to determine the cause of mucosal thickening. To do this, it is necessary to expand the list of diagnostic measures.

Treatment

Consolidation of the sinus mucosa is, in fact, one of the morphological manifestations of the pathological process. And its cause should be treated. For sinusitis, medications come first:

  • Vasoconstrictors (Otrivin, Nazivin, Noxprey).
  • Antiseptics (Chlorophyllipt, Dimexide, furacillin).
  • Antibiotics (Augmentin, Xefocam, Sumamed).

The drugs are prescribed in forms for local (drops and sprays, rinsing solutions) and systemic use (tablets, injections). But any medications should be taken only on the recommendation of a doctor to avoid negative consequences, including drug-induced rhinitis. For atopic rhinitis, antihistamines (Allergodil, Tavegil) and topical corticosteroids (Flixonase, Nasonex) are required. In this same situation, it is extremely important to completely eliminate contact with the causative allergens.

Inflammation in the maxillary sinuses can be treated by washing with a YAMIK catheter and physiotherapy (UHF, EF, laser therapy). If the effect of conservative measures is not enough, then a puncture is performed for sinusitis, evacuating pus from the affected sinuses and washing them. And the hypertrophic process requires surgical manipulation - endoscopic or radical sanitation (according to Caldwell-Luc).

When the results of the initial examination reveal that the mucous membrane of the sinuses is thickened, it is necessary to first understand the cause of the changes. This process can be observed in inflammatory and hypertrophic disorders, allergic and neurovegetative disorders. And only after the patient undergoes additional diagnostics will it become clear what he is dealing with and how to cure the disease.

Source: http://elaxsir.ru/simptomy/drugie/utolshhenie-slizistoj-gajmorovoj-pazuxi.html

Symptoms of parietal sinusitis and its treatment

Parietal sinusitis, which must be treated without fail, is one of the localized symptoms of chronic runny nose. In addition to it, sinusitis is also divided into unilateral and bilateral.

Localization and extent of the disease

The disease itself is associated with excessive accumulation of bacterial mucus in the paranasal (maxillary) sinuses, the outflow of which occurs with great difficulty against the background of sinusitis. During infection of the human body with viral infections, a large accumulation of bacteria is possible in the sinuses, which communicate with the cavities of the nose and throat. There, an environment favorable for reproduction is created for viruses, since the maxillary sinuses reach a minimum size: from 1 to 3 mm.

In this regard, sinusitis is considered to be too insidious a disease. Originating in the paranasal sinuses, it may not immediately become aggravated, and its initial stages are often confused with other colds, the symptoms of which are sometimes not paid due attention. Therefore, sinusitis often manifests itself in full some time after the main symptoms of the viral disease have passed. The stages of disease and inflammation of the maxillary sinuses are as follows:

  • initial, in which similar symptoms are observed with the ARVI group;
  • acute - the presence of pain and deterioration in well-being;
  • chronic sinusitis - the degree of neglected treatment with long periods of runny nose and imaginary recoveries.

Unilateral sinusitis develops only in one part of the nose or sinuses - left or right, hence the name: right-sided or left-sided. In this case, one part may be completely free from the disease. If both parts of the wings of the nose and sinuses are affected by complications, then bilateral sinusitis is diagnosed. In this case, symptoms of complications will appear throughout the nose.

Parietal sinusitis develops when the mucous surface of the nasal walls swells, which provokes breathing complications, but a profuse runny nose may not be observed at all. Parietal swelling of the mucous membrane is not associated with the accumulation of bacterial mucus in the appendages of the forehead and nose.

Causes

Inflammation of the mucous walls and accumulation of runny nose in the sinuses cause various infections. The most common ones are:

However, you should never discount complications after colds and their chronic stages:

  • untreated colds, especially in children;
  • allergic rhinitis;
  • chronic tonsillitis and pharyngitis;
  • measles and scarlet fever;
  • inflammatory process in the roots of teeth located near the sinuses;
  • narrow nasal passages;
  • deviated nasal septum;
  • noticeable pressure drop during frequent flights or diving.

It should be noted that the development of sinusitis can be provoked not only by the factors and diseases described above, but also by weakened immunity in general. Usually in the off-season, with vitamin deficiency and loss of strength, the body may not be able to cope with a common cold on its own. And as a result, experience for yourself to the fullest extent what sinusitis is.

What to look out for: Symptoms

Characteristic manifestations of an insidious maxillary exacerbation of a runny nose and nasal congestion include:

  • heavy discharge of snot and mucus from the nose;
  • runny nose with bloody streaks;
  • pain in the frontal part of the head;
  • state of heaviness and general headache;
  • pain on the nose and bridge of the nose;
  • periodic increase in temperature;
  • difficulty breathing, particularly through the nose;
  • pain behind the eyeballs;
  • deepened voice;
  • sleep disturbance.

Very often, the symptoms of sinusitis lead to general fatigue of the body, frequent overwork, decreased performance and blues. The chronic stage of sinusitis can even provoke the development of conjunctivitis, chronic cough and runny nose, and constant migraines. Advanced stages of the inflammatory process of the nasal mucosa and complete blockage of mucus in the paranasal sinuses can lead to arbitrary infection in the brain and the development of meningitis, which is especially fraught for the child’s body.

Treatment of sinusitis is carried out under the supervision of an ENT doctor. Depending on the location and degree of development, the necessary courses of taking medications and undergoing physiotherapeutic procedures are prescribed. Surgical intervention is possible only in the case of a long-term lack of effect from therapy and in the case of polyp growth against the background of exacerbation of sinusitis.

When diagnosing, the patient is prescribed an X-ray examination of the nasal sinuses (in other cases, tomography) and tests. Using a fiber optic device in the ENT office, the doctor examines the condition of the nasal mucosa.

Treatment is carried out with medications that can relieve the exacerbation caused by the pathogen and provide further treatment for the entire sinusitis.

In the case of parietal sinusitis, treatment can also be carried out with nasal medications, which relieve swelling of the mucous membrane and make it easier to breathe through the nose.

Nasal rinsing with flexible hoses is still relevant in the treatment of maxillary sinuses. It is recommended for all stages of the disease, except for the period of exacerbation. Within several procedures, the patient is completely relieved of ailments. Physiotherapy procedures are prescribed if there are no contraindications to them and there is an acute form of sinusitis. Physiotherapy in the treatment of persistent runny nose is ideal both for its prevention and for the restoration of the body.

Among other things, modern medicine makes it possible to enhance the effect of drug therapy using laser therapy. Treatment of sinusitis using similar methods can last from 2 weeks to 2 months. Everything will depend on the severity of the disease.

It is worth remembering that the risk of developing sinusitis is directly related to the lack of treatment for the first signs of viral and cold infections during hypothermia, colds and flu.

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Chronic course of parietal sinusitis

Inflammation of the maxillary sinuses is medically called sinusitis. This disease has long been described in detail by researchers, its symptoms are reliably known and treatment has been developed. Usually, the most unpleasant sensations for a person are caused by an acute form of pathology, which causes severe pain, nasal discharge, congestion and swelling. However, chronic sinusitis is more dangerous for the body, because with this type of disease the development of purulent processes and destruction of bone walls is possible. But parietal sinusitis, although it belongs to the chronic type of course, does not threaten such serious consequences, which, however, does not mean that it is not necessary to treat it.

Features of the disease

The paranasal sinuses (sinuses) look like small caves that communicate with the cavities of the nose and pharynx. The maxillary sinuses themselves are quite large, but their outlet openings (ostia) are narrow. Therefore, during inflammation against the background of the penetration of viruses and bacteria, the anastomosis is the first to swell and can completely clog the sinus, disrupting its gas exchange and fluid drainage. For infection, such conditions are the most favorable for active reproduction, so a person experiences all the signs of acute sinusitis.

Treatment of acute sinusitis may be ignored by the patient, or his request for help may be late, which often happens to those who try to cure the pathology without the help of conservative means. As a result, sinusitis becomes chronic, and permanent swelling forms in the area of ​​the sinus walls or both sinuses—parietal sinusitis develops.

In general, swelling of the sinus walls can often be detected even in healthy people, and in this case it is not accompanied by any pathological symptoms and is insignificant in size. Parietal edema due to the occurrence of chronic sinusitis causes a significant thickening of the mucous membrane of the sinus, in which it constantly maintains low-grade inflammation, although there is no difficulty in the outflow of fluid, and there is no pus in the paranasal sinuses. In fact, parietal sinusitis is a catarrhal form of the disease that has undergone chronicity.

Causes of parietal sinusitis

Sinusitis is an infectious disease. If its acute form in the overwhelming majority of cases is initially caused by a viral infection, then the chronic form is supported by the existence of bacterial particles in the maxillary sinuses. The causative agents of this type of sinusitis are microbes that live for a long time in the nose, nasopharynx or other foci of infection of the ENT organs:

  • streptococci;
  • hemophilus influenzae;
  • Staphylococcus aureus;
  • chlamydia;
  • mycoplasma, etc.

As already noted, the main reason for the transition of the disease to the chronic stage is inadequate therapy for the acute form of sinusitis.

In addition, parietal sinusitis can occur with recurrent pathologies of the upper respiratory tract, against the background of chronic tonsillitis, adenoiditis, pharyngitis, and rhinitis. Often, after the first episode of sinusitis, it becomes chronic if a severe infection has been suffered that has greatly weakened the local immunity - measles, scarlet fever, influenza. Provoking factors contributing to the development of the disease may be:

  • allergic pathologies;
  • vasomotor rhinitis;
  • narrowness of the nasal passages;
  • deviated nasal septum;
  • nasal polyps;
  • hyperplastic rhinitis;
  • vitamin deficiencies;
  • immunodeficiencies;
  • taking immunosuppressive drugs;
  • dental diseases;
  • bathotrauma, aerotrauma of the sinuses.

Typically, parietal sinusitis begins to develop in the cold season, when a person’s diet includes fewer vitamins and minerals, the body loses high immune defense against the background of frequent ARVI and hypothermia. The first symptoms of the disease most often appear after another rhinitis, when a person already considers himself recovered. In children under 7 years of age, inflammation of the maxillary sinuses is not a common occurrence, and after this age, overgrown adenoid vegetations can provoke parietal sinusitis as a source of latent infection.

Symptoms of sinusitis

Parietal sinusitis can be unilateral or bilateral. The presence of edema and inflammation in the left sinus means the development of left-sided sinusitis; with swelling in the right maxillary sinus, a diagnosis of right-sided sinusitis is made. The clinical picture of the disease in its localization largely depends on which side the inflammatory phenomena are located on. Parietal sinusitis is not accompanied by the appearance of pus and complete blockage of the paranasal maxillary sinus, so the intensity of the symptoms will not be too pronounced. The main signs of pathology are as follows:

  • nasal congestion on one or both sides, usually alternating, not constant;
  • periodic pain in the area of ​​the wings of the nose, bridge of the nose, temple
  • jaws;
  • headache, pain in the eyebrow area;
  • coughing against the background of mucus running down the back of the throat;
  • periodic nasal discharge of a cloudy white color, initially liquid, but with prolonged persistence - thick, viscous;
  • slight swelling of the cheeks and eyelids (usually in advanced stages of the disease);
  • fatigue, impaired performance (these symptoms are not typical for all cases of pathology).

It should be remembered that severe hypothermia or a newly suffered severe infectious disease can cause an exacerbation of parietal sinusitis, and the acute form of the disease usually proceeds according to the “traditional” type, with swelling of the sinus anastomosis and the development of purulent processes, nasal congestion and complete disruption of nasal breathing. Experts note that parietal sinusitis itself poses virtually no danger to the body, but its transition to chronic purulent sinusitis is much more serious and can threaten unpleasant consequences.

Find out more about sinusitis and its treatment.

Diagnosis and treatment methods

For diagnosis, the otolaryngologist performs rhinoscopy, during which he notes mild hyperemia of the nasal mucosa, often its swelling, patchy pallor, and thinning of blood vessels. In the absence of purulent discharge in the form of strands in the nasal cavity, but in the presence of symptoms characteristic of chronic sinusitis, radiography of the paranasal sinuses in two projections is required. Since it is sometimes difficult to distinguish the initial stage of sinus polyposis and parietal edema on an x-ray, it is preferable to carry out a more accurate examination, which is a multi-slice spiral MRI of the paranasal sinuses.

Treatment should be aimed at reducing swelling of the mucous membrane of the maxillary sinuses, as well as restoring natural drainage and air exchange. Parietal sinusitis without complications, as a rule, is well treated with conservative methods. Surgery - puncture or maxillary sinusotomy - is not indicated for this type of disease. Only a doctor should prescribe methods of therapy, because they may include taking antibiotics, which it is advisable to select only after analyzing a nasal smear for the type of pathogen. The main methods of treating parietal sinusitis are as follows:

  1. Rinsing the nose with saline solutions using a syringe, douche, kettle, or using sea water preparations with attachments for this purpose (Aqualor, No-Sol).
  2. Taking antihistamines to reduce swelling over a course of 7-14 days (Zodak, Desloratadine, Tavegil).
  3. Taking anti-inflammatory drugs for pain (Ibuprofen, Nise).
  4. Irrigation of the nose with vasoconstrictor sprays or drops in a course of 7 days (Xylen, Nazivin, Vibrocil).
  5. The use of nasal antibiotics to stop the inflammatory process against the background of bacterial contamination (Isofra, Polydex). In some cases, systemic antibiotics - Amoxiclav or Azithromycin - are recommended for the patient to sanitize the nasal cavity and maxillary sinuses.
  6. The use of nasal corticosteroids against severe parietal edema (Nasonex).
  7. Taking homeopathic medicines to thin and stop mucus secretion (Sinupret, Euphorbium Compositum). Read more about the treatment of chronic sinusitis with homeopathy

To enhance the effect of conservative therapy, a patient with parietal sinusitis is often prescribed several sessions of laser therapy, ultrasound, UHF, due to which the swelling of the sinuses and inflammation quickly subside. The general course of treatment for the disease can be days.

Among the traditional methods of treating parietal sinusitis, you can use those that effectively stop the inflammatory process and eliminate swelling:

  1. Combine equal amounts of peach oil and 20% propolis tincture (if you purchased a product with a higher alcohol concentration, you need to dilute it with water). Drop 1 ml into the nose three times a day for 10 days.
  2. Squeeze aloe juice, drop 3 drops into each nasal passage three times a day for 7 days.
  3. Grate laundry soap, combine equal amounts with honey, alcohol, milk, vegetable oil, and onion juice. The whole mass needs to be boiled in a water bath until smooth, then dipped into the ointment with cotton pads and placed in the nose for 15 minutes once a day. Repeat treatment for 7 days.
  4. Squeeze the juice from the carrots, combine with vegetable oil in equal parts. Apply 4 drops twice a day for 10 days.

What not to do

The following actions are not recommended for this type of disease:

  1. Incorrect nose blowing or improper nasal rinsing. This can cause the infection to spread to the eustachian tube.
  2. Warming the sinus area at home without consulting a doctor. Such actions can provoke increased swelling of the sinuses.
  3. Treatment of the disease with folk remedies that involve the use of aggressive or frankly useless and even dangerous recipes (urine, poisonous plants, etc.). This often leads to the development of allergies and various complications of sinusitis.
  4. Take non-traditional remedies internally without the approval of a doctor (this also applies to hydrogen peroxide, beloved by many).
  5. Treatment for parietal sinusitis by fasting. Apart from further weakening of the immune system, nothing can be achieved with this method.

Disease prevention

Immunologists and otolaryngologists say that sinusitis can be avoided if you have a well-functioning immune system. To do this, in the summer you need to start hardening, intensify your lifestyle - play sports, do gymnastics.

A diet rich in vitamins and minerals will also help strengthen your immune system, and if necessary, take immunomodulators.

During the cold season, you should not dress inappropriately for the weather, as this will lead to hypothermia. If possible, it is necessary to prevent infection with ARVI, and if indicated, it is necessary to get rid of foci of infection in the body, including diseased teeth and adenoids. Every morning and evening you need to rinse your nose with salt water during cold season, which will prevent infection from settling on the mucous membrane and causing inflammation of the nasal cavity and maxillary sinuses.

Are you one of those millions who want to strengthen their immune system?

Have all your attempts been unsuccessful?

Have you already thought about radical measures? This is understandable, because a strong body is an indicator of health and a reason for pride. In addition, this is at least human longevity. And the fact that a healthy person looks younger is an axiom that does not require proof.

Therefore, we recommend reading Elena Malysheva’s article on how to strengthen your body before the autumn cold. Read the article >>

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Causes of thickening of the mucous membranes of the maxillary sinuses

Many processes can occur in the area of ​​the maxillary sinuses, and all of them affect the condition of the respiratory tract. The accumulation of mucous contents and pus is a favorable environment for the proliferation of pathogenic microorganisms. It is worth remembering that thickening of the mucous membranes of the maxillary sinuses is often a common manifestation of many pathologies. Pathological changes in the structure of the mucous membrane are possible with rhinitis, polyps, cysts, penetration of small parts into the nasal cavity (especially important for children).

The inflammatory process during rhinitis affects not only the maxillary and frontal sinuses, but also the area of ​​the pharynx and larynx. It is worth remembering that the changes occurring on the shells may be different. If they are small, the prognosis is favorable. If the connective tissues grow, the nasal cavities are affected - in such situations the prognosis is disappointing.

Seals usually occur with chronic sinusitis. It is worth remembering that chronic sinusitis often develops with improper treatment of the acute form of the disease. If the duration of the inflammatory process exceeds 6 weeks, the disease becomes chronic. Exacerbation of pathology in this case will be regular. The structure of the mucous membrane may be damaged due to allergies.

Types of hypertrophy

The respiratory organ is designed in such a way that the anterior parts of the nasal concha are the most vulnerable, and it is in them that hypertrophic changes often occur. Quite often, hypertrophy occurs in the posterior part of the nasal concha, located in the lower part of the cavity.

During the initial examination, polyps may be detected. As they grow, breathing becomes worse due to the fact that such formations block the nasal passages. Hypertrophy often develops asymmetrically; the anterior parts of the turbinate are damaged extremely rarely. This can happen due to advanced sinusitis.

In normal conditions, the mucous membranes allow air to pass freely during inhalation, but with the development of chronic inflammation, this function is disrupted. At this moment, the body is forced to adapt to changes of this kind, and the mucous membrane, trying to cope with such a load, grows. With mechanical damage or injuries to the nasal septum, the same thing happens.

The mucous membrane grows gradually and blocks breathing from the healthy side of the nose. There are a number of other factors that provoke and influence the development of pathology:

  • smoking;
  • frequent colds;
  • formation of polyps in the nose;
  • tendency to allergic reactions;
  • constant contact with dry air;
  • being in a room with polluted air;
  • long-term use of hormonal drugs.

The deformed mucous membrane takes on a lumpy appearance. This pathology is characterized by intensive production of mucous secretion.

Diagnosis consists of rhinoscopy. During this event, the otolaryngologist examines the parts of the nasal cavity. The location of the area with formed thickening of the mucous membranes is of greatest importance.

Such a phenomenon necessarily requires treatment. Therapy may consist of home treatment with periodic visits to a specialist. In complicated cases, surgical intervention is used. In a number of cases, the surgical method is used for violations in the structure of the nasal septum and if it is necessary to remove any tumors in the nasal cavity.

Thickening of the mucous membrane of the maxillary sinus occurs gradually, but at the first alarming symptoms you need to visit a specialist. Treatment can be prescribed only after an initial examination and examination.

Signs of thickening

Thickening of the mucous membranes is characteristic of chronic sinusitis, in which the following manifestations are possible:

  1. Discharge from the nasal cavity can have different appearances, in most cases it has a thick consistency.
  2. In some cases, snot has a characteristic putrid odor.
  3. Mucus accumulates in the nasal cavity and forms crusts.
  4. Decreased sense of smell.
  5. Increased body temperature during an exacerbation.
  6. Soreness in the cheek area, the ability to palpate the lump.
  7. Swelling of the eyelids, headaches.
  8. Cracks appear on the mucous membranes, and subsequently parietal inflammation forms.

With allergic sinusitis, the discharge is liquid, but its outflow is possible if the patient’s head is in a special position.

It is worth remembering that thickening of the mucous membrane does not always occur due to sinusitis. Rhinitis and sinusitis are very similar in their manifestations, and hypertrophy can also develop against their background. In most cases, sinusitis provokes a prolonged runny nose, which causes constant nasal congestion.

Diagnostic measures and treatment methods

To make a diagnosis, rhinoscopy is used, during which a specialist can detect swelling of the mucous membranes, pallor of certain areas, and damage to blood vessels. If symptoms characteristic of chronic sinusitis are present, an x-ray of the sinuses is necessary. Only on x-rays can one notice the initial stages of formations and parietal edema.

Therapy should primarily be aimed at eliminating swelling and establishing the natural outflow of mucous contents. It is extremely important to restore normal air exchange. Only a specialist can choose the treatment method. Therapy may include the use of antibacterial agents, which should be prescribed only after a nasal swab to determine the type of pathogen.

The list of applied measures indicated for thickening of the membranes is as follows:

  1. Rinsing the nose with preparations based on sea salt.
  2. The use of antiallergic drugs in a course.
  3. For pain, anti-inflammatory drugs are prescribed.
  4. Use of vasoconstrictor drops (duration of use no more than 7 days).
  5. Nasal antibiotics.
  6. Corticosteroid drugs to relieve parietal edema.
  7. Homeopathic remedies whose action is aimed at thinning mucus.

To enhance the effect, drug therapy is often supplemented with physiotherapy. Laser therapy, UHF and ultrasound are used. The course of treatment in most cases does not exceed 1 month. Traditional medicine offers its own recipes, the action of which is aimed at combating thickening of the mucous membranes and nasal congestion, but you should remember that self-medication is dangerous and at the first signs of the disease you should consult a specialist.

Source: http://gaimorit-sl.ru/pazuxi/utolshhenie-slizistoi-gajmorovoi-pazuhi.html

Symptoms and treatment of parietal sinusitis

Sinusitis is characterized by the development of an inflammatory process in the paranasal sinuses. Parietal sinusitis is a chronic form of the disease, but is not accompanied by the development of purulent processes. It develops when the acute form of inflammation has not been adequately treated and is accompanied by constant swelling of the wall of the sinus. In this case, swelling can be observed on one or both sides.

Reasons for the development of parietal sinusitis

Sinusitis is a consequence of an infection entering the body. The parietal form develops when bacteria remain in the nasal sinuses for a long time, which include:

In addition to bacteria, the development of inflammation can result from:

  • Inadequate treatment for colds;
  • Inadequate therapy for allergic rhinitis;
  • Measles and scarlet fever;
  • Inflammation in the oral cavity, in particular – the roots of the teeth, localized near the nasal sinuses;
  • Tonsillitis and pharyngitis;
  • Deviation of the nasal septum.

It should be borne in mind that the presence of any of these causes is not necessary for the development of the disease. It can occur due to weakened immunity - this reason is most relevant in the off-season.

Symptoms

Characteristic symptoms of the parietal form of the disease are:

  • Difficulty in clearing mucus from the nasal cavity;
  • Secretion with blood streaks;
  • Headache localized in the frontal region;
  • Pain localized in the area of ​​the nose, bridge of the nose;
  • Temperature rise;
  • Inability to breathe through the nose;
  • Pain in the eyes.

The course of the disease is accompanied by a decrease in vitality and fatigue. The chronic form of the disease can lead to conjunctivitis, chronic migraines, and constant cough. In advanced cases, the infection can spread to the brain area and cause meningitis.

The basis of the symptoms is pain. They can be different, but they always indicate the development of an inflammatory process in the maxillary sinuses. Most often, the pain is localized on the side where the inflammation occurs. In this case, the classic sign will be irradiation to the temporal region, half of the face or head.

If these symptoms are accompanied by pain when changing the position of the head, this will indicate the progression of inflammation and damage to the frontal sinuses by the inflammatory process.

The nature of inflammation can be determined by the secretion released. With serous inflammation, the discharge is clear and liquid. Thick discharge with a greenish tint and an unpleasant odor indicates an inflammatory reaction with the formation of pus.

Diagnostic measures

The diagnosis is made by an otolaryngologist after rhinoscopy. During the diagnostic procedure, hyperemia (redness) of the nasal mucosa, swelling, and changes in the thickness of blood vessels (thinning) are detected. If symptoms indicating a chronic form of the disease are detected, an x-ray of the sinuses is prescribed. A more accurate diagnostic method is multislice spiral tomography.

Treatment

Therapeutic measures are aimed primarily at eliminating swelling. If the disease occurs without complications, it is easily treatable. In such cases, there is no need for intervention - puncture or sinusotomy. But even in relatively mild situations, treatment should be selected by a specialist, since it often includes antibiotic therapy, which should be prescribed after the pathogen is identified.

The main methods of treatment include:

  • Using saline solutions to rinse the nasal cavity. Washing is carried out using a syringe, syringe, or using ready-made solutions of sea water with nozzles (Humer, Aqualor).
  • The duration of taking antihistamines intended to reduce swelling is determined by the doctor, and it can range from 1 to 2 weeks.
  • If pain is present, anti-inflammatory drugs (Ibuprofen) are prescribed.
  • Irrigation of the nasal cavity with sprays that have a vasoconstrictor effect.
  • The use of special antibacterial drugs intended for irrigation of the nasal cavity (Polydex). Sometimes washing is carried out with solutions based on conventional antibiotics (Amoxiclav).
  • In cases of significant parietal swelling, the use of nasal corticosteroids (Nasonex) is prescribed.

Experts recommend combining drug therapy with physiotherapy. In this case, laser therapy and UHF may be prescribed.

Traditional medicine recipes also contain methods to cope with parietal sinusitis. However, we should not forget that any traditional methods can be used only after consultation with a specialist and act as an additional, rather than primary treatment. Some of the ingredients recommended in traditional medicine can cause an allergic reaction.

  • Instill 3 drops of aloe juice into each nasal passage for a week.
  • Mix carrot juice with vegetable oil (in a 1:1 ratio). The mixture is used for instillation 2 times a day for 1.5 weeks.

Restrictions

Since this is a bacterial disease, precautions must be taken to prevent further spread of bacteria. To do this, you should blow your nose and wash it in such a way as to prevent infection from entering the auditory tube.

It is not recommended to do warm-ups on your own, without consulting a doctor. In some cases, this can lead to increased swelling.

Preventive actions

Sinusitis is a disease that people with good immunity need not be afraid of. Therefore, in this case, classic recommendations for strengthening the immune system are relevant. These include proper and nutritious nutrition, and in the off-season - additional intake of vitamins. It is also important to maintain a work-rest schedule, since a tired, exhausted body “succumbs” to infections much faster.

Hypothermia and contact with bacteria carriers should be avoided. It should also be noted that rinsing with salt water refers not only to methods of treatment, but also to methods of prevention, therefore, after visiting places with large crowds of people during the season of increased incidence, it is recommended to rinse the nose with saline solutions.

Source: http://noslor.ru/gajmorit/pristenochnyj.html

Parietal sinusitis and specific treatment

Acute inflammation of the sinuses can be treated quite easily if appropriate measures are taken in time. When adequate therapy is absent, inflammation can take a chronic form and develop into parietal sinusitis. The initial symptoms of the disease resemble those of a common cold. Because of this, patients delay treatment or use ineffective methods.

Provoking factors

The maxillary sinuses become inflamed more often than other sinuses. The insidiousness of the disease is that it is sometimes possible to detect progressive sinusitis only after 2-4 weeks from the onset of inflammation. The following factors can cause the disease:

  • allergic rhinitis;
  • deviated nasal septum;
  • chronic pathologies of the nasopharynx;
  • dental diseases;
  • pressure changes (during immersion in water, air travel, etc.).

Weakened immunity, vitamin deficiency, and previous colds increase the risk of developing sinusitis. The causative agent of inflammation is usually coccal infections, fungi and Haemophilus influenzae.

In the catarrhal form of the disease, there is no pus in the cavities, and the ciliary layer thickens and becomes covered with mucus. In the case of purulent sinusitis, the inflammation intensifies, and purulent secretion is released profusely. In the absence of effective therapy, complications cannot be ruled out. Adjacent sinuses are often affected and otitis media develops. The most dangerous complications of sinusitis are meningitis and sepsis.

Symptoms of the disease

Parietal sinusitis usually occurs in one sinus. If treatment does not give the desired result, then bilateral sinusitis may develop. Among the characteristic symptoms of parietal sinusitis:

  • headaches, swelling in the eyebrow area;
  • swelling of the nose, eyelids and cheeks;
  • periodic nasal congestion, often unilateral;
  • mucous discharge from the nasal passages;
  • pain in the upper jaw;
  • purulent discharge in complicated sinusitis.

The presence of a dry cough also indicates inflammation of the maxillary sinuses. This is the second most common cause of chronic cough, which gets worse in the morning.

Similar symptoms accompany hyperplastic sinusitis - hyperplasia of the nasal mucosa. This type of sinusitis occurs as a consequence of long-term allergic rhinitis and is accompanied by deformation of the mucous membrane.

With sinusitis, the pain becomes more pronounced when you press on the sinuses and nearby tissues. The feeling of heaviness intensifies when tilting the head. In the acute period, photophobia, lacrimation, and inflammation of the eyes are observed. In the chronic course of the disease, appetite worsens, constant weakness occurs, and persistent nasal congestion occurs.

Establishing diagnosis

An otolaryngologist diagnoses parietal sinusitis based on the results of the examination and the collected medical history. Palpates the maxillary sinus and checks the respiratory functions of the nose. In the absence of nasal discharge with simultaneous congestion, rhinoscopy is prescribed. During the examination of the nasal cavities, it is possible to detect an accumulation of pus.

If hyperplastic sinusitis occurs, then an x-ray examination will be more informative. With its help, it is possible to assess the condition of the sinuses and identify possible complications. If sinusitis is a consequence of a nasal injury, then radiography will determine its nature.

Among other research methods recommended for sinusitis:

  • MRI – prescribed in especially severe cases, it is highly informative;
  • computed tomography is an informative and high-speed method that is often offered to children and patients with acute pain;
  • microbiological examination - necessary in case of ineffectiveness of antibacterial therapy. Involves the extraction of exudate through puncture.

Additionally, you may need the help of a dentist, allergist-immunologist, or neurologist.

Therapeutic measures

Therapy for sinusitis involves eliminating symptoms, eliminating inflammation and provoking factors. Nasal drops are used to relieve swelling and nasal congestion. Preference is given to oil-based products. They are suitable for long-term treatment and do not cause atrophy of the mucous membrane. If the use of vasoconstrictor drops is unavoidable, then it is necessary to remember the dosage and not increase the duration of the course.

For acute sinusitis, antibiotics are prescribed daily. In the chronic form of the disease, the course duration is increased to 1 month. It is important to start antibacterial treatment in a timely manner and not to abandon antibiotics if relief occurs. Untreated sinusitis can result in serious complications. Repeated therapy will be less effective due to a decrease in the sensitivity of the pathogen to the components of the drug. If antibacterial treatment does not give the desired result, antifungal drugs are offered.

Conservative therapy involves taking immunomodulators. This group of products includes “Arbidol”, “Amiksin”, “Galavit”. Preparations based on echinacea, ginseng root, and rose hips have a positive effect on the state of the immune system.

It is advisable to use antihistamines. They alleviate symptoms and reduce the likelihood of developing allergic reactions to both external irritants and medications. Among the drugs that do not have a negative effect on the central nervous system and have the smallest list of side effects are Cetrin, Loratadine, and Fenistil.

Rinsing the nasal cavity reduces inflammation and relieves swelling of the mucous membrane. It is recommended to rinse your nose with saline or salt water. Better results can be achieved if you use drugs with antiseptic properties. This group includes Miramistin, Dioxidine, Chlorhexidine. Using these products for irrigation and rinsing will help sufficiently moisturize the mucous membrane, remove excess pus, and improve the activity of the cilia of the mucociliary apparatus. It is recommended to rinse your nose before instilling medications to increase their effectiveness.

Mucolytics are prescribed to thin the mucus. Usually these are tablets and syrups, less often - sprays. “Rinofluimucil” and “Mukosol” have proven themselves well. In case of severe inflammation and the presence of an allergic component, drugs from the group of corticosteroids are indicated. Use them with caution for a limited time. Corticosteroids will help with nasal polyps and the lack of effect of antibiotics.

Other methods

A puncture for parietal sinusitis is not indicated. Typically, classical therapy allows one to achieve good results and avoid surgical intervention. Physiotherapy can improve the effectiveness of treatment. In the acute stage, ultrasound treatment and diathermy are recommended. In case of chronic sinusitis, it is advisable to carry out medicinal electrophoresis. Paraffin heating gives good results.

Traditional medicine can also provide invaluable assistance for sinusitis. It is useful to instill garlic water into the nose. Take 1 clove of garlic per 100 ml of water, squeeze out, stir and leave to infuse. Then pipette and drop into each passage. It is important to ensure that no particles of garlic get on the mucous membrane.

In order to improve the discharge of mucus, inhalations with kombucha are performed. The liquid obtained by infusing the mushroom can also be used for rinsing and instillation into the nose.

In case of chronic sinusitis or for its prevention, it is useful to visit the bathhouse. All thermal procedures are prohibited in case of exacerbation of the disease. Before visiting the steam room, it is advisable to rub yourself with natural honey, and then sit in the bath until the honey stops sticking. After the procedure, you should change into clean cotton underwear and go to bed.

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Symptoms and treatment of parietal sinusitis

For parietal sinusitis, treatment is aimed at relieving the main symptoms and protecting the patient from the development of possible complications. Parietal sinusitis is a chronic disease that occurs due to inflammation of the maxillary (maxillary) sinuses. As a result of the action of certain causes, inflammation of the mucous membrane lining these sinuses occurs, the formation of pus and the development of the corresponding clinical picture. Sinusitis itself is not so much dangerous for its clinical manifestations as for its complications. In advanced forms of the disease, pus from the maxillary sinuses can move into the frontal sinuses, which can then lead to the development of purulent damage to the brain structures, up to a brain abscess or rhinogenic meningitis.

Etiology of sinusitis

Sinusitis is essentially an infectious disease that is caused by bacteria of a certain type. In most cases (about 75% of the total), such bacteria are:

  1. Streptococci.
  2. Haemophilus influenzae.
  3. Moraxella.
  4. Staphylococcus aureus.
  5. Pyogenic staphylococcus.

In rare cases, certain types of fungi or anaerobic infections can also lead to the development of sinusitis.

In addition to distribution by type, sinusitis pathogens are also distributed according to the following principle:

Hospital or nosocomial sinusitis that occurs after 48 hours of hospital stay.

Community-acquired, occurring 48 hours before hospitalization or 48 hours after discharge from the hospital.

In addition to the etiological causes of sinusitis, there are also so-called predisposing factors that can lead to the appearance of the bacteria described above in the maxillary sinuses. The most common prerequisites are:

  1. A sharp decrease in the body's immunity.
  2. General infectious and viral diseases.
  3. Damage to the teeth of the upper jaw.
  4. Congenital disorders of the anatomical structures of the nasal cavity (curvatures, spines, ridges).
  5. The presence of chronic inflammation of the nasal mucosa (rhinitis).
  6. Adenoid vegetations and polyps.

Pathogenesis of the process

Once in the maxillary sinuses, the pathogenic bacterium begins to penetrate the mucous membrane of these sinuses, causing its damage. In response to such damage, a specific reaction develops, leading to the development of inflammation of the mucous layer of the maxillary sinuses. In the future, the parietal inflammatory response can go along 2 paths:

With catarrhal inflammation, atrophy of the functional ciliary layer of the mucosa occurs. Also, the entire mucous layer is saturated with serous secretion and increases in volume, filling part of the sinus. With the purulent variant, there is a massive migration of cellular agents (leukocytes) to the area of ​​inflammation. Leukocytes are inherently active “protective” cells of the body, which are produced to destroy foreign bacteria. Having reached the source of infection, leukocytes capture bacteria and die, forming a purulent secretion.

Purulent sinusitis is a more severe process than catarrhal sinusitis. This is explained by the fact that with purulent inflammation of the maxillary sinuses, not only abundant formation of pus occurs, but also melting of the bone walls of the sinus. It is this form of sinusitis that is characterized by a large number of complications: infectious lesions of brain structures, meningitis and abscesses.

Clinical signs

The clinical picture of the disease itself will be determined by several factors, namely:

  1. The type of flora, since some microorganisms have greater pathogenic activity than others.
  2. The type of inflammatory reaction of the body (purulent or inflammatory).
  3. The activity of the patient’s own immune system.
  4. Presence/absence of concomitant diseases.

The main complaints of patients with parietal sinusitis can be divided into 2 groups: local and general. Local are those symptoms that occur directly at the site of the disease, general are symptoms caused by the reaction of the body itself to the disease.

Thus, local symptoms include:

  1. A group of pain symptoms.
  2. Presence of nasal discharge.

Painful symptoms are the leading symptoms of sinusitis. They are quite diverse in their manifestation, but all of them will indicate the possible presence of a pathological process in the maxillary sinuses. Most often, such pain will always occur on the side of the affected sinus. The pain may radiate to the temple, half of the face or head. In addition to pain from the lesion, headaches may also appear, which may indicate the progression of a purulent lesion and the transition of sinusitis to frontal sinusitis (inflammation of the frontal sinuses). Pain may intensify when the patient changes position, moves the head or bends it forward.

Discharge from the nasal cavity can be different and depend on the type of inflammatory process in the maxillary sinuses. With serous inflammation, the secreted secretion will be serous in nature - transparent or white, watery. With a purulent inflammatory process, the discharge from the nasal cavity will be yellowish or greenish, with an unpleasant odor, and thicker.

Common symptoms usually include:

  1. Temperature increases to febrile and subfebrile values ​​(37-38 degrees).
  2. Symptoms of general intoxication of the body: weakness, muscle pain, drowsiness.
  3. Changes in certain blood parameters: erythrocyte sedimentation rate (ESR), changes in the number of white blood cells.

Diagnostic criteria

To correctly diagnose sinusitis, you must use the following methods:

  1. Examination of the nasal cavity - rhinoscopy.
  2. X-ray of the maxillary sinuses.
  3. Tomography of the maxillary sinuses is the “golden” method of modern diagnosis of sinusitis.

Principles of therapy

As with many diseases, treatment of parietal sinusitis consists of two main principles: conservative and surgical. Conservative treatment tactics include:

  1. Treatment of the inflammation site itself is local therapy.
  2. Impact on a pathogenic organism - antibiotic therapy.
  3. Physiotherapeutic methods.

The goals of local impact on the source of sinusitis are to reduce inflammation by narrowing blood vessels and sanitizing the mucous membrane itself.

For this purpose, a special series of vasoconstrictor drugs and drugs containing a high concentration of salt (hyperosmolar solutions) are used. Such solutions with a salt concentration exceeding the physiological one have the ability to “pull” pus onto themselves.

Antibiotic therapy is selected taking into account the duration of the disease, the type of pathogen and the general characteristics of the patient. This type of therapy should always be prescribed only by a doctor and last at least 5-7 days. For parietal sinusitis, treatment is also carried out using physiotherapeutic procedures - washing the maxillary cavities with saline solutions supplied using a pump (better known as a “cuckoo”), which is the most effective.

However, if during 8 such rinses purulent secretion continues to flow from the nasal cavity, then this is a direct indication for the use of surgical tactics. A classic representative of this tactic is puncture of the maxillary sinuses. With this intervention, by “punching through” one of its walls, a direct hit is made in the sinus and subsequent extraction of purulent secretion from it by pumping through a probe. This technique may include the subsequent administration of medicinal substances into the maxillary sinus (especially antibacterial and antiseptic solutions), which gives an additional good effect in the treatment of parietal sinusitis.

In order to prevent surgical intervention for sinusitis, you should consult a doctor in a timely manner and carry out treatment measures in a timely manner.

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