Treatment of sinusitis in children: drugs, folk remedies, physiotherapy
The content of the article:
- Causes of Sinusitis in Children
- Sinusitis symptoms in children
-
Treatment
- Conservative therapy
- Folk remedies
- Physiotherapy
- Video
Sinusitis is an inflammation that occurs in the lining of one or more paranasal sinuses. Depending on the place of localization, four types of such cavities are distinguished - wedge-shaped, maxillary, frontal and lattice labyrinth.
Sinusitis is diagnosed and treated by an otolaryngologist
The formation of paranasal sinuses begins during the period of intrauterine development of the fetus, and ends only after puberty. The cavities are lined from the inside with ciliated epithelium with goblet cells that produce mucus. The movement of the epithelial cilia allows mucus to move to the small openings of the sinuses. The nasal cavity is connected to the sinuses by narrow passages, through which they are continuously drained. In cases where, for any reason, cleansing stops and the secret stagnates in the sinuses, favorable conditions are created for the development of sinusitis.
Depending on the cavity in which the inflammation occurs, the following types of sinusitis are distinguished:
- ethmoiditis - in a lattice labyrinth;
- sinusitis - in the maxillary cavity;
- frontal sinus - in the frontal sinus;
- sphenoiditis - in the wedge-shaped sinus.
In rare cases, pansinusitis is diagnosed. What it is? The inflammatory process can be unilateral and occur in one or more cavities. If inflammation occurs in all of the paranasal sinuses, the disease is called pansinusitis.
Acute, subacute and chronic sinusitis is isolated downstream. The duration of the acute form is on average 2-4 weeks, if during this period there is no adequate treatment, the disease turns into a subacute form. With her, symptoms persist for 4 to 12 weeks. If children have signs of sinusitis for more than 12 weeks, the condition is considered chronic.
By the nature of the inflammation, edematous-catarrhal, purulent and mixed forms of the disease are distinguished.
In the absence of timely therapy for any type of sinusitis, serious complications such as meningitis, brain abscess, osteomyelitis, inflammation of the optic nerve and the membranes of the eye may develop.
Causes of Sinusitis in Children
The predisposing factors for the onset of pathology in children are:
- primary ciliary dyskinesia;
- cleft palate;
- immunodeficiency;
- curvature of the nasal septum;
- Down syndrome;
- cystic fibrosis;
- chronic edema of the nasal mucosa with vasomotor and allergic rhinitis;
- polyps and other neoplasms of the nose;
- bronchial asthma.
Polyps in the nose are a predisposing factor in the onset of pathology
Blocking of the anastomosis of the nasal cavities due to abnormalities in the structure of the ethmoid labyrinth and turbinates or hypertrophic rhinitis can lead to the appearance of sinusitis. Also, a viral infection is often the cause of the disease. The mucous membrane of the paranasal sinuses and nasal cavity swells as a result of inflammation, and the mucous glands begin to produce a large amount of secretion. Edema of the mucous membrane leads to a narrowing of the anastomosis of the paranasal cavities, and they are filled with thick pathological discharge.
The intensive development of opportunistic flora is facilitated by oxygen deficiency, stagnation of secretions and impaired ventilation in the tissues of the sinuses. In such cases, a bacterial infection joins the viral one. The degree to which the microbes that caused the inflammation can infect the body (virulence) directly affects the severity of the symptoms of the disease.
Since antibacterial agents are usually used in sinusitis, the bacterial flora that causes it often exhibits increased resistance to most of these drugs. Frequent use of antibiotics negatively affects immunity, disrupts the composition of the intestinal microflora and creates favorable conditions for the development of mycotic infection. Fungi are becoming more common causes of sinusitis.
At the initial stage, inflammation is not always triggered by microbes. Inhalation of certain chemicals or cold air can lead to swelling of the nasal mucosa, due to which the fistulas of the paranasal sinuses are closed.
Sinusitis can develop as a result of an allergic reaction when a bacterial infection is attached
Most often, sinusitis occurs as a result of allergic reactions and immunodeficiency conditions. Against the background of allergies, vasomotor rhinitis develops, one of the main symptoms of which is swelling of the nasal mucosa.
If the appearance of the disease is associated with deep caries or other dental pathology, together with the dentist, a treatment is selected to eliminate the root cause of sinusitis.
Sinusitis symptoms in children
The manifestations of the disease depend on the age of the child and the form of sinusitis. So, the acute course of inflammation is characterized by pronounced symptoms, and in the chronic form, the symptoms are weaker.
Sinusitis symptoms vary depending on which sinus is affected and the etiology of the disease.
In children under 3 years of age, the paranasal sinuses are physiologically underdeveloped. Basically, their inflammation develops due to viral infectious diseases and adenoids. The clinical signs of sinusitis are implicit, and in fact, it is asymptomatic. Often, the pathology in a child is accompanied by otitis media, since an infection from the nasal cavity through the wide Eustachian tube can spread to the middle ear.
In older children, the paranasal sinuses are formed, so any of them can be involved in the inflammatory process. The least common inflammation occurs in one sinus, more often in several cavities or in all at the same time.
The characteristic signs of the disease are:
- headache;
- difficulty in nasal breathing;
- decreased sense of smell;
- discharge from the nose, turning yellow-green and having a purulent character;
- runny nose lasting more than 2 weeks;
- pain in the paranasal region;
- nasal voice;
- deterioration in general health - lack of appetite, sleep disturbances, lethargy, fatigue;
- an increase in symptoms in the evening;
- increased body temperature (with acute sinusitis);
- dry throat, which causes coughing.
Treatment
How to treat sinusitis in children is determined by the doctor. At the first signs of the disease, it is important to seek advice from a pediatric otolaryngologist. Self-selection of therapy for a child, especially up to 2 years of age, can worsen the course of sinusitis and lead to the development of complications.
The main goal of therapy is to restore nasal breathing, eliminate the cause of inflammation and prevent possible complications.
Conservative therapy
Drug treatment, depending on the causative agent of sinusitis, includes the use of antibiotics, vasoconstrictors or antihistamines.
As part of a complex treatment, vasoconstrictor and antiseptic drops are usually prescribed.
Before the appointment of antibacterial agents, it is recommended to conduct a bacteriological study to determine the sensitivity of the pathogen to their action. However, on average, you can get the results of sowing in 4-5 days after the delivery of the material.
In this regard, in the acute course of inflammation, when the child has severe intoxication, high body temperature and abundant purulent discharge from the nasal cavity, a broad-spectrum antibiotic is prescribed, and then, if necessary, the selected treatment is corrected. Delay in such cases is fraught with complications that develop faster in children than in adults.
In most cases, therapy begins with the use of antibacterial agents from a number of penicillins (Amoxiclav, Ampicillin, Augmentin). If the child has an individual intolerance to this group of drugs, macrolide antibiotics (Azithromycin, Clarithromycin, Sumamed) are used.
Preparations with a vasoconstrictor effect help to eliminate swelling of the nasal mucosa, thereby increasing the outflow of mucopurulent secretions and restoring nasal breathing. In children's practice, Tizin Xylo, Nazivin, Sanorin, Naphtizin or Otrivin are used.
It is also possible to use antiseptic drops (Protargol, Kollargol, Ektericid). They act directly at the site of inflammation and facilitate breathing.
If sinusitis develops due to allergies, antihistamines are prescribed (Tavegil, Cetrin, Fenistil, Claritin). As an adjunct for exacerbation of chronic sinusitis in children aged 12 years and older, the glucocorticosteroid Nasonex can be used. This drug has anti-inflammatory and anti-allergic effects.
Homeopathic remedies selected by the pediatric homeopath can be used. The main advantage of such drugs is the absence of side effects and the immunomodulatory effect.
Along with conservative methods of treatment, Dr. Komarovsky recommends paying attention to the humidity of the room in which the child is most of the time. The optimum level is considered to be humidity in the range from 50 to 70%.
Folk remedies
In agreement with the otolaryngologist, it is possible to use traditional methods of treatment at home. These include rinsing and warming up the nasal cavity, herbal medicine, inhalation. It is important to strictly follow the doctor's instructions, since, for example, improper washing can lead to the development of complications.
Special devices can be used for nasal washes
Warming up the nose with an egg, salt, a blue lamp is possible only in the absence of a purulent process. For the correct procedure, it is recommended that you first familiarize yourself with the thematic photos and videos.
To naturally cleanse the nasal cavity from viruses, bacteria, allergens, dust particles, crusts and mucus, a sea salt solution is used. Inhalations with herbal decoctions - calendula, sage, chamomile - are also considered effective.
It should be borne in mind that the independent use of phytopreparations can lead to allergization of the body and aggravate the course of the disease, therefore it is recommended to coordinate the use of alternative methods of treatment with the ENT.
Physiotherapy
Physiotherapy can be used to treat sinusitis in children. They help to increase the body's defenses, reduce intoxication, improve blood microcirculation, activate metabolic processes in the affected tissue and eliminate the inflammatory process.
One of the physiotherapy methods used for sinusitis is photochromotherapy
Anti-inflammatory procedures include ultrasound, laser and UHF therapy (ultra-high frequency therapy). In order to influence the causative agent of the disease, a quartz tube, electrophoresis for the introduction of an antibiotic and local darsonvalization are used.
For sinusitis, photochromotherapy is considered a highly effective procedure, and it has practically no contraindications. The effect of blue color has an analgesic, relaxing, anti-inflammatory, bactericidal and epithelial effect.
Physiotherapy is contraindicated in purulent sinusitis and impaired outflow of discharge from the paranasal sinus.
In the chronic form of pathology, a complex of therapeutic measures may include breathing exercises and acupressure of biologically active points. These methods help to reduce inflammatory manifestations, improve blood and lymph circulation. Impact on the points is most effective for frontal sinusitis and sinusitis.
If conservative treatment does not lead to an improvement in the condition, a puncture of the inflamed sinus is prescribed. All pus is removed from it, then washing and administration of an antibiotic or anti-inflammatory agent is carried out.
Video
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Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
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