Sinusitis of the nose - quite frequent diagnosis, which can be heard in the office of a doctor-otolaryngologist. This disease is acute or chronic nature of the flow, which is based on the infectious inflammatory process, localized in the subordinate cavity of the nose. The fault in the occurrence of this process is usually imposed on viruses, fungi, bacteria or allergies.
Inflammation can take one, two or more sine mucosas from one or both sides of the nose.
Sinuses - this is the additional sinuses. They are also called near-nasal. Hence the disease is sinusitis and takes its name.
Sinuses are small air-bearing cavities located in the bones of the brain and facial skull. Each of them has a communication with the olfactory organ cavity.
With sinusitis, the mucous membrane covering one or more of these cavities is subjected to inflammatory changes, which causes characteristic clinical manifestations.
Sinusitis of the sinuses of the nose can be an independent process, as, for example, with allergies, and can act as a complication of any viral or bacterial infections of the acute course.
There are four groups of sinuses in the human anatomy. Their names were given in view of their location. So three pairs of sinuses are known( trellis labyrinth, frontal sinus and maxillary sinus, often called gaimorovoy) and one unpaired( wedge-shaped).
Sinusitis in adults, as well as in children older than 7-10 years, often occurs with the defeat of the maxillary sinuses. The second place is given to the inflammation of the latticed, and the third to the frontal sinuses. The sphenoid sinus is subjected to pathogenic processes much less often.
Illustrative of the sinusitis of the photo is given below:
Causes of sinusitis sinusitis of the nose
With sinus sinuses in more than 50% of cases inflamed under the influence of a Pfeiffer rod or pneumococcus. Less often as a pathogen is hemolytic streptococcus, moraxella, staphylococcus aureus, as well as anaerobes and various viruses and fungi. The disease occurs with congenital abnormalities of the trellis labyrinth and nasal concha, with adenoids and polyposis of the nose, acute viral infections.
Quite often, the causes of sinusitis are acquired during the life of deformation of the nasal structures. This can occur as a result of unsuccessful surgery, with various injuries or because of chronic inflammation of the mucosa, for example, due to hypertrophic rhinitis.
, in particular, nasotracheal intubation or nasogastric sounding, as well as tamponade of the nose, can become the causes of sinus inflammation and blockage of their anastomosis. Disease of the nose sinusitis can be a consequence of the sensitization of the body, which, for example, can manifest as allergic vasomotor rhinitis or seasonal rhinoconjunctivitis.
In the maxillary sinuses infection by the ascending way gets from the teeth, including after their poor-quality removal.
Fungal infection in the sinuses develops, usually as a result of prolonged and unjustified administration of antibiotics, especially if this occurs against a background of decreased immunity.
The risk factors for sinusitis usually become: Dentofacial Diseases;diabetes;genetic pathology due to increased secretion viscosity( particularly cystic fibrosis);ailments accompanied by immunodeficiency;reception of steroids;hypothyroidism;allergic diathesis, etc.
Signs, pains and exacerbation of sinusitis
The severity of the manifestations of the disease in question usually depends on its variety, distribution and shape. The symptomatology of the ailment is divided into local and general.
Common features include weakness, a sense of weakness and rapid fatigue. The temperature rise in the acute process occurs up to 38.9 ° C and higher, and in the chronic form, as a rule, does not hold within 37.5 or remains normal. The group of common symptoms also includes loss of appetite, sleep disturbances and headaches.
A local symptom characteristic of any kind of sinusitis is a runny nose, accompanied by nasal congestion, difficulty in nasal breathing and secretions of a different nature. This includes dryness in the nose, loss of smell, coughing, sneezing, other manifestations of infection.
Symptoms of sinusitis are quite pronounced. Common signs of intoxication are accompanied by pain.
Pains with sinusitis with a lesion of the maxillary sinus are localized in the area of the cheekbones and irradiate into the temple, upper jaw and forehead on the corresponding half of the head. Soreness also occurs when the maxillary sinuses are probed.
The bilateral process almost completely deprives the person of the ability to breathe through the nose. The result of blockage of the lacrimal duct becomes lacrimation. Discharge from the nasal passages initially liquid and serous become viscous rather quickly and acquire a purulent character with an unpleasant odor.
The manifestations of the chronic variant of the disease are more flattened. Spreading or pressing headaches are caused by a disturbance in the outflow from the sine. According to the expression of patients, the pain is located "behind the eyes" and decreases in the supine position, which can be explained by the partial restoration of the outflow of pus from their sinuses. Painful sensations increase with pressure under the eyes, as well as when lifting the eyelids.
A typical exacerbation of chronic sinusitis is often accompanied by a night cough caused by pus from the maxillary sinus flowing down the back wall of the pharynx. Perhaps the development of swelling, the appearance of maceration and cracks in the run-up to the nose.
When etmoiditis patients complain of pressing pain in the nose, as well as in the root of the nose and eyes. The immunity of odors is noted. Due to swelling, breathing through the nose is difficult. At first, the serous discharge soon becomes purulent.
The acute variant of the process often affects the orbit, leading to the appearance of edema of the eyelids and exophthalmos( protrusion of the eyeball).Children often blush conjunctiva and swollen eyelids.
Of all types of sinus lesions, it is the frontitis that is most severe. Signs of sinusitis of this form consist in intense, sometimes even unbearable painful sensations, both in the area of the projection of the frontal sinuses, and in the entire head. These feelings intensify in the morning.
With the advent of pus, the intensity of pain increases, and after its removal decreases. There are difficulties with breathing through the nose. There are abundant discharges on the sides of the lesion. Sometimes there is pain in the eyes with edema of the upper eyelid and the eyebrow. Can develop photophobia. Symptomatic of sphenoiditis usually erased. There are pains in the nape, crown, and also in the depth of the head and orbit. Inflammation in this case can affect the optic nerves, leading to a progressive decline in vision.
Sinusitis in pregnancy and complications of nose diseases
Most women believe that this disease without complications and maintenance of another pathology is completely safe. However, this is not at all the case. Sinusitis during pregnancy is unpleasant not so much because of stuffy nose, but because of possible negative consequences for the development of the fetus. After all, reduced respiratory function inevitably leads to shortness of breath, to insufficient intake of oxygen and as a consequence to hypoxia of the fetus. The latter in the early stages of pregnancy can lead to a deviation in the development of internal organs, and at later terms will cause a delay in intrauterine development.
In the course of the rapid formation of acute forms of the described ailment or with the unhurried progression of its chronic variety, not only the paranasal sinus, but also other intracranial structures, including the visual organ, can be involved in the pathogenic reaction.
As a consequence of massive accumulation of purulent masses against the background of a developing bacterial infection, phlegmons and abscesses of the optic apple can form, as a result of which the patient may lose some or all of the ability to see.
With advanced forms of the disease as a complication of sinusitis, doctors diagnose cavernous sinus thrombosis in patients. In this condition, the infection rapidly spreads through the body and causes sepsis. In some cases, otorhinolaryngologists identify patients with meningitis, as well as abscesses of the central and spinal cord.
Diagnosis of sinusitis
Before the treatment of sinusitis in adults and children, an accurate diagnosis must be made. As a rule, the procedure for identifying the disease in this case is not particularly difficult. Exceptions are only variants of the disease with erased symptoms.
The basis for the diagnosis is the clinical picture typical for the illness in question, supplemented by history data, physical examination results, instrumental and laboratory diagnostics.
Instrumental methods include x-ray examination of accessory sinuses, usually performed in two projections;ultrasonography;Rhinoscopy;diaphanoscopy;NMR or CT;and also a medical-diagnostic puncture( a sinus puncture).
Laboratory methods include blood tests that can confirm the presence of inflammation in the body;bacteriological examination of exudate obtained by puncture, in order to determine microflora and its sensitivity to antibiotics.
Treatment of sinusitis with antibiotics and other medications
In case of sinus disease, the best tactic on the part of the patient is to go to the doctor. The latter, after identifying the symptoms and treatment specific for an ailment called sinusitis, will assign exactly what is needed in a particular situation.
The main thing in the therapy of this condition is the elimination of edema and infection, as well as the fight against stagnation and discharge from the nose. As a result of such activities, the sinuses are drained and their natural drainage is ensured.
The bacterial form of the disease is treated with antibacterial agents. Antibiotics for sinusitis should be used only those to which the agent is sensitive. Most often it is Amoxicillin or Augmentin.
However, it is worth remembering that basically this pathology is caused by viruses on which such drugs do not exert any influence. In addition, in patients diagnosed with sinusitis, treatment with antibiotics without proper medical supervision can lead to the development of resistance of bacteria to these substances, which will not improve the prognosis.
In the treatment of the described disease, corticosteroids are also used. Nasal sprays, which contain these substances, are considered good drugs in the treatment of nasal allergic manifestations. This includes drugs such as Triamcinolone, Fluticasone, Beclomethasone and others.
Antihistamines are among the drugs that combat allergies. But sick sinusitis is not recommended to take them without an appointment, because they cause dryness of mucous membranes, thicken them, hindering drainage, which can aggravate the course of the disease.
When deciding how to cure sinusitis, do not forget about the anti-decongestants. Drugs that help to eliminate nasal congestion, exist both in tablets, and in the form of nasal drops and sprays. For example, Naphthysine, Sanorin, Galazolin.
How to cure sinusitis with inhalations
The aforementioned cures for sinusitis are far from the only way to treat it. Known and drug-free therapy. In particular, washing or irrigation of the nose with saline and lubricating the nose with all sorts of balms that have a warming effect, etc. Such manipulations can be carried out at home.
Steam inhalations with sinusitis, conducted 2 to 4 times / day, are also very useful. Their effect is enhanced by the addition of menthol, eucalyptus or other essential oils to the water. Such home procedures help to open and moisturize the sinuses thus creating the necessary conditions to combat mild sinusitis, which occur without signs of acute infection.
Nevertheless, treatment of sinusitis at home in adults and children should be done with caution. In order to avoid the occurrence of complications, it is necessary to consult a doctor.
Methods for the treatment and prevention of sinusitis
In addition to the conservative ones given above, physicians are also aware of surgical methods for treating sinusitis. Surgery helps to unlock the sinuses if the drug therapy is not effective or in cases where the patient has complications. Such methods include sinus puncture, balloon sinoplasty, as well as endoscopic and invasive surgery.
A puncture followed by a sinus wash is the simplest surgical intervention.
Balloon synoplasty consists in the introduction and subsequent inflation in the nasal passages of a soft catheter. This expands the previously closed sine and creates a free path for air.
Endoscopic surgery implies the use of a laser or coagulator. Invasive methods are gradually becoming history, but in some cases, they can not be dispensed with. For example, in cases of acute latticed sinusitis, when pus breaks through the sine and threatens the eyes.
The question of how to treat sinusitis surgically, is decided solely by a doctor.
Symptoms and treatment of sinusitis in adults described above will be an incomplete picture, if not a few words about the prevention of this disease. The best way to prevent sinusitis is to avoid colds and flu, and in case of illness they need to be treated effectively.
A good measure of prevention is the elimination of predisposing factors, for example, anomalies in the development of mucous membranes or nasal septum.
It is also important to systematically temper the organism in terms of preventing the disease.