Catarrhal frontal sinusitis symptoms and treatment in adults. Frontitis - symptoms and treatment. The main symptoms of frontal sinusitis

With frontal sinusitis, the paranasal sinus becomes inflamed. The disease can be caused by hypothermia, low immunity or a runny nose. If frontal sinusitis manifests itself, treatment at home must be started immediately, otherwise complications may arise, including meningitis.

Symptoms of sinusitis

Frontal sinusitis has similar symptoms to sinusitis, but they manifest themselves more acutely. If a person experiences frontal sinusitis, he will experience:

• pain when pressing on the area of ​​the frontal sinuses;
• mucous or purulent discharge from the nose;
• headache, worse at night;
• bad smell from the nose or mouth, especially in the morning;
• worsening headache when tilting the head;
• labored breathing;
• increase in body temperature.

Note! You may also experience ear pain or toothache, localized in the upper jaw.

Frontitis - causes of the disease and prevention

The main cause of the disease is infection, which can be of viral, fungal or viral origin. Also the cause may be a mechanical bruise of the frontal bone, chronic runny nose.

IN for preventive purposes it is necessary to carry out a set of measures to strengthen the immune system, protective properties body, carry out complex treatment in a timely manner viral diseases and prevent the occurrence of chronic frontal sinusitis.

How to treat frontal sinusitis at home

Treatment of frontal sinusitis can be carried out using several methods: medications and folk remedies. We will tell you how to treat frontal sinusitis at home quickly in order to forget about the problem forever.

Treatment of frontal sinusitis with medications is aimed at relieving symptoms, as well as eliminating the cause. Drug treatment is prescribed by a doctor after a series of laboratory research.

Antibiotics

If conservative treatment, including washing and instillation, does not produce results within several days, then the doctor prescribes antibiotic treatment. They can destroy the bacteria that caused the disease. But if the cause of the disease is viruses, then antibiotics will not give any result.

Before prescribing an antibiotic, a bacteriological study is carried out. If it is not possible to conduct research, then antibiotics are prescribed broad action. These may be antibiotics:

• penicillins (Augmentin, Amoxicillin, Ampisid);
• cephalosporins (Ceftriaxone, Axetil, Cefataxime);
• macrolides (Macropen, Azithromycin, Spiramycin);
• local (Bioparox, Polydex, Isofra).

For adults, drugs are often prescribed in the form of injections, and for children - in tablets or suspensions. The course of treatment is usually 5 days.

Topical antibiotics may come in the form of drops, spray, aerosol, or liquid to soak cotton swabs. This type of medication not only destroys bacteria, but also makes breathing easier, relieves swelling of the nostrils and improves general condition.

Homeopathic medicines

For the treatment of sinusitis, including frontal sinusitis, it is often used homeopathic medicines. Particularly popular are:

1. Sinuforte.
2. Traumeel.
3. Echinacia compositum.
4. Lymphomyazot.

Symptomatic remedies

When treating frontal sinusitis, the doctor prescribes medications that will help alleviate the patient’s condition and relieve symptoms. But it is worth remembering that the effect of drugs is aimed only at improving the condition. They do not eliminate the cause of the disease.

Vasoconstrictor drops

Vasoconstrictor drugs can relieve swelling and reduce the amount of mucus produced. Thanks to this, breathing is simplified and the connection between the nasal cavity and frontal sinuses is restored. For this purpose, nasal drops such as Naphthyzin, Galazolin, Nazivin, Farmazolin, and so on can be used.

Note! You can use medications for no more than 5 days.

Antipyretic medications

Medicines to reduce fever are used if the temperature exceeds 38.5°. The most commonly used drugs are ibuprofen or paracetamol.

Note! Antipyretics are used to relieve headaches, weakness or chills.

Folk remedies will help get rid of frontal sinusitis

Folk remedies are effectively used to treat frontal sinusitis. But first, inform your doctor so as not to aggravate the condition with self-medication.

Inhalations

It is easy to prepare inhalations at home. They are simple and effective in treating frontal sinusitis.

Potato

1. Boil the washed potatoes without peeling the skins.
2. Then drain the water and mash it with a masher.
3. Breathe in the steam, covered with a terry towel.

Bay leaf

Add a dozen bay leaves to a saucepan of water (1.5 liters). Let it boil well, then breathe in the steam for 5 minutes.

Garlic and apple cider vinegar

Finely chop 4 peeled garlic cloves. Mix garlic with apple cider vinegar (0.5 cup) and pour the same amount of boiling water over everything. You need to breathe steam. During inhalation, you can add hot water. The procedure should be done three times a day.

Chamomile

1. Pour water into the pan.
2. Add dry chamomile. Let it boil.
3. Then in chamomile infusion drop a couple of drops essential oil tea tree or eucalyptus.
4. Breathe the steam.

Menthol

Boil water in a saucepan. Add some dry menthol. Breathe over the steam, covered with a towel. If you don’t have menthol, you can replace it with “Star” balm.

Propolis

Add a teaspoon of propolis tincture to boiled water. Breathe in the steam while covering your head with a towel.

Washing

Treatment of frontal sinusitis at home necessarily includes rinsing. This procedure allows you to clear the frontal sinuses of pus and mucus, as well as relieve the inflammatory process. Rinsing the nose must be done in a certain sequence.

1. First, clear as much mucus from your nose as possible.
2. Bury it vasoconstrictor to reduce swelling and open up access to the sinuses.
3. Place the prepared rinsing solution into a rubber bulb. You can also use a special bottle.
4. Pour the solution into one nostril. It should pour out from the other nostril along with pus and mucus.
5. Your head should be held straight above the sink, without tilting.

Honey and onions

Peel the onion and puree it using a blender. Add a glass of boiling water. Stir and leave to cool. Then add a spoonful of honey. Stir. Rinse your sinuses with the prepared solution three times a day.

Note! This folk remedy cannot be used if you are allergic to honey or onions.

Chamomile

Brew dried chamomile flowers. Let the broth cool until warm state. Strain and use for rinsing.

Chlorophyllipt

Boil half a liter of water and cool. Add a spoonful of alcohol chlorophyllipt solution to the water.

St. John's wort

Pour dry St. John's wort herb (1 tsp) with a glass of boiling water and leave to infuse. Rinse your nostrils with the warm, strained solution.

Salt and soda

In glass warm water dissolve 0.5 teaspoon of salt. Add a pinch of baking soda and a couple of drops of tea tree oil. The procedure should be done at least 3 times a day.

Sea salt

Per liter boiled water take a teaspoon sea ​​salt. It is advisable to rinse your nose with this solution every couple of hours.

Homemade drops

There is nothing difficult in preparing drops at home, so you can easily prepare such medicine for the treatment of frontal sinusitis in adults or children.

Propolis

A small piece of frozen propolis must be crushed and mixed with a spoon vegetable oil. Let the mixture sit for three days, and then drop 2-3 drops into each nostril.

Note! Before use, make sure that you are not allergic to propolis.

Cyclamen

Take 1 part cyclamen juice and 4 parts cold boiled water. Mix and bury 2-3 drops in your nose.

Celandine and chamomile

Take chamomile and celandine juice in equal quantities. Place the prepared mixture in your nose several times a day.

Kalanchoe

Place the plucked Kalanchoe leaves in a dark place for several days. Then squeeze the juice out of it through cheesecloth. Mix juice with alcohol in a ratio of 1:20.

You can also prepare an alcohol tincture of Kalanchoe. Pour the crushed leaves of the medicinal plant with alcohol and leave in a dark place for 10 days.

Frontal sinusitis can be cured at home. But do not forget to visit your doctor on time. Be sure to watch your diet, avoid hypothermia, and follow your doctor's recommendations.

Frontitis is an inflammatory process that affects the mucous membrane of the frontal sinus. Although it occurs less frequently than ethmoiditis, it is more severe, with severe headache and intoxication. With sinusitis, general well-being is disrupted, purulent discharge is formed, and without treatment there is a high risk of serious complications.

If you do not consult a doctor in a timely manner and undergo an examination, there is a high probability of transformation of the acute form into a chronic one. Inflammation of the frontal sinuses of the chronic type is fraught with many dangerous complications and can even be fatal.

Frontit: what is it?

Frontal sinusitis is an inflammation of the mucous membrane of the frontal sinuses, which are the paranasal sinuses. The formation of inflammation occurs in the mucous membrane, which is located in the frontal sinus. This disease has another name – frontal sinusitis. Of all the types, it has the most severe form currents.

ICD code:

• ICD-10: J01.1
• ICD-9: 461.1

The development of frontal sinusitis begins as acute process with a viral or microbial infection, or as inflammation as a result of injury to the frontonasal canal and frontal bone.

Types of disease

By localization:

• Left-handed
• Right-handed
• Bilateral

With the flow:

• Acute frontal sinusitis
• Chronic frontal sinusitis

By form:

Exudative:

• Catarrhal sinusitis;
• Purulent frontal sinusitis

Productive frontitis:

• Polypous, cystic
• Parietal-hyperplastic

By etiology:

• Allergic
• Traumatic
• Viral frontal sinusitis (influenza, measles, adenoviruses, etc.),
• Bacterial (staphylococcus, streptococcus, hemophilus influenzae, other microbial flora),
• Fungal
• Mixed
• Medication.

Causes

With frontal sinusitis, inflammation of the mucous membrane that lines the sinus occurs. The reasons can be varied, often depending on the form and severity of the disease.

There are the most common causes of the formation of this pathology:

• Long-term infectious or allergic nature.
• Congenital or acquired curvature of the nasal septum.
• A source of infection formed due to infection with staphylococci, streptococci and other bacteria.
• Allergic reaction - bronchial asthma and contribute to the formation of edema of the mucous membrane. The result of this process is the closure of the hole, which facilitates the entry of fluid from the frontal sinus.
• Nasal polyps.
• Foreign bodies.

The most common causative agents of viral frontal sinusitis are:

• adenoviruses
• coronaviruses
• rhinoviruses
• respiratory syncytial viruses

Symptoms of frontal sinusitis in adults

Frontit serious illness, which is more severely tolerated than other forms of sinusitis. According to the nature of the course, there are two forms: acute and chronic. Each of them has its own characteristics and characteristics.

Photo of frontal sinusitis on an x-ray

The first signs of a general condition arise as a result of disturbances in blood flow in the human body or intoxication of the body. Among common features distinguish:

• pain in the forehead, sometimes in the eyes, temples, most often manifested in morning time;
• difficulty breathing through the nose;
• nasal discharge, often with an unpleasant odor, clear in the initial stages, then purulent;
• morning expectoration of sputum.

Acute frontal sinusitis

Pathogenic microorganisms multiply in the nasal cavity and frontal sinuses. At acute course the inflammatory process is localized in the mucous membrane, goes away on its own or in the process of adequate treatment after 10-14 days.

The symptoms of chronic frontal sinusitis are somewhat less pronounced than acute ones:

• aching or pressing pain in the area of ​​the frontal sinus, which intensifies when tapping
• when pressing, sharp pain in the inner corner of the eye
• profuse purulent discharge from the nose in the morning with an unpleasant odor
• a large amount of purulent sputum in the morning

Just because the symptoms have become weaker does not mean that there has been an improvement. Vice versa, chronic sinusitis can lead to serious consequences and life-threatening complications.

Chronic frontal sinusitis

In the chronic form of sinusitis, only one sinus is affected. Deformation processes caused by the pressure of pathogenic contents may be observed in the nasal cavity. When the disease becomes chronic, clinical picture much less pronounced. Symptoms may appear and then disappear.

The following signs of chronic frontal sinusitis are distinguished:

• decreased sense of smell, sometimes the patient cannot recognize odors at all;
• conjunctivitis;
• There may be no nasal discharge;
• in the morning, the eyelids are slightly swollen, which indicates the spread of inflammation to the walls of the eye sockets;
• persistent cough, which cannot be stopped with any antitussives or expectorants;
• severe weakness that prevents you from performing normal household chores;
• With chronic frontal sinusitis, polyps and neoplasms grow in the nasal cavity, which cause breathing problems.

IN medical practice frontal sinusitis without nasal discharge is a chronic type of disease.

Frontit	Description and symptoms
Catarrhal	Initially, a headache appears, localized mainly in the area brow ridges. Most often, the pain is observed at night and an hour after waking up and goes away by 13-14 hours, which is associated with a change in body position in the morning and the beginning of the outflow of mucus from the sinus into vertical position. The pain can radiate to the eye or both eyes, to the jaw, and its severity varies from mild to severe, cutting.
Purulent	The clinical picture includes: purulent discharge from the nose, the flow of which increases in the morning; throbbing pain in the bridge of the nose, aggravated by pressure or turning the head; fever and temperature up to 39-40 ᵒC; night and morning cough; severe headaches; distension and tension in the area of ​​the bridge of the nose; photophobia, lacrimation.
Single sided (left/right)	The causes are: viruses, bacteria, fungi and injury to the nose. With a unilateral form, the patient develops: Headache and mucopurulent discharge from one nostril Body temperature 37.3-39°C
Double-sided form	Pain occurs symmetrically on both sides. It can radiate to different parts of the head. Discharge from both nostrils.

Complications

Complications of frontal sinusitis that occur in both acute and chronic processes can be dangerous.

These include:

• transfer of infection to the bone walls of the sinus, necrosis and formation of a fistula with the release of fluid,
• transfer of infection to the orbital area with the formation of abscesses and phlegmon,
• transition of inflammation to the posterior wall with the formation of a brain abscess or meningitis,
• sepsis.

Absence optimal treatment leads to partial or complete loss of smell. The inflammatory process can impair eye function and significantly reduce visual acuity. Granulations and polyps form within the frontal sinuses. This is fraught with the appearance of fistulas in the orbital area and disruption of the integrity of the bony septa of the sinus.

Diagnostics

Frontal sinusitis often begins without nasal discharge, so the onset of the disease can only be diagnosed by examination by an otolaryngologist. An experienced otolaryngologist (ENT) will quickly diagnose correct diagnosis based on patient complaints. Additional studies are needed to clarify the severity of the disease and correct selection treatment regimens.

Diagnosis of frontal sinusitis includes the following methods:

• Taking anamnesis;
• X-ray of sinuses;
• Rhinoscopy;
• Ultrasound of the paranasal sinuses;
• Nasal endoscopy;
• Computed tomography (CT);
• Diaphanoscopy (transillumination);
• Thermal imaging (thermography);
• Bacteriological study of secretions from the nasal cavity;
• Cytological examination of the contents of the nasal cavity.

Treatment of frontal sinusitis

Treatment must be entrusted to a qualified medical worker. However, on initial stage You can cure frontal sinusitis on your own. In most cases, at the initial stage there is no need to take special drugs. It is enough to wash it several times a day nasal cavity. Rinsing will clear the cavity of mucous formations. However, it is not always possible to determine frontal sinusitis at the initial stage. Few people pay attention to headaches.

How to treat acute frontal sinusitis?

To treat the acute form of frontal sinusitis, when corresponding symptoms occur, drugs are prescribed to narrow blood vessels. Basically, these are nasal sprays. They provide high-quality elimination of nasal swelling, and also restore the full outflow of the contents of the nasal sinuses. For similar purposes they are used medical supplies based on phenylephrine, oxymetazoline, and xylometazoline.

Basic principles of treatment of acute frontal sinusitis:

• Creating conditions for normal sinus drainage.
• Antibacterial and anti-inflammatory treatment.
• Increasing the body's defenses.
• Prevention of recurrent exacerbations.

How to treat chronic frontal sinusitis?

For chronic frontal sinuses, the following is carried out:

• rinsing the nose with saline solutions;
• nasal sprays with steroid hormones(substances with anti-inflammatory effects). The drugs have proven their effectiveness and safety in numerous studies around the world: they are practically not absorbed into the blood and do not affect hormonal levels;
• long courses of macrolide antibiotics in low doses (drugs of the antibiotic group, the least toxic to the human body, have antimicrobial, anti-inflammatory, and immunomodulatory properties)
• Complete treatment of other inflammatory/infectious diseases;
• Find out the reasons for the development of allergies and get rid of the irritant - only in the case of the development of chronic frontal sinusitis against the background of an allergic rhinitis.

Medications

Before using any drug, be sure to consult an ENT doctor.

Antibiotics for sinusitis

If there are indications for taking antibiotics, then the drug of first choice is Amoxicillin in combination with Clavulanic acid. Preparations that contain this combination: “Augumentin”, “Amoxiclav”. If the patient is allergic to antibiotics of the penicillin group, then it is better to use -

• antibiotics of the fluoroquinolone group (for example, Ciprofloxacin),
• macrolides (Clarithromycin, Azithromycin).

Antibiotics for frontal sinusitis are prescribed for approximately 10-14 days. However, after 5 days from the start of treatment, it is necessary to evaluate the effectiveness of therapy. If significant improvement is not achieved, then it is best to prescribe a more potent antibiotic.

Anti-edema medications

Homeopathic remedies are also used in the treatment of frontal sinusitis.

• Sinupret: used to relieve inflammation, dilutes the contents of the sinuses.
• Sinuforte: relieves inflammation, promotes ventilation and opens the sinuses.
• Cinnabsin: relieves swelling, facilitates breathing and helps strengthen the immune system.

To reduce swelling of the mucous membranes, they are also prescribed antihistamines– Suprastin, Tavegil, Cetirizine.

Antipyretics are used for elevated temperature, many drugs have analgesic and anti-inflammatory effects. Medicines with paracetamol (Efferalgan and Panadol), ibuprofen (Nurofen) reduce the temperature.

Drops

To relieve swelling and improve drainage of the affected sinus, lubricate the mucous membrane under the middle turbinate with vasoconstrictors - adrenaline, ephedrine, naphazoline, xylometazoline. For the same purpose, instillation of drops with a similar effect is prescribed 3 to 4 times a day. These are the well-known drugs Naphthyzin, Sanorin, Galazolin, Nazivin, Nazol and others.

Physiotherapy

UHF therapy

Treatment electromagnetic field with wavelengths of 1–10 nm. The plates are applied to the area of ​​the frontal sinuses. The UHF field produces heat, reduces swelling, and activates regeneration processes.

Cuckoo method

It involves inserting a thin tube into one nasal passage through which special thinning and antibacterial drugs are delivered. Another tube is inserted into the second passage to pump out purulent mucus. Sinus rinsing is carried out using solutions such as Chlorophyllipt and Furacillin.

Rinsing for inflammation of the frontal sinuses, carried out at home, is less effective compared to similar procedures in a medical facility. But, nevertheless, you should not refuse them.

Washing of the nasal passages is carried out:

• Saline solution. To prepare it, you need to dilute a small spoon of salt in a glass of warm water. For acute frontal sinusitis, it is recommended to add 3-5 drops of tea tree ether to this solution.
• Decoctions of herbs - calendula, sage, chamomile flowers.

Puncture

Often, a puncture for frontal sinusitis is used if treatment with medications does not help. Also, when the disease is accompanied by headaches, there is a pathological cavity in the tissues and suppuration. Initially, an x-ray must be taken to determine the puncture site. The procedure can be performed through the nose or forehead under local anesthesia.

With an uncomplicated course, the prognosis is favorable, complete cure is possible, in advanced cases transition to a chronic course with periods of exacerbation is possible.

Folk remedies for frontal sinusitis

Completely cure frontal sinusitis traditional methods It is not always possible, however, it is possible to significantly speed up the healing process at home by additionally using medications.

1. Dissolve in 500 ml. warm boiled water a tablespoon alcohol solution chlorophyllipta. It has an antibacterial effect and fights even those microorganisms that have developed resistance to antibiotics. The solution is used for washing 3-4 times a day.
2. Take equal amounts of aloe juice, onion juice, honey, cyclamen root juice, Vishnevsky ointment. Mix everything well and keep in the refrigerator in a sealed jar. Before use, steam until the temperature reaches thirty-seven degrees. Apply the ointment to cotton wool and inject it into both nasal passages for half an hour. Course 3 weeks.
3. Frontal sinusitis can be treated with the plant cyclomen.. The juice of this plant is diluted with boiled water in a ratio of 4:1, the solution is dripped three times a day, two drops each.
4. Rosehip decoction(2 tablespoons per glass of water, boil for 10 minutes, steep for 20 minutes), add viburnum juice or raspberry syrup/jam to regular tea. You can make the following mixture with general strengthening effect– take 3 walnuts, hazelnuts and cashews per glass of honey, leave for 24 hours and consume half a teaspoon three times a day.
5. Bay leaf . Throw a few leaves into boiling water, simmer for 10 minutes, and then breathe over the steam. Perform the procedure in the morning, and in the evening you can leave the same decoction, warm it up and breathe again.

Prevention

High-quality prevention of frontal sinusitis in people involves treatment primary disease. It has great importance general strengthening immune system, which involves carrying out hardening and water procedures, eating vitamins, as well as fresh fruits and vegetables.

The main goal of preventing frontal sinusitis is to increase the body's protective properties, treat viral diseases, and regularly visit an otolaryngologist.

Frontal sinusitis is a disease in which an inflammatory process develops in the mucous membrane of the frontal (frontal) sinus.

The frontal sinuses are paired cavities located in the frontal bone of the skull on either side of the midline. The size and configuration of the sinuses vary from person to person. In some cases, the frontal sinuses may be underdeveloped or completely absent. The close location of the frontal sinuses to the anterior cranial fossa and orbits is fraught with serious complications of inflammation.

All age groups are equally susceptible to the disease; men suffer from frontal sinusitis more often than women.

Frontitis is an inflammatory process in the mucous membrane of the frontal sinus of the nose

Causes and risk factors

Most common cause the occurrence of acute frontal sinusitis is infectious process, spread to the mucous membrane of the frontal sinus from the nasal cavity during acute respiratory infections, as well as other infectious diseases. The causative agents can be viruses, bacteria or microscopic fungi.

Risk factors for developing frontal sinusitis include:

• nasal injuries and/or paranasal sinuses;
• congenital or acquired curvature of the nasal septum;
• impaired breathing through the nose (polyps, adenoids, vasomotor rhinitis, etc.);
• weakened immune system;
• foreign bodies in the nasal cavity.

Chronic frontal sinusitis develops against the background of incorrect or untimely treatment of the acute form of the disease; it is facilitated by features anatomical structure paranasal sinuses and/or nasal septum.

The chronic form of frontal sinusitis can take a persistent course with periodic relapses.

Forms of the disease

Depending on the nature of the pathological process, frontal sinusitis is divided into acute, recurrent, subacute and chronic.

By prevalence:

• one-sided (left- or right-sided);
• bilateral.

Depending on the etiological factor:

• bacterial;
• viral;
• fungal;
• allergic;
• traumatic;
• mixed.

Along the route of infection:

• rhinogenic – develops against the background of rhinitis;
• hematogenous - the pathogen penetrates the frontal sinus with the bloodstream;
• traumatic – occurs as a result of damage to the skull in the area of ​​the frontal sinuses.

According to the nature of inflammation:

• catarrhal;
• serous;
• purulent;
• polypous (cystic).

Most dangerous purulent form frontal sinusitis, since with inadequate or insufficient treatment it can cause serious complications.

Symptoms of sinusitis

In acute frontal sinusitis, patients complain of sharp pain in the superciliary region, which intensifies when tilting the head, during sleep, during palpation, can radiate to the temporal region and is not relieved by taking analgesic drugs. Also, symptoms of frontal sinusitis may include headaches of other localization, unpleasant bursting sensations in the bridge of the nose, photophobia, pain in the eyes, copious discharge from the nose without odor or with an unpleasant odor and particles of pus (with purulent sinusitis), difficulty breathing through the nose. These phenomena are accompanied by an increase in body temperature, cough with sputum in the morning, deterioration general condition, sleep disturbance.

The clinical picture of chronic frontal sinusitis in adults is less pronounced compared to acute sinusitis. As a rule, the chronic form of the disease is accompanied by inflammation of other paranasal sinuses, especially often the ethmoid sinus (ethmoiditis). The pain in the forehead is aching, intensifies with pressure, and its intensity varies throughout the day. Discharge from the nose often has an unpleasant odor, and there is a decrease in the sense of smell up to complete loss. Swelling of the eyelids indicates the spread of the pathological process to the orbit. Chronic frontal sinusitis is characterized by alternating periods of exacerbation and remission. Signs of frontal sinusitis during remission may include a feeling of heaviness in the superciliary area, decreased sense of smell, and nasal discharge.

Features of the course of frontal sinusitis in children

In children under 5-7 years of age, the frontal sinuses are not developed, so they do not suffer from frontal sinuses; the disease is detected in primary school and adolescence. Isolated inflammation of the frontal sinuses is rare in children; frontal sinusitis in this age group is much more often diagnosed as a component of pansinusitis.

The causative agents of frontal sinusitis can be viruses, bacteria or microscopic fungi.

In general, children are characterized by a severe course of frontal sinusitis with bilateral involvement of the sinuses; the clinical picture is similar to acute respiratory infections, but the disease’s duration is longer than that of acute respiratory infections, but it is alarming regarding inflammation of the paranasal sinuses. Specific symptoms of frontal sinusitis in children include:

• persistent headache, aggravated by head movements;
• pain in the projection of the frontal sinuses, aggravated by pressure;
• purulent nasal discharge;
• nasal voice;
• lacrimation;
• cough in the morning;
• stuffy nose and ears.

In some cases, children develop conjunctivitis against the background of frontal sinusitis.

There are also a number of nonspecific signs of the disease:

• rise in body temperature (rarely above 38.5 °C);
• pale skin;
• difficulty or complete impossibility of nasal breathing;
• swelling;
• decreased appetite;
• weakness, fatigue;
• irritability;
• sleep disorders.

Frontal sinusitis in children tends to spread to other paranasal sinuses (if it was isolated), as well as to quickly develop into a chronic form.

Diagnostics

The diagnosis is made based on the results of the following studies:

• taking anamnesis (previous respiratory disease, sinusitis of other localization, duration of manifestations, etc.);
• objective examination;
• rhinoscopic examination (helps determine the presence of an inflammatory process in the nasal cavity);
• bacteriological examination of nasal discharge (makes it possible to identify the infectious pathogen and determine its sensitivity to antibacterial drugs);
• general and biochemical blood test, urine test (determines signs of the inflammatory process, allows you to assess the general condition of the body);
• X-ray examination (allows differential diagnosis purulent frontal sinusitis and non-purulent forms of the disease, damage to other sinuses, establish the presence of curvatures of the nasal septum);
• magnetic resonance or computed tomography (help identify anatomical features nose and paranasal sinuses and the prevalence of the pathological process).

If necessary, additional studies may be used:

• cytological analysis of the contents of the nasal cavity;
• scintigraphy;
• thermography;
• diaphanoscopy, etc.

All age groups are equally susceptible to the disease; men suffer from frontal sinusitis more often than women.

Differential diagnosis of frontal sinusitis with inflammatory diseases other paranasal sinuses, trigeminal neuralgia, inflammation of the meningeal membranes, etc.

Treatment of frontal sinusitis

Treatment of frontal sinusitis is selected depending on the form of the disease, the prevalence of the pathological process, age, general condition of the patient and other factors.

Acute frontal sinusitis is an indication for hospitalization in an otolaryngological hospital.

To reduce swelling of the nasal mucosa and paranasal sinuses in order to create conditions for the outflow of pathological contents from the inflamed frontal sinuses, vasoconstrictors are used local action, which lubricate the mucous membranes of the nasal cavity (these drugs are also used in the form of drops and sprays). After the swelling is removed, antiseptic and anti-inflammatory drugs are injected into the sinuses.

General therapy for acute frontal sinusitis consists of the use of broad-spectrum antibacterial drugs, antihistamines and anti-inflammatory drugs.

In addition to drug treatment For frontal sinusitis, physiotherapeutic methods such as laser therapy, UHF therapy, electrophoresis with drugs, etc. can be used.

The purulent form of frontal sinusitis is the most dangerous, since with inadequate or insufficient treatment it can cause serious complications.

If conservative treatment is ineffective, complications occur and there is a significant deterioration in the patient’s condition, it is indicated surgical intervention(trephine puncture). During trepanopuncture, penetration into the frontal sinus is carried out through a section of the frontal bone of the smallest thickness. Manipulation can be done in two ways - by piercing the bone tissue or drilling. After removing the pathological secretion, the sinus is washed with an antiseptic solution and treated with an antibacterial and anti-inflammatory drug. With proper care of the puncture site, the puncture heals without a scar or scar. In some cases, surgery is performed endoscopic method. If all other methods are ineffective, they resort to trephination of the frontal sinus: after cutting the skin with a scalpel, the sinus is opened, washed with an antiseptic, a plastic tube is installed in the canal connecting the frontal sinus with the nasal cavity for drainage, then the incision is sutured.

In the treatment of chronic frontal sinusitis, generally the same approach is used, however, the antibacterial drug is selected taking into account the sensitivity of the infectious agent to it, and anti-inflammatory therapy is carried out using glucocorticoid drugs. Vitamins and other drugs are prescribed to strengthen the immune system. Positive effect Physiotherapy (magnetic therapy, ultraviolet irradiation, etc.) is also provided.

Treatment for acute frontal sinusitis lasts from several days to a week, for chronic sinusitis – 1-2 weeks or more.

Possible complications and consequences

In the absence of necessary treatment acute sinusitis can become chronic - this is the most common complication. Frontal sinusitis can also be complicated by the following conditions:

• atrophy of the nasal mucosa;
• conjunctivitis;

  Forecast

  If started in a timely manner and adequate treatment the prognosis is favorable. The chronic form of frontal sinusitis can take a persistent course with periodic relapses.

  Intracranial complications of frontal sinusitis are characterized by a poor prognosis and can lead to death.

  Prevention

  1. Timely treatment of respiratory diseases.
  2. Rejection of bad habits.
  3. Avoiding hypothermia.

  Video from YouTube on the topic of the article:

If a person has symptoms similar to frontal sinusitis, treatment should begin immediately. Most often, conservative treatment is sufficient, which includes drugs of local and systemic action. In those in rare cases When conservative treatment does not help, surgical treatment may be necessary.

How to recognize frontal sinusitis?

Frontitis is an inflammation of the frontal sinuses. It gives a person a lot painful sensations. Perhaps this is the most unpleasant of all sinusitis. It can be recognized by the following signs:

• high temperature;
• pain above the bridge of the nose;
• copious discharge from the nose, often greenish in color;
• difficulty in nasal breathing.

Temperatures can rise to 39–40 degrees and above. Characterized by poor general health - weakness, headaches, fatigue. Local symptoms there are varying degrees severity - from mild discomfort in the bridge of the nose to sharp, piercing pain, sometimes throbbing. They are more pronounced in the morning.

The area of ​​the forehead above the bridge of the nose is painful when pressed. In severe cases of the disease, the skin above the bridge of the nose becomes swollen or even red, pain in the eyes and photophobia appear.

If a person has symptoms similar to frontal sinusitis and treatment is started on their own, if possible, they should coordinate it with an ENT doctor as soon as possible. Incorrect treatment may contribute to the transition of frontal sinusitis to a chronic form or provoke complications.

Drug treatment of sinusitis

Medicines for sinusitis eliminate infection in the sinuses and fight inflammation. They reduce swelling and improve ventilation of the sinuses and the drainage of purulent contents. In most cases, acute frontal sinusitis responds well to medication. Treatment of exacerbations of chronic frontal sinusitis is carried out using the same methods.

Antibacterial drugs

Antibiotics for sinusitis can be prescribed for systemic use(inside) and for local (into the nasal cavity and sinuses). The doctor must first make sure that the infection is real. bacterial origin because antibiotics are not able to destroy the virus.

When viral infection unreasonable use of antibiotics causes the body to become accustomed to this group of drugs, and can also provoke symptoms of allergies and dysbacteriosis.

Before prescribing an antibiotic for frontal sinusitis, it would be optimal to determine the sensitivity of the microbes that caused the inflammation to it. This examination is possible if a bacteriological laboratory is available.

Bacteriological examination is the “gold standard”, after which it becomes clear exactly what antibiotics to take for frontal sinusitis.

Systemic antibiotics

If bacteriological culture cannot be done, it is possible to treat frontal sinusitis with broad-spectrum antibiotics. Such drugs have a detrimental effect on the most common microorganisms, that is, there is a high probability that the pathogen will fall into the spectrum of action of the antibiotic.

If frontal sinusitis develops, treatment with antibiotics at home most often begins with a group of penicillins, cephalosporins and macrolides.

According to microbiological monitoring, frontal sinusitis is most often caused by pneumococci and Haemophilus influenzae. These microorganisms are also sensitive to penicillin and cephalosporin antibiotics.

If antibiotics are not included in the treatment, frontal sinusitis will most likely go away with complications.

For outpatient treatment (at home), preference is given to antibiotics for oral administration in the form of tablets, capsules, and for small children or with difficulty swallowing - in the form of a suspension and soluble tablets.

Penicillin antibiotics

Synthetic and semi-synthetic amoxicillin preparations are primarily suitable for the treatment of frontal sinusitis. For greater effectiveness, special excipients are included in the composition of the drugs. They protect the antibiotic from destruction by bacterial enzymes.

An ENT doctor may prescribe Amoxicillin, Amoxiclav, Ampisid, Augmentin, Flemoxin Solutab. The dose of the antibiotic must be calculated by the doctor.

Cephalosporin antibiotics

If it is necessary to cure frontal sinusitis, antibiotics can also be used from the group of cephalosporins. They are an almost equivalent alternative to penicillins.

The similarity in the action of penicillin and cephalosporin antibiotics is explained by the similarity in the structure of their molecules.

Cephalosporins can also be destroyed by bacterial enzymes, so the choice of medication for frontal sinusitis is better to stop at the second or third generation. These are Cefaclor, Cefuroxime, Axetil, Ceftriaxone, Cefotaxime. In pharmacies they are represented by many trade names. Almost all of these antibiotics are available in injection form, so they are well suited for severe cases and complications of frontal sinusitis.

Drug treatment of frontal sinusitis using cephalosporins often has a negative effect on the intestinal microflora. The use of these drugs causes dysbiosis in every tenth patient.

Macrolide antibiotics

Macrolides become the antibiotics of choice if the patient cannot tolerate penicillin and cephalosporin antibiotics, or if they are ineffective. Macrolides include Macropen, Sumamed, Azithromycin, Roxithromycin, Spiramycin. They have almost no effect on the intestinal microflora.

The advantages of this group of antibiotics are an additional anti-inflammatory effect and the ability to act on intracellular microbes.

Antibiotics for topical use

Local antibacterial agents are delivered to the nasal cavity in several ways. It can be:

• nasal spray;
• nasal drops;
• aerosol;
• turundas (tampons) impregnated with a medicinal substance.

Bioparox aerosol based on the antibiotic fusafungine has an additional anti-inflammatory effect.

Isofra nasal drops and spray are based on an aminoglycoside antibiotic. Acting locally, it does not cause toxic damage to the kidneys and ears.

Polydexa spray with phenylephrine includes two antibiotics different groups: vasoconstrictor component phenylephrine and dexamethasone. The combination of neomycin and polymyxin covers the entire possible range of pathogens. Phenylephrine reduces the amount of nasal discharge, and dexamethasone for sinusitis has an anti-edematous and anti-inflammatory effect on the mucous membrane of the nose and sinuses.

Turundas with levomekol, in addition to their antibacterial effect, promote the outflow of purulent fluid from the frontal sinuses due to the hydrophilic base of the ointment.

Homeopathic remedies

Homeopathic remedies have long been used to treat sinusitis. Such drugs help both in the acute phase of the disease and during the recovery period.

If you need to cure frontal sinusitis, homeopathy can be included in treatment regimens at any stage of the disease. To do this, it offers a wide range of drugs:

• Engystol;
• Traumeel
• Lymphomyazot;
• Echinacea compositum;
• Sinuforte et al.

Sinuforte is perhaps the most famous and popular. It is produced from the roots of the cyclamen plant. The saponins contained in the preparation cause local and general reactions of the body and have an antimicrobial, decongestant and immunomodulatory effect.

To cure frontal sinusitis, sinuforte is administered into the nose using a spray once a day, one injection into each nostril. Before using it, it is advisable to cleanse the mucous membranes using preparations based on sea water and blow your nose well.

A course of Sinuforte for frontal sinusitis lasts on average 6–8 days with daily use. There is a treatment regimen where the drug is injected every other day. If the disease has not yet acquired a purulent character, with the help of Sinuforte it is possible to treat frontal sinusitis without a puncture and without the use of antibiotics, which means it will avoid many unpleasant moments and complications.

Symptomatic remedies

Symptomatic drugs act on different parts of the course of the disease. They eliminate unpleasant symptoms and make the patient feel better without affecting the causative agents of frontal sinusitis.

Vasoconstrictors

Vasoconstrictor drugs eliminate swelling of the mucous membrane and nasal turbinates, restoring communication between the frontal sinuses and the nasal cavity. They help relieve nasal congestion and difficulty breathing through the nose.

Examples of such drugs:

• Nazivin;
• Naphthyzin;
• Galazolin;
• Vibrocil.

These are the means local application, they are produced in drops or spray. They can be used for no longer than 6–7 days.

Antipyretics

Antipyretic medicine for sinusitis should be taken if the temperature rises above 38.5 degrees. Most drugs also have anti-inflammatory and analgesic effects. At temperatures below 38.5 degrees, they are taken in case of severe health problems (headaches, weakness, chills).

Most often, the temperature is reduced with drugs based on paracetamol (Panadol, Tylenol, Efferalgan) or ibuprofen (Nurofen, Ibufen). They should not be used as an antipyretic for more than 3 days without medical examination.

Anti-inflammatory drugs

If you need to cure frontal sinusitis, medications with anti-inflammatory properties will complement the therapy regimen. For example, fenspiride (Erespal) reduces the formation of biologically active substances, responsible for inflammation. In addition, it improves the discharge of mucus from the frontal sinuses.

There are forms of anti-inflammatory medications for local use. These are medications based on glucocorticoids - Nasonex, Flixonase. Proposol based on bee products and water solution Protargol based on silver.

Other treatments

Sometimes medications alone are not enough to combat frontal sinusitis, and then you have to resort to other means - sinus lavage, inhalation, sinus puncture, or even surgical methods.

Nasal rinsing

Flushing the nasal sinuses using the moving method (“cuckoo”) helps well in mild cases of frontal sinusitis; it can be used even in children. The patient should lie on his back and say “ku-ku” so that the solution does not enter the nasopharynx. The medicine is poured into one half of the nose, and a special suction is used to remove it from the other.

Rinse the frontal sinuses when moderate form frontitis is better through a special YAMIK catheter placed in the sinus. This is achieved by the difference in pressure in the sinuses and nasal cavity.

At home, it is easy and convenient to use the Dolphin method for washing.

Puncture and surgical treatment

Trepanopuncture or puncture ensures the outflow of pus through the hole, made through the frontal bone to the cavity of the frontal sinus. It is done in the presence of complications, in case of severe frontal sinusitis.

The sinus is washed through the hole 2 times a day. antiseptic solutions. In addition to healing, the puncture has diagnostic value– allows you to assess the quantity and nature of the sinus contents.

Surgical correction methods include radical surgery on the frontal sinus, performed both through external access and through the nasal cavity using an endoscope.

The frontal sinus is opened, cleaned of pus and provided with wide communication with the nasal cavity. This method of treatment is used in severe cases of frontal sinusitis, with frequent relapses of the disease.

Inhalations and traditional methods

Inhalations moisturize the mucous membranes of the nose and sinuses, improve the discharge of secretions. In addition, this is one of the ways to deliver drugs into the sinus cavity. This is done using ultrasonic, compression or conventional inhalers in the form of a funnel over a container.

At home, inhalations of steamed boiled potato tubers in their skins, a mixture based on garlic and apple cider vinegar, decoction of bay leaf.

There are many recipes folk remedies, helping to fight frontal sinusitis. They are based on beneficial features medicinal plants or individual products. For example, an ointment based on equal amounts of aloe juice, onion, honey, cyclamen root and Vishnevsky ointment helps well.

Black radish juice relieves pain and inflammation when dropped into the nose. There are many healing recipes based horse chestnut, calendula, chamomile, geranium, etc. Traditional recipes should not be used as independent method treatment, but in combination they bring significant relief.

If you select the right medicine– frontal sinusitis responds well to treatment. Therapy is almost never carried out with only one drug. Inflammation of the frontal sinuses is often caused by several causes, and it is advisable to act on all of them. A competent otolaryngologist can select the right combination of treatment methods.

is an inflammation of the mucous membrane of the frontal sinus. The main signs of the disease are headache with an epicenter in the eyebrow and spreading to the parietal, temporal regions, discharge of purulent or mucous exudate from the nose, intoxication syndrome, loss of smell. Diagnosis is based on the results of anamnesis, general examination, rhinoscopy, radiography or computed tomography, sinus endoscopy. The treatment program includes antibacterial drugs, detoxification therapy, anemia of the nasal mucosa, surgical drainage of the sinus, and physiotherapeutic procedures.

General information

Frontitis is a widespread otorhinolaryngological disease. From 24 to 32% of all episodes of hospitalization in an otolaryngological hospital are caused by pathologies of the paranasal sinuses. At the same time, about 14% of the total adult population suffers from different forms sinusitis. Up to 3-5% inflammatory processes in the sinuses are sinusitis, which ranks second in the structure of morbidity among all types of sinusitis. In the CIS countries, the disease is observed annually in approximately 1-1.3 million people. Acute forms pathologies occur 2-5% more often than chronic ones. The main group of patients consists of youth and middle age – from 16 to 35 years. In males, frontal sinuses are diagnosed somewhat more often - 55-58% of the total number of cases.

Causes of frontal sinusitis

In etiology acute inflammation frontal sinus, the leading role is played by ARVI caused by rhinoviruses, adenoviruses, coronaviruses or respiratory syncytial infection. In chronic forms, the infectious agent is often bacteria - representatives of the coccal microflora (Staphylococcus aureus, Streptococcus pneumoniae) in association with Moraxella catarrhalis and Haemophilus influenzae. Less common pathogens include pneumococci, pseudodiphtheria bacillus, pathogenic fungi. There are a number of factors contributing to the development of frontal sinusitis:

• Diseases of the upper respiratory tract. Includes acute and chronic rhinitis, adenoiditis, pharyngitis, tonsillitis, sinusitis, tubo-otitis and other pathologies that are a potential source of pathogenic microflora. In addition, this group includes pronounced growths of adenoid vegetations and benign tumors, blocking the lumen of the mouth of the sinus canal.
• Immunodeficiency states. The occurrence of frontal sinusitis may be due to a decrease in the reactivity and resistance of the body, observed in AIDS, malignant tumors, massive antibacterial, radiation or cytostatic therapy, hematological malignancies, genetic abnormalities, diabetes mellitus, hypothyroidism, autoimmune pathologies.
• Traumatic injuries. Inflammation of the frontal sinus can be caused by injuries or surgical interventions, which result in deformation or blockage of the excretory duct or narrowing of the frontal sinus. This also includes developmental anomalies that lead to similar changes - curvature of the nasal septum, deformation of the ethmoid labyrinth and middle turbinate.

Pathogenesis

The triggering factor for sinus inflammation is a violation of its normal ventilation, caused by swelling of the mucous membrane of the nasal turbinates, deformation or obstruction of the excretory canal. In this case, the air flow changes from laminar to turbulent and constantly injures the mucous membrane. Total blockage of the mouth causes a complete cessation of drainage, aeration, and provokes the accumulation of mucous secretion. Arteries and veins pass through the mouth, providing blood supply to the sinus tissue. Their compression underlies local dystrophic reactions.

The oxygen remaining in the sinus is gradually absorbed by the mucous membrane, and the partial pressure in the sinus decreases. During hypoxia, the process of anaerobic glycolysis starts, and underoxidized metabolic products accumulate. This creates an acidic environment, disrupts the acid-base balance, which interferes with mucociliary clearance and further aggravates sinus drainage disorders. In conditions metabolic acidosis the effect of lysozyme is completely neutralized. The combination of these factors creates the most favorable conditions for the proliferation of pathogenic microflora, inflammatory reactions such as edema and mucoid swelling.

Classification

Various types of lesions of the frontal sinuses are classified based on the nature inflammatory reaction, morphological changes, duration and activity of the disease. Introduction of gradations in clinical practice allows you to select optimal therapeutic tactics, resolve the issue of the need for early surgical treatment. Taking into account the characteristics of the course of the disease, the following forms are distinguished:

• Spicy. Characterized by preservation clinical manifestations illness for up to 12 weeks. With high-quality treatment, complete recovery occurs without residual effects.
• Recurrent. This option is characterized by the occurrence of 1 to 4 episodes of exacerbations within 1 year with intervals between them of at least 2 months, during which there are no symptoms of pathology and no need for treatment.
• Chronic. Manifestations of the disease persist for more than 12 weeks even with ongoing conservative therapy. Relief of symptoms is achieved after surgical treatment.

To assess the morphological features of the frontal sinus lesion, a modified classification presented by B. S. Preobrazhensky is used. According to it, the following types of chronic sinusitis are distinguished:

• Exudative. It is accompanied by the release of exudate of a different nature, which is why it has subtypes: catarrhal, serous (idiopathic or like sinus hydrops with blockage of the excretory duct) and purulent.
• Productive. Hyperplastic processes are observed on the side of the sinus mucosa. The following options exist: parietal-hyperplastic (thickening of the walls), polyposis (formation of polyps), cystic (formation of cysts).
• Alternative. This species is characterized by destructive changes in the anatomical sinuses. Considering the nature of the process, they are divided into cholesteatoma, caseous, necrotic, and atrophic.
• Mixed. A variant of the disease in which the previously mentioned forms are combined: purulent-polyposis, serous-catarrhal, serous-polyposis, parietal-hyperplastic-polyposis, etc.
• Vasomotor and allergic. Types of disease associated with vasomotor rhinitis and allergic reactions. Morphological changes and the nature of pathogenetic processes correspond to the main pathologies.

Symptoms of sinusitis

The clinical picture depends on the severity of the disease. In mild forms, predominantly local manifestations are observed, combined with signs of viral rhinitis: deterioration of nasal breathing and sense of smell, moderate headache in the superciliary area, and the presence of mucous or purulent nasal discharge. Some patients complain of discomfort or pain in the medial corner of the eye. Depending on which sinus is involved in the pathological process, the symptoms are more pronounced on the right, left, or evenly on both sides. Intoxication syndrome is usually absent. The symptoms persist for up to 5 days, after which they disappear simultaneously with the symptoms of ARVI or persist, indicating the addition of bacterial flora.

Moderate frontal sinusitis is characterized by local severe pain of a bursting, pulsating nature in the right or left superciliary region. Pain increases with movement eyeballs, tilting your head forward or backward. If the patient prefers to sleep on his back, a sharp exacerbation of pain is observed in the morning, which is associated with the accumulation of pathological masses. Often the pain radiates to the temporo-parietal area, accompanied by a feeling of pressure “behind the eyes”. A general intoxication syndrome is revealed, manifested by an increase in body temperature to 38.0-39.0 ° C, weakness, malaise, increased fatigue, loss of appetite and sleep disturbance. The severe form is characterized by severe, sometimes unbearable pain, severe systemic intoxication, reactive swelling of the eyelids, redness and swelling of the skin in the area of ​​the projection of the frontal sinus, and puffiness of the face. Patients are more likely to experience photophobia, lacrimation, and blurred vision.

In the chronic form, in the remission stage, symptoms of the disease are absent or are represented by the discharge of a small volume of pathological masses from the nose from the side of the affected sinus and low-intensity periodic diffuse headache without clear localization. An early sign of exacerbation is a sensation of “hotness” or “hotness” in the forehead. Then a constant pain syndrome occurs with an epicenter over the affected sinus of a dull, compressive nature. The pain may intensify at the end of the working day, after prolonged tilting of the head, physical activity, sometimes accompanied by a feeling of pulsation. Intoxication syndrome during exacerbations is mild.

Complications

Complications of the disease are associated with untimely or inadequate treatment, and the presence of severe immunodeficiency. Most often, the infection spreads to other paranasal sinuses, provoking the development of bilateral sinusitis, sinusitis, ethmoiditis, sphenoiditis. As a result of destruction of the lower wall of the frontal sinus, the process spreads to the tissues of the orbit, which leads to orbital complications: reactive edema of the tissue, abscess and phlegmon of the eyelid or orbit, osteoperiostitis of the orbit. Without timely treatment these complications can provoke compression and ischemia optic nerve, and, as a result, persistent visual impairment up to blindness.

For caries of the posterior or top wall sinuses, intracranial complications develop due to the penetration of purulent masses and pathogenic microorganisms to the front cranial fossa. Arachnoiditis, meningitis, encephalitis, brain tissue abscesses, thrombosis may form venous sinuses. In severe cases, hematogenous dissemination of bacteria and their metabolic products occurs, causing sepsis, the formation of metastatic foci of infection in other organs - liver, lungs, etc. All rhinogenic intracranial complications and septic conditions are associated with a high risk fatal outcome, require treatment in the intensive care unit and intensive care.

Diagnostics

The diagnosis is made on the basis of anamnestic information, the results of a physical examination, general clinical laboratory tests, bacteriological analysis and radiation methods diagnostics When interviewing a patient, the otolaryngologist details the patient’s complaints, finds out diseases or circumstances that preceded the development of current symptoms, previous injuries, operations in the area of ​​the bridge of the nose and forehead. For the purpose of a detailed examination, the following is carried out:

• Physical examination. A visual examination of the eyebrow area reveals hyperemia and moderate swelling. When pressing or percussing this area, the patient notices increased pain. During head tilt, in addition to changing the intensity pain syndrome nasal discharge increases.
• Examination of the nasal cavity. Rhinoscopy allows you to identify the characteristic symptom of a “purulent strip” - a small amount purulent exudate, draining from the front of the middle meatus. The visible mucous membrane is somewhat hyperemic and edematous.
• Radiography. X-ray of the paranasal sinuses is the leading diagnostic method. To obtain the most informative x-ray picture, the study is carried out in lateral, direct and posteraxial projections. Frontal sinusitis is indicated by darkening of the cavity, uneven contours of the sinus, decreased pneumatization, and the presence of defects in the bone walls.
• CT scan. CT scan of the paranasal sinuses is prescribed for low diagnostic value radiography, suspicion of the development of orbital or intracranial complications. The tomogram clearly displays all existing changes in bone structures and the entrance canal.
• Endoscopy of the frontal sinus. If it is impossible to reliably determine the nature of the pathological process in the frontal sinus and carry out a full differential diagnosis by other methods, perform a visual inspection of the entrance canal and the sinus cavity using a flexible endoscope.
• Bacteriological research. Used when empirical methods are ineffective antibacterial therapy. As biological material, sinus tissue samples obtained from puncture or trepanation are used, and less commonly, nasal secretions. Bacterial culture allows you to accurately identify the pathogen and assess its sensitivity to the main groups of antibiotics.

Treatment of frontal sinusitis

Medium-heavy and severe forms pathologies require constant monitoring medical personnel, so patients are hospitalized in the otolaryngology department. With frontal sinusitis mild degree severity possible ambulatory treatment. The main goals of the therapy are restoration of drainage and aeration of the sinus, removal of pathological masses, and prevention of complications. The treatment plan includes:

• Medications. Protected aminopenicillins are used as initial antibiotic therapy, and less commonly, cephalosporins of the II-III generation. Subsequently, it is possible to change medications in accordance with the results of antibiotic sensitivity tests. Non-steroidal anti-inflammatory drugs, decongestants, antihistamines, local antiseptics, vitamin complexes. In case of intoxication syndrome it is indicated infusion therapy with plasma substitutes, sorbents.
• Surgical intervention. It consists of probing the sinus after anemization of the nasal mucosa, trephine puncture of the sinus through the lower wall with washing of its cavity and drainage, endonasal opening using rigid endoscopes. If necessary, carry out open operations through the anterior wall or by widening the frontonasal canal with resection of the anterior group of ethmoid bone cells.
• Physiotherapy, conservative measures. Physiotherapeutic procedures for frontal sinusitis are represented by electrophoresis with local anesthetics, phonophoresis with corticosteroids and antibiotics on the frontal wall of the affected sinus. The nasal mucosa is anemized regularly with vasoconstrictor drops, rinsed with water-salt solutions or local antiseptics.

Prognosis and prevention

With early, complete treatment of frontal sinusitis, the prognosis for the patient’s health and life is favorable; intracranial complications, the development of sepsis is doubtful. No specific preventive measures have been developed for this pathology. Nonspecific prevention is based on the rational treatment of rhinitis, other forms of sinusitis and respiratory tract pathologies, adequate therapy ARVI, timely correction of developmental anomalies, defects of the nasal cavity and excretory ducts of the sinuses, relief of immunodeficiency conditions, prevention traumatic injuries facial area and superciliary area.