Symptoms of chronic sinusitis

Inflammation of the maxillary sinuses is a disease that carries a serious threat to the human body. It can manifest itself in an acute form with pronounced symptoms that must be removed as quickly as possible. In chronic sinusitis, symptoms appear blurred, which often causes complacency in the patient. However, this latent form of the disease is no less dangerous for people. It is important to be able to discern the signs of chronic sinusitis in time.

The reasons for the development of the disease

Chronic sinusitis is most often a consequence of the acute stage of the disease, which has not been completely cured, or therapy has been started with a delay. The basis of this form of the disease is a strong narrowing of the connecting canal between the nasal cavity and the maxillary chamber, which impairs its drainage and promotes colonization by pathogenic microflora. Most often, when sowing, streptococci or other bacteria are found, less often anaerobes and viruses. Fungal flora can also provoke the development of a persistent form of sinusitis. Polymicrobial compounds are often detected, i.e. both fungi and bacteria are present in the sinuses at the same time.

The transformation of acute sinusitis into a sluggish form occurs under the influence of such factors:

The presence in the nasopharynx of persistent sources of infection, such as tonsillitis and rhinitis in a long-term manifestation.
Untimely initiation of treatment for the acute form of the disease or unauthorized interruption by the patient of the course of prescribed antibiotics when the general condition improves.
Anatomical individual features of the structure of the internal nose. The presence of thorns or deformities of the nasal septum, proliferation and atrophy of tissues in the nasal cavity cause difficulty in nasal breathing with the subsequent development of the disease. Such disorders can be both acquired as a result of trauma or age-related changes, and congenital as a result of intrauterine growth disorders.
Polyps change the natural passage of the air flow, worsen the outflow of secretions, stimulating the phenomena of a stagnant nature.
The formation of true cysts and pseudocysts, which, when growing, can press on the walls of the sinuses, causing pain, as well as leading to bone defects.
Dental problems, consisting in diseases of the root teeth of the upper jaw and possible formations of fistulas during dental operations.
Unfavorable external factors (frequent hypothermia, polluted air, poor working conditions) and own bad habits (smoking, drinking alcohol).
The state of general and local immunity.
Allergic reactions.

Symptoms of the disease

Symptoms of chronic sinusitis in adults during remission are mild. However, according to some signs, it can be understood that the inflammatory process continues in the body:

Headache that most often affects the area around the eye sockets. In the horizontal position, the pain gradually increases, and in the vertical position, it weakens. Sometimes pain may be absent altogether.
Nasal congestion, when the head is tilted, discharge periodically appears, often with pus. They are not amenable to treatment.
"Weighting" of the face, there is a constant feeling of pressure and fullness from the inside in the cheeks.
Due to the regular drainage of mucus from the maxillary cavities along the walls of the throat, there is a feeling of "lump in the throat".
Conjunctivitis and swelling of the eyelids in the morning.
Violation of the sense of smell, which causes a lot of inconvenience in the process of human life.
Unprovoked lacrimation.
Feeling of stuffiness in the ears, hearing impairment.

A feature of this ailment in children is pronounced swelling of the mucous membranes of the maxillary sinuses, as well as a serious violation of nasal breathing. In such cases, it is recommended to urgently consult a doctor.

Experts divide all the symptoms of latent sinusitis into three groups:

Local subjective. Formed on the basis of a patient survey. Patients complain of constant headaches, purulent nasal discharge with an unpleasant odor, a feeling of pressure in the area of the affected cavity, lack of nasal breathing and poor appetite.
Local objective. Revealed upon examination by an otolaryngologist. Diffuse hyperemia and edema of the membranes of the eyes are clearly visible. Rhinoscopy shows swelling and thickening of the turbinates. On palpation of the face, soreness appears in the projection of the affected chambers. Dermatitis, impetigo, eczema and cracks appear between the lip and nose. Dental problems are often recorded: caries, periodontitis.
Are common. This is a cough, sneezing, headache, decreased performance, fatigue. Depending on the season, these signs can manifest themselves with different intensities.

Like any sluggish illness, sinusitis makes itself felt most vividly during exacerbations. As a rule, in the summer, the symptoms of the disease subside, and become more active in the cold period, along with an increase in the incidence of respiratory ailments. With an exacerbation of sinusitis, the symptoms become more pronounced, the patient begins to feel much worse. The following signs are recorded:

Increased body temperature, usually not higher than 37.5 degrees, slight chills.
General malaise, feeling of weakness and "weakness".
Irritation of the nasal mucosa with frequent sneezing.
Cough, sore throat and sore throat.
Severe pain syndrome with uncertain localization. It can be given to the forehead, root of the nose or teeth; it is noticeably aggravated by coughing, turning the head, or bending forward.
The nose is stuffy and the discharge is green. After about a week, the mucus becomes yellowish, and the purulent phase of the disease begins.
The timbre of the voice changes, it becomes deaf and nasal.

Often, latent sinusitis goes in parallel with inflammation of the cells of the ethmoid labyrinth, so the symptoms of both diseases are mixed.

Types of chronic sinusitis

Chronic inflammation of the maxillary sinuses of the nose is divided into several subspecies, depending on its symptoms and the process of flow. Based on this, the following types of latent sinusitis are distinguished:

Catarrhal. It can be one-sided and two-sided, while the entire mucous membrane of the cavity is inflamed, bloodshot and edematous. The airway itself is filled with serous mucus.
Purulent. It develops during an exacerbation, the content of the exudate changes, instead of serous fluid, pus accumulates in the voids.
Parietal hyperplastic. Its essence consists in an increase in the number of cells of the mucous membranes, later, due to hyperplasia, polyps develop. It is characterized by abundant and frequent discharge, the nose is filled alternately on one side or the other.
Fibrous. Due to the thickening of the tissues, problems arise with the drainage of the sinuses, the outflow of fluid is disturbed, and congestion develops.
Polypous. The reason is the growth of a polyp in the adventitious chamber, which interferes with the normal functioning of the epithelium.
Cystic. It is similar to polyposis, only a cyst becomes the cause of the disease, which can grow anywhere in the nasal cavity, interfering with the normal passage of the air flow.
Allergic. It can appear suddenly when exposed to a strong allergen. An active reaction of the mucous membrane leads to an abundant secretion, this process is aggravated by tissue edema.
Mixed. With this option, several types can be combined in one patient, for example, allergic and purulent.

If we consider sluggish sinusitis from the point of view of the source of infection, then the classification is as follows:

Hematogenous. The most common, arises from the entry into the accessory pockets of pathogens from the external environment - viruses or pathogenic bacteria.
Rhinogenic. There is a process of transformation of acute sinusitis into a latent form due to frequent rhinitis.
Traumatic. It is a consequence of a violation of full-fledged nasal breathing due to anatomical pathologies of the nose, congenital (thorns, curvature of the nasal septum, adenoids) or acquired character (surgery, trauma).
Odontogenic. It develops as a result of infection from the oral cavity from diseased teeth.

Complications of chronic sinusitis

Sinusitis in any form is itself a dangerous ailment, as it leads to severe intoxication of the body. In addition, it can provoke a number of complications that affect other vital human systems. Consider the most common consequences of the disease:

The development of complicated forms of laryngitis (laryngeal edema), tonsillitis (inflammation of the tonsils) and pharyngitis (inflammation of the pharynx).
Impaired memory and attention due to cerebral hypoxia. Other organs suffer from lack of oxygen, albeit to a lesser extent.
Dacryocystitis. The defeat of the lacrimal sac, there is unprovoked constant lacrimation, sometimes the release of pus. In this case, the palpebral fissure narrows, the lacrimal sac hurts.
Inflammatory processes in the soft tissues of the face with damage to muscle and subcutaneous tissue.
Intracranial complications. This is the most dangerous consequence of sinusitis, which can lead to the development of encephalitis, meningitis and brain abscess. Mortality in this course of events is very high.

The transition of inflammatory processes to the lower respiratory tract (bronchitis, pneumonia) or ears (acute otitis media).
Inflammation of the optic nerve and eyeball can cause a sharp deterioration in vision or complete blindness.
Interruption of breathing at night (apnea) leads to poor sleep and cardiovascular problems.
Sepsis due to the penetration of a pathogen into the bloodstream.
Asthma due to defective nasal breathing and the development of pathogens in the respiratory organs.
Inflammation of the trigeminal nerve, threatening severe pain, swelling of the face and impaired facial expressions.

Sinusitis negatively affects the human body throughout the entire time of its presence, regardless of whether the disease is in remission or exacerbation.

The presence of an unextinguished focus of infection in the sinuses located near the brain, eyes, nerves and large blood vessels makes it a source of constant danger.

Diagnosis of the disease

To establish an accurate diagnosis and correct differentiation of chronic inflammation of the maxillary sinuses from other diseases that have similar symptoms (for example, inflammation of the trigeminal nerve of the face), an otolaryngologist conducts a visual examination and instrumental studies.

Physical examination is usually not effective enough. Due to the absence of severe pain, palpation of the projection of the affected organ is uninformative, and the result of percussion (tapping) of the anterior sinus wall is blurred due to the relatively thick mass of skin and soft tissues.

Instrumental examination is much more effective. In a medical institution, if necessary, the following actions can be carried out:

Rhinoscopy. Examination shows hyperemia and swelling of the nasal mucosa, the lumen of the middle nasal passage is often closed. A characteristic feature is a streak of pus flowing from under the middle nasal concha. Also, polyps are detected that disrupt the normal outflow of fluid from the chambers.
Oropharyngoscopy. The mucous membranes of the gums and teeth from the affected side are examined, the filled teeth are tapped, if there is an infection, they are painful. Additional consultation with a dentist is often required.
Radiography. The main research method is carried out in different projections (lateral and semi-axial). Sometimes, to obtain a more detailed picture, a contrast agent is injected into the cavity using a puncture.
CT scan. Helps to obtain more accurate information about damage to the sinus walls, involvement of other sinuses and nearby bone tissue in the process.
Magnetic resonance therapy. Effective in detecting soft tissue defects inside the air chamber.
Endoscopy. An invasive diagnostic method for visual inspection of the cavity after micronectomy.

Treatment of chronic sinusitis

Therapy for chronic sinusitis requires constant treatment, regardless of whether the symptoms subside or are pronounced. It is from the effect on the pathogen during the period of remission that the frequency and strength of exacerbations will depend. It is very difficult to completely cure such sinusitis, but taking a number of measures can save you from exacerbations and possible complications:

Long-term use of antibiotics in low doses. Most often, low-toxic and effective against microbes macrolides are used for this, which, moreover, enhance immunity.
Continuous flushing of the sinuses with saline solutions and injecting anti-inflammatory sprays with steroid hormones into the nose.
Correction of deformities in the nasal cavity (straightening of the septum, removal of the adenoids).
The use of decongestant sprays and drops, as well as mucolytics to improve the functioning of the mucous membranes of the chambers and the removal of pathological contents.
Elimination of allergens in allergic sinusitis.
Constant observation by the dentist and timely treatment of teeth (especially chewing) of the upper jaw.
Immunomodulators, restorative drugs and vitamins are prescribed as ancillary therapy.

To remove purulent contents and high-quality treatment with antibiotics and antiseptics of the inner walls of the sinus, puncture of the maxillary sinus is practiced.

Most often, this method is used to relieve symptoms during an exacerbation of the disease. For those who are afraid of punctures, lavage can be performed using the Yamik sinus catheter under local anesthesia.

If there are no complications and contraindications, at the recovery stage of the disease, the patient is prescribed physiotherapy, such as: