Types of rhinosinusitis, symptoms and treatment in adults. Rhinosinusitis What Causes Acute Rhinosinusitis?

Rhinosinusitis - what is it? The disease occurs as a result of damage to the mucous membranes of the nose and paranasal sinuses by infections or viruses. If signs of illness appear, you should immediately consult a doctor. Treatment must begin in a timely manner, otherwise the disease will move to a severe stage..

Reasons for the development of the disease

In most cases, the disease becomes a consequence of the course of acute respiratory viral infections or the common cold, in which there was no treatment or therapy was not completed to the end. The presence of inflammation in the mucous membrane is a concomitant factor, so the disease has many manifestations.

A significant place is occupied by the deformation of the side wall of the nose. These can be anomalies of the nasal concha, which manifests itself in the form of polyps in the nose, curvature of the septum and adenoids. The hypertrophic form of rhinitis leads to stagnation of the secret and a violation of the cleaning of the sinuses.

Many viral infections lead to the development of edema in the mucosa, which leads to increased secretion of the glands. There is a blockage of the sinus openings due to the large amount of mucus. The edematous state of the membrane also matters, which also contributes to clogging. Violations can occur with improper blowing of the nose. The ingress of purulent secret into the sinuses leads to increased blocking of fistulas and an increase in the viscosity of the contents.

With bacterial and fungal infections, the patient's situation is also aggravated. In the first case, the appearance of bacteria is a consequence of mucus stagnation and outflow failure. The fungal form of rhinosinusitis is a complication that occurs when antibiotics are used improperly.

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Contribute to the occurrence of the disease and the following factors:

development of bronchial asthma;
the presence of an allergic type of rhinitis;
unfavorable ecological situation;
weakened immune system;
the development of chronic inflammatory processes in the sinuses of the nose - vasomotor rhinitis.

Signs of illness

With rhinosinusitis, the symptoms are mixed. Therefore, there is a need for differentiation of features. The presence of manifestations similar to other diseases can confuse the patient, therefore, with the development of symptoms, it is necessary to visit a doctor.

Most patients develop the following symptoms:

the general nature of the malaise;
edematous condition of the paranasal sinuses and mucous membrane;
high body temperature;
headache;
a feeling of congestion in the ears;
cough may be present;
mucus is formed;
the work of smell is disturbed, and breathing is difficult.

Symptoms of pathology differ from each other due to the development of certain forms. The main feature of this factor is the duration of manifestations. The following stages of the development of the disease are distinguished:

acute rhinosinusitis, which lasts up to 1 month;
subacute type develops no more than 3 months;
the recurrent form may occur several times a year;
chronic rhinosinusitis has been observed in a patient for more than 3 months.

Types of pathology and their characteristics

Types of diseases differ in causes, stages of development and duration. There are some features in the manifestations of diseases. Acute rhinosinusitis is more common, in which the inflammatory process occurs in the nasal mucosa. However, there is a possibility of transition of the pathology to the region of the paranasal sinuses. Acute rhinosinusitis is more often a complication that occurs after colds. The following signs appear:

lack of smell and appetite;
nasality occurs;
body temperature rises;
nose is constantly stuffed up;
a headache develops;
discharge from the nose has a different color and structure.

It is necessary to take into account the typical symptoms of pathology. Often an acute type of sinusitis is formed. Occurs in the cheek area strong pain. Pain may be aggravated if the patient turns his head. Similar manifestations have an acute form of frontal sinusitis, however, painful signs are localized in the forehead. Another typical manifestation is acute sphenoiditis. The disease affects the sphenoid sinuses and is accompanied by constant pain in my head.

The acute type is divided into several stages of development. With a mild form, the signs are poorly expressed. The temperature is slightly elevated, and there is no fluid in the sinuses, which is clearly visible during the diagnosis. In the middle stage, the temperature rises, the patient has an increase in headache. When pressing on the forehead and cheeks, the patient will experience pain that can spread to the teeth. In severe form, the temperature exceeds 38, pain occurs when you press on the sinuses. The patient's face swells, and complications can be detected during x-rays.

In the chronic type, there is also a headache and discharge that becomes purulent. The patient has a nasal and unpleasant symptoms in the face. The temperature rises, the sense of smell decreases, congestion is observed constantly. The following factors exacerbate the situation:

improper elimination of the acute type of rhinosinusitis;
dental diseases;
drinking and smoking;
bad ecology;
allergic reaction;
changes in the shape of the nasal septum.

The polyposis form is more common in patients who have a weakened immune system. The following factors also influence:

viruses;
swelling of the mucosa;
exposure to allergens;
exposure to chemicals.

The development of pathology is influenced by concomitant diseases. This applies to allergic rhinitis, obstructive bronchitis and asthma. Treatment is complicated by the occurrence of the aspirin triad, which is characterized by the formation of nasal polyps, the appearance of aspirin intolerance, and the development of bronchial asthma. The intervention of the surgeon can lead to suffocation and exacerbation of the pathology. However, endoscopic surgery is often used as the most effective tactic for eliminating an allergic focus.

Purulent rhinosinusitis occurs as a result of penetration of a bacterial infection. In some cases, this leads to the development of allergies and changes in the nasal septum. To eliminate the disease, doctors prescribe antibiotics. The disease can appear with the following types:

sinusitis;
frontitis;
sphenoiditis;
ethmoiditis.

The allergic form is formed when exposed to irritating factors in the form of allergens. They may be:

fungal spores;
wool;
dust;
plant pollen;
medications;
smog.

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During the development of the pathology, the patient experiences a variety of manifestations, which are represented by reddening of the eyes and the development of a rash on the skin. In addition, clear mucus is secreted from the nasal cavity. Treatment is represented by the elimination of the focus of an allergic reaction and the use of antihistamines.

Catarrhal rhinosinusitis is formed when an infection or SARS is attached. The patient has increased lacrimation and impaired sense of smell. Appetite is absent, sleep disturbances occur. There is burning and dryness in the nasal cavity. There are manifestations of general intoxication of the body.

Therapeutic measures

Treat the disease in adults as soon as possible. Lack of intervention can lead to the development of complications or the transition of the disease to the next stage, which will be much more difficult to get rid of. It is important to find the source of the disease and eliminate it. For this purpose, diagnostic measures are carried out, which are represented by the following methods:

x-ray, which is used to determine the degree of the inflammatory process;
rhinoscopy;
ultrasonic examination to determine the level of liquid;
with the help of an endoscope, it is possible to identify all violations that are associated with the nasal septum;
CT scan;
at an exacerbation apply a puncture.

Symptoms and treatment are interconnected with each other, since the treatment tactics will depend on the manifestations of the pathology and its form. Antibiotics and local therapy are used. The task of using antibiotics is related to the need to eliminate pathogens. There are no universal means. Therefore, the choice of the drug should be carried out with the help of a specialist. It is forbidden to take medicines on your own.

To eliminate rhinosinusitis, the following groups of drugs are used:

tetracyclines;
macrolides;
cephalosporins.

The duration of medication is 5-7 days. However, the duration of therapy may vary, due to the peculiarities of the course of rhinosinusitis. This process is affected by the development of complications, the form of the disease and the stage. The dosage of the drug is prescribed by the attending physician after the diagnosis and determination of the type of pathogenic microorganisms.

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If symptoms are detected and treatment has already been started, then topical agents are used. It is necessary to clean the nasal cavity and paranasal sinuses from purulent and mucous contents. Antibiotics and other drugs cannot accomplish their task if foci for the development of bacteria and viruses remain. Therefore, the following groups of funds are assigned:

nasal drops of antibacterial action;
nasal sprays and vasoconstrictor drops;
solutions for washing the nasal cavity with antiseptic properties.

Acute, purulent, chronic and other types of inflammation require special attention to this problem. Your doctor may recommend certain medications, but you should never use medications on your own. Before using each drug, you should consult your doctor.

Preventive measures

Prevention is essential for healthy people and patients struggling with rhinosinusitis. For patients, preventive measures are needed, as they will avoid the further development of the disease and deterioration of well-being. For healthy people, such activities help to avoid the formation of the disease.

Need to strengthen immune system. To this end, you should include in the diet foods that are rich in vitamins, minerals and nutrients. Drinking alcoholic beverages should be avoided, as alcoholic beverages significantly undermine health. Smoking, which acts as a provoking factor, has a negative effect.

You need to exercise and lead an active lifestyle. It is useful to harden your body with various procedures: air, water and solar. A walk in the fresh air away from the tracks is not only a pleasant pastime, but also hardens the body. For the same reason, you should regularly ventilate the room and carry out regular cleaning. It is especially important to eliminate dust and objects that can accumulate it. If you have a predisposition to allergies, you should not have pets.

An important component of prevention in adults is represented by rest. During this process, the body restores its strength. Improper rest can disrupt human health, so you need to be careful about such activities too.

Emerged diseases associated with the nasal cavity and respiratory tract need to be removed in a timely manner. Rhinosinusitis often occurs as a result of untreated common cold, so you should be careful about your health.

Thus, the development of rhinosinusitis must be stopped at early stage formations.

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The presence of symptoms is a reason to seek help from a doctor

It is not recommended to use a variety of means for self-treatment, since a lack of knowledge about the characteristics of drugs can lead to a negative result.

Rhinosinusitis is a disease characterized by inflammation of the mucous membranes of the olfactory organ and paranasal sinuses. With incorrect and untimely treatment of the disease, the individual characteristics of the body, the disease turns into chronic rhinosinusitis. With the progression of the disease, the mucosa thickens and an inflammatory process occurs. On this basis, many people have a question about what it is and what is the treatment of rhinosinusitis in adults.

Rhinosinusitis is the general name for various diseases olfactory organ. It is often referred to as an inconclusive diagnosis. Depending on the duration of the suppurative process, I have acute and chronic rhinosinusitis. After certain studies, the client can be found:

ethmoiditis;
sinusitis;
fronit;
sphenoiditis;
hemisinusitis;
pansinusitis.

Pathology has the following forms:

Seasonal. The impetus for the progression of pathology very often acts. In the case of a viral infection of the nasopharynx, pathogens actively multiply in the paranasal sinuses.
It is characterized by severe intoxication of the body. The disease is observed within 5-10 days. The patient becomes incapacitated. There is an increase in temperature and pus flows from the nose.
Chronic rhinosinusitis. This form may last for several months. Symptoms are less pronounced compared to the acute form. The patient tolerates the disease much easier. Due to allergens, the disease can recur.
The infectious-allergic form appears in case of infection in the pathogenic microflora. Bacteria multiply very quickly in the nasal cavity. The result is severe inflammation. Allergic rhinosinusitis requires a serious approach to it.

The cause of the progression of the disease can be vasomotor rhinitis, which is accompanied by a runny nose.

Symptoms of the disease

Regardless of the form of the disease, doctors identify several signs that indicate the disease. These include:

swelling of the mucosa;
weakness;
malaise;
pus flows down the nasopharynx;
pain in the localization of the affected paranasal cavities;
headaches of varying intensity.

If any symptom occurs, you should seek medical attention.

acute form

The acute form of the disease is characterized by pronounced symptoms. A couple of days after the onset of the progression of the disease, the patient's working capacity decreases, swelling of the face is observed, and paroxysmal pain in the head appears. The signs are:

nasality;
weakness in the whole body;
intoxication of the body;
decreased sense of smell;
hyperthermia;
weak and strong headaches.

Acute rhinosinusitis can be mild, moderate or severe.

Chronic form

The most common causes of this form are:

excessive drinking;
improper treatment of an acute form;
smoking;
allergy.

The main symptoms of this form are:

decreased sense of smell;
nasal congestion;
hyperthermia;
nasality;
increased lacrimation;
purulent discharge from the nose.

Any symptom should alert the patient, so it is important to consult a doctor. Only the attending physician will be able to prescribe a course of treatment.

allergic form

Allergic rhinosinusitis develops after the patient is exposed to various allergens. The features of this form are:

redness of the eyes;
the appearance of clear mucus from the nose;
the appearance of a rash on the epidermis.

Allergic rhinosinusitis is also characterized by cough and swelling of the throat.

catarrhal form

This is a viral runny nose that appears against the background of SARS. The main features are:

loss of smell;
swelling of the paranasal sinuses;
hyperthermia;
sleep disturbance;
increased lacrimation;
the occurrence of a burning sensation in the nose;
body intoxication.

This form is very dangerous for humans. If the disease is not properly treated, exacerbations can occur in the form of meningitis, pathologies of the upper airways, or brain abscess.

Vasomotor rhinosinusitis

This form appears on the background of a cold. Vasomotor rhinosinusitis in adults is manifested by the following symptoms:

intoxication of the body;
sleep disturbance;
weakness;
runny nose with liquid discharge;
high hyperthermia.

It is impossible to start the pathology, as it can become chronic.

Purulent rhinosinusitis

With this form of the disease, the symptoms are pronounced. The first signs of the disease include:

loss of appetite;
sleep disturbance;
high hyperthermia;
severe pain in the teeth;
intoxication of the body;
purulent discharge.

This form is the most dangerous for humans. It is often complicated by meningitis.

Treatment of rhinosinusitis

In order to cure the disease, you need to seek help from an otolaryngologist. Only a doctor can diagnose the disease and prescribe effective treatment. It is strictly forbidden to resort to self-medication.

Medical therapy

The choice of treatment method depends on the severity of the course of the disease and the personal characteristics of the patient's body. Medical treatment for rhinosinusitis includes:
1. Taking antibiotics. This group of medicines is prescribed only after the result of a microbiological analysis of the contents of the nasal cavities. Patients are shown to take macrolides, tetracyclines, cephalosporins. Most effective for rhinosinusitis:

Azithromycin;
Amoxicillin;
Clarithromycin.

The duration of antibiotic use is two weeks. In the case of an acute form of the disease, which is accompanied by high temperature, shown intramuscular injection medicines.

2. Local application antibacterial nasal sprays. Isofra and Polydex are the most effective.

3. To eliminate the symptoms of inflammation, antihistamines and corticosteroids are indicated.

4. Treatment of chronic rhinosinusitis includes taking decongestant and vasoconstrictor drugs. These are the drops:

Nazivin;
Rhinonorm;
Tizin.

It is worth taking such funds for no more than 5 days, as the patient develops addiction.
5. Application of topical combined sprays. These include Vibracil, Rinofluimucil.

6. Reception of immunomodulators. The most effective are:

Immunal;
Ismigen;
Imunorix.

7. The use of mucolytics designed to thin the secretions and normalize the outflow. These drugs include ACC, Sinupret.
8. Patients are shown antiphlogistic therapy. Patients are prescribed antipyretic drugs Ibuprofen and Paracetamol.
Only a specialist in a narrow profile can prescribe medicines.

Surgery

Treatment of chronic sinusitis often requires surgery. This occurs when conservative treatment fails. Surgical methods include:

Puncture of inflamed cavities. This procedure eliminates pus and helps to introduce antibacterial medicines. In the most refined place of the upper jaw, a puncture is made with a special needle. Perform a flush antiseptics and administer medications.
Application of the YAMIK catheter. A special rubber catheter with two rubberized balloons is inserted into the nose. They close the nasal cavity, after which the pus is removed with a syringe.

The choice of method depends on the symptoms that appear.

Rhinosinusitis, whose symptoms and treatment in an adult are different from those in a child, can and should be treated at home. The positive side is the fact that the duration of such therapy can be long. How to treat rhinosuinusitis with traditional medicine? The following folk remedies are effective:

Decoction of oak bark. Pour 5-10 grams of dried bark with boiling water. Leave to infuse, then strain and you can start washing the nasal cavities. Thanks to this, the condition of the nasal mucosa is normalized. The recovery process is greatly accelerated. This decoction has an antiphlogistic effect.
A decoction of calendula and chamomile. Calendula has a beneficial effect on the entire body. Chamomile is a strong antiseptic. Calendula can be replaced with St. John's wort or yarrow.
The use of essential oils. With their help, inhalations are made or simply applied to the sinuses. In this case, the patient's breathing becomes easier.
Composition of salt and soda. It is characterized by antibacterial and antiseptic effect. The composition is prepared 1:1 and diluted with 0.25 liters of liquid. She must be hot.

Honey and also help to cope with the disease. Sweet nectar is diluted with warm water and instilled into the nose. Aloe juice relieves nasal congestion.
Rhinosinusitis is a disease that requires close attention and competent treatment. Otherwise, severe exacerbations and complications occur. The patient may suffer from the symptoms of the disease for several years.

Watery or mucous discharge from the nasal passages is not always a symptom of a cold: they can also accompany rhinosinusitis - what is it and how medicines eliminated, most people don't know. However, doctors advise taking therapeutic measures already at the first symptoms in order to prevent serious complications. What are the consequences of this disease and how can it manifest itself?

What is rhinosinusitis

If the inflammatory process respiratory system affects the nasal cavity and sinuses at the same time (the number does not play a role), the doctor diagnoses "rhinosinusitis" or "sinusitis". Both words refer to the same disease. Inflammation of the mucosa can either happen due to mechanical damage, or be a complication of acute respiratory viral infections, acute rhinitis, other infectious-viral or bacterial diseases. Treatment for rhinosinusitis depends on the cause. Already at the first symptoms, a visit to the otolaryngologist is needed, since the patient can get as a complication:

bronchial asthma;
abscesses in soft tissues faces;
intracranial changes (in rare cases sinusitis leads to brain abscess, meningitis);
visual impairment due to damage to the optic nerves;
purulent inflammation of the middle ear;
damage to the nervous system.

causative agents of infection

Rhinosinusitis can be triggered by trauma, which will lead to a deviated septum or narrowing of the sinuses, or be the result of physiological pathologies in the structure of the face and respiratory organs, but most cases of this disease are associated with the activity of pathogenic microorganisms. It may be due to:

viruses;
bacteria;
mushrooms.

Causes

Such a complex problem as rhinosinusitis does not arise from scratch, even if a person has become infected with the influenza virus. In addition to a general decrease in the protection of the immune system and colds, predisposing factors play a role, and the more of them, the higher the likelihood of getting rhinosinusitis. These include:

polyps in the nasal cavity;
pathology endocrine system;
curvature of the nasal septum;
allergic rhinitis;
problems with the development of the anatomical structures of the nasal cavity (impaired patency of the natural fistulas of the sinuses, which prevents the timely removal of bacteria by active mucociliary transport);
immunodeficiency states;
pathology of nearby organs.

Species

This disease can have several forms, which are determined by the pathogen, symptoms, rate of development. Based on these differences, doctors have developed 4 main classifications, and in order to understand how to treat rhinosinusitis at home, you need to correctly and fully determine its type. The division can be done:

By etiology:
- Viral - rhinoviruses, influenza and parainfluenza viruses, adenoviruses are involved here, and sinusitis of viral etiology always occurs in an acute form
- Bacterial - pathogens are pneumonia and pyogenic streptococci, hemophilus, Pseudomonas aeruginosa and Escherichia coli, moraxella, Staphylococcus aureus, enterobacteria.
- Fungal - the disease is provoked by aspergillus, Alternaria, culvularia, mainly it is a superinfection (co-infection of an infected cell with another strain or microorganism).
- Mixed - inflammation is of a bacterial nature, and then it gets a viral or fungal complication, or it all starts with the flu, and then a bacterial disease is added.
According to the localization of the inflammatory process:
- maxillary - classic sinusitis;
- frontal - affects the frontal sinuses;
- ethmoidal - inflammation of the ethmoid sinuses;
- sphenoidal - an inflammatory process in the sphenoid sinuses.
According to the severity of the flow:
- Light form.
- Average.
- Heavy.
According to the nature of the manifestation:
- Spicy.
- Subacute.
- Chronic.
- Recurrent.

General symptoms of the disease

The main manifestation of rhinosinusitis in any localization of inflammation is a violation of nasal breathing, to which mucous secretions can be added (at the last stage - with pus), which are absent if the nose is blocked. Common symptoms of rhinosinusitis in people of all ages include:

an increase in body temperature to 38-39 degrees (absent in the chronic nature of the disease);
runny nose;
weakness;
loss of appetite;
headaches (towards the end of the day);
difficulty breathing;
nasal voice;
smell disorder.

Frontit

When the inflammatory process affects frontal lobe, rhinosinusitis immediately passes to a severe stage - the natural outflow of mucus from this zone is reduced, and if anomalies in the structure of the bones are added to this, frontal sinusitis can become chronic. The main symptoms include pain in the forehead in the morning (due to stagnation of the secretion in the sinuses), which can be aggravated by the same sensations in the eyes, photophobia and loss of smell. As complications arise, add:

color change skin;
swelling of the forehead;
collateral edema of the upper eyelid.

Ethmoiditis

The ethmoidal labyrinth of the sinuses is located at the very base of the nose, therefore, with an inflammatory process in this area, pain affecting the bones of the orbit becomes the main symptom. Additionally, ethmoiditis will be characterized by a decrease in the sense of smell or its complete loss, nasal congestion, the appearance of purulent or mucopurulent discharge. Children have a fever. If the disease has passed into a severe stage, bone destruction will begin, so there will be:

hyperemia and swelling of the inner corner of the eye;
swelling of the medial zone of the eyelid;
exophthalmos;
impaired visual acuity.

Sinusitis

The most common form of rhinosinusitis is sinusitis - an inflammatory process in the maxillary sinuses, which is considered a complication of influenza, measles, acute rhinitis and a consequence of the curvature of the nasal septum. It is characterized by pulling pain, aggravated by tilting the head forward and localized in the nose and bridge of the nose. Additional symptoms:

difficulty in nasal breathing along with the appearance of nasality in the voice;
headache (toward evening);
discharge from the nose is green (purulent) or yellow, if there is no congestion;
permanent runny nose;
sleep disturbance.

Sphenoiditis

If acute rhinosinusitis that has affected the ethmoid sinuses has not been cured, the process can reach the posterior regions and develop in the sphenoid sinuses, which will be the beginning of sphenoiditis. It is always acute and is considered the most dangerous, as it easily provokes complications in the eyes and brain. On the initial stages the course of the disease may be asymptomatic, and later acute sphenoiditis will manifest itself:

pain in the temporal zone, forehead and eyes;
insomnia;
decrease in working capacity;
constant aching pain in the back of the head;
dizziness;
copious thick discharge from the nasal passages.

Features

The symptoms of sinusitis should be analyzed not only by the localization of the inflammatory process - it is important to take into account the severity of the disease, its etiology and the nature of the manifestation. So acute is necessarily manifested by pronounced pain, but always has a short duration, subacute will be sluggish, lasting up to 3 months. Chronic symptoms persist for longer than 12 weeks, and with recurrent symptoms, up to 4 exacerbations can occur in a year, the periods between them are longer than 2 months.

catarrhal

An acute inflammatory process of the nasal mucosa lasts 2-3 weeks and may affect the right or left side, or both. The main manifestation is an increase in body temperature and mucous discharge from the nose, which gradually thicken. If there is swelling of the affected area (often catarrhal rhinosinusitis affects several sinuses), the discharge stops, and the nose is blocked completely. Gradually, there is an accumulation of mucus in the nasopharynx, an inflammatory process begins on the conjunctiva.

Acute purulent

With proper treatment, the duration of the acute form, even complicated by purulent discharge, does not exceed 4 weeks, while all the symptoms are pronounced - especially for pain. In such a situation, there are several affected sinuses with purulent contents, so the pain can affect half of the face or the entire surface. Thick green discharge from the nose, fever, symptoms of severe intoxication and swelling are the main manifestations of the acute phase.

Chronic

If rhinosinusitis is observed for 12 weeks or longer, the severity of symptoms is smoothed out, apart from periods of exacerbation, we are talking about a chronic form. The structure of the mucous membrane changes, with any hypothermia or a decrease in immunity, especially complicated by an infectious disease, the acute stage returns again. Often, chronic rhinosinusitis in children and adults affects individual sinuses. Nasal congestion, weakness and decreased sense of smell are constant companions of this disease.

Polyposis sinusitis

Against the background of the chronic form, to which therapeutic measures have not been applied, polyps may begin to appear - a formation from hypertrophied tissue filled with infiltrate. The more they become, the more difficult nasal breathing, so the patient is forced to breathe through the nose. There may be complaints about foreign body in the nasal passages, pain, stuffy ears and difficulty swallowing food.

Allergic

Against the background of prolonged rhinitis, provoked by seasonal allergies, a person may develop allergic sinusitis. It passes even without the use of antihistamines and is characterized by sneezing, constant itching in the nasopharynx, and redness of the eyes. There may be watery discharge from the nose, swelling that causes difficulty in breathing, and skin rashes.

Diagnosis of rhinosinusitis

When the first symptoms appear, you need to contact an ENT doctor who will analyze the patient's complaints and conduct a general examination. If the clinical manifestations of the disease are identical to those characteristic of rhinosinusitis, the doctor will prescribe additional examinations:

Anterior rhinoscopy (posterior - less often).
Endoscopy.
X-ray of the paranasal sinuses - to examine the sphenoid and frontal sinuses.
Ultrasound - for the diagnosis of cysts, inflammation of the frontal sinuses.
Computed tomography- to assess the anatomical features of the nose.
Laboratory identification of the pathogen - the most reliable is the diagnostic puncture of the maxillary sinus, but it may be necessary to culture the contents of the exudate, a blood test, and a smear for eosinophils.

How to treat

Therapeutic measures should be aimed at eliminating the pathogens that provoked sinusitis (if it is not caused by trauma) and affect the symptoms. For this purpose, sinus drainage is carried out - conservative or surgical, depending on the severity of the disease, and antiviral or antibacterial drugs. Additionally, immunomodulators are needed. TO symptomatic therapy can add:

regular ventilation of the room;
maintaining optimal humidity;
plentiful drink (there is an intoxication of the body).

Medical therapy

If rhinosinusitis is not complicated by a bacterial infection or pus, there is no need for antibiotics: they are mainly recommended at a severe stage, especially if the inflammation has gone to the frontal sinuses to prevent brain damage. Often, a penicillin and cephalosporin series, or macrolides are prescribed here, which destroy protein synthesis in the cell of a pathogenic bacterium. In other cases, complex drug treatment of rhinosinusitis consists of:

Mucolytics - to thin the contents of the sinuses.
Hormonal drugs(topical steroids) - for 3 weeks.
Antiviral drugs - Anaferon, Amantadine, etc.
Vasoconstrictor drops - on short term to restore the outflow of sinus contents, eliminate edema.

Surgical methods

The most common method of surgical treatment of rhinosinusitis is a puncture (puncture) of the maxillary sinuses. It is performed under local anesthesia, it is prescribed mainly for sinusitis with severe pain and a large accumulation of fluid. The procedure consists of washing the maxillary sinuses with an antiseptic and the subsequent administration of the medicine. The patient's condition improves rapidly, the inflammation is eliminated, but several procedures are needed for a complete cure, and the atypical structure of the sinuses can provoke complications. They may also be assigned:

YAMIK catheter is an alternative to puncture for sinusitis and ethmoiditis, non-invasive intervention. The antiseptic substance is fed into the sinus through a probe, after which the medicine is injected there. So you can clear all the sinuses, but you also need several procedures to achieve a complete cure for sinusitis.
Removal of polyps:
- Endoscopy - the introduction of a surgical instrument into the sinus through the nasal passage, healthy tissues are not damaged, the risk of recurrence is reduced by 50%.
- Sinusotomy - through opening the facial bone and removing part of it. The downside is a long rehabilitation, the presence of a large number of contraindications. Recurrence of sinusitis is not ruled out.

Non-drug methods

Nasal irrigation is the main procedure to help fight rhinosinusitis, which is carried out using saline or sea water according to the schedule with an interval of 1-2 hours. It helps to remove leaks, affect inflammation. If sinusitis was preceded by odontogenic sinusitis, rinses will be required oral cavity. In addition to saline, decoctions of herbs are used for this purpose. Additionally, the doctor may prescribe physiotherapy:

electrophoresis;
laser treatment;
exposure to diadynamic currents.

Treatment of sinusitis in children

Pediatric sinusitis therapy implies an emphasis on topical drugs, even if they are antibiotics. It is advisable to use vasoconstrictor agents (Otrivin, Nazivin) only at bedtime, 1-2 drops in the nasal passage. Doctors try not to use steroids and NSAIDs in children. Mostly babies from 2.5 years old are prescribed:

Bioparox - 1 press for each nasal passage 4 r / day.
Polydex - 1 injection into the nostril 3 r / day, the course of treatment is 5 days.
Protargol is a local antiseptic, 3 drops are injected into each nasal passage up to 3 times a day.

How to treat rhinosinusitis in adults

Washing the nasal passages can be done with a simple saline solution or take a spray of Aqualor, Aquamaris (they are also recommended for children). Vasoconstrictor drugs are selected on phenylephrine, naphazoline, tetrizoline - these are Sanorin, Vibracil, Otrivin. However, the basis of drug therapy is:

Antibiotics for bacterial infection - Erythromycin, Augmentin, Ceftriaxone.
Antipyretic at temperature - Paracetamol, Nurofen.
Topical corticosteroids to relieve inflammation and swelling - Baconase, Altsedim.
Mucolytics - Fluditec, Fluimucil.

Folk methods

In addition to drug treatment, you can use traditional medicine procedures: the main one is steam inhalation. They are carried out in chronic sinusitis without fever. You need to breathe hot steam for 10-15 minutes, using a decoction of sage, chamomile or calendula. A couple more recipes folk treatment:

After washing, instill thuja oil (1 drop in each passage) 2 times a day, especially if you need to cure rhinosinusitis in a child.
Mix 1 tsp. honey, baking soda and vegetable oil, warm and soak with a mixture of turunda, which must be inserted into the nose for 20-25 minutes. 3 times a day.
Bury Kalanchoe juice daily, 2 drops in each nasal passage.

Disease prevention

In view of the infectious etiology of sinusitis, strengthening the immune system remains the most reliable way of protection: regular intake of immunostimulants, normalization of work and rest regimes, prevention of beriberi, moderate physical activity. A few more points:

stop smoking;
treat colds in time, especially for children;
control indoor humidity.

Video

Rhinosinusitis - serious illness, in which the inflammatory process develops simultaneously in the nasal cavity and in one or more paranasal sinuses. Inflammation can begin in any paranasal sinus. The disease can be viral, bacterial or fungal in nature; allergic rhinosinusitis is also isolated.

There are acute, recurrent and chronic forms of the disease. Acute rhinosinusitis lasts no more than 12 weeks, and its symptoms completely disappear after recovery. The recurrent form of the disease is characterized by the occurrence of 1 to 4 episodes of the disease during the year, periods of exacerbation alternate with periods of remission lasting at least 2 months.

The presence of signs of the disease for more than 3 months gives grounds to say that the patient has developed chronic rhinosinusitis.

What it is?

Rhinosinusitis is a complex disease that has developed as a result of the impact of viruses or bacteria on the nasal passages and sinuses. When the inflammatory process spreads to the inside of the nose, the mucosal tissues swell, thicken and block the anastomoses through which the pathological secret should come out. Further, purulent contents begin to accumulate in the sinuses, which leads to the development of pathology.

Most often the reason this disease is an untreated acute viral infection. Pathology can develop against the background of influenza, SARS, adenovirus and others infectious diseases. When rhinosinusitis occurs, the causes of inflammation are determined:

fungal microorganisms;
polyposis;
allergic reactions;
staphylococcus and streptococcus.

If the nose is injured, a curvature of the nasal septum and the appearance of other defects are possible, which can also lead to narrowing of the sinuses and, as a result, to the accumulation of pus. If rhinosinusitis has appeared, then the symptoms and treatment in adults and children require special attention. Depending on the type of this pathology, the appropriate treatment is selected.

Classification

By etiology:

Viral - rhinoviruses, influenza and parainfluenza viruses, adenoviruses are involved here, and sinusitis of viral etiology always occurs in an acute form
Bacterial - pathogens are pneumonia and pyogenic streptococci, hemophilus, Pseudomonas aeruginosa and Escherichia coli, moraxella, Staphylococcus aureus, enterobacteria.
Fungal - the disease is provoked by aspergillus, Alternaria, culvularia, mainly it is a superinfection (co-infection of an infected cell with another strain or microorganism).
Mixed - inflammation is of a bacterial nature, and then it gets a viral or fungal complication, or it all starts with the flu, and then a bacterial disease is added.

According to the localization of the inflammatory process:

maxillary - classic sinusitis;
frontal - affects the frontal sinuses;
ethmoidal - inflammation of the ethmoid sinuses;
sphenoidal - an inflammatory process in the sphenoid sinuses.

According to the severity of the flow:

Light form.
Average.
Heavy.

According to the nature of the manifestation:

Spicy.
Subacute.
Chronic.
Recurrent.

Symptoms

The main manifestation of rhinosinusitis in adults with any localization of inflammation is a violation of nasal breathing, to which mucous secretions can be added (at the last stage - with pus), which are absent if the nose is blocked. Common symptoms of rhinosinusitis in people of all ages include:

an increase in body temperature to 38-39 degrees (absent in the chronic nature of the disease);
runny nose;
weakness;
loss of appetite;
headaches (towards the end of the day);
difficulty breathing;
nasal voice;
smell disorder.

Acute rhinosinusitis: symptoms

Acute rhinosinusitis is characterized by a pronounced clinical picture. A few days after the onset of the progression of the disease, a person has swelling of a part of the face on the side of the lesion, paroxysmal pain in the head, and a decrease in working capacity. If the symptoms of this form do not subside within 7 days, then this indicates the addition of a bacterial infection. In this case, it is necessary to deliver the patient to the hospital as soon as possible and carry out antibiotic therapy.

Symptoms of acute rhinosinusitis:

pronounced intoxication syndrome;
weakness in the whole body;
decreased sense of smell up to its complete absence;
hyperthermia;
headache of varying degrees of intensity. Paroxysmal character;
nasality;
mucus runs down the back of the throat.

Typical symptoms of rhinosinusitis (depending on the affected sinuses):

acute sinusitis is characterized by severe pain and heaviness from the affected sinus. The pain syndrome tends to increase during the implementation of the turn or tilt of the head;
with acute frontal sinusitis, the appearance of painful sensations in the frontal region is noted;
with ethmoiditis, the first symptom is the appearance of nasality;
with sphenoiditis, a person has a severe headache.

Degrees of acute rhinosinusitis:

light. In this case, the symptoms are not pronounced. Hyperthermia up to 37.5–38 degrees is noted. If in this moment to conduct an x-ray examination, then the image will show that there is no pathological exudate (mucous or purulent) in the sinuses;
average. The temperature rises to 38.5 degrees. During palpation of the affected sinuses, the occurrence of pain syndrome is noted. The pain may radiate to the ears or teeth. Also, the patient has a headache;
heavy. Severe hyperthermia. On palpation of the affected sinuses, severe pain is manifested. Edema is visually noted in the cheek area.

Chronic rhinosinusitis: symptoms

Symptoms of chronic rhinosinusitis appear gradually in the patient. Sometimes they can be expressed not brightly, and the patient does not pay attention to them. But as the disease progresses, the following symptoms appear:

decreased sense of smell;
nasal congestion. This symptom gives the patient a lot of inconvenience, since he cannot fully breathe;
voice becomes nasal;
purulent exudate may periodically stand out from the nose;
mucus from the nose flows down the back of the throat;
lacrimation;
heaviness in various parts of the face. This symptom is due to the accumulation of exudate in the sinuses;
headache. Taking painkillers gives only temporary relief, after which this symptom returns again.

During an exacerbation, the following symptoms are observed:

increased nasal congestion;
hyperthermia, but not higher than 37.5–38 degrees;
viscous brown, green or white mucus is released from the nasal cavity;
pain in the facial area;
severe headache. This symptom manifests itself most intensely in the case of progression of the purulent process.

polyposis

Running inflammation of the paranasal sinuses leads to the growth of the mucous membranes. Chronic polyposis rhinosinusitis develops against the background of a decrease in the concentration of immunoglobulin G. The provoking factor is exposure to aggressive chemicals, allergens, viruses, and a hereditary predisposition to allergies. The development of the disease occurs according to the following scheme:

there is swelling of the mucous membranes;
the walls thicken, grow;
outgrowths - polyps are formed;
in the sinuses there is a stagnation of purulent contents.

The disease is dangerous for its complications - meningitis, damage to the eyeballs. Required surgery- Removal of polyps. The clinical picture is characterized by symptoms:

nasal congestion;
feeling inside a foreign body;
loss or decrease in taste, smell;
swallowing problems - with a running form;
sleep disturbance;
tachycardia;
stuffy ears;
chronic fatigue;
pain in the head, sinus area.

Allergic

Provoking factors in the development of this type of disease is exposure to allergens. It can be food, medicines, plants, dust, fungal spores, animal hair. Allergic rhinosinusitis requires the exclusion of irritants that lead to illness, the use of antihistamines medicines.

The disease is distinguished by clinical symptoms:

redness eyeball;
copious clear exudate from the nose;
lacrimation;
itching in the nasopharynx;
malaise;
headaches;
drowsiness;
sneezing.

Purulent

The most common cause of the disease in this case is the common cold. When viruses enter the nasal passages, inflammation develops, which is accompanied by swelling of the mucous membrane. As a result, the mucous contents of the sinuses come out with difficulty, and in places where the secret accumulates, a favorable environment is formed for the reproduction of pathogens.

The formation of pus in the sinuses is often accompanied by a rise in temperature to high levels. The patient suffers from headaches, aggravated by bending over, weakness and general malaise appear. Nasal breathing is difficult due to congestion, a person tries to breathe through the mouth, which can lead to the development of a cough.

In especially severe cases, there is bad smell mouth, swollen cheeks and eyelids. In the affected sinuses there is a feeling of fullness. Against the background of high temperature, general intoxication of the body may develop.

Vasomotor

If there is a violation in the paranasal sinuses and the nasal cavity of the tone of the blood vessels, swelling of the mucous membranes occurs. Vasomotor rhinosinusitis begins against the background of colds, SARS. Provoke the development of the disease:

frequent use of nasal drops;
stressful situations;
hormonal changes;
smoking;
air temperature fluctuations;
hypothermia;
alcohol consumption;
chronic diseases of the stomach;
anatomical pathologies of the nose;
injury.

The sudden expansion of blood vessels leads to the appearance of edema, while the clinical picture of the disease is characterized by constant nasal congestion, watery mucous secretions that turn into green exudate with the progression of the disease. Symptoms are observed:

nasal voice;
sneezing
lacrimation;
labored breathing;
decreased sense of smell;
headache;
lack of appetite;
sleep disorder;
temperature rise.

catarrhal

This is one of the respiratory diseases, in which the mucous membrane of the nasal cavity becomes inflamed, as well as the paranasal sinuses. The acute stage of the disease is not dangerous and responds very well to treatment. The symptoms of the pathology are in many ways similar to those of other types of rhinosinusitis:

pain syndrome with localization in the sinus area;
swelling of the mucosa and its redness;
an increase in body temperature, sometimes to very high levels;
conjunctivitis;
tearing;
profuse mucous discharge.

Complications of this disease are extremely rare. However, some patients may develop bacterial rhinosinusitis against the background of catarrh. In this case, the treatment is supplemented with antibiotics.

Complications

Viral sinusitis is usually harmless, but bacterial infection can have dire consequences, especially if it is not treated properly. Complications of rhinosinusitis arise as direct erosion of the thin walls of the sinuses adjacent to the orbit and skull, or through hematogenous spread.

Among possible complications may be:

orbital cellulitis;
orbital abscess;
osteomyelitis;
subdural or epidural empyema;
meningitis;
brain encephalitis;
cortical thrombophlebitis;
cavernous sinus thrombosis.

Early detection of these complications is vital.

signs severe course illnesses include:

fever
swelling around the eyes;
red and inflamed skin;
severe facial pain
sensitivity to light;
diplopia and decreased visual acuity.

If you notice these symptoms, contact your doctor immediately!

How to treat rhinosinusitis?

When the first signs of the disease appear, you should immediately contact an ENT doctor. Only he will make the correct diagnosis and prescribe the appropriate treatment. It is strictly forbidden to self-medicate. During pregnancy, the treatment of rhinosinusitis is prescribed by an ENT with the permission of a gynecologist.

Basic principles drug treatment rhinosinusitis in adults:

Antibiotic therapy is carried out taking into account the results of microbiological examination of the contents of the sinuses. Patients are prescribed cephalosporins, macrolides, tetracyclines. Most effective means with rhinosinusitis are "Amoxicillin", "Azithromycin", "Clarithromycin". The duration of taking antibacterial drugs is 10-14 days. In acute rhinosinusitis, accompanied by high fever, intramuscular antibiotics are prescribed. For the treatment of children, antibiotics are used in the form of suspensions or soluble tablets.
Local antibacterial nasal sprays - Polydex, Isofra.
To reduce the symptoms of inflammation - corticosteroids and antihistamines.
Local decongestants and vasoconstrictors - nose drops "Nazivin", "Tizin", "Rinonorm". They should not be used for more than 5 days due to possible development addiction.
Local combined sprays - Vibracil, Rinofluimucil.
Immunomodulators - "Immunal", "Imunorix", "Ismigen".
Mucolytics for liquefying mucus and normalizing outflow - Sinupret, ACC, locally Aquamaris.
Anti-inflammatory and detoxification therapy - antipyretic and painkillers "Ibuprofen", "Paracetamol".

Folk remedies

At home, you can treat rhinitis and sinusitis in adults folk remedies. But they should not be the only medicine, it is better to supplement the doctor's prescriptions with them. It is not recommended to use folk remedies in children.

As ingredients for the preparation of homemade drops, you can use the following products: aloe, beets, honey, propolis, onions, cyclamen, etc.:

The juice from one root crop is diluted in equal proportions with water. Drip nose 4 rubles / day, 3-4 drops into each nasal opening;
Combine the juice of beets, carrots with olive oil in a ratio of 1: 1, add 2 k. Garlic juice, let it brew. Use 2 drops, 2 rubles / day;
Grate the cyclamen root, dilute the resulting juice with boiled water 1:4. Insist in a cool place for 2 hours. Use for 7 days, 2 drops in each nostril. Daily rate- one instillation after waking up.

To prepare the ointment, you need aloe juice, bulbs in the same amount, to which you need to add Vishnevsky ointment. Moisten with the resulting turunda solution, insert into the nasal passages for 10 minutes. Apply morning and evening for ten days.

Herbal medicine and simple products will help alleviate the course of chronic rhinosinusitis and even completely get rid of the disease. Before using traditional medicine, you should consult with a specialist in order to avoid side effects, deterioration and development of comorbidities.

Surgery

With inefficiency conservative treatment moving on to surgery.

A puncture of the inflamed sinuses allows you to extract pus and administer antibacterial drugs. A special needle is used to make a puncture in the thinnest part of the maxillary sinus. After washing the sinus with antiseptics, medicine is injected into it.
An alternative to puncture is the use of a Yamik catheter. A rubber catheter with two inflatable balloons is inserted into the nose, which close the nasal cavity, then the contents are removed with a syringe.
A non-invasive method of treating the disease is the movement of drugs, the so-called "cuckoo". This procedure allows you to simultaneously remove the contents from the sinuses and rinse them with an antiseptic. To prevent the remedy from getting into the throat, the patient must constantly say “cuckoo”.

Forecast

Rhinosinusitis is successfully treated with modern methods of drug and surgical therapy, in the absence of complications, the prognosis is favorable.

Rhinosinusitis is a complex disease in which the paranasal sinuses and, in fact, the nasal mucosa, are simultaneously affected by an infection or viruses. As a rule, the inflammatory process starts in the maxillary sinus and later passes to the main mucous protective structures.

Signs and symptoms

The main symptoms of rhinosinusitis usually include significant difficulty in breathing. Regardless of the degree and severity of the disease, the patient is also observed with localization at the base of the nose, a constant release of purulent secretion with its regular entry into the nasopharynx, as well as a general swelling of the nasal mucosa.

The remaining symptoms determine the main type of this disease and its specific form.

The main types and forms of rhinosinusitis

Current and clinical pictures with different types of the above disease, they differ in particular cases:

Acute rhinosinusitis

The acute form of this type of disease is characterized by severe intoxication of the body, a rapid and vivid manifestation of the above symptoms. Within five to seven days after the onset of inflammatory processes, a person cannot lead a full life, his performance is significantly reduced, pain syndromes in the head become paroxysmal in nature.

At the same time, body temperature almost always rises, often overcoming the mark of 39 degrees Celsius. Puffiness of the mucous membranes can go beyond the organ, and spread to the eyelids and upper facial tissues. Pathogenic microflora actively reproduces and captures more and more spaces, affecting neighboring sinuses and provoking complications.

Chronic rhinosinusitis

The inflammatory process of this kind is less pronounced when compared with the previous form of rhinosinusitis, but it is longer and can often proceed in a sluggish form from twelve to thirty weeks. The main symptoms of this condition are normal temperature, a significant weakening of hearing and smell, constant moderate swelling of the mucous membranes with a strong blockade of the nasal passages, as well as a nasal voice and a mucopurulent secret released from the nose.

Pain syndromes in this case appear much less frequently, they are “smeared” and, if they occur regularly, cause a feeling of weakness and irritation.

In the chronic form of rhinosinusitis, the likelihood of getting a complication is much higher than in the case of an acute course of the disease.

Polypous rhinosinusitis

Further progression of chronic rhinosinusitis usually leads to the formation of polyps - active growth and thickening of the walls of the mucous membranes, as a result of which the swelling increases significantly in size, and vasoconstrictor drugs do not help temporarily restore normal breathing. This condition is often accompanied by stagnation in the sinuses, a large amount of purulent masses, which further activate the inflammatory processes in the body and form the basis for the development of concomitant complications, in particular deadly meningitis and tissue damage / eyeballs.

This type of rhinosinusitis can only be cured with surgical methods by mechanically removing polyps.

Allergic rhinosinusitis

The main cause of allergic rhinosinusitis and catarrhal purulent course of the disease is the effect of allergens on the body. Such allergens can be plant pollen, wool, body reactions to certain drugs, fungal spores, car smog and dust, etc.

The main symptom, directly indicating an allergic type of disease, is considered to be side rashes on the skin, significant redness of the membranes of the eyeball, itching in the nasopharynx, and abundant clear discharge from the nose. Fighting allergic rhinosinusitis with antibiotics is useless; antihistamines and isolating the person/environment from the allergen are used to effectively get rid of the problem.

Treatment of rhinosinusitis

The treatment of rhinosinusitis in adults is a complex process, including the elimination of the cause that caused the reaction, the elimination of the focus of inflammation, the reduction of symptoms, and the restoration of natural immune defenses.

Antibacterial therapy with broad-spectrum antibiotics is drugs or alternative Augmentin. The duration of such a course does not exceed ten days.
Maximum removal from the nose and sinuses, pathogenic secretions. For this, (Naphthyzinum), moisturizing and mucolytic drugs (Aquamaris), as well as means for (saline) are used.
Reducing inflammation. For this, the ENT doctor may advise corticosteroids (hydrocortisone) and antihistamines (Loratadine).
Strengthening immunity. It can be carried out both at the local level with the help of special homeopathic sprays (IRS 19), and general procedures, including normalization of nutrition, taking interferon, and regular exercise.

Treatment of the disease in children

Rhinosinusitis in children is treated in a more gentle way, excluding the use of broad-spectrum antibiotics and glucocorticosteroids. In this case, it is rational to use local steroids / antibiotics (Isofra, Bioparox, Protargol), rinse the sinuses more often with saline solutions, use Borjomi, and strengthen the child's immunity.

Only in the most extreme case, with a very advanced form of the disease and in the event of a direct danger to the life of the baby, is it necessary to use classic "adult" drugs that have strong side effects and causing serious harm to the liver, kidneys and heart of your child.

Folk remedies

Folk remedies against rhinosinusitis, of course, are not a panacea for this disease, but they can really help to recover faster in the case of complex therapy with medications.

The most popular methods "from the people" are considered to be heating the nasal septum with hot salt in a bag, inhalation and instillation into the nose. herbal preparations based on calendula, valerian, chamomile, eucalyptus and sage, as well as compresses based on tinctures of the same herbs. It should be understood that the above methods must be agreed with your doctor in order to prevent deterioration and the occurrence of concomitant diseases.

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Get well soon!