How to treat unilateral sinusitis (right and left)?

Right-sided maxillary sinusitis is a type of sinusitis in which only one maxillary sinus is affected, located on the right side of the skull. Accordingly, the pain syndrome is localized to the right of the bridge of the nose. Right-sided and left-sided sinusitis is the most common disease in medical otolaryngological practice. What are the features of the onset and treatment of such sinusitis?

The mechanism of manifestation of the pathological process and its development

The causes of unilateral sinusitis can be bacteria, viruses, fungi and other pathogens that can enter the accessory pocket in various ways. In accordance with this, right-sided and left-sided sinusitis can be classified as follows:

Rhinogenic. The most common method, which is a consequence of respiratory diseases of the nasal cavity (ARVI, rhinitis). The transfer of infection to the air chamber can occur both naturally and in connection with improper rinsing of the nose or blowing the nose.
Traumatic. It is provoked by various injuries and anomalies in the development of the bones of the skull, which prevent the normal outflow of fluid from the paranasal sinuses.
Odontogenic. It develops as a result of the transition of infection from diseased teeth of the upper jaw (molars and premolars) to the maxillary chamber through a thin wall or as a result of an unsuccessful dental operation through the formed fistula.
Hematogenous. The pathogen spreads through the blood. This type of disease is rare and is a complication of infectious diseases of a general nature, such as syphilis or tuberculosis.

A contributing factor in which unilateral sinusitis appears is a general weakening of the body's defenses. The development of the disease and the side of the lesion are determined by the following factors:

Anatomical features of the structure of the nasal cavity, the presence of spines, ridges and curvature of the nasal septum.
Overgrowth of adenoids, polyps, cysts, vasomotor rhinitis.
Benign and malignant tumors that change the direction of the outflow of mucus or block the fistula.
Drafts or staying near an air conditioner in hot weather.
General pathological diseases that weaken the immune system (tuberculosis, HIV, diabetes mellitus).

Right-sided and left-sided sinusitis is most often caused by bacteria, fungi, viruses, or mixed microflora.

The clinical picture of acute and chronic forms of the disease

Inflammation of the maxillary sinus has an extensive clinical picture and manifests itself in a number of symptoms. Right-sided sinusitis in acute form is characterized by the following manifestations:

Severity and dull throbbing pain in the area of the affected accessory chamber, radiating to the bridge of the nose, temple, orbit, teeth, neck, forehead on the right side. The sensations are enhanced by tapping or pressing with your fingers, and by leaning forward and to the right.
Prolonged (over a week) rhinitis and congestion of the right nasal passage, although sometimes general congestion is also noted.
Mucous discharge from right nostril only. The secretion is enhanced when the head is tilted to the left side.
Swelling of the cheek or corner of the eye on the affected side, tenderness of the skin on the cheekbone.
Signs of intoxication of the body: weakness, lethargy, fatigue, decreased performance, loss of appetite. Also, there is a headache and a rise in temperature up to 38-39 degrees.
Vile sounding voice.

The chronic form of sinusitis is somewhat different from the acute one and is manifested by the following symptoms:

Violation of nasal breathing on the right, it is necessary to constantly use vasoconstrictor drugs for normal sleep.
Feeling of dryness in the throat.
Headaches, fatigue and general weakness.
The presence of an unpleasant odor from the nose.

Infected mucus dripping down the inner larynx, resulting in persistent coughing.
Discharge in a small amount of mucus and pus from the nostril on the affected side (the color of the snot is yellowish).
Small cracks are noticeable around the right nostril, and in the nasal passage itself there are dried crusts from the constant outflow of purulent secretions.

Left-sided sinusitis has the same symptoms, only they are localized in the opposite part of the skull.

Diagnostic methods and conservative therapy of right-sided sinusitis

An experienced otolaryngologist, after listening to the patient's complaints and performing a visual examination with a rhinoscope, can most likely diagnose "unilateral maxillary sinusitis". Palpation and percussion are additional confirmation of the physician's conclusion.

But in order to determine the degree of damage to the sinus and the development of a purulent process, it is necessary to undergo an in-depth examination. The internal structure and changes in the tissues of the accessory chamber, the presence of a horizontal level of pus or foreign bodies can best be seen using an x-ray or computed tomography. A nasal swab and bacteriological analysis of its contents allows you to accurately determine the causative agent of the disease. Taking into account all the information received, the otolaryngologist determines how to treat sinusitis and develops a therapy regimen.

With right-sided sinusitis, it is advisable to start treatment with medications at an early stage, before the appearance of pus in the accessory pockets. This will help avoid puncture or the transition of the disease into a chronic stage.

It is important to determine the cause of the disease in time and not only eliminate unpleasant symptoms, but also eliminate the focus of infection:

with odontogenic sinusitis, a diseased tooth is treated or removed;
for allergic - contact with the allergen is eliminated;
in case of traumatic surgery, surgery is performed in order to eliminate the obstacle to the outflow of mucus;
with bacterial, the pathogen is destroyed both directly in the sinus and in the entire nasopharynx.

Drug therapy is carried out on an outpatient basis. The acute form of the disease does not lead to irreversible changes in the mucous membranes of the sinuses, therefore, correctly selected medications and strict compliance with all doctor's prescriptions allow you to get rid of sinusitis forever. Conservative treatment of sinusitis has been worked out for decades of practice and in almost all cases includes the use of such types of drugs:

Antibiotics Common drugs in this group are penicillins (Amoxicillin, Amoxiclav, Flemoxin solutab), cephalosporins (Cefazolin, Ceftriaxone), macrolides (Azithromycin, Macropen, Sumamed), fluoroquinolones (Ciprofloxacin, Ofloxacin). In the acute form, the course lasts 7 days, in the chronic - from 14 days or more, depending on the dynamics of the disease.
Drops and sprays in the nose. The bulk of these drugs have a vasoconstrictor effect, which allows you to restore breathing through the nose and ensure the removal of mucous masses from the nasal cavity. The most popular of them are Naphtizin, Galazolin, Nazivin, Otrivin, Nazol. Depending on the active ingredient, their effect can last from 4 to 12 hours. However, they are capable of causing side effects, which are expressed in vascular fragility and bleeding. The second group of local drops are corticosteroids (Avamis), which relieve swelling and allergies in various types of sinusitis.
Antihistamines. They are necessary in cases where the cause of sinusitis is an allergy, as well as when there is a strong swelling of the soft tissues of the nose.Adults are prescribed pills, and children are prescribed syrups. They are used systemically once a day (Zirtek, Tavegil, Loratadin).
Antiseptics. Can be used for rinsing the nose (Miramistin, Dioxidin), as well as for irrigation (Polydexa, Isofra). Their main task is to destroy microbes and disinfect mucous membranes.
Analgesics. They are prescribed to eliminate such symptoms of the disease as hyperthermia (above 38.5 degrees) and pain syndrome. The three most common types of analgesics are acetylsalicylic acid, ibuprofen, and paracetamol. The most famous drugs based on them are Aspirin, Nurofen and Panadol, respectively.
Mucolytic agents. They dilute the secretion and facilitate its removal from the nasal cavity and accessory pockets (Sinuforte, Acetylcysteine).
Immunomodulators enhance the body's immune response, which reduces the likelihood of a common cold developing into sinusitis.

Flushing the air chambers

The most important condition for a complete cure for maxillary sinusitis is regular cleansing of the sinuses and nasal cavity from mucopurulent secretions and dried crusts.

This can be done efficiently and quickly using various nasal rinsing techniques. In medical practice, the following rinsing methods are used:

"Cuckoo". The procedure is carried out by a doctor in a polyclinic. It is based on the movement of fluids inside closed cavities under the influence of a pressure difference. An antiseptic solution is poured into one nostril, and from the other it is sucked off with an aspirator along with the dissolved mucus.
YAMIK procedure. It is done in a medical facility using local anesthesia. Special A balloon catheter in the nasopharynx and nostril creates a vacuum that opens the anastomosis and allows exudate to flow into the nasal cavity. After the sinus is released, drugs are poured into it. This method is not recommended for the elderly, children and people with mechanical obstructions to the fluid flow (polyposis, deformation of the septum, swelling).
Flow-through rinsing. You can do it yourself at home using a special teapot, syringe, syringe or device that comes with some ready-made solutions (like "Dolphin"). A saline solution or decoction of medicinal plants is poured into one nostril and out of the other under slight pressure. You cannot rinse swollen sinuses with a high quality in this way, but the nasal cavity is cleaned in a timely manner, which helps to reduce the amount of pathogenic microflora.

Surgical methods of treating right-sided sinusitis

Conservative therapy does not always lead to the expected result, the patient's condition may worsen, and the symptoms may increase. In these cases, the otolaryngologist proposes surgery to the patient. To date, a number of methods have been developed, both full-fledged operations and minimally invasive interventions. The most widespread are:

Puncture (puncture) through the nose of the sinus wall in the thinnest place. A special bent needle easily pierces a thin bone and penetrates into the void by 1.5-2 cm. An antiseptic solution is injected with a syringe, and the accumulations of pus and mucus are washed out. The sinus is then treated with antibiotics and other medications. 2-3 procedures are enough to eliminate all dangerous symptoms and further drug treatment. The manipulation is carried out under local anesthesia; hospitalization is not required.
Balloon sinusoplasty. A modern method, which consists in widening the connecting canal using a special catheter to restore the drainage of the accessory pocket.
Sinusitis. Open surgery, in which part of the sinus floor is removed to access the inside of the sinus for debridement. The most dangerous and painful surgical intervention for sinusitis.