Sinusitis - Causes, symptoms and treatment. MF.

Genyantritis - one of the types of sinusitis, which is characterized by inflammation of the maxillary sinus( maxillary sinus).Sinusitis is an acute or chronic inflammation of the maxillary sinus. The name of the disease comes from the name of the sinus, the defeat of which causes the disease( the maxillary sinus in medicine is called gaymorovoy, these sinuses are located on either side of the nose, just below the eyes).The inflammatory process affects one or both of the maxillary sinuses.

The maxillary sinuses lie in the thickness of the maxillary bone. The sinuses have common walls with the oral cavity, the nasal cavity, the orbit. Like all other paranasal sinuses, the maxillary sinus is internally lined with a thin layer of cells( epithelium, mucous membrane), located on a thin layer of connective tissue adjacent directly to the bone. During acute sinusitis( acute sinusitis), the inflammatory process mainly captures the layer of epithelial cells and the underlying loose tissue and blood vessels beneath it. In chronic sinusitis, the inflammatory process extends to the submucosa and to the sinus bone walls. The genyantritis is an inflammation of the maxillary paranasal sinuses( a maxillary sinus or sinus sinus).The adnexal sinuses are a formation in the form of small caverns that have a communication with the nasal cavity. The maxillary sinuses in man are two - right and left. Often, specialists establish such diagnoses as maxillary sinusitis. There is no fundamental difference between the last terms and the term sinusitis.

Sinusitis can develop at any age, including the case in children. The incidence of sinusitis is significantly increased during the cold season.

Causes of sinusitis

Sinusitis can be triggered by a number of factors. In its development an important role is played by various infections of the upper respiratory tract, pathological processes occurring in the nasal cavity, mouth, pharynx. Sinusitis often occurs during an acute cold, influenza, measles, scarlet fever and other infectious diseases, as well as due to the root disease of the four posterior upper teeth.

The main cause of sinusitis is infection - bacteria or viruses penetrate into the maxillary sinus through the nasal cavity or through the blood and cause inflammation. An organism with a weakened immune system is not able to fight such viruses.

Factors predisposing to the occurrence of sinusitis:

• Conditions that disrupt the nasal breathing: curvature of the nasal septum, vasomotor rhinitis, hypertrophic rhinitis( nasal congestion), in children - adenoids, allergic diseases of the nose.
• Immunity disorders, resulting in long-term chronic diseases, parasitosis, allergic conditions, etc.
• Untimely or incorrect treatment of common cold, acute respiratory disease, rhinitis.
• Bacteriosis( existence of foci of chronic infection in the body, for example, staphylococcus).Many of you are familiar with the procedure of medical examination, when doctors take smears from the nose on bacteriological crops. Often a patient has a so-called staphylococcus, which lives for a long time in the nasopharynx of a person. The latter, if not examined, would not know that he is a carrier. For a long time these bacteria can not cause serious damage to health.but even with the common cold, staphylococcus can activate and manifest its pathogenic properties.
• Congenital disorders of development of anatomical structures of the nasal cavity.
• obstructed nasal breathing due to hypertrophy of nasal conchae, adenoids( in children).

The main causes of acute sinusitis are ARI( influenza, parainfluenza, measles), the spread of infection from dental patients( odontogenic sinusitis), allergies( allergic sinusitis) and other viral and bacterial infections. Virtually all viruses affecting the upper respiratory tract( pathogens ARVI) can cause sinusitis. The epithelium of the paranasal sinuses is very similar to the epithelium of the respiratory tract and therefore during the acute respiratory disease the disease also seizes this part of the respiratory tract. If a lesion of the nasal mucosa causes acute rhinitis and a runny nose, the lesion of the mucous membrane of the paranasal sinuses is sinusitis, which is also accompanied by secretions of the mucous fluid. Viral infections( influenza, parainfluenza, adenovirus) provoke acute forms of sinusitis and never cause chronic forms of the disease. The main role in the development of chronic sinusitis is a bacterial infection( streptococci, staphylococcus), as well as chlamydia and mycoplasma. Often a bacterial infection will replace a viral infection.

In children, sinusitis is often caused by mycoplasmal or chlamydial infections. This fact must be taken into account in diagnosis and treatment( especially in children), since these pathogens are insensitive to antibiotics of the b-lactam group( penicillins, cephalosporins) and therefore, even after the course of treatment with these antibiotics, the patient's health state is not improved. Treatment of microplasma or chlamydial sinusitis is carried out mainly with antibiotics from the group of macrolides( Azithromycin, Sumamed, Erythromycin, etc.).

Diseases of the ENT organs - this is the second most important cause of sinusitis. Acute and chronic rhinitis can lead to the development of sinusitis due to occlusion of the opening of the maxillary sinus( connects the cavity of the maxillary sinus with the nasal cavity) through which the sinus is drained and cleansed. The reason for closing the opening of the maxillary sinus in rhinitis is edema of the nasal mucosa. It is for this reason that it is recommended to use vasoconstrictive drugs in the treatment of acute rhinitis( rhinitis), which not only eliminate the runny nose, but also remove the swelling of the nasal mucosa, which in turn contributes to the normal cleansing of the maxillary sinus and protects it from inflammation.

Chronic tonsillitis can serve as a source of infection, which is entered into the maxillary sinus when nose blowing. Such a relationship of chronic tonsillitis and sinusitis is confirmed by high incidence of maxillary sinusitis in patients with chronic tonsillitis or with frequent recurrences of sore throat.

Chronic pharyngitis, as well as chronic tonsillitis can play the role of a source of infection.

Curvature of the nasal septum can cause sinusitis due to a pathological narrowing of the new stroke and a violation of drainage and ventilation of the maxillary sinus. For the genyantritis, which arose because of the curvature of the nasal septum, a very stubborn course and frequent relapses after taking the course of treatment are characteristic. On the other hand, in patients with curvature of the nasal septum, the problem can be solved by surgery to restore the normal structure of the nasal septum.

Diseases of the teeth( caries, pulpitis) can lead to the appearance of sinusitis in the case of spreading infection from a sick tooth directly to the maxillary sinus. The pathology of the teeth and maxillary sinus is closely related, especially in the case of teeth of the upper jaw, whose roots, in some people, germinate directly into the cavity of the maxillary sinus.

Allergens are the cause of allergic sinusitis. Usually this form of the disease develops in people who are hypersensitive to any allergen. Simultaneously with allergic sinusitis, allergic rhinitis, allergic conjunctivitis can be observed.

Chronic sinusitis develops due to untreated acute sinusitis and is characterized by a prolonged purulent bacterial inflammation of the maxillary sinuses.

Other causes may be chronic foci of infection in the mouth and nose( chronic tonsillitis, chronic pharyngitis, adenoids, chronic rhinitis).

The cause of development of odontogenic maxillary sinuses can be carious teeth of the upper jaw, basal cysts and granuloma, fistulas from the oral cavity to the maxillary sinus through the socket of the removed tooth, paradontosis, foreign sinus( tooth root, filling material, etc.).Odontogenic sinusitis often from the very beginning take a dull chronic course.

As a result of destruction of sinus walls by malignant tumors and subsequent infection, there is often a marked symptom of chronic sinusitis, which often mask the clinical picture of the tumor itself. Chronic sinusitis often occurs as a result of injuries, when foreign bodies and bone fragments enter the sinus. In recent years, cases of allergic origin of sinusitis have become more frequent.

The main link of the mechanism of development of both acute and chronic sinusitis is occlusion of the exit aperture of the maxillary sinus, which leads to its inflammation and accumulation of pus in the sinuses. Blockage of the opening of the maxillary sinus occurs, for example, against the background of ARI, due to edema and inflammation of the nasal mucosa, or against a background of chronic rhinitis, due to thickening of the nasal mucosa.

Symptoms of sinusitis

Symptoms of sinusitis can be very diverse and do not always suggest an inflammation of the maxillary sinus, signs of sinusitis depend on the stage and form of the disease.

Symptoms of acute sinusitis

The main clinical symptoms in acute sinusitis are: a feeling of pressure and tension in the affected sinus, in more severe cases, severe pains are localized often 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 a one-sided process) or the entire face( with a two-sided process).These symptoms are often associated with toothache in the corresponding half of the upper jaw, which is enhanced by chewing. Pain depends on the infectious neuritis of the branches of the trigeminal nerve and on the compression of the nerves with collateral edema. In patients with sinusitis, nasal breathing is disrupted and there are discharge from the nose.

Appears discomfort in the nose and near-nasal area, which gradually increase. Less pronounced pain in the morning, increase - in the evening. Gradually, the pain "loses" a certain place and the patient starts to get a headache. If the process is unilateral, then the pains are noted on the one hand.

One of the classic symptoms of sinusitis is headache .The occurrence of a headache is associated with the accumulation of pus in the inflamed sinus. Headache with genyantritis, the pressure is often located in the forehead, behind the eyes. Often, patients can tell about the pain that increases with pressure on the infraorbital area or when lifting the eyelids. Another characteristic sign of headache in sinusitis is its noticeable relief in a prone position or in the night, which is explained by the release of pus from the affected sinus.

Difficulty with nasal breathing .The patient has a stuffy nose. The voice acquires a nasal hue. As a rule, both halves of the nose are laid. Difficulty of nasal breathing is constant or with little relief. Alternate obstruction of the right and left halves of the nose is possible.

Runny nose .In most cases, the patient has a mucous( transparent) or purulent( yellow, green) discharge from the nose. This symptom may not be, if the nose is heavily stuffed, since outflow from the sinus is difficult( this was mentioned above).

Body temperature rise up to 38 and above. As a rule, this symptom is observed in acute maxillary sinusitis. In a chronic process, body temperature rarely rises.

Another symptom of maxillary sinusitis is malaise. This is expressed by fatigue, weakness, patients refuse food, they are disturbed by sleep.

There are complaints of such symptoms as: photophobia, lacrimation on the side of defeat, a decrease in smell. In the first days of the disease, especially with purulent and mixed forms of sinusitis, there is an increase in body temperature, chills, general state disorders. There is swelling of the cheek on the side of the lesion and sometimes a collateral edema of the lower eyelid.

In the case of acute respiratory infections, the symptoms of sinusitis are superimposed on the symptoms of a respiratory infection that triggers the mechanism of sinusitis. The first signs are fever, general malaise, chills, nasal congestion, runny nose, sneezing. Quite quickly, the pain in the face, giving in the teeth, the root of the nose, the forehead, joins the described symptoms of maxillary sinusitis. The pain increases with the pressure on the infraorbital area of ​​the face( this is a feature of pain in sinusitis and one of the indicative symptoms).In some cases, edema of the eyelids and redness of the eyelids can be observed.

The course of acute sinusitis takes 2-3 weeks and, as a rule, ends in recovery.

Symptoms of chronic sinusitis

Symptoms of chronic sinusitis can be erased and mild, which often delays diagnosis and treatment of the disease. The main symptom is a chronic cold that does not respond to traditional treatment. Often patients complain of headaches and pains in the depth of the eye sockets. Such pain can increase with blinking and pass in the prone position. A characteristic sign of chronic sinusitis - morning swelling of the eyelids and conjunctivitis( inflammation of the conjunctiva of the eyes) is a sign of the spread of the inflammation of the maxillary sinus to the orbital walls.

Chronic maxillary sinusitis is characterized by recurrent blunt pains in the infraorbital region, chronic nasal congestion( often one-sided), chronic conjunctivitis, headache( headache calms when lying down).An important symptom is considered to be a dry chronic cough that does not respond to treatment with antitussive or expectorant drugs. The appearance of coughing in chronic sinusitis is due to the irritating effect of pus flowing from the affected sinus along the wall of the pharynx.

Both types of sinusitis( acute and chronic) are characterized by blunting of the sense of smell. The course and prognosis of the disease depends on the quality of treatment and structural changes in the maxillary sinus.

Forms of chronic sinusitis

Subjective symptoms in chronic sinusitis largely depend on the form of sinusitis. In exudative forms, one of the main complaints is a prolonged one- or two-sided rhinitis. The nature of the secretions( pus, mucus, watery discharge) depend in this case on the form of the sinusitis. With purulent sinusitis, it often has an unpleasant odor;with scant excretions, the feeling of patients with this unpleasant odor is the only symptom of the disease. In other cases, the discharge is mucous, ductile( catarrhal form).

In serous form, the exudate has a watery nature. Difficulty of nasal breathing is characteristic for both productive and exudative and mixed forms.

Special dryness of pharynx, frequent expectoration, abundant discharge of mucous or mucous purulent sputum in the mornings and throughout the day, often vomiting occurs when obstruction of the secretion outflow from the sinus anteriorly due to hypertrophy of the anterior end of the middle shell or the presence of polyps. Pain in chronic cases does not reach that intensity, as in acute processes. Headaches are often absent;in cases with persistent nasal congestion they are more often spilled, indefinite, but can be localized on the side of lesions - in the jaw sinus, in the temple or orbit, less often in the forehead - or have the character of neuralgia of the trigeminal nerve.

With chronic inflammation, there are associated complaints of memory loss, rapid fatigue, especially with mental work. The sense of smell can be weakened and absent altogether. Objectively marked swelling of the cheeks and eyelids. There is a corresponding rhinoscopic picture.

Treatment in mild cases can be conservative in the form of rinsing of the maxillary sinus after puncturing the lower nasal passage and introducing antiseptic solutions, antibacterial drugs, antifungal and antihistamine drugs into the sinus in combination with UHF therapy or diadynamic current. The main principle of surgical intervention for sinusitis is the creation of a constant wide communication of the maxillary sinus with the nasal cavity. This can be done either in vnenonosovym or intranasal way.

The basis of recurrence of edematous-catarrhal forms after operations may be an allergic basis in their development. After the operation, a bubble with ice is put on the cheek for 1-2 days with interruptions after 1 / 2-1 hour to reduce the swelling of the cheek.

In patients with perforated odontogenic sinusitis apply sparing gaymorotomy with the subsequent introduction of reagencour hydrogels with dioxidine.

The patient is prescribed liquid and inclemish food for several days. Radical surgery for chronic sinusitis in most cases leads to recovery of the disease of other sinuses. At the heart of the radical operation is an exfoliation of the soft tissues and exposure of the osteal wall, through which they penetrate into the sinus. The detachment is carried out after the incision of the mucous membrane of the gums under the upper lip. Remove pus and pathologically altered mucous membranes. Removing a portion of the inner wall at the level of the lower nasal passage establishes a constant anastomosis with the nasal cavity. Through him, the necessary drugs are injected.

Chronic maxilloembolitis may occur with a predominance of inflammatory and allergic changes. The treatment is complex taking into account an infectious or allergic agent.

Symptoms of sinusitis in children

For acute inflammation of the maxillary sinuses are characterized by such symptoms as general weakness, lethargy, capriciousness, eating and sleeping disorders, fever to high figures;there are headaches( increasing with the inclination of the head), giving to the cheek or temple on the side of the lesion, abundant discharge from the nose( usually purulent), disruption of nasal breathing and smell;with strong edema of mucus discharge from the nose absent;the face can be a little swollen - especially swelling is seen on the eyelids. More often with sinuits in children - bilateral defeat. A small child may not say with sufficient certainty where it hurts, so parents should be especially careful, and if you suspect a sinusitis( or any of the sinusitis), do not take risks - do not self-medicate.

If you have symptoms of sinusitis, you should consult an otolaryngologist( Lor's doctor).Do not treat sinusitis yourself!

Complications of sinusitis

The danger of sinusitis comes from the anatomical location and structure of the maxillary sinus, the thin walls of which form the eye socket and contact the membranes of the brain, while the risk of infection spreading into the cranial cavity with the development of meningitis always remains. Fortunately, such complications of sinusitis are very rare. Much more often the infection from the affected maxillary sinus can go to the orbit filling its fiber and the eye membranes. One of the signs of infection in the orbit is the puffiness of the eyelids and some bulging of the eye, accompanied by severe pain.

In addition, chronic sinusitis can play the role of a source of infection, which leads to frequent recurrences of sore throat, pharyngitis, can cause dental diseases, osteomyelitis of the upper jaw. In acute sinusitis, neuritis of the trigeminal nerve can develop, accompanied by severe attacks of pain in the obsolescence of the face. Often, chronic sinusitis is complicated by the formation of an abscess - a closed cavity filled with pus.

Chronic rhinitis, caused by sinusitis, can lead to atrophy of the nasal mucosa and loss of smell.

Usually patients with sinusitis( especially chronic) are long and unsuccessfully treated for chronic bronchitis and other possible causes of chronic cough. Genyantritis requires compulsory treatment, while it is important that the treatment is handled by an experienced doctor.

The use of folk remedies for treatment of sinusitis, including the Buteyko method, is possible only in parallel to conservative treatment.

Diagnosis of sinusitis

Clinical diagnosis of sinusitis includes finding out the patient's complaints( nasal congestion, headache, pain in the projection of the maxillary sinus, chronic cough, etc.), examination of the patient - revealing reflex dilatation of the vessels of the infraorbital skin( red spot), examination of the inner surface of the mucosanose( you can notice swelling and inflammation, as well as purulent discharge from the outlet of the maxillary sinus).

The most convenient instrumental diagnostic method is the x-ray of the paranasal sinuses. On the x-ray, maxillary sinusitis( inflammation of the maxillary sinus) looks like a darkening of the sinus image( white in the picture).In healthy people, the intensity of the color of the maxillary sinus should be the same as that of the orbit. Despite the fact that the X-ray examination is the most convenient and affordable method of diagnosis, the sensitivity of this method is limited, especially in children( in children similar changes in the image of the maxillary sinus can be observed even with simple rhinitis).

The most informative method of diagnosis of sinusitis is a puncture of the maxillary sinus. During the puncture with a special needle, the doctor punctures the sinus wall and sucks the contents of the syringe( it is also possible to rinse the sinus with a disinfectant).This is a fairly simple procedure that, if done correctly, is easily tolerated by patients, but even so, puncture is rare, when all other methods of diagnosis and treatment have been unsuccessful. Possible complications of puncture are: the formation of emphysema of the cheek or eye socket( when air from the syringe falls into the soft tissues of the orbit or cheek), the development of the abscess or phlegmon of the orbit, embolism( blockage) of the blood vessels. Despite the fact that the risk of the described complications, with proper execution of the puncture is rather small, the possibility of their development significantly narrows the horizon of using this procedure.

The basic method of investigation with sinusitis is the radiography of the sinuses, diaphanoscopy.

Treatment of sinusitis

The modern approach to the treatment of sinusitis includes a set of measures to restore drainage and suppress the focus of infection in the maxillary sinus. Treatment of acute maxillary sinusitis is usually conservative - mainly providing a good outflow of contents from the sinus. Acute maxillary sinusitis and chronic sinusitis are most often treated with the help of usual pharmacotherapy, which the doctor chooses for consultations. Rinsing of the paranasal sinuses( without puncture) is performed only with severe pain syndrome or copious pus. Laser therapy is performed to eliminate the effects of inflammation and the effect of drug treatment. Completely the course of treatment of an acute process takes depending on the severity of two weeks to two months. With severe intoxication, antibiotics are prescribed intramuscularly. To reduce swelling and swelling of the mucous membrane in the nose, vasoconstrictive agents are instilled. A significant role is played by physiotherapeutic methods of treatment. The inhalation of aerosols of antibiotics also have a favorable effect. In persistent cases resorted to sinus puncture and washing it with solutions of antiseptic drugs followed by the introduction of antibiotics.
Treatment with acute frontitis conservative.

When the body temperature is elevated, it is recommended that bed rest and the appointment of antipyretic agents. When the temperature rises above 38 ° C, the patient is usually prescribed antipyretic and analgesic drugs: acetylsalicylic acid( aspirin) 0.5 g 3 times a day, amidopyrine with analgin at 0.25 g 2-3 times a day, paracetamol, orpreparations containing them in its composition. In the presence of general intoxication and sharp pains, as well as abundant discharge from the nose, it is very effective to prescribe sulfanilamide preparations( sulfadimezine and others 0.5 g 4-5 times a day) and antibacterial drugs.

The best results of treatment of sinusitis are achieved with systemic use of antibiotics of new generations( augmentin, cephalosproins of the 3rd generation, azithromycin).With intolerance to patients with antibiotics from the penicillin group, I appoint macrolides( Azithromycin) or tetracyclines( the latter are contraindicated in children).The last two drugs are especially effective in sinusitis caused by chlamydia or mycoplasmas. Currently, there are a number of antibiotics for local treatment of sinusitis( bioparox, zofra).Their use makes it possible to achieve a high concentration of antibiotics in the focus of the infection and avoid adverse reactions from systemic use of antibiotics. The treatment with antibiotics helps to suppress the infection and stop the spread of microbes. The use of local antimicrobial and immunostimulating sprays helps fight infection by creating a region of inflammation with a high concentration of antibiotics. The choice of antibiotics should be carried out taking into account the isolated infectious agent and a certain individual sensitivity, otherwise antibiotic therapy can be a useless and risky waste of money and time. A certain benefit can be provided by an approximate rapid assessment of the pathogen in the Gram stain and the smear microscopy.

The most common sinusitis is caused by gram-negative flora. Therefore, the drugs of choice are cefuroxime axetil or amoxicillin plus clavulanic acid;alternative agents are: macrolides, cefaclor, cephalosporin 3, amoxicillin, co-trimoxazole. In acute purulent processes, the listed medicinal substances are administered orally, intramuscularly or intravenously. Possible and topical application( the introduction of solution into the cavity) antibacterial agents. In this case, the possibility of their exerting an irritant effect on the mucosa should be considered.

Usually, the positive effect of antibiotic therapy should be noted in the first 48 hours. This is confirmed by an improvement in well-being, a decrease in fever. It should be taken into account that too short courses in 3-4 days( in this case a relapse of the disease is possible) and long courses are undesirable( because they can lead to superinfection( bacterial, fungal).)

Local treatment consists ofmeasures that promote the outflow of exudate from the sinus and resorption of the existing infiltration of the mucous membrane. The use of nasal vasoconstrictive sprays - helps restore the natural drainage of the maxillary sinus. It is well known that inflammation of the mucosa leads to itsedema, which closes the exit opening of the maxillary sinus and accumulates pus in this situation, recovery of the patient with sinusitis does not occur until normal sinus drainage is restored. Nasal sprays and drops containing nasal sprays and drops are used to remove the edema of the mucosa and open the sinus outletvasoconstrictive drugs( nasivin, otilin, prinos, etc.) The use of these drugs allows to achieve an immediate elimination of the edema of the nasal mucosa, which in turn has a beneficial effect on the purification of sinusa. Treatment with nasal vasoconstrictive drugs is performed no more than 5 days because of the risk of atrophy of the nasal mucosa.

To reduce mucosal edema in the area of ​​the outlets of the paranasal sinuses and to facilitate the outflow of the discharge, lubricants or insertions of gauze tampons moistened in vasoconstrictive agents are also prescribed as drops, ointments and inwards. The most common are local alpha-2-adrenolytics, which are derivatives of imidazoline( oxytolazoline, xylometazoline and naphazoline).The course of treatment is not recommended to continue for more than 7-10 days, given the risk of developing drug rhinitis. Ephedrine, pseudoephedrine and phenylpropanolamine are administered orally. In recent years, combined oral preparations containing alpha-2-adrenomimetics( for example, pseudoephedrine) and non-selective antihistamines( eg, terfenadine) with a prolonged effect have gained great popularity.

In case of allergic sinusitis, antihistamine therapy is indicated( astemizole, cetirizine, loratidine, acryvastatin, etc.).

The treatment of acute inflammation of the maxillary sinus is also facilitated by physical procedures( blue light, sollyx).These procedures in the first days of the disease can be repeated several times a day for 10-15 minutes, and the intensity of irradiation should be within the pleasant sensation of heat. UHF-therapy, dynamic currents, etc. are more effective. In prolonged cases with abundant pus excretion and in the absence of a tendency to cure, it is necessary to puncture and wash the sinuses, followed by the introduction of antimicrobials and antiseptics( quinazole, octenisept, dioxidine) into the sinuses. At the expressed edema and an allergic genyantritis the introduction in gajmorovu a cavity of antihistamine preparations( a levocabastin and an allergodylum), and also glucocorticoids is shown.

If the cause of sinusitis is the curvature of the nasal septum or an aching tooth, then treatment should begin with the elimination of the underlying cause. Treatment of the primary focus of infection( chronic tonsillitis, aching tooth, chronic rhinitis) is shown in all cases of the existence of suspicion of the secondary nature of sinusitis.

Puncture drainage and lavage of the maxillary sinus are indicated if the measures described above are ineffective.

Puncture of the maxillary sinus with sinusitis

Puncture of the maxillary sinus can be prescribed both for the purpose of diagnosis and for the treatment of sinusitis. Puncture is done under local anesthesia. The sinus wall is punctured with a special needle, sucked out pus and washed with antimicrobials.

Unfortunately, many patients, fearing such "punctures", are delayed with a visit to a doctor with genyantritis, thereby causing harm to themselves: creating the threat of development of severe complications of sinusitis associated with the possible spread of infection, as well as the conditions for the formation of chronic sinusitis.

Treatment of sinusitis without puncture

With the timely application to the ENT doctor, it is possible to treat maxillary sinusitis without a puncture. At the initial stage of sinusitis you can do without puncture.

"Non-puncture" method of treatment of sinusitis is the washing of the nose by the method of moving the liquid( "cuckoo") in combination with laser therapy. The washing procedure clears nasal passages and nasal cavities from pus and mucus, and the laser removes inflammation. The course is designed for 5-7 procedures. After the 1st procedure, patients see a significant improvement in their condition.

Against sinusitis and for the prevention of diseases of the ENT organs, as well as complications at home, a nose wash is used. However, most solutions for the treatment of the nose in the form of ready-made aerosols imply a procedure for nasal irrigation, rather than for immediate rinsing. Irrigation, unlike washing, can only reduce the thick consistency of nasal secretions, but will not solve the problems with their removal along with harmful bacteria. After irrigation the mucous membrane quickly dries up, which further aggravates the rhinitis, provokes swelling.
Flushing promotes the reduction of inflammation, improves the mucous membrane of the nose and prevents the development of sinusitis and sinusitis. Modern methods involve the washing of the nasal passages with special antiseptic agents. For example, the components of the drug "Dolphin" get to the sinuses of the nose, diluting the clots of mucus and naturally leading them out.

Another way to do without a puncture is using an apparatus that creates a negative pressure in the nasal cavity, and thereby contributes to the removal of the secretion from the maxillary sinuses.

Treatment of sinusitis without a puncture is possible only if there are nasal discharge, indicating that there is an outflow of the contents of the maxillary sinus. Even the anatomical features of the structure of the ENT organs are important.

That is, to determine the optimal treatment tactics, it is necessary to contact the otolaryngologist as soon as possible.

Advantages of treatment of sinusitis without puncture

• No pain and blood
• No perforation of maxillary sinuses
• In just one and a half hour

Methods of treatment of sinusitis without surgery:

• Nasal washing by moving( "Cuckoo");
• anemia of the nasal mucosa;
• Intranasal blockades;
• bow shower;
• suction of mucus;
• washing of maxillary sinuses through drainage with the introduction of drugs;
• ozone therapy;
• laser therapy( 8-10 sessions per 1 course);
• Puncture of the paranasal sinuses with the administration of anti-inflammatory drugs( as indicated),
• Antimicrobial treatment of antritics( antibiotics for treatment of sinusitis are selected individually).

If conservative treatment does not help, then surgical treatment is possible:

• septoplasty( correction of nasal septum);
• radioturbation of nasal concha;
• concotomy;
• Polyphotomy of the nose.

Treatment of sinusitis in children

Genitalis in children often occurs during an acute cold, flu, measles, scarlet fever and other infectious diseases, as well as due to the disease of the roots of the four posterior upper teeth.

Sinusitis is chronic with repeated acute inflammations and especially with prolonged inflammation of the maxillary sinuses, as well as with a chronic cold. A certain role is played by curvature of the nasal septum, congenital narrowness of the nasal passages. From the outset, the odontogenic process often has a dull chronic course. There are also vasomotor and allergic forms of the disease, which are observed simultaneously with the same phenomena in the nasal cavity. Symptoms, the course depends on the form of the lesion and do not differ from the symptoms in adults.

In exudative forms of maxillary sinitis, the main complaint of the patient is the abundant discharge from the nose. With a difficult outflow of secretions from the sinuses of discharge from the nose, there is almost no, and patients complain of dryness in the pharynx, expectoration of a large amount of sputum in the morning, an unpleasant odor from the mouth. Often there are headaches and nervous system disorders( fatigue, inability to concentrate).With an exacerbation, swelling of the cheeks and swelling of the eyelids can be observed. Sometimes there are cracks and wet skin at the entrance to the nose.

Maxillary sinusitis in children is most often successfully treated with the help of usual pharmacotherapy, which the doctor chooses for consultations. Rinsing of the paranasal sinuses( without puncture) is performed only with severe pain syndrome or copious pus.

Laser therapy is performed to eliminate the effects of inflammation and enhance the effect of drug treatment. In a number of cases( for example, with a severe course of the disease), treatment with an otorhinolaryngologist should be combined with acupuncture. The full course of treatment of sinusitis in children takes depending on the severity of one to two weeks.

The principle by which the treatment of chronic sinusitis in children is the same. The course sometimes lasts up to 3 weeks. The main direction of therapy for chronic sinusitis is the prevention of exacerbation of the process.

Prophylaxis of sinusitis

Prevention should be aimed at timely treatment of the underlying disease, elimination of predisposing factors, without waiting for the appearance of symptoms of sinusitis.