home Drugs Acute and chronic frontal sinusitis (frontitis): symptoms, causes, diagnosis, treatment. Acute frontal sinusitis - what is it? Traditional methods of treating frontal sinusitis

Acute and chronic frontal sinusitis (frontitis): symptoms, causes, diagnosis, treatment. Acute frontal sinusitis - what is it? Traditional methods of treating frontal sinusitis

The last few decades of sinusitis various kinds They are very common diseases, affecting every tenth person in the world. Acute frontal sinusitis is a type of sinusitis in which inflammatory process localized in the frontal paranasal sinus. The disease causes many discomfort, has a number severe complications. What therapeutic and preventive actions used to eliminate pathology?

Acute frontal sinusitis - what is it?

Acute frontal sinusitis (frontal sinusitis) is an inflammatory process in the mucosal tissues frontal sinus. The pathology is not diagnosed as often as sinusitis, but it has more serious complications. Occurs against a background of viral, bacterial or fungal infectious lesions respiratory organs, hypothermia.

The main causes of frontal sinusitis:

abnormal position of the septum, congenital or acquired due to injury;
an increase in the size of the nasal concha due to chronic allergic and medicinal rhinitis;
neoplasms and polyps.

Unlike the maxillary sinus, the frontal sinus is connected to the nasal cavity not by an anastomosis, but by a narrow canal 2.5 - 3 cm long. This creates the preconditions for difficulty in the outflow of sinus contents due to swelling of the canal walls or blockage with purulent discharge.

Important! Frontal sinusitis is rare in children; the frontal sinus is fully formed at 3–4 years.

There are several types of classification of frontal sinusitis. The acute form develops against the background of injuries, allergies and infections. Chronic frontal sinusitis is a consequence of influenza, prolonged rhinitis, polyps.

Based on the location of the source of inflammation, acute left-sided frontal sinusitis and acute right-sided frontal sinusitis are distinguished. At bilateral inflammation all symptoms become more severe and surgical intervention is often required.

Classification of frontitis:

Spicy catarrhal sinusitis– it is characterized by constant throbbing pain in the central frontal part, high temperature, noticeable swelling of the tissues around the eyes. Develops against the background of long-term infectious and inflammatory processes in the nose.
Spicy purulent frontal sinusitis– a bacterial form of the disease that can occur due to a violation of the outflow of mucus. The discharge is purulent in nature, the disease is accompanied by high temperature, weakness, severe pain in the temporal, frontal region, superciliary arches.
Cystic and polypous frontal sinusitis refers to the productive forms of the disease. Breathing through the nose is difficult, the person is worried constant pain in the forehead area, copious mucous discharge. This form of pathology requires surgical intervention and removal of tumors.
Parietal-hyperplastic frontal sinusitis - against the background of the inflammatory process, the mucous membrane lining the sinus from the inside begins to grow.

ICD-10 code –J32–J32.1 – chronic sinusitis and chronic frontal sinusitis. For the acute form, code J01–J01.1 is used.

Symptoms of the disease

Frontit has a number characteristic features, which greatly facilitates diagnosis. Signs of an acute form of pathology:

pain in the frontal part, which becomes more intense when the body is tilted forward, pressing on the superciliary arches;
difficulty breathing through the nose, often completely absent;
deterioration of sense of smell;
copious purulent or mucous discharge;
increased lacrimation;
swelling, redness of the skin in the upper part of the face.

Important! Pain in acute frontal sinusitis is cyclical in nature - it intensifies immediately after waking up, when the outflow of mucus is severely impaired. After removing stagnation pain syndrome becomes weaker.

Acute inflammation progresses to chronic form 1–2 months after the onset of inflammation. The main reason is incorrect or untimely drug therapy. Chronic frontal sinusitis manifests itself in a weaker form - the pain is aching and pressing in nature, in the morning hours a lot of sputum with pus appears.

The weakening of symptoms in the chronic form does not indicate the beginning of the recovery process. It is this form of pathology that entails the development of complications and concomitant diseases.

Without proper treatment, the infection spreads to nearby tissues, the frontal bone, and the retina of the eyes. The most severe complications of inflammation in adults are osteomyelitis of the frontal bone, sepsis, and meningitis.

The main method of treatment in adults is the use of antibacterial agents in the form of tablets and sprays. The main indication to start with antibacterial therapy- purulent discharge. The duration of antibacterial therapy is 10-14 days.

Effective antibacterial agents:

on initial stage inflammation is helped by sprays and drops with antibacterial properties - Isofra, Bioparox;
in acute forms, antibacterial drugs are prescribed wide range actions – Sumamed;
in the chronic form, an analysis is required to determine the sensitivity of pathogenic microflora to antibiotics; drugs such as Amoxiclav and Ampicillin are used.

In addition to antibiotics, complex therapy include antihistamines to reduce swelling - Diazolin, Suprastin. When thick purulent mucus oozes out, ACC-long is prescribed, and painkillers and antipyretics are additionally used.

Additionally, the treatment regimen includes methods of physiotherapy - microwave, UHF, heating with a blue lamp, light therapy. All these remedies are effective only in mild forms of pathology, when there are no pus impurities in the mucus. Otherwise, any warming methods are prohibited.

"Cuckoo" is the most popular and effective procedure for the treatment of various inflammatory processes of the respiratory system. For washing, a solution of furatsilin and other medications is used. This procedure helps to cleanse the sinuses well.

Hospital treatment is necessary for severe forms pathology, in this case medications administered by injection. Surgical intervention - trephine puncture of the frontal sinus is indicated in the absence of positive dynamics after drug therapy - the pain intensifies, the temperature is constantly elevated.

When treating at home, you need to remember that any type of heating is contraindicated for purulent pathology. Any methods of alternative therapy should be discussed with your doctor.

To quickly eliminate inflammation, you need to frequently rinse your nasal passages with a solution of regular or sea salt– dissolve 5 g of salt in 200 ml of water, add 1 g of soda and 3 drops of tea tree oil.

For inhalation you can use hot potato broth. Or prepare a solution for inhalation from 1.5 liters of boiling water and 10 bay leaves - you need to breathe in steam for at least a quarter of an hour.

Black radish juice has a strong antibacterial property. Needs to be rubbed fresh vegetable, squeeze out the juice, instill 1-2 drops into each nasal passage three times a day.

To improve the outflow of mucus in the morning, before going to bed, you need to insert turunda into your nose for half an hour with medicinal ointment. Mix 30 g of liquid honey, fresh aloe juice, onion and cyclamen, Vishnevsky ointment. The procedure must be repeated daily for 10–14 days.

Prevention

The inflammatory process of the nasal sinuses requires a long, often expensive treatment– therefore, simple precautions should not be neglected.

Preventive actions:

avoid hypothermia;
hardening, regular moderate physical activity;
strengthening the immune system;
timely treatment of rhinitis and respiratory diseases.

To prevent inflammation, you need to take vitamin complexes in spring and autumn, wear gauze bandages during epidemics, eat a balanced diet, get rid of bad habits.

Acute frontal sinusitis is dangerous due to complications, so at the first signs of inflammation you should consult a doctor. Traditional methods can only be a good support for drug therapy; it is impossible to cure inflammation of the frontal sinus with herbs alone.

You caught a cold, were treated for the required time, but did not receive proper relief. You are tormented by headaches that become stronger when bending forward and the slightest effort, there is pounding and throbbing in your temples, it is very difficult to think, the temperature rises, and the discharge from the nose has become unpleasant, purulent, with a disgusting odor. All this may indicate the development of inflammation of the frontal sinuses.

The bones of the human skull have a porous structure and are equipped with several sinuses, which are lined with mucous membrane on the inside. It was conceived by nature for a reason, but in order to fulfill protective functions, trapping mechanical particles and various microorganisms that can become pathogens of various types. However, when immunity declines, the body’s resistance decreases and microorganisms easily enter the human body.

Since the nasal and frontal sinuses communicate with, when severe inflammation develops, pathogens penetrate them and become the cause of development, or provoke inflammation of the frontal sinuses - frontal sinusitis.

Hypothermia, strong and incorrect frequent blowing of the nose, lack of treatment of the underlying disease or its termination prematurely, the use of inappropriate medications and non-compliance with a full treatment regimen (neglecting medical recommendations about the need for surgical intervention, going to work until complete recovery, and so on) contribute to the spread of infection.

Signs of the disease

Frontal sinusitis provokes abundant mucous or mucopurulent discharge from the nose, since this disease usually involves severe discomfort, headache, which may be accompanied by spasms when trying to blow the nose or with a sudden change in body position, especially when bending over.

Patients complain of a feeling of heaviness in the head, throbbing pain in the area of the frontal sinuses, which can radiate to the temples. If the disease is started, it can quickly become complicated and cause very dangerous condition- meningitis, or inflammation meninges. This is due to the fact that the bones facial section the skulls are thin and porous, containing a number of cavities and canals through which infection can enter the brain and other vital organs.

Outside in the area of the frontal sinuses, areas of swelling and slight redness may appear, which may be greater on the more inflamed and “clogged” side. Swelling may affect the orbital part and the corner of the eye, which is located closer to the source of infection.

As the disease develops, the patient feels severe weakness, chills, increase.

The presence of pus in the frontal sinuses is due to infection, mainly of a bacterial nature.Since the canal connecting the sinuses with the nasopharynx is very narrow and tortuous, then severe inflammation mucous membranes can actually “clog” the frontal sinuses and interfere with the free release of purulent contents. Aggravates the patient's situation and the presence of of different origins- hereditary or acquired as a result of injury.

Diagnosis of pathology

External manifestations of the disease can be noticeable to the naked eye (puffiness of the face, local swelling and redness of the skin with “swimming” of the eye from the side of the more inflamed sinus). Also inflammation of the frontal sinuses in acute condition It is quite easily determined by palpation and tapping - the patient winces from touch, percussion causes increased pain, as does finger pressure on the forehead.

Anterior rhinoscopy demonstrates the presence of abundant purulent discharge, severe hyperemia of the mucous membranes, their swelling and thickening.More accurate and full information X-rays in frontal and lateral projections, as well as computed tomography, provide information about the condition of the sinuses.

Obtaining data helps to better assess the patient's condition and make the right decision about the required type of treatment.

A blood test allows you to see an acute inflammatory process, which is manifested by leukocytosis, a shift in the blood count to the left and an increase in ESR. If the collected data is insufficient to obtain an accurate diagnosis, a diagnostic trephine puncture of the frontal sinuses may be prescribed.

Types of medications and their use

In uncomplicated cases of the disease, conservative treatment is usually used using several types of treatments and a variety of drugs.

To reduce swelling and reduce mucus formation, so-called high adrenalization of the mucous membranes is performed. To do this, they are often and generously lubricated or irrigated. the following drugs: Galazolin, Ephedrine or Adrenaline. Adrenaline-based drugs are also prescribed for instillation into the nose. As a result of their use, the thickness and looseness of the mucous membrane of the nose and sinuses decreases, a huge amount of mucus stops being produced and the patient feels relief from his condition.

A whole range of drugs is prescribed internally to the patient:

Broad-spectrum antibiotics, especially during development purulent infection, for example, Claforan, Klacid and others.
Analgesics that help reduce pain in the presence of an inflammatory process.
Antihistamines that alleviate the patient’s general condition (Tavegil, Suprastin, Claritin and others).

For frontal sinuses, warming and other physiotherapeutic procedures, for example, warm ones on the frontal sinus area, UHF sessions, laser and infrared therapy, are very helpful. Only a doctor prescribes such manipulations and only if they cannot worsen a person’s condition.

More information about frontitis can be found in the video:

If all conservative efforts do not produce results, and drug treatment does not bring relief, then the doctor recommends trepanopuncture, that is, of the frontal sinus in order to cleanse it of its contents and cure sinusitis.

When diagnosing frontal sinusitis in a pregnant woman, the decision to carry out drug treatment can only be accepted by a specialist. He evaluates possible risks both for the health of the pregnant woman and for the development of the fetus. Based on his conclusions, he makes a decision. In most cases, treatment of frontal sinusitis in pregnant women comes down to rinsing the nasal cavity and warming it up, as well as using some harmless physiotherapeutic procedures. IN in rare cases a puncture is prescribed

Recipes for nasal rinsing

The presence of a large amount of contents in the sinuses and nasal cavity creates serious discomfort for the patient and prevents normal breathing, and this, in turn, causes a lack of oxygen, increased headaches and worsening of already feeling unwell.

In order to remove mucous and purulent discharge and reduce inflammation of the frontal sinuses, the following is used:

Most often, a solution of sea salt is used for rinsing. It has several advantages: salt promotes quick withdrawal swelling, disinfects well and soaks possible crusts of dried pus, relieves pain and has antimicrobial effect due to the content of iodine and other healing trace elements. After such rinsing, the patient feels much better, his nose is freed and air flows freely. In addition, this procedure helps reduce headaches due to decreased pressure in the sinuses.
You can also rinse your sinuses with alkaline mineral water without gas. It should be warm. This water contains soda, which has a softening effect on irritated and inflamed mucous membranes. By alkalizing nasal mucus, it helps reduce the amount of discharge and makes breathing easier.
Rinse the nose with decoctions of various medicinal herbs. Chamomile is especially good and gentle. With its warm decoction you can quickly rinse the nasal passages, relieving inflammation and swelling of the mucous membrane and thereby simplifying the release of pus from the frontal sinuses. To prepare such a decoction, you usually take a tablespoon of dried chamomile flowers and pour a glass of boiling water. You need to leave for about an hour, then strain well and cool to a pleasant temperature.

The addition of infection and the appearance of purulent contents means the development of an acute infectious inflammatory process. You can cope with this condition only with the help of powerful ones.

If possible, it is highly advisable to conduct a sensitivity test to determine which group of bacteria caused the inflammatory process. In this case, it will be much easier to choose the ideal antibacterial drug, whose action will specifically “hit” the bacteria that cause the disease.However, such a study often takes too much time, and if the patient is unwell, it is contraindicated to hesitate.

Therefore, in acute frontal sinusitis it is most often used strong antibiotics general action Claforan type.

The duration of treatment and dosage, as well as the drug itself, are chosen by the attending physician. It is very risky to interfere with the treatment regimen he has accepted, since advanced disease becomes chronic and can lead to numerous dangers.

Folk recipes

Among the people, inflammation of the frontal sinuses is often treated with heating:

To do this, you can use the usual chicken egg, hard-boiled. It is first wrapped in cotton cloth and applied to the affected area. As the egg cools, unwrap it and begin to “roll” it frontal part sinuses. This procedure is especially well received by young children. They do not regard it as a treatment, and after warming up they experience relief.
It is also good to warm your forehead with bags of rock salt or coarse sand. They are made small and sewn from thick fabric. A heated bag is placed on the frontal sinus area and the inflammation is thoroughly warmed up. Since sand and salt retain heat well, the procedure is long and effective.

Surgery

If none of the methods of conservative and medicinal treatment has the expected effect, the doctor prescribes trephine puncture of the frontal sinus. This operation can be carried out in two ways:

Through the frontal surface of the frontal bone.
Through orbital wall frontal sinus.

The second method is used much less frequently due to the high risk of deep perforation of the orbital socket and penetration of infection into it.

To perform this, special markings are used, which are performed using an x-ray of the skull in order to determine the thinnest area of the frontal bone above the sinus. It is in this place that a special mark is placed into which the drill is placed and a hole is made. A special cannula is inserted into it, the contents of the sinus are drained and it is washed. Through the same cannula, medications are injected into the cavity. Treatment usually lasts from 3 days to a week, rarely a little longer.

Surgical treatment is combined with medication to speed up recovery and completely eliminate the source of infection.

To speed up the healing of the injury, the patient is recommended to have a high-calorie diet high in vitamins and microelements. After recovery, the patient needs to observe for some time special precaution and avoid hypothermia and colds.

Possible complications and prevention

Inflammation of the frontal sinuses is dangerous because the source of infection is located close to the vital important organs. And since the bones of the facial part of the skull are porous and contain many different sinuses and cavities, the penetration of pus into them can lead to very dangerous infections and the spread of infection to the ears, eyes, and mouth.

The same thing dangerous complication frontal sinusitis is the occurrence of meningitis, or inflammation of the meninges. It develops very quickly and can lead to disability and even death.

When infection enters the bloodstream, another deadly threat can arise - sepsis, or blood poisoning.

If frontal sinusitis is not completely cured in time, it can become a chronic disease.

To ensure that inflammation of the frontal sinuses never gives you unpleasant moments, you need to have good health and powerful immunity. To do this, you need to play sports, harden yourself, avoid overheating and hypothermia, eat properly and balanced, preferring plant foods, take vitamins, follow a daily routine, and when epidemics develop, use individual means protection, and also avoid places where large numbers of people gather.

When the disease begins, you need to immediately consult a doctor and strictly follow all his instructions, then the disease will not have a chance, you simply will not give it the opportunity to develop and “strangle” it for another initial stages development. Optimism and cheerfulness help to resist diseases; it is noted that cheerful and active people suffer from colds much less often than pessimists.

Everyone experiences a runny nose and stuffy nose at least several times a year, and the number of episodes of headaches is difficult to count, but most people do not pay any attention to it. However, this may begin to appear quite dangerous illness frontal sinusitis, the symptoms and treatment of which have a number of features.

What is frontal sinusitis and why is it dangerous?

Frequently occurring among professional athletes, frontal sinusitis is the most severe type of sinusitis, manifested by inflammation of the mucous membrane of the frontal sinus. It causes disruption general condition the body, so many patients lose their ability to work and are forced to undergo long-term treatment.

If you ignore its signs for a long time, this can cause the development of serious complications, including:

meningitis;
pneumonia;
sepsis;
osteomyelitis;
phlegmon of the orbit, etc.

Thus, if symptoms of frontal sinusitis appear, you should immediately contact an ENT specialist and begin treatment. Otherwise, the patient may require serious surgery, and developing complications can cause death.

Types of frontal sinusitis

Traditionally, the disease can occur in acute and chronic forms. Depending on the accompanying symptoms, the following types of frontal sinusitis are distinguished:

catarrhal;
purulent;
polyposis;
polyposis-purulent;
complicated.

Inflammation can also be:

left-handed;
right-handed;
bilateral.

Spicy

Acute frontal sinusitis in many (usually young men) begins against the background of a common ARVI or influenza. It is characterized by:

increase in body temperature up to 39°C;
malaise;
severe headaches;
cough;
feeling of fullness in the area between the eyebrows;

An acute inflammatory process is accompanied by the production of a large amount of secretion and a significant decrease in the rate of its outflow. Therefore, acute frontal sinusitis without nasal discharge is quite often observed. In this form, the process persists only for 3 weeks; after this time, the disease is considered chronic.

Chronic

Chronic frontal sinusitis is a disease that persists for a long time paranasal sinuses Ah inflammation, which does not appear too pronounced. It often develops in the absence of acute treatment, but it is much more difficult to diagnose. Chronic frontal sinusitis is in most cases unilateral, and typical for it:

periodic aching pain in the corresponding part of the forehead;
constant presence of mucous discharge from the nose;
thickening of the mucosa;
formation of granulomas and polyps;
morning cough with the release of a large amount of sputum mixed with pus.

Left-handed

For a left-sided process, dullness is typical pressing pain on the left side of the forehead. It gets worse in the evenings, after physical exertion, long reading, computer work, or other activities that require tilting the head.

In addition, it can radiate to the right eyebrow or temple, as well as the crown. As a rule, it is constant, but sometimes it can become pulsating. In addition, discharge and congestion are also observed only on the left. Source: website

Right-handed

Inflammation of the right frontal sinus is accompanied by almost continuous discomfort in this part of the forehead, which increases significantly when pressed. Increased discomfort was also noted in evening time, after physical activity and working with a bowed head. By analogy with a left-sided lesion, discomfort can be felt in the left temple and eyebrow, sometimes in the crown, and nasal congestion and discharge are present only in the right side.

What are the symptoms and complaints of frontal sinusitis?

Frontal sinusitis is characterized by both local and general clinical manifestations, the intensity of which is directly dependent on its shape and the age of the patient. The first include:

difficulty in nasal breathing;
sudden headaches in the eyebrow from the infected paranasal sinus, often worsening in the morning or when pressing on the corner of the eye or between the eyebrows;
runny nose;
a feeling of fullness in the bridge of the nose, increasing throughout the day;
feeling of heaviness behind the eyes;
swelling of the eyelids and soft tissues between the eyebrows.

The most specific sign is headaches due to frontal sinusitis. If the pathology has become chronic, it may be diffuse and not clearly localized.

This is a consequence of impaired cerebral lymph and blood circulation, deterioration of the outflow of contents from the frontal sinuses, mechanical irritation of the endings trigeminal nerve, poisoning of the body with waste products pathogens etc.

Attention

With an exacerbation of this type of sinusitis, bursting pain occurs in the forehead, which intensifies significantly during eye movements or when tilting the head forward. But applying cold usually brings relief.

The present discharge is viscous, thick and has an unpleasant odor, and the use traditional means for a runny nose usually does not give results. Initially they are transparent, but as the disease progresses they acquire a yellow or greenish color, which indicates the beginning purulent process. Although frontal sinusitis without nasal discharge often occurs.

This occurs when the outflow from the affected sinuses is seriously impaired. In such cases, the main sign of pathology is severe headaches, and a visual examination of the nasal cavity reveals deformities anatomical structures, provoked by the pressure of accumulated pus.

Sometimes patients note that the symptoms characteristic of frontal sinusitis disappear , and treatment is unreasonably stopped. This is a huge mistake, since the disappearance typical signs does not always indicate recovery. After all, they may be absent when the outflow from the sinuses is normalized, despite the persistence of their purulent lesions.

Patients also suffer from general condition disorders, in particular:

In rare cases it is observed:

decrease or even disappearance of the sense of smell;
lacrimation;
photophobia;
blurred vision.

Causes of development of frontal sinusitis

The causative agents of sinusitis are different kinds staphylococci and streptococci, which can live on the mucous membranes of even absolutely healthy people. But with development various diseases immunity decreases, as a result of which bacteria are able to actively multiply and, consequently, provoke the development of frontal sinusitis.

IN last years There has also been evidence that the pathology can be caused by Haemophilus influenzae, some fungi, etc. A clear connection has also been noted between its development and environmental pollution with dust, toxins, etc.

The trigger for the onset of the disease may be:

untreated rhinitis;
injuries and abnormalities in the structure of the nose, causing difficulty breathing;
infectious diseases, in particular tonsillitis, scarlet fever, diphtheria;
proliferation of tissues of the pharyngeal tonsil.

Create good conditions for the formation of inflammation and diseases such as:

the presence of polyps, tumors and other neoplasms in the nose;
violation of nose blowing culture;
immunodeficiencies of various natures.

Features of the disease

Frontitis, especially purulent, is very often combined with sinusitis or cell damage lattice labyrinth. For this reason, the pathology is difficult and causes patients a lot of trouble.

After all, the symptoms of frontal sinusitis are accompanied by signs of these ailments, and patients suffer from severe discomfort not only in the forehead and eyebrow area, but throughout the entire face. The disease also often provokes the occurrence of conjunctivitis and persistent cough, not amenable to treatment.

It is especially difficult to timely diagnose frontal sinusitis in children, which is quite dangerous for them. Moreover, especially in children, due to the excessive use of various medicines the disease quietly becomes chronic and, due to the specific anatomy, often provokes the development of otitis media. And one of the reasons for its formation may be the entry of foreign bodies into the nose.

Basic methods for diagnosing frontal sinusitis

A significant role in identifying the disease is given to interviewing the patient and palpation. The diagnosis can be confirmed by:

rhinoscopy;
radiography;
diaphanoscopy (more often used when examining pregnant women and children);
sinuscopy;
thermography;
scintigraphy (used to detect complications and diagnose latent forms of pathology);

What does frontitis look like? x-ray? An x-ray helps determine the presence pathological formations, fluid, and deformation of the structure of the frontal sinuses. This is one of the most reliable ways to detect pathology at an early stage. Flaw- radiation exposure. An X-ray of the frontal sinuses shows:

nature of inflammation (presence of fluid and its quantity)
any darkening indicating any formation in the frontal sinuses
cushion-shaped protrusion in chronic hyperplasia.
no cysts

To avoid the development of such an unpleasant pathology, you should be attentive to the treatment of acute rhinitis, various acute respiratory viral infections, and influenza. It is also necessary to restore the normal anatomy of the nasal structures in the presence of septal deformities, etc. And if it was still not possible to avoid its occurrence, it is necessary to begin treatment immediately.

How should frontal sinusitis be treated?

Frontal sinusitis can significantly reduce a person’s ability to work and disrupt the usual course of his life, but the main danger of the disease is the appearance of complications. Therefore, diagnosis of pathology should be carried out as early as possible, and treatment should begin just as early.

When the first symptoms of frontal sinusitis appear, you should seek help. medical assistance. Only a specialist, taking into account the stage, severity and all the characteristics of the patient, will be able to prescribe correctly justified therapy.

Justification of treatment directions

Treatment of frontal sinuses in adults and children over 12 years of age (before 12 years of age, the frontal sinuses are not anatomically formed) is based on the etiology and pathogenesis of the disease. That is, each medication or procedure is aimed either at eliminating the provoking factor of the pathology, or at relieving its symptoms.

The vast majority of cases of the disease occur due to the introduction of bacterial microflora into the mucous membrane, leading to inflammation of infectious origin. Much less often - due to sensitization of the body to a certain antigen, which causes inflammation of allergic origin.

Having diagnosed infectious or allergic frontal sinusitis, the ENT doctor determines the main direction of therapy - etiological. In case of bacterial inflammation, antibacterial agents are prescribed.

If the pathology is of an allergic nature, antihistamines, hormonal, barrier drugs, as well as cell membrane stabilizers are needed.

The pathogenesis of inflammation of the frontal sinuses develops in the following directions:

expansion of the capillaries of the mucous membrane of the sinuses and excretory channels;
release of blood plasma into the intercellular space with the formation of significant swelling of the membrane;
blockage of drainage channels by increased mucous membrane;
increased production of mucopurulent contents in the frontal cavities;
violation of drainage of secretions into the nasal passages.

Purpose medications or procedures that can stop the development of the inflammatory process at these stages is symptomatic therapy.
It includes:

use of vasoconstrictor drugs;
restoration of drainage function, cleansing the sinuses of purulent contents and treating them with antiseptics;
normalization local immunity mucous membrane, accelerating the regeneration of destroyed epithelium.

Early seeking help, as well as the appointment of competent therapy, allows treatment of frontal sinusitis without a puncture, which can be carried out both through the nasal cavity and directly through the frontal bone.

A complex of medications, optimally selected for each patient, can cure acute inflammation in 7-10 days, and in the case of chronic inflammation - to prolong remission as much as possible.

How to treat frontal sinusitis with antibiotics?

Targeting the bacterial infection is the basis of therapy. Antibacterial drugs presented in a wide range, it is necessary to choose the most effective ones in each specific case.

Most the best option- this is to inoculate the separated frontal sinus on a nutrient medium, followed by determining the sensitivity of the pathogen to antibiotics. This method will give results within 24 hours and will avoid the prescription of ineffective drugs.

But in practice, in medical institutions it is often not possible to carry out such a study at all in the first days of illness. Or the material is collected, but sent to distant laboratories.

That's why medical tactics is as follows: the first course is prescribed a broad-spectrum antibiotic; if recovery does not occur, then a narrow-spectrum antibiotic is used in the second course (upon receipt of results from the laboratory, a strictly defined drug is prescribed).

Antibiotics for frontal sinusitis, prescribed in the first course, also take into account the fact that most often the disease is caused by Haemophilus influenzae or pneumococcus. Therefore, among the broad-spectrum agents, preference is given to the penicillin group, macrolides and cephalosporins.

From penicillins Amoxicillin derivatives (Amoxiclav, Augmentin, Doxycycline) are more often used in the form of tablets or injections, the dosage is calculated depending on the patient’s weight.

From cephalosporins antibiotics latest generation Cefaclor, Cefotaxime, Ceftriaxone are prescribed.

Funds from the group macrolides can be used not only as the first course, but also as the second, if penicillin or cephalosporin antibiotics are ineffective. An example of macrolides is Sumamed, which contains azithromycin.

It has a bactericidal effect on streptococci, pneumococci, Haemophilus influenzae, fusobacteria, clostridia, and some protozoa. The drug is used for intramuscular or intravenous administration.
There are antibacterial agents for local application. This is a nasal spray Bioparox containing fusafungin, which is very effective for acute and chronic sinusitis, as well as Isofra and the combined drug Polydex (a complex with a vasoconstrictor and hormonal component).

Symptomatic treatment of frontal sinusitis

Etiological therapy should be supplemented symptomatic treatment. To reduce swelling of the mucous membrane, vasoconstrictors (vasoconstrictors) are needed for topical use.

Their selection, dosage and course duration must be made by a doctor, since any violation can lead to damage to the epithelium.

The drug is selected from the groups of short, medium or long acting. Examples:

Galazolin
Nazol
Rhinostop
Nazivin
Polydexa is very effective.

Vasoconstrictors not only reduce swelling of the mucous membrane, but also restore the patency of the drainage ducts and reduce the production of purulent secretion. As a result, the outflow of contents is normalized and the sinuses are cleansed.

Treatment of frontal sinusitis can be carried out using homeopathy remedies, for example, Sinuforte. This drug, produced on the basis of the active substances of cyclamen, is an absolutely natural herbal medicine. Sinuforte, like Echinacea, Traumeel or Engystol, has a complex effect (antimicrobial, vasoconstrictor and immunomodulatory).

The most important direction of therapy is hot or cold inhalations and rinsing the sinuses with special solutions. This can be easily done at home, but it must be remembered that the procedures are not carried out at elevated body temperatures. To reduce it, you can use antipyretics based on Paracetamol.

Inhalations are carried out both through a nebulizer and with the help of ordinary hot infusions (chamomile, calendula, boiled potatoes, sage). Washing is carried out using saline solution(2 teaspoons of salt per 2 liters of water) or pharmaceutical drugs

In conditions medical institution the “cuckoo” procedure is performed, or the supply of a solution under pressure through one nostril, and the removal of rinsing water through the other. At the same time, drainage and cleansing of all paranasal sinuses occurs. The use of the YAMIK sinus catheter is also very effective

Under the influence of viruses, bacteria and fungi, inflammation occurs in the nasal cavity, in most cases limited to a runny nose. However, under unfavorable circumstances, hypothermia or inadequate care, complications develop in the form of damage to the paranasal sinuses. This group of diseases is called sinusitis: sinusitis, frontal sinusitis, sphenoiditis and ethmoiditis. Most often, the maxillary and frontal sinuses become inflamed. That's what we'll talk about.

Symptoms of diseases

Sinusitis in general accounts for about 20% of annual diseases of the population, of which 4% belong to sinusitis, and 10-12% to sinusitis.

An interesting fact: inflammation of the frontal sinuses is more often diagnosed in young men than in women, but the reason for this “love” of the disease for the noses of gentlemen is still not clear.

In many ways, the signs of sinusitis and sinusitis are similar:

However, there are other characteristic symptoms indicating sinusitis:

accumulation of mucus in the nasopharynx at night;
posterior rhinitis;
nasal congestion;
pain syndrome that spreads more to upper jaw And upper area cheeks;
dry mouth;
unpleasant odor from the mouth and nose.

Or frontal sinusitis:

Although for ordinary person, not owning medical knowledge, a runny nose remains a runny nose, knowing the symptoms of frontal sinusitis and sinusitis will help you navigate in time and seek the help of an ENT doctor.

Causes of sinusitis

The vast majority of sinusitis and sinusitis are caused by viral and bacterial diseases. The trigger for inflammation can be a common cold, flu, other acute respiratory viral infections, and even measles. A certain number of cases are due to allergic, including seasonal, manifestations. Often sinusitis occurs due to injuries, especially to the frontal sinuses, and exposure to nasal cavity foreign objects. The cause of sinusitis can be “unfinished” caries or accidental entry of filling material into the root canals.

Most often, an infection in the nasal sinuses is secondary and is a consequence of an advanced cold or viral illness with passive “non-treatment” or, on the contrary, active self-therapy with all available means.

Both are dangerous, since rhinitis may not be limited to progression to sinusitis or frontal sinusitis, but go further and provoke inflammation of the meninges, damage to the eyes and auditory tubes.

Diagnostic methods

Besides clinical picture and patient complaints, several additional examination options are in the hands of specialists. Laboratory methods include general analysis blood, allowing you to determine the culprit of the disease by leukocyte formula. Knowing this radically influences treatment tactics, since antibiotics for frontal sinusitis and sinusitis are necessary only when bacterial origin illness. Viral diseases do not respond to antibiotic therapy.

Blood analysis

Instrumental examination methods are represented, first of all, by radiography, which displays the affected area in the image as a darkening, and computed tomography, which allows one to accurately determine the location of the infection and anatomical features sinuses

Among other options, other additional methods are used:

rhinoscopy;
endoscopy;
diaphanoscopy;
ultrasound examination of the paranasal sinuses;
thermography;
immunological analysis;
diagnostic puncture;
bacteriological examination of mucus.

If an allergy is the provoking factor for the infection, appropriate allergy tests are performed.

Treatment methods

Sinusitis is by no means a mild inflammation that can go away on its own without consequences. Therefore, in principle, we cannot talk about treating frontal sinusitis and sinusitis at home.

To eliminate inflammation of the maxillary sinuses applies conservative therapy as:

If gentle methods do not provide pronounced impact or have an insufficient effect for recovery, they resort to radical methods.

Classic maxillary sinusotomy. Performed under local or general anesthesia and consists of open access to the affected sinuses. The procedure is well studied and is performed everywhere. Among the disadvantages are the long recovery period, high risk of damage to healthy tissues, swelling after the intervention.
Laser maxillary sinusotomy. The type of access is similar classical operation, however, the risk of tissue trauma is reduced, as is the recovery period.
Endoscopic maxillary sinusotomy. Today it is the best way radical treatment inflammation of the maxillary sinuses. Trauma to healthy mucous membranes is minimal, the recovery period is shortened, swelling is mild or absent. Moreover, such intervention does not require general anesthesia and may well be performed on an outpatient basis.

It is also possible to use a sinus catheter.

Regarding frontal sinusitis therapy is aimed at eliminating the cause of inflammation and ensuring air exchange in the frontal sinuses. It is also divided into conservative and radical techniques. In case of uncomplicated course of the disease, they resort to the help of vasoconstrictors and antiallergic drugs, physiotherapy, antibiotics if confirmed bacterial infection. If these measures do not help, use sinus lavage, including the moving method, which is popularly called “cuckoo”.

Washing using the cuckoo method

In the case when the disease is advanced, it has progressed to purulent stage and is not subject to influence conservative methods, all that remains is to resort to surgery.

One of the most effective ways evacuation of the contents of the sinuses during frontal sinusitis - trephine puncture.

This procedure is most often performed under local anesthesia. Before the intervention, a mandatory X-ray with contrast is performed, following which special marks are applied to the patient’s forehead for best access.

The hole for subsequent drainage is made with a long special needle, the dimensions of which are adjustable, or with a drill. A rigid plastic conductor is inserted into the puncture, through which it is inserted into the frontal sinus. cannula– an elastic needle with a round end made of stainless metal or high-quality plastic, necessary for rinsing the sinuses and delivering medications to the site of inflammation. This device is carefully fixed with adhesive tapes on the patient’s forehead and left for several days for regular procedures until the disease “loses ground.” This period should not exceed 5 days from the moment of puncture, since more long stay drainage structure in the sinus can negatively affect tissue repair.

Trepanopuncture is contraindicated:

with meningitis;
with osteomyelitis of the skull bones;
with purulent abscesses;
with thrombophlebitis.

The list of contraindications may include other diseases that can negatively affect the result of therapy or the patient’s health during treatment. Determined strictly individually by the attending physician.

Treatment of frontal sinusitis and sinusitis is the prerogative of otolaryngologists. Attempts to get rid of inflammation on your own often lead to worsening of the condition and transformation acute illness V chronic illness. If you suspect inflammation of the frontal, maxillary or other sinuses, you should definitely see an ENT specialist.

Sinusitis is an inflammation of the nasal mucosa, which often occurs as a complication of a cold. Sinusitis especially often appears after the patient has had rhinitis. There are a huge number of subspecies of this insidious disease, so first we’ll find out what kinds of sinusitis there are and how they differ from each other.

For now medical practice distinguishes more than ten forms of sinusitis and several classifications. According to the course and degree of complications, they are distinguished: easy, medium, heavy sinusitis. According to the duration of the disease: spicy(1 - 3.5 months), recurrent(1-2 times throughout the year) and chronic(more than 3 months). By localization of inflammation: monosinusitis(inflammation affects one paranasal sinus), polysinusitis(at least two paranasal sinuses are involved in the process), hemisinusitis(inflammation of several paranasal sinuses), pansinusitis(inflammation of all paranasal sinuses), sinusitis(inflammation maxillary sinus), sphenoiditis(inflammatory process of the sphenoid sinus) and (inflammation of the frontal sinus). It is obvious that the inflammatory process may be involved different areas nasal mucosa. Today we will talk about frontal sinusitis.

Symptoms of frontal sinusitis

There are acute and chronic sinusitis. Acute frontal sinusitis often occurs against the background of an infectious or viral disease upper respiratory tract. Edema develops and frontal sinusitis progresses rapidly. Symptoms of acute frontal sinusitis are sharp pains in the frontal part of the head (discomfort increases with pressure), eye pain without manifestations of conjunctivitis, fear of light, constant nasal congestion and difficulty breathing, significant increase in temperature (up to 38 °). In some cases, subfibrile temperature is observed.

Three main symptoms should be cause for concern and see a doctor:

headache;
nasal congestion;
elevated temperature.

As for the symptoms of chronic sinusitis, they are not so pronounced. Headache in the frontal lobe is not constant and lasts more aching character. The eye sockets are rarely affected by inflammation, but the headache increases with pressure on them. There is a constant need to cough up mucus. Purulent nasal discharge is possible during an exacerbation of chronic frontal sinusitis. If you ignore the sluggish chronic sinusitis, you can earn yourself polysinusitis. Without treatment, acute sinusitis will become chronic.

Diagnosis of frontal sinusitis

Diagnosing the disease is not difficult. A presumptive diagnosis is made after examining the patient by a doctor, and a final diagnosis is made through laboratory tests. If there is reason to think that you have frontal sinusitis, you need to contact a specialized specialist - an atolaryngologist - as quickly as possible. Remember that the acute form of frontal sinusitis is fraught with the involvement of other areas of the mucous membrane in the inflammatory process and transition to a chronic form, which is more difficult to treat.

Treatment of frontal sinusitis

Treatment is primarily aimed at reducing swelling and inflammation in the sinus. The patient is prescribed vasoconstrictors to improve the outflow of pus. The mucous membrane must be irrigated with antimicrobial and anti-inflammatory agents, for example, or. Antibiotics are used only in acute period diseases. Patients are recommended to take short weekly courses of antibiotics along with antihistamines. This combination of drugs does an excellent job of relieving swelling, without which the treatment of sinusitis cannot be considered successful.

All medications for the treatment of frontal sinusitis must be prescribed directly by the attending otolaryngologist; self-treatment at home is unacceptable. Additional therapy Herbal inhalations, as well as natural compresses to reduce swelling, can help treat sinusitis.

Consult with your doctor to determine the best form of treatment for you. It also happens that treatment does not bring the desired results due to many factors, such as prolonged chronic course. In such cases, surgical intervention replaces conservative treatment.

If you consult a doctor in a timely manner, the consequences of frontal sinusitis can be minimal, and the disease can be completely cured.