How and how to treat acute sinusitis?

Acute maxillary sinusitis is an inflammatory process that develops in the mucous membranes lining the maxillary sinuses. It is characterized by the presence of a large amount of purulent discharge and swelling of the tissues of the nose. The disease in its acute form carries a number of serious threats to human health and life, if timely adequate treatment is not carried out. Next, we will consider what this ailment is, and how to treat acute sinusitis in various ways.

What is acute sinusitis and what causes it?

The name "acute" is evidence that this type of ailment develops quickly (in a few days) and has pronounced manifestations. It is not so easy to answer the question of how much sinusitis is treated, it all depends on the time of initiation of treatment, the pathogen, the effectiveness of the drugs and the state of the patient's body. The majority of cases of acute sinusitis last from 1 to 3 weeks, in contrast to subacute (1 to 3 months) and chronic (over 3 months) forms.

The causes of the onset of the disease can be:

viruses trapped in the maxillary sinuses after colds and flu;
pathogenic bacteria from ARVI, rhinitis, scarlet fever, measles, inflammation of the tonsils and other infectious diseases;
some types of fungi;
the passage of infection from the oral cavity from the affected tooth or ingress of filling material into the accessory chamber;
allergic reactions causing tissue edema;
physiological structural features and anomalies of the nasal cavity (curvature of the septum, trauma, polyps, adenoids);
weakened immunity due to prolonged use of drugs (antibiotics, chemotherapy) or the presence of a severe general illness (HIV, diabetes mellitus);
decreased activity of the cilia of the ciliated epithelium due to drying out or breathing polluted air.

In almost all cases, regardless of the cause of the onset of the disease, after a few days the bacterial microflora joins and pus accumulates in the sinuses, which sharply exacerbates the patient's condition. When sowing, Staphylococcus aureus, streptococci, pneumococci, Escherichia coli are most often determined.

Typical symptoms of acute sinusitis

After the pathogen enters the body, its defense system reacts sharply, releasing a large number of leukocytes, designed to destroy the "uninvited guests". As a result, due to the accumulation of leukocytes in the area of the maxillary sinus, swelling of the mucous membranes of the nose occurs, the anastomosis narrows or overlaps, the evacuation of mucus and air exchange are disrupted. A purulent process develops in the accessory pocket, which affects all vital systems of a person.

All this leads to the manifestation of a number of symptoms characteristic of maxillary sinusitis:

Nasal congestion, most often alternating. The mucous membranes are dry, sneezing and itching are possible.
Runny nose. Depending on the stage of the disease, the discharge can have a different color: transparent at the initial stage, green - when bacteria are attached, yellow - in the presence of a purulent component. Blowing your nose does not improve the situation.
Fever and an increase in body temperature up to 39 degrees as a reaction of the body to the pathogen and the presence of a purulent focus in the sinus.
Pain syndrome in the area of the affected organ - a throbbing dull pain, aggravated by tilting the head, can be given to the ear, teeth, temples, or spill over the entire head.
Bad breath.
A nasty voice.
Muscle pain as a result of intoxication of the body.
Mouth breathing and nocturnal snoring.
Smell disorder.

Diagnosis of the disease

At the first sign of sinusitis, you need to see an otolaryngologist. You should not try to cure the disease on your own, you can only waste time and worsen your condition.

Treatment of acute sinusitis should always be complex, and it should be prescribed exclusively by a specialist after a series of examinations.

For the correct diagnosis and development of an effective treatment regimen, the ENT doctor interviews the patient, examines his medical history about previous diseases, injuries, the presence of allergies, palpates the cheekbones and forehead. After that, he carries out a number of studies:

Rhinoscopy or endoscopy - a visual examination of the tissues of the nose using a rhinoscope. If necessary, an endoscope with a flexible tube is used.
Radiography. The picture allows you to see darkening, indicating the presence of inflammation in the accessory chambers. It is usually done in two projections.
CT scan. A more modern and expensive method that can detect deeply hidden infection, edema, and fungal infection.
Fingerprint test.

Less commonly, diagnostic methods such as puncture for collecting exudate for bacterial culture and magnetic resonance imaging are used.

Drug therapy for acute sinusitis

Based on the results of the diagnosis, the otolaryngologist determines which drugs should be used. In acute sinusitis, treatment is aimed at eliminating tissue swelling, removing purulent secretions from the accessory pockets, suppressing pathogens and relieving symptoms. This scheme is typical for catarrhal sinusitis at the initial stage.

However, when the bacterial microflora begins to multiply in the sinus, antibiotic therapy becomes mandatory, as well as the use of drugs aimed at improving the general condition of the patient and restoring nasal breathing. In the drug therapy of maxillary sinusitis, several types of drugs of various orientations are used.

Vasoconstrictor drugs in the form of sprays and nasal drops. The most common are Sanorin, Galazolin, Oxymetazoline, Tizin, Naftizin, Pharmazolin. The instillation is carried out as follows: the patient lies on his side and pours 2-3 drops of the medicine into the nasal passage of that half of the nose on which the person lies. This facilitates the ingress of the active substance onto the side wall of the cavity and the anastomosis. You need to lie down for about 5 minutes, then repeat all the steps, turning on the other side. The procedure ends with blowing out. After a while, it is recommended to irrigate the nasal cavity with Bioparox, Cameton or Ingalipt sprays. Decongestants should not be dripped for more than 7 days, otherwise they may lead to bleeding and increased secretion congestion.

Antibiotics They are applied in courses from 7 to 10 days. It is most effective to prescribe a specialized antibiotic based on the bacterial culture taken from the patient's nose. However, this is often not possible, so otolaryngologists prescribe the most common broad-spectrum antibiotics.

Amoxiclav, Augmentin, Sumamed, Flemoxin solutab, Rovamycin, Macropen, Azithromycin taken orally have good reviews. Ceftriaxone is injected by injection. The attending physician should monitor the dynamics of the patient's condition, and, if necessary, change the antibiotic to a more effective one after 2-3 days. Most antibiotics have side effects such as vomiting, nausea, diarrhea, and skin rashes. In parallel with antibiotic therapy, it is recommended to take prebiotics or probiotics to normalize the state of the intestinal microflora.

Antihistamines. In combination with antibiotics and vasoconstrictor agents, they relieve swelling of the mucous membranes. Usually, 1 tablet is prescribed per day of Diazolin, Loratadin, Suprastin, Zirtek, Claritin or Tavegil for a week.

Antipyretic and anti-inflammatory drugs. The proposed medications combine both of these actions and also relieve pain. Will help relieve unpleasant symptoms, proven by many years of clinical practice, Paracetamol, Panadol, Nurofen, Aspirin, Nalgezin. However, they cannot be taken haphazardly, since they all have certain warnings for use (childhood, the presence of diseases, etc.), therefore, a doctor should prescribe an antipyretic agent.

Analgesics can be taken as tablets or syrups for children. In some cases, hot drinks, which are prescribed for flu and colds, help a lot. The paracetamol contained in them knocks down the temperature, excipients (pheniramine, phenylephrine) constrict blood vessels, relieve spasm, reduce rhinorrhea, and vitamin C has a general strengthening effect. The most famous representatives of this family are Coldrex Hotrem, TeraFlu, Fervex, Pharmacitron.

Mucolytics. To liquefy mucus to facilitate its removal, you can use pharmacological preparations in the form of syrups and drops (ACC, Ambrobene, Fluditek, Mucodin) or on a plant basis (Sinupret, Cinnabsin).

Corticosteroids. They act with various types of sinusitis, are relevant for allergic and bacterial forms, they simultaneously have a decongestant and antihistamine effect. The most commonly used sprays (Avamis, Nasonex), with fungal or polypous sinusitis, corticosteroids are prescribed in tablets (Prednisolone).

Physiological procedures for acute sinusitis

To promptly remove the secretion accumulated in the air pockets, the nose wash procedure is used.

There are several different techniques, some of them are carried out by a doctor in a polyclinic or hospital ("cuckoo", YAMIK catheterization), some are easy to carry out at home. Having passed a special procedure for cleansing the sinuses of the nose from exudate in time, a puncture can be avoided even with a purulent form of the disease.

YAMIK catheting invented in the mid-70s of the XX century by the Russian doctor V.S. Kozlov. To cleanse the maxillary sinuses, a special soft YAMIK catheter is used, which consists of two inflatable balloons (anterior and posterior), connected by a flexible tube and a cuff with the possibility of connecting a syringe. The procedure is contraindicated only for small children (up to 5 years old), the elderly, patients with a deviated nasal septum, epilepsy, polyposis or hemorrhagic vasculitis.

To avoid discomfort, the patient is given local anesthesia with novocaine or lidocaine. Also, the patency of the nasal passages is ensured using turunda dipped in adrenaline. After that, a structure is inserted into the nose, the back and front balloons are inflated alternately. A vacuum is created in the occluded part of the nasal cavity by suctioning air with an attached syringe. Under the influence of intermittent pressure, the fistulas open, and pathological mucus flows out of the sinuses, after which it enters the syringe.

The manipulation is repeated several times until the maxillary chambers are completely cleared, after which antiseptics and other drugs are injected into the sinuses. Already after the second wash, nasal breathing is normalized. For a full recovery, 3-4 visits to the doctor are usually enough.

"Cuckoo" (washing according to Proetz). This procedure is cheaper than YAMIK, but also effective. It is based on creating a difference in pressure, which allows fluid to circulate freely within the sinus. The procedure only needs a syringe and an aspirator. Contraindications - bleeding and epilepsy.

After applying a vasoconstrictor spray and blowing out the patient, the patient sits on a stool and tilts his head back. The doctor pours a solution of water and an antiseptic (Furacilin, Miramistin) into one nostril. After passing through the accessory chamber, the fluid with purulent accumulations is sucked out through the other nostril using an aspirator (nozzle suction). The name "cuckoo" comes from the fact that when rinsing the patient pronounces "cuckoo" so that the soft palate blocks the passage to the throat.

Surgical treatments for acute sinusitis

The most common surgical treatment for sinusitis is a puncture. It is prescribed in the serious condition of the patient, the accumulation of a large amount of pus and blood in the accessory pocket, the inability to remove the swelling of the anastomosis in a conservative way and severe pain syndrome. Puncture is a very effective manipulation, it belongs to minimally invasive interventions, after which the patient's condition quickly improves.

After local anesthesia and anemization of the nasal passages, the otolaryngologist, using a special Kulikovsky needle with a curved tip, pierces the bony wall of the sinus in the thinnest place through the nose. An antiseptic solution is poured inside with a syringe connected through a cannula, which dilutes the exudate and then is sucked off. After the release of the sinus, medications (antibiotics, mucolytics, antiseptics) are poured into it. The whole procedure takes 10-15 minutes, it must be repeated 2-3 times to achieve a stable result.

In the most advanced cases, with a threat to the patient's life and the possibility of developing severe complications, a full-fledged operation can be prescribed, in which the sinus is opened, and the mucous membranes of the sinus are cleaned forcibly.

Prevention of acute sinusitis

In order to prevent the disease of maxillary sinusitis, it is enough to follow a number of simple rules:

moisten the mucous membranes in various ways (household humidifiers, drinking plenty of fluids, nasal irrigation) for the normal functioning of the ciliated epithelium;
limit your stay on the street during the flowering period of allergens;
do not swim in chlorinated waters;
avoid substances that emit volatile elements into the air (paint, cleaning agents);
strengthen immunity, eat right and take vitamins;
timely start treatment of any colds.