Sinusitis: what is it, types, causes, symptoms, treatment
The content of the article:
- Types of sinusitis
- Causes and risk factors for inflammation
-
Symptoms
- Symptoms of acute sinusitis
- Symptoms of chronic sinusitis
- Diagnostics
-
Conservative treatment of sinusitis
- Acute maxillitis
- Chronic maxillitis
- Treatment of sinusitis at home
- Video
Sinusitis (maxillary sinusitis, maxillitis) is an inflammation of the mucous membrane of the maxillary (maxillary) sinuses. The sinuses are connected by common bony walls with the nasal cavity, mouth and orbit (orbit) and are normally filled with air.
Sinusitis is an inflammation of the mucous membrane of the maxillary sinuses
The main functions of the maxillary sinuses, along with the frontal, sphenoid and ethmoid, are:
- the formation of an individual sound of the voice;
- warming and purifying the inhaled air;
- equalization of pressure in the cavities of the skull in relation to the external atmospheric pressure.
Through small holes, all the sinuses communicate with each other, but if for some reason these holes are closed, their cleansing and ventilation stops. This contributes to the accumulation of microbes and the development of inflammation.
The development of maxillitis is accompanied by an increase in body temperature, swelling of the cheek and eyelid from the side of the lesion, intense pain in the bridge of the nose and in the wings of the nose, mucopurulent discharge from the nasal passages and difficulty in nasal breathing. With timely started therapy, which is prescribed by an otolaryngologist (ENT), you can avoid serious complications - osteomyelitis, phlegmon of the orbit, brain abscess, meningitis, otitis media, as well as kidney and myocardial damage.
Inflammation of the mucous membrane of the maxillary sinuses occurs in people of all ages, however, in children under the age of 5 years, pathology develops extremely rarely, since they have insufficiently developed paranasal sinuses.
Types of sinusitis
Sinusitis code according to ICD-10 (international classification of diseases of the 10th revision, developed by the World Health Organization):
- acute sinusitis: J01 (class - respiratory diseases, heading - acute respiratory infections of the upper respiratory tract);
- chronic sinusitis: J32 (class - respiratory diseases, rubric - other diseases of the upper respiratory tract).
Maxillitis can be exudative or catarrhal. These forms of the disease are accompanied by a large amount of mucus or purulent discharge. Depending on the nature of the discharge, there are purulent, mucous and serous sinusitis.
According to the prevalence of the process, maxillitis is unilateral, which, depending on the affected side, is divided into right-sided and left-sided, as well as bilateral.
Sinusitis can be one- or two-sided
Classification by the course of the disease:
- Acute: Symptoms are similar to a runny nose, acute respiratory viral infection, and other colds. Typically, the duration of the inflammation ranges from 14 to 21 days;
- chronic: can develop in the absence of adequate therapy for acute sinusitis. The duration of this form of the disease usually ranges from 2 months or more. Symptoms may disappear almost completely and then come on again;
- recurrent: characterized by the onset of symptoms two, three, or more times a year.
Classification by etiological factor:
- viral;
- traumatic;
- bacterial, subdivided into bacterial aerobic and bacterial anaerobic;
- fungal;
- endogenous, subdivided into vasomotor, otogenic, odontogenic;
- mixed;
- allergic;
- perforated;
- iatrogenic.
Classification by the route of infection:
- hematogenous: the infectious agent enters through the blood. Most often, this form of sinusitis develops in children;
- rhinogenic: the infection enters through the nasal cavity. Usually occurs in adults;
- odontogenic: microbes enter the maxillary sinus from the molars of the upper jaw;
- traumatic.
Chronic sinusitis, by the nature of morphological changes, is divided into the following types:
- productive (parietal-hyperplastic, atrophic, necrotic, polyposis, purulent-polyposis, etc.). Against its background, changes in the mucous membrane of the maxillary sinus are observed (hyperplasia, atrophy, polyps, and others);
- exudative (purulent and catarrhal), in which pus is formed.
In the chronic course of the disease, due to blockage of the mucous glands, small pseudocysts and true cysts of the maxillary sinus are often formed. The most common forms of chronic inflammation are polyposis and polyposis-purulent. Catarrhal allergic and parietal-hyperplastic forms are found in rare cases, and necrotic, ozeous, cholesteatomic and caseous - in very rare cases.
Causes and risk factors for inflammation
The causative agents of sinusitis can be viruses, chlamydia, fungi, staphylococci, streptococci, haemophilus influenzae and mycoplasma. In adults, viruses, pneumococci and Haemophilus influenzae most often cause maxillitis, in children - mycoplasma and chlamydia. In case of impaired immunity and in weakened patients, inflammation can occur due to saprophytic and fungal microflora.
Possible causative agents of the disease - staphylococci, streptococci, viruses, chlamydia, fungi, mycoplasma and hemophilus influenzae
Risk factors for the development of maxillitis are pathologies and conditions that impede ventilation of the maxillary sinus and facilitate the penetration of infection into its cavity. These include:
- congenital narrowness of the nasal passages;
- acute respiratory viral infection, acute and chronic rhinitis of any origin;
- chronic tonsillitis, pharyngitis;
- adenoids (in children);
- curvature of the nasal septum;
- surgical interventions performed on the alveolar process of the upper jaw or teeth;
- carious lesion of the upper molars.
The risk of developing the disease increases in the autumn-winter period, which is due to the natural seasonal decrease in immunity.
Symptoms
Symptoms of acute sinusitis
The inflammation begins acutely. The patient has an increase in body temperature to febrile (38–39 ° C), pronounced signs of general intoxication and, possibly, chills. In some cases, body temperature may remain normal or subfebrile (37.1–38 ° C). The main complaints of the patient are pain in the area of the affected maxillary sinus, forehead, root of the nose and zygomatic bone. On palpation, the pain intensifies, it can radiate to the corresponding half of the eyelid and temple. It is also possible the appearance of a diffuse headache of varying intensity.
On the side of inflammation, nasal breathing is disturbed, and in cases of bilateral sinusitis, nasal congestion forces the patient to breathe through the mouth. Due to blockage of the lacrimal canal, the development of lacrimation is sometimes observed. Nasal discharge from serous and liquid gradually becomes greenish, cloudy and viscous.
Symptoms of chronic sinusitis
Usually chronic sinusitis develops as a result of an acute process. During the period of remission, the general condition, as a rule, does not worsen. With an exacerbation, symptoms of general intoxication appear in the form of headache, weakness and weakness, and the body temperature can rise to febrile or subfebrile.
With exudative forms of maxillitis, the amount of discharge increases during an exacerbation, and when the patient's condition improves, it decreases. Catarrhal sinusitis is characterized by a liquid and serous discharge, with an unpleasant odor, with a purulent form it is a thick, yellowish-green, abundant, viscous mucus, which dries up and turns into crusts.
As a rule, a headache develops only during an exacerbation of the chronic form of maxillitis or against the background of a violation of the outflow of discharge from the maxillary sinus. The patient may experience a pressing or bursting headache, which is localized behind the eyes and is aggravated by pressure on the infraorbital region and by raising the eyelids. When lying down or during sleep, the severity of the pain syndrome decreases, since in a horizontal position the outflow of pus resumes.
Often, chronic sinusitis is accompanied by a nocturnal cough that does not respond to conventional therapy. The reason for its appearance is pus flowing down the back wall of the pharynx from the maxillary sinus.
In chronic maxillitis, skin lesions (oozing, maceration, swelling, or cracks) are often detected in the run-up to the nasal cavity. Many patients develop concomitant keratitis and conjunctivitis.
Diagnostics
To diagnose sinusitis, it is necessary to collect the patient's complaints, his external examination, including the determination of reflex expansion of the skin vessels of the infraorbital region, and examination of the mucous membrane of the nasal cavity in order to detect edema, inflammation and purulent discharge from the opening of the sinus.
X-rays may be ordered to diagnose the disease.
When carrying out an X-ray, a darkening of the maxillary sinus is revealed. If the informativeness of these research methods to determine whether the patient is contagious or not is not enough, a maxillary sinus puncture is performed.
Conservative treatment of sinusitis
Acute maxillitis
In order to reduce edema of the mucous membrane of the maxillary sinuses and to restore normal ventilation, local vasoconstrictor agents (for example, xylometazoline hydrochloride, naphazoline) are used in a course of up to 5 days.
If the patient has significant hyperthermia, antipyretic drugs are prescribed, in cases of severe intoxication - drugs with antibacterial action.
In order to avoid the development of side effects and to obtain a high concentration of the drug in the inflammation focus, local antibiotics are used.
After normalization of body temperature, physiotherapy is recommended, for example, UHF therapy (ultra-high frequency), Sollux infrared lamp.
Chronic maxillitis
In the chronic course of the disease, a stable therapeutic effect can be achieved only by eliminating the cause that caused inflammation in the maxillary sinus (bad teeth, curvature of the nasal septum, chronic pathologies of the ENT organs, adenoids, and others). With an exacerbation of the disease, in order to avoid atrophy of the mucous membrane of the maxillary sinuses, local vasoconstrictor drugs are used in short courses.
Patients are assigned to drain the maxillary sinus. Sinus lavage is performed by sinus evacuation or cuckoo (vacuum displacement method). For procedures, disinfectant solutions are used (for example, Potassium permanganate, Furacilin). Solutions of antibacterial agents and proteolytic enzymes are introduced into the cavity. Of the physiotherapeutic procedures, phonophoresis with hydrocortisone, diathermy, inhalation, UHF therapy are most often prescribed. Speleotherapy is also effective.
Patients with necrotic, cholesteatomic, caseous, polyposis and purulent-polyposis forms of chronic maxillitis are shown a surgical operation - sinusitis.
Treatment of sinusitis at home
Alternative medicine can be used as an adjunct therapy for maxillary sinusitis at home.
Decoctions and herbal infusions are often used at home as an adjunct therapy.
An infusion of herbs can be used orally. To prepare it, add 2 tbsp each to an enamel or glass dish with a lid. spoons of St. John's wort, eucalyptus, lavender, chamomile and sage medicinal, 1 tbsp. spoon yarrow and string, mix thoroughly. From the resulting mixture, take 3 tbsp. spoons, pour them in 2 liters of boiling water, close the container with a lid and insist at room temperature for half an hour, then filter. The finished infusion is taken orally, 100 g every 3 hours.
Also, in the treatment of the chronic form of the disease, horseradish root is often used in the form of grated gruel in combination with lemon juice (1/3 cup of gruel and juice from three lemons). The ready-made mixture is taken daily in the morning by mouth 1/2 teaspoon 20 minutes before meals. Treatment is carried out in courses, repeating them in the fall and spring until complete recovery.
In home therapy, topical agents are often used (the nasal sinuses are washed with a solution of sodium chloride or sodium chloride before the procedure):
- clay compresses: 50 g of clay are diluted in hot water to the consistency of plasticine. Gauze is moistened in warm vegetable oil and placed on both sides of the nose (on the area of the maxillary sinuses). On top of the gauze, spread cakes of warm clay and keep them for 1 hour;
- honey ointment: 1 tbsp. a spoonful of fragrance-free baby soap is grated. Mix in 1 tbsp. spoon of honey, milk and vegetable oil and add them to the grated soap. The resulting mixture is heated in a water bath until the soap has melted. Add 1 tbsp to the resulting product. a spoonful of alcohol, the whole mixture is poured into a glass jar and allowed to cool. Using a cotton swab, the ointment is injected into the nasal passages and left for 15 minutes. Duration of treatment is 21 days. The ointment should be stored in a sealed container in the refrigerator;
- inhalation with sea buckthorn oil: add 10 drops of sea buckthorn oil to a saucepan with boiling water. The released vapor is inhaled for about 15 minutes;
- drops from the mummy: 10 crushed mummy tablets (0.2 g each) are thoroughly mixed with 1 teaspoon of glycerin and 4 teaspoons of water. The resulting agent is instilled into the nose 3 times a day. The duration of therapy is 21 days. The course of treatment is repeated several times at intervals of 5 days until complete recovery.
Traditional medicines are recommended to be used with caution, especially if the components they contain can cause allergic reactions. If within several days there is no therapeutic effect, or there is a deterioration in the patient's condition, you need to consult an otolaryngologist for advice.
Video
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
