19Feb

Clinical course and drug treatment of sinusitis without puncture

Genyantritis( maxillary sinusitis) is a disease characterized by inflammatory changes in the epithelium of the mucosa of the maxillary sinus( maxillary).According to the nature of the course of sinusitis can be acute or chronic. Treatment of sinusitis without puncture( intranasal anthrosis) is usually performed with an acute form of the flow without septic complications.

Treatment of sinusitis without puncture

Anatomy of the maxillary sinuses

A sinus sinus is a paired cavity located in the upper jaw. Its internal surface is lined with a ciliated epithelium, the cilia of which help to clear the respiratory tract from dust particles. The maxillary sinus opens on the inside of the nose in its upper part, which complicates its normal drainage. If the mucous membrane develops inflammation, the mucus stops evacuating and accumulates in the cavity of the sinus. If the inflammation is caused by an infectious agent, pus accumulates in this cavity.

Anatomy of the maxillary sinuses

Anatomy of the maxillary sinuses

Table of contents:

  1. Main causes of the disease
  2. Clinical picture of sinusitis
  3. Modern methods of treatment of sinusitis
  4. Physiotherapeutic treatment of sinusitis

The main causes of development of maxillary sinusitis are:

  1. Infectious processes. The disease develops as a result of entering the sinus cavity of pathogenic microflora, usually pneumococci, hemolytic streptococci, escherichia, or fungi. In this regard, the disease often develops as a result of prolonged rhinitis or acute respiratory infections.
  2. Diseases. In this case, the infectious process spreads through the thin lower wall of the maxillary sinus over the molars of the upper jaw.
  3. Allergic reactions. Hypersensitization of the body is a predisposing factor. The ingestion of an allergen on the mucous membrane can provoke increased secretion of mucus and swelling of the epithelium of the sinus.
  4. Immunodeficiency states. Decrease in the general immunity of the organism promotes seeding of the mucosa by pathogenic microorganisms, which is accompanied by an inflammatory reaction.

Clinical picture of sinusitis

Inflammation of the mucous membrane of the paranasal sinuses is accompanied by pain of varying intensity, which can radiate into the temple or imitate toothache. Characteristic for a sinusitis symptom is increased pain and a feeling of heaviness with a sharp tilt of the head forward. Pain is also felt during palpation at the site of the projection of the maxillary sinus( anterior wall of the upper jaw).During the course of the disease, a mucous or purulent secretion from the nasal cavity is isolated, which is due to its accumulation in the maxillary sinuses. With genyantritis, general symptoms may appear, such as fever, nasal congestion, headaches, loss of appetite.

In case of inadequate treatment, the disease can take a chronic course.

Chronic sinusitis is characterized by a protracted course for more than 6 weeks. At the same time, a typical clinical picture can appear only during periods of exacerbation, however, the focus of infection in the cavity of the sinus sinuses will persist. Therefore, treatment of sinusitis should include drainage and sanitation of the maxillary sinuses.
X-ray examination is used to diagnose the disease. On the roentgenogram, there is an intense shadow or level of fluid in the area of ​​the maxillary sinuses. To identify the pathogen, with sinusitis of an infectious nature, sowing from the nasal cavity and subsequent analysis on the flora are carried out. An additional method of investigation is MRI or computed tomography.

Modern methods of treatment of sinusitis

The purpose of sinusitis treatment is elimination of the infectious focus, restoration of ventilation of the maxillary sinuses and adequate functioning of the ciliary epithelium. The choice of treatment depends on the cause of the disease. When odontogenic sinusitis is shown the removal of a carious tooth in order to eliminate a chronic focus of infection. Several modern methods of treatment will be described below.

Means promoting treatment of genyantritis:

1. Anti-inflammatory drugs.

2. Vasodilating preparations .They are applied topically to reduce edema of the mucosa and restore the drainage of the maxillary sinus. Some authors( Evans K.L., 1994) recommend after taking these medications to take the "Mecca" pose, which improves the outflow of mucus or pus from the maxillary sinuses.

Modern methods of treatment of sinusitis

Regulation "Mecca"

3. Antibacterial drugs. To combat infection, such drugs as amoxicillin, trimethoprim, sulfamethoxazole, erythromycin, azithromycin and others are used. Treatment of sinusitis in chronic Foma is carried out after determining the sensitivity of microorganisms to antibiotics and only during periods of exacerbation. Acute sinusitis requires antibacterial treatment for one to two weeks.

4. Hyposensitizing drugs. Used to treat allergic sinusitis. Of antihistamines, terfenadine, loratadine, and others are used.

5. Mucolytic agents. These drugs dilute mucus and promote its removal from the sinus cavity. For this purpose, guaifenesin is used, which is effective even in small doses.

6. Corticosteroids. are strong anti-inflammatory drugs. Significantly reduce the edema of the mucosa and improve the drainage of the sinus cavity. To prevent the appearance of undesirable side effects are appointed topically in the form of drops.

One of the methods of treatment of sinusitis without puncture is sanation of the maxillary sinus cavity with the help of a special sinus catheter "Yamik".With it, you can create a negative pressure in the nasal cavity and successfully evacuate the contents of the maxillary sinus. With the help of this catheter, you can inject drugs directly into the sinus cavity. It is a tube equipped with two cylinders, which, when inserted, are located in front and behind the entrance to the maxillary sinus and prevent entry of the drug. Between these cylinders opens the opening of the tube, through which the drug is administered and the suction of the contents of the maxillary sinus.

Treatment of chronic sinusitis

Catheter "YAMIK"

Physiotherapeutic methods of treatment of sinusitis

Various physiotherapeutic procedures are widely used for the treatment of sinusitis. Most often, electrophoresis and phonophoresis are prescribed for the sinus area. This involves the introduction of a variety of drugs( suspension of hydrocortisone, zinc sulfate solution) under the influence of galvanic current or ultrasound. In addition, it is recommended to apply ultrasound to the sinus area for the purpose of warming up and improving blood supply. With therapeutic purpose, the radiation of a therapeutic helium-neon laser and intraspecific phonophoresis are used. For the purpose of antibacterial therapy, inhalations of a 1% solution of imanine, ecolin, UHF and UV irradiation are used. In addition, with the catarrhal form of chronic sinusitis, mud therapy is used, which is prescribed in combination with electrophoresis and phonophoresis.
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