Maxillary sinusitis: causes, symptoms, treatment

What is maxillary sinusitis?
Symptoms
Complications
Types and types of maxillary sinusitis
How is maxillary sinusitis diagnosed?
Treatment
Etiotropic therapy
Puncture
"YaMiK"-catheterization
Treatment of symptoms of maxillary sinusitis
Surgical intervention
Treatment at home
Prevention

Maxillary sinusitis (from the Latin “sinus” and “inflammation”) is an inflammation of the mucous membrane of the corresponding sinuses. The causes of this disease are various: allergies, rhinitis, diseased teeth, inflammation of the tissues around the teeth, injuries. Treatment includes conservative procedures, home remedies, and surgery.

What is maxillary sinusitis?

A person has several types of sinuses: frontal, sphenoid, maxillary and cells of the ethmoid labyrinth.
In each of these types, inflammation of the mucous membrane can occur. Then sinusitis will begin. Maxillary sinusitis is otherwise called sinusitis and is an inflammation of the paranasal sinuses. The maxillary sinuses were first illustrated by Leonardo da Vinci, and the disease itself was discovered by Nathaniel Highmore, a British surgeon and anatomist (he also described the maxillary sinuses in detail in his treatise of 1651). At that time, sinusitis was treated with home methods and heating.

Causes and course of the disease

Maxillary sinusitis occurs:

catarrhal;
purulent;
parietal-hyperplastic;
polyposis;
fibrous;
cystic;
allergic.

The causative agent of the disease is coccal flora, most often streptococcus. Recently, fungal microflora, anaerobes, and viruses have begun to act as pathogens. An increase in various types of aggressive associations is also noted, which increase the degree of pathogenicity of pathogens. Due to the transition of the inflammatory process to a chronic form, obstruction (closure) of the outlet (ostium) occurs and the drainage and ventilation function is disrupted, which leads to the accumulation of exudate and the inflammatory process worsens.

The development of the disease is promoted by:

deformation of the nasal septum;
synechia (pathological adhesions in the nasal cavity);
adenoids;
aggression of pathogenic microorganisms, as well as the formation of their associations.

The following factors predispose to the development of this disease:

incomplete cure of acute rhinitis;
allergy;
decreased local and general immunity;
disruption of microcirculation of the mucous membrane and permeability of blood vessels and tissues.

Types and types of maxillary sinusitis

Depending on the etiology (cause of occurrence) of the disease, rhinogenic, odontogenic, traumatic and allergic maxillary sinusitis are distinguished.

Rhinogenic sinusitis occurs against the background of rhinitis (when the nasal mucosa becomes inflamed). The mucous membrane is the main obstacle to infections. When bacteria gets on it, a runny nose or rhinitis develops. The causes of rhinitis are different: viruses, hyperthermia, allergies.

, decreased protective properties of the body, penetration of synthetic agents, influence of dry air, too long use of drugs with a vasodilator or vasoconstrictor effect.

Rhinitis is characterized by congestion, nasal discharge, impaired circulation in the nasal cavity, and the development of congestive blood phenomena. There are 4 types of rhinitis: allergic

, chronic, acute, vasomotor.

Odontogenic sinusitis occurs due to inflammation of the mucous membrane of the maxillary sinus due to infection from an unhealthy tooth, the tissues around it, and the communication formed between the sinus and the oral cavity after tooth extraction. Symptoms of this disease can be apathy, loss of appetite, headache, aching temples, discharge from the nose or ear, cough, runny nose and others. Depending on the course of the disease, different treatment methods are chosen: antibacterial therapy and washing of the maxillary sinuses, pumping out pus or surgery.

Injury to the maxillary sinus or jaw can also lead to sinusitis.

The cause of allergic sinusitis is the body's hypersensitivity to one of the irritants. The disease begins in the nasal cavity and then spreads to the maxillary sinuses. What usually serves as an allergen? This is pollen during the flowering period, fur and excrement of pets, dust mites, medicines, household chemicals, perfumes, cosmetics, chemicals, dirty city air.

According to the duration of the disease, sinusitis is divided into:

acute (less than 3 months);
recurrent acute (can repeat up to four times a year);
chronic (more than 3 months);
exacerbation of chronic sinusitis (adding new symptoms to existing ones).

According to the severity of symptoms, sinusitis is:

lungs
moderate severity
heavy.

When to suspect the development of acute purulent sinusitis:

If against the background of a runny nose and nasal congestion:

the discharge from the nose becomes yellow-green in color and sometimes acquires a foul odor
nasal congestion gets worse
a feeling of stuffiness or heaviness in the area of the maxillary sinuses (infraorbital area to the right and left of the nose) occurs
headache
pain in the projection of the maxillary sinus (facial pain), a feeling of pressure and pain in the maxillary sinuses may intensify when the head is tilted down.
often there is a feeling of inability to concentrate, deterioration in general well-being
the temperature may rise to subfebrile levels (37-37.8 degrees)

How is maxillary sinusitis diagnosed?

When diagnosing a disease, it is necessary to collect a number of indications: find out about complaints, write down symptoms, analyze the patient’s medical history and conduct an examination (computed tomography, x-ray).

Possible symptoms: headache, temporal pain, nasal and ear discharge, accumulation of mucus in the back of the throat, intoxication (in severe cases).

The medical history should contain information about past illnesses, injuries, hypothermia, etc.

The examination usually consists of palpation and percussion in the area of the paranasal sinuses, and also includes pharyngoscopy and rhinoscopy.

Why, when symptoms of acute purulent sinusitis appear, you should urgently consult an ENT doctor:

Do not forget that “the nose grows on the head,” which means that any purulent diseases of the paranasal sinuses mean the presence of pus in the skull, in close proximity to the cavity of the orbits and to the brain, therefore complications can be extremely serious, with the most unpredictable consequences:

Otitis
Intraorbital complications (orbital cellulitis, orbital abscess)
Intracranial complications (meningitis, encephalitis, brain abscess)

There is no need to try to cope with sinusitis on your own. The presence of a purulent process in the sinus indicates that it cannot empty itself and if time is lost, there is a high probability that the pus will make its way into one of the nearby organs.

Treatment

Etiotropic therapy

Prescribing antibacterial agents (the main causative agents of acute sinusitis) helps to achieve rapid results in therapy:

β-lactams: amoxicillin, clavulanate, cefaclor, cefuroxime axetil, sulbactam;
fluoroquinolones: levofloxacin, gatifloxacin, moxifloxacin;
macrolides: azithromycin, clarithromycin.

Puncture

This method is used if the disease cannot be cured with medication. It is the most famous method for removing pus from the maxillary sinuses. Quite painful, unlike other procedures.

"YaMiK"-catheterization

A fairly effective remedy in the fight against maxillary sinusitis, it does not cause complications. The procedure is quite painful, like puncture; patients cannot always tolerate it well.

Important: the operation is not advisable for isolated lesions of one paranasal sinus, since infection can be introduced into healthy paranasal sinuses.

Clinical picture

Mostly during an exacerbation, patients complain of difficulty breathing through the nose and discharge from the nasal cavity, which can be mucous, mucopurulent or purulent.

The purulent form of the disease is accompanied by complaints of discomfort in the area of the canine fossa and the root of the nose from the inflamed maxillary sinus. In some cases, pain may radiate to the superciliary or temporal region. Headache during an exacerbation is most often diffuse in nature, resembling trigeminal neuralgia. Hyposmia or anosmia (decreased or loss of sense of smell) is often observed. Quite rarely there are cases of closure of the nasolacrimal duct, and then lacrimation from the eye is observed.

Hyperplastic bilateral maxillary sinusitis occurs. During the period of exacerbation, along with all the signs of this disease, general weakness, malaise, and high (febrile) temperature (38-390C) are noted.

Friends! Timely and correct treatment will ensure you a speedy recovery!

Treatment of symptoms of maxillary sinusitis

Symptomatic treatment of sinusitis includes topical decongestants (such as xylometazoline and oxymetazoline) that improve sinus ventilation, mucolytics (such as carbocysteine) that improve mucus secretion, topical antiseptics (miramistin and others) and irrigation therapy (such as nasal douches). , before using which you need to use vasoconstrictor drugs), which flush out mucus and kill microbes in the sinus cavity, topical glucocorticosteroids, combined drugs (non-steroidal and anti-inflammatory drugs - paracetamol, ibuprofen).

Among the most effective drugs for treating the symptoms of sinusitis are
Sialor based on silver ions . It has an anti-inflammatory effect and prevents the proliferation of bacteria. Thanks to the mild action of the drug, the balance of microflora is maintained and favorable conditions are created for the regeneration of the nasal mucosa.

Surgical intervention

Drug treatments are not always effective; sometimes it is necessary to resort to surgery. At the same time, both approaches to diseased sinuses (extranasal, endonasal, combined), surgical technologies (magnifying devices and lighting devices), and surgical methods differ.

Important: after sinusitis, patients should be periodically (at least once every 3 months) observed by an otolaryngologist.

Treatment at home

An option for treating maxillary sinusitis at home is steam inhalation, which improves blood circulation, thins mucus accumulations, and also improves the flow of medications from the blood. But in acute cases of maxillary sinusitis, this method is dangerous; it can provoke generalization of the infectious process.

You can do inhalations with a decoction of herbs (calendula, celandine, bay leaf, string of sage, chamomile). Add alcohol tincture of propolis (1 teaspoon per 0.5 liter of decoction) and a couple of drops of iodine to boiling water.

In addition to such inhalations, you can also breathe over boiled potatoes. Important: you need to breathe for 10 minutes every day, the course is a week.

Warm the nose with table salt in a bag, boiled with an egg, and a blue lamp. Rinse the nose with the following solution: 1 teaspoon per glass, furatsilin (2 tablets), herbal decoctions (sage, celandine, chamomile). The procedure can be repeated up to 10 times a day.

Diagnostics

Physical and instrumental examinations together with radiation diagnostics (computer and magnetic resonance imaging) and a thorough analysis of the patient’s ENT complaints allow us to make the correct diagnosis. It is necessary to distinguish maxillary sinusitis first of all from trigeminal neuralgia, in which pain appears suddenly and is “burning” in nature. Sinusitis is indicated by the appearance of a strip of pus under the middle concha, after the introduction of vasoconstrictor drugs on the probe, or by the predominance of pain in the sinus area without nasal discharge.

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