Symptoms of rhinosinusitis in adults. Symptoms and treatment of rhinosinusitis in adults. Therapy for fungal forms of rhinosinusitis

Rhinosinusitis is an acute or chronic inflammation of the mucous membrane of the nasal canals and paranasal sinuses, which was caused by a cold and prolonged hypothermia, infection of the upper respiratory tract with a fungal, bacterial or viral infection. The disease differs in the severity of the clinical picture depending on what exactly caused the damage to the epithelial tissues of the nasopharynx.

Rhinosinusitis is a disease that simultaneously affects the entire system of the upper respiratory tract located in the nasopharynx. The inflammation is so extensive that the patient’s health is extremely unsatisfactory, and the disease itself requires urgent medical treatment. As a result pathological process in the nasal canals, severe swelling of the mucous membrane of all tissues of the nasopharynx develops and natural circulation air. The intensity of the symptoms depends on which particular strain of microorganisms caused the disease, as well as how quickly the person sought treatment. medical care.

The most dangerous is purulent rhinosinusitis, which developed under the influence of pathogenic microorganisms such as Staphylococcus aureus, Pseudomonas aeruginosa or streptococcal infection. Treatment of rhinosinusitis, regardless of the form of the disease and the nature of its origin, is based on the patient taking antibacterial drugs, anti-inflammatory drops, warming and rinsing the nose antiseptic solutions. A radical method of therapy is puncture of the inflamed sinus and forced evacuation of purulent exudate.

Individual properties play a major role in the treatment of the disease. immune system sick, since in people with strong immunity, rhinosinusitis goes away much faster and without the risk of reoccurring in the form of a relapse. Among the large number of factors influencing the development of rhinosinusitis in previously absolutely healthy people, most often in medical practice meet following reasons diseases:

the presence of a diseased lesion in the body chronic infection, which develops in a sluggish state, but is regularly spread to all parts of the body along with the blood flow (sore teeth, prostatitis, tonsillitis, pyelonephritis, gastritis and other pathologies internal organs, prone to hidden flow).
daily work in conditions low temperatures, which causes constant hypothermia and colds;
acute respiratory bacterial, viral or fungal infection that entered the cavity of the paranasal sinuses along with the air flow during the act of breathing;
bad habits in the form of alcohol abuse, smoking, taking narcotic drugs(have an indirect effect on the occurrence of rhinosinusitis, as they significantly weaken the immune system);
living in a region with an unfavorable environmental situation, where the air is oversaturated with toxic vapors of chemicals;
an acute allergic reaction, manifested in the form of profuse rhinitis, which continues for several weeks;
severe injuries to the surface of the face, as a result of which the integrity of the bones of the bridge of the nose or directly one of the paranasal sinuses was damaged;
undergone surgery on the upper jaw, which was performed incorrectly, leading to infection, or ineffective medications were used during the recovery period.

It is these causative factors that are most often determined by an otolaryngologist based on the results of the initial examination of the patient.

Based on this, the doctor selects a list of tests for the patient that will need to be taken, and subsequently creates a treatment regimen.

The first symptoms of rhinosinusitis

Signs of the disease can easily be confused with a cold or ARVI, which often happens in the first days of the development of the disease. Still, there are some features of the manifestation of rhinosinusitis in adults, which are characterized by the following symptoms:

Complicated forms of rhinosinusitis can also manifest as pain in the upper teeth (with inflammation maxillary sinus), cough, if an infection has entered the lower respiratory tract. When the first signs of the disease appear, you should immediately seek help from an otolaryngologist.

Types and forms of the disease

Depending on what triggered the development of the disease, rhinosinusitis is classified into types and forms of flow. This allows the attending physician to more effectively formulate a therapeutic course to combat the disease and select medications that are appropriate to use in a specific clinical case.

Forms of rhinosinusitis

The main forms of rhinosinusitis include:

chronic, characterized by sluggish inflammation, which is formed as a result of an untreated cold, influenza virus, acute respiratory viral infection, or exposure to any other infectious agent (manifests itself in the form of periodic exacerbations and is difficult to treat conservatively);
spicy with stormy clinical picture, a vivid manifestation of symptoms and accumulation of purulent exudate in the cavity of the paranasal sinuses (lasts from 3 to 7 days, and then passes or transforms into a chronic form).

Types of rhinosinusitis

The main types of rhinosinusitis include:

hyperplastic;
odontogenic;
exudative;
viral;
fungal;
bacterial rhinosinusitis;
left-handed;
right-sided;
catarrhal;
vasomotor rhinosinusitis
purulent;
allergic.

The most severe type of inflammatory disease of the nasopharynx is considered to be the occurrence of bilateral rhinosinusitis in the patient, regardless of its form. In this case, the doctor has to deal with a very extensive focus of the pathological process, the elimination of which will require a long period of time and the patient taking a large number of potent medications.

Diagnosis and which doctor to contact?

Rhinosinusitis, like most other inflammatory diseases of the mucous membrane and epithelial tissues of the nasopharynx, are under the care of an otolaryngologist. If, due to certain circumstances, this specialist specialist is not available on staff at the clinic, then in this case the patient needs to make an appointment with a therapist. To make a diagnosis, the doctor prescribes the patient to undergo following procedures

and taking tests:
blood from a finger for general clinical examination;
urine for which biochemical analysis is carried out;
endoscopy with insertion of a probe into the nasal cavity with visual examination of the internal state of the inflamed paranasal sinuses;
CT scan of the skull and directly all types of tissues of the facial disc;
X-ray of the frontal part of the head to determine foci of inflammation and the presence of purulent exudate in the paranasal sinuses;
venous blood for testing the body’s immune response to potential allergens (prescribed if there is a suspicion of an allergic type of rhinosinusitis);

Having received conclusions on these types of tests, the attending physician has comprehensive information, which plays a key role in making a diagnosis and further developing a treatment regimen.

Treatment of rhinosinusitis in adults - how and with what?

In order to get rid of rhinosinusitis once and for all, it is necessary to pay great attention to the selection medicines and therapeutic techniques in general. Only in this case is a complete cure possible without the risk of relapse and the onset of severe complications. For this purpose, modern otolaryngology uses medications of the following pharmacological categories.

Antibiotics and other drugs

Effective in the treatment of rhinosinusitis caused by bacterial invasion of pathogenic microorganisms. Antibiotics for rhinosinusitis are indispensable if, according to the results of bacteriological culture of mucus secreted from the nasal cavity selected for research, pathogenic bacteria are detected in concentrations exceeding permissible norms. The most commonly used are antibacterial agents, How:

These medications can be used in the form of tablets and intramuscular injections. The latter method of introducing medicine into the patient’s body brings more positive result and the active components of the medication are better absorbed, and therefore reach the site infectious inflammation. In most cases, injections are prescribed as a therapeutic course, lasting from 7 to 10 days, 2 injections per day (morning and evening).

Antibacterial tablets are taken 2-3 times a day before or after meals, depending on the manufacturer’s recommendations shown in the instructions for use of the medication.

Pills

Medicines for rhinosinusitis, produced by pharmacological companies in the form of tablets, have the following therapeutic properties:

Each group of tablets finds its application at one or another stage of treatment of rhinosinusitis, and the task of the attending physician is to select correct view medication and in the required dosage and duration of use.

Drops and sprays

This category of drugs is intended to directly affect the mucous membrane of the nasal canals, as well as dilate blood vessels that are spasmodic as a result of extensive and acute inflammation. In this case, the best therapeutic effect differs the following types anti-inflammatory sprays and drops:

The patient independently instills these drops 2-3 times a day for 5-7 days. If a patient is being treated for rhinosinusitis in an inpatient department, then the drops are administered by a nurse as a therapeutic procedure. Drops and sprays are always included in the treatment course as an auxiliary element and cannot be used as an independent medicine.

Inhalation with a nebulizer

One of the newest methods of treating rhinosinusitis. Indicated for use in chronic forms of this disease, since the acute type of the disease does not always allow steam inhalations, because there is a real risk of an even greater exacerbation of the inflammatory process and worsening general condition sick. The following medications are used as a therapeutic basis for inhalation:

decoctions of anti-inflammatory herbs (chamomile, St. John's wort, thyme, sage, coltsfoot, plantain);
saline solution to provide a general steam effect without saturating the inflamed epithelial tissues with the active components of chemicals;
mineral water without gases, which contains a high concentration of alkali;
soda solution prepared by mixing baking soda with distilled water;
syrups and antibacterial suspensions, which are prescribed by a doctor if their use is therapeutically appropriate.

In each clinical case, one or another inhalation base is effective. Throughout the course of treatment, each type of medication can be used alternately to ensure maximum antimicrobial or anti-inflammatory effect.

The principle of treating rhinosinusitis using a nebulizer is as follows:

the patient fills the filling compartment of the inhaler with a liquid medicinal base, which will be used to relieve inflammation and fight pathogenic microorganisms;
the device is turned on and begins heating the liquid and converting it into steam;
the mouthpiece of the nebulizer, like a hookah, is inserted into the cavity of the nostril and the patient draws in healing steam, thereby inhaling the mucous membrane of the upper respiratory tract of the nasopharynx, as well as the paranasal sinuses;
The duration of the procedure for each nostril is from 3 to 5 minutes, but no more.

The general treatment course for inhalation with a nebulizer if the patient has rhinosinusitis lasts from 5 to 7 days, and depends on the type of drug used as a healing base. If necessary, at the insistence of the attending physician, the duration of therapy can be extended to 10-15 days.

Traditional treatment at home

Non-traditional methods of treating rhinosinusitis are based on practical application folk recipes, which have been popular among a large number of people for many centuries and have proven themselves to be a truly effective means of combating acute or chronic inflammation in the nasal canals and paranasal sinuses. They were used when medicine, in the modern sense of the word, did not exist in principle and in the matter of treating diseases people could only rely on their own strength. There are the following most effective ways traditional treatment rhinosinusitis, while at home.

Aloe juice with honey

These are natural anti-inflammatory drops, which are quite possible to prepare yourself from improvised means. To do this, you will need to take 1 leaf of an indoor aloe flower, wash it under running water, put in a food processor or mechanical meat grinder, and then grind to a paste. Having received the green mass, it must be placed on clean gauze, folded in two layers, wrapped and squeezed out the juice into a container prepared in advance for this purpose.

Add half a teaspoon of honey to the resulting green liquid and stir thoroughly until completely dissolved. This home remedy instill 1 drop into the nose in the morning and evening for the next 5 days. During application, drops are possible discomfort inside the nose, itching, urge to sneeze, copious secretion of mucus from the nasal canals. Despite all the discomfort, the effect of aloe juice in combination with honey is very high and has its own medicinal properties acts as an alternative to chemical antibacterial drugs. If this does not grow in the house indoor plant

, then it can be replaced with Kalanchoe. This flower is no less effective.

Nasal rinsing At home, this is one of the most useful and at the same time accessible folk remedies for treating rhinosinusitis. To prepare an antiseptic solution, use kitchen salt and boiled water, cooled to a temperature of 37 degrees Celsius. To do saline solution , you will need to take 1 teaspoon of salt and dissolve it in 1 liter. After all the salt crystals are completely dissolved, the salt water is poured into a metal bowl and the patient begins the procedure of rinsing the paranasal sinuses.

To do this, one nostril is pinched with a finger, and an antiseptic liquid is drawn in through the free nasal opening. As soon as the paranasal sinuses are completely filled, the blocked nostril is released and the patient releases a solution through it, along with which the purulent mucus accumulated in the paranasal sinuses comes out, as well as a large number of bacterial microorganism. Thus, an anti-inflammatory and antibacterial effect is achieved. In this case, the saline solution destroys not only bacteria, but also viral and fungal microorganisms.

An alternative to kitchen salt can be potassium permanganate (potassium permanganate), the preparation of which is not a particularly difficult task even for those people who have not previously encountered this kind of antiseptic solutions. 1-2 manganese crystals dissolve in 1 liter of warm water. It is very important that they dissolve completely, otherwise a chemical burn is possible if a small grain of this chemical substance gets on the delicate mucous membrane of the nasal canal. Subsequently, all manipulations are similar, as in the case of rinsing the nose with a salt-based solution.

Warming up with dry heat

In order to warm up the paranasal sinuses at home and achieve a positive therapeutic result, you need to take 3 tablespoons of kitchen salt and pour it onto the surface of a clean handkerchief. After this, a bag is formed from it by tying the corners. Place a handkerchief with salt on a dry frying pan or radiator so that it warms up to the optimal temperature. As soon as the salt reaches a sufficient temperature, the handkerchief is placed against the surface of the face in the area where the source of chronic inflammation is located.

The procedure is performed in the morning and evening for 10-15 minutes. In acute rhinosinusitis, heating is not recommended.

Acupressure

This physiotherapeutic method of treatment is easy to perform at home, and it is based on the fact that 2 times a day the patient independently massages the wings of the nose in the upper and lower parts in order to provide additional blood flow to the epithelial tissues of the nasopharynx, with which the source of inflammation enters a larger number of immune system cells that fight pathogenic infection. Massage movements should be circular so that it is physically possible to cover the entire area of the inflamed sinus.

The duration of one massage session is 15-20 minutes. To enhance the therapeutic effect in combination with massage, it is recommended to use warming ointment Zvezdochka, sea buckthorn or eucalyptus oil.

Complications and consequences

Rhinosinusitis, regardless of the type and form of its origin, is a dangerous disease due to the high likelihood of developing severe complications and negative consequences for organs and tissues located in close proximity to the inflamed paranasal sinuses, as well as the nasal canals in general. This is possible if the patient ignored the symptoms of the disease for a long period of time and did not seek medical help at the clinic, or, due to the incompetence of the doctor, the course of treatment was incorrectly formed. In this case, the patient expects the following health problems:

in women who are pregnant, rhinosinusitis can provoke premature birth if the due date is at the beginning of the 3rd trimester, and a miscarriage is possible in the 1st trimester (rhinosinusitis during pregnancy is still dangerous due to pathologies of fetal development);
osteomyelitis of the facial bones due to untimely evacuation of pus from the paranasal sinuses;
infection in the roots of the upper teeth with their destruction and loss;
spread of pathogenic microorganisms from the tissues of the nasopharynx throughout the body along with the blood;
bacterial inflammation of the heart muscle, destruction of its valves and various heart dysfunctions;
violation of the integrity of the paranasal sinus and the entry of purulent exudate into the cavity of the cranium, which in 89% of cases ends in meningitis varying degrees heaviness;
complete or partial loss of sensitivity to odors with irreversible consequences;
exhaustion of the immune system caused by the constant presence of a chronic focus of inflammation saturated with pathogenic microorganisms.

Most dangerous complication rhinosinusitis for each patient is blood poisoning and the onset fatal outcome. These consequences are possible if a person has been suffering from acute purulent rhinosinusitis for a long time, initially had a severely weakened immune system, and did not take anti-inflammatory and antibacterial medications.

Rhinosinusitis, like any other inflammatory disease upper respiratory tract of the nasopharynx, it is better to prevent it than to subsequently treat it. Therefore, it is necessary to take the following steps in a timely manner clinical guidelines disease prevention measures:

always dress according to weather conditions, wear a hat in the cold season;
harden the body with daily dousing cold water, taking a contrast shower, wiping with snow and a damp towel;
do a light jog every day in the fresh air to strengthen the immune system and saturate all tissues with oxygen (20-30 minutes of light jogging is enough);
sleep at least 8 hours a day, avoid physical and psycho-emotional fatigue;
balance your diet, avoid bad habits, eat more fresh vegetables, fruits, cereal porridges, boiled chicken, beef, lamb, which contain maximum protein and a small percentage of fat.

The main preventive rule for rhinosinusitis is monitoring your health and timely treatment of colds and acute illnesses. respiratory diseases, inflammatory processes in the tonsils and the front wall of the throat.

We will talk about several inflammatory processes that simultaneously affect the nasal mucosa and paranasal sinuses. This combination of disorders has a common name - “rhinosinusitis”. It is diagnosed in almost 5% of people seeking medical help. In this case, a severe course of the disease is quite often observed. Why is this happening? If the diagnosis is rhinosinusitis, can treatment be effective? Let us consider further the answers to the questions posed.

What is rhinosinusitis?

Rhinosinusitis is the collective name for various diseases nose It is usually indicated as a preliminary diagnosis. Depending on the duration of the inflammatory process, acute and chronic rhinosinusitis are distinguished. After an examination involving the use of various methods, patients are found to have:

sinusitis, in which the inflammation was localized in the maxillary (maxillary) sinus;
ethmoiditis with edema in the ethmoidal labyrinth;
frontal sinusitis with damage to the frontal sinus;
sphenoiditis (pathology of the sphenoid sinus);
pansinusitis - inflammation of all sinuses at once;
hemisinusitis, in which several sinuses are affected, but on one side.

The impetus for the development of the disease is often given by ARVI. With a viral infection of the nasopharynx, microorganisms intensively develop in the paranasal sinuses. Due to severe swelling, the passage of air through the nose and the outflow of secretions worsen, creating conditions for the spread of infection.

The cause of rhinosinusitis may be untreated vasomotor rhinitis, accompanied by a runny nose and a feeling of complete blockage of the nose.

Bacteria can cause the disease. Allergies and weakening of local/general immunity contribute to damage to the mucous membrane.

Pathology affecting several nasal sinuses is also caused by the growth of polyps. If the tumors are not removed, conservative treatment will not give the desired result, and the inflammation will spread.

Paying attention to symptoms

Rhinosinusitis in adults and children is characterized by difficulty breathing and nasal congestion. Regardless of the stage of development and severity of the disease, common symptoms are noted:

Depending on the severity of the lesion, other symptoms are added to these symptoms.

Inflammation is most pronounced in the acute form of rhinosinusitis. Since it is characterized by active reproduction of pathogenic bacteria, general poisoning of the body occurs. Symptoms last no longer than 12 weeks. This disease can recur 4 times during the year - once a season.

With further development of the disease appears heat(up to 38 degrees), pain in the paranasal areas, swelling spreading to the eyelids and other areas of the face. The discharge becomes profuse and purulent. If these symptoms are ignored and the disease continues, changes occur that require immediate medical intervention.

In severe cases of the disease, the following are noted:

severe pain and swelling in the forehead;
swelling around the eyes;
body temperature above 38 degrees;
double vision, decreased visual acuity;
displacement/protrusion eyeball and paralysis of the eye muscles;
hearing impairment;
loss of smell.

When treatment was untimely and the disease could not be eliminated within 12 weeks, a chronic form of the disease develops.

Diagnosis and treatment

A patient with suspected rhinosinusitis should be examined. To clarify the diagnosis it is necessary to:

Only based on the diagnostic results can you decide how to treat rhinosinusitis in order to obtain a lasting result.

To relieve symptoms, measures are taken to eliminate the source of the disease process, its causes (pathogenic pathogens, polyps, allergens) and free up channels for mucus removal. The attending physician prescribes antibiotics, and this is done based on the results laboratory research nasal discharge. The most popular medications are Amoxicillin, Cefaclor, and Clarithromycin.

An important stage of therapy is cleansing the nasal cavity. Drops of vasoconstrictor and antibacterial action, drugs to ensure the outflow of mucus (Naphazoline or Xylometazoline) are used. Complex treatment it is impossible without rinsing the nose with effective products “Dolphin”, “Aquamaris”, containing sea salt rich in microelements.

If the inflammation is caused by an allergy, the use of antihistamines(“Allercaps”, “Fenistil”). With their help they eliminate severe runny nose, sneezing, watery eyes, dry cough. However, antihistamines should not be taken at the same time as antifungals, since this combination negatively affects the functioning of the heart.

At complex therapy the use of drugs to strengthen the body's defenses is provided. In this regard, bacterial lysates have proven their effectiveness. We are talking about a vaccine that helps develop immunity and prevent relapse.

Medicines from a folk pharmacy

To some, concepts such as rhinosinusitis and treatment seem incompatible folk remedies. However, for many nasal diseases, doctors recommend contacting folk medicine. Medicines based on medicinal plants− valerian, eucalyptus, sage, calendula, chamomile. They have antibacterial properties and can reduce inflammation and swelling.

According to one of the recipes, a decoction of calendula, valerian, sage, and eucalyptus leaves is prepared. All components are taken in equal parts and placed in a three-liter pan so that they occupy a third of the container. The raw materials are poured with water to the top of the pan and boiled for 10 minutes. When the broth has cooled down to room temperature, it is filtered and used for washing. The procedure is carried out 3 times a day. This decoction can be dropped into the nose. Products based on St. John's wort, chamomile, and marshweed are also prepared.

You can make drops at home. You need to take celandine and aloe juice in a 1:1 ratio, and then add honey. It should occupy 1/3 of the volume of the entire product. The mixture is instilled 6 drops into each nostril 3 times a day. For treatment, cyclamen juice extract (2 drops each) and linden liquid honey (2 drops each) are also used.

Healers advise preparing oil drops based on propolis. Needed in 100 ml olive oil dissolve a small piece of propolis, and then apply the resulting product to your nose twice a day. Patients claim that with the help of this medicine almost all symptoms of the disease are relieved.

Prognosis and prevention

Timely treatment of rhinosinusitis always gives a chance for a complete recovery, and the correctness of the chosen measures is confirmed by a decrease in the manifestations of the disease. Passes headache, discharge, nasal congestion. The radiograph shows an improvement in the permeability of the canals. In the acute form of the disease, recovery occurs within a few days, but sometimes it takes about two weeks to get the effect.

The chronic form of rhinosinusitis threatens the spread of infection into the orbit and cranial cavity, the development dangerous diseases, including orbital phlegmon, purulent meningitis. However, such complications arise when medical recommendations are ignored or incorrect therapy. In the absence of complications, treatment gives a positive result, and the period required for rehabilitation depends on the response to the drugs.

If the cause of inflammation is odontogenic sinusitis, reproduction of one of the types of fungus, growth of polyps, shown surgical intervention. Without the use of drastic measures, the therapeutic effect will not last long, and the body will develop resistance to the drugs.

As a preventative measure, it is recommended not to overcool, lead a healthy and active lifestyle, and visit the dentist on time. For acute respiratory viral infections and infectious rhinitis, it is necessary to carry out timely therapy, but for any disease you should not abuse antibiotics and self-medicate.

There are diseases that are characterized by widespread occurrence according to medical statistics. These include rhinosinusitis - what is it? Rhinosinusitis is a disease of the mucous membranes of the nose and paranasal sinuses due to various infections and bacteria.

The disease appears in the form of an inflammatory process that affects the nasal mucosa.

Depending on how long they last clinical symptoms, the following forms of rhinosinusitis are distinguished:

acute – the disease lasts for at least one month, and the symptoms are pronounced;
subacute - a person is sick for about three months, but after recovery the symptoms completely stop;
recurrent - the duration of symptoms is more than 10 days, and such episodes can occur up to 4 times a year;
chronic rhinosinusitis – bothering a person for more than 3 months.

Clinical picture of rhinosinusitis

The main symptoms of the disease include constant headache, copious discharge from the nasal cavity, and difficulty breathing. In addition, symptoms are often observed that are not characterized by constant manifestations. These include a decrease in the quality of smell and periodic coughing. Some people, as a result of the disease, have blocked ears, an increase in body temperature, and a general feeling of weakness in the body.

Maxillary rhinogenic sinusitis is accompanied by pain in the face, bridge of the nose and above the eyebrows. If a person suffers from sphenoiditis, he feels pain at the back of the head and in the central part of the head. Especially painful sensations increase if you sharply turn or tilt your head.

When the sphenoid sinuses or ethmoid labyrinth are affected, mucous or purulent discharge is observed, which can flow down the nasopharynx or during blowing the nose.

To treatment chronic rhinosinusitis was effective, it is necessary to seek help from an otolaryngologist when the first signs of the disease appear. He must find out the cause of the disease and then prescribe quality treatment.

Why can a person get rhinosinusitis?

Most often, due to their constant employment, people suffer from ARVI and runny nose on their legs, despite the fact that all experts recommend bed rest. This is the first step to rhinosinusitis.

In addition, the inflammatory process in the nose quickly activates with physical deformation of the nasal walls. Thus, a deviated septum, the presence of adenoids or polyps in the nose interfere with its independent cleansing, which leads to stagnation of mucus.

If a viral infection enters the body, the mucous membrane swells and the glands begin to actively secrete their secretions. When mucus stagnates, bacteria can easily settle there. If patients use uncontrollably antibacterial drugs, fungal rhinosinusitis develops.

Chronic allergies may also be the cause. bronchial asthma, weakened immune system. As external factor The disease is considered to be the influence of poor ecology.

Vasomotor form of the disease

Vasomotor rhinosinusitis is characterized by narrowing of the nasal cavity and occurs due to swelling of the nasal turbinates. With this pathology, the blood vessels dilate and the nasal turbinates swell, resulting in a severe runny nose. How to treat vasomotor sinusitis with difficulty breathing and watery nasal discharge? Why can self-medication lead to suppuration of the sinuses?

To properly treat rhinosinusitis of this form, you need to conduct a thorough examination to identify signs of VSD, do a visual examination of the nasal cavity, and take samples for allergens.

This is the only way to accurately establish the diagnosis – vasomotor rhinosinusitis.

Chronic rhinosinusitis

This form of the disease can affect all paranasal sinuses, either on one side or on both sides at once. Headaches often refer to the visual organs, especially at night and in bright sunlight. In addition to the secretion of viscous mucus, there is always an unpleasant odor in the nose.

If a person knows what rhinosinusitis is and is aware that he has it, but does not see a doctor, this can lead to:
inflammation of the soft tissues of the face;
development of otitis media, bronchitis or pneumonia;
the formation of abscesses in the eyes, which can result in permanent loss of vision;
meningitis, abscess or encephalitis; disruption of the central nervous system
, after which a person may fall into a coma;
spread of infection through the blood to all vital organs;

the worst outcome – death. TO preventive measures treatment refers acute form

diseases, timely removal or filling of teeth, elimination of allergies, strengthening the immune system through frequent walks in the fresh air, sports, and hardening. It is very important to give up all bad habits.

Purulent rhinosinusitis

It occurs when infections and bacteria and other pathogens enter the epithelial tissue of the sinuses. Before treating purulent rhinosinusitis, it is important to test the bacteria from the nose by culture. Only then can the doctor make an accurate diagnosis and prescribe the necessary medications.

Purulent form of rhinosinusitis - symptoms and treatment: signs of the disease include pain in the teeth, swollen face, discomfort on palpation, aching joints, problems sleeping. Treatment of chronic purulent rhinosinusitis involves thinning the mucus in the nose, restoring its patency, as well as tissue regeneration, relieving swelling, and increasing immunity.

Often this type of disease can be confused with a common cold. At the very beginning, a person feels a general malaise, gets tired quickly, while the body temperature rises, it becomes difficult to breathe, expectoration appears, the face swells, the head hurts, tears often flow, this is how catarrhal rhinosinusitis manifests itself.

If constant relapses are observed, the situation is complicated by decreased performance, deterioration in memory quality, and loss of the sense of smell. Before deciding how to treat catarrhal rhinosinusitis, you should consult your doctor in order to avoid allergic reactions.

Manifestation of rhinosinusitis during pregnancy

During such a delicate period, a woman’s body experiences hormonal changes, so the nasal mucosa may swell. Discharge and bleeding appear from the nose. In addition, the cause may be a respiratory viral infection.

The manifestation of the disease is discomfort in nasal breathing for 10 days or more. So, the attending physician understands that a complication of simple rhinitis has developed into rhinosinusitis. The respiratory function becomes very complicated, so a specialist may prescribe the use of vasoconstrictor drugs.

Treatment of the disease

The main principle of treatment is a local effect on the source of inflammation, as well as work to improve the protective functions of the body. The doctor’s task is to help destroy the causative agent of the disease, prevent complications and cases of relapse, and reduce the duration of symptoms.

Before starting to treat rhinosinusitis, doctors must conduct an instrumental examination, collect the patient’s medical history, and conduct laboratory tests.

Characteristic clinical manifestations suggest the use of antibacterial therapy. If there is purulent inflammation, antibiotics must be prescribed.

To cure chronic rhinosinusitis, physiomagnetic therapy and laser treatment are used to relieve swelling, in addition to special means. The contents of all sinuses must be removed, and allergens must also be dealt with.

If you have to deal with maxillary rhinosinusitis, puncture and cleaning are very often resorted to, since they are quite easy to perform. This makes it possible to rinse the sinuses from the accumulated secretions, as well as treat them with antiseptic agents.

Depending on the current situation, the clinic may recommend rinsing the nose with solutions, performing so-called nasal showers, and being treated with ultrasound, microwaves or ultra-high-frequency current.

Surgical intervention

Patients often ask their doctor what the diagnosis of rhinosinusitis means? Perhaps this is due to the fact that many are thinking about the need for surgery. Indications for this method arise if antibacterial therapy did not bring relief, and serious complications developed inside the skull.

Today, preference is given to those treatment methods that are less traumatic to a person, do not lead to progression of the disease, and do not cause bronchial asthma.

Treatment of the disease with folk remedies at home

For rhinosinusitis, treatment with folk remedies can be effective when used drug therapy. Previously, grandmothers forced their children and grandchildren to breathe over boiled potatoes, covered with a towel.

So, after twenty minutes of steam therapy, you had to lie down in a warm bed until your face cooled down. In addition to potatoes, “Zvezdochka” balm or other substances with menthol or garlic are often used for inhalation.

To effectively eliminate rhinosinusitis, treatment should be carried out by inhalation. Today, homemade poultices have been replaced by nebulizer inhalation products. These include saline and alkaline solutions, drugs with antibiotics.

One of the most frequently asked questions, which doctors receive, is it possible to warm the nose with rhinosinusitis? It is prohibited to warm up such a disease, since the inflammatory process can only intensify, which will lead to meningitis.

It must be remembered that vasomotor rhinosinusitis is a disease that affects the nasal sinuses, in which a lot of secretion appears, which greatly interferes with breathing. A recurring illness manifests itself in a person if no action is taken in time.

To know exactly what rhinosinusitis is and how to treat the disease, first of all you need to consult a doctor, and then follow all the instructions.

Sinusitis (“sinus” means paranasal sinus) is an inflammatory disease of the mucous membrane of the nasal sinuses (maxillary, frontal, sphenoid or ethmoid). Sinusitis is almost always accompanied by simultaneous inflammation of the nasal airways and often precedes symptoms of rhinitis, so the term "" was introduced to more accurately describe this condition.

Rhinosinusitis can be acute (lasting from 2 to 12 weeks, depending on the severity of the disease) and chronic, lasting more than 12 weeks. Chronic rhinosinusitis often develops against the background of allergies. Prolonged inflammation and accumulation of mucus in the sinuses contributes to the addition of a secondary infection (various bacteria and fungi).

As a result, the mucociliary function of the nose is disrupted, changes occur in the mucous membrane and polyps begin to grow. The condition of the nasal passages and sinuses worsens even more, new infections appear, new polyps grow, the cycle repeats, and it is difficult to break it.

Features of the disease in children and pregnant women

Chronic rhinosinusitis is a common disease in children, but it may be underestimated because it is very difficult to suspect. Symptoms in babies are limited and may be very similar to common cold or allergies. Cough and nasal discharge are often the only manifestations of rhinosinusitis. also in childhood The sinonasal complex is not fully developed and the immune system is not strengthened, so there is more high risk complications.

In pregnant women, the development of the disease is associated with decreased immunity and hormonal changes in the body. Treatment in such circumstances becomes more difficult as strong drugs must be avoided.

Classification of chronic rhinosinusitis

There are 3 forms of chronic rhinosinusitis:

no nasal polyps (common inflammation);
polypous (with nasal polyps);
allergic rhinosinusitis.

In origin, it can be infectious (viral, bacterial and fungal) and non-infectious (caused by allergies, deviated nasal septum, immunodeficiency diseases, etc.).

This classification has great therapeutic significance, since each type of rhinosinusitis has its own manifestations and is treated differently.

What causes chronic rhinosinusitis?

Most cases of chronic sinusitis are associated with acute sinusitis, which is either untreatable or does not respond to treatment. Chronicity of the disease occurs under the influence of many factors at once, leading to disruption of the patency of the sinus mouth and ciliary function, a decrease in the level of oxygen in the sinus, and an increase in the viscosity of the mucous secretion.

These include:

allergy;
asthma;
cystic fibrosis;
allergic and non-allergic rhinitis;
anatomical deviations in the structure of the nose and paranasal sinuses;
immunological disorders;
inhalation of polluted air and cigarette smoke;
dental diseases;
hormonal changes ( puberty, pregnancy, oral contraception);
tumors;
repeated viral infections upper respiratory tract.

With sinusitis, a favorable environment for the growth of bacteria is created in the sinuses, which, in turn, further contributes to increased inflammation of the mucous membrane.

Bacteria thought to be involved in chronic inflammatory process, differ from the bacteria that cause acute rhinosinusitis. Moreover, the carrier often has several types of microbes.

Scientists have compiled the following list of common bacterial infections that occur in chronic rhinosinusitis:

Staphylococcus aureus (Staphylococcus aureus);
hemophilus influenzae;
M catarrhalis (Moraxella catarrhalis);
Pneumococcus;
Streptococcus intermedius;
Pseudomonas aeruginosa;
anaerobic bacteria (Peptostreptococcus, Prevotella, Porphyromonas, Bacteroides, Fusobacterium species).

Also recently, a theory has been put forward that fungi may be the cause of chronic rhinosinusitis. Since fungal spores are present in the air, they can be found in respiratory tract even in healthy people. Under the influence of certain factors (listed above), mushrooms lead to inflammation, and in some people they can cause allergic reaction. The most common types of fungal infections that cause chronic rhinosinusitis are Aspergillus, Candida, Cryptococcus, Sporotrix.

Symptoms and signs of chronic rhinosinusitis

Most cases of chronic rhinosinusitis are a continuation of unresolved acute sinusitis, but the chronic form of the disease manifests itself differently than the acute form.

Primary symptoms of chronic rhinosinusitis include:

nasal congestion;
not a profuse runny nose (can be mucous or purulent), with a characteristic flow of mucus into the throat, or purulent discharge during rhinoscopy;
pressure in the face, pain;
decreased sense of smell.

Secondary signs of chronic rhinosinusitis include:

headache;
fever;
unpleasant odor from the mouth and nose;
general weakness, fatigue, malaise;
toothache;
cough;
pain and pressure in the ear.

These manifestations are hardly noticeable, not the same as in acute rhinosinusitis, so they are often ignored. As a rule, when a secondary infection occurs, the patient’s condition worsens.

Diagnosis of the disease

Diagnosis of chronic rhinosinusitis consists of successive steps:

It begins with a thorough and detailed history taking. The clinician should be able to collect information about the timing and severity of symptoms associated with the disease. There are certain criteria (signs and symptoms of chronic rhinosinusitis) that help establish the correct diagnosis. The disease is suspected if the patient has 2 or more major symptoms, or 1 major and 2 or more minor symptoms, that persist for more than 12 weeks.

Interesting! When diagnosing, doctors determine the severity of the patient’s condition and the impact of the disease on his quality of life. A severity scoring system was developed to evaluate these parameters. Clarification of the effect of chronic rhinosinusitis on the patient’s body functions is necessary to establish future treatment results.

In addition to medical history, physical signs are important criteria in the diagnosis of ENT diseases. The most simple method Rhinoscopy is used to examine the nasal mucosa, but it does not allow you to see distant areas of the nasal passages. Nasal endoscopy, although more invasive, is the preferred method of examination. It provides a magnified image of the nasal mucosa, turbinates and the inside of the nasal airways.

Endoscopy helps in assessing the integrity of the mucous membrane and also directly shows changes in it, polyps, crusts or discharge. Endoscopy can also be used to take samples of tissue and secretions for further laboratory testing.

Finally, an X-ray or CT scan is performed, which give a clear picture of the condition of the bone structures and nasal mucosa. CT helps to identify various abnormalities, confirm the diagnosis and choose the right treatment option, and in candidates for surgery, clearly determine the anatomy and extent of the disease.

Magnetic resonance imaging (MRI) is not recommended for the diagnosis of chronic rhinosinusitis, but it is superior to CT in differentiating infectious (bacterial or viral) inflammation from fungal lesions, as well as in identifying malignant neoplasms. In addition, MRI can help detect orbital and intracranial complications.

Laboratory tests such as nasal cytology, mucosal biopsy, and blood tests are not necessary for clinical diagnosis. They only help determine the presence of a bacterial infection or allergy, or more serious conditions such as cystic fibrosis, ciliary dysfunction, or various immunodeficiencies.

How and with what to treat chronic rhinosinusitis in adults and children?

Treatment of chronic rhinosinusitis in adults and children is aimed at:

reduction of swelling of sinus tissues;
facilitating mucus drainage;
elimination of concomitant infections.

In addition, to cure rhinosinusitis, it is necessary to eliminate predisposing factors such as allergies, deviated nasal septum, polyps, etc. Patients with immunodeficiency should be given intravenous immunoglobulin therapy.

A clear principle of treatment for chronic rhinosinusitis has not been fully established, largely due to the fact that doctors cannot determine the exact causes of its origin.

In different cases, the following methods are used:

Corticosteroids. They relieve symptoms of the disease, but it is unclear whether this is due to a decrease in nasal congestion or a decrease in inflammation in the sinuses themselves. There is evidence that corticosteroids are effective in polypous chronic rhinosinusitis. It is preferable to use nasal agents, that is, drops and sprays: “Nasonex”, “Beconase”, “Risonel”, “Nazofan”. They are suitable for the treatment of chronic rhinosinusitis in children and adults. The course of treatment lasts 1-3 months or more. In severe cases or before surgery, a 3-5 day course of oral corticosteroids may be recommended.
Decongestants. To eliminate nasal congestion and runny nose, you can periodically use vasoconstrictors (Naphthyzin, Nazolong, Xinos, Rinoxyl, Nazol, etc.), which eliminate swelling. Pregnant women can use them only with the permission of a doctor!
Irrigation with hypertonic saline solution. This method helps clear the nasal passages and relieve symptoms of the disease, but does not cure it. At the pharmacy you can buy a ready-made saline solution for rinsing the nose in a convenient bottle, for example, “No-Sol”, “Physiodoza”, “Nosalen”, “Physiomer”, “Aqua Maris”. Nasal rinsing is useful for any type of chronic rhinosinusitis, and such procedures can be combined with any other medicines. The saline solution is safe even for the smallest children and pregnant women.
Antihistamines. Allergic chronic rhinosinusitis must be additionally treated with antiallergic drugs. You can use nasal medications (Cromohexal or Prevalin) or tablets (Loratadine, Claritin, Erolin, etc.). It is advisable not to choose a medicine yourself, but to entrust this matter to a doctor.
Antibiotics. They are indicated for purulent rhinosinusitis, but should not be administered unless there is suspicion of acute bacterial infection. Pregnant women are prescribed antibiotics in extreme cases. The first line drug is usually "" or "". If they do not give results, then another antibiotic is prescribed, with more wide range actions. The duration of the course for the chronic form is 2-3 weeks, but if necessary it can be extended.
Antifungal drugs. They are necessary if the disease is caused by fungi. Topical antifungals (eg, Amphotericin B) inhibit fungal growth and reduce inflammation.
Surgery. It has long been the method of choice for advanced cases of chronic rhinosinusitis that does not respond to drug treatment. With the advent of endoscopy, most surgeries are now minimally invasive. Purpose surgical treatment is the restoration of sinus ventilation, correction and restoration of functionality of the mucous membrane. Functional endoscopic surgery for chronic rhinosinusitis helps achieve positive results with complete or moderate relief of symptoms in 80-90% of patients. Of course, the operation must be supplemented with drug therapy.

Therapy is continued until remission occurs, but after some time an exacerbation may occur. Exacerbation of rhinosinusitis chronic form are treated again using the same regimen or, if necessary, other options are considered.

Treatment of catarrhal rhinosinusitis at home

Below are traditional methods treatment of chronic rhinosinusitis. They should be used after consultation with a doctor and only in combination with traditional medicines.

Warming up with dry heat. To relieve the symptoms of pain and speed up the healing process, it is recommended to warm the sinus and nose areas with a bag of heated salt (or other bulk material) or a boiled egg. Warming up lasts 15-20 minutes. You can do it 1-2 times a day. Please note that during the procedure you should not experience discomfort, so the salt should not be hot, and you can additionally apply a towel to your face. At purulent inflammation Warming up is strictly prohibited!
Nasal rinsing. Make your own saline solution by mixing 0.5 tsp in 0.5 liters of boiled warm water. salt. Bend over the sink and, turning your head to the side, pour the solution into the upper nostril through a syringe or bulb. Do the same with the other nostril. Such procedures are very useful both for the treatment of rhinosinusitis and for prevention. They can be done every day.
Steam inhalations. At home, you can do them using a special inhaler or in another convenient way. You need to breathe over the steam for about 10 minutes 2-3 times a day. Inhalations help soften mucus, steam and moisturize the nasal mucosa. If you add herbal decoctions to the water for inhalation, essential oils or bee products, then an additional anti-inflammatory effect is obtained.
Homemade drops. You can use beet, carrot, and aloe juice as drops for sinusitis. Onions are also an effective antimicrobial agent. Its juice must be mixed with water in a ratio of 1:5 so as not to burn the mucous membrane.

Why is chronic rhinosinusitis dangerous?

Chronic rhinosinusitis is rarely life-threatening, although serious complications can occur due to proximity to the orbit and cranial cavity. Approximately 75% of all orbital infections are directly related to sinusitis. Intracranial complications of chronic rhinosinusitis (meningitis, brain abscess) remain relatively rare, but they are the most dangerous and can be fatal.

In most cases, the disease leads to consequences such as a persistent decrease in the sense of smell, deterioration in the quality of life and performance.

Disease prevention

The best prevention of chronic rhinosinusitis is the correct treatment of acute sinusitis. In addition, you need to eliminate possible irritants (cigarette smoke, dust) and monitor the air humidity in the house so that it is not too dry.

To prevent relapse of chronic rhinosinusitis, related conditions should be treated: allergies, asthma, adenoids, immunodeficiency, etc.