Treatment of sinusitis in children largely coincides with the treatment regimen for this disease in adult patients. The main task is to ensure drainage of the sinus and influence on the factor causing the disease. The difference lies mainly in the strength of the drugs taken. Elucidation of the nature of inflammation of the maxillary (maxillary) sinuses plays a key role in determining therapy. Since there are many reasons that can provoke the development of sinusitis, only by establishing the etiology of the disease, the doctor can prescribe an effective treatment.
In addition, before learning how to treat sinusitis in children, parents should learn to distinguish it from rhinitis common (runny nose). Premature treatment of sinusitis with antibiotics or, on the contrary, untimely initiation of therapy can entail serious consequences for the child's health (in the first case, antibiotics will only increase the risk of developing sinusitis with complications, and in the second, there is a danger of chronicity of the disease and even the spread of infection into the cranial cavity). It is also important to remember that sinusitis occurs only in children from 5-7 years of age.
Causes and symptoms of sinusitis
Having determined the nature of the onset of the disease, it is possible to cure sinusitis in a child in a relatively short time and prevent the development of complications. Among the most common reasons for the development of sinusitis are:
- untreated acute respiratory viral infections;
- curvature of the nasal septum;
- allergic reactions;
- the appearance of cysts, polyps (in children it is less common than in adults);
- inflammation of the teeth of the upper row, caries.
In addition, it is important to be able to recognize the symptoms of sinusitis in order to receive timely medical care for your child. In the clinical picture of inflammation of the maxillary sinuses, the following signs prevail:
- mucous or purulent nasal discharge (yellowish green);
- pain when turning and tilting the head;
- throbbing pain in the sinuses (may radiate to the teeth of the upper jaw, ears, temples);
- swelling of the eye;
- subfebrile temperature (not higher than 38 degrees);
- lack of appetite and general weakness.
Types of sinusitis
In accordance with the nature of the causative agent that causes inflammation, a distinction is made between viral and bacterial types of diseases. The mixed type is also often found.
Depending on the localization of the inflammation, a distinction is made between unilateral (inflammation of the maxillary sinus on one side) and bilateral sinusitis (simultaneous inflammation of both maxillary sinuses).
In addition, the disease is also classified according to the form of inflammation: catarrhal (swelling of the nasal mucosa, hyperemia and intense mucus production), purulent, odontogenic and allergic. Finally, according to the characteristics and speed of the course, the pathology is acute and chronic.
Treatment of catarrhal sinusitis
Considering that the respiratory muscles in children are not as well developed as in adults, they are much more demanding on the quality of the air (its moisture content and freshness) and it is much easier to pick up rhinoviruses. In most cases, catarrhal bilateral sinusitis in a child develops precisely against the background of an acute respiratory viral infection. First, the virus acts on the ciliated epithelium of the nasal cavity, disrupting its normal functioning, as a result of which mucus transport is disrupted. Secondly, due to improper blowing of the nose (drawing in mucus), or even just with the air, the virus can enter the sinus mucosa through the connecting fistula.
Thus, penetrating into the sinus, the virus provokes an intense production of mucus. However, the normal outflow of pathogenic exudate is impossible due to blockage of the anastomosis due to edema of the nasal mucosa. If at this moment an X-ray is taken for a sick child, then darkened areas will be clearly visible in the picture, which means the presence of pathogenic discharge in the sinuses. Nevertheless, almost nowhere in the world, radiography has not been used as a diagnostic method for a long time, because any rhinovirus leads to accumulation of mucus in the sinuses.
In the absence of the classic symptoms of sinusitis in a child, no special treatment is required, because the accumulation of mucus itself is not a reason to sound the alarm. It will be enough to properly treat ARVI and catarrhal sinusitis will pass along with a runny nose. Meanwhile, in order to prevent the occurrence of complications, some parents during ARVI give their children antibiotics on their own, which are actually powerless in the fight against viruses. Antibiotic therapy only increases the risk of developing bacterial sinusitis and can harm the child's body.
Treatment of bacterial sinusitis
If ARVI in a child (starting from 5-7 years old) is treated incorrectly or therapy does not begin from the first days of the disease, blockage of the anastomosis leads to the fact that there is no normal air exchange in the sinus and pathogenic organisms begin to multiply there. As a result, the mucous exudate in the sinuses gradually turns into purulent, and the child develops signs of bacterial sinusitis (headache, yellowish-green nasal discharge, pain in the sinuses). In addition, the infection can enter the sinuses and hematogenous (with blood flow). In any case, in such a situation, self-treatment at home is no longer enough and it is urgent to consult with an otolaryngologist.
At this stage, the attending physician necessarily prescribes antibiotic therapy, since it is not possible to cure purulent sinusitis in other ways. Now the pharmaceutical market offers a large selection of various antibacterial drugs in tablets, so injection therapy is no longer used. Considering that for an effective fight against bacteria it is necessary that the medicine accumulates in the body, the course of antibiotic therapy, as a rule, is at least 10-14 days.
It is important not to interrupt treatment after the first improvements.
Treatment of other types of sinusitis
Inflammation of the maxillary sinuses, which does not develop against the background of ARVI and is not a complication of it, is quite rare and often in such cases it is impossible to do only with a consultation with an otolaryngologist, it is necessary to involve other specialists. For example, after the loss of milk teeth, a child may develop odontogenic sinusitis. An incorrectly positioned tooth or even a small undetected tooth decay of the upper row can provoke an inflammation of the maxillary sinuses. A child will be able to completely recover from it only after solving dental problems. By the way, proper oral hygiene is one of the ways to protect a child from "dental" sinusitis.
Doctors usually prescribe antihistamines to deal with sinus inflammation triggered by an allergic reaction in the body. In addition to the treatment itself, it is necessary, if possible, to eliminate the allergen that causes the corresponding reaction. If we are talking about sinusitis, which arose as a result of the appearance of neoplasms (cysts, polyps) in the nasal cavity or as a result of trauma to the walls of the sinuses, then the problem is solved with the help of surgical intervention.
Puncture
Unlike many countries of the world, domestic medicine still uses such a method of treating sinusitis in children as a puncture of the maxillary sinus wall from the inside of the nose. This procedure is performed under local anesthesia using a long needle with a curved end (Kulikovsky needle).By attaching a syringe to the needle, a saline solution is injected into the maxillary cavity, which helps to flush out purulent exudate through the oral cavity.
In order to prevent the re-accumulation of pathological secretions, antiseptics or antibiotics are injected into the sinus.
Otolaryngologists refute the opinion that once having made a puncture, the patient will never again be able to cure sinusitis without resorting to this procedure. However, even in this situation, puncture has not been used as a therapy for a long time in foreign countries. The puncture is done exclusively for diagnostic purposes and only as a last resort. For example, if after a two-week course of treatment the patient does not show any improvement, doctors take a sample of purulent exudate using a puncture. After sowing and growing the bacteria, doctors figure out how to treat sinusitis most effectively.
Washing according to the Proetz method
In the early stages of the development of the disease, doctors often prescribe children a lavage according to the Proetz method, which is popularly called the "cuckoo". This procedure is performed to kill bacteria and cleanse the maxillary sinuses from mucopurulent masses.
The patient is in a horizontal position with his head thrown back at an angle of 45 degrees, and special devices are inserted into his nasal passages: an antibacterial solution is injected into the sinus through the catheter, and the pathogenic exudate is pumped out through the suction. In this case, the patient must repeat the "cuckoo" all the time so that the pathological secret does not get into the larynx.
The disadvantage of this treatment is that children are often afraid of this procedure. In addition, performing this manipulation incorrectly can harm the health of the child. Since children have a special structure of the nasopharynx (the mouth of the auditory tube is too close), the liquid that is used for washing can get into the tympanic cavity and provoke otitis media. Also, if the body is not properly positioned, there is a risk of impairment of the olfactory function. In addition, the procedure should not be repeated if the first 3-4 sessions did not bring the desired result.
Traditional methods of treatment
In order to speed up the child's recovery process, traditional medicine methods can be used in parallel with drug treatment. However, the use of any folk recipes must necessarily be coordinated with the attending doctor, since the same procedures at different stages of the disease can have different effects on the body. Among the most popular methods of treatment at home, there are: rinsing the nose, inhalation, warming up, using turunda and self-prepared drops. The following are the most effective recipes that are allowed to be used in the treatment of children:
- Rinse the nose with saline solution (1 teaspoon of baking soda or baking soda in 1 liter of water). Soda (1 teaspoon) and a few drops of iodine are often added to this solution.
- Rinsing the nose with decoctions of medicinal herbs (St. John's wort, oak bark, chamomile, eucalyptus, string, sage, etc.).
- Inhalation based on 5-7 drops of eucalyptus essential oil (you can also use fir or tea tree oil).
- Soak turundas in a mixture of propolis (1 teaspoon), melted butter (50 ml) and vegetable oil (50 ml) and insert into the nasal passages for 20 minutes.
- Soak turundas in sea buckthorn oil and insert into the nasal passages for an hour.
- Drops made from freshly squeezed juice of carrots and beets (in a 1: 1 ratio). Instill 3 drops in each nasal passage.
- Drops prepared on the basis of boiled water and flower honey (in a 1: 1 ratio). Instill 3 drops in each nasal passage 2-3 times a day.
