Sinusitis in adults

Sinusitis can develop at any age. Most often, this disease is ill in the cold season, as well as in the summer swimming season. The main reason for the development of sinusitis is the spread to the paranasal (maxillary) sinuses of a viral and bacterial infection from the nasopharynx. Sinusitis can also develop as a complication of rhinitis and other diseases of the respiratory system.

Causes of sinusitis

Infection of the paranasal sinuses is caused by bacteria and less often by fungi, it is possible to be affected by viruses, allergens.

Sinusitis can also develop as a complication of rhinitis and other diseases of the respiratory system. Other causes of the disease include:

• respiratory forms of allergy (hay fever, year-round rhinitis);
• anatomical features of the structure of the nasal cavity, congenital or acquired anomalies in the structure of bones and cartilage;
• a weakened immune system;
• influenza and SARS;
• polyps and adenoids;
• chronic diseases of ENT organs and the respiratory system;
• uncontrolled use of nasal drops;
• neoplasms of the paranasal sinuses and nasal cavity;
• diseases of the dental system;
• ENT injuries.

If acute sinusitis is not treated, it can develop into a chronic one, in which exacerbations of the inflammatory process periodically occur with the release of a large amount of mucus and pus.

Classification

Along the course, acute sinusitis is distinguished, with the most pronounced manifestations, and chronic, with periods of exacerbations (intensification of symptoms) and remissions (when there are no signs of the disease or they are minimal).

By the nature of the discharge, they distinguish:

• catarrhal sinusitis with mucous discharge from the sinuses (aseptic, not infected);
• purulent – with the release of purulent contents from the sinus, with pathogenic microflora.

According to the way the infection spreads, they are distinguished:

• hematogenous drift (with blood flow, more typical for children);
• rhinogenic (from the nasal cavity, more typical for adults);
• odontogenic (drift into the sinus of pathogens from the area of ​​diseased teeth in the upper jaw);
• traumatic (with bone fractures, injuries of the face and nose).

According to the nature of changes in tissues, chronic forms of sinusitis are divided into:

• exudative (with catarrhal or purulent inflammation) – secretion predominates;
• productive – polypous or polypous-purulent, atrophic, parietal-hyperplastic, necrotic processes, changes in the structure of the mucous membrane;
• sinusitis with the formation of true and pseudo-cysts of the maxillary sinuses.

According to the affected area, one-sided and two-sided sinusitis is distinguished.

Symptoms of sinusitis in adults

Symptoms of sinusitis include:

• weakness;
• nasal congestion;
• nasal discharge;
• chills;
• an increase in temperature from slight to extremely high;
• pain that radiates to the eye, tooth, head;
• swelling of the eyelids, buccal region;
• sinus pain.

Sinusitis is a rather severe pathology, and if left untreated, it can become a source of complications. The most common complications of sinusitis are the transition to a chronic form, the development of tonsillitis, bronchitis and pneumonia, otitis media and more severe ones: meningitis, sinus thrombosis with the development of sepsis, brain abscess, pericarditis, myocarditis, glomerulo- and pyelonephritis.

Treatment of sinusitis in adults

Treatment of sinusitis depends on the cause that caused it. It is necessary to contact an ENT doctor, and in case of a serious condition or the need for surgical intervention, hospitalization in a hospital.

Diagnostics

The doctor makes a diagnosis, carefully analyzing the patient’s complaints and the history of the disease (when the symptoms began and how they developed), evaluates the earlier the person was ill. In addition, the diagnosis requires:

• external examination with the definition of vasodilation under the orbit area;
• examination of the nasal cavity, where inflammation, swelling and discharge from the mouth of the sinus are visible;
• radiography of the maxillary sinuses with the detection of blackouts, where inflammation is localized and pus accumulates;
• MSCT of the paranasal sinuses, ultrasound, MRI;
• sinus puncture (if there is not enough data for the diagnosis).

Additionally, the doctor prescribes blood and urine tests, and when performing a puncture, sowing the contents on the flora.

Modern treatments

To reduce swelling of the mucous membranes and normalize the ventilation of the sinuses, the outflow of secretions, vasoconstrictor drugs are used in a short course (Tizin, Nazol, SNUP, Rinostop, Rinonorm).

If the temperature is elevated and general malaise is expressed, antipyretic and combined drugs (Nurofen, Ibuklin, Paracetamol, Pentalgin, Rinza) are used to reduce fever and malaise, headache. Against the background of intoxication, antibacterial drugs are used, selected by the doctor strictly individually. They can be administered both systemically and locally, into the sinus cavity.

As the condition improves, a complex of physiotherapeutic procedures is used to completely suppress inflammation and prevent relapses.

If it is chronic sinusitis, it is important to treat those processes that lead to exacerbations – bad teeth, adenoid vegetations, straightening of the nasal septum (septoplasty). With an exacerbation, the tactics are the same as with an acute process. If pus accumulates, the sinuses are washed – “cuckoo” or sinus evacuation (YAMIK-therapy) with disinfectant solutions, the introduction of antibiotics and proteolytic enzymes into the sinus cavity.

Supplement the treatment with physiotherapy during the period of remission or attenuation of the acute process. With the ineffectiveness of conservative measures, the doctor will recommend an operation – sinusotomy.

What antibiotics to use for sinusitis?

The choice of antibiotic for sinusitis depends on the severity of the process and the pathogen that caused it. The most effective for sinusitis are: ampicillin, azithromycin, clindamycin, antibiotics of the cephalosporin group.

Antibacterial therapy is selected only by a doctor, it depends on the clinic of the disease, age and the state of the general immune system.

What drops can be used for sinusitis?

In the initial stage of sinusitis, especially with nasal congestion, vasoconstrictor nasal drops may be useful. They relieve swelling of the nasal mucosa and maxillary sinuses, it becomes easier to breathe. Vasoconstrictors include:

• Xylene;
• Your knees;
• Sinupret;
• Vibrocil;
• Atryvin

The mucous membranes are well washed and preparations based on pure sea water prevent the accumulation of mucus and pus. These drugs do not contain chemicals, so they do not have side effects and contraindications. These include:

• Aquamaris;
• Aqualor;
• Physiometer.

Folk remedies

Everyone decides for himself to use folk remedies or give preference to drugs with proven effectiveness.

Folk remedies for the treatment of sinusitis are divided into:

• inhalations (for example, inhalations with alcohol tincture of propolis);
• compresses (often use clay compresses, which can be bought at a pharmacy);
• drops (for example, drops from rosehip oil or sea buckthorn).

It is important to emphasize that these should not be the main methods of treatment, and all manipulations should be carried out only after consultation with the attending physician.

Prevention at home

In order to prevent the development of sinusitis and prevent its transition into a chronic form, it is important to follow a few rules:

• dress according to the weather;
• engage in physical education – physical activity helps to strengthen the immune system, however, you should not engage in them during an exacerbation;
• it is important to observe the correct diet – in winter, the body needs more vitamins;
• timely treatment of colds;
• strengthening immunity;
• treatment of chronic ENT pathology: deviated septum, chronic rhinitis, adenoid vegetations, nasal cavity polyps;
• dental sanitation.

Popular questions and answers

We discussed with the doctor otrinolaryngologist Tatyana Odarenko possible complications, effective techniques and some home treatments for sinusitis, as well as the possibility of self-treatment.