Schimorite is the most common disease in LOR-Practice. It is characterized by an infectious-inflammatory damage to the apparent sinuses and a pronounced clinical picture. It may proceed in different forms, when untimely therapy leads to severe complications.
What is hymoritis
Given the anatomical features, the skull bones have special cavities that participate in the respiratory process and perform a number of other important functions. One of these cavities is the Gaimores of the sinus. It is localized in the maxillary area and is the biggest. With inflammation, its mucosa is developing sinusitis. This is a serious illness, which is accompanied by a purulent process, nasal congestion, malaise, high temperature and other signs of intoxication. Pathology is prone to quickly progress, so complications are often observed.
Causes of pathology
The predisposing factors of the disease can be internal and external causes. The following states are provoked more often:
Infectious processes localized in respiratory tract.
Regular supercooling of the body.
Rinith on the background of an allergic reaction.
Reduced immune status.
Attacks of bronchial asthma.
Anomalies in the structure of the nasal cavity and partition due to diseases or injuries.
Caries and other infectious and inflammatory pathologies of the dental system.
Other etiological factors of the sinusitis are tumors in the nose, underdevelopment of nasal holes and fibrosis. Such states are less likely to provoke a disease, but they can still call it.
Symptoms of hymorita
Signs of pathology directly depend on the clinical form, general well-being, the reasons, the age of the patient and the presence of burdened diseases.
As a rule, the symptoms of the sinusitis are more pronounced in the acute stage, rather than chronic and manifest themselves almost immediately after the occurrence of the disease.
The following characteristic features of the inflammatory process of the apparent sinuses are distinguished:
Pain. May have one-sided or double-sided localization, different intensity. Basically, it is nulling and driving, increases before bedtime, when the head is tilted forward.
Nasal isolation of purulent nature. The snot clog the moves, causing difficulty breathing. Less often meets the exudate mucosa.
Reducing the olfactory function.
Strong weakness and indisposition.
High temperatures up to 39 ° C.
Geimorite treatment in adults
Treatment of inflammation of the gaymorovy sinuses implies an integrated approach. Patients prescribe symptomatic and etiological therapy. The main medical events in the fight against infectious inflammatory pathology are:
Medicines. Local and systemic preparations are shown in the form of spray, drops, solutions and tablets. Patients prescribe antibiotics, antiseptics, vesseloring medicines and salt solutions for washing the apparent sinuses from purulent content. Also used anti-inflammatory, antihistamine drugs and vitamins. All medicines are encouraged to take strictly to appoint a specialist, adhering to the course and dosage.
Physiotherapeutic methods. It is helpful to relieve respiration, improving the fuma of the purulent discharge and suppressed the inflammatory process. Effective UHF, UFO. Such manipulations are prescribed only during the remission.
Surgical intervention. When conservative methods become not valid, resort to surgery. Patients carry out puncture of the affected sinus to eliminate the pathological secret and washing the nasal cavity with antibacterial, antiseptic means. The operation is made under local anesthesia in several stages.
Geimorite treatment in adults at home
Not only traditional therapy, but also traditional therapy, but also traditional therapy is effective for combating inflammation of the apparent sinuses. It includes safe recipes for the relief of symptoms and the causes of the hymorite. Various means for intakes and solutions for irrigation of the nasal cavity are used.
At home, you can take advantage of the following folk methods:
Tincture of berries. Take fresh sea buckthorn fruits, rosehips and viburnum 1 glasses, pass through a blender. The resulting thing is mixed with 0.5 liters of honey and leave overnight in a cool place. After 500 ml of vodka are added, they are well covered and the week is impeded. Take the remedy before eating three times a day for 1 tbsp.
Drops. For cooking, 1 h Calendula and daisies are used. Dry herbs are poured with a glass of water and boil on fire for 5-10 minutes. The decoction is styled and filtered. Apply in the form of drops 3-4 times a day to reduce the inflammatory process.
Infusion to strengthen the protective functions of the body. To prepare a healing agent, take a Cora Viburnum, John's wort and nettle in a 2: 1: 1 ratio. The dry mixture in the amount of 2 g is poured 200 ml of boiling water and insist 40-50 minutes. Then they pass through the sieve and take inside 2 times.
The following methods use for the prevention of sinusitis:
Sanitation of the nasal cavity by salt solutions during the flu and colds.
Reception of vitamins.
Hardening the body, regular walks in the fresh air.
Compliance with hygienic rules.
Exception of supercooling.
Also to warn the sinusitis helps healthy nutrition, lack of bad habits and timely treatment of viral infections.
Skimorites are called inflammatory processes in the maxillary sinuses of the nose. Gaymorov sinuses occupy the entire bone cavity of the upper jaw. Sinusitis is one of the varieties of sinusitis - sinus inflammation, i.e. Empty bone cavities forming a person's face. The disease is based on the inflammation of the mucous membrane covering the inner walls of the sinuses, sometimes the disease penetrates into the bone tissue.
Types of hymorita
Depending on the causes of the disease, the mechanism and the course of the disease, the hymorites are divided into several types or types.
A sharp hymorite is a rapidly developing form of a disease, which, as a rule, is a consequence of sharp respiratory diseases: ARVI, colds, conventional runny nose, as well as inflammation of the roots of the anterior teeth of the upper jaw. The mechanism of the disease is the same: the pathogens of the disease through thin channels, which are connected by the sinuses with the nose, or through bone jaw tissue penetrate the sinuses. The body begins to produce lymphocytes - special cells of the immune system, which are designed to neutralize dangerous microorganisms. A mucus accumulates in the sinuses, which flows into the nose through the channels. If the mucus clogs the channels, it accumulates in the sinuses, starts putting on the walls, causing even greater inflammation.
If the mucus without obstacles leave the place of inflammation, the disease passes without complications. When the channels are blocked, problems begin:
- Increased temperature;
- breathing difficult;
- With touches, the upper jaw hurts around the nose;
- man sleeps bad at night;
- There is ailment, fatigue;
- reduced performance;
- swells face.
In some cases, the inflammation of the hymiclines takes a chronic form: as a rule, this happens after one or more attempts to treat acute hymorite. Chronic inflammation of the apparel sinuses may be due to the presence of other diseases that are not related to ENT organs or traumatic factors. Symptoms of inflammation periodically poke and sharpen:
- The body temperature is increasing, not exceeding 38 degrees;
- Headaches arising when head slopes appear and disappear;
- From the nose, the sniles of yellow, yellow-green shades flow;
- The smell worsens - the patient does not feel smell of food;
- constantly swells face;
- For no reason, tears go and conjunctivitis appears.
Purulent sinusitis is a complication caused by incorrect treatment or an attempt to independently treat acute forms of the disease. The cause of the disease is most often colds, infectious and viral diseases that a person unfolded or suffered "on the legs". Purulent sinusitis causes the accumulation of pathogenic bacteria in the gaymorovy sinuses. The main danger of this disease is the ability to defeat bone fabrics of the face, it will seriously complicate the treatment and will stretch it indefinitely.
The most difficult flows and is healing the bilateral hymorite - simultaneous inflammation of the mucous membrane in sines located on both sides of the nose. The cause of the disease is most often microorganisms that penetrate into sines from the oral cavity or respiratory organs affected by pathogens - bacteria, fungi and viruses. More often, bilateral hymorite is manifested in acute form, flowing into chronic with ineffective treatment.
The disease is easily diagnosed by the following features:
- intoxication of the whole organism: a sharp increase in temperature, vomiting, pain in the joints and muscles;
- lethargy, apathy, disability;
- swelling of the face on both sides;
- soreness of the region of the hymorrheal sinuses during palpants;
- increased tears;
- highlighting a large number of snot.
People who suffer from a negative reaction of the body's immune system on external stimuli are subject to the disease of the allergic sinister: flower pollen, dust, poplar fluff and even water. Allergen, penetrating the apparent sinuses, causes reinforced the production of leukocytes, which, accumulating in sinus, clog the channels, and praise the mucous membrane.
For allergic sinusitis characteristic:
- Weakness and apathy;
- Pain in the eye and cheeky;
- temperature rise;
- Nose obstruction.
Children and teenagers are most often sick of the catarrhal. It occurs after the harmful bacteria fall into the sinuses, when the mucous membranes of the nasal cavity swell. At the same time, the channel is narrowed through which the mucus is derived. Catarial sinusitis is the easiest form of inflammation, which, with timely treatment, passes quickly and without consequences. People who have undergone catarrhal sinusitis celebrate:
- extension of appetite;
- eyelidity, faces;
- Change color snot;
- elevated temperature;
- the appearance of headaches and a sensation of pressure around the nose;
- Lomotic in the whole body, pain in the muscles.
Polypose sinusitis develops when polyps appeared in the nasal sinuses, overlapping channels to remove mucus from sines. Polyps in sinuses are anomalous painful growths that appear on the mucous membrane as a result of rapid cell division. Doctors have not developed the exact cause of the formation of polyps, believing that they appear as a result of the effects of one or more negative factors: heredity, injuries transferred viral or bacterioligious diseases.
Patients complain about the signs characteristic of most forms of hymorite: an increased temperature, singlation of snot; The deterioration of the overall state, the blurring of taste and smell, nasal congestion.
Teeth disease affect the health of ENT organs, proof of this is an odontogenic hymorite that appears in people who do not follow their teeth. The roots of 4, 5 and 6 teeth in a moay of jaw are very close to the walls of the gaymorny sinuses or germinate inside. Dental disease, hitting the dental crown and root, infects the mucous membrane of the sinuses, "releasing" pus in the sinuses. The mucus, accumulating in the sinus, clogs the channel - a sinusitis develops.
Causes of burning
Gaimorov sinuses are a natural barrier against infections, causative agents of the disease and other negative factors that are in the air, therefore the main cause of the disease by the hymifier is to enter the mucous membrane of infections, allergens, fungi. The pathogens of inflammatory processes can get into the sinuses sinuses through blood.
Detect the operation of the mucous membranes can weaken the immune system of a person: the reasons for the discharge of an insufficient number of leukocytes are constant diseases of the cold, ORVI, rhinitis, allege reactions, improper treatment of diseases.
A person can be a staphylococcus carrier - a kind of harmful bacterium, which may not harm to his owner for a while: immunity successfully copes with it. As soon as the immune defense weakens - Staphylococcus begins his destructive work.
The main reasons that cause a sinusitis can be allocated:
- The injuries of the skimmer sinuses that disturb the mucous membrane;
- illiterate or incomplete cure of a cold or colds;
- hitting the nasopharynx of pathogenic bacteria, fungi and viruses;
- burns of the mucous membranes of sinuses with harmful chemicals;
- insufficient humidification of air in closed rooms;
- Transferred infectious diseases: ORZ, influenza;
- improper structure of nasopharynx organs;
- Physical injury of the nasal partition;
- appearance of neoplasms (adenoids, polyps);
- Allergic reactions to various stimuli;
- HIV, AIDS, tuberculosis;
- Some methods of treatment (radiation irradiation);
- The appearance of malignant and benign tumors.
Medical Fact: One of the main causes of the occurrence of a hymorite is the frequent use of droplets for the treatment of rhinitis. As a result of an excessively frequent use of drugs in sinuses, a large number of mucus in the gaymorette sinuses is formed, causing the blockage of channels into the nasal cavity.
The emergence of several disturbing symptoms individually or at the same time should alert the patient: to launch the development of the sinusitis - it means to lose the best time for treatment and to react many complications up to the inflammation of the brain shell.
Pouring sensations most often appear in the area of the nose and the vigor of it: in the morning the pain is weaker, intensifying by night. The pain acquires an increasing nature: an intexivity is different, from several days to a pair of hours. After some time, pain cease to be felt in specific places and headache appears.
An increase in temperature is the body's reaction to the appearance of pathogens of the disease, which caused such a phenomenon as general intoxication - the poisoning of the body. In the acute form of the disease, the temperature rises to 38 degrees and above. The chronic course of the hymorite may not cause a high temperature or its increase to 37-37.8 degrees. The temperature of the immune system, the characteristics of the body and the age of the sick, the presence of other diseases affect the temperature indicator.
An explicit sign of sinusitis is a plenty of snot. At different stages of the disease, snot can change the shade:
- At the initial stage of the disease, white snot is released - when infection, the mucous membrane actively produces a protective liquid - a white or translucent mucus;
- The development of inflammation causes the extraction of green snot, which will tell the doctor that the sinusitis is in the acute stage;
- Adding to green yellow shade testifies to the appearance of pus and the need for urgent medical intervention.
Footprints and clots of blood in snot - a hazard signal, indicating the severe form of a hymorite, which can lead to the most unpredictable consequences if it does not start treatment in time. Blood can poison during the injury of heavy sinuses, painful changes in the shell and bone fabrics.
Schimorite develops against the background of other signs:
- stuffy nose;
- Pressure in the nose increasing when a man tilts his head;
- apathy and fast fatigue;
- Pain in areas around the nose, eye, cheeky; gums;
- Headache of different intensity;
- lack of appetite;
- It is lost smelling and taste;
- tear appears;
- Unpleasant smell of mouth and nose.
Diagnose a samorite with a high probability can a otolaryngologist, if it is impossible to make a consultation to a profile specialist, you need to make an appointment to the therapist.
Diagnosis of the disease is performed using:
- Anamnese: analysis of data that informed sick, entries from the history of diseases, an outdoor examination of the patient, taking care of painful areas on the face;
- studies using instrumental methods - computer and magnetic tomography, radiogram, ultrasound equipment, biopsy of the sinuses, fibroid endoscopy, diaphanoscopy;
- laboratory testing of tests: blood, discharge from the nose.
Identify an anomaly in the apparent sinuses, a diapaloskop variolates - a medical instrument, "translucent" upper jaw. The final part of the instrument tube contains a powerful light source - a very bright light bulb. In a special darkened room, the doctor introduces a tool into the patient's mouth, directs the light to the upper heaven and looks at the "translucent" sinuses.
Fibroid endoscopy is a research method, in which the examination of the patient's nasopharynx is produced through an endoscope, an optical device that allows you to inspect the organs with their increasing. Modern endoscopes have the functions of the fence of fabrics and the contents of the nose for analysis.
Biopsy - penetration into the nasal sinuses using a special IGY and taking mucus to analyze directly from the place of inflammation.
Help profile doctors
If the diagnosis reveals signs of polypotic sinusitis, then the patient will have to consult with an immunologist, a pulmonologist and an allergist to avoid possible complications: treatment is carried out only surgically. The consultation of the allergist will be necessary in the event of a detection of allergic hymoritis.
For the successful treatment of an odontogenic form of the disease, a dentist will be required: to eliminate the main annoying factor, you will have to heal or remove the roots of affected teeth.
The key to successful treatment is the timely appeal for qualified medical care. Do not hope that "will pass" itself, "do not tolerate pain until the latter - sign up for a doctor. Painty drugs that can be bought at the pharmacy will not get rid of the disease - they will simply weaken the pain.
The treatment of acute hymorite lies in the removal of the swelling of the mucous membrane of the sinuses and the release of the channels for the passage of the mucus: the doctor is prescribed the vasoconstrictor drugs of the local action, for example, Nafazolin. The patient takes the drug not more than 5 days. In order to knock down a high temperature, discharge various antipyretic drugs if the patient continues the lubrication and pain in the muscles, other signs of intoxication are prescribed antibiotics of a common or local action.
The main task in the treatment of chronic sinusitis is to eliminate the causes: the unrealized ENT diseases, diseases of the teeth, incorrectly surrounded the nasal partition, adenoids. If the disease is exacerbated - exacerbations are removed by vesseloring drugs of local action.
To clean the nasal sinuses, wash, which doctors are called "cuckoo": a disinfecting solution is introduced on the back of the patient through the nasal channels. The procedure has received its name because of the request of the medical procedure to repeat the word "ku-ku" - this is done so that the solution does not fall into the respiratory tract. The feeling of the procedure is like immersion in water with a slow "inhalation" of water.
Physiotherapeutic procedures are prescribed to patients who have progress in treatment: the channels of the sinuses are clean, the temperature slept. One of these methods is heating: it is carried out using a blue lamp. Warming up and inhalation can be done on their own at home, having risen above the potatoes with potatoes, covered with a blanket, or applying a hot boiled egg to the area near the nose.
For patients healing from sinusitis, speleotherapy is useful - treatment with air of karst or salt mines, caves: there are no microorganisms in this air, it is saturated with carbon dioxide.
For the treatment of launched molds, and for removal of a polyp and other neoplasms, surgical treatment methods are used.
Puncture or puncture of the sinus make a special needle for the diagnosis and extraction of purulent masses.
Gayrotomy is a surgical operation to open the apparent sinuses to clean them from foreign bodies, pus clusters, channel expansion or the creation of an additional mucus removal path. Guidomy prescribe:
- with severe forms of purulent inflammation;
- when polyps are detected, the expansions of the tissues of the sinus mucosa;
- To remove parts of the roots of teeth, seals.
Do or not do?
When prescribing treatment, the doctor, of course, takes into account the wishes of the patient and with the slightest opportunity to avoid interference appoints conservative treatment. However, it is worth listening to the persistent advice of a specialist to make puncture of the nasal sinus. The fear of the bunch is most often based on the story-stories of a friend, a friend or relative: "I did five times," the hole did not bother a month, although the doctor said he touches three days. "
In most cases, the operation on the puncture of the gaymorovy sinuses occurs without complications, and the wound heals another day depending on the human body. Puncture will allow the doctor to put a more accurate diagnosis, quickly and timely clean the sinus, removing the pus, accelerate the cure.
In order to avoid inflammation in the apparent sinuses, you need to perform a few simple rules:
- fully heal the runny nose, colds, viral and microbial diseases;
- Carefully monitor the hygiene of the teeth, in a timely manner to contact the dentist when the caries appears, the gum diseases;
- Avoid finding in dusty, smoke rooms;
- If possible, avoid sources of allergies, visit the allergist, to take antihistamines prescribed by a doctor;
- There are more fresh vegetables and fruits, buy in a pharmacy and take vitamin complexes to maintain natural immunity;
- With the same purpose, it is possible to start harding - gradually, without extremes like druising with cold water in the winter frost;
- avoid contact with sick people or use medical masks;
- In the event that a member of the family fell ill - to allocate a separate dishes, a towel;
- Do not abuse drops from rhinitis;
- drink more water;
- Wash the nose with a salt of sea salt or with the help of special nozal sprays.
People prone to sickness of sinusitis need to be smaller in cold air, avoid bathing in chlorinated water pools, irritating mucous membrane of the nasal sinuses.
If a person has already picked up a runny nose, then washing with a salt solution - a good means of preventing the blockage of channels of the apparent sinuses. Use the recipes of grandmothers: Install the solutions of chamomile tables in the nostrils, calendulas - natural destroyers of the disease sources.
Reference: You can not independently warm the apparent sinuses in acute hymorite: the high temperature will only "spur" the development of the disease and complicates further treatment.
Among the diseases of the ENT organs, the hymorite is among the most common among adults. Under this term is understood as an inflammatory process, which flows in the epithelial tissue of the maxillary sinuses of the nose, while painful sensations can be given to the forehead area, upper and lower jaws.
The sinusite is dangerous in that in the absence of adequate and timely treatment, it easily goes into a chronic form and can cause a number of complications, since this stage is accompanied by the formation of pus in the cavity of the nasal sinuses.
Among the worst consequences of chronic hymorite in adults can be: meningitis, meningoencephalitis, brain edema (shells) and pus formation in the brain area. All these pathologies can lead to death, so it is important to take action on time and pay attention to the possible symptoms of this disease.
According to WHO statistics (World Health Organization), each eighth person over the age of 20 is diagnosed with acute (78 percent cases) or chronic (22 percent) sinusitis.
The main factor that allows infection to spread to the area of the sinus is to reduce immunity (both local and general). The pathogen of the pathological process is most often golden staphylococcus, but it may be any microorganism, which is present in the microflora of each, even an absolutely healthy person.
The natural protective barrier suppresses the pathogenic growth and development of these microorganisms, so they (as well as their livelihoods) cannot harm the person. But in cases where the body is weakened, excellent conditions are created to manifest the maximum activity of staphylococcal bacteria.
The mucous membranes of the gaymorovy sinuses are most vulnerable, so infectious processes are developing here in the first place.
The sinusitis is often a complication after the transferred influenza, ORVI or ARS, as well as other pathologies caused by viruses and bacteria. The chance to get sick by hymic is significantly increasing in people having the following prerequisites:
- congenital defects of the nasal partition (curve form);
- injury to the nasal bone (fractures and other mechanical damage);
- work under reduced temperature (for example, in warehouses with refrigeration and freezer);
- Polyps and adenoids;
- prolonged use of vasoconducting drugs;
- termination of therapy of colds without recommendation of the doctor;
- impaired nasal cavity anatomy;
- tendency to allergies;
- Temporary decrease in immunity as a result of bacterial, fungal or viral diseases.
It is also worth considering that one of the most common causes of inflammation of the skimorovy sinuses is the poor oral hygiene and poor teeth care, which includes the late appeal to the dental care and the refusal of the proposed treatment.
People suffering from caries or other diseases of the teeth have an increased risk of sinusitis and sinusit (disease in which inflammation affects frontal sines).
One of the first signs pointing to the beginning of the inflammatory process is a toothache that gives the temple and gradually spreading to the forehead.
The acute stage develops rather rapidly and proceeds very painful. The body temperature usually comes to 39 degrees (in some cases it is possible to raise 39.5 degrees). This is due to the fact that the pathogenic flora is actively multiplying, which populates the cavity of the maxillary sinuses, and the immune system is trying to destroy malicious bacteria with its own forces.
The second bright symptom of the sharp stage of the sinus is painful syndrome in the forehead, nasal sinuses, as well as jaws. The pain can be significantly intensified when tilting forward, cough (sneezing), as well as an attempt to press on the wings of the nose.
There are other symptoms that allow you to determine that the pathogenic process in the "fastest". These include:
- The discharge from the nose (usually the mucus has a transparent shade, but when the infection is attached, the snot will be green; if the process proceeds with the formation of a pus, then the dischargeable content is painted in yellow color);
- fear of light;
- ENGLISH ENGLISH.
Under the acute stage of the disease, a person often ceases to distinguish the smells, in very rare cases, violations are possible in the work of taste receptors.
If the disease was not treated to the end, chronic sinusitis develops. Diagnose this condition is quite difficult, since there are practically no characteristic symptoms that can indicate the presence of a pathogenic process.
Nevertheless, certain signs of chronic hymorite in adults still allocate. This is primarily:
- Permanent runny nose who does not give in drug therapy;
- deterioration of general well-being (weakness, reduced performance, drowsiness);
- Periodic temperature rise to subfebrile values (short-term);
- painful sensations in the eye area (internal pain);
- Headaches increasing when changing body position.
This is a special kind of illness, in which irritation of the mucous membrane of the nasal sinus occurs as a result of entering external stimuli (allergens). To occur in this type of pathology, even a small contact with an allergenic agent.
Signs of allergic hymorite in adults are pretty characteristic. The main ones are:
- cough at night of the day (poorly bought by medicines);
- resistant respiratory impairment;
- prelation of the nasal cavity;
- Department of mucus from nasal moves in combination with painful sensations in the field of temporal bone, forehead and cheekbones.
With this form of the sinusitis, it is very often possible to observe a change in voice timbre, which becomes lower, the characteristic "hoarse" appears.
The treatment tactics of sinusitis depends on what type of disease is diagnosed in a patient. For example, to eliminate the allergic type of inflammation of the gaymorette sinuses, the local administration of microscopic doses of allergens is often used in order to produce natural lifelong immunity. Allergic sinusitis does not require surgical intervention - treatment is carried out exclusively conservative ways.
The situation with the acute and chronic form of hymoritis is very different. At the initial stage (if there is no complications), treatment is allowed in outpatient conditions. An integrated therapy is assigned to the patient, including:
Council of the doctor
A good effect is observed from 10-15 session of the massage of the cervical spine. Improving blood circulation increases the body's protective forces, obstructs the exacerbation of the chronic process or contributes to recovery in the complex of therapeutic measures.
- washing the nasal cavity using special preparations or saline;
- the use of antibiotics;
- reception of antihistamine;
- Immunomodulators and vitamins (if necessary).
Nasal washing. This procedure is necessary, since the mucus accumulates in the nasal passages, containing a large number of bacteria, as well as productivity products of microorganisms. To speed up recovery, you need to remove the mucus using drugs.
For these purposes, compositions prepared on sea water are used: Aquamaris, Akvalor. Also for washing the nose can be used by saline (prepared independently or purchased pharmacy).
Antibiotics. Since the inflammation of the geimor sinuses is caused by bacteria, without using these drugs can not do. In each particular case, the doctor individually selects a medicine that will be the most efficient and will give the optimal result.
Most often, the following antibiotics are used to treat adult patients: "Amoxiclav", "Amoxicillin", "Macropen", "Zitrolide", etc. These funds kill the pathogenic flora, helping to get rid of the disease for 7-10 days.
Antihistamines. Used to prevent allergies (if necessary). These drugs include: "Zirtek", "Supratin", "Tueva", "Diazoline", "Loratadine" and others.
Physical. Good results in the treatment of chronic sinusitis give UHF procedures (heating the nasal sinuses). Typically, 5-7 sessions are required to make a significant improvement. The decision on the possibility of conducting UHF is received by the otolaryngologist. In the sharp phase, the inflamed area is impossible.
In the diagnosis, the leading place is occupied by radiography, CT, MRI skull sinus. They show the presence of an inflammatory process, pus, cyst, edema, which is important when choosing a patient's tactics.
Sinus evacuation. This method allows you to quickly clean the sinuses from purulent content. It is used only when the disease has a weak or average severity.
The patient is placed on the couch, after which the catheter with a soft tip is inserted into one nostril, and in another special suction. For washing, a furacilina solution has disinfectant and antibacterial properties, which makes it possible to prevent re-occurrence of infection.
In order for the patient during the procedure does not choose, he needs to constantly utter the word "ku-ku" - it prevents the solution to the solution and in the airway.
Puncture (puncture) sinuses. This method is surgical, as it is required to perform a puncture of the bone partition, which is located between the gaimore sinus and the nasal stroke. Through a sterile needle, the doctor pours salmon to wash the sinuse cavity and remove purulent content that flows into a special capacity through the patient's mouth.
Schimorite is a dangerous and heavy illness, if it is not treated on time, as it can entail the development of complications, including life-threatening (meningitis, the accumulation of pus in the brain area, etc.).
If the ENT doctor diagnosed in the patient a sinusitis, it should be seriously related to the prescribed treatment and strictly fulfill all the prescriptions of the specialist. This will help avoid serious consequences and keep health.
Read more about the diagnosis and treatment of hymoritis, see the video:
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Schimorite is the inflammation of the maxillary sinus, which, by name for the first time describing his English ENT doctor, is called a gaimor. It is connected to the nasal cavity of narrow output holes (odds) of only 1-3 mm in diameter (slightly larger than the diameter of the pens). The inflammation of the nasal cavity causes an edema, and the edema quickly overlaps these same thanks. As a result, the Gaimores of the sinus first closes partially, and if it does not start the treatment on time, it turns out to be completely blocked. Leukocytes rushed into a blocked sinus to fight inflammation. From the school course of biology, everything, for sure, remember that their task is to destroy the infection. So begins acute catarrhal sinusitis. If the correct treatment is started at this time, the chance that the sinusitis will not be purulent or go into a chronic form is very large.
Purulent sinusitis: treatment and proper diagnosis
The number of alien bacteria can be huge, then in response the body produces the same huge amount of leukocytes (diagnosed with such a symptom as leukocytosis). Increased ESP (erythrocyte sedimentation rate) and significantly higher than usual, leukocyte levels in general blood test will show a physician state, so-called inflamed blood.
But it also happens that leukocytes cannot overcome the infection and die. Pnu is formed - the accumulation of dead leukocytes. Then this is a purulent sinusitis - treatment must be immediate and correct.
When the mucous-purulent masses cannot get out of the gaymorny sinuses, they begin to "wander". Any sensible person will understand - it's time in Lor Clinic. With purulent inflammation, flasheled next to the brain, it is better not to joke! It is necessary to contact the doctor, without waiting for the transition to a chronic shape and other hazardous complications.
Complications for hyimorite
Secondary rhingen meningitis (inflammation of the brain shells) is perhaps the most dangerous consequence of a sinusitis. But other rinegenic intracranial complications are also not the best life acquisitions.
As soon as there is a suspicion of the sinusitis, it is necessary to urgently look for an experienced doctor and begin treatment.
How to recognize sinusitis: symptoms
The first sign of the Schimorite is constantly laid out. Usually the forefront is felt on the side of inflammation. With bilateral - on both sides. Can appear bellows.
Another symptom is the pressure in the transfer. Often - pain in the area of the cheek, as well as at the bottom of the orstand. The patient can feel the pressure in the eyeballs and the lower eyelids. In the morning the pain is usually invisible, but becomes very tangible in the evening. Because of the flaring localization, the patient sometimes seems that the reason is simply in headaches. Pain in the gaymor sinus in the perception of a person can be transferred to the teeth of the upper jaw.
Often a sign of sinusitis - swells and lower eyelids swell. And sometimes on the side of inflammation - and the top.
Yellow and green nasal discharge with an unpleasant smell - another sign of inflammation.
The thermometer usually shows up to 38 ° C and higher. But subfebrile (37.1-37.5 ° С) The temperature during the hyamorite - the sign is not rare. It happens more often with chronic form of inflammation.
The chronic form of sinusitis is distinguished by long, sluggish flow and is accompanied by symptoms that worsen the quality of the patient's life
Fatigue and loss of appetite are signs of both acute and chronic hymorite. In patients, due to the overall weakness, usually reduced performance, and disturbing restless sleep
People with a deformed nose partition are risky. Hypertrophied (enlarged) The lower shells of the nose also contribute to the development of the disease, as they close the outlet. Other anatomical changes in the nasal cavity can also provoke sinusitis.
Various formations, the fact that the Laura doctors themselves are usually called the "plus fabric": polyps in the nasal cavity and the incomplete sinuses, cystic education and other growths also increase the risk of sinusitis.
Weakened local immune defense due to the suffered disease, allergies and autoimmune type diseases can also contribute to the development of inflammation.
Environmental environmental factors can also provoke environmental factors: gas acquisition, harmful conditions in production, dust and so on.
How to treat hymoritis?
Even from the previously stated it is clear that the factors of the disease differ, respectively, the recovery rate is selected individually. But the first task of the doctor is always - "otkuping" the vestion of the fatal sinus closed by the essay, in order to ensure the possibility of the outflow of mucus and pus.
Modern treatment of samorite without puncture
To treat the sinusitis without a puncture, conduct "soft" antibacterial and probiotic therapy, that is, use antibiotics, so to speak, the average action force. Normoflorin, Linex, Bion-3 and others are most often among probiotics. Prescribed preparations for removing the edema, as well as vasoconductive action. Use softening means to restore the nasal mucosa. It can be pinsol, euphorbium composites, etc. To restore the mucosa, the sinuspension is most often used. To save the body from microbes and inflamed masses, the incomplete sinuses are washed with aqualor, Doltin, Aquamaris (for the choice of a doctor and, of course, depending on the patient tolerance) is used octenisept, dioxidine, Miramistin and other antiseptics.
"Cuckoo" (washing all the incomplete sinuses) are prescribed as a procedure for extracting mucous-purulent masses, as well as for antiseptic and antibacterial treatment of the nasal cavity and nasopharynx.
Physiotherapy at Gaimorite
So, the priority task is solved - the pus from the sinuses is removed! The time of auxiliary procedures comes. For this purpose, the sessions of infrared laser and vibroacoustic therapy are effective, as well as the quartzing of the mucous membrane of the nasal moves (UFO).
When the sinusitis is launched, one medications can no longer cost. Then make puncture. Or, speaking by medical language, puncture of the Gaimoreskoy sinus. The goal is still the same - extract mucous-purulent allocations and deliver medicine into the inflamed place.
Puncture of the maxillary sinus - the treatment-diagnostic procedure. It is carried out in cases if it is difficult to determine the type of sinusitis, or there is doubts for the appearance of the patient's disease.
With all the perfect modern equipment there are situations where the results of research, patient complaints and the abstract data of the disease contradict each other. It will help the doctor to understand what is the case, and puts all the points over "i" only puncture.
Friends! Timely and proper treatment will provide you soon recovery!
Despite the fears of patients, the puncture of the sinus of Kulikovsky is the most effective technique, and that is why it is used more often than non-surgical ways of treatment of sinusitis.
After putting the diagnosis, ENT doctor informs the patient about the disease and the possibilities of treatment, but to decide whether to make a puncture or not, a patient will have to do.
Sinus catheter Yamik: Is it panacea?
I will say right away, not a panacea. But there are also disadvantages of this technique for the treatment of hymorite too. And alas, quite significant.
- The yamik catheter is impossible to sterilize in a dry closet - it is simply melted. In the autoclave - difficult, but you can. After autoclaving, the properties of rubber are changing, it becomes not so elastic, the balloon itself is often glued and it makes it difficult for subsequent washing. Another way to sterilization is an antiseptic solution. But if you move with its concentration, the air balloon sheath can drop, and the ball can break in the procedure. The explosion of the ball in the nasopharynk is hurt and unexpectedly, and claims to make a doctor impossible: sterilizes the tools. Cabinet or dressing nurse.
- One yamik procedure is performed - for one inflamed side. With bilateral inflammation, you will have to make a full-fledged second manipulation.
- Yamik-catheterization is ineffective or, it will be more correct to say, it is difficult to perform for patients with a spontaneous nasal partition.
- Sometimes the yamik catheter due to a strong contact with the mucous membrane of the nasal cavity overlap it and provokes a strong and poorly stopped bleeding. The problem on the eve of the nose is solved pretty quickly, but if "disclosed" the rear departments of the nose cavity, everything is much more complicated.
- Washing sinuses yamik occurs due to the frivolous movement of the fluid, which creates a piston of a plastic syringe (per capita). Accordingly, the sinuses do not have to speak about accurate medication in inflamed gaymors.
- There is a chance of an immunition of healthy neighboring sinuses on the sheathing side by purulent masses, since the pus under pressure can get there. And rinse only the inflamed sinus technique, alas, does not allow.
- Yes, puncture will not. But the increase in the volume of the balloon in the nasopharynk is quite painful so that patients regret that they did not agree to the puncture. Otherwise, it is impossible - you need to create a certain level of pressure for washing.
- For one minute, rinse the sinuses is impossible (more precisely, you can, of course, but Halurbo). The quality procedure takes 10-15 minutes. Otherwise, it is impossible ineffective. And all this time the patient moans from pain. Despite anesthesia. The technique of complete pain relief, alas, does not provide.
- With a spontaneous nose partition, the yamik catheter is sometimes inserted to insert a tweezers and with force. It also hurt. And the catheter can be broken.
- And one more important detail: the cost of medical preparations and medstruments. With this procedure, the patient will have to pay for the yamik-catheter itself, and for anesthesia, and for washing. If the inflammation of bilateral, then the manipulations will be two: two sets of drugs, two anesthesia, bilateral reduction of the mucous membrane and bilateral washing. Expensive. Twice the longer. And it will also hurt two times.
Yamik, of course, is not puncture, but not a panacea with a sinus. But the patient, reading medical advertising, begins to understand this only during the procedure itself, when it is already necessary to endure the doctor to bring to the end. And then regrets that he did not listen to the doctor.
So how to treat sinusitis? Answer! Complex!
To cure sinusitis geimer and efficiently, it is better to apply a comprehensive technique. Its general meaning in the combination of drug treatment with physiotherapy procedures and washing the sinuses by moving liquids ("cuckoo"). Punch - Already in the extreme case.
The total treatment tactics of the hymorite will be as follows:
- Remove the edema of the nasal mucosa as a whole;
- removing the ecass mucous membranes in the dusty zone;
- We carry out the procedure of vacuum washing of the incomplete sinuses - "Cuckoo";
- After the nasal mucosa washed, when it became clean, irrigate the cavity to the nasopharynx with antiseptic - dioxidine;
- We carry out a session of infrared laser therapy (the laser removes the edema and inflammation of the nose mucosa);
- We carry out ultraviolet effect on the nasal cavity (quartzing). UFO kills microbes in the nasal cavity, sterilizes and dries mucous membranes;
- We carry out a session of vibroacoustic therapy (vibroacousty is similar to ultrasound. The device works at different frequencies. Sensors are on the skin in the projection of the gaymorovy sinuses and affect the bone directly on the sinus, as a result, the microcirculation of tissues and capillary blood circulation is improved, and the inflammation in the sneakers subsides).
Each method and each procedure are pathogenetically substantiated. One machine cannot replace another. In the complex, the technique gives excellent results. It is well tolerated even children from three years. The final individualized variant of the hymorite cure depends on the intensity of the inflammatory process, the amount of pus, the prescription of the disease and other factors.
But, let me forgive me colleagues from state medical institutions, make it in a conventional clinic, most likely, will not succeed. According to the stories of the patients themselves, the events are unfolded. Patient will come with a sharp sinusitis in the clinic. And he will say: or puncture here, in a clinic, or go to the hospital, and let you treat you, as they want (most likely, the same puncture), or write a refusal of puncture and hospitalization! So they do to not worry and reinforce it. If something goes wrong, there will be a proceedings, and ask the question, why the puncture will not be offered during the hymorite, the doctor will not reproach. Plus - the influx of patients big. Tactics are simple: I sent a patient to the hospital - and ready! The gentle individualized integrated treatment of sinusitis in the clinic is likely to be offered. Make a "cuckoo" in the sick state of the patient either, not to mention the yamik. They are simply not there.
Therefore, come to be treated for us.
Do not be ill!
And if this happens, sign up for the reception. COLLIME!
Always yours, Dr. Zaitsev.
Before talking about how to cure from a sinusitis, we will arrange a small excursion in anatomy.
The human nose cavity through many channels is reported to the surrounding apparel sinuses - by the incomplete sinus. In total, their seven: 2 frontal, 2 maxillary, 2 - lattice maze and 1 main (wedge-shaped). These sinuses were formed during evolution in the human skull not by chance: they perform important buffer, resonant, protective and receptor functions. Only 2 of the 7 sinuses are the author's name - Gaimorov. The name is given by the name of the English doctor Nathaniel Gaimor, in the XVII century described the inflammation of the maxillary sinuses.
The English physician did not accidentally give aiming attention to the disease of these sinuses due to the features of the location (not only communicate with the cavity of the nose, but also fit to the upper dental row) and the wall thickness of the topless sinuses are much more likely. The incidence statistics indicate that every tenth at least once in his life came across this ailment and wondered how to quickly cure a sinusitis, and those who had a disease gained a chronic character, sought to learn how to cure a sinner forever.
Why arises and how the hymorite is manifested
As mentioned above, the maxillary sinuses are communicated with the cavity of the nose, therefore, with sharp respiratory diseases accompanied by rhinitis (rhinar), a sinusitis occurs. Depending on the nature of microorganisms that caused the disease, it may be viral (rinovirus, coronavirus) or bacterial (streptococcus, staphylococcus, hemophilic stick). Therefore, it is so important for the prevention of sinusitis so that the treatment of nose pathology was timely and adequate. If inflammation penetrated into the sinus of the teeth roots (with deep caries, the installation of the implant, an unsuccessful tooth filling), an odontogenic sinusite occurs. Unlike bilateral rhinogenic, it usually affects one sinus - on the side of the sick tooth.
The risk factors of the occurrence of the nose of the nose structure (polyps, curvature of the nasal partition) and the adverse environmental impact (tobacco smoke, irritatants), as well as the presence of chronic diseases, as a result of which the mucous membrane of the nose and sinuses or the consistency of the nasal mucus is changed (fibrousosis, Chronic rhinitis, gastroesophageal reflux disease).
The sinusitis can be acute (symptoms are completely disappearing after recovery), recurrent (4 or more episodes of the disease per year) or go into a chronic form (symptoms of the disease are preserved for 12 or more).
Schimorite can manifest themselves with the following symptoms:
- Increase body temperature
- discharge from the nose (with viral swing - mucous membranes, with attachments of the bacterial flora - purulent); nasal congestion;
- cough (due to the flow of the pharynx separated by the rear wall);
- Expanding pain in the projection of the sinuses, amplifying when pressed and tilting the head down;
- infringement of sense of smell;
- unpleasant smell of mouth;
- Swelling of soft fabrics of the face in the sinus projection.
In the absence of proper treatment of sinusitis, complications of the disease, both local, due to the spread of inflammation of nearby organs, and systemic are possible.
К Local complications Diseases include inflammation of the ear (otitis), the lymphoid tissue of the nose and pharynx (adenoite, tonsillitis), eyes (phlegmon fiber of the orbit, neuritis the visual nerve), purulent melting of the bones of the upper jaw (osteomyelitis), the distribution of the process on the frontal sinuses and cells of the lattice bone. Infection from the maxillary sinuses can go down and provoke the development of bronchitis and pneumonia.
For chronic process Often begin hyperplastic processes in the sinuses mucosa to form polyps. Polyps, raging, make it difficult to breathe significantly and provoke the occurrence of broncho-pulmonary diseases.
Because of the proximity to the walls of the gaimore sinus of a trigeminal nerve, his inflammation may occur - neuritis. This complication is accompanied by quite intense pain (neuralgia) in the field of the lower eyelid, the upper lip, the gums and teeth of the upper jaw.
The most terrible are intracranial complications of hymorita , which is often the cause of the patient's death: meningitis (brain-shell inflammation), brain abscesses and cerebsis of the cavernous sinus (blockage clogging of the brain-shell structure, providing a venous outflow from the brain). To suspect the development of intracranial complications, it is possible if the patient appears the focal neurological symptoms, the intensity of the headache is significantly increased, consciousness is disturbed.
Install the diagnosis of sinusitis can be a general practitioner or a otolaryngologist. After collecting complaints, the specialist will inspect and palpation of the area of the sinuses, as well as the front rosicopy (when inspection of the nose cavity, swelling and redness of the mucous membranes are detected, pathological discharges in the middle nose) and pharyngoscopy (help to see the flow separated by the rear wall).
If necessary, a diaphanoscopy can be performed (study of the difference in the sinus walls), ultrasonic survey of the sinuses (helps to reveal the level of liquid and cysts) and endoscopic examination of the nasal cavity. As additional research methods, radiography or computed tomography of the apparent sinuses are prescribed. In accordance with modern recommendations for the diagnosis of hymorite, it is believed that the conduct of radiography of the apparent sinuses as a routine study is impractical in mind low informativeness. Computer tomography is preferred, especially with complicated samorite forms.
If the polypose process is suspected, it is also advisable to perform magnetic resonance imaging of the apparent sinuses of the nose.
When suspected the forethogenic character of the sinusitis, orthopantomography is also held. In order to more accurately select an antibacterial drug by type of pathogen, for obtaining discharged on bacteriological sowing, the diagnostic puncture of the gayymorous sinuses is sometimes.
How the hymorite is treated
The treatment of sinusitis is complex. Its basic principles - ensuring the normal ventilation of the sinuses of the nose, the creation of conditions for the outflow of inflammatory exudate and the struggle against infection.
First of all, drugs are prescribed various groups. Vasoconducting (decongestants) are appointed for a period of no more than 7 days, with a frequency of not more than 2-4 times a day (by duration). Violation of these rules can lead to the development of dependence syndrome - drug rhinitis, to cope with which is in the subsequent, it is quite difficult. It is recommended to use vesseloring drugs in the form of dosage aerosols, since the drops are harder to dose, and most of the active substance does not reach the focus, staining into the throat.
Anti-inflammatory drugs Applied both non-steroid (NSAIDs) inside and glucocorticoids are locally as sprays. Preferred is the local use of drugs, which allows minimizing the number of side effects. It should be remembered that glucocorticoids are contraindicated with a purulent process.
Also for removing the edema of the mucous membrane Antihistamines , It is preferable to use tools 3 and 4 generations.
To disperse the inflammatory exudate, the sinuses are used Mukolitiki (both synthetic and vegetable origin).
In cases where the disease is limited to viral inflammation, and the bacterial flora does not join, the treatment of the sinus is carried out without the purpose of antibiotics, but this course is rarely due to the aggressiveness of the surrounding microflora. Therefore, most cases of hymorite are accompanied by the addition of bacterial infection and require Antibacterial therapy . Semi-synthetic penicillins are prescribed (especially often inhibitors), fluoroquinolones, macrolides with a duration of at least a week.
To evacuate the contents of the sinuses at home use Sterile salt solutions .
With the inefficiency of the described methods washing the apparent sinuses Conducts an ENT doctor. Popular vacuum washing "Cuckoo" and the imposition of a yamik - catheter. In some cases, puncture (puncture) of the apparent sinuses is required, this allows not only to remove the contents of the sinuses, but also to rinse it by completing the procedure by introducing antiseptics. Among patients there is an opinion on the extreme pain and traumatic puncture, but this is a delusion.
In addition to medicinal therapy and manipulations use Physical church : Magnetotherapy, Medicine Electrophoresis, Laser therapy, Galotherapy (Salt Inhalation). However, for the purpose of physioprocessor, it is necessary to comply with the conditions: the absence of high body temperature and purulent process, a good outflow of the contents of the sinuses. It should be remembered that it is advisable to carry out physiotics to the phase of the acute process or during the remission (with a chronic hymorite), since the use at the time of the sickness of the disease can produce an opposite effect, reinforcing inflammation.
National standards are recommended to conduct during a hymorite Magnetotherapy In various modes. The effects of the magnetic field to the region of the hymic melor reduces the swelling of the mucous membrane, improves the operation of glassworm cells producing mucus, has a light analgesic effect. Currently, there are portable magnetotherapeutic devices in the medical ordery market that implement the availability of the procedure at any time at home.
Speaking about the physiospection of hymorites, I also want to mention such a method as Teplotherapy . The whole sign of a people's way, in which two hot, cooked "into the steep" eggs are applied to the maxillary area in the projection of inflamed sinuses. The meaning of such manipulation is to create a local zone of hyperthermia (40-45 degrees C) in order to destroy the virus, reducing edema and pain in the inflammation zone. But this method does not allow for a long time to maintain a high temperature created, while modern heat-medicaratus devices succeed. Today, the patient is available to heat therapy devices, which can be used at home without having special skills. It should be remembered that it is desirable to carry out physiotics to the phase of the poem of the acute process or during the remission (with chronic hymorite), because Application at the time of the rank of illness may have a reverse effect, enhance inflammation.
Healthy lifestyle, hardening, ORVI prevention, compliance with the doctors' recommendations and regular use of magnetotherapy and thermal procedures for the prevention of exacerbations of the disease - this is the answer to the question "how to get rid of the hymorite forever."
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Schimorite: symptoms and treatment in adults
From this article you will learn:
- How to understand that you have a sinusitis (signs),
- In which cases it proceeds without temperature,
- how to treat hymoritis in adults,
- What kind of medicines to drink with a hymorite, drops, etc.
The sinusitis is inflammation of the mucous membrane of the Gaimori sinuses, which can occur as a complication in the development of acute infectious diseases (ARVI, flu), with chronic inflammatory diseases of the nose, as well as in the presence of inflammatory foci in the tops of the roots of the side teeth of the upper jaw. The presence of a patient of an allergic rhinitis - may also be a predisposing factor for the development of this disease.
The sinuses are pushed by air filled with air, which are seduced from the inside with a mucous membrane (Fig. 1-3). They relate to the apparent sinuses of the nose, and they are also called the maxillary sinus. Accordingly, the sinusitis can also be denoted by the term "maxillary sinusitis". Because Each person in the thicker of the upper jaw is 2 gaymors of the sinuses (one on each side) - sinusitis can be one-sided or bilateral.
Gaimorovy sinuses in the diagram and pictures of CT -
If you assume that you have developed samorite - symptoms and treatment in adults can be very variable, and depend on the form of the inflammatory process and the nature of its flow. The source of infection of the sinuse will also have a great influence on the first signs of sinusitis in adults. Infection can be a rinegenic nature (from the nose cavity), an odonogenic nature (from the top of the roots of 5-6-7 upper teeth).
However, the most severe forms of sinusitis take place when the patient has infection in the sinus simultaneously from the nose side, and from the side of the teeth, because In this case, a mixed microflora is present in the sinus, resistant to most antibiotics. Also, a serious flow is observed in patients with long-term experience of self-treatment (regular intake of antibiotics), and in such patients to remove purulent inflammation - it is very difficult, plus they still have a mass of complications.
Signs of hymorite in adults -
Signs of hymorite depend on the form of the disease - it can be sharp or chronic, as well as on the nature of the inflammatory process. A sharp sinovitis in the form of inflammation is divided into serous and purulent, and chronic sinusitis - on catarrhal, purulent, polypotic and purulent polypose. In addition, the first symptoms of the sinusitis will differ depending on what served as a source of infection - nasal moves, or this "dental infection", associated with inflammation of the roots of the upper side teeth.
1. Symptoms of acute hymorite -
Rinogenic sinusitis (it is sometimes called the term "rhinosinusitis") - usually arises either against the background of acute rhusing with infectious diseases of the ORVI and influenza, against the background of allergic rhinitis, or against the background of chronic inflammatory diseases of the nose. The latter are usually accompanied by a constant nasal congestion and not pronounced rhushed. The development of hymorite in this case is associated with the development of edema of the mucous membrane of the nasal moves and an increase in mucus products.
The fact is that each Gaimorto glands is communicated with the nasal strokes with a small fat (hole). These holes are designed for ventilation and physiological cleansing of the sinuses from mucus, the epithelial cells that fall into the sinus pathogenic bacteria. The resulting edema of the mucous membrane of the nasal moves leads to an increase in its volume, which leads to a partial or complete overlapping of these basics and impaired mucus outflow. What creates good conditions for breeding bacteria and the development of inflammation.
With acute rinegenic sinusitis of the patient (in addition to the running and nasal congestion) - first is usually concerned about only malaise. In the initial period, inflammation has the serous nature and the formation of pus in the sinus has not yet occurs. The mucous allocations from the nose during this period still have a transparent color, without an unpleasant odor. The temperature is usually normal, or the temperature can be increased, but this is not connected with the development of serous hymorite, but with the main disease (for example, ORVI and flu). In the absence of timely measures at this stage - serous sinusitis turns into purulent.
First symptoms of sinteogenic samorite :
According to statistics, the rhinogenic origin of the hymorite is observed about 62% of patients, and in more than 30% of all cases - the sinusitis has an odontogenic nature (that is, primarily connected with inflammatory foci in the tops of the roots of 5-6-7 upper teeth). Although it should be noted that a number of patients may also have a combined type of infection of the sinuses. With the sinusitis of odonotogenic nature, patients may recall that the development of symptoms they preceded pain or discomfort in one of the side teeth of the upper jaw (24stoma.ru).
Pain may be acute, or occur only when proud tooth. In a number of patients, the toothaches may be absent altogether, and in this case the causal tooth can be defined only by X-ray. Among the very first symptoms (in addition to the dental pain), it is usually noted only to make up. Thus, the runny nose and nasal mortgage in the development of sinthogenic nature sinusitis is usually absent (discharge from the nose appear only later, and are not associated with a runny nose).
Inflammation at the top of the root with a hyimorite -
Symptoms when moving a serous sinusitis to purulent -
In the serous hymorite, a sharp swelling of the mucous membrane of the gaimor sinus is developing, which can lead to a narrowing or complete closure of the fatal between the sinus and the nasal cavity. In addition, there is a sharp increase in mucus products, and the formation of serous inflammatory exudate (Pump in the sinus at this stage is still missing). All this leads to the transition of serous inflammation into purulent, and haymorite symptoms sharply.
A sharp purulent sinusitis has characteristic symptoms that already allows you to establish the correct diagnosis without any problems. And besides, with acute purulent hymorite, there are already specific changes in radiographs and images of computer tomography (CT), which allow you to confirm the diagnosed diagnosis.
Signs of acute purulent hymorite:
- General symptoms: weakness, lethargy, weakening of smell, chills, loss of appetite.
- The body temperature rises to 37.5 - 39.0 degrees (sometimes higher). The degree of temperature rise depends on the peculiarities of the reaction of the body's immune system of a particular person to infection. Those. If you usually have colds proceed without a significant rise in temperature, it should not be expected to be strongly lifted temperatures and with acute purulent hymorite.
- In the development of inflammation in only one sinus - there may be a sense of gravity in the appropriate half of the person.
- When pressing on the skin in the projection of the front wall sinus can be felt soreness. In addition, pain or discomfort can appear when tapping on the teeth located in the projection of the inflamed sinus (usually 5-6-7 teeth of the upper jaw).
- From the nasal stroke on the side of the inflamed gymore sinus, tend to be distinguished by purulent exudate (its extinguishing increases when the head slope forward). In the morning on the pillowcase, patients often notice traces of a pus leaked from the nose. But! If the outflow of purulent exudate from the sinus to the nasal cavity is completely disturbed, then this symptom may be absent.
- In case of violation of the outflow from the sinuses of purulent content - first periodic may occur, and then a constant increasing pain, which will first be localized in the projection of the inflamed sinus. Subsequently, pain can begin to spread to the frontal, temporal, occipient area, as well as to the area of the tooth of the upper jaw (from the side of the affected sinus).
- With a severe form of a purulent sinus, the swelling of soft fabrics of the face can also be observed, their redness, plus purulent jaw periostitis (flux) can develop them.
Computed tomography (CT) and radiography –
The diagnosis of "acute purulent sinusitis" is made on the basis of symptoms, as well as CT data or radiography. Traditional radiography will make only to see the "darkening" of the sinuses and the level of fluid in it (the level of the pm), without any details. In turn, the CT snapshot will allow not only to get a much clearer image of the sinuses, but at the same time evaluate the quality of the filling of the root channels of teeth in the projection of the sinuses, as well as see the presence of inflammatory foci in the root tops. It is very important to establish a source of infection and choose the right treatment strategy.
Purulent hymorite on x-ray and CT –
2. Symptoms of chronic hymorite -
If you have developed chronic sinusitis - the symptoms in adults will depend on the shape of chronic inflammation, which can be catarrhal, purulent, polypose, or purulent polypose. Each form has characteristic signs, and some of them occur even without temperature. It should be noted that the chronic form of the sinusitis is the result of the incorrect treatment of acute purulent hymorite or self-treatment, but may be an independent form of the disease.
- Catarial form (proceeds without temperature) - if you are looking for "Symptoms of sinusitis in adults without temperature," then it is most likely about the catarrhal form of chronic sinusitis. This form is characterized by almost asymptomatic flow, although in some periods these patients can feel in a sense of gravity in a certain half of the person (from the affected gaimore sinus), a periodic disruption of nasal respiration, as well as some malaise by the end of the day.
When examining the nasal moves, the ENT doctor can detect the bias and the swelling of their mucous membrane. Ordinary radiography does not give any results, but the computed tomography will show an increase in the thickness of the mucous membrane of the Gaimore sinus in those areas where it is inflamed. If you look at the snapshot of the CT below, then in the sinus (in the picture it is left) - just observes the thickening of the mucous membrane in the bottom of the bottom and one of the side walls, which, accordingly, is the catarrhal form of chronic hymorite (Fig. 9).
- Purulent and polypose (Fig. 9-10) - with purulent form of the sinus, partially filled with purulent exudate, and the polypose form assumes the presence on the surface of the mucous membrane of the polyps. In addition, a combined purulent polypotic form of chronic hymorite is also found. Polyps in a gaimore sinus are in fact no difference from polyps, which grow in nasal strokes in chronic polyposnial rhythi (Fig. 11).
With these forms of sinusitis, patients complain: → on rapid fatigue, → on the rotor smell, → Periodic isolation of a pus from the corresponding half of the nose, → at a temperature of 37.5 - 37.8.
The diagnosis is made on the basis of symptoms, data of computed tomography, as well as in some cases, endoscopic endonazal hyperoscopy may be required (with the help of a thin flexible endoscope with a video camera and the light at the end). By the way, in the image of a computed tomography in Fig. 10 - you can see a chronic polypose sinusitis. The accumulations of polyps in the picture are shown by arrows, and note that the polyps are localized not only in the gaimor sinus, but including their nasal moves from this side are filled.
How to treat hymoritis in adults -
Patients are actively interested - how to cure a sinusitis of the house, but in fact without complications and the chronic of the process - you will independently be able to cure only acute serous samorite of rhinogenic origin (i.e. acute serous rhinosinusitis). With acute purulent or any chronic forms of sinusitis - drops or antibiotics that you can apply yourself - no way will not allow you to fully cure the disease, and below we will tell why.
Recently, there have been a lot of patients with very heavy forms of sinusitis. Typically, these patients use the strongest antibiotics (for example, ceftriaxone) - as a result of which the pathogenic microflora is formed in the sinuses, in the future, not sensitive to any strongest antibiotics. And such patients can already be offered only radical surgical treatment. It is necessary to carry out the treatment of sinusitis - depending first of all on the cause of its occurrence, and therefore the most important part of the treatment is to establish a source of infection of the sinuse.
According to statistics, rhinogenic sinusitis (rhinosinusitis) - according to statistics, it takes about 62% of patients with sinusitis. Odontogenic origin sinusitis is found in at least 32% of cases. At the same time, many patients have combined infection of the sinuses - simultaneously from the side of the teeth, and from the nose side, and in this case there will be a mixed microflora in the sinus, steady to many antibiotics. What diagnostic procedures we need for treatment planning are CT and endoscopic endonazal hyperoscopy, as well as in some cases and sowing on the microflora.
1. Acute Schimorite: Treatment in Adults
A sharp sinusitis of rinegenic origin can be cured even without the use of antibiotics, but only if you turned to the ENT doctor at the first symptoms of the disease (until the serous inflammation passed into purulent). The most important thing in the treatment of rhinogenic sinusitis is to remove the swelling of the nasal mucosa. After all, the swelling of the mucosa leads to an increase in its volume, and this leads to a complete or partial overlap of the ignition between the gaimore sinus and nasal strokes. Therefore, the removal of edema will allow us to normalize the outflow from the sulfur sinus (or already purulent) inflammatory exudate.
Drops from hymoritis -
Traditional sprays from the cold have a big minus, because With their long-term use, we get the opposite effect - the resistant swelling of the mucous membrane. Therefore, ordinary sprays from a cold (based on nafazolin, xylomezoline, oxymetazoline, etc.) - it is better to use no more than 2-3 days. An exception may be spray from the rhinitis "rinofluumucil", which can be used up to 7 days. This drug has a big plus, because In addition to removing the swelling of the mucous membrane - it contains components to reduce the viscosity of the mucous-purulent discharge, which will improve the outflow from the sinuses.
But after the elimination of acute symptoms, it is better to go to sprays containing low dosages of glucocorticoids, for example, Nedonex spray (up to 3 weeks). It has a pronounced anti-inflammatory, anti-allergic and anti-ethnic effect, and at the same time low dosages of glucocorticoids do not have systemic exposure. Only, provided that the outflow from the sinuse is not difficult - such vegetative preparations can be appointed as a spray "Sinufort", Sinuperet or Gelomyrtol Forte. These drugs actively stimulate the conclusion of the mucus and inflammatory exudate from the sinuses.
Drops from hymorite in adults -
If serous inflammation has already passed into purulent, antibiotic therapy and the rinse procedures are prescribed through the nose. Obsolete washing procedures are better to carry out using the yamik sinus catheter. And if in some clinic, instead of a sinus catheter, traditional punctures still use, then it is generally unpervently and worth searching for another clinic. Please note that serious ENT clinics must be carried out endoscopic endonazal geimerotomy using a shawl, and the sinus catheter yamik is used to wash the sinuses. For these criteria, you can find a decent clinic.
Antibiotics with hyamorite -
Associate antibiotics with a hymorite should a doctor. It is very difficult to choose them, and if you plan to do self-medication (especially from the very beginning, using powerful ceftriaxone type antibiotics) - very quickly you will get a multi-resistant flora in the sinuses, is generally not sensitive to most antibiotics. The choice of antibiotics will also depend on the source of infection of the sinus (from the nose or on the side of the teeth, or at the same time), because The composition of microflora in the sinus in this case will be different.
Antibiotics for the treatment of sinusitis :
- β-lactam lactamaz-protected synthetic penicillins ("amoxicillin + clavulanic acid", or "ampicillin + sulbactam", or "pepertillalin + pelubacam", or "cefoperazone + sulbactam", or "ticarcilline + clavulanic acid"), or carbapenes (imipenem or meropenem ).
- Macrolids (azithromycin or clarithromycin).
- Fluoroquinolones (levofloxacin or moxifloxacin).
- Cephalosporins III-IV generations (for example, ceftriaxone, cefepim).
- Oxazolidones (linesolid) - only after sowing on the microflora and isolating the multi-resistant flora.
In the treatment of non-heaven forms of sinusitis (light and moderate) - treatment is better to start with β-lactam lactamase-proof synthetic penicillins. The optimal option is a combination of amoxicillin with clavulanic acid (for example, these are tableted preparations of augumenten, amoxiclav, etc.). In severe flow, we choose or modern fluoroquinolones (levofloxacin or moxifloxacin), or from cephalosporins III-II-IV generation (for example, ceftriaxone, cefepim), but with severe course, all these drugs are already entered by parenterally.
In the intolerance of penicillins - with the lungs and secondary forms of the disease, antibiotics of the macrolides groups (for example, azithromycin) in tablets can be prescribed, and under heavy forms - modern fluoroquinolones (already parenterally). Remember that cephalosporins in case of intolerance to penicillins can not be prescribed. With a long chronic hymorite, the fungal flora is often joined to bacterial infection, so antifungal drugs can be additionally appointed with such patients.
In total, the duration of antibiotics is usually from 7 to 10 days, but in some cases up to 14 days. We sincerely advise never under any circumstances to use Russian antibiotics (high risk to know what pseudomambranous colitis is). It is also worth considering that the effectiveness of antibacterial therapy increases significantly when the patient is also carried out and the procedures for washing the sinuses with antiseptics (for example, with the help of the Sinus catheter "Yamik").
Important :If the source of infection in a patient with a sinusitis of only odontogenic, or at the same time an odontogenic and rinegenic nature (combined microbial flora), it significantly increases the stability of the microbial flora in the sinus to antibacterial therapy. In this case, the treatment of mild and moderate sinusitis is better to start immediately from modern fluoroquinolones (tableted), and heavy forms with parenteral administration of cephalosporins III-IV generation. But in the odontogenic infection, the sinus will not be limited enough only to the appointment of a strong antibiotic ...
The fact is that in this case we will have a focus of inflammation in the roots of the roots of one of 5-6-7 teeth, which is associated with the presence of an infection in the root channels of the causation tooth. Sange root channels by intake of antibiotics is impossible. Therefore, when inflammatory foci is found in the tops of the roots and poorly integrated root channels, the root channels are needed. In this case, the causal tooth is revealed, disinfection of root canals is carried out, in which a calcium hydroxide-based drug is left for 1-1.5 months. If this is not done - infection of the sinus will continue and we will get new cases of sinusitis.
2. Treatment of chronic hymorite -
In the development of chronic hymoritis - the treatment in adults also begin with determining the cause (source of infection). Now there are especially many patients with severe forms of purulent, polypotic and purulent polypotica hymorite, which is explained by self-treatment and uncontrolled antibiotics. And many such patients then have to be sent to surgical treatment methods, including radical geimerotomy in the hospital.
Modern methods of diagnosing chronic hymorite is CT or endoscopic endonazal hyperoscopy (traditional radiography is not completely effective here). As for modern methods of treatment, it is still - 1) washing the sinuses with the help of sinus catheter yamik, 2) antibiotic therapy, 3) surgical techniques, including endoscopic endonazal geimerotomy, well, and radical geimerotomy.
CT scan (CT) - This diagnostic method is particularly indispensable for chronic samorite forms. For example, in a chronic catarrhal sinus, it may not be pusually in the sinus, and the inflammation proceeds along the type of hyperplastic process (that is, with the thickening of the mucous membrane of the sinus). And the CT allows us to see - in which areas of the mucous membrane in the sinus occur, how much they are expressed and there will be enough conservative methods of treatment.
Traditional radiography of such changes is not able to show. And if we see the thickening of the mucous membrane mainly in the field of the bottom of the sinus (i.e. near the top of the roots of the teeth) - here we immediately assume that inflammation is associated with teeth. If the mucosa is thickened primarily in the collapse area (sinuses with nasal strokes), then most likely the infection of the sinuse occurs from the nasal cavity side. A significant thickening of the sinus mucosa makes it possible to suspect the polypose process, and in this case it will be necessary to further conduct an endoscopic endonazal hyperoscopy.
Endoscopic endonazal hyperoscopy - With a pronounced catarrhal gingivitis (suspicion of polypotic sinusitis) or, if suspected the presence of foreign bodies in the sulk - it is important to make a diagnostic endoscopic hyperoscopy. This procedure is done under local anesthesia; Through the nose in the sinus introduced a thin flexible probe with a video camera. This will allow you to see the sinus from the inside (to determine the presence of polyps and the degree of lesion of the sinus, plan the operation of removing polyps), and also resolve the issue of the need to expand the oustion between the sinus and the nasal cavity. This service can also be called the "diagnostic endoscopy of the hymorosphea sinuses", and its cost is about 2000 rubles per one sick.
Commentary on video - in the sinus, the tops of the three roots 7 of the tooth are well visualized, which shine through the mucous membrane, as well as a cyst size up to 1 cm (having a rounded shape and yellow color) filled with pus. Endoscopic hyperoscopy is carried out under local anesthesia.
Surgical treatment of hymoritis (Gaimururotomy) -
In a remote past in maxillofacial surgery and LOR-Practices for the treatment of chronic polypotic or purulent polypose hymoritis - there was only one version of surgery, called the term "radical geimerotomy". But now most surgical operations on the sinus can be made endonazal access using an endoscope and such a device as a shaver. Read more about the techniques ...
one) Endoscopic endonazal Gaya - if the diagnostic hemoroscopy confirmed the presence in the sinus of polyps, a foreign body or cysts - endoscopic geimerotomy using the "Sheer" apparatus. The operation is carried out under anesthesia, with endoscopic access through the nose. Sheer allows you to scold all polypose growth from the sinuses. In the process of this operation, if necessary, the expansion of the message between the sinuses and the nasal strokes can also be carried out (to improve the physiological cleansing of the sinuses and reducing the risk of new hyimorite cases).
2) The method of radical geimorotomy - this method is shown in total damage to the mucous membrane of the gaimor sinus and its irreversible changes (for example, fibrous). Radical geimerotomy is carried out through the mouth - for what the ridge of the mucous membrane is taken on the eve of the oral cavity in the projection of the upper 4-5-6-6-7 teeth, and the "window" is made in the naked surface of the jaw. Overweight Polyps scatter on the surface of the mucous membrane.
It is important to draw attention to the fact that the reversible echo-infiltrative changes in the mucous membrane of the sinuse is not an indication for its radical removal. We want to say that during the catarrhal form of chronic hymoritis - there is usually no need to carry out radical geimerotomy. With the advent of endoscopic operations with the use of Shawra, the radical geimerotomy has become much less likely. However, this technique is indispensable in difficult situations, for example, when the sinusitis develops against the background of the oroantral message (the fistula between the sneakers and the oral cavity).
Treatment of hymorite (case from practice) –
The following example clearly shows a typical medical error, as a result of which patients even with timely appeal to the doctor - for years suffer from sinusitis. As you will see below: After eliminating errors in the diagnosis - the treatment of sinusitis in this patient was carried out in full (using endoscopic methods).
The patient of 28 years later appealed to the medical center with the symptoms of one-sided acute purulent swivel. Computer tomography revealed that the sinus half was filled with pus (Fig.15-16). The treatment that was appointed is puncturing and washing the sinus with antiseptics and massive antibiotic therapy. As a result, the following 3 years, the patient regularly applied to this clinic with similar symptoms, and it was carried out similar therapy.
Unilateral acute purulent sinusitis on CT (different projections):
The doctor during this time never sent a patient to the dentist to determine how well the root channels were folded in 5-6-7 teeth on this side. And during this time the patient was made by the pictures of the CT and outside the exacerbation period. When the patient falls toward me for consultation, on the picture made outside the period of the exacerbation - in the field of the Gaimore sinus, a rounded formation is detected by a size of up to 1 cm, not characteristic of the topography of the sinus (Fig. 17). My preliminary diagnosis is the cyst of the gaimore sinus on the right (it is on the left side of the CT).
Own cysts of the mucous membrane sinuses are extremely rare, and almost the only cause of their formation is inflammation in the area of the roots of the roots of one of the 5-6-7 upper teeth. In addition, it was clearly clear that the tops of the roots are located right under the mucous membrane of the sinuses (that is, there is no layer of bones between the tops of the roots and the bottom of the sinuses). As a result, the patient is directed to me on the "diagnostic endonazal hyperoscopy", which involves the use of a thin flexible probation with a video camera. As a result - we see the mostedy cyst, which is in the projection of 5 or 6 teeth (Fig. 18). To accurately determine the causal tooth neither by CT, nor by video - we failed (plus each of these teeth had problems with the quality of root canal filling).
As a result, the patient was first aimed at endoscopic geimerotomy using a shawl (through the nose) - this technique is used to scrape and remove polyps and cysts in the sinus. Also, the patient in the process of operation was expanded by the odds between the gaimor sinus and nasal strokes. 1.5 months after surgery and re-diagnostic hyperoscopy - the patient was aimed at leaving 5-6-7 teeth (including root channels with calcium hydroxide preparations). As a result, the patient is happy and satisfied.
Important :As a maxillofacial surgeon, I sincerely recommend you (if Laura doesn't think it's necessary to direct you to the CT teeth, as well as to consult a dentist) - to refer to the dentist-therapist for consultation. In order for a careful examination of each root canal in the 5-6-7-8 of the teeth. Unfortunately, as we see this on a specific example - ENT doctors very often make mistakes in the diagnosis of the odontogenic nature of the origin of the hymorite.
Factors increasing the risk of developing hymorite -
A number of patients may attend a number of predisposing factors that increase the risk of developing a hymorite. For example, each Gaimores belong has a message with a middle nasal progress - by means of a small hole (cooler). The hole is intended for the physiological cleansing of the sinuses (evacuation of these mucus and lunned epithelial cells), as well as their ventilation. By the way, the bacteria regularly fall from the nasal strokes to the sinuses, but most people for certain reasons do not lead to the development of a hymorite.
Purification of the sinuses from the mucus occurs due to the movement of the cilia of the fiscal epithelium, which is the surface layer of the sinus mucosa. And if bacteria fall into the sinus, then in the norm they are removed along with mucus through these fatings. Thanks to this mechanism of purification, the number of pathogenic bacteria in the gaymorovy sinuses is almost always lower than a critical level, which will necessarily come to the development of inflammation in them (sinusitis). But in some cases, there is a violation of the evacuation of mucus and bacteria from the sinuses, and let's look at what it is connected with ...
Firstly, this may be due to a violation of the functions of a fiscal epithelium, which usually happens in patients with chronic inflammatory diseases of the nose, in patients "sitting" on vasoconducting drops from a cold. The fact is that the long-term swelling of the mucous membrane in chronic diseases of the nose, as well as the long-term use of droplets from a cold (having a vesseloring effect) - leads to a violation of the flexor epithelium function.
Secondly, it can be in patients with allergic rhinitis, which have sharply increased products of mucus in nasal strokes and hymic commodities, and also there is a constant swelling of their mucous membranes. There is even such a diagnosis as "allergic rhinosinusitis" (it is also a sinusitis of allergic origin). The third is a very important factor - the swelling of the mucous membrane of the nasal moves leads to an increase in its volume, as a result of which the enemy mucosa is fully or partially overlaps the hole through which the Gaimores of the sinus is reported to the nose stroke.
Accordingly, in this case, the outflow from the sinus of mucus and bacteria is disturbed, and conditions are created for the rapid growth of pathogenic bacteria and the development of purulent inflammation. In different patients, the size of the basics is different, and therefore with a small amount of their size - the risk of the development of the hymorite will always be higher, because In this case, the violation of the outflow of mucus from the sinus will be more pronounced. We hope that our article on the topic: sinusitis and its treatment in adults - it turned out to be useful to you!
1. Higher medical education author, 2. Based on personal experience in maxillofacial surgery, 3. "Guidelines for Maxillofacial Surgery" (Timofeev A.A.), 4. "Complex treatment of odontogenic maxillary sinusits" (Schulman F.), 5. " Clinical recommendations for the diagnosis and treatment of acute rhinosinusitis "(Lopatin A.S., Swistushkin V.M.).