Acute and chronic sinusitis - two forms of the same disease, acute flows into the chronic with repeated relapses. In both cases, as a rule, conservative treatment is applied, but in the chronic course of the disease, emphasis is placed on antibacterial drugs. Treatment of chronic sinusitis in a purulent form can be prompt.
Acute antritis: symptoms and how to treat inflammation
In this section of the article you will learn about the symptoms and treatment of acute sinusitis, often complicating the course of influenza, acute cold, scarlet fever, measles and other infectious diseases. First of all, it is necessary to emphasize the etiological dependence between influenza and acute sinusitis. Also, a fairly common cause of acute inflammation of the maxillary sinus are root diseases of the four posterior upper teeth: small molars, 1st and 2nd molars and wisdom teeth.
Traumatic injuries of the sinus walls, operations in the nasal cavity and subsequent tamponade can lead to infection of the maxillary sinus and subsequent inflammation.
Symptoms of acute maxillary sinusitis are pressure and tension in the affected sinuses, in severe cases they are pained by severe pains that often localize not only within the maxillary sinus, but also in the forehead, zygomatic area, less often the temple, capturing the entire half of the face. In acute cases, toothache often occurs in the corresponding half of the upper jaw, which is enhanced by chewing. Nasal breathing is disturbed, there are discharge from the nose. Since the diagnosis of acute sinusitis is usually one-sided, then these phenomena are of a one-sided nature. Patients also complain of photophobia and lacrimation on the side of the lesion, as well as a decrease in the sense of smell. In the first days of the disease, the body temperature rises, chills arise, general state disorders. Often there is swelling of the cheek on the affected side, and sometimes collateral edema of the lower eyelid. With anterior rhinoscopy, hyperemia and swelling of the mucous membrane of the middle nasal passage are visible, there is an excess of mucous discharge and often a characteristic strip of pus that flows out from under the middle shell.
In the treatment of acute sinusitis, conservative methods are used. When the disease is accompanied by fever, the patients are shown bed rest, antipyretic and analgesic agents. In the presence of general intoxication and sharp pains, copious discharge from the nose, sulfonamide preparations and intramuscular penicillin are prescribed for 5-7 days every 3-4 hours, sometimes in combination with streptomycin( 0.25 g 2 times a day).To reduce the swelling of the mucous membrane in the area of the outlets of the paranasal sinuses and to facilitate the outflow of the discharge, lubrication or insertion of gauze tampons which are moistened in vasoconstrictive agents( 3% solution of ephedrine or 2-3% solution of cocaine with epinephrine), as well as instillationthese funds in the middle nasal passage several times a day.
The treatment of acute inflammation is also helped by physiotherapy( blue light, sollyx).UHF-therapy gives a good result even in severe cases of sinusitis, as well as diadynamic currents.
And how to treat acute genyantritis when tightening the disease with copious pus and if there is no tendency to cure? In this case, the sinus is punctured and washed, followed by penicillin( 300,000-500,000 units) or streptomycin( 250,000 units) or a combination thereof. Exemption of the sinus from exudate often leads to a rapid cure.
A more effective method of treating is a puncture with the introduction of a polyethylene tube, through which, for a week, the sinus is washed with a mixture of corticosteroid preparations and antibiotics.
Chronic sinusitis: signs and how to treat the disease
This section is devoted to the symptoms and treatment of chronic sinusitis, which occurs with repeated acute inflammation and especially with prolonged inflammation of the maxillary sinuses. The transition of the process to a chronic form is facilitated both by the anatomical features of the maxillary sinus( the sinus opening is located in the uppermost part of the sinus and is often covered by the swollen mucosa of the middle shell), and pathological changes in the nasal cavity( congenital narrowness of the nasal passages, close contact of the middle shell withlateral wall of the nose, curvature of the nasal septum, hypertrophy and polyps in the middle nasal passage).To chronic sinusitis often lead inflammatory processes of dental origin. Odontogenic sinusitis often from the very beginning is characterized by a sluggish chronic course. The cause of chronic sinusitis can also be injuries, especially when foreign limbs and bone fragments enter the maxillary sinus. In some cases, such a sinusitis can lead to an allergy.
Exceptional forms exudative forms ( catarrhal, purulent, serous, which includes allergic) and productive ( parieto-hyperplastic, polypous, caseous, cholestatic, necrotic and atrophic) .
Subjective signs of chronic sinusitis depend on the form of the disease. In exudative forms, patients complain of a prolonged one- or two-sided rhinitis. The nature of secretions( pus, mucus, watery discharge) depends on the shape of the sinusitis. With a purulent form, the discharge often has an unpleasant odor;with scant excretions sometimes it is he who is the only symptom of the disease. In other cases, the discharge is mucous, ductile( catarrhal form).In serous form, the exudate is watery. The second complaint of patients on the difficulty of nasal breathing. It is characteristic for both productive and exudative and mixed forms. Painful symptoms of chronic sinusitis in chronic cases are weaker than in acute processes. Headaches are often absent;if there is a persistent nasal congestion, they often have a diffuse, indeterminate nature, but can be localized on the side of the lesion - in the temple or orbit, in the jaw sinus region, less often in the forehead - or resemble neuralgia of the trigeminal nerve. Patients often complain of memory loss, quick fatigue with mental work. Often the sense of smell on the side of the lesion is weakened or absent altogether.
Before you cure chronic sinusitis, you need to undergo a full medical examination. In mild cases, conservative treatment is possible: washing the maxillary sinus after puncturing the lower nasal passage and injecting a solution of antibiotics( 500,000 units of penicillin and others) in combination with UHF therapy or diadynamic current.
In fungal lesions, treatment with nystatin or levorin is indicated( 500,000 units 4-6 times a day) for 2 weeks. After 2 weeks, the course should be repeated.
Sometimes, before treating chronic sinusitis, it is advised to visit a dentist. When the cause of sinusitis is a sick tooth, it is removed and through a drilled denticle it is repeatedly washed with a sinus with the introduction of antibiotics. If there are polyps in the nasal cavity( polypous or mixed form), they should be removed.
When such treatment is ineffective, resort to surgical treatment. The main principle of surgical intervention is the creation of a constant wide communication of the maxillary sinus with the nasal cavity. Radical surgery for chronic sinusitis usually leads to recovery, if there is no simultaneous disease of other sinuses.