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Is chronic sinusitis curable? How to cure chronic sinusitis at home

Sinusitis is one of the most serious diseases, characterized as an active inflammatory process that develops in the paranasal sinuses. The disease most often occurs against the background of a cold or prolonged runny nose. The likelihood of sinusitis increases significantly if prolonged rhinitis has not been completely cured.

A predisposing factor influencing the development of the disease is reduced immunity. Another reason why sinusitis can develop is bad teeth. This disease is characterized by nasal congestion, in which mucus accumulates in the nasal sinuses, after which pus begins to be released.

The main signs of acute sinusitis are:

It is imperative to treat sinusitis, and the sooner you start therapy, the better. If this is not done immediately, the disease will go into a purulent stage, which is fraught with the development of serious complications, often manifesting as diseases with an independent course.

In acute sinusitis, inflammation of the nasal mucosa occurs, which is supplied with a large number of blood vessels. The inflammatory process affects connective tissue. When the disease becomes chronic, the bone tissue of the maxillary sinuses and submucosa are affected.

The most common causative agents of sinusitis are:

hemophilus influenzae;
pneumococcal infection.

In addition, the disease can develop if the structure of the ethmoid labyrinth is abnormal. As a result, insufficiently purified air masses can enter the nasal sinuses, which contributes to the development of inflammation.

Sinusitis affects people of all age groups. Most often this happens in the autumn-winter period. Although in early spring there are also cases of exacerbations of this disease.

If sinusitis has become chronic, then one should expect the development of recurrent processes. Moreover, for some category of people who have a severely weakened immune system, it may be enough to catch a mild cold accompanied by a runny nose. Unfortunately, this happens quite often, even with the slightest hypothermia of the body.

Many patients have a natural question: what to do during an exacerbation of chronic sinusitis? In order to answer it, it is advisable to consider information about how exacerbations occur and what this condition threatens the patient with.

Exacerbation of the chronic form of the disease

During exacerbations of chronic sinusitis Patients experience the following symptoms:

With an exacerbation of chronic sinusitis, patients often experience skin damage near the nasal cavity, which consists of swelling, weeping and small cracks.

Against the background of exacerbations of sinusitis, diseases such as ocular conjunctivitis and keratitis may develop. If the inflammatory process involves the periosteum, the patient may have swollen eyelids and a swollen face.

Exacerbations of sinusitis are fraught with the development of the following serious complications:

swelling of the meninges;
meningitis;
blockage of the orbital veins;
brain abscess;
eye abscess.

The process starts during exacerbations as a result of exposure to a viral infection, followed by bacterial infection of the maxillary sinuses. Damage to the nasal mucosa provokes congestion in the sinuses, as a result of which pathogenic microorganisms begin to come into contact with healthy cells. This leads to secondary bacterial infection.

If an exacerbation of sinusitis occurs, its symptoms should never be ignored

Treatment options

For exacerbations of sinusitis, in addition to puncture of the nasal septum, a complex therapy, including:

rinsing the nasal sinuses with saline solution using drainage;
laser treatment;
carrying out ozone therapy;
drug treatment.

Treatment of exacerbation of sinusitis is carried out with the aim of relieving symptoms: therapy ensures the outflow of mucus and purulent discharge from.

Medicines

Patients are prescribed antibiotics, antipyretic drugs and sulfonamides. In order to strengthen the immune system, vitamin therapy is carried out in parallel. If the disease is accompanied by allergic manifestations, then treatment is supplemented by the prescription of calcium chloride and antihistamines.

You can speed up the healing process by using nasal drops and sprays that have a vasoconstrictor effect. Their list includes:

Nazol;
Naphthyzin and so on.

As for the use of homeopathic medicines made on the basis of natural ingredients, it is advisable to use them to activate the body's defenses. The main advantage of these medications is the complete absence of side effects when using them.

Before carrying out treatment, you should first visit a homeopathic doctor, and then make a visit to an otolaryngologist.

Procedures

If sinusitis has worsened, they will help you cope with the problem following procedures:

warming up;
steam inhalations using medicinal herbs and;
mud therapy;
irradiation of the nasal sinuses using ultrasound;
therapeutic applications with paraffin and other physiotherapy procedures.

Puncture of the maxillary sinus is performed to separate the nasal passage from the maxillary cavity. After this, the nasal sinus is washed with saline, as a result of which the pathogenic contents are removed. Further, in order to prevent the development of relapses of sinusitis and suppuration, it is proposed to introduce antibiotics into it.

The surgical operation under the name is opening the maxillary sinus for the purpose of cleansing it. The manipulation is carried out in case of infection after tooth extraction in the upper jaw.

Prevention

In order to prevent the development of complications with, All you need to do is follow simple rules:

when the first pronounced manifestations occur, immediately contact an otolaryngologist for advice and medical assistance;
treat any colds to the end;
strictly adhere to medical recommendations;
eat properly and balanced;
include a sufficient amount of vitamins in the diet to maintain normal immunity;
avoid hypothermia;
treat colds, alternating drug therapy and traditional medicine methods.

Conclusion

In conclusion, it can be noted that the treatment of a disease such as sinusitis should be taken very seriously. In this way, relapses and complications can be avoided.

Inflammation of the mucous membrane of the maxillary, or maxillary, paranasal sinuses, lasting more than 4 weeks, is called chronic sinusitis. According to statistics, this pathology accounts for exactly half of all inflammatory diseases of the sinuses (sinusitis). Chronic sinusitis occurs in waves - the remission stage is replaced by an exacerbation stage, after which remission occurs again. In the absence of adequate treatment, the pathological process also affects other organs adjacent to the maxillary sinuses and complications develop.

Causes of chronic sinusitis

The main cause of this disease is prolonged exposure to pathogenic microflora on the sinus mucosa. In the vast majority of cases, it is caused by bacteria; less often, viruses and fungi act as causative agents. There are often cases when, when examining the contents of the sinuses, several types of microorganisms are found in it.

Disturbed nasal breathing due to congenital or acquired anatomical defects (for example,) contributes to the onset of the pathological process in the sinus. Since the lower wall of the maxillary sinuses is very thin, infection can enter them from the oral cavity (for example, from teeth affected by caries, inflamed gums, etc.) - in this case, the disease is called chronic odontogenic sinusitis.

Factors predisposing to the development of the disease are:

frequent infectious diseases of the upper respiratory tract;
bad habits, in particular smoking;
cold season;
barotrauma;
hypovitaminosis;
severe concomitant diseases that have a negative impact on the immune system as a whole;
tendency to.

The mechanism of development of sinusitis

Paranasal sinuses with sinusitis. The maxillary sinuses are on the sides of the wings of the nose.

The infection, entering the mucous membrane of the nasopharynx and maxillary sinus, causes local inflammation, one of the components of which is swelling. The mucous membrane of the anastomosis connecting the nasal cavity with the maxillary sinus also swells, which causes deterioration of air circulation in the latter and the outflow of mucus from it. Accumulated mucus is an excellent breeding ground for microorganisms, which further intensify inflammation.

In most cases, with this disease, only one sinus is involved in the pathological process, but there are also cases bilateral chronic sinusitis.

Classification of chronic sinusitis

The main forms of chronic sinusitis are:

polyposis;
mixed (purulent-polyposis).

Allergic and odontogenic forms of this disease also often occur.

Symptoms of chronic sinusitis in adults

Chronic sinusitis in remission occurs with mild symptoms. Patients are usually concerned about:

slight weakness, fatigue;
mild headache without clear localization;
, as a result of which;
pain when swallowing, caused by the irritating effect of mucus flowing from the inflamed sinus along the back wall of the pharynx;
some swelling in the area of the projection of the sinus onto the face.

When chronic sinusitis enters the acute stage, the patients’ well-being worsens: they note severe weakness, a slight increase in temperature (usually no more than 37.5–37.7 C); The headache becomes more intense, especially when tilting the head forward, and a feeling of heaviness appears in the head. Since it is in the inflammation stage, bursting pain may appear in this area. Complaints of tickling and coughing persist. Characterized by redness of the skin, cracks, swelling under the nose (due to constant irritation of this area with mucus). Complaints of swelling of the lower eyelid or the appearance of discharge from the eyes (conjunctivitis) indicate the spread of the inflammatory process to the eye sockets.

Complications of chronic sinusitis

If left untreated, an infection from the maxillary sinus can spread to the ear area - otitis media will develop.

Untreated chronic sinusitis can provoke the development of the following diseases:

phlegmon of the orbital tissue;
abscess of the lower eyelid;
meningitis, brain abscess and sepsis should be noted among the serious complications;
diseases of the bronchopulmonary system (bronchitis, pneumonia);
kidney disease (pyelonephritis);
heart disease (myocarditis).

Diagnostics

Based on the patient’s complaints, medical history and life history, the otorhinolaryngologist will suspect a disease, which will be confirmed by rhinoscopy, as well as additional examination methods.

When visually examining the nasal mucosa, attention will be drawn to its hyperplasia (thickening), hyperemia (redness), swelling, and the presence of discharge in the form of viscous mucus or pus.

The leading methods used to confirm the diagnosis are:

bacteriological examination of material from a smear taken from the nasal cavity during rhinoscopy;
rhinoendoscopy (examination of the nasal mucosa and paranasal sinuses using a special device - a video endoscope);
X-ray of the paranasal sinuses.

Less often, for diagnostic purposes, puncture of the maxillary sinus is performed, and allergy tests are performed to determine the patient’s immune status - an immunogram.

How to cure chronic sinusitis

It is almost impossible to completely get rid of chronic sinusitis.

When the process worsens, comprehensive treatment should be carried out, the goals of which are to restore normal nasal breathing and destroy the causative agent of the disease.

To achieve an optimal treatment result, it is important to sanitize foci of chronic infection, which could cause an exacerbation of sinusitis, as quickly as possible. For this purpose, as well as to suppress the growth and reproduction of microorganisms in the sinus itself, antibacterial drugs from the group of cephalosporins (Ceftriaxone, Cefodox, Cefix) or fluoroquinolones (Ciprofloxacin, Gatifloxacin, Moxifloxacin) are prescribed.

The optimal solution is to prescribe, in parallel with systemic antibiotics, local antibacterial drugs, for example, Bioparox (available in the form of a spray).

avoid acute infectious diseases;
promptly sanitize foci of chronic infection, especially those localized in the ENT organs and in the oral cavity;
monitor the patency of the nasal passages (, straighten a deviated nasal septum, etc.);
lead a healthy lifestyle (this concept includes a nutritious diet rich in vitamins and microelements, healthy sleep, regular exercise, walks in the fresh air, giving up bad habits, in particular smoking).

Forecast

As mentioned above, it is impossible to get rid of chronic sinusitis. Timely initiation of comprehensive treatment and compliance with all preventive measures will help put the disease into stable remission and prevent possible complications.

About the treatment of sinusitis in the “Health” program by Elena Malysheva:

Currently, there is a large percentage of people suffering from sinusitis in the world. According to statistics, the frequency of continuously ongoing inflammation is 146 cases per 1 thousand population. Of these, sinusitis accounts for 65–73%. Unfortunately, modern people do not always pay due attention to the first signs of pathology, as a result of which the acute process takes on a protracted course. Another reason for the continued high incidence of chronic sinusitis is the increase in the number of hay fevers, which are accompanied by increased secretion of mucus from the nose. A person who encounters an allergy for the first time often does not recognize the cause of his painful condition and continues to “endure” seemingly harmless symptoms. Difficult nasal breathing in combination with abundant mucus formation quickly leads to inflammation of the paranasal sinuses, the most vulnerable of which are the maxillary (maxillary) sinuses.

Features of chronic sinusitis

Sinusitis is an inflammation of the mucous membrane of the maxillary sinuses. The chronic process is characterized by a sluggish course with vague symptoms (no increase in temperature and pain in the cheekbones, upper jaw, head, etc.). Its intensification occurs during periods of exacerbation of the disease. Despite the absence of unpleasant manifestations, the mucous membrane lining the sinuses remains constantly inflamed, and any slightest stress on the body (hypothermia, overwork, etc.) will lead to an aggravation of the pathology.

When talking about chronic sinusitis, most often a more general term is meant - polysinusitis. The fact is that a protracted disease of the nasal mucosa and sinuses, as a rule, does not occur locally in one cavity, but spreads to several sinuses.

Along with damage to the maxillary sinuses, the inflammation process can involve the frontal (frontitis), ethmoidal (ethmoiditis), and sphenoid (sphenoiditis) cavities.

Main types of pathology

Sinusitis can be unilateral, if inflammation occurs in one of the maxillary sinuses, and bilateral, when both sinuses are affected.

Depending on the route of infection in the maxillary sinuses, the disease is distinguished:

Rhinogenic. An infection caused by bacteria, viruses or fungi enters the mucous membranes of the paranasal sinuses from the nasal cavity during prolonged rhinitis or during breathing.
Hematogenous. If there is even a distant focus of inflammation in organs and tissues, there is a risk that the infection will enter the sinuses through the bloodstream, resulting in the development of sinusitis. Such processes are characterized by a low level of the body's defenses.
Traumatic. Develops after injury. Stagnation of mucus as a result of edema is also a favorable environment for infection. In addition, displacement of the nasal septum causes uneven entry of air into the upper respiratory tract, which leads to injury to the membrane lining them in certain places and, as a consequence, to its growth. Hypertrophy of the mucosa leads to a delay in natural secretions and the creation of favorable conditions for the proliferation of harmful microorganisms.
Odontogenic. Occurs when teeth become inflamed. In this case, the primary source of infection is the roots of the teeth located close to the maxillary sinuses.
Allergic. Appears with the development of edema of the mucous membrane against the background of profuse mucus production due to allergies.
Vasomotor. In some cases, the tone of the vessels lining the inner lining of the sinuses decreases, which leads to swelling of the mucous membrane and difficulty in the outflow of secretions from the sinus. Sometimes this condition occurs during hormonal changes, in particular during pregnancy.

Based on the nature of changes in the mucous membranes, sinusitis is distinguished:

Exudative. In this case, the presence of nasal discharge is noted. They are divided into 2 types:
- Catarrhal. The discharge is mucous and transparent, swelling of the inner membranes of the sinuses and nose is noted, and the outflow of secretions is difficult. This course is typical for the acute stage of sinusitis.
- Purulent. Nasal discharge contains dense purulent clots (discharge may be green, yellow, streaked with blood). Such sinusitis may also be preceded by catarrhal sinusitis, which passes into the next stage when a bacterial infection is attached due to stagnation of mucus, resulting in the creation of a favorable environment for the proliferation of bacteria. This type of pathology most often develops acutely, but sometimes it can also have a chronic course.
Productive. Occurs with impaired nasal breathing. They also have several types:
- Hyperplastic. It is characterized by thickening of the mucosa as a result of long-term inflammation, which is typical for the chronic stage of the disease. Due to the proliferation of the internal membranes, the entrance openings of the sinuses narrow, nasal breathing remains difficult (and may be completely disrupted) even in the absence of inflammation.
- Polypous. It is characterized by the proliferation of mucous membranes in the form of polyps, which is characteristic of the chronic course of the disease.
- Cystic. It occurs when cysts form in the maxillary sinus (usually only one), which are round in shape and filled with fluid. The reasons for their formation may be diseases of the roots of the teeth and blockage of one of the many glands on the mucous membrane. Polyps can also become activators of the growth of cysts in the maxillary sinus. The presence of the formation complicates normal air exchange in the accessory cavity and leads to periodic inflammation.
- Atrophic. It is characterized by scanty discharge (sometimes with an unpleasant odor) as a result of atrophy of the mucosal glands.
- Fibrous. It is characterized by the formation of thickenings on the inflamed mucous membranes of the maxillary sinuses, as a result of which the drainage of the sinuses worsens and the removal of mucus and pus becomes more difficult.

Causes and development factors

The development of sinusitis is promoted by many factors, the main of which are:

past infections (ARVI, influenza and others);
hypothermia;
allergy;
violation of the tone of the walls of mucous vessels;
hormonal disorders;
foci of infection in the oral cavity;
injuries and anatomical features;
unfavorable environmental conditions;
severe concomitant diseases;
certain medications (especially those used off-label).

In the absence of timely and effective therapy, the inflammatory process is prolonged, as a result of which it can spread deep into the mucous membrane, into bone tissue, other sinuses and the bloodstream, thus becoming chronic, difficult to treat.

Symptoms and signs of chronic sinusitis

Particular attention should be paid to the fact that in the chronic course of the pathology, pronounced symptoms (runny nose, fever, etc.) may be absent, but the patient is often bothered by the following manifestations of the disease:

general intoxication: lethargy, apathy, sleep disturbances, body aches;
severe paroxysmal cough;
the appearance of crusts in the nose, unpleasant odor from the nose and mouth, deterioration of the sense of smell;
constant nasal and ear congestion, heaviness and pressure in the eye area;
persistent runny nose;
periodic pain in the face, upper jaw, head, neck, temples.

The main symptom of the onset of chronic sinusitis in adults is cough. Most often it occurs at night or in the morning due to the drainage of secretions from the affected sinuses along the back wall of the pharynx and their entry into the middle respiratory tract.

Features during pregnancy, breastfeeding and childhood

Often sinusitis develops against the background of a decrease in the body's defenses. First of all, pregnant and lactating women, whose support resources are shared between two, fall into the risk category. In addition, during the period of bearing a baby, almost every third representative of the fair sex, under the influence of hormones, develops vasomotor rhinitis (rhinitis of pregnant women), which is a good soil for the development of sinusitis.

Normally, rhinitis in pregnant women goes away within the first hours after birth.

Diagnosis and treatment of sinusitis in a pregnant woman will be very gentle, and therefore less effective, because most procedures are extremely undesirable or prohibited, and medications are selected with extreme caution.

The course of treatment depends on the duration of pregnancy and the degree of neglect of the process. Therapy should be carried out under the strict supervision of a specialist, since incorrect actions can cause significant harm to the baby. In addition, there is a risk of infection of the fetus as a result of infection passing through the placenta.

In children, the peak incidence of sinusitis occurs in the autumn-winter period, when immunity decreases. Diagnosis and treatment follow the same scheme as in adults. However, the size of children's paranasal sinuses is much smaller, and their formation ends only by 15–20 years. In this regard, the main location of inflammation is the maxillary sinus and ethmoid cells.

It is worth paying special attention to the features of the anatomical structure of the Eustachian tube in children. In children under three years of age, it is quite wide and short, which requires caution when organizing the position of the head during sleep with a runny nose and when rinsing the nose. It is important to prevent the infection from spreading to the ears and the development of otitis media.

Diagnosis of the disease

Diagnosis of sinusitis includes:

Examination by an otolaryngologist. This is the main diagnostic method in which the doctor assesses the nature of nasal discharge and swelling of the mucous membrane. However, this does not allow us to say unambiguously whether the paranasal sinuses are involved in the process.
X-ray. An x-ray allows you to see inflammation and pathological contents in the sinuses. The downside is that the sphenoid sinus is poorly visible, and the method itself is associated with exposure to ionizing radiation on the body, which is extremely undesirable, for example, during pregnancy.
Computed tomography (CT). The most informative method of visualizing the contents of all paranasal sinuses, which allows you to obtain many photographic sections. Associated with exposure to x-ray radiation, therefore not used during pregnancy.
Magnetic resonance imaging (MRI). The method is based on the effect of a magnetic field on the body. It also allows you to obtain many photographic sections without the influence of x-ray radiation. Unlike CT scans, MRI images are less clear and not as informative. In addition, MRI is impossible when there are metal objects in the body (implants, stents, pacemakers, etc.), and the duration of the procedure with the requirement not to move makes it unsuitable for studying children. During pregnancy, MRI is more preferable than CT or X-ray, but still undesirable.
Ultrasound examination (ultrasound) of the sinuses. Another method of visualizing the contents of the sinuses using ultrasound (relatively harmless and allowed for pregnant women). It is rarely used, since not all sinuses are visible and it is not always possible to judge the nature of their contents (pus or mucus).
Endoscopic examination. Allows you to assess the condition of the mucous membrane, partially see the contents of the sinuses and the source of inflammation in them. However, this method is less informative than CT, MRI and X-ray.
Biopsy. Allows you to exclude malignant neoplasms, fungal infection or granulomatous diseases.
Laboratory methods. They include a blood test, secretion culture, immunodeficiency test, and sweat test. The use of these diagnostic methods provides a more accurate approach to the choice of therapy.

Diagnosis of sinusitis can combine various methods. Most often, the initial studies are an examination by a specialist and a CT scan, after which a diagnosis is made and treatment begins.

Pregnant and lactating women are recommended to undergo endoscopic examination or MRI diagnostics instead of CT for an accurate diagnosis. In addition to being examined by a specialist, children are given an x-ray, which does not involve standing still for a long time during the examination, like an MRI. This is sufficient to visualize all the most developed sinuses.

How can pathology be cured?

Treatment of chronic sinusitis requires an integrated approach and a long time. As a rule, elimination of the main cause of the disease and the source of inflammation, as well as a number of preventive measures after the main course of therapy, give a stable positive result.

The main approach to conservative treatment of sinusitis consists of the following components:

ensuring air exchange in the sinuses;
eliminating the source of infection;
physiotherapy;
prevention.

Drug therapy

Ensuring proper air exchange and eliminating the source of infection is achieved by using a number of medications:

Vasoconstrictors. They increase the tone of the capillary walls, narrow their lumen, as a result of which the swelling of the mucous membrane subsides and breathing is restored. The main disadvantage is that their use for more than one week is addictive, which can cause the opposite effect - after use it does not get better, sometimes the condition even gets worse. Of these, the most commonly used are nasal sprays or drops based on the following substances:
- phenylephrine (Vibrocil, Nazol Baby, Nazol Kids), acting for 2 to 4 hours, most suitable for children;
- xylometazoline (drugs: Otrivin, Galazolin, Xymelin) - lasts up to 8 hours;
- oxymetazoline (drugs: Nazivin, Nazol, Rinazolin) - lasts up to 10 hours;
- naphazoline (drugs: Naphthyzin, Sanorin) - acts from 4 to 8 hours;
- sea water (Marimer, Solin, Physiomer) - has not only a vasoconstrictor effect, but also helps to flush the nasal passages from accumulated mucus.
Hormonal drugs (corticosteroids). Most effective if nasal congestion is caused by an allergic reaction. Among the local drugs used: Avamis, Flixonase, Nasonex, Tafen nasal. Do not be afraid to use them, as they act locally and provide highly effective treatment.
Antiseptics. In addition to the disinfecting effect, they have drying properties. Protargol, Sialor and so on are often used.
Antibiotics. Before using them, it is necessary to determine the pathogen by inoculating the pathological contents of the sinus, but in this case a puncture is required. In addition, the microflora on the mucous membrane of the sinuses and nose is extremely diverse and in laboratory conditions can grow unevenly; for example, Staphylococcus aureus often displaces other pathogens, even if the sinus contents are collected cleanly. In addition, culture results have to wait from 3 to 5 days. Therefore, some specialists select the drug without waiting for them. If the prescribed antibiotic does not lead to an improvement within 2–3 days, then you should consider selecting a different antibacterial agent. Mainly prescribed:
- Local remedies. They act exclusively at the site of inflammation. These include drugs such as Isofra, Polydex with phenylephrine, Bactroban ointment and others. In addition, you can use broad-spectrum antiseptics to rinse the nasal passages (Miramistin, Chlorhexidine, Furacilin and others).
- Systemic drugs. Mainly used in complicated cases. The following groups of these funds are most effective:
  - penicillins (most preferred);
  - macrolides (used for allergies to penicillins);
  - cephalosporins (allowed during pregnancy, administered intramuscularly, used when penicillins or macrolides do not work);
  - fluoroquinolones (a synthetic substance that has not yet caused addiction in most modern bacteria);
  - aminoglycosides (used if others do not work).
Herbal medicines. Made from medicinal plants with the addition of chemical components. They gently relieve inflammation, promote the removal of mucus, restore mucous membranes and normalize breathing (Pinosol, Sinupret, and so on).
Mucolytics. They contain plant components. These agents help to liquefy thick secretions and remove them from the sinus cavity (Mukaltin, Acetal S and others).

The most commonly used medications - photo gallery

Galazolin narrows the capillaries of the nasal mucosa, as a result of which breathing is restored
Sialor has antiseptic properties due to the presence of silver ions in its composition
Isofra is a local antibiotic that is very popular
Amoxicillin is a commonly prescribed oral antibacterial drug.
Avamis will relieve tissue swelling
Sinupret helps remove accumulated mucus from the sinuses Mucaltin helps to liquefy viscous secretions accumulated in the maxillary sinuses

Physiotherapeutic methods

Physiotherapy is aimed at activating metabolic processes in the lesion and deeper action of medications. Each method requires on average 10 to 15 sessions, performed every other day or daily. Most of them are prohibited during pregnancy, except for inhalation using a nebulizer. Most often doctors prescribe:

Ultrasonic exposure. Promotes massage, warming and blood flow to the epithelial tissues, thus stimulating metabolic processes in them and increasing the production of beneficial enzymes.
Inhalations with medications. They help thin thick secretions (mucolytics), relieve swelling, and eliminate inflammation (antibiotics). Spraying medications into small particles and directing them into the affected area is more effective than using them in the form of drops, ointments and sprays.
Electrophoresis. Medicines enter the problem area in the form of active ions. This helps improve blood supply to the sinuses and warm them up.
Phonophoresis. It combines the supply of medication and the effects of ultrasound, resulting in a deeper, targeted effect of the drug in combination with warming, improving metabolic processes and increasing blood flow.
UHF and microwave (electromagnetic therapy). Ultrashort and ultra-frequency electromagnetic waves cause instant expansion of capillaries in the tissues of the sinuses, resulting in increased blood flow with good fluid outflow. The procedure increases vascular permeability, enhances metabolism, accelerates the removal of metabolic products, and resolves swelling. UHF acts mainly on surface structures, and microwaves have an effect at a depth of 4–6 cm.
Mud therapy. Pies are made from medicinal mud, rich in minerals, and applied to the area of the maxillary sinuses. A thermal effect is created that promotes deep penetration of its medicinal components, eliminating inflammation and liquefying thick mucus in the sinuses.
Diadynamic pulse currents. This procedure allows you to eliminate pain without the use of analgesics.

Preventative diet

A special diet for the treatment of sinusitis has not yet been invented, however, there are a number of general recommendations that will allow you to quickly cope with the infection:

drinking plenty of warm water to dilute and remove pathological secretions;
eating alkaline foods such as whole milk, greens, bananas, spinach;
introducing into the diet foods rich in vitamin A, a “builder” of the mucous membranes of the nasopharynx (egg yolk, yogurt, pumpkin, carrots, tomatoes, carrot and beet juice, cucumbers, spinach);
consumption of garlic and horseradish root, which help relieve inflammation and thin the secretions of the sinuses;
drinking mineral water, which will help replenish minerals;
limiting the consumption of salt, which retains moisture and contributes to the preservation of swelling;
reducing the consumption of fried, sweet, flour, fatty, marinades, alcohol - these products help slow down metabolism, reduce the body's immune defense, and help lower blood pH (acidification).

Operation

When conservative therapy methods do not help, or the cause of sinusitis is a foreign object entering the sinus, it is advisable to use the most radical and effective approach to treatment - surgical intervention. Modern techniques make it not only painless, but also minimize contraindications and the development of complications. In some cases, surgery causes less damage to the body than medication. For example, during pregnancy, long-term use of vasoconstrictor drugs and antibiotics is extremely undesirable, while non-puncture methods or even a puncture imply only a single local anesthesia and the injection of antiseptic solutions into the sinus.

The main types of surgical treatment of sinusitis are:

Puncture, or puncture of the nose. This is a therapeutic and diagnostic procedure, during which you can take the contents of the paranasal sinus for examination, determine the causative agent of the disease and its sensitivity to antibiotics. The operation is performed both under local anesthesia and general anesthesia, depending on the general condition of the patient.
Balloon sinuplasty. It is a new, low-traumatic method in which a flexible catheter is inserted into the maxillary sinus through the natural nasal passages and strengthened there by inflating the cuff, thereby expanding the area of the anastomosis. The sinus is then flushed with a medicinal solution, resulting in the removal of its contents.
Yamik sinus catheter. Also a non-puncture method of aspiration of the contents of all paranasal sinuses by creating negative pressure in them. The sinus catheter consists of three tubes, two of which are equipped with cuffs. By swelling, they delimit the area where the anastomosis exits into the nasal cavity from its communication with the pharynx and the entrance to the nose. Then a vacuum is created in the resulting small space, which facilitates the evacuation of the accumulated purulent secretion from the maxillary cavity.
Endoscopic surgery. It is carried out through an endoscope, which is a fiber optic tube equipped with channels through which additional instruments can be inserted. A special feature of the operation is visual control with good lighting of the nasal cavity.
Laser treatment. It is also carried out using an endoscope, but the main working tool here is a laser. Its radiation is absorbed by the cells of the mucosa and leads to a microburn of its surface, thereby relieving swelling, accelerating metabolic processes, increasing local immunity and increasing blood flow.
Caldwell-Luke operation. The most radical surgical intervention, which is used when all less traumatic methods fail. The operation is performed under general anesthesia and involves cleaning the cavity from pathological contents and removing altered areas of the mucosa through the hole under the upper lip.

In the postoperative period, the patient should especially carefully monitor the condition of the nasal cavity. Doctors often recommend rinsing with saline solutions and using antiseptics.

Traditional methods

Traditional recipes can be combined with traditional treatment methods or used to prevent relapses. Widely used:

Hot soda inhalations. You should pour 2 tbsp into a glass. l. soda, which needs to be poured with half a glass of boiling water. It is necessary to breathe the fumes. Baking soda helps thin out thick sinus secretions and relieves swelling.
Instillation of beet juice. To prepare it you need to mix 1 tsp. beet juice and 1 tsp. olive oil. It is necessary to instill 3 drops into each nasal passage in the morning. Beetroot juice has an anti-inflammatory effect.
There are cases when, after unsuccessful traditional therapy, chronic sinusitis was treated with beetroot juice and massage, which led to complete recovery within 3–4 months.
Turunda with propolis. Used to eliminate inflammation. To do this, mix a teaspoon of olive oil and 4-5 drops of propolis tincture. Insert a turunda soaked in the resulting mixture into the nasal passage on the side of the sinus lesion overnight. Propolis is an excellent natural antiseptic, and olive oil softens and moisturizes irritated mucous membranes.
Aloe juice. It can be instilled 2-3 times a day, 3 drops into each nasal passage.
Onion juice. Relieves inflammation and has a mild antiseptic effect. It must be mixed with olive oil in a 1:1 ratio and instilled into the nose, 2-3 drops up to 5 times a day.
Turundas with Vishnevsky ointment. They are usually inserted into the nasal passage at night, which helps remove purulent contents.
Hot oil inhalations. Tea tree, eucalyptus and mint oils help ease breathing, relieve swelling and inflammation.

Remedies for the treatment of sinusitis at home - photo gallery

Propolis - a powerful natural antiseptic

Aloe juice helps restore mucous membranes and draw out pathological contents from the sinuses

Onion juice has a slight antibacterial effect

Homeopathy

Despite many disputes about the effectiveness of homeopathic medicines, many doctors still prescribe remedies from this group. They gently relieve the inflammatory process, stimulate local immune defense, dilute the viscous pathological secretion accumulated in the cavities and improve its removal from the paranasal sinuses. Such medications are used both internally and locally (they exist in the form of tablets, nasal drops and sprays). The most commonly used drugs are Cinnabsin, Euphorbium compositum Nazentropfen S and Delufen.

Delufen can also be used for a common runny nose, including allergic ones.

Treatment prognosis and possible complications

The sooner treatment for acute sinusitis or its chronic stage begins, the more favorable the prognosis. Even in advanced cases, a combination of conservative and radical treatment methods allows you to achieve a sustainable positive result (recovery).

If complex therapy is absent for a long time, then the risk of complications is high, namely:

orbital abscess;
meningitis;
acute otitis;
sepsis (blood poisoning);
bronchitis and pneumonia.

To prevent relapse and serious consequences of the chronic process, immediately after treatment, a long recovery with many preventive procedures is required.

Prevention of chronic sinusitis and the development of exacerbations

Preventive measures include:

timely elimination of viral infections (use of oxolinic ointment during disease outbreaks, drugs containing interferons at an early stage of infection);
rinsing with saline solutions before going to bed (at the first sensation of discomfort in the nose, you should increase the frequency of the procedure or have a deeper cleansing of the sinuses - “cuckoo” - by an otolaryngologist);
active lifestyle;
frequent exposure to fresh air;
healthy eating.

Video about the disease

Coping with such a serious disease as chronic sinusitis is difficult, but possible. It is important to visit a doctor on time, act comprehensively and not be afraid of radical measures if conservative treatment is ineffective.

Chronic sinusitis is a long-term inflammatory process of the maxillary sinus, which, depending on the form and stage, manifests itself in a varied clinical picture. The danger is that in the absence of treatment and erased signs, the disease causes constant intoxication of the body.

Reasons for development

Anomalies in the structure of the nasopharynx (deviated nasal septum, hypertrophy of the inferior turbinates, adenoids);
Irrational antibiotic therapy and resistant strains of bacteria;
Unfavorable external factors (dust, gas, smoke, dry indoor air);
History of allergic diseases (chronic allergic rhinitis, bronchial asthma);
Fungal invasion (candida, molds) with decreased immunity;
Chronic infectious diseases of the nose and throat (chronic tonsillitis, adenoiditis);
Odontogenic pathology and foreign bodies in the sinus cavity (filling material);
See a detailed analysis of each.

Among the bacteria most often sown in the sinus during a chronic process are H. influenzae, S. pneumoniae and Moraxella catarrhalis.

Symptoms of chronic sinusitis depending on the form

Exacerbation of chronic sinusitis occurs in exactly the same way as acute sinusitis. The patient experiences headache, nasal discharge, fever, sinus pain, and nasal congestion.

Outside of exacerbation, the nature of the symptoms depends on the form of sinusitis and the characteristics of the body.

Symptoms of purulent form

Main features:

Difficulty in nasal breathing to varying degrees;
Decreased or absent sense of smell;
Recurrent headaches without precise localization;
Symptoms of chronic intoxication of the body: lethargy, fatigue, loss of appetite, low-grade fever, increased nervousness;
Copious nasal discharge of various types: mucous, mucopurulent and purulent;
Ear congestion;
Development of cough due to irritation of the mucous membrane of the back of the throat by constant secretions;
Less common is the appearance of lacrimation due to blockage of the nasolacrimal duct.

Symptoms of the odontogenic (dental) form

The lower wall of the maxillary sinus is formed by the alveolar process of the upper jaw. In most people, the roots of the 4th and 5th teeth protrude into the lumen of the sinus, which sometimes are not even covered with mucous membrane. With the development of pathological processes in the oral cavity, the infection penetrates the sinus and an inflammatory process develops.

Features:

As a rule, inflammation appears on one side - where the diseased tooth is;
The development of the disease may be preceded by a visit to the dentist and treatment of the upper teeth;
Does not respond to the standard treatment regimen (antibiotic therapy, sinus lavage) without eliminating dental pathology;
Nasal discharge has a specific foul odor.

Symptoms of the fungal form

Washing and disinfection.

Treatment of the disease is carried out using herbs with antiseptic properties: chamomile, calendula, St. John's wort. The nose is washed with a solution prepared from these herbs to remove pathological contents from the sinuses.

They also use plants that increase overall immunity and help the body cope with the infection itself: ginseng root, eleutherococcus, echinacea.

Inhalations.

Steam inhalations with potatoes, bay leaves, aloe and other herbs are used to relieve nasal congestion and improve sinus drainage.

Ointment.

You can make an ointment that will help clear your nasal passages. Garlic, honey and vegetable oil are mixed in equal proportions, the resulting mixture is spread on cotton wool and injected into both nostrils for a few minutes.

After this, the turundas are removed and the nose is actively cleaned. This ointment irritates the nasal mucosa and helps get rid of mucus that accumulates in the nose.

Preventive actions

Prevention of colds by strengthening the general immunity of adults and children through normal sleep and rest, hardening, moderate physical activity, and walks in the fresh air;
Vaccination against influenza and other infections;
Timely sanitation of foci of chronic infection: tonsillitis, rhinitis and adenoiditis;
Treatment and prevention of diseases of the dental system: regular brushing of teeth after meals, use of dental floss, visiting the dentist once a year, treatment of caries, periodontal disease, etc.
Control of allergic diseases and elimination of contact with the causative allergen;
Creating an optimal temperature and humidity regime in the room, since dryness or excessive moisture of the nasal mucosa disrupts its functioning and makes it difficult to remove mucus and dust particles from the nasal cavity and sinuses. For this purpose, climate control technology can be used;
Periodic irrigation or rinsing of the nose with solutions of sea salt, purchased at a pharmacy or prepared independently;
Living in an ecologically unfavorable area or area can cause another exacerbation of the disease, so in critical situations you should think about moving to a place with a more favorable environment and climatic conditions;
When diagnosing “chronic sinusitis,” you should reconsider the types of sports that a person enjoys. Visiting the pool or swimming can cause infected or chlorinated water to enter the sinus and provoke another exacerbation. Diving, flying, or climbing mountains due to pressure changes sometimes cause exacerbation or development of ear, nose, and sinus diseases.

With a competent approach to prevention, you can achieve a state of stable remission and a noticeable improvement in the quality of life.

Chronic sinusitis (maxillary sinusitis) is a long-term inflammatory process that occurs in the maxillary maxillary sinus.

The disease is dangerous because it is practically asymptomatic, worsening only during seasonal periods, and causes constant intoxication of the body.

Doctors from all over the world have developed the International Classification of Diseases (ICD - 10), which helps group information about the disease.

Acute and chronic sinusitis were classified as “respiratory diseases” (J00-J99), but they were placed under different codes and blocks. Chronic sinusitis belongs to the block “Other diseases of the respiratory tract” (J30-J39) with the ICD 10 code “Chronic maxillary sinusitis” (J32.0).

Causes and symptoms

Untreated conditions contribute to the development of the chronic course of the disease. Initially, inflammation is caused by bacteria and viruses, which begin to multiply rapidly. A suitable environment for microbial activity is created under certain circumstances.

Etiology of sinusitis development:

frequent acute respiratory infections, ARVI, several times a year;
the presence of adenoids, polyps, cysts;
rhinitis, tonsillitis;
pathology of the upper teeth;
deviated nasal septum;
decreased immunity;

In adults, the chronic form of sinusitis is most often caused by staphylococci, streptococci; in children, chlamydia and mycoplasma. Therefore, when diagnosing a disease, it is important to determine the type of pathogen, otherwise it will be difficult to choose the right treatment.

Signs of chronic sinusitis appear only during exacerbations, which occur due to hypothermia. The symptoms of the disease are similar to the clinical picture of acute sinusitis. 😐

The patient feels:

weakness, malaise;
change in voice (nasal tone);
pain at the root of the nose and eye socket;
pain eroded into the teeth, temple, superciliary area;
yellow-green discharge of mucus and pus from the nasal cavity;
nausea due to a large amount of discharge;
bad breath;
loss of smell;
low-grade fever;

The discharge of large amounts of mucus and pus affects the organs of the digestive system and upper respiratory tract. The patient has to frequently blow his nose and cough. Against the background of this condition, diseases develop in the form of: laryngotracheitis, bronchitis, pharyngitis, sore throat. During development, anosmia is observed - a complete loss of smell.

Form and development of sinusitis

Chronic sinusitis is divided into forms, distinguished by the type of inflammation, localization, and source of infection;

Type of inflammation:

. A disease manifested in the form of swelling of the mucous membrane, nasal congestion, discharge, sensations of heaviness in the eye area, cheeks.
Chronic purulent sinusitis, which is characterized by the accumulation of a large amount of pus in the cavity. The patient not only has to blow his nose, but also expectorate, because some of the pus drains down the back wall of the mouth.
. Formation of a cyst in the cavity.
Mixed. A combination of several symptoms of sinusitis, for example, pus and the presence of polyps.

Localization of inflammation happens:

Unilateral, when one side of the sinus is affected.
Bilateral, both sides become inflamed.

Routes of infection:

Rhinogenic, when the disease occurs due to a runny nose.
Hematogenous. Infection enters directly into the sinus cavity.
. Sinusitis occurs due to unhealthy teeth.
. The disease manifests itself under the influence of an allergen.
Traumatic. The disease develops after injuries.

What complications can there be?

Chronic sinusitis is very difficult to treat, but the lack of timely treatment leads to a number of complications. Pus formed in the maxillary sinuses can move to other cavities, affecting the roots of the teeth, nerve endings, eyes, and brain.

Complications manifest themselves as:

cerebral edema;
infection in the brain;
sepsis, abscess;
phlegmon of the orbit;
trigeminal neuritis;

With proper timely treatment, the risk of complications is practically absent. ➡ ➡ ➡ 💡

Diagnosis and treatment methods

If the disease recurs, you should contact an otolaryngologist. The doctor begins diagnosing the disease with a history and examination of the patient. Additional methods include a number of laboratory and instrumental studies.

Diagnosis is based on:

radiography of the sinus;
computed tomography;
culture of nasal discharge;
UAC, OAM;
visual examination of the sinus using the endoscopic method;

To exclude odontogenic sinusitis, a consultation with a dentist is necessary. Based on the results of the ENT diagnosis, the doctor determines the treatment that will be carried out without surgery or with surgery.

Treatment of chronic sinusitis

Drug therapy with the use of antibiotics, vasoconstrictors, antihistamines and anti-inflammatory drugs.
Washing the cavity using the “cuckoo” method, YAMIK - catheter. Pus and mucus from the sinus are removed and filled with medicinal solutions.
Physiotherapy.
A puncture of the maxillary sinus is performed to eliminate signs of the disease. If the cause of the disease is a deviated nasal septum or injury to the nose, then plastic surgery is used to restore respiratory function.
The use of folk remedies should be discussed with your doctor. Traditional medicine should be used as a complementary treatment. At home, you can irrigate the nasal cavity with silver water to reduce germs. Aloe juice is the most effective for eliminating inflammation and swelling of the mucous membrane.

Can chronic sinusitis be cured? The prognosis for treatment is always favorable if you follow all the doctor’s recommendations.

Radical maxillary sinusotomy (surgery)

Sometimes treatment of chronic sinusitis requires more serious measures. If conservative treatment is not effective, a radical maxillary sinusotomy is performed.

The essence of the surgical intervention is to penetrate the sinus with special instruments to remove the contents. During the operation, communication is made between the sinus and the nasal passage. A tube is inserted into the hole for convenient rinsing of the cavity, and left for 2-3 days. After surgery, antibiotic therapy is administered.

Preventive actions

To avoid the development of chronic sinusitis, you must follow your doctor's recommendations.

Necessary:

Carry out timely treatment of common runny nose and severe forms of sinusitis.
Maintain oral hygiene.
The allergen should be eliminated if the disease occurs against the background of an allergic reaction.
Increase immunity, prevent hypothermia.
Carry out general strengthening therapy, try to harden the body.
Lead a healthy lifestyle.
If the cause of the disease is related to curvature or a previous injury, then the problem needs to be solved with plastic surgery.

People prone to colds are recommended to get vaccinated against influenza annually.