Chronic sinusitis: symptoms and treatment in adults and children

Symptoms of sinusitis often develop inpatients after colds. Especially often this complication occurs in cases where the proper attention has not been paid to the treatment of the infection. Nowadays, this disease is extremely common. In otolaryngology sinusitis is called sinus inflammation, which is located in the region of the nasal wings and upper jaw. They are called "maxillary sinuses", hence the name of the disease. There are few vessels and nerve endings. For this reason, patients may not notice the signs and symptoms of sinusitis for a long time. But the disease is developing rapidly, and the inflammation soon becomes chronic.

Causes of the disease

Chronic sinusitis is a diseaseinfectious origin. Microorganisms enter the sinuses from the nasal passages, throat and mouth. By reducing the body's defenses, favorable conditions are created for the spread of infection. Symptoms of sinusitis in the acute form are quite rare. The disease usually very quickly becomes chronic. The pathological process most often affects one sinus, but there is also bilateral sinusitis.

The disease is caused by various microorganisms: streptococci, viruses, fungi, hemophilus bacilli, staphylococci. Sometimes several different bacteria become the cause of inflammation, which makes it difficult to choose a drug for treating the symptoms of sinusitis.

However, in order for the infection to lead to a chronic inflammatory process, additional adverse factors are necessary. These include:

  1. Pathologies that prevent free breathing. These are consequences of injuries and congenital anomalies of the nose, allergic rhinitis, polyps. Respiratory impairment leads to the accumulation of mucus in the nasal passages and the multiplication of harmful microorganisms.
  2. Weakening of the immune system. Symptoms of sinusitis in a chronic form usually develop in frequently ill people. Often, sinus inflammation occurs in patients who abuse antibiotics or take cytotoxic drugs (immunosuppressants).
  3. Dental diseases. This is one of the common causes of sinusitis. The sinuses are located above the 4th, 5th and 6th teeth of the upper jaw. If there is chronic caries, pulpitis or periodontitis in this area, the infection may spread from the oral cavity to the paranasal areas.
  4. Viral diseases of the respiratory system. The sinuses are connected to the nasal passages through a small hole through which they are cleaned. In chronic and acute rhinitis, it becomes obstructed, resulting in mucous secretions accumulating and disease causing bacteria to multiply. Therefore, when the head cold, doctors recommend constantly using drops. This will help the maxillary sinuses to clear the discharge.
  5. Foci of chronic infection in the body. If a person is a bacteriocarrier (for example, staphylococcus or streptococcus), then the infection can be entered into the maxillary sinuses with blood flow.

Causes, symptoms and treatment of sinusitis in childrenhas its own characteristics. This disease practically does not occur in babies up to 4-5 years, since at this age the sinuses are still not sufficiently formed. As for older children, chlamydia and mycoplasma are often the cause of sinusitis. This requires the appointment of special antibiotics.

Sinusitis in a child

Symptoms of pathology

Symptoms of chronic sinusitis are usually pronounced.unsharp and manifest inconsistently. This disease occurs with periodic exacerbations. During remission, the person’s condition usually remains normal. There may be only minor signs of chronic inflammation (weakness, fatigue, slightly elevated temperature) that a person does not usually associate with the disease.

Exacerbations occur as a result of hypothermia, weakened immunity, colds or allergies. The following signs of pathology can be distinguished:

  • feeling of heaviness and pressure in the sinus;
  • thick discharge from the nose;
  • cough that is difficult to treat;
  • headache;
  • arching pain in the sinus radiating to the forehead, teeth, temples;
  • difficulty breathing;
  • impaired sense of smell due to constant nasal congestion (a person badly distinguishes odors);
  • pain in the upper jaw when chewing;
  • signs of conjunctivitis;
  • nasal, changes in voice;
  • constantly open mouth during sleep (due to difficulty in nasal breathing);
  • moist skin lesions around the nostrils;
  • dry cough due to nasal irritation of the throat.

A bursting sensation in the paranasal region is one of the main signs and symptoms of sinusitis. Where does the inflammation of the maxillary sinuses hurt? This question often worries patients.

Often in the period of cold people occurbursting pain in the frontal region. Many patients consider this a symptom of sinusitis. But it's not always the case. In medicine, there is the concept of "sinuses of the nose." These include all the paranasal sinuses: maxillary, ethmoid, frontal and wedge-shaped. Inflammation of these departments is called "sinusitis". Sinusitis is a particular case of this disease.

Sinus headache

The pain in the superciliary region is characteristic of sinusitis.frontal sinuses (frontal sinusitis). When sinusitis a feeling of distention occurs near the nose, in the upper jaw. However, the pain may go to the forehead. In addition, patients often combine both pathologies: both sinusitis of the frontal sinuses and chronic sinusitis.

It is sometimes difficult for a patient to determine whereit hurts. A symptom and symptom of sinusitis is radiating pain, which gives to different parts of the face. The clinical picture of this disease may resemble the manifestations of many other ailments, such as trigeminal neuralgia.

Often the disease occurs in childhood, afterfrequent colds. A young child usually suffers from inflammation of the paranasal sinuses is heavier than a teenager, since his immunity is not yet fully formed. In general, the symptoms of sinusitis in children do not differ from the manifestations of this pathology in adults.

Forms of the disease

The clinical picture of the pathology largely depends on the form of the disease. There are the following types of sinusitis:

  1. Catarrhal In this form of the disease from the nasal passages discharge in the form of transparent, viscous mucus. Often, patients may notice swelling of the face.
  2. Purulent. The discharge is thick, greenish or yellowish, with an unpleasant odor.
  3. Odontogenic. In this case, the cause of the symptoms of chronic sinusitis in adults and children are sore teeth. Inflammation always appears on the side where caries, periodontitis or other dental pathology is found. Discharge from the nose offensive, worried about the pain in the upper jaw. Mandatory sanation of the oral cavity is required, otherwise such antritis is not amenable to therapy.
  4. Rinogenny. This form of pathology occurs in more than half of patients. Inflammation of the sinuses precedes rhinitis. In this case, the patient completely laid one nasal passage (from the affected side), and the discharge away from the other nostrils.
  5. Allergic. In this form, the aggravation of the symptoms of sinusitis in adults and children occurs after exposure to an allergen. Sneezing and tearing appear, clear liquid mucus is released from the nasal passages. This form of the disease can be complicated by polyposis changes, which aggravate the pathology.
  6. Fungal. It occurs in patients with a sharply reduced immunity or after uncontrolled self-treatment with antibiotics. It is caused by fungi: candida aspergillus and various types of mold. Nasal discharge has an unusual appearance. They may look like cheesy lumps of white, yellowish jelly-like mass or black-gray mucus.
Sinus pain

If you find these symptomschronic sinusitis is an urgent need to consult a doctor-otorhinolaryngologist. Persistent inflammation in the paranasal sinuses can lead to serious complications.

Possible complications

If symptoms of sinusitis bother the patient inover time, this also affects the condition of other organs. Running this disease is dangerous, since the nasal sinuses are in close proximity to the brain. Infection from the paranasal sinuses can easily spread to nearby organs. The most dangerous complications of the disease include meningitis and meningoecephalitis, brain abscess, sepsis. Such pathologies can even be fatal. Therefore, the symptoms of sinusitis in adults and children should be a reason for immediate treatment to a specialist. This disease does not go away on its own.

Infection from the sinuses can penetrate the orbit,middle ear or bone tissue of the jaw. There are otitis, osteomyelitis, phlegmon of the eye orbit. In addition, a patient with sinusitis becomes susceptible to diseases of the upper respiratory tract: sore throat, pharyngitis, laryngitis. Chronic inflammation of the paranasal sinuses can provoke a painful and unpleasant disease - neuralgia of the facial nerve.

However, if symptoms are detected earlyantritis in adults and children, and correctly prescribed therapy, complications are very rare. Nowadays, this disease has a favorable prognosis. It lends itself well to modern methods of treatment.

Diagnosis of the disease

Symptoms and treatment of sinusitis in adults and childrendepend on the form and experience of the disease. However, it is first necessary to diagnose pathology. An experienced otorhinolaryngologist may suspect this disease already during the examination and collection of anamnesis. But to confirm the diagnosis will require additional research.

When probing the area of ​​the nasal sinuses usuallythere is pain and a feeling of distention. Some patients have noticeable swelling of the face. During the inspection of the throat, you can notice the discharge flowing down the back wall. These signs and the characteristic complaints of the patient suggest chronic sinusitis. The doctor also conducts an instrumental examination of the nasal passages with the help of a rhinoscope. Sometimes prescribe endoscopic examination of the sinus. To do this, use a special probe with optics, which is injected into the sinus cavity.

Endoscopic examination of the sinuses

The most common and accurate waydiagnosis of the disease is an x-ray of the sinuses. This study helps to determine not only the presence of the inflammatory process, but also the polypous cystic changes that often accompany sinusitis. In some cases, to clarify the diagnosis carried out tomographic study.

However, pregnant women and children x-raycontraindicated. They spend diaphanoscopy. The study is done in a darkened office. A special lamp is introduced into the mouth and its glow is monitored. The inflamed sinus of the nose is obscured.

An effective way to detect sinusitis issinus puncture. A special needle is inserted into the nostril, a puncture is made in the wall of the sinus and washing is performed. The fluid is sent for laboratory analysis. This method can be used not only for diagnostics, but also for the treatment of symptoms of chronic sinusitis in adults and children. In this case, when washing, apply disinfecting solutions.

Once the diagnosis is established, the doctor mayassign a bacteriological analysis of the contents of the sinus. This helps to choose the right antibiotic for therapy. When odontogenic sinusitis requires consultation and treatment by a dentist.

Drug and physiotherapy treatment

How to treat the symptoms of sinusitis without surgicalinterventions? Modern antibiotics come to the rescue. If the disease is not started, then properly selected antibiotic therapy will be able to cope with the inflammatory process.

The use of antibiotics is indicated for infectiousform of chronic sinusitis, which occurs in most cases. If the disease is caused by allergies, then antibiotic therapy will not help. In this case, it is necessary to prescribe antihistamines: Ebastina, Chloropyramine.

In the treatment of sinusitis most often usedpenicillin and tetracycline drugs: "Doxycycline", "Amoxicillin" or sulfonamide combination drug "Co-trimoxazole". They can affect a wide range of bacteria. The course of treatment takes about 14 days.

Drug treatment of sinusitis

If sinusitis has a fungal nature,used "Ketoconazole", "Amphotericin B", "Itraconazole". Drugs have to be taken for a long time, as this form of the disease is difficult to treat. It is imperative that immunomodulators are prescribed, so the fungal infection in the sinuses is always the result of the fall of the body's defenses.

As mentioned above, symptoms and treatmentSinusitis in children have their own specifics. The cause of the disease in a child is often chlamydial and mycoplasmal infection. These microorganisms are poorly exposed to penicillins and tetracyclines. Therefore, the prescription of macrolide antibiotics is required: "Clarithromycin", "Azithromycin", "Roxitromycin".

In the treatment of symptoms of sinusitis in adults and children, antibiotic therapy is always combined with the appointment of nasal drops: "Dimetidine", "Nafazolin", "Oxymetazoline".

The use of drops from sinusitis

Drug treatment supplement the physiotherapeutic procedures in the sinus area:

  • electrophoresis with antibiotics;
  • UHF and microwave therapy;
  • phonophoresis with drugs;
  • magnetic and laser therapy.

Such an integrated approach to treatment in manycases allows you to get rid of chronic sinusitis completely. It must be remembered that the course of therapy must be completed. If you interrupt treatment early, then all signs of pathology may return.

Conduct a conservative treatment of symptoms.sinusitis at home is quite possible. In most cases, this disease does not require the placement of a patient in a hospital. Hospitalization is necessary only if there are complications, in severe cases of exacerbation of purulent sinusitis and, if necessary, surgery.

Sinus lavage

Sinus lavage according to the ProAtz method complements drug therapy. This is a painless treatment that does not require a sinus puncture. In the people this method is called "cuckoo".

Catheters are inserted into the patient's nasal passages. Disinfectant solution is fed through one tube into the cavity of the sinus. From the other nostril, purulent contents are sucked through the catheter using a vacuum. During the procedure, the patient is recommended to pronounce the "cuckoo", so that the liquid does not get into the throat, hence the popular name of the method.

This method of treatment is quite effective. Usually, after a few procedures, it becomes easier for the patient to breathe through the nose, headache and pain in the sinuses disappear.


For surgical intervention resorted toadvanced cases of chronic sinusitis. A puncture (puncture) of the sinus is performed under local anesthesia. Catheters are inserted into the nasal passages, through which the sinus cavity is washed with furacilin or saline. After surgery, the patient remains in the hospital for some time under the supervision of doctors.

This method can permanently save the patient fromsinusitis However, the puncture has its drawbacks. After a patient has been punctured, pain in the sinus and the forehead may be troubling, sometimes there are complications of the throat. Some patients with chronic pathologies of internal organs puncture is contraindicated.

Some patients fear surgical treatment. They mistakenly believe that, having made the puncture once, it will have to be repeated in the future. This is a wrong opinion, such a surgical intervention can save the patient from sinusitis once and for all. Relapses of pathology after puncture are found only when the curvature of the nasal septum. This requires additional plastic surgery.

In difficult cases of sinusitis spend moresurgery The sinuses are opened through the mouth, washed and the affected tissue is removed. Postoperative scar remains invisible. The intervention is carried out under general anesthesia. The operation lasts about 1-1.5 hours. This method of treatment is used only in extreme cases, at risk of developing brain complications.

Folk methods

Patients are often interested in folk methods.treatment of symptoms of sinusitis at home. It should be remembered that this can not replace traditional medical therapy. Traditional recipes for sinusitis can only complement the treatment prescribed by the otorhinolaryngologist.

Completely eliminate the symptoms of sinusitis at homeconditions is impossible, since pathogens still remain in the sinuses. However, you can ease breathing and reduce nasal congestion. It is useful to use solutions with sea water, they can be purchased in pharmacy chains. They wash the nasal passages with a syringe or syringe. You can also use a solution of propolis, decoction of herbs (chamomile, calendula, St. John's wort) or silver water for this purpose.

Flushing nasal passages

Often patients are interested in whetherantiseptic apply heat to the sinuses. Warming up with inflammation of the sinuses is not always shown. The application of warm compresses is permissible only when the initial symptoms of sinusitis and the absence of purulent discharge. In other cases, warming up can lead to the proliferation of bacteria. Especially not recommended to do such compresses in the fungal form of the disease. It is necessary to consult with a doctor, only a specialist can decide on the feasibility of heating procedures.


To prevent the occurrence of chronicantritis, it is necessary to eliminate its causes in time. It is necessary to complete the treatment of colds, flu and other infectious diseases. You should regularly visit the dentist and carry out rehabilitation of foci of caries.

For allergies, avoid contact withirritants provoking exacerbation of the disease. It is also important to maintain optimum humidity in the room, too dry air can cause the development of sinusitis. It is useful from time to time to carry out preventive washing of the nasal passages with saline solutions, this prevents the accumulation of mucus and the multiplication of bacteria.

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