Sinusitis types, symptoms and treatment - Recommendations and warnings
In the middle of our face, we call the bone cavities that surround the nasal cavity and call it sinus. Even a newborn baby has sinuses even if it is very small. These gaps, originally pea-sized, are those that expand through the nose into the face and skull bones. It continues to grow and expand in childhood and young adulthood. They're air pockets. They are covered by the same membrane that covers the inner face of the nose and are connected to the nasal cavity with openings as large as a pencil head. Sinuses are part of the system of the nose, which forms normal secretion (mucus).
Normally, the nose and sinuses secrete about half a liter of mucus per day. The produced mucus acts on the nasal membrane, sweeping and washing dust particles, bacteria and other airborne particles. This mucus is then drained back into the throat and swallowed. Particles and bacteria are broken down by stomach acid. Many people are not aware of this because it is a normal body function.
What is Sinusitis?
Sinusitis is an infection of the sinuses. A typical case of acute sinusitis is caused by a cold or an excess of mucus secreted by an allergic attack. The membranes can swell so much that the small openings of the sinuses close. If the air and mucus cannot move freely between the nose and sinuses, the mucus accumulates in the sinuses and causes increased pressure. Depending on which sinus is affected, pain occurs between the eyes or behind, cheeks and upper teeth, caused by pressing on the face or forehead.
What is Sinusitis? Causes, symptoms and treatment of sinusitis
A closed and mucus-filled sinus is a suitable medium for the growth of bacteria. If the cold lasts longer than normal and the color of the slime turns green-yellow or a strange taste occurs, a possible bacterial infection has developed. Pain in the face and forehead can be very bad in cases of acute sinusitis. Chronic sinusitis develops when the sinus output is closed for a long time. Headache is rare but discharge and bad smell persist. As a result of excessive inflammation, formations called polyps develop. Some cases of sinusitis occur as a result of infection of the upper tooth into the sinus.
IS SINUSITIS DANGEROUS?
The majority of cases of sinusitis respond to medical treatment and are not dangerous. However, an infection within the sinus is very close to both the eye and the brain. The spread of infection to the eye or brain is very rare. Mucus flowing from infected sinuses is dangerous to the lungs. Thus, sinusitis; bronchitis, chronic cough, or asthma, or causes them to occur.
What is Sinusitis Headache?
During the cold or when the nasal cuff swells and the nose flows, or when the nose is full of mucus, headache on the face, cheeks, forehead or around the eyes is probably sinusitis pain. Sinus infection causes this. Another type of sinus headache occurs when the plane descends to land. This is especially noticeable if you have a cold or active allergy (this is called um Vacuum Headache)). Unfortunately, there are many other reasons that can be mistaken for sinus headaches.
For example, migraine and other vascular headaches or tension headaches can be confused with sinusitis as they can cause pain in the forehead and around the eyes as well as runny nose. However, this type of headache without a doctor's intervention in a short time to come and pass. They differ from sinusitis, which lasts long without doctor intervention and can only be corrected with antibiotic therapy. However, occasional headaches, which cause nausea and vomiting, are rather migraine headaches. A doctor should be consulted for the diagnosis of severe, frequent and prolonged headaches.
Who meets the sinus problem?
In fact, everyone can have a sinus infection, but some groups are more sensitive.
Those with allergies, those with structural nasal disorders that prevent good breathing and mucus flow, those who are frequently exposed to infection, smokers.
Treatment of sinusitis
We need three goals in the treatment of sinusitis. One, to fight inflammation. Two, eliminate the pain. Three, prevent the disease from becoming invasive. Antibiotics, painkillers and edema remedies are used in general treatment. Antibiotics should be selected according to the most common microbes. For example, fortified penicillin and cefolasporin antibiotics are successful in treatment. Treatment should be continued for 10 days. If necessary, the patient should be given painkillers and edema resolvers for four to six days.
Treatment should also be regional. In other words, the edema and swelling of the membrane layer should be eliminated and the inflammation inside should be thrown out. Nasal drops should be used no later than four to five days. If the patient is not allergic, misteptiles can be used. Nasal sprays with cortisone and antibiotics should be given.
Your doctor will ask you questions about your breathing, the color and smell of your runny nose, and what events (at what time of day or season) cause these symptoms. Be prepared to describe your headache; When and how often, how long it lasts, whether it is associated with nausea, vomiting, visual impairment, or nasal congestion. The Otorhinolaryngologist will examine your ear, nose, mouth, teeth and throat, paying particular attention to the appearance of the mucosa and the nature of the outbreak. It will examine the sensitivity of your nose. In some cases, x-rays of your sinuses may be necessary. The treatment will be linked to your doctor's diagnosis.
Antibiotics for infections
Antibiotic therapy or surgical intervention may sometimes be required. Acute sinusitis usually responds to antibiotic treatment, whereas chronic surgery usually requires surgery. In recent years, Functional Endoscopic Sinus Surgery (FESS) is a simple technique used to solve these diseases. The results are quite successful. If the symptoms are due to allergy, migraine or sinusitis, your doctor will apply an alternative treatment plan.
Drugs used in the treatment of sinusitis
Drugs have “local (directly into the nose)” and “systemic (oral or injection)” use. In sinusitis, different drugs are used alone or in combination for different factors.
Drugs for microbiology
Antibiotics: Antibiotics are used only if bacteria are present. They are used in bacterial species of acute sinusitis, acute exacerbations of chronic sinusitis.
Antiviral agents: In virus-derived species, they are used not always, but only in people with high complication status (low defense system, cortisone users, cancer patients, very old and fond people etc.). There are yet very effective antiviral agents.
Antifungal agents: They are used in fungal infections in sinusitis.
Medicines for payment
Cortisone: They can be given as nasal spray or systemically orally or by injection. Spray forms have less side effects, systemic use is generally short-term, and pre-operative preparation is common.
Antiallergic drugs: Antihistamines should only be used in allergic persons. In patients without allergic structure, mucus secretion may cause darkening and may adversely affect the treatment.
Mast cell stabilizers: They are used to keep the mast cells stable that produce edema-enhancing secretions in allergic individuals. They have few side effects and can be used for a long time.
Leukotriene antagonists: newer drugs. They are used to prevent inflammation as in mast cells.
Reflux drugs: Reflux in sinusitis can be an important underlying cause of edema - in people with reflux - reflux preventive lifestyle along with reflux drugs are part of the treatment. There are serious publications and they should not be neglected.
Decongestant drugs: Drugs taken by mouth and drops. Long-term use of both forms is not recommended. Nasal openers can make habit, nasal decongestants taken by mouth openers, blood pressure, eye pressure, prostate, rhythm disorder is dangerous in those with problems, not used; they can also have different degrees of insomnia or drowsiness and restlessness. It is known that prolonged use disrupts the function of broom cells.
Drugs for mucous secretion
Anti-secretion; Anticholinergic: They act by affecting the nerve stimulation of mucous secreting glands. There are also medications taken by mouth as well as nasal spray. Oral species are rarely preferred because of the multiplicity of side effects.
Antihistamines and cortisone also reduce and regulate mucus secretion. Edema-reducing drugs are described in the section.
Mucolytic: Mucus secretion by reducing the consistency of the movement helps to more comfortable. They help to clear the accumulated epidemic more easily.
Nasal drops
There are sub-groups with different mechanisms of action. It is important to understand the differences.
1-Nasal decongestant sprays: For short-term use only. If used longer, they will cause habitual and nasal mucosa damage.
2-Sprays containing cortisone: Can be used for a long time. Blood mixing rates are generally well tolerated.
3-Antihistamine containing sprays. Allergies are species that contain drugs.
4-Sprays containing anticholinergic substances.
5-Sprays with moisturizing properties: As well as herbal sprays, there are nasal sprays containing salt water or sea water.
6-Mechanical sprays. Salt water, sea water etc.
7- Drops and sprays where several drugs are used together. Recently, apparatus for the application of mixed drugs into small pieces in the form of spray or nebulizer has been introduced. It is controversial whether these drugs enter into the sinus in nebulous form.
Surgery for Sinusitis Treatment
Surgical opening of sinus openings and / or sinus formations (polyps, mucoceles, etc.) are performed for the purpose of cleaning. Operation reasons:
In mechanical blockages that permanently affect sinus drainage. (Cell sizes that narrow the sinus mouth, concha bullosa etc.)
In case of solidified mucus secretion that does not flow out in the sinus for a long time
In the presence of large cyst, mucocele, polyp in the sinus
Sinusitis that does not respond to long-term and appropriate medication
People with frequent sinusitis attacks have narrowed sinus canals
People with Barosinusitis
Primary diseases of mucosa (Kartagener syndrome, cystic fibrosis, etc.)
The development of endoscopes in sinusitis surgery has opened a new era. Endoscopes have made a lot of difference about the development, diagnosis and treatment of the disease.
Endoscopic examination of the nose and sinus mouths are much more comfortable, detailed examination, problems can be detected quickly and easily. Today's information is about making targeted interventions as respectful to the tissue as possible. Most sinus operations can be performed with endoscopes.
Rarely, we need direct interventions to the sinus. Endoscopic interventions provided both minimal tissue damage, increased success and patient comfort. Thus, the patient can return home even on the same day and there is no swelling and bruising on his face and nose. Operational safety has increased with technological advances.
Technological developments:
-Endoscope and image quality
-Recording
- Expanding sinus mouths with balloon technique
- Determination of intervention location in risky situations by navigation methods
- Improved patient comfort with convenient pads
Difference in treatment of sinusitis in children
The mechanism of sinusitis in children is similar to adults. Nevertheless, there are two main differences:
Reflux in children should be considered in the foreground. Some studies routinely recommend reflux treatment in children with chronic sinusitis without considering symptoms.
Sinus surgery is much more rare and the first choice for sinusitis is nasal surgery. It does not matter whether the flesh is large or not. Microbes are thought to serve as reservoirs, albeit small nasal flesh is taken.
SUMMARY
The characteristics of each sinusitis type and each sinusitis patient are different.
Protection is the first step
Individual treatment should be provided.
It is essential to avoid triggering reasons.
It is important to take medication when necessary and as long as necessary.
I recommend careful use of salt water. There are no publications other than a study showing that it is effective in adults.
If necessary, the operation should not be afraid.
What to do to avoid sinusitis?
Check if you are allergic. Use a steam humidifier when you have a cold. Sleep with the head of your bed raised. Decongestants can be used, but the chemicals in them can act as adrenaline, which can be risky for people with high blood pressure. They are also stimulants that cause insomnia. Consult your doctor before use. Avoid contaminants that irritate your nose, especially cigarette smoke. Eat a balanced diet, exercise regularly. Try to limit your relationship with people you know to be infected, and if that doesn't happen, take some precautions (washing hands, not using common towels and gowns).
Many non-prescription sinus medicines are sold, but it is not correct to use them without proper diagnosis. It is best to use the medications provided by your doctor who will examine you and know your complaints. Those with sinusitis should stay away from smoking. Sinusitis is also frequently seen in boarders, divers and climbers. The treatment of sinusitis is also recommended for patients with spa treatments. Sulfur in the spa water is known to increase resistance to microbes.
Can rotten teeth cause sinusitis?
One of the important factors in the formation of sinusitis is teeth. Cysts, inflammation or caries in the tooth roots lead to sinusitis. Cysts, inflammations and caries in the tooth roots cause sinusitis. If you complain of symptoms such as bad breath with one-sided runny nose, severe pain when touching teeth, beware! You may have dental sinusitis.
What are the most common causes of sinusitis?
Sinusitis occurs in two ways. The first is sinusitis through the nose. In other words, it occurs as a result of influenza, colds or pharyngitis. The second way in the formation of sinusitis is teeth. Cysts, inflammations or caries in the tooth roots lead to sinusitis. There are also reasons for less sinusitis. Blows to the face, like a long-term probing.
What are the symptoms of dental sinusitis?
The cause of this type of sinusitis is the problems in the molars. The table is a classic sinusitis table, but three features are remarkable. Inflammation is on one side. The discharge is very bad smelling. Touching the teeth causes severe pain. On examination, inflamed discharge is seen in the middle nasal canal. Diagnosis of this type of sinusitis is made by x-ray and dental examination.
Does flu or flu necessarily turn into sinusitis?
No. 5 percent of upper respiratory tract infections turn into sinusitis. However, considering that everyone has flu, a few times a year, it is understood why we have so many sinusitis patients. Children develop upper respiratory infections six to eight times a year and adults three times.
What is the effect of smoking on sinusitis?
The person with sinusitis should not smoke. There are 4,000 chemicals in cigarette smoke. Especially ‘benzene’ and ‘toluene mad substances cause more sinus diseases. The interesting thing is that both substances are thought to do more harm to passive smokers. Because these substances in the smoke from the smoke, the smoke is more than in the smoke.
What microbes do sinusitis?
The most common nasal sinuses are microbes called staphylococcal pneumonia and hemophilus influanza. These microbes cause upper respiratory tract infections. Other strains of streptecocci and staphylococci may play a role in sinusitis. This issue is important for the selection of antibiotics. Because some microbes have the ability to break down antibiotics. So the antibiotic we used to kill the germs could be ineffective.
It was also easier to treat some staphylococci in the past. Due to their ability to strengthen and develop themselves, these microbes gained resistance to antibiotics. In this respect, according to the type of microbes need to arrange treatment. Especially because the germs coming through the teeth can live without oxygen, the drugs and approaches should be different.
Sinusitis may be hiding other dangerous diseases!
Sinus cancer, cysts, calcification in the neck, eye fatigue may present as sinusitis. Therefore, sinusitis that do not respond to treatment should be carefully examined by the ENT specialist!
What is the role of allergy in chronic sinusitis?
Allergies and sinusitis may coexist. Allergies aggravate the condition of patients with chronic sinusitis, especially in seasonal changes.
Is chronic sinusitis associated with bronchitis and lung diseases?
Invasive sinusitis is almost always associated with bronchial and lung disease. The disease is caused by the sensitivity of both the upper and lower respiratory tract. Asthma and nasal polyps coexist in up to 70 percent. Inflammatory discharge from the back of the nose of chronic sinusitis also reduces chronic bronchitis. It may lead to exacerbation of sinusitis and inflammation of the sinuses. Therefore, sinusitis must be treated.
Can fungi cause sinusitis?
Generally, ‘Asperpillus mantar fungi cause sinusitis. Some create simple sinusitis and cause gray discharge in the nose. Some patients say they have had dental problems before. We make the definitive diagnosis with the help of computed tomography. CT images have holes such as gravy cheese. Fungi can be microscopically shown in the nasal secretion. Although rarely seen, the structure of the bones starts to deteriorate in patients with fungal-induced sinusitis. The eye pops out. The treatment is surgical.
How does sinusitis hide sinus cancer?
Some symptoms of sinusitis can be dangerous by hiding other diseases. One of them is sinus cancer. If symptoms are unilateral and bleeding, cancer should be suspected. In sinusitis that do not respond to the treatment, tomographic examinations should be performed and if necessary, a biopsy should be taken into the sinus against a possible cancer risk.
What is a sinus cyst?
Another disease that presents itself as sinusitis is sinus cysts. These are the liquid-filled vesicles formed by the accumulation of secretions in the membrane layer in the sinus. Sinus cysts are benign. These cysts, which do not cause headaches, can sometimes give a feeling of fullness and slight tingling.
Can sinus pains be confused with other pains?
In addition, diseases such as calcification in the neck, vascular pain of the face and eye fatigue can be confused with sinusitis.
Do spa treatments have a place in the treatment of sinusitis?
Some research shows that sulfur in spa waters is good for people with sinusitis whose upper respiratory tract is sensitive. Sulfur increases the resistance of the mucosa to microbes. Therefore, in terms of strengthening the infrastructure, it is beneficial to send patients with chronic sinusitis to spa treatment. However, if the reasons such as polyps and deviations that obstruct before going to the spa are eliminated, patients benefit more from the spa waters. The spring water enters the sinuses more easily. These waters can be sprayed into the nose by various means and instruments.
When should the needle be drained?
The treatment of sinusitis is done with antibiotics. However, we can refer to sinus drainage in highly painful blocked sinusitis that do not respond to antibiotics. This is called puncture in the medical language. Thus, the sinus is evacuated and a serious abscess is prevented. This can be done to the face and forehead sinuses. A thin rubber tube is placed in the hole where the sinus is evacuated for six days. Sinusitis can cause meats called polyps in the nose.
Nasal polyps should be suspected if olfactory sinusitis and persistent nasal obstruction have started in a patient with chronic sinusitis. Nasal polyps can sometimes open and close like a valve with the passage of air. Patients with bronchial sensitivity, asthmatics and patients with aspirin tolerance disorder are at risk for nasal polyps. Diagnosis is extremely easy. The presence of polyps in the nose examination is sufficient for diagnosis.
What is the treatment of nasal polyps?
For this purpose, cortisone treatment and antibiotic treatment in combination with sinusitis are performed.
Acute maxillary sinusitis
Diagnostic imaging for diagnosing antibiotics or sinusitis is not effective in the first 10 days of colds.
The diagnosis of sinusitis in adults and children over 7 years is made by sinus ultrasonography.
Antibiotics only work in patients with symptoms of the common cold for more than a week and who have fluid detected in the maxillary sinus.
Sinusitis may aggravate asthma symptoms.
In cases of recurrent sinusitis, the causes of susceptibility should be investigated.
Causes of maxillary sinusitis
Haemofilus: 30–40%
Pneumococcal: about 20–30%
Others: Moraxella, streptococci, viruses, anaerobes, other bacteria
Treatment of maxillary sinusitis
When symptoms persist for more than a week, the preferred treatment is a 7-day antibiotic regimen.
If the patient has severe pain or is frequently exposed to recurrent sinusitis, lavage may be performed.
Steroids are useful in recurrent and chronic sinusitis.
Preparations containing pseudoephedrine and antihistamine may be additionally used.
Washing with saline brings subjective relaxation.
If symptoms persist after antibiotic treatment, it is necessary to consult a physician again. If sinus ultrasound or x-rays show fluid in the sinus, maxillary lavage may be applied.
If symptoms are reduced and no fluid is detected on ultrasonography, there is no need for ongoing treatment.
Detection of predisposing factors in recurrent sinusitis
Allergic rhinitis (past, nasal eosinophilia)
Mucosal swelling, polyps, septum deflection (anterior rhinoscopy)
The condition of the teeth (sinusitis due to dental causes)
Growth of adenoids (snoring, mouth breathing)
Situations requiring expert evaluation
If the treatment did not bring relief within 4-6 weeks.
Continuous sinusitis in children after two antibiotic regimens.
Adults with recurrent chronic sinusitis more than 3 times within 6 months (persistent discharge despite 5 lavages)
Insertion of lavage tubes is a procedure requiring expertise. Tubes should not be kept in place for more than 3 weeks. If the currents persist, re-examination is required.
Symptoms and diagnosis of acute frontal sinusitis
If rhinitis or maxillary sinusitis is accompanied by an intense frontal headache, frontal sinusitis should always be suspected.
Other symptoms are similar to maxillary sinusitis.
Morning headaches, fever and deterioration of general condition are common in frontal sinusitis.
Diagnosis cannot be made on the basis of symptoms or laboratory tests alone.
Fluid level is diagnostic in sinus x-rays. The presence of open frontal sinuses on the X-ray is the reason for the elimination of frontal sinusitis.
It is sufficient for ultrasound-detected posterior wall echo 1 but X-rays are also necessary if symptoms persist for more than 3 days.
Some patients have pain between symptoms. The risk of complications (meningitis, orbital abscess, etc.) is higher than in maxillary sinusitis. Intense headache, eyelid edema or meningitis are symptoms of a new complication and the patient should be referred to a hospital immediately.
Treatment and follow-up of acute frontal sinusitis
Do not forget the appropriate treatment for maxillary sinusitis.
Maxillary lavage helps clean the medial outer ear area and improve fluid drainage from the frontal sinus.
Antibacterial treatment is indicated for all patients. If the causative agent is unknown, the following drugs (in the order given) are recommended: amoxicillin, tekracycline and cephalosporins.
Decongestive nasal drops should be used as part of conservative treatment. The maximum duration of treatment is 10 days.
If secretion is obtained in maxillary lavage, the procedure should be repeated after 2-3 days.
If frontal ligament pain persists and there is fluid retention in the frontal sinus, the patient should be referred to a specialist clinic where the frontal sinus will be surgically drained.
Symptoms and diagnosis of chronic sinusitis
Symptoms of chronic sinusitis are usually caused by pharyngeal, laryngeal and bronchial inflammation and rhinitis caused by sinusitis.
Local pain may rarely occur.
Chronic anterior sinusitis can cause continuous pain and eyelid edema.
Headache and vertigo are common in chronic sphenoidal sinusitis.
It is important to distinguish chronic sinusitis from pus from mucous edema filling the sinuses. Subsequent secretions can be adequately eliminated and surgical treatment is not indicated. In this way, mucosal thickening may be due to allergies, but non-specific mucosal irritation is a more common cause.
Diagnostic methods in basic care are x-rays and ultrasound of the sinuses that are completed by maxillary puncture in problematic cases.
Treatment of chronic sinusitis
Metered therapy aims to open the ostium by avoiding worsening of the factors that treat the symptoms.
Intranasal steroids provide recovery from an episode of acute rhinosinusitis in selected patients with recurrent or chronic sinusitis.
Repeated washing with 0.9% saline solution may alleviate the patient's symptoms.
Surgical treatment is aimed at retaining secretions, removing an anatomic problem that leads to a drainage outlet, resection of the inflamed mucosa or removal of the entire sinus.
Chronic sinusitis should be treated by a specialist, but repeated washings and follow-up are performed in basic care.
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