Sinusitis (sinusitis, frontal sinusitis, ethmoiditis, sphenoiditis)

Sinusitis is an infectious and inflammatory process localized in the sinuses or within the sinuses. Doctors distinguish two types of this disease: acute sinusitis (characterized by serous hyperemia, then purulent discharge and usually lasts 2-3 weeks) and chronic sinusitis (traditionally occurs as a result of more than one-time repeated and insufficiently cured acute sinusitis).

What are sinuses?

The sinuses are four pairs of air cavities located inside the head, within the nose. They are also called paranasal cavities or within the nasal sinuses. Types of sinuses:

  • sinusitis – inflammation of the mucous membrane of the maxillary (maxillary) sinus;
  • frontal sinusitis – inflammation of the frontal sinus;
  • ethmoiditis – inflammation of the ethmoid labyrinth;
  • sphenoiditis – inflammation of the sphenoid sinus.

Each sinus opens into the nasal cavity for free passage of air and mucus, so any infection, immune or allergic reaction in the nasal cavity also captures the sinuses. With inflammation, the air in the sinus, along with pus or other discharge, puts pressure on the walls of the sinus and causes pain. Also, if the inflamed sinus membrane prevents air from getting inside, a vacuum appears in the cavity, causing pain.

Symptoms of sinusitis

The localization of pain depends on which of the sinuses is covered by inflammation. The typical symptoms of sinusitis are:

  • headache, especially severe in the morning;
  • mucous or purulent discharge from the nose;
  • pain in the upper jaw, toothache, pain when pressing on the cheeks with inflammation of the maxillary sinuses (sinusitis);
  • inflammation of the ethmoid sinuses (ethmoiditis) causes swelling and swelling of the soft tissues within the eyes, eyelids, pain between the eyes. The wings of the nose become sensitive to the slightest touch, there is a partial loss of smell and nasal congestion;
  • with inflammation of the frontal sinuses (frontal sinusitis), the leading symptoms are severe headaches, mainly in the forehead and a feeling of heaviness in the projection of the affected sinus;
  • infections of the sphenoid sinuses (sphenoiditis) are relatively infrequent and are manifested by ear pain, pain in the neck, pain “at the top” of the head.

The remaining symptoms of sinusitis are similar to those of colds, namely: high fever, weakness, fatigue, night cough, nasal congestion, etc. Penetration of mucous, serous or purulent secretions from the sinuses into the throat can cause inflammation. It is not uncommon for sinusitis to cause brain infections, especially in frequently ill babies.

What are the causes of acute sinusitis?

The most common cause of acute sinusitis is a respiratory viral infection or, simply put, the common cold. Viruses can enter the sinuses, causing them to become inflamed. For example, when viruses or bacteria enter the nasal cavity, the body responds with an immediate immune response, overproduction of mucus and an increase in the number of lymphocytes in the nasal mucosa. All this leads to a narrowing of the lumen of the nasal passages and difficulty in breathing. When the inflammatory process captures the mucous membrane of the sinuses, this also leads to its swelling and difficulty in the release of air and mucous discharged from the sinus cavity. A slow or complicated outflow of mucus creates additional conditions for the reproduction of bacteria.

Bacteria such as Streptococcus pneumoniae or Haemophilus influenzae can normally reside in the upper respiratory tract without causing an inflammatory reaction. However, in the case when the body’s defenses are weakened or the outflow of mucus from the sinuses is hampered by an infectious cold, these bacteria begin to multiply intensively, causing acute sinusitis.

Sometimes sinus inflammation is caused by a fungal infection. It occurs in cases where the immune system of the body is weakened and often proceeds according to the allergic type.

Chronic inflammation of the sinuses, vasomotor rhinitis, inhalation of cold air, and even some deodorants can also lead to the development of sinusitis.

What are the causes of chronic sinusitis?

Allergic reactions, bronchial asthma, immunodeficiency states are the most common causes of chronic sinusitis. When allergic to dust, plant pollen or mold, vasomotor rhinitis occurs, which serves as a trigger in the development of chronic sinusitis. Studies conducted in the United States have shown that 80% of patients with allergic rhinitis and 75% of patients with bronchial asthma also suffer from sinusitis.

In some people, cold, damp climates and polluted environments contribute greatly to the development of chronic sinusitis.

As in the case of acute sinusitis, immunodeficiency states (AIDS, cystic fibrosis), as well as nasal polyps, play an important role in the development of chronic inflammation.

Sometimes sinusitis occurs as an adverse reaction to certain medications, such as non-steroidal anti-inflammatory drugs.

How is sinusitis diagnosed?

Your doctor can diagnose sinusitis by listening to the symptoms, examining the nasopharynx, ordering an X-ray and, if necessary, a CT scan.

Sinusitis treatment

After the diagnosis has been made and the possible cause of the disease has been identified, the doctor will prescribe the appropriate treatment for you.

In acute sinusitis, decongestant products are mainly prescribed to eliminate nasal congestion, antibiotics, painkillers and immunocorrectors.

When using decongestant drops or sprays, you must strictly adhere to the prescribed treatment schedule and dosage of the product, because. with uncontrolled use, the symptoms of edema or nasal congestion may increase.

Antibiotics that are effective against a certain type of microorganism that caused the disease can be prescribed for sinusitis both in monotherapy and in combination with antifungal products and immunocorrectors. When prescribing antibiotics, you must constantly be under the supervision of a doctor in order to avoid the development of complications (allergic reaction).

Separately, it is necessary to dwell on the treatment of chronic sinusitis. Treatment of this type of sinusitis is a rather difficult task, because. often present in the sinuses microorganisms do not respond well to antibiotic therapy. Steroidal anti-inflammatory products (oral or nasal spray) are usually prescribed to reduce inflammation and swelling, although they have a number of undesirable side effects.

In cases where sinusitis is the result of another, more serious disease (for example, bronchial asthma or an allergic reaction), treatment is started from the last.

With the ineffectiveness of drug treatment, they resort to a surgical operation (removal of polyps and serous contents of the cavities). In pediatric practice, for example, the removal of adenoids is often practiced to facilitate nasal breathing. The most modern and safe surgical method for the treatment of sinusitis is the use of endoscopic sinus surgery.

Prevention of sinusitis

Of course, you will not be able to protect yourself from any cold, but it is in your power to increase the body’s resistance, thereby reducing the number of colds and preventing their chronic course.

Here are some simple tips:

  • if you are prone to colds, ventilate the room more often, also avoid inhaling humid and cold air for a long time;
  • try not to breathe dust, cigarette smoke, and other air pollutants (especially if you have allergies);
  • if you suffer from allergies, be sure to identify the allergen with your doctor and take a course of desensitization;
  • avoid swimming in pools with chlorinated water, because. chlorine has an irritating effect on the mucous membrane of the nasal passages;
  • If you fly by plane, the increasing pressure can cause discomfort and even pain in chronic sinusitis, so doctors recommend that you always use decongestant drops before flying to avoid these problems.