Symptoms and treatment of chronic sinusitis - how to cure the disease forever? Chronic sinusitis - symptoms and treatment in adults at home Why chronic sinusitis is not treated.

The date: 19.10.2019

The patient's condition with chronic sinusitis - inflammation of the mucous membrane of the maxillary cavity, sharply worsens with exacerbation of the disease. Relapses of chronic sinusitis (rhinosinusitis) are accompanied by impaired nasal breathing, throbbing headaches.

Chronic inflammation of the maxillary cavity can be one-sided, accompanied by nasal congestion, pain symptoms from the affected side.

There are also cases of bilateral chronic sinusitis, a symptom of the disease is complete nasal congestion, impaired nasal breathing.

By the nature of the course, chronic sinusitis is distinguished:

Chronic sinusitis 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.

Pathogenic microorganisms form complex conglomerates, which makes it difficult to choose a treatment regimen for chronic sinusitis.

Causes of chronic sinusitis

The maxillary sinus is located above 4-6 teeth of the upper jaw. It is separated from the roots of the teeth by a bony septum, which in some cases is thinned, represented only by the periosteum or mucous membrane.

Such an arrangement of the roots of the teeth becomes a common cause of infection of the maxillary sinus with stomatitis, caries, infections of the oral cavity.

The cause of chronic sinusitis can be a violation of the natural drainage of the sinus, blockage of the excretory duct, deformation of the nasal septum.

Decreased immunity, allergic predisposition, untreated acute rhinitis, and influenza are considered as predisposing factors for the development of sinusitis.

Symptoms

Chronic sinusitis lasts for years, exacerbating with a decrease in the patient's immunity, adverse external conditions. It provokes an exacerbation of chronic sinusitis, hypothermia, high humidity, colds, allergic reactions, runny nose, flu.

In the period between exacerbations of the disease, the patient's condition is satisfactory, physical activity does not decrease, and the ability to work is not lost.

With an exacerbation of chronic sinusitis, symptoms similar to those of acute sinusitis are noted. As with acute sinusitis in chronic sinusitis, the most abundant discharge occurs after a night's sleep.

The patient's temperature rises, malaise appears, the timbre of the voice changes, and a nasal tinge appears. Relapses of chronic sinusitis are characterized by increased pain and a feeling of heaviness in the area of the root of the nose and the upper jaw under the eye.

The pain is diffuse, extending to the brow ridges, teeth, temple. The clinical picture of chronic sinusitis has some similarities with the symptoms of inflammation of the trigeminal nerve, but differs in less intensity.

A characteristic symptom of chronic purulent sinusitis is thick yellow-green nasal discharge.

A diagnostic examination shows how thick mucus with inclusions of pus flows down the back of the pharynx.

The patient is forced to constantly otmarkkivatsya, clearing his throat. Some of the mucus gets into the stomach and causes complications from the digestive system. The other part enters the upper respiratory tract, causing laryngotracheitis, bronchitis, pharyngitis, tonsillitis.

The need for treatment is indicated by such symptoms of sinusitis as a night cough, pain in the ear, teeth. Inflammation is manifested by signs of intoxication of the body with waste products of pathogenic microflora.

The patient develops nausea, an unpleasant odor from the oral cavity, loss of strength, weakness. The general condition of the patient worsens, the temperature rises to 38 o C. Outwardly, in the morning, the patient has swelling of the eyelids, the area around the eyes, eyebrows, and forehead.

With chronic sinusitis, the sense of smell worsens, with bilateral maxillary sinusitis, there is often a complete absence of smell - anosmia.

Diagnostics

The main way to diagnose chronic sinusitis is an X-ray examination. X-ray allows you to confirm the inflammatory process in the sinus, detect cysts, polyps in the maxillary cavity. Accurate data on the degree of pathology can be obtained by the method of computed tomography.

It is necessary to humidify the air in the house, especially in winter, do not smoke, avoid the use of household aerosols with a pungent odor for allergic chronic sinusitis.

Forecast

Many people think that sinusitis is a separate disease. But this is not the case. This is a form of inflammation of the mucous membrane of the paranasal sinuses. With sinusitis, the maxillary sinus, which is also called the maxillary sinus, becomes inflamed. Chronic sinusitis, which can lead to serious complications, is especially troublesome.
Statistics show that the proportion of chronic sinusitis among all nasal pathologies reaches 50%. In Russia, there are 12 cases of sinusitis per 100 inhabitants. In Europe, this figure is half as much - 6 people out of 100 are ill. The twofold difference is easy to explain: residents of the country are usually irresponsible to their health, "start" a runny nose, hoping that it will pass within a week.

Origin

Chronic sinusitis in adults develops gradually. At the onset of the disease, the infection settles on the membrane of the nasopharynx, maxillary sinus, which provokes inflammation. The consequence of exposure to infection is swelling, which makes it difficult for air to pass and mucus outflow. The mucus itself is a favorable environment for the reproduction of pathogens and the inflammatory process is activated. Most often, only the left or right sinus is affected, bilateral chronic sinusitis is rare.

Causes of the disease

A number of reasons contribute to the occurrence of chronic sinusitis. Key risk factors for the chronic course of the disease:

Transferred earlier that has not been treated or has not been treated;
lingering nasopharyngeal infections department - tonsillitis, rhinitis, etc.;
a disease or deficiency that interferes with the flow of mucus, for example - deviated nasal septum;
cysts, polyps in the maxillary sinus;
diseases of the upper teeth;
interventions in the upper jaw area;
bad habits- smoking, alcohol abuse;
tendency to allergic reactions.

Symptoms

During the period of remission (decay), the disease makes itself felt by the following phenomena:

There is a feeling that nose is stuffed;
worried about a runny nose that does not respond to treatment, pus is periodically secreted;
the patient constantly wants to swallow mucus flowing down the back wall of the nasopharynx, sometimes he feels a characteristic lump that cannot be swallowed;
worried about headaches, which are localized mainly near the eye sockets, they increase with intense blinking and weaken when a person lies;
pressure and distension are felt in the face of the head and cheeks;
the eyelids look swollen in the morning(one of the main symptoms);
conjunctivitis develops- eye disease, in which the conjunctiva becomes inflamed, or the mucous membrane of the eye;
nasalness appears- violation of sound pronunciation due to poor nasal patency.

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

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

Types of chronic sinusitis

The forms of the disease are distinguished by several characteristics:

Type of inflammation;
localization;
source of infection.

Type of inflammation

Catarrhal- edema develops on the mucous membrane, with exacerbations the nose is stuffed up, discharge is observed, there is heaviness in the area of the eye sockets, cheeks;
chronic purulent sinusitis- pus collects in the maxillary sinus, which is then excreted from the nose;
cystic- cysts form in the inflamed sinus;
mixed- combines several signs of sinusitis (for example, polyps and pus form at the same time).

Localization

Unilateral - the sinus is inflamed only on the right or left side;
bilateral - the sinuses are inflamed on both sides.

Source of infection

Rhinogenic- the disease makes itself felt after a runny nose (rhinitis);
hematogenous- an infection enters the sinus cavity;
odontogenic- the disease is caused by unhealthy teeth;
allergic- the allergen affects the mucous membrane;
traumatic- the disease appears after injuries near the maxillary sinuses.

Diagnostics

To make an accurate diagnosis, a set of the following activities is carried out:

Analysis of patient complaints and anamnesis... The doctor specifies whether the patient is experiencing nasal congestion, whether there is discharge, whether there is pus and blood in them, whether he has had acute sinusitis before, whether he has treated his teeth;
general examination. The doctor feels and pounds the patient's face in the cheeks, forehead, with chronic sinusitis, the patient may experience pain during these manipulations;
rhinoscopy... Using a special tool, the nose is examined. Such an examination allows you to consider signs of inflammation - edema, redness, pus, and also to detect some causes of pathology - polyps, anatomical features of the structure of the nasal septum, nasal concha;
endoscopy- a more detailed study of the nasal cavity;
radiography... An X-ray does not give an accurate result in all cases, but it allows you to detect neoplasms, determine the level of fluid, and examine irregularities in the structure of the nose. In some cases, an X-ray image can distinguish a purulent form from a catarrhal one. An alternative is ultrasound;
CT scan The paranasal sinuses are performed during remission and are considered the main research method for this disease. In layered images, the doctor has the opportunity to consider how extensive the inflammatory process is, what are the features of the structure of the nose, septa, sinuses;
diagnostic puncture... It is carried out with exacerbation. The patient is injected with a local anesthetic and with a thin needle in the thinnest place, the wall of the maxillary sinus is pierced, pus is extracted with a syringe through the puncture, and the medicine is injected into the vacated cavity;
bacteriological culture... Fluid from the nasal sinuses is sown on a nutrient medium in order to determine the causative agent of the inflammatory process, as well as to choose a suitable antibiotic for treatment;
oropharyngoscopy, or examination of the oral cavity allows you to identify teeth affected by caries, to assess the condition of the fillings;
diaphanoscopy using a Hering lamp helps in the diagnosis of sinus inflammation. The examination process is carried out in a dark room. A light bulb is inserted into the patient's mouth and asked to wrap his lips around its base: if there is inflammation, the glow will be less bright than when examining a healthy person.

Treatment of chronic sinusitis without surgery

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

Remission

Nasal medications are prescribed in the form of sprays with steroid hormones as an active ingredient that relieves inflammation. They are highly effective, do not enter the bloodstream, do not change hormonal levels and are widespread;
rinsing the nose with saline solutions;
macrolide antibiotics affect the pathogen, increase immunity, but are not toxic to the patient;
if chronic sinusitis is caused by an allergy, this disease is treated;
dental treatment is indicated to eliminate the focus of infection.

With exacerbation

If the inflammatory process has worsened, more intensive therapy is indicated.

Drug treatment

Nasal sprays for 5-7 days;
vasoconstrictor drops with antibiotics and steroid hormones. They eliminate puffiness, help fluids leave the maxillary sinuses;
mucolytic preparations for thinning mucus and cleansing the maxillary sinuses;
antibiotic therapy is carried out with purulent inflammation;
fortifying drugs.

Vasoconstrictor drugs are used to relieve symptoms. They do not eliminate the infection and have a bad effect on the work of the mucous membrane: the self-cleaning mechanism is disrupted, local immunity is weakened.

Chronic sinusitis is diagnosed if mucosal inflammation cannot be cured for more than 4 weeks.

In Western countries, such drugs are rarely used. In addition, much attention is paid to the prevention of complications of the common cold, in particular sinusitis, because they develop in 90% of cases if the patient does not receive treatment appropriate to the condition in a timely manner.

Drug-free treatment

Puncture of the sinuses. Allows the patient to quickly relieve pain, improve his general condition, inject the drug directly into the center of inflammation. The disadvantage is the need for multiple punctures. Sometimes, as an alternative, after the first puncture, a drain is installed to flush the affected cavity.

Treatment also involves a non-functional method - the installation of a YAMIK catheter without damaging the membranes.

And also washing with medicinal salt preparations, decoctions and herbal infusions, antiseptics.

Physiotherapy

With exacerbation, physiotherapy methods are aimed at stabilizing the patient's condition, with remission - at stopping (suppressing) the syndrome. Apply:

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

ethnoscience

Traditional medicine, many patients find effective for themselves. They are also recommended by official medicine as an auxiliary line of treatment. Before using any prescription, you need to consult with your doctor.

It is proposed to use honey beading for the treatment of chronic sinusitis in adults. In case of exacerbations, it is recommended to chew it 1 tablespoon half an hour before eating.

The horseradish root is washed, peeled, rubbed on a fine grater. Juice from three lemons is added to a third of a glass of grated horseradish. This gruel is taken in the morning, 20 minutes before the first meal, half a teaspoon. Treatment is carried out in spring and autumn.

Surgery

If conservative methods do not bring the desired result, surgical treatment is performed. The indications for surgical intervention are:

Proliferative processes in the sinus (tissue proliferation);
impossibility of puncture;
purulent fistulas, gunshot foreign bodies, teeth sinking into the sinus;
infected neoplasms;
intracranial and secondary complications.

In this case, under general anesthesia, an endoscopic operation is performed, in which air aeration is restored, and anatomical deficiencies are corrected.

Operations with the removal of the mucous membrane, until this time they are offered by some clinics, are fraught with the fact that the sinus is no longer able to perform its functions. Moreover, surgery will not prevent future relapses.

Forecast

In general, the prognosis is favorable if the patient received appropriate treatment and also observes preventive measures.

Chronic sinusitis requires mandatory treatment, since infections in the head area sometimes end in intracranial complications and the death of the patient.

The risk of sepsis ("blood poisoning") is not excluded, when the pathogen is spread through the bloodstream to other organs.
The following complications are likely:

Chronic forms, , (respectively, diseases affecting the mucous membrane of the pharynx, palatine tonsils, larynx);
nasolacrimal canals become inflamed, the eyeball and its membranes, blindness develops;
nasal breathing is disturbed and a chronic lack of oxygen develops (hypoxia);
inflamed soft tissues of the face;
the infection spreads to the ears, descends into the bronchi and even the lungs,;
inflammation of the bones of the skull with the formation of pus, which require surgical treatment;
the trigeminal nerve is affected.

Sinusitis can develop even from a simple cold infection. Everything can start similar to an acute respiratory illness, accompanied by nasal congestion, loss of smell, general fatigue.

If you ignore these symptoms, they will disappear over time, periodically reappearing and making themselves felt. Does this mean that the disease has begun to pass? No, rather, on the contrary, sinusitis has acquired a chronic form.

Chronic sinusitis is an ailment characterized by a protracted and sluggish course. Its phases are constantly alternating, then exacerbated, then go into remission. The disease manifests itself in frequent pains in the head, ailments, etc. A feature of the disease is considered to be an inflamed condition of the maxillary (maxillary) sinus.

In general, any of the sinusitis is a type of sinusitis, which is why the ailment is also called the chronic form of maxillary sinusitis. This disease is dangerous in that, with insufficient or incorrect therapy and erased signs, it leads to intoxication of the body.

What is the cause of the disease

Why does such a problem appear as a chronic form of sinusitis? Chronic sinusitis is the result of incomplete treatment of acute sinusitis or complications after it. If the patient is not engaged in the treatment of inflammatory processes in the nose, then viral or bacterial infections can capture not only the surface of the mucous membrane, but also the bone tissue of the walls of the sinuses.

It is not possible to get rid of chronic sinusitis forever. Of all the problems with nasal breathing, more than 50 percent of cases of the disease in adults and young patients (toddlers and adolescents) fall into the chronic stage of sinusitis.

If we consider the pathogenesis of this disease, then there are factors that favor its progression:

Frequent exposure to infectious diseases in the upper respiratory tract.
Smoking habit.
Diseases of a seasonal nature.
The presence of hypovitaminosis.
Associated health problems that negatively affect immunity.
Susceptibility to allergies.
The presence of anatomical anomalies of the nose (curvature of the nasal septum, the development of neoplasms, tumors, polyps, etc.).

Basically, inflammation of the maxillary sinuses is the result of a cold or flu that affects the upper respiratory tract. After acute respiratory infections, an infection of bacterial origin may in addition begin to develop. Thus, the membranes covering the inner sinuses become inflamed.

The chronic form of sinusitis begins to develop when there is a recurrence of acute inflammation, due to a neglected inflammatory process in the maxillary sinuses and with chronic rhinitis.

Tooth infections can cause sinus inflammation. Periodic root inflammation on the back teeth is a predisposition to sinusitis.

Also, the chronic stage of sinusitis can appear due to disorders that weaken the immune system, or diseases that provoke inflammatory processes and stagnation of mucous masses in the upper respiratory tract. Such diseases include ailments like:

diabetes mellitus;
AIDS;
cystic fibrosis;
Wegener's granulomatosis;
gastroesophageal reflux disease;
fungal sinusitis;
asthma and others.

Sinusitis can appear as a complication from a severe infectious disease.

Viruses often cause acute sinusitis, and chronic sinusitis is characterized by bacterial origin. The bacterial pathogen ends up in the nasopharynx. Bacteria multiply in the blocked sinus and sinusitis appears. Sinusitis of bacterial origin is difficult to treat. Treatment will depend on the cause of the disease, since the antibiotic does not affect viruses.

Allergic reactions to fungal infections can cause some cases of the chronic stage of sinusitis. Aspergillus is the most common fungal pathogen associated with sinusitis.

Symptoms of chronic sinusitis

An exacerbation of the chronic form of this ailment tends to manifest itself similarly to acute sinusitis. During periods of exacerbation, the patient suffers from severe headaches, nasal congestion and mucous discharge from them, increased body temperature, pain in the sinuses.

The nature of the manifestations of this disease is dependent on its forms and how strong the patient's body is.

Symptoms related to purulent form

Difficulty breathing through the nose.
Deterioration of smell up to its complete absence.
Frequent headache with vague localization.
Intoxication, expressed in weakness and weakness, increased fatigue, poor appetite, nervous disorders, low-grade fever.
Thick and stringy nasal discharge, which may be purulent.
Ears bridging.
Attacks of cough caused by irritation of the mucous membrane of the nasopharynx.
Possible lacrimation caused by blockage of the nasolacrimal canal.

Symptoms associated with odontogenic (dental) form, include the following:

The inflammatory process is deployed from the side of the diseased tooth. Treatment by a dentist can lead to the development of this form of the disease, especially when it comes to the upper row of teeth.
Ineffectiveness of standard treatment regimens, including antibiotic therapy and sinus debridement. In this case, it is necessary to eliminate the dental problem. Without this measure, drug treatment does not give a positive result.
Heavy offensive odor from nasal discharge.

Pathological processes in the oral cavity caused by dental problems are involved in the onset of this form of the disease. The infection affects the maxillary sinus, in which the inflammatory process develops.

Symptoms of sinusitis associated with different types fungal infection, are the following features:

Discharge from the sinuses has a curd structure and a white tint (candidiasis).
The discharge has a thick consistency and a dark grayish (possibly black) tint (aspergillosis).
The discharge has a jelly-like consistency and a yellow tint (molds).

Long-term drug therapy, characterized by uncontrolled intake of drugs, in particular with antibacterial properties, can lead to a fungal infection of the nasal sinuses.

A similar form of sinusitis can develop in people suffering from an immunodeficiency state or simply weak immunity. At risk are HIV patients and people taking cytostatics.

Symptoms of a disease with allergic form, include the following signs:

The disease manifests itself paroxysm, taking into account the periods of seasonal flowering of plants (trees, grasses), in some cases - cereals.
Deterioration after contact with an allergen, manifested in sneezing attacks, itching, tearing, abundant nasal discharge with a liquid vitreous structure, pain in the sinuses.
The appearance of polyposis lesions of the mucous membrane of the nasal passages, leading to difficulty breathing, is possible.

This form of the disease is dangerous because it depletes the immune system and leads to severe complications.

What is chronic sinusitis

In the classification of this ailment, there are the following subspecies:

Catarrhal, characterized by inflammation of the mucous membrane of the maxillary sinus. It swells, reddens, bloodshot. Inside contains a mucous mass.
Purulent, in which pus accumulates in the sinus instead of a mucous mass.
Parietal hyperplastic, accompanied by hyperplasia of the mucous membrane with the formation of polyps and profuse nasal discharge.
Fibrous.
Allergic, caused by the body's reaction to certain stimuli and accompanied by swelling of the mucous membrane with profuse nasal discharge.
Cystic, caused by a cyst in the nasal cavity.
Polypoid, the cause of the development of which is polyps that have grown in the nasal cavity.

Sometimes there are cases of combining several forms of the disease, for example, polypous with a purulent process.

Another classification of chronic sinusitis is based on the reasons that cause it. Chronic sinusitis can be:

Traumatic - when the disease is caused by trauma to the skull, resulting in disturbances in nasal breathing.
Rhinogenic - when the disease is provoked by frequent rhinitis.
Odontogenic - when sinusitis has arisen as a result of dental diseases.
Hematogenous (most common) - when the cause of the disease was the penetration of a bacterial or fungal pathogen into the area of the nasal sinuses.

Regardless of what cause caused this disease, and what form it has, it can be either unilateral or bilateral (when both sinuses are affected).

Diagnostics

At an appointment at the clinic, a specialist must study the medical history, listen to the patient's complaints. In addition to visual examination, the doctor must apply rhinoscopy or other examination methods. During a visual examination, it is determined that the patient has a thickening of the mucous membrane (hyperplasia), its redness (hyperemia), swelling, viscous nasal discharge.

Other methods used to diagnose chronic sinusitis include the following:

Taking a smear during rhinoscopy for bacteriological analysis.
Video endoscopy.
X-ray of the paranasal sinuses.
Puncture of the maxillary sinuses.
Immunogram.

Treatment features

To date, it is not possible to completely cure chronic sinusitis, alas. However, it is possible to ensure that periods of exacerbation of the disease pass with less pronounced unpleasant symptoms. The main task in this case is to restore normal nasal breathing (if not completely, then at least partially) and the destruction of the causative agent of the disease.

First of all, the patient needs to reorganize the foci of infection with the use of medications. To wash the maxillary sinuses, freeing them from mucous or purulent masses, and also to destroy pathogenic bacteria, special disinfectant solutions should be used.

As a rule, for this purpose, the doctor prescribes medications belonging to the group of fluoroquinolones or cephalosporins. In addition, the patient is prescribed systemic antibiotics with antibacterial drugs that have a local effect.

To facilitate breathing, it is recommended to use nasal drops and sprays that have a vasoconstrictor effect. They will effectively pierce the stuffy nose and quickly eliminate the swelling of the mucous membrane. However, they cannot be used for a long time, otherwise the opposite effect is possible.

To increase the body's immune defense, the doctor prescribes to the sick person drugs related to immunoglobulins and immunocorrectors.

As an addition to the main treatment, drugs related to homeopathy (nasal sprays and tablets with herbal substances) are used. They have immunostimulating and anti-inflammatory effects.

Their use in the treatment of chronic sinusitis eases the patient's condition, helps to restore breathing through the nose, relieve swelling and nasal congestion, and get rid of snot.

With an allergic nature of the disease, the doctor will prescribe the patient to take antihistamines.

During periods of remission, it is recommended to undergo procedures such as UHF maxillary sinuses, electrophoresis, magnetotherapy, laser therapy, ultrasound manipulations, speleotherapy (treatment with the healing microclimate of salt caves).

An extreme measure prescribed to patients in severe cases of the disease is sinusitis - an operation during which a specialist makes a puncture (opening) in the inflamed maxillary sinus with the aim of its subsequent sanitation.

Folk recipes

How to treat chronic sinusitis at home? Sometimes traditional medicine can be an effective adjunct to mainstream drug therapy. Many folk recipes, according to the reviews of herbalists, are successfully used in order to alleviate the condition of those suffering from this disease.

In addition to pharmaceutical preparations, herbs with an antiseptic effect can be used:

chamomile;
calendula;
inflorescences of St. John's wort.

A decoction of these plants is used to rinse the nasal passages in order to remove pathological contents from them.

An excellent remedy is nasal drops, prepared according to the following recipe: you need to mix a little honey with the juice of aloe and celandine (1: 1: 1).

You can use sea buckthorn oil instead of nasal drops.

It is advisable to ingest herbal infusions that increase immunity and help the body fight infection. This applies to tinctures on ginseng, eleutherococcus, echinacea.

Used for home treatment, steam inhalation from hot mashed potatoes, decoction with bay leaves, with the addition of aloe juice and other herbs that relieve nasal congestion and improve sinus drainage.

You can prepare a healing ointment to cleanse the nasal passages. To do this, mix the gruel from a clove of garlic with honey and sunflower oil (1: 1: 1). The cotton wool turundas lubricated in the resulting mixture are placed in the nostrils and kept there for several minutes.

Infusion of propolis is applied topically. Cotton swabs, which are soaked in propolis tincture, are placed in the nostrils for half an hour. The manipulation is repeated three times a day. Very soon the patient feels relief from breathing through the nose.

Is it allowed to warm up the nose with salt or a boiled egg for chronic sinusitis? This should not be done without visiting a specialist and his recommendation. It is contraindicated to warm the nasal area when there is an exacerbation of chronic sinusitis. This procedure can lead to the opposite effect and worsen the patient's condition.

The process of treating chronic sinusitis with hydrogen peroxide according to the Neumyvakin method is a common method that belongs to alternative medicine. According to this method, diluted hydrogen peroxide (10 drops of peroxide per tablespoon of water) is instilled into the nasal cavity.

Another unconventional method of treating chronic sinusitis is the use of ASD (antiseptic stimulant Dorogov). It is a biogenic stimulant that causes cells to regenerate from the inside out. Many people take it orally, diluted with water, or use it in the form of compresses.

Doctor Komarovsky opposes that parents self-medicate sinusitis in a child through folk recipes. First of all, you need to consult with a specialist, including about the possibility of using folk remedies.

Komarovsky insists that any rhinitis must be treated by flushing the nasal mucosa with saline to prevent it from drying out. The same applies to the treatment of sinusitis in pregnant women.

Complications

This disease can cause other diseases. The consequences of chronic sinusitis include:

otitis media;
bronchitis or pneumonia;
meningitis;
diseases of the cardiovascular system;
pyelonephritis.

With the right therapy, you can achieve a stable remission, avoid recurrence of the disease and significantly improve the quality of life.

Chronic sinusitis (maxillary sinusitis) is a prolonged inflammatory process that occurs in the maxillary maxillary sinus.

The disease is dangerous because it is practically asymptomatic, exacerbating only during seasonal periods, and causes constant intoxication of the body.

Doctors from all over the world have developed an international classification of diseases (ICD - 10), which helps to group information about a disease.

Acute and chronic sinusitis were classified as "respiratory diseases" (J00-J99), but they were placed under different codes and blocks. Chronic sinusitis belongs to the block "Other diseases of the respiratory tract" (J30-J39) with a code of µB 10 "Chronic maxillary sinusitis" (J32.0).

Causes and symptoms

The development of the chronic course of the disease is promoted by an untreated one. Initially, the inflammation is caused by bacteria and viruses that multiply rapidly. A suitable environment for the activity of microorganisms is created under some circumstances.

Etiology of the development of sinusitis:

frequent acute respiratory infections, acute respiratory viral infections, several times a year;
the presence of adenoids, polyps, cysts;
rhinitis, tonsillitis;
pathology of the upper teeth;
curvature of the nasal septum;
decreased immunity;

In adults, more often the chronic form of sinusitis is caused by staphylococci, streptococci, in children, chlamydia and mycoplasma. Therefore, when diagnosing a disease, it is important to determine the type of pathogen, otherwise it will be difficult to find the right treatment.

Signs of chronic sinusitis appear only during an exacerbation, which arise as a result of hypothermia. Symptoms of the disease are similar to the clinic of the acute course of sinusitis. 😐

The patient feels:

weakness, malaise;
change in voice (nasal tone);
pain at the root of the nose and orbit;
pain eroded into the teeth, temple, brow region;
discharge from the nasal cavity of mucus and pus of a yellow-green color;
nausea against the background of a large amount of discharge;
bad breath;
loss of scent;
subfebrile temperature;

The discharge of large amounts of mucus and pus affects the organs of the digestive system and upper respiratory tract. The patient often has to blow his nose and clear his throat. Against the background of this condition, diseases develop in the form of: laryngotracheitis, bronchitis, pharyngitis, tonsillitis. With development, anosmia is observed - a complete loss of smell.

Form and development of sinusitis

Chronic sinusitis is divided into forms, differentiated by the type of inflammation, localization, source of infection;

Inflammation type:

... The disease manifests itself in the form of edema of the mucous membrane, nasal congestion, discharge, sensations of heaviness in the eyes, cheeks.
Chronic purulent sinusitis, which is characterized by the accumulation of a large amount of pus in the cavity. The patient not only has to blow his nose, but also expectorate, because some of the pus flows down the back wall of the oral cavity.
... The formation of a cyst in the cavity.
Mixed. A combination of several symptoms of sinusitis, such as pus and polyps.

The localization of inflammation is:

Unilateral, when one side of the sinus is affected.
Bilateral, both sides become inflamed.

Routes of infection:

Rhinogenic, when the disease occurs due to the common cold.
Hematogenous. Infection directly into the sinus cavity.
... Sinusitis occurs due to unhealthy teeth.
... The disease manifests itself under the influence of an allergen.
Traumatic. The development of the disease after the trauma is observed.

What complications can there be?

Chronic sinusitis is very difficult to treat, but the lack of timely treatment pushes to a number of complications. Pus formed in the maxillary sinuses can move to other cavities, affecting the roots of the teeth, nerve endings, eyes, and the brain.

Complications appear in the form of:

swelling of the brain;
getting the infection into the brain;
sepsis, abscess;
phlegmon of the orbit;
trigeminal neuritis;

With proper timely treatment, there is practically no risk of complications. ➡ ➡ ➡ 💡

Diagnostics and treatment methods

In case of relapses of the disease, it is necessary to consult an otolaryngologist. The doctor begins the diagnosis of the disease with an anamnesis and examination of the patient. Additional methods include a number of laboratory and instrumental studies.

Diagnostics is based on:

X-ray of the sinus;
computed tomography;
sowing tank secreted from the nose;
UAC, OAM;
visual examination of the sinus by the endoscopic method;

To exclude odontogenic sinusitis, it is necessary to consult a dentist. Based on the results of the ENT diagnosis, the doctor determines the treatment that will be carried out without surgery or with surgery.

Treatment of chronic sinusitis

Drug therapy using antibiotics, vasoconstrictors, antihistamines and anti-inflammatory drugs.
Lavage of the cavity by the "cuckoo" method, YAMIK - catheter. Pus and mucus from the sinus are removed and filled with medicinal solutions.
Physiotherapy.
Puncture of the maxillary sinus is performed to eliminate signs of the disease. If the cause of the disease is a curvature of the nasal septum or trauma to the nose, then with the help of plastic surgery, the respiratory function is restored.
The use of folk remedies should be discussed with your doctor. Traditional medicine should be used as complementary treatments. At home, you can carry out irrigation of the nasal cavity with silver water to reduce germs. Aloe juice is the most effective for eliminating inflammation and swelling of the mucous membranes.

Can chronic sinusitis be cured? The prognosis of treatment is always favorable if you follow all the doctor's recommendations.

Radical sinusitis (surgery)

Sometimes the treatment of chronic sinusitis requires more serious measures. If conservative treatment is not effective, radical sinusitis is performed.

The essence of the surgical intervention is to penetrate the sinus with special tools that allows you to remove the contents. During the operation, a connection is made between the sinus and the nasal passage. A tube is inserted into the hole for convenient rinsing of the cavity, and left for 2-3 days. After the operation, antibiotic therapy is performed.

Preventive actions

To avoid the development of chronic sinusitis, you need to follow the doctor's recommendations.

Necessary:

To carry out timely treatment of a common rhinitis and a form of sinusitis.
Monitor oral hygiene.
The allergen should be eliminated if the disease has arisen against the background of an allergic reaction.
Improve immunity, prevent hypothermia.
Conduct restorative therapy, try to temper the body.
Lead a healthy lifestyle.
If the cause of the disease is associated with a curvature or a previous injury, then the problem must be solved with the help of plastic surgery.

People prone to colds are advised to get the flu vaccine annually.

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If we go to the ENT department and talk to patients and doctors, it turns out that every third patient is hospitalized with one or another problem with the maxillary sinuses. And most often, the cause is an acute or chronic inflammatory process that affects the maxillary sinus, which is called the maxillary sinus, after the name of the first described English doctor, Highmore, who lived in the middle of the 17th century.

The scientific name for this sinus is maxillary, or maxillary sinus.

Why are acute and chronic forms of this disease so widespread? It's all about the inconvenient anatomical localization of the sinuses and their neighborhood. This can be called a kind of clinical and anatomical prerequisites. By the way, thanks to them it is very difficult to cure chronic sinusitis forever, and these are the "culprits":

The outflow of the contents of the maxillary sinus can be produced into the nasal cavity only through the area of the upper third of its wall, which is closer to the midline (doctors say, "medial");
On each side, the last four molars in the upper jaw are very close to the sinus. Sometimes their long roots are just inside it. As a result, with an inflammatory process in the tooth tissue (with pulpitis, chronic periodontitis), the process occurs in the sinus itself.

In some cases, a more general and serious inflammation occurs, in which signs of polysinusitis appear. In this case, the frontal, ethmoid, and also the main (sphenoid) sinus are involved in the process. What are the signs of chronic sinusitis, and how can this condition be determined?

Chronic sinusitis - what is it?

Chronic sinusitis is a sluggish inflammation of the affected maxillary sinus (on one or both sides), which is characterized by alternating exacerbations and remissions.

From such a short and "capacious" definition, it follows that the main period in which distinct clinical symptoms appear is the period of exacerbation - we will tell about it separately. During the period of remission, the disease may not manifest itself at all.

The cause of any chronic process is the acute phase in the beginning. It can be really acute (for example, no one will ever forget in their life). But, in some cases, the first attack can proceed half erased, with an unexpressed clinical picture and, then, transform into a chronic process somehow "gradually". In many ways, this applies to chronic in general, and to sinusitis in particular.

The causes of chronic sinusitis is a protracted course of an acute process, or its frequent repetition, with a restructuring of the mucous membrane of the sinus tissues. Important links in the development of the disease are:

Decreased local and general immunity;
Frequent colds (rhinitis) occurring with microbial contamination of the nasal mucosa;
Violation of outflow (decreased drainage function) from the maxillary sinus, in various conditions (edema, polyposis, curvature of the nasal septum);
Odontogenic factor associated with aching teeth in the upper jaw.

Of all these factors, it is the violation of the outflow that is the link in the pathogenesis that triggers all the signs and symptoms of chronic sinusitis. Further, when considering the methods of treatment, it will be seen that only effective drainage can cure this disease.

Symptoms of chronic sinusitis in adults (exacerbation stage)

It is clear that the greatest severity of symptoms of chronic sinusitis in adults occurs in the exacerbation phase. Let's get acquainted with some of them, the most typical for this disease. The most common symptoms are:

Subfebrile temperature, almost never exceeding 37.5 ° C;
The general state of health, if it suffers, is insignificant. Perhaps a feeling of weakness, weakness, general malaise, decreased performance;
There is a nasal congestion on the affected side. In the event that the process is bilateral, then during the period of exacerbation, nasal breathing is absent;
Discharge of yellow-greenish color appears.

In most cases, the discharge can persist during the period of remission, only their amount will be more scarce. If the inflammation has ceased to be serous and become purulent, then the discharge of the nasal passages acquires an unpleasant odor. In the presence of pus, crusts also appear in the nasal passages, which are difficult to remove and dry out as the disease progresses.

In the case of an allergic and serous process, exacerbation of chronic sinusitis is accompanied by the release of a liquid secretion. In these forms, the fluid accumulating in the sinus cavity causes a pulling, bursting pain when the head is tilted forward.

Quite often, the process is accompanied by rhinitis. Regular sneezing occurs. Considering that the secretion of secretions from the nasal passages is almost constant, and the inflammation at the time of exacerbation is pronounced, then the cheek, and even the eyelids, may swell. In the area of the nasolabial triangle, weeping, maceration may appear, cracks appear with drying of the crusts. In prolonged cases, eczema of the facial skin may occur.
A characteristic sign of chronic sinusitis is pain syndrome. As a rule, pain is localized in the face, not far from the central line, but its irradiation can occur in different parts of the facial skull, and where other sinuses are located nearby. So, the pain "gives" to the teeth, from one and two sides, to the base of the nose, and to the forehead.

For the chronic form, it is uncharacteristic that the pain is localized in the temples, the base of the skull, radiates to the back of the head and neck, and also has a one-sided pulsating character, with irradiation into the eye. This most often occurs when.

For sinusitis (especially for a long time), the appearance of a nasal voice is characteristic.

It is necessary to distinguish between "nasal" in diseases of the ENT - organs, which is always associated with swelling of the mucous membrane, "restriction" of the airways, nasal congestion. Also, nasalism can occur with pronounced adenoid growths. The second variant of nasal nasal is "neurological" nasal, which is a consequence of decreased tone and peripheral paresis of the pharyngeal muscles.

In the second case, this is a sign of bulbar syndrome, which speaks of damage to the medulla oblongata. Other symptoms that indicate the development of bulbar syndrome are dysphagia (swallowing disorder) and dysphonia (weakness and hoarseness of the voice). When such signs appear in a patient with sinusitis, consultation with a neurologist is needed.

Almost always, on the affected side, the sense of smell is impaired, up to anosmia, or its complete absence.

In the event that a bilateral process occurs, then, a decrease in the sense of smell is one of the first complaints, just as in the presence of bilateral sulfur plugs in the ear, complaints of hearing loss occur. The mechanism of the appearance of such a symptom of chronic sinusitis is the same - the occurrence of a mechanical obstacle in the passages.

It is important to know that if an acute or first-onset sinusitis in an adult continues without significant improvement for more than 3 weeks, then we can talk about a protracted process. If the process continues for more than 6 weeks or longer than one and a half months, then the doctor has the right to talk about the chronic form of the disease.

All of the above symptoms are unpleasant, significantly reducing the quality of life. In some cases, complications can develop. If they are not treated in a timely manner, the situation can become much more complicated.

Some “sad” scenarios are described in the final section “forecast”.

Treatment of chronic sinusitis without puncture, drugs

Treatment of chronic sinusitis at home is reduced to conservative treatment. However, a puncture of the maxillary sinus immediately brings significant relief, and subsequent intensive treatment at home allows you to quickly complete the stage of inflammation. But, unfortunately, very often adult patients are terrified of a small operation, and agree to anything to get rid of the disease.

But, as we said above, due to the anatomical features of the location of the maxillary sinus, it is a large reservoir with a difficult drainage system. Therefore, timely and early puncture, with washing with disinfectants and antibacterial drugs, can quickly stop the exacerbation of the chronic process that has begun.

And if you do it regularly, you can achieve a stable clinical remission. By increasing your immunity, in some cases, you can completely get rid of this disease.

First of all, the treatment of the symptoms of chronic sinusitis is reduced to eliminating the possible causes of the infection. So, you need to sanitize all the teeth located above and behind (4 each on the left and on the right). In the event that there are polyps in the sinus, then they need to be removed, since conservative therapy will be ineffective. And only when the tissues surrounding the sinus are devoid of a source of infection, it is possible to be taken for the treatment of an exacerbation in the sinus itself.

Classic treatment

Basic principles effective relief of exacerbation is currently the following:

Puncture of the sinus, washing it (for example, with furacillin, a weak solution of potassium permanganate), as well as the introduction of a solution of a broad-spectrum antibiotic into it.

The possibility of subjecting punctate to bacteriological culture is also a positive point. As a result, the sensitivity of pathogens to antibiotics will be clearly determined.

In addition, during puncture, it is possible to inject into the sinus a solution of special enzymes that are proteolytic - trypsin, or chymotrypsin.

Normally it produces them, and in the intestines they break down proteins. When injected into the maxillary sinus cavity, they quickly and effectively liquefy thickened mucus, which is a perennial source of infection.

In the event that a solution of hydrocortisone or prednisolone is introduced into the sinus, then as a result of a pronounced anti-inflammatory effect, secretion decreases, and the volume of serous fluid immediately decreases.

As a result, the state of health improves, headaches are relieved. Punctures are performed every other day, and their total number is 8-10 per course, carried out during an exacerbation.

How to do without a puncture?

I must say that science does not stand still. Currently, it is possible to carry out all of the above manipulations using a special sinus catheter, which is firmly attached (using inflatable cuffs), going into the sinus. Therefore, puncture can be dispensed with.

Of course, for this you need to visit an ENT doctor, but it is much easier to puncture the sinus wall.

What to do at home?

If the treatment of chronic sinusitis is carried out at home, and there is no indication for puncture or non-puncture sinus drainage, then it is recommended:

Rinsing the nasal passages with salt water (it has an anti-edema and anti-inflammatory effect). Aquamaris and seawater-based preparations can be used;
Instillation of modern vasoconstrictor drugs. This should not continue for more than 10 days, in order to avoid the development of resistance and thickening of the mucosa. These funds include: "Nazol", "Nazivin". They are made on the basis of oxymetazoline, they are long-lasting and soft. It is not recommended to use "crude" drugs based on naphazoline, such as "Naphthyzin". You can use drugs "Xymelin", "Otrivin", based on xylometazoline;
With a fading exacerbation of sinusitis, you can use physiotherapy (UHF, magnetotherapy);
As a symptomatic treatment, antihistamines, NSAIDs, special gymnastics aimed at cleaning the nasal passages are used;
An important component of therapy is the intake of immunomodulatory drugs, and the sanitation of all foci of chronic infection in the body. It is in this area that the use of various means and achievements of traditional medicine is recommended: mumiyo, propolis, treatment with honey and aloe.

Prognosis and surgery for chronic sinusitis

We have touched upon the main symptoms and principles of treatment of chronic sinusitis in adults, but the story of "insidious sinuses" does not end there. In some cases, when conservative treatment is ineffective, and puncture or catheter placement is difficult, or the sinus is not completely flushed, surgical treatment may be required.

The operation is relatively small - the wall of the sinus is opened, and a wide anastomosis is formed, in which the lower nasal passage is connected to the sinus.

This event once and for all solves the problem of "ventilation" and sinus drainage. In this case, complete recovery is possible.

In the same case, if the patient resists and refuses the indicated surgical treatment, then the chronic form may be complicated by the following conditions:

The transition of inflammation to the tonsils, with the appearance of frequent acute and chronic tonsillitis (tonsillitis);
Possible damage to the lacrimal sac, with the development of dacryocystitis in adults. There is purulent inflammation, lacrimation and edema, narrowing of the palpebral fissure occurs;
At night, due to severe difficulty in nasal breathing, especially in old age, periods of sleep apnea, that is, respiratory arrest, may occur. And this, in turn, can lead to a violation of the rhythm of the heart, and even the appearance of fatal ventricular fibrillation. This can cause sudden death;
With dissemination of a purulent process (for example, when swallowing purulent mucus), laryngitis, bronchitis, and even pneumonia may appear. The appearance of sepsis is possible, and when the infection spreads into the cranial cavity, and a breakthrough through the blood-brain barrier, such dangerous complications as purulent meningitis and meningoencephalitis may appear.

In conclusion, it must be said that we have listed some complications not at all in order to "frighten" patients. All of the above should lead to the idea that the most correct tactics and strategy in the treatment of chronic sinusitis will be timely sanitation of the maxillary sinus in the form of a course of flushing without a puncture, with the placement of a catheter.

All other home methods, in which there is no way out for the infected contents of the maxillary sinus, are like trying to get rid of the unpleasant odor in the refrigerator by wiping it outside.