Sinusitis is an inflammation of the maxillary sinuses of the nose, which is very common all over the world. It carries a danger for many systems of the human body, so it is important to know how to identify sinusitis in order to distinguish it from other diseases and understand what actions should be taken. The day of avoiding complications or the transition of the disease into a chronic form, it is necessary to know how sinusitis manifests itself, and to identify it at an early stage.
Symptoms of the acute form of the disease
Sinusitis can occur in two main forms - acute and chronic.
The most common causes of the acute form are bacteria, viruses and allergens, which lead to swelling of the nose and a deterioration in the outflow of mucus from the air chamber.
The initial stage of the disease is short, since the development of the disease is very rapid.
At the same time, the first signs of sinusitis are similar to ordinary rhinitis, therefore, it is not possible to assume sinusitis right away.
The main signs of sinusitis in adults:
- A runny nose with discharge of green and yellow, which makes it possible to diagnose a purulent course of sinusitis. Blowing your nose does not improve the situation.
- Pressing pain in the area of the affected cavity may appear as pulsating. It intensifies when the head is tilted forward or palpation and is defined as the main sign of sinusitis. Gradually, the pain syndrome spreads to the entire head, weakens somewhat in a horizontal position.
- Nasal congestion, alternating nostrils. In this regard, difficulty in nasal breathing begins and the transition to breathing through the mouth, which, with sinusitis in adults and children, causes nighttime snoring and sleep disturbances.
- Increase in body temperature up to 38-39 degrees, chills and fever. Hyperthermia is a sign that bacteria are actively multiplying in the sinuses, and the purulent stage of the disease begins.
- Sneezing, coughing due to mucus running down the walls, feeling of fullness and pressure in the ears, muscle aches.
- Swelling of the cheeks, eyelids and area around the eyes.
- Toothache, worse when chewing, and bad breath.
- Changing the timbre of the voice, it becomes lower, nasal appears.
- Decreased working capacity, increased fatigue, memory impairment.
- Weakening of the sense of smell up to its complete loss.
The first symptoms of sinusitis may appear as a common respiratory illness, especially if a virus becomes the causative agent. In the early stages, in order to find out if there is a lesion of the paranasal chambers, a doctor's consultation is required.
Symptoms of sinusitis in adolescents are more acute, the manifestation of the respiratory system is especially noticeable. Breathing becomes heavy, intermittent and negatively affects all body functions.
Otherwise, the signs of adolescent sinusitis are similar to those of sinusitis in adults.
If the temperature, yellow-green nasal discharge, cough and headache persist within 4-5 days, then it can be argued with a high degree of probability that these are the initial signs of sinusitis.
Signs of the chronic stage of the disease
With inflammation of the maxillary sinuses, symptoms that last more than 12 weeks indicate that the disease has become chronic. Signs and symptoms of chronic sinusitis appear blurred. Only an otolaryngologist knows how to recognize sinusitis in a sluggish form, and then only after additional research.
How to understand that sinusitis is not completely cured and continues to develop imperceptibly in the maxillary sinuses:
- The presence of low-grade body temperature (up to 37 degrees). It is practically not felt by the patient subjectively, but objectively weakens the body.
- A persistent runny nose, which is not affected by traditional rhinitis medications, the doctor sees a "streak of pus" during rhinoscopy, which stands out from under the middle turbinate. May worsen when the head is tilted.
- Pain in the head and behind the eye sockets, which is better when lying down, but may begin on blinking.
- Conjunctivitis and swelling of the eyelids in the morning indicate that the inflammatory process from the airway covers the orbit of the eye.
- Nasal congestion is often unilateral, and nasal breathing is absent or difficult.
- Dry cough caused by secretion with purulent contents down the walls of the pharynx. In this case, expectorant and antitussive drugs do not help.
- Deterioration of smell and taste.
What is sinusitis in a latent form, you can find out only after studying all the subjective and objective signs. Subjectively, with sinusitis, the patient complains of an unpleasant-smelling discharge from the nose, poor appetite and sleep, headache, a feeling of pressure in the projection of the sinus. Objectively, his symptoms are confirmed by examination data: swelling of the eye membranes, thickening of the nasal concha, signs of dermatitis and cracks between the upper lip and the vestibule of the nose, pain on palpation of the face. In addition, the chronic stage of sinusitis is complemented by general symptoms such as sneezing, coughing, weakness, and fatigue.
Inflammation is accompanied by the presence of a large number of symptoms that add up to an extensive clinical picture. However, the most characteristic symptoms of sinusitis are a runny nose, fever, and pain. It is worth dwelling on them in more detail.
Nasal discharge
The main inflammatory process in maxillary sinusitis occurs in the closed space of the maxillary sinus. Based on this, the ENT doctor can understand at what stage of development the disease is at the current time.
So, how to identify sinusitis and determine its stage, based on the color of the snot:
- Initial stage. The mucus is liquid, transparent and odorless, watery, it can also be white. The discharge is not much different from the usual rhinitis with a respiratory illness, so it is difficult to differentiate them.
- Acute stage. The color of the snot is dominated by a green tint, indicating the activity of pathogenic bacteria inside the cavity.
- Purulent stage. The discharge becomes yellow or brownish, characteristic of the purulent component. The consistency of the snot becomes thicker, they often come off in clots, and may contain traces of blood.
- The severe (advanced) stage is distinguished by a gray-green tint of mucus and its unpleasant odor, which indicates stagnation in the chamber.
- Recovery stage. The color of the snot changes to white, the consistency is thick. Their number gradually decreases in parallel with the subsidence of other signs of the disease until they disappear completely.
The presence of inclusions of various shades in the exudate should suggest fungal sinusitis, and their unpleasant odor, in parallel with dental problems, should suggest an odontogenic form of the disease. A liquid transparent secret for a long time is a sign of an allergic causative agent of sinusitis.
Many patients are frightened by the presence of veins and blood clots in the exudate. They ask how to find out if this phenomenon is dangerous. As a rule, in most cases, this phenomenon does not pose a serious threat to the body. The causes of blood can be:
- Congenital thin vascular walls.
- Fragility of blood vessels and capillaries due to past diseases.
- Excessively sharp blowing of the nose with severe nasal congestion and swelling of the anastomosis.
- The use of vasoconstrictor drugs in the nose for several months.
- Consequence of earlier damage to the bridge of the nose.
- The presence of severe chronic diseases in a person: tuberculosis, diabetes mellitus, liver problems.
Small bleeding can be stopped by applying cold to the bridge of the nose and tilting your head back. If the bleeding is severe and does not stop, an ambulance should be called.
Body temperature
If a person has sinusitis, the symptoms almost always proceed against the background of hyperthermia. The severity of the disease and the nature of its course can initially be determined by the patient's body temperature even before a detailed examination:
- Subfebrile temperature (about 37 degrees) develops in the chronic form of the disease during the period of remission or in the mild form of the disease. This temperature is also characteristic of the initial stage of polyposis, cystic, radiation and fungal sinusitis. In the presence of a malignant tumor, hypothermia may even be observed. If the bacterial component is attached to the original pathogen, then the temperature rises rapidly.
- Febrile (37 to 38.5 degrees). As a rule, in this case, the sinusitis is in a catarrhal form, or pathogenic bacteria have joined the allergic sinusitis.
- High (more than 38 degrees). This is a sign of an acute purulent infection, when microbes multiply rapidly and pus accumulates in the infected cavities. In addition, such a fever is caused by an exacerbation of sluggish sinusitis.
While the temperature is in the range of 37-38.5 degrees, it is not recommended to bring it down with antipyretic drugs. The only exceptions are infants and people with poor tolerance to hyperthermia. Higher fever already requires medical attention.
Pain syndrome
Unpleasant sensations in the nose and pain are obligatory companions of inflammation of the respiratory cavities. Pain can be localized in different parts of the head and take on a different character.
The cause of an unpleasant feeling in the nose and cheekbones at an early stage is the inflammation itself, as well as the swelling of the nasal cavity and the connecting canal of the sinus caused by the pathogen. At the same time, the already thin anastomosis decreases in diameter, preventing the normal drainage of the accessory pocket or completely blocking it.
For this reason, bacteria proliferate in an almost isolated cavity, and the amount of exudate, consisting of mucus and pus secreted by the goblet cells of the epithelium, sharply increases. The accumulated fluid presses more and more on the walls of the sinus, causing pain that becomes more intense and widespread. Tilting the head forward responds with an increase in pain syndrome under the eyes in the projection of the infected cavities. This symptom is characteristic only of sinusitis and allows it to be differentiated from other sinusitis, in particular, frontal sinusitis.
When the patient's condition worsens and without proper therapy, pain spreads throughout the skull and may occur in different places or not be clearly localized at all. It can be spilled on the forehead, ears, teeth, gums, or spilled. If the syndrome is very severe, then analgesics must be used.
How to relieve sinusitis symptoms
It is ineffective to remove any individual signs of inflammation of the accessory pockets. Without suppressing the primary source of infection, all symptoms will recur over and over again. Therefore, therapy for this dangerous disease should be carried out in a comprehensive manner.
However, for the correct construction of a treatment strategy, it is necessary to correctly diagnose maxillary sinusitis and differentiate it from other diseases with similar symptoms. For this, in addition to interviewing the patient, the otolaryngologist, depending on the need, conducts instrumental studies, such as:
- Visual inspection of the nose (rhinoscopy).
- Fluoroscopy in different projections. In the chronic form, a contrast dye is sometimes used, which is injected into the cavity. In women who are expecting a baby, the examination is carried out using an ultrasound machine (sonography).
- Computed tomography for a better study of bone tissue.
- General blood analysis.
- A swab from the nasal passage to determine the pathogen by bacteriological examination.
The most radical remedy that can quickly relieve symptoms is a puncture of the sinus wall with a special needle.
After the puncture, the needle is fixed in the wall of the cavity for some time, and the exudate is sucked through it and the drugs are injected.
Most people try to avoid surgery, and try to get rid of the disease with a medication, which includes:
- The use of antibiotics is mandatory for the bacterial form of the disease. The most commonly used tablet formulations of the genus penicillins (Flemoxin solutab, Amoxiclav) and macrolides (Macropen) or injections of cephalosporins (Ceftriaxone, Cefazolin). At the same time, it is recommended to simultaneously use fermented milk products (yogurt) or probiotics (Bifiform, Linex).
- Antipyretic drugs. They are needed to reduce hyperthermia and fight pain. Such drugs as Nurofen, Panadol, Aspirin have proven themselves well. All of them have a different active substance, therefore, they should be prescribed by the attending physician, taking into account all contraindications and individual characteristics of the patient.
- Decongestants can be local or general. Local - drops and sprays in the nose with a vasoconstrictor effect (Galazolin, Rinazolin, Naphtizin). General - combination drugs usually used for influenza and SARS.
- Antiseptics are used for injection into the nasal passages (Isofra, Polydexa) and for washing the sinuses (Dioxidin).
- Mucolytics are used to liquefy the secreted mucus and make it easier to evacuate (Fluditek).
- Corticosteroids work well for different types of sinusitis, have a pronounced decongestant and antihistamine effect (Avamis).
Both at home and in the hospital, sinus lavage is performed to remove mucus from the paranasal sinuses and normalize the functioning of ciliated epithelial cells.
