Chronic sinusitis in children and adultsChronic sinusitis, the symptoms and treatment of which are discussed in this article, belongs to the group diseases of the paranasal sinuses (sinusitis) and, in particular, is an inflammation of the maxillary sinus.
In its prevalence, this form of pathology occupies one of the first places among ENT diseases.
Causes of purulent, hyperplastic and other chronic sinusitis
The most widely known is catarrhal, chronic purulent maxillary sinusitis, and also a mixed form of the disease. In addition, the classification of the disease can be identified chronic hyperplastic maxillary sinusitis, polyposis and atrophic variants of the disease.
The immediate cause of the development in the sinuses of the pathological process, which later turns into a chronic form, most often become streptococci, less often viruses, anaerobic microbes and fungi.
However, the causes of chronic maxillary sinusitis can be seen from the other side: not from the position of the causative agent of the infectious process, but from the point of chronicization of the formed inflammation.
First of all, the transition to a chronic form is promoted by illiterate therapy of acute sinusitis.The non-observance of the therapeutic scheme is important:a violation of the dosage and timing of taking medications and other inconsistencies to the prescribed measures.
The chronicity of the described disease is also caused by the constant presence of foci of chronic infection in the nasopharynx: rhinitis, tonsillitis, etc.
Chronic sinusitis can form and against the background of the curvature of the septum of the nose, and with such formations as polyps and cysts, which naturally disrupt the normal movement of air in the sinuses, while stimulating the stagnation of mucus and breaking it Departure.
The development of the disease is influenced by the environment:the more gassed and dusty the higher the risk of getting sick.
Their role in the development of the described ailment is also played by bad habits, allergy and immunity.
Symptoms of chronic sinusitis in children and adults
SymptomsChronic sinusitis in adults and children are often erased or mild. This fact causes difficulties in the diagnosis and treatment of the described ailment.
The main manifestation of the disease is a chronic runny nose, not amenable to traditional therapy. Runny nose is accompanied by nasal congestion (more often one-sided) and other characteristic symptoms.
Often patients have complaints of pain localized in the head and depth of the orbit, passing in the prone position and intensifying with blinking. Dull pain can occur in the infraorbital area.
SymptomsChronic sinusitis include the morning swelling of the eyelids and chronic inflammation of the conjunctiva of the eyes. This characterizes the spread of the process from the maxillary sinus to the orbital walls.
A significant manifestation of the described disease is also considered to be a symptom such as a chronic dry cough. Moreover, this cough does not respond to therapy with the use of antitussive and expectorant drugs. The appearance of a cough for a given disease can be explained by an irritating effect on the pharyngeal region, which pus flows from its affected sinus.
Characteristic for the diagnosis of chronic sinusitis symptoms also include dulling of the olfactory function of the nose.
And the course and prognosis for this disease depend on the quality of the treatment used, as well as on the presence of structural changes in the sinus.
Exacerbations and complications of chronic sinusitisExacerbation of the chronic form of sinusitis, as a rule, happens after an infectious disease, for example, scarlet fever, measles, influenza, etc.
If the body is weakened by a factor that provokes an exacerbation, even the slightest hypothermia can occur.
In patients with a diagnosis of chronic sinusitis, exacerbation may be accompanied by the appearance of a rather intense pain in the area of the affected sinus. When you click on this area, the pain intensifies. Such a painful sensation is often accompanied by bursting when tilted or abruptly moving the head, which can be, for example, by sneezing or coughing.
Often, the ill begin to tear from the bright light of the eye, due to which there is some photophobia.
The main danger of the described illness comes from the structure and location of the maxillary sinus. Thin walls of this anatomical formation participate in the formation, as well as contact with the membranes of the brain. Given this fact, patients with this disease always have the risk of spreading infection into the cranial cavity with the development of meningitis.However, with the diagnosis of chronic sinusitis complications of this nature are extremely rare. Bole is likely to transfer infection from the affected maxillary sinus to the orbit, the fiber that fills the orbit, and also to the eye membranes.
This swelling of the process is evidenced by puffiness of the eyelids and a certain bulge of the eye on the background of severe pain.
In addition, chronic sinusitis in adults and children plays the role of a source of infection. Because of this, the described disease becomes the cause of frequent recurrences of angina, pharyngitis, and also can lead to the occurrence of diseases of the teeth or maxillary osteomyelitis.
With genyantritis, neuritis of the trigeminal nerve can form, which will be indicated by strong attacks of pain in the face area. Chronic rhinitis, which has appeared as a result of inflammation of the maxillary sinus, can cause atrophy of the mucous membrane and loss of smell. The disease can be complicated by the formation of an abscess.
Patients with chronic sinusitis, as a rule, are treated long and unsuccessfully for chronic bronchitis and other possible causes of chronic cough.
Treatment of chronic sinusitis at home with drugs
Chronic sinusitis in children and adults requires compulsory treatment, while it is very important that the appointment of therapy carried out by an experienced specialist.
Treatment of this disease should be complex. As a rule, physicians prescribe local or common glucocorticoids, antibiotics and saline solutions for rinsing.
Of all these groups of drugs, antibiotics are considered to be the most important, although the role of bacteria in the development of this ailment remains controversial.
Treatment in a hospital is shown primarily to patients with developed orbital and intracranial complications. In addition, patients with immunodeficiency and children need hospital treatment.
In deciding the question of how to treat chronic sinusitis, one should be guided by drugs that affect the various links of the pathological process. One of these means are decongestants. They cause narrowing of the vessels of the mucous membrane and thereby contribute to the elimination of edema, the reduction of local inflammation and the normalization of outflow from the sinuses.The most popular drugs in this group are drugs that include oxymetazoline (for example, Nasivin or Nasol), phenylephrine (in particular, Vibrocil), naphazoline (all known as Naphthysin), xylometazoline (these are familiar to many Otrivin and Galazolin).
Care should be taken when using drugs of this group in patients diagnosed with chronic sinusitis. You can not tolerate treatment with these drugs for more than 5-7 days, otherwise there is a risk of addiction and drug rhinitis.
After the doctor has determined the symptoms of chronic maxillary sinusitis and treatment in adults, and the children are selected appropriate. And it is quite possible that to obtain the best result the patient will need to prescribe corticosteroids.
Such means for direct introduction into the nose (sprays, drops) are especially effective in the combination of sinusitis with polyps, a medicamentous variant of rhinitis and an allergic rhinitis.
Along with antibiotics, these drugs are key components of the therapy of this ailment.
The most well-known of this group of drugs are fluticasone-based drugs (eg, Fliksonase), beclomethasone (Aldecin) and mometasone (Nazonex).
In the question of how to cure chronic sinusitis, not the last role of the physician is assigned to the lavage of the nose. Used for this, saline solutions, moisturizing the mucous membrane, reducing edema and mucus viscosity.
Solutions may include a solution of sodium chloride or sea water. Most often in pharmacies there are Aqua Maris, Dolphin and Marimer.
The pharmaceutical industry also produces combined preparations, which, in addition to sea water, also contain vasoconstrictor substances. An example of such drugs is Snoop, which is a combination of sea water with xylometazoline.
How to treat chronic sinusitis with antibiotics?Antibiotics for chronic sinusitis can be used only when there are signs of bacterial infection in the clinical picture of the disease. If this ailment has developed for some other reason, then the use of antibacterial medicines will not yield any results.
As a rule, such drugs as Doxycycline and Amoxicillin are used as antibacterial therapy for patients with sinusitis. Trimethoprim or Sulfamethoxazole is also used. If such treatment of chronic sinusitis does not have an effect, then the drugs should be replaced by others.
In the treatment of antimicrobial medicines, it is extremely important to follow the prescribed course of treatment. In most cases this is 10-14 days, but a longer period of therapy may well be required. It all depends on how soon the patient's condition will improve.
If you stop taking medication after a few days, then the manifestations of the illness come back and quickly enough.
How to cure chronic sinusitis at home using folk methods?Helps with the diagnosis of chronic sinusitis and treatment at home using folk methods.
It should be remembered that a good help in the fight against the disease rest. And to dilute the secretions and improve the patency of the nasal passages, you need to drink plenty of fluids. It is better to avoid drinks with caffeine and alcohol, tk. they lead to dehydration, and alcohol also worsens the swelling of the mucous sinuses.
Sleep with this disease is recommended in a position with a slightly raised head. Due to this, it is possible to reduce congestion in the sinuses of the nose.
In patients with a diagnosis of sinusitis, chronic home treatment should include moistening of the sinuses. To do this, you can inhale the steam from the hot water tank while holding the towel over your head and trying not to direct the steam into your face. In addition, you can inhale warm moist air by taking a hot shower. Such procedures facilitate pain and help in the mucus.
Pain can also be reduced with a warm compress:for example, put a warm towel on the cheek area of the nose.
Solving the question of how to cure chronic sinusitis at home, do not forget about washing.
Usually, for this disease, special devices are used to rinse the nasal passages:in particular, a syringe with a flexible tube or syringing. Used for washing, usually salt water. You can also rinse your nose with propolis.
Surgical treatment of chronic sinusitis
If even after adequate, properly prescribed therapy the disease continues to develop, then the treatment of chronic sinusitis in adults and children should be performed surgically.
Nowadays there is endoscopic surgery. Doctors using an endoscope first examine the paranasal sinuses, and then remove polyps and tissues that cause nasal congestion with a special tool.
Chronic sinusitis - symptoms and treatment in adults
Genyanthitis refers to the inflammation of the paranasal sinuses arising from infection in the nasal cavity when inhalation or blood on the background of a runny nose, ARVI, colds, sick teeth, as well as hypothermia, drafts and etc.
The disease develops as follows: in the paranasal sinuses, with the laying of the nose, mucus begins to accumulate, which then can cause purulent discharge. Sinusitis can occur in an acute form, but often this disease becomes chronic.
Symptoms and treatment of chronic sinusitis in adults
Sinusitis is a very unpleasant disease, it can provoke various unwell conditions of the body, headaches and pain in the nose.
The disease is one-sided, when the sinus is affected only on one side, and, accordingly, bilateral if the inflammatory process has swept both sinuses.
Symptoms of chronic sinusitis in adults:
- pain in the bridge of the nose, frontal part of the face, upper jaw, and even in the eye area, which usually intensify toward evening;
- the nasal voice appears in the patient's voice;
- the temperature rises;
- difficulty breathing and lays the nose;
- there is a feeling of nausea, there is a loss of smell and taste;
- there is general malaise, fatigue, a sense of weakness and loss of attention;
- The snot can be white, bright yellow or green, sometimes with an unpleasant odor.
Symptoms of chronic sinusitis in adults are confused with another disease, since pain and heaviness in the nose can speak mainly only about sinus inflammation.
If treatment is not carried out on time, then the disease is accompanied by a more severe purulent form of the flow and can give serious complications.
What and how to treat chronic sinusitis in adults, determines the ENT doctor at the reception. In some cases, the course of treatment can be carried out on an outpatient basis, and with a more complex genesis the doctor prescribes a referral to a hospital.
The treatment of sinusitis is based on antibiotics and necessarily in parallel with them the procedurewashing of the nose with a solution of furacilin or other antiseptics.
In addition to the basic treatment of chronic sinusitis in adults, respiratory droplets may be prescribed to the nose and such preparations like Sinuphorte and Sinupret, which promote the acceleration of the healing process and the better removal of mucus or purulent fluid from sinuses, and others.
It is worth noting that in acute, and the more purulent stage of sinusitis, in any case, do not expose the nose and sinuses to warming. Since under the influence of temperature the infection will spread much faster and can even hit the brain.
Methods and methods of treatment of sinusitis in adultsSinusitis - inflammation of the paranasal sinuses, many do not consider it an important and dangerous disease. Treatment of maxillary sinusitis in adults is more often associated with persuasions, moods and refusals of drugs than children.Adult intelligent people come to the doctor already with a severe form of chronic sinusitis, with severe headaches, complete absence of nasal breathing.
In such cases, for a quick relief of the condition, it remains to puncture and wash the sinuses. The procedure is not pleasant, but the patients themselves do not leave themselves the choice. The doctor thinks about possible complications and spread of the inflammatory process to the meninges, damage to the facial and trigeminal nerves.
When you go to an early stage of the disease, you can pick up medicines to treat sinusitis, offer folk remedies, physiotherapy, massage.
Methods of treatment of sinusitis in adults
In adult patients, a polyclinic of the genyantritis is most often associated with an untreated viral infection after a respiratory illness or flu. A prolonged runny nose causes pathological pathogens to penetrate into the maxillary and frontal sinuses of the nose, a bacterial infection joins and suppuration occurs. A chronic process is quickly formed. Exacerbations occur after each hypothermia, several times a year.
To treat chronic sinusitis you need a whole complex of medications.
- Treatment with antibiotics of acute sinusitis, as a rule, is not effective. Not because the drugs are not prescribed, but because of the lack of the ability of antibiotics to act on viruses. Pathogens of influenza, adenoviruses, herpes infection are insensitive to antibiotics. However, a bacterial infection complicates the disease and leads to severe inflammation. Therefore, the use of broad-spectrum antibiotics with a short course in this case is justified, the dose and duration of treatment is determined only by the doctor.
You can not prescribe antibiotic treatment yourself or stop prescribing ahead of schedule.This contributes to the loss of sensitivity of pathogens to the antibiotic.
In the severe stage of chronic sinusitis, antibiotics are administered intramuscularly, hormonal agents are prescribed.
A more effective way of treatment is the local use of anti-inflammatory drugs based on antibiotics in the form of sprays. "Bioparox "Isofra "Polidex" are popular in chronic sinusitis sprays with a deep penetration of the anti-inflammatory drug close to the source of the disease. Use medicinal sprays need 15-20 minutes after the use of vasoconstrictors and possible cleansing of the nasal passages.
For treatment of chronic sinusitis, a spray with an antiviral effect is recommended - Sinupret.
- As vasoconstrictive medications for adults, nasal drops (naphthyzine, galazoline, ximelin) or sprays are recommended. It is necessary to use these drugs no longer than five days, as they cause the mucous membrane to overdry. To hypertensive people any vasoconstrictive medicines are contraindicated.
- To dilute the contents of the sinuses, wash the nasal passages from the remains of mucus, pus and germs can be used sprays based on sea water containing plant mucolytic agents - "Marine "Aqua Maris " "Sinuforte". For washing, a weak solution of potassium permanganate or furacilin is suitable.
- Symptomatic means. With severe headaches, you can apply aspirin, analgin, ibuprofen. Do not abuse these drugs if there is chronic gastritis.
Traditional medicine is widely recommended for the treatment of chronic sinusitis.
- With the help of chamomile, marigold, plantain, it is possible to effectively and safely wash the nose both during the period of exacerbation and for prophylaxis. Decoctions are prepared as tea one spoon for a glass of boiling water.
- These same broths are used for compresses on the forehead, nose and nose. Treating from sinusitis with compresses is better at night.
- From calanchoe, aloe, beet, juice is obtained for instillation in the nose or treatment with nasal tampons moistened in solution.
Puncture of the maxillary sinus
In severe inflammatory process, adult patients after local anesthesia undergo a puncture of the maxillary sinuses followed by washing, suctioning of purulent contents and the introduction directly into the inflammatory focus of antibiotics, diluting enzymes (trypsin, chymotrypsin). In the period between the punctures, it is possible to use the washing of the nose with folk methods.
Treatment by physiotherapy methods
It is carried out in conjunction with medicines and folk remedies. Applied UHF apparatus, lamp "Sollux tube-quartz, laser therapy. These apparatuses allow, in addition to a small bactericidal action, to remove edema of the nasal passages, to restore epithelial cells, and to stimulate local immunity.
The use of electrophoresis and ultrasound therapy presupposes a profound introduction of medicinal anti-inflammatory drugs with the help of physical stimulation.
To treat chronic sinusitis, laser irradiation can be performed inside the nasal passages and outside at the points of acupuncture points.
Massage or self-massage is prescribed in the early stages of the disease or during the recovery period. If there is purulent contents in the sinuses, the massage is strictly contraindicated.
Any kind of treatment of sinusitis in adults is associated with possible side effects of drugs, antibiotics, herbal remedies, with increased individual sensitivity of the body. Therefore, it is necessary to consult with the attending physician on all matters.
With a clear performance of all medical measures, exacerbation of the sinusitis is cured within 7-10 days. To get rid of the chronic process, you will have to be treated with all possible measures for two to three months and will be involved in the prevention of the disease.
Chronic sinusitis: definition and causes
What is chronic sinusitis? It is a disease that can cause the patient to periodically feel unhappy. It lasts from 12 weeks to several months.
A type of sinusitis is sinusitis - inflammation, localized in the maxillary sinuses of the nose.
In the bones of the face and head there are sinuses (sinuses) - hollow air pockets, which exist in order to amortize the brain during the trauma.
Sinuses are lined with a thin layer of tissue that produces a small amount of mucus.
This mucus keeps the sinuses healthy and "flushes" the microbes.
Sinusitis occurs when the mucous membrane of the sinuses is infected or irritated. In this case, it swells and produces additional mucus.
Failure to understand the distinctive features that indicate chronic sinusitis can lead to an erroneous diagnosis.
"The therapist can label the condition as allergic rhinitis, but the treatment for sinusitis (chronic and allergies) and its results will be completely different. The problem that the therapist faces is to understand how to determine which patients with synonasal symptoms actually have sinusitis themselves or in combination with other conditions, "said Neil Bhattacharya, MD, associate professor of otology and laryngology at Harvard Medical School.
It is important to know
Chronic sinusitis is a multifactorial disease that requires a thorough diagnosis and therapeutic approach. There is no single therapy that will work for every patient.
A number of factors may increase the risk of chronic sinusitis or worsen its symptoms. These include:
- Allergy: much more common among people with chronic rhinosinusitis than among healthy people. This is especially true for allergies that are present all year round, for example, on dust mites, animal hair, mold and cockroaches. Poorly controlled allergies can worsen the symptoms of chronic sinusitis and cause allergic sinusitis.
- Exposure to tobacco smokeor certain environmental toxins, such as formaldehyde, can translate sinusitis into a chronic one.
- From the immune system: the majority of people with chronic sinusitis normally function as the immune system. However, people with certain immune system problems are at increased risk of developing chronic sinusitis.
- Viral infections: some people develop chronic rhinosinusitis after a recurrence of a viral infection (eg, a cold), although there is no exact evidence that the infection is the true cause of chronic sinusitis.
- Curvature of nasal septum(a piece of cartilage that separates the nostrils from each other). This condition can be from birth or develop later as a result of a nose injury.
Chronic sinusitis and its symptoms in adults
In chronic sinusitis, the membranes of both paranasal sinuses thicken due to constant inflammation.
In chronic and acute sinusitis, signs and symptoms are similar, but the duration of acute sinusitis does not exceed ten days.
In chronic sinusitis, the symptoms in adults are as follows:
- Isolation of a thick, greenish or yellowish liquid from the nostrils.
- A feeling of pressure and swelling in the eyes, cheeks, nose, or forehead.
- Dulling of smell, change in taste.
- Relentless pressure and swelling in the sinuses can give a side effect in the form of a headache. Pain can also be seen in places that you might not have thought of during sinusitis. For example, sinusitis can provoke pain in the ear, toothache and pain in the jaw and cheeks.
- Unpleasant sensation in the ears.
- Cough, which at night can be worse.
- The smell from the mouth becomes unpleasant.
- Constant nasal congestion, which causes shortness of breath through the nose.
- Fatigue or irritability.
It is important to know
Acute and chronic sinusitis is not an explanation for a chronic headache. In some patients with chronic headache, chronic sinusitis is sometimes incorrectly diagnosed, but often the opposite occurs.
Before symptoms of chronic sinusitis appear in adults, the patient may experience several episodes of acute sinusitis lasting less than four weeks.
Read also "Pansinusitis, what is it?"
Methods of treating chronic sinusitis
The doctor can recommend a number of procedures to help alleviate the symptoms of sinusitis. These include:
- Saline nasal irrigationusing a spray to cleanse the nasal passages.
- Corticosteroidsin the form of nasal sprays, such as budesonide and fluticasone. They are used to prevent inflammation and treatment of an already existing one.
- Glucocorticoid tablets. In some cases, in the treatment of chronic sinusitis, the doctor will recommend the patient to take glucocorticoids. The most commonly used oral glucocorticoid is prednisolone. Glucocorticoids taken in the form of tablets provide higher doses of the drug compared to nasal sprays, rinses or drops. This can lead to a reduction in inflammation and a significant improvement in the symptoms of sinusitis. Nevertheless, glucocorticoids taken orally suppress normal immune responses throughout body and can cause side effects, so doctors use them only in case of acute necessity.
- Antileukotriene drugs. These include Montelukast, zafirlukast and zileuton. These medications work by reducing inflammation, but other than glucocorticoids. Antileukotriene drugs are not suitable for all types of chronic sinusitis. They are most useful for people with chronic nasal congestion accompanied by polyposis and asthma.
- Painkillers(aspirin, acetaminophen or ibuprofen). Aspirin is associated with the risk of developing Reye's syndrome, so it is given only to people over 18 years of age. Some of these drugs can exacerbate the symptoms of chronic sinusitis, so do not prescribe pain medication yourself, consult your doctor.
- In case of bacterial infection, people suffering from sinusitis should takeantibiotics.
- If sinusitis is caused by an allergy, thenimmunotherapywill help reduce the body's reaction to certain allergens.
- In cases in which the body continues to resist drugs, one of the options for treating chronic sinusitis may beendoscopic surgery. After the operation with sinusitis, you can again open the aisles and sinuses of the nose and remove the mucus or polyps that have entered them.
Self-help for chronic sinusitis and its treatment with folk remediesHere are the simple steps that can help alleviate the symptoms of chronic sinusitis:
Rest more often. This will help your body fight inflammation and accelerate recovery.
To dilute the secretion of mucus and improve its drainage,drink juice, tea or other liquid. Just do not during the illness to drink caffeinated or alcoholic drinks, since they can promote dehydration.
In chronic sinusitis treatment of folk remedies and its symptoms in adults and children necessarily includeshydration of the paranasal sinuses. At home, you can do this as follows: cover your head with a towel and breathe a few minutes of steam from the pot with hot water. Or take a hot shower, or even better - a bath with sea salt or tea tree oil. This will improve the outflow of mucus from the facial sinuses.
Warm compressesare useful for alleviating pain in the nose and sinuses.
Rinse the nasal passageswith the help of sprays, sold in a pharmacy or made with his own hands. In the second case distilled or boiled and cooled water, which does not contain harmful substances, is needed.
Here's how to treat chronic sinusitis with folk remedies with the help of salt washing:Dilute 1 teaspoon of table salt in 500 ml of water. Pour a little liquid in the palm of your hand, pull it in with your nostrils, and back it should pour through your nose or mouth. And for greater convenience, you can use a special "watering can which is sold in pharmacies. Since the symptoms of chronic sinusitis in adults and children are very similar to the symptoms of chronic sinusitis, this method will be effective and with inflammation of the maxillary sinuses.
Sleep with a raised head. This contributes to a better outflow of mucus from the sinuses..