Acute sinusitis - symptoms and treatment

Differences between headaches due to sinusitis and migraines

Their symptoms are very difficult to distinguish. Both with sinusitis and with neurological disease, the pain is characterized as throbbing. When turning or tilting the head, the painful sensation becomes stronger.

The symptoms of these diseases are similar, but they also have differences. Migraine sufferers experience headaches that are aggravated by loud noises. It may be accompanied by vomiting or nausea.

Pain in the head with sinusitis intensifies when turning and tilting the head. However, only a doctor who is well acquainted with the symptoms of these diseases can professionally distinguish the nature of the painful sensations.

Features of headaches with sinusitis:

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.

How to get rid of pain?

To remove pain, it is necessary to eliminate the source that provokes this pain - the accumulation of pus and mucus in the sinuses. As soon as it becomes clear that the disease has moved from the category of a common runny nose to a more serious stage, you should immediately consult a doctor. He will conduct an examination and prescribe medications to quickly relieve symptoms, and a course of physiotherapy. In extremely severe cases, a puncture is made to remove the contents of the sinuses.

You should not prescribe medicine on your own or try to solve the problem using “grandmother’s” methods. Sinusitis is a serious disease that is fraught with dangerous consequences for the body.

A disease in which inflammation of the maxillary paranasal sinus occurs is called sinusitis. The symptoms of sinusitis are varied.

Sinusitis is part of a group of diseases that are currently defined by the general term sinusitis, so we will use this term further. Sinusitis, synonym: sinusitis is acute or chronic inflammation of one or more paranasal sinuses. Usually occurs as a complication of a runny nose, flu, measles, scarlet fever and other diseases.

Sinusitis is divided into:

• Sinusitis - inflammation of the maxillary paranasal sinus;
• Frontitis - inflammation of the frontal paranasal sinus;
• Ethmoiditis - inflammation of the cells of the ethmoid bone;
• Sphenoiditis - inflammation of the sphenoid sinus

In acute sinusitis , the cavities adjacent to the nasal passages (sinuses) become inflamed and swollen. This makes it difficult for mucus to pass through, and it accumulates inside. This common condition is also called acute rhinosinusitis.

With acute sinusitis, it becomes difficult to breathe through the nose, and the area of ​​the face, in particular around the eyes, becomes inflamed. Possible throbbing pain in the face or headache.

Most often, acute sinusitis occurs as a complication of a common runny nose. Other causes may be bacteria, allergic reactions or fungal infections. Treatment of acute sinusitis is necessary depending on the cause of its occurrence. In most cases, home remedies are sufficient. However, prolonged sinusitis can lead to serious infections and other complications. If the disease lasts more than eight weeks or recurs periodically, it is already chronic sinusitis.

Symptoms of acute sinusitis include:

• Thick yellow or greenish discharge from the nose or running down the back of the throat;
• Nasal congestion and, as a result, difficulty breathing;
• Pain, increased sensitivity, swelling, feeling of fullness in the areas around the eyes, cheeks, nose and forehead;

In addition, there may be other symptoms of acute sinusitis:

• pain or pressure in the ear;
• A sore throat;
• Bad breath;
• Fatigue;
• Temperature;
• Pain in the upper jaw and/or toothache;
• Decreased sense of smell and taste;
• Cough that may get worse at night.

When to see a doctor

If symptoms are not expressed, try to treat yourself; but you should see your doctor if you have any of the following symptoms:

• The condition does not improve for several days or worsens;
• Temperature above 38.1 C;
• The disease recurs.

Call your doctor right away if you have symptoms that could cause a serious infection:

• Pain and swelling of the area around the eyes;
• Swelling in the forehead area;
• Strong headache;
• Confusion;
• Double vision or any other visual disturbances;
• Stiff neck;
• Dyspnea.

You can get more detailed information about acute sinusitis from the otolaryngologists of the Health 365 clinic in Yekaterinburg.
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Treatment methods for sinusitis

Physiotherapy

Physiotherapy in combination with drug treatment allows you to quickly and painlessly get rid of an unpleasant illness.

1. UHF.
   Effectively relieves pain, restores sinus tissue, and also helps improve local immunity. It consists in the effect of an electromagnetic field on the body. This procedure has several contraindications:

• cardiovascular diseases;
• presence of tumors;
• low pressure.
• The procedure is recommended for the treatment of young children and pregnant women. On average, the course of treatment is 12-15 days.

Puncture

Treatment of an advanced form of purulent sinusitis is carried out using a puncture. The procedure consists of piercing the wall of the sinus with a special needle in order to remove purulent contents from the sinus and also introduce medications into it.

Many patients tolerate the procedure easily. Qualified doctors are fluent in it, so they carry it out quickly and painlessly. Moreover, the effect is noticeable immediately: pain and heaviness go away, and breathing also improves.

The procedure is carried out as follows:

1. Anesthesia
   of the nasal mucosa.
2. Piercing the sinus wall
   with a special needle.
3. Removing fluid
   with a syringe, as well as rinsing with medications

The puncture is performed in rare cases. For this procedure, the patient must have the following symptoms:

• serious condition (high fever and severe weakness);
• unbearable headache, pulsation in the maxillary sinus area.

A puncture is also prescribed in cases where the infection needs to be cured as soon as possible. For example, during pregnancy.

Drug treatment

When prescribing medications, the ENT doctor takes into account the severity of the disease, as well as the causative agent that caused it.

For sinusitis, medications for various purposes are prescribed to affect a specific symptom of the disease:

1. Antibacterial drugs.
   Their main task is to destroy the infection, as well as relieve inflammation.
2. Corticosteroid drugs.
   They have an anti-inflammatory effect.
3. Analgesics
   . These medications relieve headaches.
4. Vasoconstrictor drugs
   . Relieves swelling and a feeling of “fullness” in the nose.
5. Preparations for rinsing the nose.

Important

! Only a doctor should prescribe and prescribe medications for sinusitis. After all, most medications have many contraindications.

When complications develop, injectable antibiotics are used.

In the initial stages of the disease, when the nasal cavity is congested, special nasal drops are used that relieve swelling and ensure free breathing - vasoconstrictor drugs.

Medicines based on sea water not only wash, moisturize and cleanse the mucous membranes of crusts, but also prevent the appearance of mucus and pus. Such drugs include Sialor Aqua.

Acute sinusitis - symptoms and treatment

May include:

• anterior rhinoscopy;
• radiography of the sinuses;
• ultrasonography;
• diagnostic puncture;
• laboratory research;
• microbiological examination;
• diaphanoscopy.

Anterior rhinoscopy

The main method of objective diagnosis of acute sinusitis [1][6][7]. It is carried out by an otorhinolaryngologist using a nasal speculum. Before its administration, the nasal mucosa is lubricated with a solution of a vasoconstrictor drug (anemization). This is done in order to reduce swelling of the mucous membrane.

The doctor assesses the condition of the mucous membrane of the nasal turbinates and passages, the absence or presence of discharge. Signs of sinusitis are the presence of purulent or mucopurulent discharge in the area of ​​the outlet openings of the affected sinuses. It is accompanied by redness and swelling of the nasal mucosa.

A pathological secretion can be visible on the posterior wall of the oropharynx and in the nasopharynx when examined with a spatula and a nasopharyngeal speculum (posterior rhinoscopy) and examination of the pharynx (pharyngoscopy).

Endoscopic examination of the nasal cavity

Allows you to examine in detail the nasal passages and turbinates to the nasopharynx, identifying the smallest anatomical changes. Often, video endoscopy is performed and the result is recorded, which later helps to assess how the disease progresses.

X-ray of the sinuses

Use only for prolonged runny nose and headache for about 7–10 days [1][6][7]. During the procedure, the head is fixed in a certain position - in the nasomental, nasofrontal and lateral projections. The position of the head is determined by the radiologist. With sinusitis, the mucous membrane thickens, a horizontal fluid level is revealed and the pneumatization of the sinus is significantly reduced.

Computed tomography (CT) is used for chronic pathology of the paranasal sinuses, orbital and intracranial complications. It is not advisable to use it to diagnose acute sinusitis. Neither X-ray nor CT scan can differentiate between viral and bacterial sinusitis.

Ultrasound examination (ultrasound)

Non-invasive screening method. Allows you to identify effusion in the lumen of the frontal and maxillary sinuses and evaluate the effectiveness of the therapy [2]. It is actively used in examining children and pregnant women.

The action of ultrasound is based on the reflection of an ultrasonic signal at the boundary of two substances with different acoustic properties (bone - air, air - exudate, etc.) in a linear and two-dimensional mode. In the first case, ultrasound scanners are used for the paranasal sinuses (“Sinuscope”, “Sinuscan”), in the second case, standard ultrasound machines are used.

Diagnostic puncture

Sinus puncture (from Latin “puncture”) is not a routine diagnostic method due to the high risk of complications. It is used if there are contraindications to radiography, for example during pregnancy.

Laboratory diagnostics

Includes a complete blood count and determination of C-reactive protein (CRP).

Allows:

• distinguish viral sinusitis from bacterial sinusitis, and therefore determine whether you need to take antibiotics;
• assess the severity and dynamics of the disease.

Microbiological examination

It is carried out in cases of prolonged forms of sinusitis and the ineffectiveness of antibiotic therapy. For the study, you will need nasal cavity discharge or material from the affected sinus, extracted by puncture.

The reliability of the method is relative, and the information content is small. Firstly, the microflora of the nasal cavity and sinuses are initially different. Taking a smear, even if all conditions are met, does not guarantee that the bacterium cultured on the media is the cause of inflammation in the sinus, and not an accidental “fellow traveler” when removing a cotton probe from the nose.

In children, the information content of microbiological research is even lower. This is due to the child’s negative reaction to the manipulation and the inability to carry out the procedure correctly [11].

Secondly, the reliability may be affected by non-compliance with the storage and transportation conditions of the biomaterial [12]. Therefore, assessing the results of microbiological research is complex and ambiguous.

Diaphanoscopy

An outdated non-invasive method for diagnosing sinusitis of the maxillary sinus. This is done using a special lamp. If the cavity is airy, then the sinus will be highlighted in red. [5]. If the sinus contains pus, the glow becomes black.

Complications

Many patients do not seek medical help for sinusitis in a timely manner. Unfortunately, the complications of this disease are serious. For example, with purulent sinusitis, complications are possible, including those affecting the brain.

What might patients encounter?

1. Orbital complications.
   There is a sharp increase in temperature and severe pain.
2. Intracranial complications.
3. Mucocele
   . A cyst-like formation forms inside the sinus, which prevents the movement of air and mucus.
4. Pneumocele
   . This is a formation similar in size to a tumor.

To prevent complications from occurring, you need to contact an ENT doctor in time and not self-medicate!

Sinusitis

Cold

Allergy

Fungus

21270 May 25

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-treatment.
In case of pain or other exacerbation of the disease, diagnostic tests should be prescribed only by the attending physician. To make a diagnosis and properly prescribe treatment, you should contact your doctor. Sinusitis: causes, symptoms, diagnosis and treatment methods.

Definition

Sinusitis is an inflammation of the mucous membrane of the paranasal sinuses and nasal cavity. Sinusitis is one of the most common diseases and, although there are no exact statistics on its prevalence, according to various sources, up to 15% of the adult population worldwide suffers from this pathology, and in children it is even more common.

The nose is the initial part of the upper respiratory tract. It is divided into three sections: the external nose, the nasal cavity and the paranasal sinuses (SNS). OPN are air cavities that are located around the nasal cavity and communicate with it through excretory openings, or ducts. There are four pairs of sinuses: maxillary, frontal, ethmoidal labyrinth and sphenoid sinuses. The largest sinus - the maxillary, or maxillary - is located in the body of the upper jaw, the frontal sinus is in the thickness of the frontal bone, the ethmoid labyrinth is numerous cells in the ethmoid bone, and the sphenoid sinus is located in the body of the bone of the same name.

Causes of sinusitis

The main cause of acute sinusitis is infection. In 90-98% of cases, sinusitis is caused by viruses, in 2-10% of cases - by bacteria. In addition, sinusitis can be fungal in nature, or be the result of exposure to allergens or irritants (substances with an irritating effect).

Secondary bacterial infection of acute renal failure after a viral illness affecting the upper respiratory tract develops in 0.5–2% of adults and 5% of children.

Typically, acute sinusitis is observed against the background of an acute respiratory viral infection (ARVI), most often caused by rhinoviruses. According to research, almost 90% of patients with acute respiratory viral infection showed changes in the form of swelling of the mucous membrane of the acute respiratory tract according to magnetic resonance imaging, which confirms that sinusitis is one of the typical manifestations of acute respiratory viral infection.

Among bacteria, acute inflammation of the mucous membrane of acute renal failure is most often caused by pneumococcus and Haemophilus influenzae. In addition, so-called atypical pathogens - chlamydia and mycoplasma (about 10%) - are increasingly being discovered in both adults and children.

There is no single theory why chronic sinusitis develops. Predisposing factors include a large number of conditions and diseases, including anatomical abnormalities in the structure of the nasal cavity and acute renal failure (for example, deviated nasal septum), chronic rhinitis, atopy (hereditary predisposition of the immune system to an inadequate response to common allergens in the environment), intolerance to non-steroidal anti-inflammatory drugs drugs, immunodeficiency conditions, etc.

Sinusitis can also occur as a result of aero- and barotrauma, gunshot and mechanical injuries (traumatic sinusitis) or in the presence of a focus of acute or chronic inflammation in the oral cavity (odontogenic sinusitis). In odontogenic maxillary sinusitis, the main role is played by the presence of communication of acute renal failure with the oral cavity after the removal of the teeth of the upper jaw and the entry of fragments of foreign material into the sinus during the filling of the canals of these teeth, as well as chronic inflammation of the structures of the upper teeth (pulpitis) and periodontal disease.

Classification of the disease

Sinusitis is classified depending on the causative factor (traumatic, viral, bacterial, fungal, mixed, allergic) and depending on the severity of the process (acute and chronic).

In addition, sinusitis is divided into exudative (serous, catarrhal, purulent) and productive (parietal hyperplastic and polypous).

Depending on which sinuses are affected, there are:

• sinusitis (sinusitis of the maxillary sinus) - inflammation of the mucous membrane of the maxillary sinus;
• frontal sinusitis (sinusitis of the frontal sinus) - inflammation of the mucous membrane of the frontal sinus;
• ethmoiditis - inflammation of the mucous membrane of the cells of the ethmoid labyrinth;
• sphenoiditis - inflammation of the mucous membrane of the sphenoid sinus.

If all sinuses of one half of the nasal cavity are involved in the inflammatory process, the disease is called hemisinusitis, and both halves are called pansinusitis.
Symptoms of sinusitis
The main symptoms of sinusitis are persistent nasal discharge, difficulty nasal breathing, headache or pain in the projection of acute renal failure, decreased sense of smell, stuffy ears, general malaise and cough, fever.

Headache is one of the leading symptoms of acute sinusitis; it occurs due to the effect of the inflammatory process on the membranes of the brain. The pain is localized in the area of ​​the bridge of the nose and eyebrows, and can radiate to the upper jaw. Sphenoiditis is characterized by pain in the crown and back of the head (“casque-like” pain); it is usually diffuse in nature, but with more severe inflammation in one of the sinuses it can be local.

Nasal breathing disturbance can be periodic or constant, unilateral or bilateral. With unilateral sinusitis, difficulty in nasal breathing usually corresponds to the affected side.

Discharge from the nasal cavity can be mucous, mucopurulent, purulent and come away when you blow your nose, or flow down the back wall of the pharynx. With a severe acute process, the intensity of these symptoms usually increases - signs of general intoxication are added. In some cases, reactive swelling of the eyelids and complications in the orbit (especially in children) and swelling of the soft tissues of the face develop.

In children, acute sinusitis is often combined with hypertrophy and chronic inflammation of the pharyngeal tonsil and can manifest itself with nonspecific symptoms - persistent cough and enlarged cervical lymph nodes.

According to the severity of the course, acute sinusitis is divided into mild, moderate and severe.

In mild cases, the temperature does not rise, and nasal congestion, nasal discharge and cough are moderate. Symptoms do not affect the patient’s quality of life (sleep, daily activity) or have a slight effect.

In mild cases, there is no headache in the projection of the paranasal sinuses, and the disease resolves without complications.

Moderate severity of sinusitis is characterized by elevated temperature, but it does not exceed 38°C. Nasal congestion, nasal discharge and cough are severe and affect the patient's quality of life. In the projection of the paranasal sinuses, when the head moves and when the head is tilted, a feeling of heaviness arises. A complication of the middle ear may develop - acute otitis media.

Severe sinusitis is characterized by a body temperature above 38°C. Nasal congestion, nasal discharge and cough are severe, can be distressing, and have a moderate or significant impact on quality of life. Periodic or constant pain occurs in the projection of the paranasal sinuses, which intensifies with movement or tilting of the head, with percussion (tapping) in the projection of the paranasal sinus. Intracranial and orbital complications (orbital complications) may occur.

Diagnosis of sinusitis

To make a diagnosis of sinusitis, the patient must have two or more symptoms: difficulty breathing or nasal discharge, pressure or pain in the area of ​​acute respiratory failure, decreased or loss of smell, as well as rhinoscopic or endoscopic signs (mucopurulent discharge mainly in the middle nasal cavity). course and/or swelling or mucous obstruction predominantly in the middle meatus). If these symptoms are observed for less than 12 weeks, then sinusitis is defined as acute, if more - as chronic.

A general clinical examination may be recommended for all patients with suspected sinusitis, including:

• general blood analysis;

Prevention and precautions

To always feel in good shape and not encounter this unpleasant disease, you must follow several recommendations from doctors:

1. In winter, be sure to wear a hat.
2. Do exercises every morning.
3. Ventilate the apartment at any time of the year.
4. For prevention, rinse your nose with preparations based on sea water.

The danger of sinusitis is that its symptoms are very similar to those of a common runny nose. If proper measures are not taken, the disease develops into chronic sinusitis. That is why it is important not to self-medicate, but to immediately consult a doctor.

What other complications of sinusitis can there be?

Secondary complications are possible . These include narrowing of the upper airways during sleep, which leads to snoring and stopping breathing during sleep (sleep apnea).

Tumors can also be a complication of sinusitis, especially rhinosinusitis (sinusitis with concomitant inflammation of the nasal mucosa). With chronic sinusitis, there is a slightly higher level of development of malignant tumors in the soft areas of the nasopharyngeal space (nasopharyngeal carcinomas). But more often benign formations (polyps) form.

Transition to a chronic form of sinusitis

Acute sinusitis (sinusitis) can develop into a chronic form. Chronic sinusitis occurs when the disease lasts more than six weeks or recurs several times a year. This always returns the patient to headaches, cold symptoms and other manifestations of this disease. Treatment with conventional means such as rinsing or antibiotics usually ceases to be successful. And surgical treatment is already being prescribed.

There is a proven connection between chronic sinusitis and the development of other diseases, such as pneumonia, asthma, COPD and stroke.

Therefore, do not delay visiting the ENT doctor, get treatment on time. Sincerely, otorhinolaryngologist surgeon Ph.D. Boklin A.K.

PDF version: https://boklin.ru/pdf/tchem-opasen-gaymorit-ili-oslozhneniya-verhnetchelyustnogo-sinusita.pdf