Acute rhinosinusitis mcb. The coding of sinusitis in the mcb. Acute sinusitis and its symptoms

RCHD (Republican Center for Healthcare Development of the Ministry of Health of the Republic of Kazakhstan)
Version: Clinical protocols of the Ministry of Health of the Republic of Kazakhstan - 2017

Acute sinusitis (J01), Chronic sinusitis (J32)

Otorhinolaryngology, Pediatric Otorhinolaryngology, Pediatrics

general information

Short description

Approved
Joint Commission on the Quality of Medical Services
Ministry of Health of the Republic of Kazakhstan
dated November 10, 2017
Minutes No. 32

Sinusitis- This is an inflammation of the mucous membrane, submucosa, and sometimes the periosteum and bone walls of the paranasal sinuses.
NB! It is one of the most common conditions that general practitioners and otorhinolaryngologists deal with. According to the duration of the course, acute sinusitis is distinguished - with the duration of the disease up to 8 weeks and chronic - with a longer course of the pathological process or with four or more relapses of acute sinusitis per year.
Any of the paranasal sinuses can be involved in the inflammatory process, however, most often in adults and children over 7 years old, the maxillary sinuses are affected, then the ethmoid, frontal sinuses, and somewhat less often the sphenoid sinuses. The process can develop simultaneously in two or more sinuses of one or both sides: maxillary ethmoiditis, hemisinusitis, pansinusitis or polysinusitis.

INTRODUCTORY PART

ICD-10 code (s):

ICD - 10
Code	Name
J01	Acute sinusitis
J01.0	Acute maxillary sinusitis
J01.1	Acute frontal sinusitis
J01.2	Acute ethmoidal sinusitis
J01.3	Acute sphenoidal sinusitis Acute hemisinusitis
J01.4	Acute pansinusitis
J01.8	Other acute sinusitis
J01.9	Acute sinusitis, unspecified
J32	Chronic sinusitis
J32.0	Chronic maxillary sinusitis
J32.1	Chronic frontal sinusitis
J32.2	Chronic ethmoidal sinusitis
J32.3	Chronic sphenoidal sinusitis
J32.4	Chronic pansinusitis
J32.8	Other chronic pansinusitis
J32.8	Other chronic sinusitis
J32.9	Chronic sinusitis, unspecified

Date of development / revision of the protocol: 2013 (revised in 2017)

Abbreviations used in the protocol:

Protocol users: general practitioners, therapists, pediatricians, otorhinolaryngologists, pediatric otorhinolaryngologists.

Evidence level scale:

A	High quality meta-analysis, systematic review of RCTs, or large RCTs with very low likelihood (++) of bias that can be generalized to the relevant population.
B	High quality (++) systematic review of cohort or case-control studies or high-quality (++) cohort or case-control studies with very low risk of bias or RCTs with low (+) risk of bias that can be generalized to the relevant population ...
C	A cohort or case-control study or controlled trial without randomization with a low risk of bias (+), the results of which can be generalized to the relevant population, or RCTs with a very low or low risk of bias (++ or +), the results of which cannot be directly extended to the relevant population.
D	Description of a series of cases or uncontrolled research or expert opinion.
GPP	Best Clinical Practice.

Classification

By the course and form of the lesion:

· Acute (catarrhal, purulent, necrotic).
Chronic (catarrhal, purulent, parietal-hyperplastic, polyposis, fibrous, cystic, mixed forms, complicated - osteomyelitis, cholesteatoma, pyomucocele, spread of the process to the tissue of the orbit, cranial cavity).
· Vasomotor (allergic, non-allergic).

By etiology:
Rhinogenic;
· Odontogenic;
· Traumatic.

By the nature of the pathogen:
Viral;
· Bacterial aerobic;
· Bacterial anaerobic;
Fungal;
· Mixed.

By the prevalence of the process:
· Ethmoiditis (anterior, posterior, total);
Sinusitis;
Frontal sinusitis;
Sphenoiditis;
· Ethmoidogaymoritis;
Hemisinuitis (right, left);
Pansinusitis.

Diagnostics

DIAGNOSTIC METHODS, APPROACHES AND PROCEDURES

Diagnostic criteria

Complaints:
· Violation of nasal breathing;
Localized pain depending on the lesion of the sinuses:
- in the infraorbital (sinusitis);
- superciliary (frontal sinusitis);
- occipital (sphenoiditis);
- in the area of ​​the bridge of the nose (ethmoiditis);
Purulent discharge from the nasal cavity;
· nasal congestion;
Swelling of soft tissues in the cheek area, at the root of the nose;
Malaise.

From the anamnesis: we find out the terms and frequency of the disease.

Physical examination:
Rhinoscopy: hyperemia, swelling of the mucous membrane, purulent discharge from under the middle turbinate, purulent discharge in the back of the nose, discharge with a fetid odor.
Palpation of the projection of the paranasal sinuses:
- Frontal;
- Lattice;
- Maxillary sinuses.
NB! When pressing the thumbs of both hands on the points of the first and second branches of the trigeminal nerve, their soreness is checked, which should not be normal. Palpate the anterior walls in the area of ​​the canine fossa by gently pressing. Signs of involvement in the pathological process of the ethmoid labyrinth and the frontal sinuses can be pain on palpation in the area of ​​the inner surface of the medial and upper parts of the orbits.
Percussion in the projection of the paranasal sinuses: with the middle finger bent at a right angle, percussion of the front walls of the paranasal sinuses is performed.

Laboratory research:
· Complete blood count: leukocytosis, increased ESR;
· Research of microflora: identification of the pathogen;
· Cytological examination: neutrophillosis, cells of desquamated epithelium, mucus.

Instrumental research:
· Endoscopy of the nose and paranasal sinuses: using a flexible endoscope, rigid endoscope 0, 30 and 45 degrees. with a diameter of 4 mm, using a rigid endoscope 0, 30 and 45 degrees. with a diameter of 2.8 mm in children. To identify the features of the anatomical structure
· X-ray examination of the paranasal sinuses (nasolabial, nasolabial, lateral projections): decreased pneumatization of the paranasal sinuses, sometimes it is possible to determine the horizontal level of fluid in the sinus (if the survey was performed in a sitting position).
· Contrast radiography: performed to clarify the form of a chronic process in the sinuses.
· Fluorography PPN: changes in the mucous membrane, the presence of exudate.
· Puncture of the maxillary sinus: the presence of purulent contents.

Indications for specialist consultation:
· Consultation with an ophthalmologist - if you suspect the presence of intraorbital complications;
· Consultation of a neuropathologist, neurosurgeon - in case of intracranial complications;
· Consultation of a dentist, maxillofacial surgeon - in the presence of tooth damage (sinusitis of odontogenic origin).

Diagnostic algorithm:

Differential diagnosis

Differential diagnosis and justification for additional research:

Diagnosis	Rationale for differential diagnosis	Surveys	Diagnosis exclusion criteria
Polyps of the nasal cavity	Clinical research methods (history, examination by an otorhinolaryngologist - the presence of polyposis tissue in the nasal cavity.	Rhinoscopy. X-ray, CT PPN	The process takes place within the entire nasal cavity with the involvement of PPN, the presence of polyposis tissue.
Juvenile nasopharyngeal angiofibroma	Clinical research methods (history, examination by an otorhinolaryngologist - Decreased nasal breathing, recurrent nosebleeds.	Rhinoscopy. Radiography of the spread of the process in the nasopharynx and PPN and the presence of bone destruction	The process takes place within the nasopharynx. With the involvement of PPN. There is education bleeding when touched.

Treatment abroad

Undergo treatment in Korea, Israel, Germany, USA

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Treatment

Preparations (active ingredients) used in the treatment

Azithromycin (Azithromycin)

Amoxicillin

Ampicillin

Acetylcysteine

Beclomethasone

Budesonide

Hydrogen peroxide (Hydrogen peroxide)

Dexamethasone

Josamycin

Ibuprofen

Ketoprofen (Ketoprofen)

Clavulanic acid

Clemastine

Loratadine

Metamizole sodium (Metamizole)

Mometasone

Paracetamol (Paracetamol)

Povidone - iodine (Povidone - iodine)

Prednisolone

Theophylline

Fluticasone

Chlorhexidine

Cefazolin (Cefazolin)

Cefixime

Cefuroxime

Ethanol

Treatment (outpatient clinic)

TACTICS OF TREATMENT AT THE AMBULATORY STAGE: for mild disease and moderate sinusitis, the patient is treated on an outpatient basis under the supervision of an otorhinolaryngologist. The basis of therapeutic measures is systemic or local antibiotic therapy.

Outpatient sinusitis treatment regimen:

Non-drug treatment:
· Mode - general;
· Diet number 15.

Drug treatment: with sinusitis of a bacterial nature, antibacterial drugs are used; to release the sinus from pus, it is opened. In viral sinusitis, antibiotic therapy is not indicated, since antibiotics in this case are ineffective and can aggravate the violation of the immune status, disrupt the normal composition of the microflora of the upper respiratory tract and cause the process to become chronic. And also, patients with acute sinusitis are prescribed antihistamines and absorbable drugs to prevent the formation of adhesions in the inflamed sinuses. Antiallergic therapy is indicated for patients with sinusitis of allergic etiology.

Drug group		Mode of application	Evidence level
Antibacterial drugs	Ampicillin or	250 or 500 mg x 4 times a day. For children up to 20 kg, a daily dose of 50-100 mg / kg of body weight for 4 doses	A
	or		A
	azithromycin	infections of ENT organs,	A
	beclomethasone dipropionate or		V
	budesonide or		V
	mometasone furoate or		V
	fluticosone furoate		V
Non-steroidal anti-inflammatory drugs	acetaminophen or	10-15 mg / kg single dose inside The maximum daily dose of acetaminophen in tablets for infants up to six months is 350 mg, up to a year - 500 mg, up to three years - 750 mg, up to 6 years - 1 gram, up to 9 years - 1.5 grams, up to 12 years old - 2 grams. Frequency rate of admission - 4 times / day with an interval between doses of 4 hours or more. The maximum duration of treatment is 3 days (as an antipyretic drug) and 5 days (when taken as an analgesic).	V
	ibuprofen or	200-800 mg, the frequency of administration is 3-4 times / day; for children - 20-40 mg / kg / day in several doses.	V
	ketoprofen	100mg single dose. 300 mg daily dose. Contraindicated: children under 18 years of age - for injections, up to 6 years - for gel, up to 15 years - for tablets.	V
Antihistamines	clemastine or		V
	loratadine	10 mg / day Children weighing less than 30 kg divide the tablet into 2 days or 5 mg per day	V
Mucolytic drugs	theophylline or	Children weighing up to 30 kg 10-20 mg / kg are taken twice a day. In adults, from 200 to 400 mg per day. Treatment is selected individually.	V
	Acetylcysteine	Children from 2 years of age 200mg is divided into three doses. Adults 200 mg 2 or 3 times a day.	V

(having a 100% chance of being applied):

Drug group	International non-proprietary drug name	Mode of application	Evidence level
Non-narcotic analgesics	Metamizole sodium **	children are injected with 0.1 - 0.5 ml. Inside, after meals, or rectally 2 - 3 times a day, 250 - 500 mg, the maximum single dose is 1 g, daily - 3 g. For children 2 - 3 times a day, the usual dose 2 - 3 years - 50 - 100 mg , 4 - 5 years old - 100 - 200 mg, 6 - 7 years old - 200 mg, 8 - 14 years old - 250 - 300 mg.	V
Antiseptic drugs	Hydrogen peroxide	3% solution, 100 ml	WITH
	Iodized povidone	20-50 ml	WITH
	Ethanol	70% vs. 96%	WITH
	Chlorgesidine	Solution for local and external use	WITH

** use with extreme caution under constant supervision

Surgery:
Benefits puncture treatment at the outpatient stage, it is possible to quickly and purposefully evacuate purulent discharge from the paranasal sinus cavity. This is in line with the fundamental principles of purulent surgery. For children, puncture treatment is carried out according to strict indications, taking into account the development of the sinuses and the anatomical structure.
Contraindication for puncture treatment at the outpatient stage is:
· Signs of intracranial purulent complications;
· Expressed psychomotor agitation.

· Relief of the purulent-inflammatory process in the nasal cavity and PPN;
· Lack of discharge from the nose;
· Restoration of respiratory function;

Treatment (hospital)

TACTICS OF TREATMENT AT STATIONARY LEVEL: in case of severe sinusitis, and in some cases with a moderate illness, hospitalization of the patient in the otolaryngology department is indicated. Treatment tactics include a set of general and local medication and physiotherapy.

Patient observation chart, patient routing (schemes, algorithms):

Non-drug treatment:
· Mode - general;
· Diet number 15.

Drug treatment: the main task of the ongoing drug therapy is the eradication of the pathogen and the restoration of the biocenosis of the paranasal sinuses. When choosing an antibiotic for the treatment of sinusitis, the severity of the patient's condition is taken into account.

Essential Medicines List(having a 100% chance of being applied):

Drug group	International non-proprietary drug name	Mode of application	Evidence level
Antibacterial drugs	Ampicillin or	250 or 500 mg x 4 times a day. For children up to 20 kg, a daily dose of 50-100 mg / kg of body weight for 4 doses	A
	Amoxicillin + clavulanic acid or	mild and moderate infections, 1 tab 250 mg + 125 mg every 8 hours or 1 tab 500 mg + 125 mg every 12 hours, with a severe course of infection - 1 tab 500 mg + 125 mg every 8 hours or 1 tab 875 mg + 125 mg every 12 hours. Children 50 mg / kg body weight. 500 mg single dose. Frequency of administration 2 times a day / 100-200 mg / kg	A
	Azithromycin or	0.5 g daily (course dose 1.5 g) Children over 12 years old and weighing more than 45 kg. At infections of ENT organs,- 500 mg / day for 1 dose for 3 days (course dose - 1.5 g).	A
	Cefuroxime or	Adults are prescribed 750 mg 3 times a day. Children are prescribed 30-100 mg / kg per day in 3-4 doses Newborns and children under 3 months are prescribed 30 mg / kg per day in 2 - 3 doses.	A
	Cefazolin or	The average daily dose for adults is 0.25-1 g; the frequency of administration is 2-4 times a day. The maximum daily dose is 6 g. Children 1 month and older - 25-50 mg / kg per day; in severe infections, the dose may be increased to 100 mg / kg per day. The frequency of administration is 2-4 times a day.	A
	Cefixime or	Adults and children over 12 years old and weighing more than 50 kg, the daily dose is 400 mg (200 mg 2 times a day or 400 mg 1 time a day). Children aged 0.5 to 12 years: 4 mg / kg every 12 hours or 8 mg / kg / day	A
	Josamycin	When taken orally for adults and children over 14 years old - 1-2 g per day in 2-3 doses. Children under the age of 14 - 30-50 mg / kg per day in 3 divided doses.	A
Hormonal drugs	Prednisone	The dose of Prednisolone and the duration of treatment are set by the doctor individually, depending on the indications and severity of the disease. Prednisolone is administered intravenously (drip or jet) in droppers or intramuscularly. The intravenous drug is usually administered first as a jet, then drip	V
	Dexamethasone	The dosage regimen is individual and depends on the indications, the patient's condition and his response to therapy. The drug is injected intravenously slowly in a stream or drip (in acute and urgent conditions); intramuscularly	V
Topical corticosteroids	beclomethasone dipropionate or	The average daily intake for adults is 400 mcg in 2-4 doses. If necessary, the dose can be increased to 600-800-1000 mcg / day. For children, a single dose is 50-100 mcg, the frequency of use is 2-4 r / day.	V
	Budesonide or	Adults from two to 4 inhalations. Children over 6 years old 1-2 inhalations (50-200 mcg per day)	V
	mometasone furoate or	Adults and children over 12 years of age take 2 inhalations 1 time per day. the daily dose of the drug is 200 mcg. Children 2-11 years old, one inhalation. The total single dosage of the drug is 100 mcg	V
	fluticosone furoate	Children 6-11 years old, one dose per day (55 μg). Children over 12 years old and adults two doses per day (100 mcg)	V
Antihistamines	Clemastine or	Inside, before meals, 1 mg 2 times a day, if necessary, the dose is increased to 3-6 mg / day. Children aged 6 to 12 years are prescribed 0.5 mg in the morning and in the evening (2 times a day), at the age from 1 to 6 years - 0.67 mg syrup (1 teaspoon).	V
	loratadine	10 mg / day Children weighing over 30 kg 1 tablet (10 mg) per day or syrup at the rate of 10 mg of active ingredient. Children weighing less than 30 kg divide the tablet into 2 days or 5 mg per day

List of Complementary Medicines(less than 100% likely to be used): see Outpatient clinic.

Further management:
With CCA:
· Observation by an otolaryngologist in a polyclinic at the place of residence for 6 months, control audiometry.
With HCW:
· Dispensary observation by an otolaryngologist with examination 2 times a year, consultation of a neurologist 1 time a year, and an audiologist 2 times a year.

Treatment effectiveness indicators:
· Relief of the purulent-inflammatory process in the middle ear cavity;
· No pain in the ear;
· Restoration of auditory function;
· Normalization of laboratory parameters;
· Absence of complicated forms of the disease.

Hospitalization

INDICATIONS FOR HOSPITALIZATION WITH INDICATION OF THE TYPE OF HOSPITALIZATION

Indications for planned hospitalization:
· Hospitalization in the otorhinolaryngological department for sanitation and reconstruction of the nasal cavity and PNP.

Indications for emergency hospitalization:
· The presence of a purulent-inflammatory process in the nasal cavity and PPN not stopped during outpatient treatment;
· The presence of signs of intracranial rhinogenic complications;
· Severe symptoms of intoxication with a tendency to deteriorate the general condition of the patient.

Information

Sources and Literature

1. Minutes of meetings of the Joint Commission on the Quality of Medical Services of the Ministry of Health of the Republic of Kazakhstan, 2017
   1. 1) Itzhak Brook, Kaparaboyana Ashok Kumar, Maggie Kramper, Richard R. Orlandi Clinical Practice Guideline: Adult. Society of Otorhinolaryngology, oct. 2014 2) Bezrukov V.M., Brusova L.A. Guide to Surgical Dentistry and Oral and Maxillofacial Surgery. M., 2005. -366s. 3) Bogomilsky M.R., Chistyakova V.R. Pediatric otorhinolaryngology. Textbook for universities. M .: Geotar-Med. -2002, p. 259-268. 4) Kryukov A.I., Ivoilov A.Yu., Turovsky A.B., Khamzalieva R.B., Tovmasyan A.S. Conservative therapy and surgical treatment of chronic tonsillitis in children. Bulletin of otorhinolaryngology, No. 4, 2013 S.15-21. 5) Ovchinnikov Yu.M., Gamov V.P. Diseases of the nose, pharynx, larynx and ear. - M., 2005, -328s. 6) Palchun V.T. Classification and treatment tactics for chronic tonsillitis. Bulletin of otorhinolaryngology, No. 3, 2013 S.8-11. 7) Soldatov I.B. ENT Guideline. - M .: Medicine / 608s. 8) Beahm E.K., Walton R.L. Auricular reconstruction for microtia: Part I. Anatomy, embryology and clinical evolution // Plast. Reconstr. Surg.-2002.-Vol.109, No. 7.-P.2473-2484. 9) Likith V. Reddy, Zide F. M. Reconstruction of skin cancer defects of the auricle // J. Oral Maxillofac. Surg. 2004. - Vol. 62, N12. - P.1457-1471. 10) Nachlas N. Otoplasty // Plastic and Reconstructive, Facial Surgery Ed. A. D. Peypl. M .: BINOM Laboratory of Knowledge, 2007. -P.340-352. 11) Bonding P., Ectopic adenoid tissue in the choanae // J. Laryngol. Otol.-2001 / Vol.115, No. 3. R.198-201.

Information

ORGANIZATIONAL ASPECTS OF THE PROTOCOL

List of clinical protocol developers:
1) Azhenov Talapbek Muratovich - Doctor of Medical Sciences, Head of the Surgical Department No. 1 of the Republican State Enterprise on the REM "Hospital of the Medical Center, Administrative Department of the President of the Republic of Kazakhstan."
2) Baymenov Amanzhol Zhumagaleevich - Candidate of Medical Sciences, Associate Professor of the Department of Otorhinolaryngology of JSC "Astana Medical University".
3) Bekpanov Almat Zhaksylykovich - Candidate of Medical Sciences, Pediatric Otorhinolaryngologist of the Branch of the KF "UMC" National Scientific Center for Motherhood and Childhood.
4) Smagulova Gaziza Azhmagievna - Ph.D. Ospanov ".

No Conflict of Interest Statement: no.

Reviewer:
Ismagulova Elnara Kireevna - Doctor of Medical Sciences, Professor, Head of the Course of Otorhinolaryngology at the Department of Surgical Diseases No. Ospanov ".

Indication of the conditions for revision of the protocol: revision of the protocol 5 years after its publication and from the date of its entry into force or if there are new methods with a level of evidence.

Attached files

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Acute sinusitis is a lesion of the sinuses of the nose, which manifests itself, depending on the type of pathology, with various symptoms with mucus, headache, fever, weakness, and so on. This course of the disease often turns into a chronic stage or causes a number of complications throughout the body. Therefore, it is important to choose the right therapy according to the type of sinusitis, severity and cause of development.

About the disease

Sinusitis is an inflammation of the paranasal sinuses, which is accompanied by rather vivid symptoms. The disease in adults and children requires comprehensive and full-fledged treatment, since it often not only becomes chronic, but also causes a number of complications up to damage to the meninges, periosteum, decreased vision and other negative consequences.

ICD-10 code - J01. Accordingly, the disease is divided by type.

Types and localization

The types of sinusitis are divided depending on where the inflammation is located:

• In the maxillary sinuses;
• Wedge-shaped sinuses;
• Frontal sinuses;
• The sinuses of the trellis labyrinth.

Localization of sinusitis

Sinusitis

Affects the paranasal maxillary sinuses. It is the most common type of sinusitis. It causes a lot of discomfort in the area of ​​the nose and cheeks, while the pain can be given to the teeth.

Sphenoiditis

Sphenoiditis is less common, but often more intense than the same sinusitis. This is explained by the peculiar structure of the sphenoid sinus.

As an independent pathology, it rarely manifests itself, most often it is paired with ethmoiditis.

Ethmoiditis

- inflammation of the sinuses of the ethmoid labyrinth (in the area of ​​the nose bridge). As a rule, it is either viral or bacterial in nature.

A characteristic feature is the rapid spread of the inflammatory process to neighboring departments. In acute course, it is often supplemented by other types of sinusitis.

Frontit

- Inflammation of the frontal sinuses. In terms of frequency, it ranks second after sinusitis. In this case, painful sensations are localized in the forehead and eyebrows. In this case, the pain can be given to the area of ​​the teeth and ears, which is why patients often mistake this disease for dental pathologies or otitis media.

Classification

Sinusitis is also divided according to the localization and type of inflammation, the reasons that could cause them:

• Double-sided and one-sided;
• One-sided, in turn, is divided into right-sided and left-sided;
• Also isolated according to the type of pathogen - bacterial, viral, fungal, allergic;
• By the type of discharge: mucous, purulent, purulent-mucous, with blood impurities;
• By severity: light, medium, heavy.

In the photo, the classification of sinusitis

Causes of Acute Sinusitis

If we talk about specific reasons, then sinusitis is initially provoked by either allergens or pathogens. In the latter case, the disease usually develops against the background of other pathologies:

• , flu,;
• Neoplasms in the area of ​​the nose and sinuses - cysts, polyps, and so on;
• Facial bone injury;
• Availability ;
• Curved septum;
• Abnormal structure of the congenital sinuses;
• Allergy;
• The presence of a viral, bacterial and / or fungal infection;
• Infectious diseases accompanied by a runny nose: measles and so on.

But even if there is such a cause, sinusitis may not develop without risk factors. These include:

• Bad habits;
• Constant overstrain, stress;
• Improper and inadequate nutrition;
• Decreased immunity;
• Gas contamination, dry air;
• Recently transferred infectious diseases of ENT organs;
• The presence of diseases, factors or conditions that affect the immune system (HIV, diabetes, chemotherapy, the use of hormonal drugs, etc.)

Symptoms

Common symptoms include manifestations such as:

• Discharge from the nose of a mucous, purulent-mucous, purulent or bloody type;
• Headache;
• Feeling of fullness and pain in the affected area (it is especially intense when pressing on the area of ​​inflammation);
• Temperatures;
• Impairment or loss of smell;
• Swelling of the soft tissues of the face.

These are common manifestations that are generally common to all types of sinusitis. But they are also distinguished by doctors, which means that they also have specific symptoms:

• With sinusitis, the pain is localized in the area of ​​the maxillary sinuses. With pressure on the cheek area closer to the nose, unpleasant and uncomfortable sensations develop. At the same time, there is a feeling of fullness. The pain tends to intensify in the late afternoon, and gradually disappear during sleep.
• With frontal sinusitis, pain is localized in the forehead above the eyebrows, closer to the bridge of the nose. There are also bursting pains, but already in this part of the face. At the same time, unpleasant symptoms tend to intensify in the morning after waking up.
• With sphenoiditis, pain is more often localized in the occiput. In this case, the deterioration is most often observed at night.
• With ethmoidal sinusitis, painful sensations develop and are localized to the greatest extent in the region of the nose and eyes. It worsens throughout the day. In this case, it is possible in patients to observe a slight protrusion of the eyeballs with swelling of the conjunctiva and eyes in general, and deteriorating vision may also appear.

What tests and research you need to go through

Such types of research as:

• Blood for biochemistry and other pathogens;
• A swab from the nasal cavity or sinus for bacterial culture;
• X-ray of the sinuses;
• Ultrasound of the sinuses.

As a rule, an ENT doctor can make a diagnosis already upon examination, but if there are doubts or suspicions of complications, then a detailed diagnosis is considered necessary.

How to properly treat sinusitis:

A visit to a doctor is imperative. Only he will decide, based on the indications, what type of treatment may be required and whether neighboring departments are involved in pathological processes. Based on this, it is usually chosen:

• Medication;
• Physiotherapy;
• Surgery.

The first consists of vasoconstrictor, anti-inflammatory, mucolytic, immunomodulating, antihistamines, antibacterial, antiviral, antimycotic drugs.

Moreover, each tool has its own duration of use, which should also be taken into account. Not all of them need to be applied at the same time. So, for example, antiviral drugs are used for viral sinusitis, antimycotics for fungal infections, and for bacterial infections.

Physiotherapy involves flushing the sinuses. Now this is done not only with the help of puncture, but also with the help of a YAMIK catheter. The procedure is generally unpleasant, but effective and painless, since a tube is simply inserted into the sinus through which an antiseptic is supplied, and the other tube sucks the medication and the contents of the sinuses through the adjacent nasal passage.

Surgical treatment is usually prescribed only when urgently needed, if the patient's condition is assessed as severe and there is a risk of developing serious complications such as sepsis, abscess. It is impossible to refuse the procedure, since such conditions threaten to end in disability and even death of the patient.

Prophylaxis

Prevention of sinusitis is quite simple:

• Timely treatment of infectious diseases of ENT organs and respiratory organs;
• Strengthening the immune system;
• Normalization of the daily routine;
• Normalization of nutrition;
• Rejection of bad habits;
• Taking vitamins;
• Timely medical examination;
• Do not overcool;
• Observe the norms of oral and nasal hygiene;
• Regularly ventilate the room where you live and work, as well as humidify the air;
• Body hardening;
• Carry out the prevention of allergies in the presence of such a history;
• In case of contact with a patient with acute respiratory viral infections or influenza, it is worth using rinsing the sinuses or special irrigation sprays.

Forecast

The prognosis for acute illness is generally positive if therapy is started on time. It is possible to completely and without consequences cure sinusitis without the risk of recurrence.

When the pathology is started, sinusitis either becomes chronic or causes severe complications, which significantly worsens the patient's condition, and in some cases it is life-threatening.

Sinusitis is a type of sinusitis that can be acute or chronic. It is considered a complication of rhinitis when the inflammation affects the maxillary sinus (sinus).

Among all sinusitis, sinusitis occupies a leading position. Adults and children are ill with it, and in everyday life the word "sinusitis" occurs quite often, even when in fact the patient has a banal runny nose.

People without medical education have different interpretations of rhinitis. Some say that they suffer from snot, others - sinusitis, although in fact nasal discharge may indicate different forms of rhinitis or sinusitis, but have similar symptoms of the disease.

Sometimes patients treat a mild form of the common cold on their own with "shock" doses of nasal agents, and, in some cases, on the contrary, sinusitis is ignored or weak solutions are instilled. Both are unacceptable.

Doctors necessarily establish the cause of nasal discharge, make a diagnosis, and, based on the studies obtained, prescribe a treatment regimen. For the convenience of systematizing all kinds of pathologies and their varieties, the International Classification of Diseases (ICD-10) has been developed, which helps doctors around the world to group data on the desired disease.

In the ICD-10 regulatory framework, sinusitis, like many other diseases, takes its own steps: classes, blocks, codes. Every 10 years, WHO strictly monitors this baseline document and verifies the accuracy of the information entered. Let's dwell on the classifier itself, and determine how sinusitis is encoded.

Acute and chronic sinusitis is placed in the classroom Respiratory diseases (J00-J99) , but these two forms of the disease are in different blocks .

Acute sinusitis placed in a block "Acute upper respiratory tract infections" (J00-J06) under the following name and code - « Acute maxillary sinusitis "(J01.0).

Chronic sinusitis credited to another block - "Other respiratory diseases" (J30-J39) codenamed - « Chronic maxillary sinusitis "(J32.0).

When the causative agent of the disease is found (bacterial inoculation was carried out), it is recommended to use an additional coding (auxiliary):

• B95 - streptococcus or staphylococcus are the cause of sinusitis;
• B96 - various bacteria not including the above;
• B97 - the viral nature of sinusitis.

The presented classification is actively used in world practice, and otolaryngologists can easily find all the necessary information about sinusitis. And now let's move on to the acute and chronic form of sinusitis, which we examined in the classifier, and we will dwell on each in detail.

Acute sinusitis - " Acute maxillary sinusitis "(J01.0) according to ICD-10

The acute form develops rapidly and after a couple of days the disease has all the characteristic symptoms:

• breathing through the nose is difficult;
• violation of the sense of smell;
• body temperature is significantly increased;
• pressing headaches;
• lacrimation;
• swelling over the affected area;
• pain in the facial area when chewing;
• blowing your nose does not alleviate the patient's condition;
• there is soreness in the cheekbones and the bridge of the nose;
• there are yellow, green or mucopurulent discharge, sometimes with an unpleasant odor;
• apathy and lack of appetite.

The acute process lasts from 7 to 20 days, and is more common in children from 5 to 14 years old.

The trigger mechanism for acute sinusitis can be:

• stomatitis;
• tonsillitis;
• untreated rhinitis;
• caries;
• bacterial and fungal infection of the maxillary sinuses;
• flu and SARS;
• anatomical problems causing insufficient ventilation of the paranasal sinuses;
• infectious diseases (scarlet fever, measles, others).

The inflammatory process contributes to obstructive sinus disorders. Bacteria are “delivered” to the maxillary sinus in three ways, consider them:

• hematogenous (through the blood) - observed in infectious diseases;
• rhinogenic - the primary focus is in the nasal cavity;
• odontogenic - arises from pathological processes in the oral cavity. Such sinusitis is called odontogenic. After sanitation of the focus of infection, this form of sinusitis is quickly cured.

The predisposing factors for the development of the disease can be:

• bronchial asthma;
• foreign bodies (more often in children when putting beads, peas and other small objects into the nose);
• polyps in the nasal cavity;
• violation of the structure of the nasal passages;
• curvature of the nasal septum;
• diseases of the immune system;
• facial trauma;
• medical manipulations in the area of ​​the nose;
• diabetes;
• bad ecology;
• sharp fluctuations in atmospheric pressure;
• other.

Diagnostic methods for detecting acute sinusitis according to ICD-10

The diagnosis of acute sinusitis is made on the basis of examination, rhinoscopy and patient complaints. An experienced doctor will immediately say that you are the "owner" of sinusitis. To confirm the diagnosis, additional diagnostic methods can be assigned:

• X-ray of the maxillary sinus;
• survey radiography of the paranasal sinuses;
• CT and MRI;
• puncture of the sinuses;
• laboratory tests (complete blood count, bacterial culture of the contents of the sinuses).

Treatment of acute maxillary sinusitis (sinusitis)

The emphasis in the treatment of the disease is reduced to the removal of puffiness in the nasal cavity, the release of the sinus from pus and mucous discharge, as well as the elimination of pathogenic microflora, which caused the focus of inflammation. The main task is to prevent the development of purulent sinusitis and to take all the necessary measures at the first signs of pus in the sinuses.

To solve this problem, drugs of the following groups are prescribed:

• antibiotics (augmentin, zinnat, azithromycin, polydexa, bioparox, isofra) - local and systemic drugs are used;
• antiseptics (furacilin, collargol, protargol);
• antihistamines (Telfast, Suprastin, Erius, Tavegil, Claritin);
• vasoconstrictor agents (rinazoline, pharmacoline, tizine, xymelin, naphthyzine) - they are not used for a long time;
• moisturizing nasal preparations (saline, rhinolux, quicks, humer, delufen);
• anti-inflammatory drugs (iburprofen, aspirin, paracetamol);
• corticosteroids (nazonex, baconase, avamis, prednisolone) - in drops and tablets;
• probiotics (linex, bifiform, probifor, bifilis, biosporin) - “cover” the body from the harmful effects of antibacterial agents.

All these drugs are prescribed only by a doctor, taking into account the age, history and weight of the patient.

In the process of rehabilitation, physiotherapy methods are used:

• laser therapy;
• acupuncture;
• phonopharesis.

Important! During acute sinusitis, all heating procedures are excluded, due to the high probability of the spread of the inflammatory process beyond the lesion.

If conservative therapy is inadequate, they resort to drainage of the maxillary cavity, followed by rinsing and sanitation, and antibiotics are injected into the cavity. Manipulations of this kind are carried out only in an ENT hospital.

If acute sinusitis was not cured in time, that is, there is a great chance of the transition of the disease to a chronic form, in which the treatment will be longer and not always effective.

Particular attention should be paid to the treatment of bilateral sinusitis, when both sinuses are affected. The earlier therapy is started, the sooner you can get rid of the disease and forget about it forever. Otherwise, the focus of infection can reach other sinuses, affect the brain and enter the systemic circulation by hematogenous route.

Chronic sinusitis - "Chronic maxillary sinusitis" (J32.0) according to ICD-10

A protracted acute process in a month turns into a chronic stage, which is subdivided into the following forms:

• catarrhal (superficial, most favorable) - abundant discharge;
• allergic - the source is more often an allergen of unknown etiology;
• purulent or purulent-polyposis - a dangerous form when there is a rapid multiplication of bacteria and snot acquires a green tint;
• polyposis - formation of focal hyperplastic growths in the sinuses;
• parietal hyperplastic;
• necrotic (decay of tissues inside the sinus occurs).

Diagnosis of chronic sinusitis is carried out in the same way as in acute forms. Only after the diagnosis is made - chronic sinusitis, according to the ICD-10 code J32.0, the doctor draws up an individual treatment regimen. It should be noted that the doctor indicates this code on the certificate of incapacity for work ("sick leave").

The causes and predisposing factors for the development of the chronic form are practically no different from acute sinusitis. The only difference is that the main cause of chronic sinusitis is a neglected acute inflammation of the maxillary sinuses.

The symptomatology of the disease varies from the degree of damage to the sinuses, and again is very similar to acute sinusitis, only all manifestations of the disease are less pronounced. The body is so adaptable to infection that the general condition of patients is quite satisfactory. During exacerbations, symptoms tend to become active.

As a result, we have a sluggish chronic process, which often becomes the cause of the following complications:

• arthritis;
• myocarditis;
• pyelonephritis or glomerulonephritis;
• tonsillitis;
• dacryocystitis (inflammation of the lacrimal sac);
• inflammatory processes of the lower respiratory tract;
• and many others.

Treatment of chronic sinusitis

Chronic sinusitis is treated not only by an otolaryngologist, but also by other specialists: allergists, immunologists, dentists, and gastroenterologists. The patient is washed with the nasal sinuses, anti-inflammatory and antibacterial therapy is carried out. Sanitation of teeth is mandatory.

In the case of anatomical abnormalities, surgical rhinoplasty is necessary to improve the ventilation of the sinuses, which are blocked.

In general, the treatment is the same as for acute sinusitis, but in addition, a course of treatment with immunomodulators is carried out, which increase the body's defenses. To increase immunity, the following are shown: vitamin therapy, resort therapy on the sea coast, in pine groves, salt mines, hardening, physiotherapy exercises, dietary nutrition and other restorative techniques.

Currently, such methods are popular as: body flex, reflexology, ozone therapy, Kneipp baths and various meditations, which allow you to focus on the diseased organ and "expel" the disease from the body.

Physiotherapy is possible only after elimination of the purulent process, when the body is being rehabilitated and the function of the mucous membranes is restored.

Getting rid of chronic sinusitis is not easy, and only relying on a doctor is a thankless task... No one argues that pills, drops and procedures eliminate the focus of inflammation, but it should be remembered that any chemical preparations lower immunity, and each time it becomes more difficult for the body to fight the infection.

Therefore, human health is not only in the hands of doctors, but also half in his power. Laziness is the main enemy that interferes with health. Go in for sports, smile more often, do not read horror stories about formidable diseases, follow the doctor's recommendations, and chronic sinusitis will surely recede. Be healthy!

How to cure sinusitis without a puncture

Almost everyone knows about sinusitis. ICD-10 classified it like all other diseases. Almost every branch of knowledge is systematized and medicine is no exception.

Sinusitis in the ICD-10 system

The basic normative document in this area is the international statistical classification of diseases and problems associated with human health (ICD). This edition includes 3 volumes - an alphabetical index, instructions and the classification itself.

This compendium has been compiled by the World Health Organization. Every 10 years she revises the document and makes various additions. Thanks to the ICD, it is possible to compare data on diseases between different countries. At the moment, the document is valid after 10 revisions - ICD-10.

This document has been compiled in order to create optimal conditions for the processing of statistical data and their analysis. In this way, different diseases and mortality rates can be analyzed, and such rates can be compared between countries.

Thanks to the ICD-10 classification, any diagnosis is transformed into a code, a set of letters and numbers, which greatly facilitates the process of analyzing and storing information.

Classification structure

The structure is simple enough. After the introduction of the tenth version of the document, a new feature appeared. Now, in addition to 4 digits, the code will also contain a letter. Thanks to this trick, the dimensional structures are doubled, since about 300 new three-digit categories have appeared.

By the way, all the letters are taken from the Latin alphabet, and only U remained as a spare. In other words, the U00-U49 codes are used only as temporary ones. They are used to denote diseases that do not currently have a well-known origin. But the codes U50-U99 are used only for various studies.

In addition, the code numbers have been extended from A00.0 to Z99.9, and all diseases are divided into 21 classes. By the way, there are also diseases that appear after medical intervention.

• chronic sinusitis according to ICD-10 has the J32.0 code;
• the frontite is numbered J32.1;
• ethmoiditis - J32.2;
• sphenoiditis - J32.3;
• pansinusitis - J32.4.

All other types of sinusitis, including the chronic form, should be labeled J32.8. If unspecified then J32.9 code must be supplied.

Varieties of sinusitis, depending on the location of the inflammation

Sinusitis is a very common disease. Moreover, scientists have not established dependence on the region. In almost every country, microflora from microorganisms are very similar.

The most common cause of this disease is the flu epidemic, which repeats itself in cycles. Hence, the risk of a chronic disease increases. And human immunity is constantly weakening.

However, in recent years, another relationship has become noticeable - between the development of the disease and unfavorable environmental factors. For example, it affects gas pollution, toxic emissions into the atmosphere, dustiness.

Sinusitis is often confused with sinusitis, in fact, it is not the same disease. Sinusitis is considered a term that unites all diseases associated with inflammation in the sinuses around the nose.

There are 4 main forms of sinusitis:

1. Sinusitis - inflammation occurs in one or two maxillary sinuses.
2. Frontitis - only the frontal sinuses are affected.
3. Ethmoiditis - the labyrinth becomes inflamed.
4. Sphenoiditis - wedge-shaped sinuses are affected.

Rhinosinusitis is also isolated separately. This is a disease in which both the mucous membranes of the nasal canals and the paranasal sinuses become inflamed. For example, with such a disease, sinusitis is often combined with a simple rhinitis.

The maxillary sinus is a paired sinus. If we consider the projection on the face, it turns out that they are located directly under the eyes - on the left and right sides of the bridge of the nose. Sinusitis can develop in one or both sinuses. Depending on the side of the lesion, left-sided, right-sided or bilateral are distinguished.

You can even determine the variety visually, since mucus will be released from only one nostril. Severe pain is also felt on one side of the face. Inflammatory processes are always accompanied by the appearance of puffiness, so there will be bags under the eyes. By their appearance, you can determine the type of disease. If the edema appears on only one side, then the inflammation is also located in one sinus.

In this case, standard treatment procedures are applied. If this does not help in the acute form, then you will have to puncture the sinuses.

Forms depending on the course of the disease

Depending on the course of the disease, there are the following forms:

• sharp;
• chronic;
• exudative;
• productive.

There are differences in symptoms, consequences and duration of the course of the disease.

Acute sinusitis

It is the result of a complication. Usually this form lasts about a month. In this case, the patient develops a headache, body temperature rises, and chills occur. He feels mildly unwell.

If you often tilt your head forward, then the painful sensations will begin to become more intense. This is due to the fact that pressure increases from the front surface of the sinus. Sometimes there is photophobia and intense tears.

With this form, it is very difficult to breathe through the nose or not at all due to the fact that it is heavily stuffed up. The patient begins to worry about the profuse discharge of mucus and clots of pus in it. The sense of smell will disappear, the eyelids will swell, and the cheeks will swell.

Treatment of the acute form is carried out by a conservative method. Anti-inflammatory drugs, rinsing are required. You can't warm up your nose.

Chronic sinusitis

It is long lasting, usually about 2 months, and sometimes more. At the same time, the patient constantly suffers from malaise, gets tired quickly, and feels weak. The headache gets worse in the evening, as does the congestion.

Since the inflammatory processes do not stop for a long time, they can cause serious side effects. For example, the meninges or orbital tissue swells, meningitis, brain abscess, venous thrombosis develop.

Chronic sinusitis is usually treated with physiotherapy procedures. It helps a lot, you can use dry heating. The chronic form of sinusitis takes much longer to heal than the acute one.

It must be remembered that the mucous membranes change from disease. Sinusitis may be accompanied by active release of pus and mucus, or the membrane itself will begin to actively change. Depending on this, exudative or productive forms are distinguished.

Exudative sinusitis

Mucus and pus come out profusely, making it difficult to breathe. Depending on the discharge itself, sinusitis will be purulent or catarrhal. In the catarrhal form, the discharge is thin but stringy. The mucous layers swell, the intensity of discharge increases. This condition is dangerous due to the fact that if it is not treated, then the stagnation of mucus leads to the formation of a purulent form.

To treat this form, you will need medications that have vasoconstrictor properties. This will help reduce the swelling. You also need to rinse regularly.

Productive form of sinusitis

With a productive form, not only inflammatory processes develop, but the mucous membrane begins to change. In this case, degeneration causes sinusitis of the polyposis and hyperplastic type.

With a polyposis form, growths can be found on the mucous membranes - these are polyps. They can completely close the ducts so that mucus does not come off. Breathing and smelling problems occur. In severe form, it will hurt a person to swallow.

In the hyperplastic form, the mucous membranes begin to thicken. It is because of these processes that the lumen of the channels begins to become thinner and thinner. Sometimes treatment is complicated by the fact that the nasal septum is crooked. In this case, you will need surgery.

Inflammatory processes in the cavities around the nose can be caused by various reasons. These can be viral, bacterial, fungal infections, taking medications, the effect of toxic substances, trauma.

Sinusitis in the ICD-10 classification is listed as a type of sinusitis, although it is one of the most famous diseases. By the way, with an incorrect diagnosis, you can really confuse this ailment with other forms of sinusitis, which are very diverse.

Acute sinusitis is a form of the disease based on a prolonged inflammatory process in the maxillary sinuses, when the mucous membranes swell and provoke abundant discharge. The disease is characterized by a runny nose with an unpleasant odor, swelling of the face and increased body temperature.

On the x-ray of the maxillary sinuses, there is an accumulation of fluid in the form of darkening.

An illness occurs due to a cold, flu "carried on the legs", the cause is the presence of a virus in the body, which could not suppress the immune system. In the process of weakening the immune function, the work of the local microflora is disrupted and bacteria develop on the mucous membranes of the nose, which enter the sinuses, where the development of acute sinusitis begins.

Development of exudative acute sinusitis from catarrhal form to advanced

When a disease enters the body, 3 main protective functions are included in its elimination: lymphatic, cardiovascular and immune. They increase blood flow to the affected area (in this case, the nasal mucosa) and provoke the production of "main defenders" - leukocytes.

This leads to the fact that a large number of antibodies accumulate in one place, swelling of the mucous membrane develops, which disrupts the natural circulation of air and the outflow of secretions. They accumulate in the maxillary sinuses (rhinosinusitis begins to develop), the patient has headaches and discomfort in the cheek area due to the pressure exerted by exudate inside the sinuses.

How to breathe correctly over potatoes with a cold is described.

1. Catarrhal form - discharge from the nasal cavity of fluid mixed with exudate.
2. Serous is characterized by swelling of the nasal mucosa and shortness of breath.
3. The purulent form is distinguished by the discharge of pus from the sinuses (in a significant amount).
4. Mixed includes the symptoms of the three previous forms.

Typical symptoms and signs

The characteristic clinical signs and symptoms of sinusitis in acute form (mild course of the disease) are:

• nasal congestion, difficulty breathing;
• the appearance of nasal discharge (sometimes mixed with pus);
• weaker sense of smell;
• pain in the forehead and cheeks.

Symptoms of acute sinusitis: purulent discharge, nasal congestion, edema, unpleasant odor, polyps, bloody discharge.

With moderate and severe severity of acute sinusitis, the following signs are connected:

• dehydration of the body;
• increased body temperature (over 38 degrees);
• increased headache with rebound in the temples, back of the head.

Diagnosis

When you go to the hospital, the otolaryngologist makes a diagnosis based on the following indications:

1. Gathers anamnesis: when the development of the disease began - the first ailments, how many days lasted, what painful sensations were observed, whether there was a temperature.
2. Conducts a rhinoscopy - examines the mucous membranes of the nose with a rhinoscope to assess the stage of swelling.
3. Prescribes additional studies - X-ray to determine the degree of filling of the sinuses, the transparency of the discharge.

If the previous methods did not give a clear clinical picture, MRI, CT, ultrasound of the sinuses can be prescribed, but, as a rule, in most cases, the previous methods are sufficient to determine acute sinusitis.

If it is impossible to determine the degree of development of the disease, a sinus puncture may be prescribed, followed by bacteriological culture of the discharge. This is necessary in order to think over the scheme of drug and physiotherapy treatment.

According to ICD-10

In the international classification of diseases 10 revision (ICD-10), acute sinusitis is defined under the identifier J01.0, where 0 is the definition of the location of the inflammatory process depending on the area of ​​the lesion. For example, frontal sinusitis will have a J01.1 code, and J01.4 - all sinuses of the upper respiratory tract are affected.

How is it different from acute sinusitis

The acute form of sinusitis is characterized by more severe pain symptoms that appear with minor palpation of the eyes, nose and cheeks (in the area of ​​the maxillary sinuses). The headache begins to worsen even when lying down.

In the acute form of sinusitis, in contrast to the acute form of sinusitis, maximum tissue sensitivity occurs, even with careful contact with the skin.

Also, with sinusitis, the symptom "discharge of mucus from the nose even when leaning forward" appears. In addition, the difference is the appearance of a dry cough (at night), shortness of breath appears when walking, etc.

How many headaches after an illness

The headache goes away even at the stage of recovery, and this symptom does not bother the patient after the illness. If the head hurts even after treatment, then this may indicate that the treatment regimen is incorrectly selected (the chronic stage of the disease begins to develop) or a migraine develops, which is not associated with sinusitis.

What is dangerous: complications and consequences

In the absence of timely and adequate therapy, as well as as a result of a strong weakening of the protective function of the body, various complications and consequences for the body may occur. Commonly seen in adults and children are the following:

1. Transition to a chronic form. This complication is difficult to distinguish from the usual sinusitis, general malaise. The disease occurs with untreated acute sinusitis (becomes chronic). With this form, the disease is practically not amenable to treatment and requires surgical intervention, therefore it is considered dangerous, because can provoke inflammation in the internal structures of the head.
2. Otitis media. As a result of the spread of infection from the maxillary sinus into the middle ear, inflammation begins there, which leads to purulent formation. A characteristic feature is shooting pain in the check and a sharp jump in temperature.
3. Inflammation of the trigeminal nerve. In this case, pain occurs with a lumbago in the face. The disease is very difficult to treat.
4. Vision problems: venous thrombosis, retinal edema. The simplest is bacterial conjunctivitis.
5. Periostitis and osteitis. It is characterized by inflammation in the bone tissue as the infection spreads throughout the body. Requires surgical intervention.
6. Meningitis is an inflammatory process that affects the lining of the brain. It is a treatable disease but can be fatal. Amenable to treatment only under the supervision of a doctor in a hospital.

How to heal quickly at home

Home treatment includes washing, inhalation, and the use of folk remedies. They allow you to quickly get rid of a cold only in the initial stages. The methods only complement the medical therapy prescribed by the doctor. But it is not worth treating yourself without consulting a doctor, because you can choose the wrong drugs and aggravate the situation.

Drug treatment

If the acute form has catarrhal discharge, then the doctor will not rush to prescribe antibiotics. Treatment will include drugs that support immunity, vitamins and aids such as.

This is a Bionorica drug that has an anti-inflammatory effect and enhances the secretion of the nasal mucous membranes, which helps to remove the infection from the sinuses. It relieves puffiness, strengthens local immunity, and is often prescribed for the viral form. You need to take it for 7-10 days, 2 tablets 3 times a day.

Antibiotics

For sinusitis, antibiotics are often prescribed. Usually they begin to be used if the disease has become long and persistent, fever occurs, and the temperature rises. Antibiotics are relevant for exudative form with purulent contents.

Antibiotics are used for moderate and severe forms of acute sinusitis. The course of treatment with any of the medicines is determined individually by the attending physician. Antibiotics are also included in nasal drops and sprays. In such forms of funds, they are most effective.

Some of the effective antibiotics during the treatment of sinusitis in a chronic form are:

1. Summamed belongs to the last generation macrolide group. The main active ingredient is azithromycin. Effective against streptococci and staphylococci. It is taken with the following scheme: 1 tablet 1 time per day for 3 days. If there is no effect, then the course is increased to 5 days of admission.
2. Augmetin. The composition contains penicillin in a synthetic form. Acts on gram-positive and gram-negative aerobes and anaerobes (coagulase-negative staphylococci, etc.). Among the contraindications to the use of the drug include the presence of pathologies in the functioning of the liver and kidneys, age (up to three months is not prescribed), etc. During pregnancy and breastfeeding, a specialist consultation is necessary. The recommended dosage is up to 40 microns per 1 kg of the patient's body.
3. Bioparox. Included in the group of polypeptide antibiotics. Actively affects group A streptococci, pneumococci, staphylococci and other bacteria. Not prescribed until 12 years of age, with the risk of an allergic reaction. Recommended to be taken up to 50 microns (1 release).
4. Azithromycin. It belongs to the group of azalide antibiotics. It has a point effect on the inflammation focus. If there are contraindications (hypersensitivity, liver and kidney failure, etc.), this medication is not prescribed. The maximum dosage of the drug should not exceed 500 mg of the active substance (corresponds to one tablet).

Price - from 230 rubles.

Drops and sprays

Sprays containing antibiotics are the most effective treatments for sinusitis (even when compared to drops). With their help, you can be sure of the dosage accuracy and they are distributed as evenly as possible over the nasal mucosa.

1. Isofra. The spray contains framycetin. Efficiency is due to the fact that the active substance acts in a targeted manner on the inflammation focus. At the same time, the sensitivity of other organs (for example, hearing) is not disturbed, since this antibiotic has a large number of side effects.
2. Polydexa. Includes phenylephrine and vasoconstrictor components.
3. Rinofluimucil is a complex drug capable of thinning mucus, as well as having an anti-inflammatory effect, gently affecting the vessels of the mucous membrane.
4. ... It belongs to the group of glucocorticosteroids, is aimed at relieving symptoms - congestion and swelling of the mucous membrane, restores breathing. Available in the form of a spray suspension. Apply no more than 2 times a day, no more than 5 days.

Nasonex is a hormonal drug. Uncontrolled intake can lead to disruption of the endocrine system.

Antipyretic and pain relievers

The use of funds that are included in this group can significantly reduce the patient's body temperature, as well as provide an analgesic effect. Among them are:

• Aspirin;
• Paracetamol;
• Ibuprofen;
• Citramon.

Price - from 8 rubles.

Folk recipes for adults

During the treatment of sinusitis in an acute form, traditional medicine recipes are also used. In the case of an integrated approach, the best results can be achieved in the shortest possible time.

1. The use of drops based on the cyclamen root: the juice of the plant is diluted in a ratio of 1:20 with boiled water and dripped into each nostril no more than 3 times a day.
2. The use of honeycomb is a substance used by bees to "seal" the honeycomb. The bee product must be chewed (1 tsp) for 15 minutes every hour. Take no more than 8 times a day.
3. Breathe steam with propolis tincture. Add 1 teaspoon of propolis to boiling water, stir and breathe over the container, covered with a towel, no more than 20 minutes.
4. Also, experts recommend using.

Inhalation with a nebulizer

Due to the fact that it is strictly forbidden to warm up the nose with sinusitis, you can only use a nebulizer. Essential oils, decoctions of chamomile or St. John's wort are placed in this device. The procedure lasts for 10-20 minutes. After it, it is not advisable to eat food or liquids, as well as go out into the fresh air.

You may also be interested in the Dolphin nasal flushing device, which you read about.

How to treat in a hospital

In hospitals, in the treatment of acute sinusitis, the following procedures are used.

Physiotherapy

It is prescribed by a doctor as an additional treatment to enhance the effect of drug therapy.

1. Quartz tube. The apparatus "Solnyshko" is used. Result: metabolism accelerates, cell permeability improves. Immunity is also significantly increased.
2. UHF. UHF and microwave therapy courses are used. Their essence is associated with the effect of devices on the area of ​​the affected sinus. Recommends at least 15 treatments. The use of vasoconstrictors (Galazolin, Otrivin, etc.) can also be prescribed in parallel. Contraindications: high blood pressure, oncology.
3. Laser therapy Its purpose is associated with an analgesic effect, as a result of which blood circulation increases, the concentration of bacteria in the sinuses and allergens decreases, and also helps to relieve the inflammatory process.
4. Magnetotherapy. When small electric currents occur, redox reactions are activated and blood circulation is stimulated.

Treatments to cure sinusitis

In medical institutions, the following procedures are performed, which are preferable in the treatment of acute sinusitis.

Also read about how the nose is rinsed with hydrogen peroxide.

Puncture

If the problem cannot be eliminated and sinusitis cannot be treated with medication, then the doctor prescribes a puncture. The puncture is performed under local anesthesia (using lidocaine), and the cartilaginous tissue of the sinus is punctured with a special needle. Then an antibacterial or antiseptic agent is injected into the cavity.

YAMIK catheter

A YAMIK sinus catheter is used. The essence of the procedure is to alternately cleanse the paranasal sinuses (on one side of the nose, then on the other). The advantage of the method is that it does not require a puncture and acts as the most painless and preferred option in the treatment of sinusitis in a hospital setting.

"Cuckoo"

Another name for the method is "drug movement according to Proetz". During the procedure, a mixture of antibiotics and hydrocortisone is injected into the sinuses. The solution, penetrating into the maxillary sinus when the patient pronounces the sound "cuckoo", allows you to create negative pressure (an electric aspirator is used for this) and mucus begins to come out of the other nostril. Thus, you can easily clear the sinuses from the accumulated secretions and pus.

Video

This video will tell you about the types of sinusitis.

Conclusion

1. Treatment of sinusitis in an acute form should be carried out when the first symptoms appear.
2. It is better to combine several types of treatment: drug regimens, the use of folk recipes (), physiotherapy.
3. If sinusitis has become chronic, it is almost impossible to cure it, because the structure of the sinus mucosa is disrupted.
4. As measures for the prevention of sinusitis, one can name: strengthening the immune functions of the body, timely treatment of ARVI, etc.
5. Only an ENT specialist can prescribe and cancel medications, as well as prolong the course of therapy.