19Feb

Acute sinusitis: frontal, purulent and catarrhal

The very concept of acute sinusitis, the symptoms and treatment of this disease and its prevention are quite familiar to both doctors and people not related to medicine. And this is not surprising, because this disease is widespread and represents one of the most urgent problems of otolaryngology.

It is believed that annually about 10 million Russians suffer from this pathology with a peak incidence in the autumn-winter time.

Acute sinusitis in children is more common than in adults and takes second place in the structure of ENT diseases. And the younger the child, the harder it will be.

Causes of acute bacterial and viral sinusitis

Depending on the type of the affected sinus, sinusitis is isolated in the form of sinusitis, frontalitis, sphenoiditis and etmoiditis.

With genyantritis, the process is localized in the maxillary, and with the front - in the frontal sinus. These are the two most common types of sinusitis, which is explained by the proximity of the sinuses relative to the nasal passages. Of these two forms, acute frontal sinusitis ranks second in terms of occurrence, while the leader is

maxillary sinusitis .

Sphenoiditis is an inflammation of the sphenoid sinus, and etmoiditis is a lesion of the cells of the trellis labyrinth. These forms are less common, but they are much more complicated and require more attention from the doctor.

If, however, all paranasal sinuses are involved in the process, the diagnosis will sound like "pansinusitis".And with the defeat of the sinuses only on one side - "gemisinusit."

Classify the described ailment and the causal factor. Thus, acute viral and acute bacterial sinusitis are isolated.

The pathogenesis of this disease is purulent and catarrhal.

Formation in the mucosa of the inflammatory process is known to contribute to general and / or local factors. Common causes of acute sinusitis include constitutional prerequisites, changes in individual reactivity, impaired immune forces, plus various external adverse factors. Among the prerequisites of a local nature, those in which the sinus drainage and ventilation suffer, as well as the work of the mucociliary transport system, are of particular importance. For example, systemic( in particular, allergies) and local factors can disrupt the activity of the sinus outlets. The latter are divided into anatomical and pathophysiological.

Anatomical include crests, spines, curvature of the septum, hypertrophy of shells, tumors and polyps, and hyperplasia of the nasal mucosa. These factors not only disrupt drainage and ventilation through natural anastomoses, but also contribute to the malformation of the sinuses themselves. This is especially true with the long existence of pathology in childhood.

The main significance in the etiology of acute sinusitis is usually given to infectious agents that enter the sinuses from the nasal cavity, teeth or distant foci of the disease. In general, we are talking about cocci flora( strepto-, staphylo- or pneumococcus).Gram-plus or gram-negative sticks, influenza, parainfluenza and adenoviruses, fungi become much less frequent than pathogens.

Signs of acute catarrhal and purulent sinusitis

Acute sinusitis occurs not only with local manifestations. This is a process in which many systems and organs react. The general reaction of the body to inflammation in the sinuses includes fever, headache, weakness and malaise.

However, such signs accompany almost every focal infection and, in their presence, it is difficult to make an accurate diagnosis. Therefore, in diagnosing the described disease, it is better to rely on local manifestations.

This includes, as a rule, complaints of nasal breathing difficulties with smell disorders and pathological nasal discharge.

Acute catarrhal sinusitis is manifested by sensations of burning and dryness in the nose and a sharp loss of smell against the background of worsening of nasal breathing. At the same time there is hyperemia of the mucous tissues of the nasal passages, lacrimation and general intoxication of the body.

Since this type of disease is caused mainly by viruses, sleep and appetite disorders, headache, and in some cases, elevated body temperature, are characteristic for it. This sinusitis is complicated by diseases of the upper respiratory tract and meningitis.

Acute purulent sinusitis, in contrast to the previous one, is caused mainly by bacterial agents. The main symptom in this case are purulent discharge, the difficulty of outflow which worsens the nasal breathing, leads to edema of the mucosa and as a consequence to smell disorders.

Characteristic for the disease and headache in the forehead and temples, which increases with the tilting of the head. Also accompanied by acute sinusitis are symptoms of general deterioration: weakness, dizziness, etc.

Complications and Diagnosis of Acute Sinusitis


The complications that characterize acute sinusitis can be divided into orbital and intracranial. The first arise when the latticed labyrinth and frontal sinus are affected, as a result of which the inflammation moves the orbit. Eventually, a phlegmon or abscess is formed.

Intracranial complications arise from the movement of pathogenic microbes into the cranium. In this case, the inflammatory process can be either local or diffuse. Clinically, it is expressed by abscesses, meningitis, arachnoiditis.

Symptoms observed in this disease are helpful in diagnosing acute sinusitis. In addition, physicians traditionally rely on laboratory data.

From the physical methods allow you to speak about acute sinusitis signs that are detected with a rhinoscope( front, middle or back).And instrumental methods usually boil down to radiography and diagnostic puncture.

How to treat acute sinusitis: antibiotics and other medications

A specialist doctor should decide how to treat acute sinusitis. Usually, the therapy of this disease is aimed at eliminating inflammation and fighting infection. In addition, it is very important to establish a normal outflow of sinus contents. Taking into account the severity of the process, the doctor can offer either medication or non-drug treatment.

The latter is a puncture, which is perhaps the most effective method of quickly getting rid of purulent contents. This procedure allows to eliminate the infectious focus at the local level with the help of antibacterial and anti-inflammatory drugs.

Helping to overcome acute sinusitis medication treatment involves the use of drops, sprays and aerosols with vasoconstrictors. The most famous of them are Nafazolin and Oksimetazolin.

You can take vasoconstrictive drugs through your mouth. For example, Pseudoephedrine or Phenylephrine. To avoid allergies, it is better to combine them with Loratadine or other antihistamines. Very good eliminate acute sinusitis antibiotics, of which the most popular is Bioparox, which includes fusaphungin.

When choosing an antibacterial drug, one should pay attention to its activity in relation to certain groups of microbes and the ability to resist the pathogen.

As a rule, with a light course of the antibiotic is not required. He is appointed only in the absence of improvement after 10 days of illness or with worsening of the condition.

Disease of medium severity is best treated with Amoxicillin.

In the case of severe disease, the drug is enhanced with clavulanic acid. Ceftriaxone, Cefuroxime and other cephalosporins may also be used.

How to treat acute sinusitis in pregnancy

The main method of treatment of the described disease in pregnant women is the use of vasoconstrictors. They help to eliminate mucosal edema, thereby restoring breathing through the nose and improving overall health.

If acute sinusitis occurs during pregnancy with a rise in temperature, then it is necessary to use antipyretic drugs, however, it is not worthwhile to self-medicate, but only the drug prescribed by the doctor should be taken.