Treatment of maxillary sinusitis in Cherkasy

The maxillary sinuses are small cavities in the upper jaw connected to nasal passages. Due to provoking factors, for example, acute respiratory viral infection, inflammation of the mucous membrane occurs in the sinus. This condition is called maxillary sinusitis being a type of sinusitis – inflammation of the sinuses.

Causes of maxillary sinusitis development:

• disturbance of nasal breathing: curvature of the nasal septum, chronic inflammation of the nasal mucosa, adenoids and allergic diseases;
• weak immunity, which leads to chronic lingering infectious and parasitic diseases;
• incorrect or late treatment of ARVI;
• dental pathology or complications of interventions in the oral cavity (odontogenic maxillary sinusitis);
• congenital anatomical features of the structure of the nose and maxillary sinuses.

In most cases, maxillary sinusitis occurs as a complication of other diseases: chronic runny nose, flu, measles and scarlet fever. Maxillary sinusitis is like a prolonged runny nose. This raises the problem: patients begin to take medicine, but they are ineffective. Severe headaches, fatigue and irritability occur. The patient visits the doctor only at the stage of complications.

Symptoms of maxillary sinusitis

Maxillary sinusitis manifests itself in different ways: from nasal congestion to severe algors and headaches. Manifestations of maxillary sinusitis:

• a runny nose, which feels like a stuffy nose on one or both sides. A feeling of stuffiness disappears when a nasal discharge appears. It can be different, depending on the nature of the inflammation. For example, with purulent maxillary sinusitis, a fluid with pus is secreted, with catarrhal maxillary sinusitis, abundant, liquid, transparent or yellow discharge. Runny nose accompanied by a decreased sense of smell and sometimes lacrimation;
• malaise: fatigue, superficial sleep, fatigue, distracted attention;
• temperature: in acute maxillary sinusitis rises to 38.0 °C. The temperature in chronic maxillary sinusitis is usually normal or rises to 37.5 °C;
• headaches and pains around the nose. A distinctive feature of sinusitis of the maxillary sinus is increased pain in the afternoon: at this time, mucus and edema inside the maxillary sinus accumulate most of all. The pain can be often so strong that painkillers fail to help.

The color of the discharge depends on the stage of maxillary sinusitis. At the first stage, white thick nasal discharge appears. On the second – yellow-green discharge. Yellow color indicates active inflammation inside the maxillary sinuses and accumulation of pus (urgent reason to consult a doctor). In the third stage, green discharge usually appears. A green color indicates that a bacterial infection has joined the inflammation.

Severe course of the disease is indicated by discharge containing clots or particles of blood. In this case, the patient should immediately seek medical help from the ENT doctor in Cherkassy.

Features of the course depend on the form of maxillary sinusitis. In patients with catarrhal form, symptoms are usually limited to transparent and thick nasal discharge. In most cases, catarrhal maxillary sinusitis occurs in school children and adolescents.

The catarrhal form occurs due to previous viral diseases, exposure to hot steam or cold air, allergic reactions. With a catarrhal form, there is no appetite, body temperature rises to 38.0 °C, fatigue and malaise occur, general well-being worsens, performance decreases, and headaches appear in the evening.

If you do not treat the catarrhal form or ARVI for a long time, bilateral maxillary sinusitis develops – the mucous membrane of both maxillary sinuses becomes inflamed. More often it is acute and can go into a chronic form. Bilateral maxillary sinusitis is a rare occurrence with a severe course.

Symptoms of bilateral maxillary sinusitis:

• swelling and stuffiness on both sides of the nose;
• profuse nasal discharge;
• periodic tearing;
• headaches, malaise, poor appetite, fatigue, irritability and superficial sleep.

Maxillary sinusitis polyposa develops due to allergies, abnormalities in the structure of the nose and paranasal sinuses, chronic inflammation of nasal mucosa. The first symptom of maxillary sinusitis polyposa is nasal breathing problems. Most patients begin to breathe through the mouth, since both sides of the nose are completely blocked. Thick transparent or yellowish mucus is released from the nose. Smells and appetite decrease, severe headaches appear.

It is impossible to treat maxillary sinusitis polyposa with folk remedies – overgrown tissues can only be removed surgically. Only in isolated cases when polyps are small, antihistamines, glucocorticoids and antibiotics help.

Allergic maxillary sinusitis develops due to allergic reactions to external factors that irritate the mucous membrane. For example, continuous work in a dusty room. The response allergic reaction is manifested by tearing, runny nose and profuse nasal discharge. Typical allergic symptoms: fever, pain in the eyes and nose, general weakness and fatigue. In most cases, allergic maxillary sinusitis develops in spring and autumn.

Purulent maxillary sinusitis develops after previous viral or bacterial diseases that have not been cured on time. The most common cause is improper self-medication and lack of medical care.

Purulent maxillary sinusitis is a dangerous form of the disease: pyogenic bacteria and their waste products accumulate in the sinuses of the nose. This leads to the melting of the bone tissue of the skull and involves the teeth and elements of the oral cavity.

How to treat maxillary sinusitis?

Maxillary sinusitis can be treated by otolaryngologist after consultation with the patient. For treatment, medicines, physiotherapeutic procedures and, if necessary, surgical intervention are used. In acute maxillary sinusitis, the doctor prescribes antibiotics, vasoconstrictors, electrophoresis with the addition of drugs, ultra-high-frequency therapy and inhaling. Acute maxillary sinusitis is treated on average from 7 to 10 days.

Do not treat maxillary sinusitis with folk remedies; consult your doctor. If you do not visit otolaryngologist and start treating purulent maxillary sinusitis at home on your own, serious complications can develop. For example, a bone can melt and pus enters the brain – this will lead to inflammation of the meninges. The worst thing you can do is to self-medicate without a doctor’s supervision.

The important procedure in the treatment of maxillary sinusitis is rinsing of the sinuses. For this, doctors use an isotonic solution of sodium chloride, a solution with the addition of antibiotics, silver nitrate and potassium permanganate. If a patient takes medication on time and complies with a doctor’s prescription, the prognosis for treatment of maxillary sinusitis is favorable.

If severe swelling occurs with maxillary sinusitis, the doctor makes a sinus puncture. However, many patients are afraid of this procedure due to the ignorance of the puncture essence. Puncture in case of maxillary sinusitis is performed as follows:

1. The otolaryngologist inserts cotton wool with lidocaine (anesthetic) deep into the nostril and waits until the local pain sensitivity is lost.
2. He takes a sterile needle and pierces the bone tissue between the nasal septum and maxillary sinus. ENT specialist inserts a syringe into this needle and extracts the entire contents of the sinus and rinses it with solutions.

Otolaryngologists at “ON Clinic Cherkasy” perform physiotherapeutic procedures and, if necessary, puncture the maxillary sinuses in the following cases: if antibiotics are ineffective and pus continues to accumulate, if the patient has severe swelling, high temperature and poor health, and if there is a risk of complications.

Maxillary sinusitis can be treated on an outpatient basis. But in the following cases, hospitalization is indicated:

• severe course of maxillary sinusitis: body temperature above 38.0 °C, severe headaches, chills, purulent nasal discharge, light touch on the upper jaw causes severe pains;
• if maxillary sinusitis has arisen in the setting of severe infectious diseases or immunodeficiency conditions.

In addition, maxillary sinusitis during pregnancy is also treated in the hospital.

Treatment of chronic maxillary sinusitis and antibiotics

In case of chronic inflammation, the main task of otolaryngologist is to prescribe the drug with the greatest effectiveness for a particular patient. Typically, with maxillary sinusitis, ENT specialist prescribes antibiotics: amoxicillin and ampicillin. Many people are mistakenly afraid of antibiotics, see them as a strong "poison". In fact, antibiotic is the only treatment for bacterial maxillary sinusitis and the prevention of bacterial complications.

Treatment depends on the severity of maxillary sinusitis. With a mild form, if there is no viral infection, antibiotics are not prescribed. The doctor prescribes standard treatment: vasoconstrictors, physiotherapy and rinsing. If in 10 days the symptoms have not weakened and even progress, it is most likely that bacterial microflora has joined the inflammation. In this case, the prescription of antibiotics is indicated.

In case of moderate severity of maxillary sinusitis, antibiotics are prescribed. Usually, it is amoxicillin, cefuroxime, azithromycin and antipneumococcal fluoroquinolones (levofloxacin or sifloxacin). The patient must inform the doctor about whether he has taken any antibiotics in the last month – the prescription of the medicine depends on it.

In severe cases, cephalosporins, amoxicillin or ampicillin, carbapenems or fluoroquinolones are prescribed. The decision to prescribe antibiotics is made only by the otolaryngologist. Self-medication with antibiotics is fraught with side effects and unwanted reactions. Chronic maxillary sinusitis is usually treated for up to 3 weeks. 

Patients with previous bacterial maxillary sinusitis should be observed by otolaryngologist once every 3 months. If within one year there were no repeated episodes of the disease, the person is removed from the regular medical checkup.