Very often, the ENT doctor puts his patientsdiagnosed as acute rhinosinusitis, which is a disease of the upper respiratory tract. This disease is treated with antibiotics. Often it causes complications, with the result that the acute form becomes purulent or chronic. Perhaps sales will require surgery. Let us consider in more detail the disease such as rhinosinusitis, the symptoms and treatment of this pathology.
Forms
Depending on where this ailment occurs, they are distinguished:
- sinusitis (maxillary sinusitis);
- ethmoiditis (inflammation of the ethmoid bone);
- sphenoiditis (inflammation of the sphenoid sinus);
- pansinusitis and polysinusitis (lesion of several or all of the sinuses);
- frontal sinusitis (frontal sinus inflamed).
All these pathologies are called by one term - “rhinosinusitis”.
Causes
Acute rhinosinusitis can occur for the following reasons:
- due to infection;
- under the influence of allergens.
Most often, this disease is caused by a banala cold. Viruses enter the paranasal sinuses and contribute to their inflammation. Usually, if an infection penetrates the nasal cavity, then the body instantly responds to this with an immune response, an increase in mucus and the formation of edema. This leads to the fact that from the paranasal sinuses the content begins to be removed with difficulty, and favorable conditions are created for the subsequent reproduction of harmful microorganisms and the formation of pus.
In the human body are constantlysome types of bacteria in minimal quantities that do not provoke the occurrence of inflammatory processes. By reducing the protective functions of the body, they begin to multiply vigorously, often causing acute purulent rhinosinusitis.
In addition, there are pathological conditions that are predisposing factors for the development of this disease:
- anatomical features of the structure of the nose (enlarged turbinates, septal deformation, etc.);
- immunodeficiency;
- the presence of diseases such as cystic fibrosis, allergic rhinitis, adenoiditis and others;
- reduced immunity.
Symptoms
The following primary signs of an inflammatory process of the sinuses are noted:
- feverish state;
- Strong headache;
- changes in blood;
- weakness and general malaise;
- nasal congestion.
After a while, acute rhinosinusitis manifests itself as follows:
- increased body temperature;
- abnormal discharge from the nasal cavity;
- swelling of the eyelids or cheeks;
- bad breath;
- cough, often worse at night;
- shortness of nasal breathing;
- sense of smell;
- tension and pressure in the affected sinuses;
- feeling tired all the time;
- toothache, most acutely manifested during chewing.
Acute purulent rhinosinusitis may have enougha large variety of common and local signs. Its symptoms depend on the reasons for its occurrence, the presence of other diseases and the age of the patient. Moreover, children are harder to suffer this disease.
Polypous rhinosinusitis has almost the samethe most symptoms as acute. Since this form of the disease is more severe, endoscopic surgery is used for its treatment in combination with antiallergic therapy.
Diagnostics
As soon as the first signs appearedrhinosinusitis, which not only does not go away after a few days, but also increases, then you should definitely see a doctor. To make an accurate diagnosis, the specialist determines the location of the disease, its shape, as well as the type of bacteria or virus that caused the development of the infection.
To confirm the clinical manifestations of acute rhinosinusitis, the following measures are taken:
- the general condition of the patient is assessed;
- analyzes are taken;
- carry out instrumental research methods.
ENT examination
Examination of the patient begins with the collection of hiscase histories. To do this, the patient describes all the symptoms, the duration of nasal discharge and their nature, the presence of pain in the head and face and their localization. He should also inform the doctor about any manifestations of allergies and recent colds.
Even the information on the dental procedures carried out, medications taken, facial injuries, and immunity disorders will help in the diagnosis.
After that, the doctor conducts a physical examination.patient, palpation of the cheekbones and forehead to determine the pain of the sinuses. Using otolaryngological examination can detect defects in the nasal cavity.
Lab tests
The presence of the inflammatory process and the nature of its course helps to determine the complete blood count. In this case, the analysis of the number of leukocytes and the ratio of their forms.
In addition, under laboratory conditions, investigatepathogenic contents of the affected nasal sinuses. Using microbiological studies establish the type of pathogen and its sensitivity to various antibacterial agents. But it should be remembered that the results of such analyzes in acute form are obtained only 3-4 days after the onset of the first signs of the disease. Therefore, very often they lose their relevance.
Instrumental study
For making an accurate diagnosis, use special instrumental studies:
- Nose endoscopy - for herA fiber-optic tube is used, at the end of which the light source is located. With the help of this study, it is possible to detect even the smallest deviations in the nasal cavity, as well as to evaluate the defect of the septum and the presence of tumors, for example, polyps.
- Computed tomography - is considered the best visual method for examining the sinuses. It is recommended in case of complications.
- Radiography - was widely used until endoscopy and computed tomography appeared. Currently, it began to resort much less.
- Magnetic resonance imaging - isremarkable method for the diagnosis of inflammatory processes, complications within the skull, malignant tumors. Maxillary sinusitis manifests as a darkening of the maxillary sinuses.
Methods of treatment
Acute rhinosinusitis is treated as medicamentous,and surgical way. The effectiveness of each method is considered by the doctor individually for each patient. The choice of treatment depends on various factors: the patient's age, the form of the disease and the nature of its course, the possibility of allergic reactions, etc. But whatever treatment regimen would be chosen, it should be aimed at:
- eliminate signs of inflammation;
- to restore the permeability of the passages that connect the nasal passages with the sinuses;
- extract pathogenic contents from the sinuses;
- eliminate the source of infection.
Treatment of rhinosinusitis in adults shouldbe carried out under the strict supervision of a physician, as uncontrolled medication often leads to complications. And the main goal of treatment is the elimination of the pathogen and restoration of the ability of the paranasal sinuses to cleanse themselves.
Medication
Acute purulent rhinosinusitis is treated with the following medications:
- decongestants;
- immunomodulators;
- antibiotics;
- additional symptomatic drugs.
Decongestants and vasoconstrictor agentsthey are usually prescribed in the first place, and they should not be used for more than 4–5 days, since prolonged use only increases the swelling and nasal congestion. Such drugs include "Ephedrine", "Nazivin", "Sanorin", "Galazolin", "Naphthyzin", etc. Such remedies do not cure the disease, but temporarily eliminate its symptoms.
При определенных формах такого заболевания, как Rhinosinusitis, treatment is possible only with antibiotics, which should be taken within two weeks. They help to completely eliminate all symptoms, but their reception should be carried out only under the supervision of a specialist. The most commonly prescribed antibiotic is Amoxicillin. But if, three days after his reception, there was no improvement, it must be replaced with drugs with an active substance such as tetracycline or cephalosporin. The following antibiotics are also fully justified: Clarithromycin, Azithromycin and Roxithromycin.
Despite a wide selection of diverseThe drugs used to treat acute rhinosinusitis are not always effective. This is due to the fact that many microorganisms that cause inflammation of the upper respiratory tract, successfully resist antibiotics. That is why in acute rhinosinusitis, especially when the frontal sinus is inflamed, stimulation of the person’s immune defenses is used.
For this purpose, immunomodulators and immunomodulators are used. They contain such substances that restore the function of immune protection. The course of treatment is usually 1.5–2 weeks.
If a form of the disease is identified aspolypous rhinosinusitis, treatment should be carried out with the help of mucolytic drugs ("Myrtol", "Sinupret", "Acetylcysteine"). They contribute to the dilution of the thick and viscous contents of the nasal sinuses, as a result of which the outflow of pus begins. Also, drugs of this pharmacological group can also have an antibacterial effect.
If the body temperature rises, then the patientmust comply with bed rest. For this, he is prescribed antipyretic drugs such as Amidopyrine and Aspirin. As painkillers drugs usually prescribed "Paracetamol", "Ibuprofen". Stronger means are rarely used and should be taken no more than 7 days.
Allergic rhinosinusitis is treated with antihistamine drops and pills. You can also use ointments and creams, but hormonal preparations are prescribed quite rarely.
It is worth adding that, in addition to drug treatment, carry out the following therapy:
- wash the sinuses with antiseptic solutions to remove the pathological contents;
- It is recommended to drink plenty of warm liquids: fruit drinks, dried fruit compotes, natural fruit juices, weak tea, rosehip decoction;
- use physiotherapeutic methods: microwave therapy, ultrasound, UHF.
If these methods have not brought due result, resort to surgical treatment.
Surgical intervention
If drug therapy for a disease such as rhinosinusitis did not help, treatment in this case is performed surgically. Most often, a puncture is prescribed, which helps:
- quickly remove purulent contents from the paranasal sinuses;
- directly affect the mucous membrane of the paranasal sinuses with antiseptic, anti-inflammatory and antibacterial drugs.
But there is such a treatment and disadvantages. The risk of developing blood poisoning, vision loss, etc., is possible. Therefore, it is most often not recommended.
Features of the disease in children
Rhinosinusitis in children is dominantdisease, since it accounts for one third of all diseases that are associated with the upper respiratory tract. And having matured, half of the guys continue to suffer them.
При таком заболевании велика вероятность развития serious complications. The purulent-septic orbital complication leading to visual impairment is considered the most dangerous, and intracranial changes occur in 2% of cases. If you do not promptly diagnose the disease and do not treat it, then pneumonia develops.
Acute rhinosinusitis in children is manifested as follows:
- agonizing, prolonged cough;
- difficulty breathing through the nose;
- fast fatiguability;
- general malaise;
- nasal voice;
- fever.
The main treatment is considered to be antibiotic therapy against the background of increased immunity.
Features of the disease during pregnancy
Quite often, acute purulent rhinosinusitis occurs during pregnancy; moreover, it can be accompanied by complications, since during this period any treatment is limited.
Only a doctor can prescribe antibiotics.which can harm a woman and child if taken uncontrollably. If the penicillin group and cephalosporin are not well tolerated, then macrolides are used. These may be Moxifloxacin, Levofloxacin and Sparfloxacin. Under their influence, the synthesis of protein in the cells of pathogenic microorganisms is destroyed. Such drugs are considered the most effective and safe for treating pregnant women.
Prevention
To avoid such a disease as acute rhinosinusitis, the following preventive measures should be taken:
- avoid drafts and hypothermia;
- walk a lot in the fresh air, exercise physical activity;
- harden;
- do sport;
- promptly treat ARVI and runny nose;
- time to contact the dentist to treat the teeth of the upper jaw;
- It is advisable to swim in the sea water and breathe in the healing sea air.
Conclusion
Таким образом, острый гнойный риносинусит be sure to be treated under the supervision of a physician, so as not to have rather dangerous complications that may even pose a threat to life. It is necessary to avoid the factors provoking the disease, to spend less time in unventilated and dusty rooms, to quit smoking. With adequate and timely treatment, rhinosinusitis is completely cured.
