Acute sinusitis: how to prevent the disease from leading to serious complications?

Acute sinusitis is an inflammatory process that occurs in the mucous membrane of the nasal appendages (sinuses), so sometimes the diagnosis of sinusitis is also related to inflammation. This disease is characterized by swelling of the cheeks and purulent discharge, accompanied by an unpleasant odor.

In terms of its symptoms at the onset of the disease, the acute form of sinusitis is very similar to a common runny nose, only the treatment of the disease can be more difficult and lengthy. And the condition itself causes enormous discomfort to the patient and interferes with a full life.

Anatomy of the sinuses

There are 4 types of sinuses in the human skull:

• frontal (in the forehead area);
• maxillary, also known as maxillary (in the area of ​​the cheeks under the eyes);
• ethmoid sinuses, or cells of the ethmoid labyrinth (in the area between the nose and eye);
• wedge-shaped (in the very middle of the skull, behind the eyeballs).

The sinuses are peculiar voids that reduce the weight of the skull, participate in the formation and sonority of the voice, in the process of smell, and also serve as shock absorbers for injuries to the facial skeleton.

They also perform a protective function: when foreign particles and bacteria enter the nasal cavity, the nasal mucosa is irritated, sneezing begins, and the particles are evacuated from the body along with mucus. But if the body’s defenses are weakened, bacteria can enter the sinuses from the nasal passages and cause severe inflammation, which is what we observe during the development of acute manifestations of the disease.

Why do the maxillary sinuses become inflamed more often?

Among inflammations of the paranasal sinuses, acute sinusitis - inflammation of the maxillary sinuses - is most often diagnosed. And there are several reasons for this:

• the maxillary sinuses are the largest in volume;
• The maxillary sinuses are connected to the nasal cavity using anastomoses - small openings covered with mucous membrane (these openings are quite narrow, and even a slight swelling of the mucous membrane with minor inflammation can make it difficult for mucus to come out of them, and the formed and accumulated mucus in the absence of proper outflow becomes a powerful catalyst, if the inflammatory process develops first in neighboring ones.).

Chronic sinusitis

Chronic sinusitis is diagnosed if the inflammatory process in the maxillary sinuses continues for more than 4 weeks. In the chronic form of the disease, periods of relatively good health are followed by exacerbations, when the symptoms of sinusitis appear again.

Between exacerbations, the symptoms of sinusitis are usually mild. The temperature, as a rule, does not rise or rises slightly - up to 37−37.5 °C. The most indicative symptom of chronic sinusitis is attacks of dry night cough, which does not respond to traditional treatment. A cough is caused by phlegm running down the back of the throat.

Chronic sinusitis is very difficult to completely cure. Therefore, if you get sinusitis, you should immediately consult a doctor before the disease becomes chronic.

Types of acute sinusitis

There are catarrhal and purulent forms of sinusitis.

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The name “catarrhal” comes from the medical term “catarrh,” meaning “to flow, drain.” That is, with this form of sinusitis, inflammation of the mucous membrane and its swelling develop quite quickly. Initially, the changes affect only the mucous membrane. Inflammation during sinusitis of this form is accompanied by severe swelling of the mucous membrane - it noticeably increases in size and, as a result, a little later transparent mucus forms. Only thanks to timely treatment, it is possible to prevent the transition of catarrhal forms into purulent sinusitis, which with a high degree of probability can become chronic.

With purulent sinusitis, direct contact of pus with the mucous membrane degenerates it, quite quickly and, what is most dangerous, irrevocably. Thus, with improper treatment or no treatment at all, you can very easily and simply join the army of people suffering from a chronic form of sinusitis.

The cause of the purulent form of sinusitis (acute sinusitis) is bacteria. The secreted mucus contains streptococci, staphylococci, and less commonly pneumococci and fungi, which leads to the appearance of purulent contents in the sinus itself.

Prevention of sinusitis

The main condition for preventing sinusitis is maintaining a healthy nose.
At the end of treatment, the otorhinolaryngologist draws up a detailed scheme of preventive measures that are aimed at restoring proper nasal breathing. In medical

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Gorokhovaya st., 14/26 (metro station Admiralteyskaya, Admiralteysky district) and on Varshavskaya st., 59 (metro station Moskovskaya, Moskovsky district) you can get diagnosed and treated for sinusitis and other ENT diseases by an otorhinolaryngologist
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Reasons for the development of sinusitis

Acute sinusitis can be caused by the following factors:

• colds;
• viral infections: ARVI, measles, influenza, etc.;
• allergic reactions;
• damage and injury to the nose;
• untreated teeth, tooth roots entering the cavity of the maxillary sinus, inflammation of the gums.

In medicine, it is customary to distinguish two ways of infection entering the maxillary sinuses: when the infection penetrates from the nasal mucosa into the maxillary sinus or when the infection develops directly in the maxillary sinus through blood flow and general inflammation.

Sinusitis (in addition to bacteria) can be provoked by factors that interfere with normal air circulation and the release of mucous masses from the sinuses. These include:

• deviated nasal septum;
• adenoids;
• cyst;
• polypous formations;
• and etc.

Unfavorable environmental conditions - dust, gas pollution, work in hazardous industries - can also disrupt the process of the release of mucous masses from the sinuses and further treatment.

Sensorineural hearing loss

The cause of hearing loss and a feeling of fullness in the ears may be sensorineural hearing loss, which occurs as a result of a violation of the blood supply or innervation in the inner ear.

Sensorineural hearing loss can result from:

• changes in blood pressure due to hypertension;
• acute viral diseases;
• barotrauma;
• fracture of the base of the skull;
• ischemia of the central areas of the auditory analyzer;
• neuroma of the vestibulocochlear nerve;
• compression from the outside by neoplasms and vascular aneurysms.

Symptoms

Symptoms of acute sinusitis include:

• pain in the cheek area under the eyes;
• pain in the orbital region;
• pressure on teeth and toothache;
• headache;
• pain when tilting the head forward (the pain “radiates” to the back of the head and forehead; the nature of the sensation resembles the pain of a migraine; as a rule, the pain intensifies in the evening);
• difficulty breathing through the nose;
• a feeling of continuous nasal congestion (it may be accompanied by itching, sneezing, dryness);
• the nature of the mucous discharge helps determine the severity of the disease (transparent discharge in a mild form of the disease and thick green discharge in a purulent form);
• bad odor from the nose and mouth (the nose and pharynx are connected to each other; with sinusitis, pus accumulates in the sinuses and causes bad breath; it is difficult to get rid of it, even after brushing your teeth);
• eyes become watery;
• nasality appears in the voice;
• impaired sense of smell;
• high body temperature from 37.5 to 39°C - the body’s response to the presence of infection;
• increased fatigue, decreased appetite, sleep problems;
• swelling of the eyelids, cheekbones, and areas near the nose;
• pain when pressing on the area where the sinuses are located.

Inflammation

Inflammatory causes of ear congestion:

• external otitis of any etiology (fungal, bacterial, viral);
• eustacheitis (tubootitis);
• catarrhal otitis media, bullous otitis (with influenza);
• purulent otitis media (including chronic);
• exudative otitis;
• adhesive otitis media

With inflammation in the nasal cavity, paranasal sinuses or pharynx, swelling of the nasopharyngeal mouth of the auditory tube occurs, due to which the pressure in the tympanic cavity and the environment ceases to equalize, and the drainage function of the auditory tube is disrupted. The infectious agent, together with the discharged contents from the nasal cavity and paranasal (paranasal) sinuses, enters the auditory tube and tympanic cavity, causing inflammation of the auditory tube - eustacheitis (tubo-otitis) and otitis media.

Due to inflammation, swelling of the mucous membrane of the middle ear and eardrum occurs, sound-conducting mechanisms stop working normally, and ear congestion occurs, and hearing decreases. A common cause of dysfunction of the auditory tube and the development of otitis in children is hypertrophy of the nasopharyngeal tonsil and adenoiditis. In adults, vasomotor and allergic rhinitis and deviated septum are common causes of swelling at the mouth of the auditory tube. The cause may also be a violation of blood circulation and innervation in the inner ear.

With inflammation in the external auditory canal, swelling of its walls appears, fungal or purulent masses clog the ear canal, and the surface layers of the eardrum become inflamed (myrinigitis). Because of this, the mobility of the eardrum, necessary for proper sound transmission, is reduced.

Most of the described forms of otitis often occur as complications of acute respiratory diseases, sinusitis, rhinitis, especially in the case of improper cleansing of the nasal cavity. In addition to the feeling of congestion during otitis media, shooting, sharp or aching pains, hearing problems, bloody, fungal, purulent discharge, itching, a feeling of pulsation or fluid transfusion in the ear can be added.

A feeling of ear fullness also occurs when:

• water getting into the ears (usually when swimming), the water usually evacuates on its own and does not require intervention;
• when a cerumen or epithelial plug forms (can also occur after water gets into the ear due to swelling of the cerumen plug);
• foreign bodies getting into the ears: insects, earbuds, cotton wool from cosmetic sticks, etc.

After eliminating the provoking factor, the discomfort disappears and hearing is restored.

Are complications possible with acute sinusitis?

With delayed treatment or lack of properly selected treatment, acute sinusitis can become chronic and lead to the development of a number of other serious complications.

Friends! Timely and correct treatment will ensure you a speedy recovery!

Chronic inflammation in the sinuses is the most common complication of acute sinusitis. The chronic form requires long-term competent treatment.

An infection from the maxillary sinuses can enter the middle part of the ear and provoke a severe inflammatory process there (otitis media). Otitis is accompanied by sharp pain in the ear, hearing loss occurs, and body temperature may rise.

Diseases of the ternary nerve are associated with sinusitis, since it is located close to the source of inflammation. This condition is characterized by shooting pains in the face. Patients describe the sensations as electric shocks. Such neuritis is extremely difficult to treat.

Complications of sinusitis associated with the eyes are possible. With inflammation, we observe swelling of the eyelids, pain when pressing on the eye socket, and vision may begin to “deteriorate.” Pus entering the eye socket and vein thrombosis can lead to loss of vision and even loss of the eye itself (panophthalmitis).

The worst consequence of sinusitis is inflammation of the lining of the brain (meningitis). A similar complication develops with prolonged and incorrect attempts to independently cure sinus inflammation.

Other common complications of sinusitis in adults: periostitis of the jaw, meningoencephalitis, sinus thrombosis, up to generalized blood poisoning (sepsis).

Remember, sinusitis with complications is much more difficult to treat, so it is very important to promptly seek qualified help from an ENT specialist.

Why, when symptoms of acute purulent sinusitis appear, you should urgently consult an ENT doctor:

Do not forget that “the nose grows on the head,” which means that any purulent diseases of the paranasal sinuses mean the presence of pus in the skull, in close proximity to the cavity of the orbits and to the brain, therefore complications can be extremely serious, with the most unpredictable consequences:

• Otitis
• Intraorbital complications (orbital cellulitis, orbital abscess)
• Intracranial complications (meningitis, encephalitis, brain abscess)

There is no need to try to cope with sinusitis on your own. The presence of a purulent process in the sinus indicates that it cannot empty itself and if time is lost, there is a high probability that the pus will make its way into one of the nearby organs.

How is diagnosis carried out?

Treatment of acute sinusitis in adults and children must be carried out under the supervision of an experienced otolaryngologist.

At the appointment, the ENT doctor will collect anamnesis and conduct an examination of the nasal cavity. Painful sensations when palpating the area under the eyes at the level of the cheeks will indicate the presence of an inflammatory process in the sinuses.

A reliable diagnostic method is x-ray examination. But young children and pregnant women are not prescribed x-rays. They are shown CT and ultrasound examination of the sinuses - sinus scanning.

To obtain complete information about the disease, rhinoscopy and endoscopy of the nasal cavity and nasopharynx are performed.

Methods for diagnosing sinusitis

Diagnostic procedures for sinusitis are designed to determine the condition of the maxillary sinuses: the degree of swelling of the mucous membrane, the presence and level of fluid in the sinus. For this purpose the following are used:

X-ray of the sinuses

The radiography method of the paranasal sinuses is used most often.

More information about the diagnostic method

MSCT of the paranasal sinuses

A CT scan of the sinuses also uses X-rays. But it allows you to get a more detailed picture of bone structures. This diagnostic method is used, as a rule, for chronic sinusitis.

More information about the diagnostic method

Ultrasound of the sinuses

An ultrasound of the nasal sinuses is usually performed if an x-ray is undesirable (during pregnancy, examination of children, or during a repeat examination). Ultrasound can be performed using the Sinuscan ultrasound diagnostic device.

MRI of the sinuses

MRI of the sinuses is used if it is necessary to evaluate the condition of the sinus mucosa.

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Treatment methods for acute sinusitis

The mildest disease does not require the use of any special measures or antibacterial agents for treatment. It is enough to take anti-inflammatory drugs to relieve general symptoms and use vasoconstrictor drops to relieve swelling and facilitate the release of mucus.

Sinusitis with a purulent form is treated with the help of antibiotics (for example, Amoxiclav).

Therapy for the acute form of the disease is best supplemented by rinsing the nasal cavity and paranasal sinuses. The most effective method of treating sinusitis is Proetz lavage, better known as the “cuckoo” method.

Physiotherapeutic procedures and irrigation of the nasal cavity with antiseptic agents will help to consolidate the effect of treating sinusitis.

Washing “cuckoo”: description of the method of treating sinusitis

The “cuckoo” method is a painless and, most importantly, effective procedure. Thanks to conservative treatment, purulent masses, mucous secretions along with pathogenic microorganisms are effectively washed out of the sinuses, the mucous membrane improves its function, nasal congestion decreases, and inflammation subsides. In some cases, thanks to Proetz lavage, puncture can be avoided. How is this procedure carried out?

The patient is positioned comfortably, lying on the couch, face up. The ENT doctor carefully pours an antiseptic into one nostril (Chlorhexidine, Furacilin, Miramistin, etc.). And at the same time, with the help of a special metal olive connected by a medical suction device, it sucks out this rinsing solution, but from the other nostril. The manipulation is repeated three times on each side, using a sterile plastic syringe with a volume of twenty ml. The entire procedure lasts about five minutes.

Physiotherapeutic treatment

Are you worried about a severe headache due to sinusitis? How to treat? Is it possible to do without additional medications? Special types of treatment always had a positive effect on the course of therapy. These include:

• UHF.
• Sollux.
• Electrophoresis.
• Inhalations.
• Saline solution.

If conservative treatment fails to achieve a positive result, a puncture of the maxillary sinuses is performed. This creates a fistula that promotes the drainage of pus from the sinuses. After the procedure, a decrease in headaches is observed.

If the infection begins to spread to the brain area, surgery is performed. With its help, accumulated mucus is removed from the sinuses.

Puncture for sinusitis

If all conservative methods of treating sinusitis do not help, the ENT doctor will suggest a puncture of the maxillary sinus. This measure is necessary because pus accumulated in the sinus, as we already know, can lead to serious consequences, including inflammation of the brain.

During the procedure, the otolaryngologist releases the purulent contents of the sinuses and injects medication into the sinus. There is no need to be afraid of a puncture - before the procedure, anesthesia is performed: the ENT doctor inserts a cotton swab soaked in a lidocaine solution into the nasal passage of the patient sitting in a chair. It is completely safe and does not require patient preparation.

As soon as the anesthesia takes effect, the otolaryngologist, using a Kulikovsky needle, carefully inserts it into the sinus through the nasal cavity. Using a syringe, the purulent contents are sucked out. As soon as the purulent masses are completely removed, rinsing is carried out. The sinus should continue to be rinsed for several days after the procedure.

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