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What is chronic sinusitis?
Chronic sinusitis – This is a disease characterized by a rather long and sluggish course, with alternating phases of exacerbation and remission, manifested in frequent headaches, malaise and stuffy nose, as well as other symptoms, depending on how advanced the pathological process in the affected sinuses is. With this disease, it is the maxillary sinus that becomes inflamed, or, as it is also called, the maxillary sinus. In general, any sinusitis is a type of sinusitis, so sometimes doctors call it chronic maxillary sinusitis.
Symptoms of chronic sinusitis
Since we are talking about a disease that is chronic, the symptoms mainly manifest themselves during the exacerbation stage. It is for this period that the following symptoms are characteristic:
Weakness and general malaise, a feeling of “brokenness”.
Body temperature rises, but, as a rule, not to high numbers and can be 37,5 ° C. In this case, there is often a slight chill.
Nasal congestion with characteristic green discharge.
Due to the fact that the mucous membrane is irritated, sneezing appears.
Pain that radiates to different places. Irradiation can occur in the forehead, in the root of the nose and even in the teeth. Especially painful sensations intensify when a person leans forward or coughs.
The voice begins to change, the nasality characteristic of this disease appears.
Allocations change their color most often a week after the exacerbation of the disease, they become yellow and sinusitis flows into a purulent form.
If we consider chronic sinusitis not during the stage of exacerbation, then there are also a number of symptoms indicating that the disease is present in the body:
Stuffy nose, discharge appear periodically, therapy is not amenable, may be purulent.
Sensation of a “coma in the throat” due to the constant flow of mucus from the sinuses.
Headache, which periodically increases, depending on what position the patient takes. The greatest intensity of discomfort is gained in the supine position. The pain is localized in the region of the eye sockets.
The face can become “heavy”, it seems to be bursting and pressing from the inside, especially in the cheek area.
Often, especially in the morning, the eyelids swell in patients, and conjunctivitis appears.
The appearance of tears, without irritating external factors.
The sense of smell is constantly impaired, which significantly reduces the quality of life.
Also, the symptoms of chronic sinusitis can be classified as follows:
Local subjective, which include people’s complaints about nasal discharge, which are purulent in nature, persistent headaches, sensations of fullness of the affected sinus, discharge that has a putrid odor, and therefore loss of appetite. Naturally, nasal breathing is practically absent.
Local objective, which include swelling of the eye membranes, their diffuse hyperemia, which is clearly visible during examination. Between the lip and nose there are signs of permanent dermatitis, fissures, eczema or impetigo. Feelings are painful during palpation of the corresponding zones, during rhinoscopy, polyps are often found, the turbinates are edematous and thickened. Teeth are often damaged by caries, periodontitis, fistulas are observed.
Symptoms are common, which include sneezing, coughing, headache, fatigue. As for exacerbation, they are most often observed in the cold season, while in summer there is a lull. During the manifestations of the disease, a general blood test shows changes characteristic of acute respiratory infections. The general weakness is growing.
Causes of chronic sinusitis
The reason that a pathological process begins in the sinuses, which then develops into a chronic form, is often caused by microorganisms – streptococci. But sometimes the disease is caused by viruses, fungi and anaerobes.
The fact that sinusitis becomes chronic is facilitated by such reasons as:
Illiterate treatment, non-compliance with the therapeutic scheme, a shortened period of taking medications during the development of acute sinusitis.
The constant presence of a chronic infection in the nasopharynx, namely such foci as: chronic rhinitis, chronic tonsillitis.
Curvature of the septum and, as a result, a violation of the outflow of mucus. Such disorders occur both during fetal development and are congenital, and can be acquired during life, for example, as a result of trauma.
Formations such as cysts or polyps naturally disrupt normal air exchange in the sinuses, stimulating congestion and disrupting mucus discharge, and as a result, the development of sinusitis.
Dental problems such as disease of the teeth, located in particular in the upper jaw.
The environment has a significant impact on the development of this chronic disease. This applies precisely to the air that a person constantly breathes. The more it is gassed, dusty and toxic, the higher the risk of developing the disease.
Bad habits.
Allergy.
The state of immunity, both local and general.
Violation of both tissue and vascular permeability in the sinuses.
Types of chronic sinusitis
If we consider the classification of chronic sinusitis, then there are several of its subspecies:
Catarrhal chronic sinusitis. In this case, the entire mucous membrane of the maxillary sinus is inflamed, it looks reddened, swollen and filled with blood. Inside it is the mucous content. It can be both one-sided and develop on both sides.
Purulent sinusitis. In this case, the internal mucous contents change to pus. This occurs in the event of an exacerbation of a chronic disease.
Parietal-hyperplastic – this is a form of chronic sinusitis, hyperplasia of the mucosa occurs, and then polyps form on it. The nose alternately stuffs up, the discharge is frequent and profuse.
Fibrous chronic sinusitis.
Allergic sinusitis in a chronic form occurs, as a rule, abruptly and unexpectedly, under the influence of a certain stimulus. The mucosa swells, its activity increases, abundant discharge appears.
Cystic chronic sinusitis is characterized by the fact that a cyst is formed inside the nasal cavity, its size and location in the nose can be almost any.
Polypous, when a polyp that grows in the nasal sinus becomes the cause of a pathology of a chronic nature.
Sometimes there are its mixed forms, when, for example, in the presence of polyps in the sinuses, a purulent process begins.
Some doctors distinguish the following types of sinusitis, which occurs in a chronic form, based on what was the source of the infection:
Traumatic, when a violation of nasal breathing, and as a result, the development of the disease occurs due to various kinds of skull injuries.
Rhinogenic, when sinusitis develops into a chronic form due to frequent rhinitis and sinusitis.
Odontogenic, is a consequence of various kinds of diseases of the teeth.
Hematogenous chronic sinusitis is the most common, as it is caused by the penetration into the sinuses of a certain pathogen – bacteria (bacterial) or fungus (fungal).
Regardless of what caused the development of the disease and no matter what subspecies it belongs to, chronic sinusitis can be either unilateral or affect both sinuses.
Complications of chronic sinusitis
Like any other disease that occurs in a chronic form, sinusitis can cause quite serious complications. Among them are the following consequences:
The appearance of such chronic diseases as tonsillitis (with it the palatine tonsils are constantly inflamed), laryngitis (edema and inflammation of the larynx), pharyngitis (characterized by an inflammatory process in the mucous membrane of the pharynx.
Dacryocystitis, when the inflammatory process affects the lacrimal sac. There is constant lacrimation, there may be a purulent discharge, all adjacent tissues are edematous, the lacrimal sac hurts, the palpebral fissure is narrowed.
Violation of attention and memory is due to the fact that due to impaired breathing, a person constantly suffers from hypoxia. Mental activity suffers in the first place, but not receiving oxygen in the required volume, the work of all organs is disrupted.
Often, patients with chronic sinusitis experience apnea. And this, in turn, leads to the development of heart disease, increased drowsiness during the daytime.
Inflammation of the soft tissues of the face can be observed when the subcutaneous and muscle tissue is affected.
Often chronic sinusitis is complicated by such diseases as: otitis media, bronchitis, pneumonia.
If purulent contents enter the cranial cavity, then the most serious complications may occur – these are meningitis, encephalitis, or brain abscess. Most often, such diseases end in death.
Sometimes, against the background of sinusitis, a disease develops that requires urgent surgical intervention – this is a purulent inflammation of the cranial bones.
Partial or complete loss of vision associated with such a complication of sinusitis as inflammation of the eyeball.
Sepsis, in which the infectious agent enters the bloodstream.
Asthma.
A very painful complication, like inflammation of the tertiary nerve.
It should be understood that any form of sinusitis, and, in particular, purulent, can cause quite serious complications. This is due to the location of the infection, and the close proximity of the maxillary sinuses to the brain. That is why competent and qualified treatment of the disease is necessary, both during the period of exacerbation and during remission.
How to cure chronic sinusitis?
The treatment of chronic sinusitis differs from the treatment of a common disease in that even during a period of calm it should not be ignored. After all, the frequency and severity of the course of the disease in the acute phase depend on how well prevention and treatment will be carried out.
So, during the period of remission, it is imperative to perform such a procedure as washing the sinuses with various solutions. Normal saline or a weak saline solution is best suited for this purpose. You can use special sprays that contain steroid hormones and have an anti-inflammatory effect. But, although these drugs are considered practically harmless, nevertheless, consultation with a doctor is necessary.
Sometimes therapists and ENT doctors recommend using a long course of antibiotics, but they must be taken in small doses. This applies to macroloid preparations, which are characterized by low toxicity and high antimicrobial activity. In addition, they additionally stimulate the immune system, strengthening the body’s defenses.
If chronic sinusitis develops against the background of an allergy, then contact with an irritating factor should be avoided if possible, appropriate remedies should be taken and observed by an allergist.
Since inflammation of the teeth of the upper jaw is a common cause of chronic sinusitis, it is necessary to see a dentist every six months and carry out timely treatment, even, as it seems, of minor caries.
When sinusitis is caused by damage to the nasal septum, both injuries and congenital pathologies, it is necessary to contact a plastic surgeon. In this case, after the operation, relapses do not occur, provided that everything went well.
As for the treatment of sinusitis at a time when it is in the phase of exacerbation, here we can distinguish drug therapy, non-drug therapy. The first should include the use of sprays and drops, which are aimed at reducing the swelling of the sinus mucosa, which has undergone inflammation. Also, such drugs contribute to the discharge of pathological contents. Such treatment is carried out for a week, if the therapy does not have the desired effect, then the prescribed funds should be reviewed.
Drugs containing antibiotics. If sinusitis is purulent, then they are used both in injections and in the form of tablets. At the initial stage, you can use antibiotics that are part of a variety of drops.
Doctors also prescribe mucolytics, which thin the mucus and promote its excretion.
If we talk about other methods of treatment, then a fairly common procedure is a puncture of the sinuses. For this, a special needle is used, then the sinus is washed with antiseptics and a certain drug is injected. This method is very effective for removing puffiness, reducing headaches, up to its complete elimination, and also in general for treating the acute phase of sinusitis.
As an alternative to punctures, at the moment there is such a procedure as the installation of a YAMIK catheter. This procedure is practically painless, as it is performed under local anesthesia, and there is no need to make a puncture.
Nasal lavage can be carried out both independently and in the office of an otolaryngologist. It depends on the severity of the disease. To achieve this goal, both antiseptics and saline solutions are used.
As an auxiliary therapy, general strengthening drugs, vitamins and immunomodulators are prescribed. Physiotherapy is carried out if the patient is on the mend and chronic sinusitis proceeds without complications. Sanatorium treatment gives good results. A visit to the salt rooms gives good results and significantly reduces the risk of a runny nose, and hence sinusitis.
When it comes to prevention, then the most effective method is adequate and competent treatment of the disease at the initial stage, when a slight runny nose begins. That is why it is important for people who know that they have such a disease not to let it flow by itself. The less hypothermia will be, the more regular hardening procedures will be carried out, the more balanced and rational the diet will be, the easier the disease itself will proceed. Do not forget to wear masks, especially during the rampant SARS. By following the appropriate doctor’s recommendations, you can not remember the recurrence of chronic sinusitis for a long time.
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