Chronic Sinusitis - Causes, Symptoms, Complications. How To Cure Chronic Sinusitis

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Causes, symptoms and treatment of chronic sinusitis

What is chronic sinusitis?

Chronic sinusitis is a disease characterized by a rather long and sluggish course, with alternating phases of exacerbation and remission, manifested in frequent headaches, ailments and a stuffy nose, as well as other symptoms, depending on how advanced the pathological process is in the affected sinuses. With this disease, it is the maxillary, or as it is also called, the maxillary sinus that becomes inflamed. In general, any sinusitis is a type of sinusitis, so sometimes doctors call it chronic maxillary sinusitis.

Symptoms of chronic sinusitis

Since we are talking about a disease that is chronic in nature, the symptoms mainly manifest themselves during the exacerbation stage. It is for this period that the following symptoms are characteristic:

• Weakness and general malaise, a feeling of "weakness".
• The body temperature rises, but, as a rule, not to high numbers and can be 37.5 ° C. In this case, a slight chill often occurs.
• Nasal congestion with characteristic green discharge.
• Due to the fact that the mucous membrane is irritated, sneezing appears.
• Pain that radiates to different places. Irradiation can occur to the forehead, to the root of the nose, and even to the teeth. Particularly painful sensations intensify when a person bends forward or coughs.
• The voice begins to change, the nasal tone characteristic of this disease appears.
• The discharge changes its color most often a week after the exacerbation of the disease, they turn yellow and sinusitis flows into a purulent form.

If we consider chronic sinusitis not during the exacerbation stage, then there are also a number of symptoms that indicate that the disease is present in the body:

• A stuffy nose, discharge appears periodically, does not respond to therapy, and may be purulent.
• Sensation of "lump in the throat", due to the constant flow of mucus from the sinuses.
• Headache, which periodically worsens, depending on what position the patient takes. The greatest intensity of discomfort is gaining in the supine position. The pain is localized in the eye socket.
• The face can become "heavy", it seems to be bursting and pressing from the inside, especially in the cheeks.
• Often, especially in the morning, patients have swollen eyelids, and conjunctivitis appears.
• The appearance of tears, without annoying external factors.
• The sense of smell is constantly impaired, which significantly reduces the quality of life.

Also, the symptoms of chronic sinusitis can be classified as follows:

• Local subjective, which include complaints of people about nasal discharge that are purulent in nature, incessant headaches, a feeling of distention of the affected sinus, discharge that has a putrid odor, and therefore loss of appetite. Naturally, nasal breathing is practically absent.

• Local objective, which include edema of the eye membranes, their diffuse hyperemia, which is clearly visible on examination. There are signs of persistent dermatitis, cracks, eczema or impetigo between the lip and nose. Painful sensations during palpation of the corresponding zones; during rhinoscopy, polyps are often found, the nasal conchas are swollen and thickened. The teeth are often damaged by caries, periodontitis and fistulas are observed.
• Symptoms are common and include sneezing, coughing, headache, and fatigue. As for the exacerbation, they are most often observed in the cold season, while in summer there is a lull. During manifestations of the disease, a general blood test shows changes characteristic of acute respiratory infections. General weakness is growing.

The reasons for the development of chronic sinusitis

The reason that a pathological process begins in the sinuses, which then develops into a chronic form, often becomes microorganisms - streptococci. But sometimes the disease is caused by viruses, fungi and anaerobes.

The fact that sinusitis becomes chronic is facilitated by such reasons as:

• Illiterate treatment, non-compliance with the therapeutic regimen, a shortened period of taking medications during the development of acute sinusitis.
• The constant presence of a chronic infection in the nasopharynx, namely such foci as: chronic rhinitis, chronic tonsillitis.
• Curvature of the septum and, as a result, a violation of the outflow of mucus. Such disorders occur both during intrauterine development and are congenital, and can be acquired during life, for example, as a result of trauma.
• Formations such as cysts or polyps naturally disrupt normal air exchange in the sinuses, stimulating congestion and disrupting the passage of mucus, and as a result, the development of sinusitis.
• Dental problems such as dental disease, particularly in the upper jaw.
• The environment has a significant impact on the development of this chronic disease. This applies exactly to the air that a person constantly breathes. The more it is gassed, dusty and toxic, the higher the risk of developing the disease.
• Bad habits.
• Allergy.
• State of immunity, both local and general.
• Violation of both tissue and vascular permeability in the nasal sinuses.

Types of chronic sinusitis

If we consider the classification of chronic sinusitis, then there are several of its subspecies:

• Catarrhal chronic sinusitis. In this case, the entire mucous membrane of the maxillary sinus is inflamed, it looks reddened, swollen and bloodshot. Inside it is mucous contents. It can be either one-sided or develop from two sides.
• Purulent sinusitis. In this case, the internally mucous contents change to pus. This happens in the event of an exacerbation of a chronic illness.
• Parietal hyperplastic is a form of chronic sinusitis, mucosal hyperplasia occurs, and then polyps form on it. The nose alternately clogs up, the discharge is frequent and copious.
• Fibrous chronic sinusitis.
• Allergic sinusitis in a chronic form occurs, as a rule, sharply and unexpectedly, under the influence of a certain irritant. The mucous membrane swells, its activity increases, abundant discharge appears.
• Cystic chronic sinusitis is characterized by the fact that a cyst forms inside the nasal cavity, its size and location in the nose can be almost any.
• Polypoid, when a polyp, which grows in the nasal sinus, becomes the culprit of a chronic pathology.
• Sometimes its mixed forms are found, when, for example, in the presence of polyps in the sinuses, a purulent process begins.

Some doctors distinguish the following types of sinusitis, which occurs in a chronic form, based on what was the source of the infection:

• Traumatic, when a violation of nasal breathing, and as a result, the development of the disease occurs due to various kinds of skull injuries.
• Rhinogenic, when sinusitis develops into a chronic form due to frequent rhinitis and sinusitis.
• Odontogenic, is a consequence of various kinds of dental diseases.
• Hematogenous chronic sinusitis is the most common, as it is caused by the penetration of a certain pathogen into the sinuses - bacteria (bacterial) or fungus (fungal).

Regardless of what caused the development of the disease and whatever subspecies it belongs to, chronic sinusitis can be either one-sided or affect both sinuses.

Complications of chronic sinusitis

Like any other disease that occurs in a chronic form, sinusitis can cause rather severe complications. Among them, the following consequences are distinguished:

• The appearance of such chronic diseases as tonsillitis (with it constantly inflamed palatine tonsils), laryngitis (edema and inflammation of the larynx), pharyngitis (characterized by an inflammatory process in the mucous membrane of the pharynx.
• Dacryocystitis, when the inflammatory process affects the lacrimal sac. There is constant lacrimation, purulent discharge is possible, all adjacent tissues are swollen, the lacrimal sac hurts, the palpebral fissure is narrowed.
• Impaired attention and memory is due to the fact that, due to impaired breathing, a person constantly suffers from hypoxia. Mental activity suffers in the first place, but the lack of oxygen in the required volume disrupts the work of all organs.
• Apnea is often observed in patients with chronic sinusitis. And this, in turn, leads to the development of heart disease, increased sleepiness during the daytime.
• There can be inflammation of the soft tissues of the face when the subcutaneous and muscle tissue is affected.
• Often, chronic sinusitis is complicated by diseases such as: otitis media, bronchitis, pneumonia.
• If the purulent contents enter the cranial cavity, then the most serious complications may occur - these are meningitis, encephalitis or brain abscess. Most often, these diseases are fatal.
• Sometimes, against the background of sinusitis, a disease develops that requires urgent surgical intervention - this is a purulent inflammation of the cranial bones.
• Partial or complete loss of vision associated with such a complication of sinusitis as inflammation of the eyeball.
• Sepsis, in which the infectious agent enters the bloodstream.
• Asthma.
• A very painful complication like inflammation of the tertiary nerve.

It should be understood that any form of sinusitis, and, in particular, purulent, can cause quite serious complications. This is due to the site of localization of the infection, and the immediate proximity of the maxillary sinuses to the brain. That is why competent and qualified treatment of the disease is necessary, both during an exacerbation and during remission.

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How to cure chronic sinusitis?

Treatment of chronic sinusitis differs from the treatment of a common disease in that even during a calm period it should not be ignored. After all, the frequency, as well as the severity of the disease in the acute phase, depends on how well the prevention and treatment will be carried out.

• So, during the period of remission, it is imperative to perform a procedure such as washing the sinuses with various solutions. Normal saline or a weak salt solution is best for this purpose. You can use special sprays that contain steroid hormones and have an anti-inflammatory effect. But, although these drugs are considered practically harmless, nevertheless, consultation with a doctor is necessary.
• Sometimes therapists and ENT doctors recommend using a long course of antibiotics, but they must be taken in small doses. This applies to macroloid preparations, which are characterized by low toxicity and high antimicrobial activity. In addition, they further stimulate the immune system, enhancing the body's defenses.
• If chronic sinusitis develops on the background of allergies, then contact with the irritating factor should be avoided, if possible, appropriate means should be taken and monitored by an allergist.
• Since a common cause of chronic sinusitis is inflammation of the teeth of the upper jaw, it is necessary to be observed by the dentist every six months and carry out timely treatment, even, it seems, of minor caries.
• When sinusitis is caused by damage to the nasal septum, both trauma and congenital pathologies, then it is necessary to contact a plastic surgeon. In this case, after the operation, relapses do not occur, provided that everything went well.
• As for the treatment of sinusitis at a time when it is in the exacerbation phase, here it is possible to distinguish drug therapy, non-drug therapy. The first should include the use of sprays and drops, which are aimed at reducing the swelling of the sinus mucosa, which has undergone inflammation. Also, such drugs contribute to the discharge of pathological contents. Such treatment is carried out for a week, if the therapy does not have the desired effect, then the prescribed funds should be reviewed.
• Drugs that contain antibiotics. If sinusitis is purulent, then they are used both in injections and in the form of tablets. At the initial stage, you can use antibiotics that are part of a variety of drops.
• Also, doctors prescribe mucolytics, which thin the mucus and promote its excretion.
• If we talk about other methods of treatment, then a fairly common procedure is a sinus puncture. To do this, use a special needle, then wash the sinus with antiseptics and inject a specific drug. This method is very effective for removing puffiness, reducing headache, up to its complete elimination, as well as in general for the treatment of the acute phase of sinusitis.
• As an alternative to punctures, at the moment there is such a procedure as the installation of a YAMIK catheter. This procedure is practically painless as it is performed under local anesthesia and there is no need to make a puncture.
• Rinsing the nose can be carried out both independently and in the office of an otolaryngologist. It depends on the severity of the disease. To achieve this goal, both antiseptics and saline solutions are used.
• As an auxiliary therapy, general strengthening drugs, vitamins and immunomodulators are prescribed. Physiotherapy is carried out if the patient is recovering and chronic sinusitis proceeds without complications. Sanatorium treatment is giving good results. A visit to the salt rooms gives good results and significantly reduces the risk of a runny nose, and therefore sinusitis.

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If we talk about prevention, then the most effective method is adequate and competent treatment of the disease at the initial stage, when a mild runny nose begins. That is why it is important for people who know about the presence of such a disease in themselves not to let its course take its course. The less hypothermia, the more regular hardening procedures are carried out, the more balanced and rational the diet, the easier the disease itself will be. Do not forget to wear masks, especially during the period of ARVI rampant. Observing the appropriate doctor's recommendations, you can forget about the recurrence of chronic sinusitis for a long time.

The author of the article: Lazarev Oleg Vladimirovich | ENT

Education: In 2009, he received a diploma in the specialty "General Medicine" at the Petrozavodsk State University. After completing an internship at the Murmansk Regional Clinical Hospital, he received a diploma in Otorhinolaryngology (2010)