Chronic and acute purulent sinusitis: symptoms, treatment, complications
The content of the article:
- Development reasons
- Symptoms of purulent sinusitis
- Treatment of purulent sinusitis
- Video
Sinusitis is an inflammation of the mucous membranes of the paranasal sinuses. The pathological process can involve one or several, as well as all the paranasal sinuses at the same time. There are four groups of these cavities - wedge-shaped, maxillary, frontal and lattice labyrinth. Depending on the localization of the inflammatory process, there are such varieties as:
- sinusitis (maxillary sinus);
- frontal sinus (frontal sinus);
- ethmoiditis (ethmoid cells);
- sphenoiditis (sphenoid sinus).
With purulent sinusitis, one or more paranasal sinuses may be affected
By the nature of the course, inflammation is acute and chronic. Infectious diseases lead to the development of the first, its symptoms persist for a period of 2 to 4 weeks. The chronic form is characterized by a long course - 12 weeks or more, it develops with repeated acute sinusitis or due to allergic rhinitis.
If the patient has the formation of purulent exudate in the affected area, and the inflammatory process spreads to the deep layers of the tissues of the paranasal sinuses, the otolaryngologist diagnoses purulent sinusitis. In the absence of timely treatment of this form of inflammation, complications may develop in the form of meningitis, osteomyelitis, abscess, tracheitis, bronchitis or pneumonia.
Development reasons
There are many factors contributing to the development of a purulent form of the disease. These include:
- neoplasms or penetration of a foreign body into the nasal cavity;
- adenoiditis;
- polyposis of the nose;
- bronchial asthma;
- bacterial, viral, or fungal infection;
- anomalies in the structure of the nasal cavity, including curvature of the nasal septum;
- diseases of the teeth located in the upper jaw;
- hypothermia;
- hereditary predisposition;
- decreased immune defense of the body;
- rhinitis of allergic origin;
- physical or chemical injury;
- measles or scarlet fever in children;
- misuse of local medicines.
One of the risk factors for the development of the disease is adenoiditis
In some cases, purulent sinusitis (maxillary sinusitis) develops after sinus perforation due to the removal of the upper chewing teeth.
Symptoms of purulent sinusitis
The severity of signs of acute or chronic forms of pathology are different. A complication of the course of the process may be the appearance of symptoms of intoxication due to the reproduction of pathogenic microflora.
Signs of acute sinusitis are:
- headache in the frontal lobe and temples, aggravated by bending the head;
- purulent discharge from the nose. In the absence of an outflow of discharge, breathing becomes difficult, swelling of the nasal mucosa occurs and, as a result, a disorder of smell;
- deterioration of the general condition of the body, weakness, dizziness;
- a feeling of pressure in the affected sinuses;
- increased body temperature.
The development of chronic purulent sinusitis is indicated by symptoms such as:
- swelling of the mucous membrane and nasal congestion;
- change of voice;
- cough developed as a result of the flow of purulent secretion into the pharynx;
- dryness of the pharynx (since the patient mostly breathes through the mouth);
- bad smell from the nose and mouth;
- violation of taste and, in some cases, auditory functions;
- the occurrence of mucopurulent exudate.
Patients with a chronic purulent form of pathology, an increase in body temperature and headache are extremely rare. Constant swelling of the nasal mucosa is the main danger of this form of the disease, since it leads to its growth and the formation of polyps. Surgery is required to eliminate polyps.
Treatment of purulent sinusitis
It is important to consult an otolaryngologist at the first manifestations of the disease, since only a doctor can make an accurate diagnosis and, in accordance with it, determine how to treat sinusitis in a particular case. In general, the treatment of pathology should be comprehensive and may include:
- the use of medicines;
- rinsing the nasal cavity (saline or antiseptic solution, etc.);
- physiotherapy procedures - electrophoresis, UHF therapy;
- minimally invasive treatment techniques - the use of a YAMIK sinus catheter, balloon sinusoplasty;
- puncture (puncture) of the sinus;
- opening the affected sinus.
The list of medicines prescribed for patients with purulent inflammation of the accessory sinuses includes:
- antibiotics in the form of injection solutions and tablets. The selection of an effective drug is carried out after receiving the results of inoculation on the microflora. The study allows you to determine to which group of antibacterial agents the bacteria that caused inflammation are most sensitive. In some cases, antibiotic sprays are sufficient. They act directly in the focus of inflammation and, in extremely rare cases, lead to the development of side reactions;
- vasoconstrictor agents. The use of this group of drugs should not exceed 7 days, a longer course can lead to atrophic changes in the nasal mucosa and the development of addiction to active ingredients. In adults, such drugs are used in the form of sprays, in children - drops;
- anti-inflammatory drugs;
- antifungal drugs. They are prescribed in cases where the cause of the development of pathology is a fungal infection.
Lavage of the nasal cavity using the Cuckoo method is performed by a doctor in a physiotherapy room. A drug is poured into one nostril of the patient, and a suction is installed in the other. To prevent the solution from entering the pharynx, during the procedure, the patient pronounces "cuckoo", which contributes to the adherence of the soft palate to the back of the throat. Thanks to this, the drug flows directly into the sinuses, and the mucus and purulent exudate accumulated in them are washed out.
At home, antiseptics or saline can be injected into the nasal cavity for rinsing through a syringe without a needle, syringe or nasal shower.
Physiotherapy procedures are used to eliminate the inflammatory process, reduce intoxication, improve microcirculation, and also to activate metabolic processes in the affected tissues. Their conduct with a purulent course of inflammation is contraindicated in cases where the outflow of secretion is impossible.
The use of the YAMIK sinus catheter in some cases avoids puncture
Minimally invasive treatment techniques are used to stimulate sinus drainage. They are highly effective, the risk of complications during their implementation is minimal. These techniques include:
- The YAMIK procedure is a procedure performed under surface anesthesia of the nasal mucosa, which is performed using a catheter with two balloons. The first is located at its end and is necessary for entry into the nostril and excretion into the nasopharynx, and the second, in the middle of the catheter, remains directly near the nostril. Also, the device is equipped with two gaps. A syringe is attached to the first, with which air is injected to seal the nasal cavity. A syringe is connected to the second, through which an antiseptic solution is injected. The procedure allows you to remove the contents from the sinuses without surgery;
- Balloon sinusoplasty is a minimally invasive method of sinusitis therapy, in which a guidewire with a special balloon is inserted into the anastomosis of the nasal sinus. The procedure is performed under local anesthesia and endoscopic control. The balloon is filled with liquid, which helps to open the lumen for the evacuation of pus.
The doctor decides on the need for a puncture after evaluating the effectiveness of the therapy and the risk of complications.
A puncture is one of the most effective and quickest methods of extracting pus from the affected sinus. Its implementation is justified in the following cases:
- the purulent process occurs in one or more sinuses with a closed outlet;
- the medical treatment carried out was ineffective;
- the patient complains of severe headache that does not respond to drug treatment;
- body temperature does not decrease after taking antibiotics for three days.
Puncture also has an important diagnostic value, since it allows you to assess the patency of the sinus fistula and determine the nature of the pathological process. The algorithm of the procedure differs depending on the cavity in which the inflammation occurs.
The opening of the affected sinus is carried out only in cases where other methods of treatment have proved ineffective, the patient's condition worsens and there is a threat of complications.
Also, folk remedies can be used as an auxiliary therapy, but only as prescribed by a doctor, since some of them can aggravate the course of pathology. For example, warming up the nasal cavity, widely used in alternative medicine, is contraindicated in a purulent course of inflammation, since heat enhances the formation of exudate in the affected sinus.
Video
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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