Chronic sinusitis: treatment, causes and symptoms
Chronic sinusitis is a long-term ongoing inflammation of the paranasal sinuses, prone to recurrence. It is chronic sinusitis that is the most frequent reason for patients to go to otolaryngologists.
According to statistics, chronic sinus inflammation is the leading among ENT infections in children and adults. It is noteworthy that most often several sinuses are involved in the pathological process. Isolated sinusitis is a rare disease. Chronic polysinusitis affects the patient's quality of life, disrupts his general health and ability to work.
Content:
- The causes of chronic sinusitis
- Chronic sinusitis symptoms
- Diagnostics of the chronic sinusitis
- Chronic sinusitis treatment
The causes of chronic sinusitis
Experts identify the following causes of chronic sinusitis:
- Respiratory infections that have not been adequately treated.
- Inadequate therapy with antibacterial drugs.
- The presence of foreign bodies in the nasal cavity, curvature of the nasal septum, which affects the patency of the nasal passages.
- Overgrowth of adenoids, as the most common cause of sinusitis in childhood.
- Polyps in the nasal cavity, nasal tumors.
- Allergy provoking constant swelling of the nasal mucosa.
- Injuries to the skull and face with bone fractures.
- Violations in the functioning of the immune system of acquired and congenital nature.
The presence of such a bad habit as tobacco smoking, as well as passive inhalation of tobacco smoke, increases the risk of developing chronic sinusitis. Various toxic substances inhaled by humans have a similar negative effect.
Other risk factors are:
- Chronic lung diseases;
- Aspirin intolerance;
- Cystic fibrosis;
- HIV and AIDS;
- Bronchial asthma, etc.
Chronic vasomotor sinusitis can be a consequence of allergic rhinitis to alcoholic beverages, perfumery. High humidity of the environment and other negative influences are a potential risk factor.
Chronic sinusitis symptoms
The symptoms of chronic sinusitis depend on a number of factors, primarily the location of the inflammation and the nature of the infection.
Most often, sinusitis develops with colds, while there is:
- Increased body temperature;
- Weakness increases;
- General malaise appears.
Specific symptoms for chronic and acute sinusitis are the following clinical signs:
- The appearance of discharge from the nasal passages (they can be green or yellow, sometimes they contain blood impurities);
- The sense of smell is impaired;
- The nose is stuffy, possibly a feeling of one-sided stuffiness from the side of inflammation;
- The appearance of a dry cough, which tends to intensify during a night's rest;
- Headaches, pains in the area of the face with irradiation to its various parts;
- Hyperemia of the skin from the inflamed sinus.
Nevertheless, despite the similarity of the symptoms of acute and chronic forms of sinusitis, there are certain differences. So, in the chronic course of the disease, the symptoms are longer in time, but less intense.
Chronic sinusitis is characterized by a latent course, in which the symptoms can completely disappear for a certain period and not bother the patient. However, a relapse of the disease is inevitable.
In childhood, the chronic course of inflammation practically does not differ from the symptoms of the disease in adults.
Parents should be extremely careful and if they find the following signs of sinusitis in a child, seek medical help:
- The appearance of blue circles under the eyes;
- Increased fatigue, not typical for healthy children;
- Blanching of the skin;
- Weight loss;
- Lack of desire to eat.
A suspicion of sinusitis should also arise if a child has purulent discharge from the nose for 10 days or more, and at night the cough increases.
Diagnostics of the chronic sinusitis
Diagnosis of chronic sinusitis involves several tests:
- Taking anamnesis, interviewing the patient.
- Diaphanoscopy. The procedure consists of illuminating the sinuses with a small light bulb in a dark room. The light bulb is then inserted into the oral cavity. This method allows you to make a preliminary diagnosis and get an idea of the condition of the sinuses.
- Radiography. This method is the most common in the diagnosis of sinusitis in patients of any age.
- Diagnostic puncture. Provides information about the nature and form of the disease.
- CT and MRI. These techniques allow you to get a maximum of information about the state of the examined organ.
- Endoscopic diagnostic technique. Allows not only to visualize the condition of the nasal sinuses, but also to perform minimally invasive surgical intervention.
In addition, it is possible to undergo sinusoscopy, which is based on the use of ultrasound waves. There is also such a method as a thermal imaging survey using a thermal imager. To implement the technique, the temperature of the skin of the face is measured in the place where the sinuses are located.
If there is a suspicion of an allergic nature of chronic sinusitis, the doctor performs skin tests using the most common allergens.
Chronic sinusitis treatment
Treating chronic sinusitis is a complex and lengthy process. Often, the bacterial flora that causes the disease manages to develop resistance to common drugs and does not die even with the most intense exposure to it.
The tasks facing the doctor and the patient are reduced to the following points:
- Eliminate the etiological factor that led to the development of the disease.
- Normalize drainage and aeration of the sinuses.
- Eliminate the symptoms of the disease.
- Prevent recurrence of sinusitis.
Therapy for chronic sinusitis should be comprehensive and include anti-inflammatory, antibacterial treatment. It is also worth paying attention to the state of the patient's immunity, etc.
Symptomatic treatment
Treatment of chronic sinusitis is reduced to reducing the swelling of the mucous membrane of the sinuses, for which medications are used. Removal of edema will normalize the outflow of exudate from the sinuses and accelerate the healing process. To reduce puffiness, vasoconstrictor drugs are used, such as: Nazivin, Naphtizin, Sanorin, Galazolin, etc. Although these are over-the-counter drugs, you should not use them for more than five days.
If there are symptoms of allergy, then the appointment of antihistamines is indicated. To relieve inflammation and reduce body temperature, drugs such as Nurofen, Paracetamol, Aspirin are used.
Antibiotics are selected on an individual basis, taking into account the following factors:
- The age of the patient;
- The duration of the illness;
- The sensitivity of the causative agent;
- Epidemiological situation in the area of residence.
Antibiotic therapy
The use of antibacterial agents for chronic sinusitis is quite justified, since it is impossible to get rid of the infection without them.
Most often, doctors prescribe Amoxicillin (Augmentin, Amoxiclav, Amoxil, Ospamox), Doxycycline (Doxibene, Monodox, Unidox), Biseptol, Bactrim.
Chronic sinusitis is not always due to bacterial flora. Therefore, before starting a long course of antibiotic treatment, you should find out the cause of the infection.
A therapeutic course using antibiotics should be completed completely, according to the recommendations of the treating doctor. Most often, the full course is 2 weeks, but in some cases it can be extended. Do not interrupt treatment immediately after elimination of sinusitis symptoms. The doctor should cancel the drug.
Antibiotics can help get rid of the disease. However, do not forget about the side effects of drugs in this category. From the intake of antibacterial agents, human immunity suffers, which makes his body vulnerable to other diseases.
Immunomodulatory drugs
One of the priority tasks in the treatment of chronic sinusitis is to increase the body's immunity in general and local protection in particular. Therefore, experts recommend taking immunomodulators, which not only speed up the healing process, but also help prevent the development of diseases in the future.
To increase local immunity, to clear the sinuses of mucus, the drug Sinuforte allows. It is based on the extract of the Cyclamen plant. After discontinuation of the drug, one should not be afraid of the development of addiction, which is an important component of the successful treatment of chronic sinusitis. In order to obtain the desired effect, Sinuforte should be applied once every 24 hours for 7 days.
Healing procedures
Sinus lavage is an effective treatment for chronic sinusitis. This allows you to get rid of accumulated mucus, clear the nasal passages and normalize breathing. You can rinse your nose several times a day, as needed. The procedure should be performed with caution so as not to harm your own health.
In the doctor's office, you can go through the washing procedure using the YAMIK apparatus. This will put catheters in the nasal passages. Through one of them, the antiseptic solution is supplied, and through the other catheter, this solution is sucked off. Together with the antiseptic, the pathogenic contents are washed out from the nasal cavity.
Outside the exacerbation stage, you can use a method such as steam inhalation. For brewing useful solutions, sage leaves, eucalyptus leaves, chamomile, oregano and other herbs are used. It is possible to add essential oils, propolis tincture to the solution for inhalation. All of these products have a disinfecting effect.
To achieve the effect of steam inhalations, you should first use vasoconstrictor drops, which will remove swelling from the nasal passages and normalize the breathing process. Only in this case it will be possible to obtain a therapeutic effect. It makes no sense to inhale with congested sinuses.
You can not do steam inhalations under the age of 5 years, at high body temperature, during chills, in the presence of a predisposition to bleeding, with inflammatory diseases and with a tendency to allergic reactions.
It is possible to undergo physiotherapy, which allows you to speed up the healing process. These can be procedures such as: UHF, mud therapy, laser therapy, etc. However, there are contraindications to these techniques, for example, the presence of polyps in the nose, so you need to consult a doctor first.
When the effect of conservative treatment is absent, it is necessary to resort to surgical intervention. Modern methods of getting rid of a patient from sinusitis are: ultrasound surgery, endoscopy.
It is impossible to guarantee the absence of recurrence of chronic sinusitis after treatment.
However, it is possible to reduce the frequency of exacerbations of the disease with the help of preventive measures, such as: strengthening local and general immunity, eliminating anomalies in the nasal cavity, timely treatment of infectious diseases and eliminating dental problems.
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)
