The second largest in size after the maxillary paranasal cavities are the frontal sinuses, otherwise called the frontal sinuses. They are located in the thickness of the frontal bone immediately above the bridge of the nose and represent a paired formation, divided by a septum into two parts. However, not all people have frontal sinuses; about 5% of the population do not even have their rudiments.
Normally, the final formation of the frontal sinuses ends by 12-14 years. It is by this age that they become fully functional structures, having a volume of 6-7 ml and playing an important role in nasal breathing, the formation of the voice and facial skeleton. This fact explains the absence of pathology of the frontal cavities in children - from 2 to 12 years old, they may develop diseases of only the maxillary paranasal sinuses.
The frontal sinuses are lined with mucous membrane, the epithelium of which constantly produces a small amount of mucus. Through the narrow frontonasal duct, which opens under the middle turbinate, the sinuses are cleansed of mucus - with it, microorganisms and dust particles that have entered them are removed from the sinuses.
The presence of this channel, under certain conditions, can greatly complicate drainage, since with severe swelling of the mucous membrane, the duct is blocked, and cleansing the frontal sinuses becomes impossible. Such persistent blockade of drainage does not occur, for example, in diseases of the maxillary sinuses, which are connected to the nasal cavity not by a canal, but in most cases by an opening. This is important to remember when prescribing treatment for pathologies of the frontal cavities.
In what cases is it necessary to cleanse the frontal sinuses?
The most common diseases of the paranasal sinuses are their inflammations caused by the penetration of pathological microflora into the nasal cavity and further into the sinuses. In most situations, sinusitis (inflammation of the sinuses) becomes a complication of a runny nose of an infectious nature, but cases of isolated damage to the paranasal sinuses are also recorded, as well as a pathological process in the accessory cavities of allergic origin.
In terms of frequency, various inflammations of the maxillary sinuses are in first place, frontal sinuses are in second place, and ethmoiditis and sphenoiditis (lesions of the ethmoid and sphenoid sinuses) are more rare.
With frontal sinusitis (inflammation of the frontal sinuses) of an infectious or allergic nature, swelling of the mucous membrane of the sinuses and the frontonasal duct always occurs. In this case, the epithelium begins to produce an increased amount of mucus, which is a protective reaction.
Its significance lies in the removal of harmful viruses and bacteria, their toxins, decay products, destroyed epithelial cells, and allergic agents with mucus. If the inflammation is infectious in nature, then the abundant contents of the frontal cavities are a mixture of mucus and pus. If allergic, then the discharge does not contain a purulent component.
Cleansing the frontal sinuses is necessary for any form of inflammatory process, since the mass discharged during persistent blockage of the frontonasal canal by the swollen mucous membrane cannot drain independently. Its accumulation causes a characteristic clinical picture of frontal sinusitis.
These are symptoms of intoxication (with infectious inflammation) with an increase in body temperature to 38-39 degrees, severe and excruciating pain in the forehead and eye sockets, nasal congestion, copious discharge of mucus and pus from it (when drainage is restored), impaired sense of smell and timbre of voice.
It is also necessary to clean the frontal sinuses in a timely manner due to the risk of serious complications. Thus, when a huge amount of mucus and pus accumulates in them, a “melting” of the bone wall of the sinus can occur and the contents can break into the orbital cavity or damage the meninges, which is very dangerous for the patient’s life.
Therefore, when symptoms of frontal sinusitis appear, you do not need to take any independent steps in treatment; you must immediately contact a doctor who will diagnose the pathology and prescribe therapeutic measures to clean and sanitize the frontal cavities.
What methods of cleansing the frontal sinuses exist?
When a patient seeks help, all necessary diagnostic measures are prescribed to determine the form of inflammation, as well as to differentiate frontal sinusitis from diseases of the maxillary sinuses or from other sinusitis. Using the methods of anterior and posterior rhinoscopy, the ENT doctor notes changes in the nasal cavity, the presence of hyperemia in a certain area and the nature of the contents.
By tapping, you can find out the location of the pain, and using a blood test, you can determine infectious or allergic inflammation. To obtain final data for the diagnosis of inflammation of the frontal, maxillary and other cavities, additional instrumental research is necessary. This includes diaphanoscopy, radiography, computed tomography, ultrasound.
Using these methods, it is possible to determine whether there is an accumulation of contents in the sinus, whether it is draining, or whether there is a blockage of the frontonasal canal. These data determine which method of cleansing the frontal sinuses will be chosen by a specialist, conservative or surgical.
In most situations, conservative methods of therapy are sufficient to cleanse the maxillary or frontal paranasal sinuses. This means that the use of certain medications is quite capable of both reducing the production of mucopurulent discharge and restoring normal cavities by eliminating swelling of the mucous membrane of the excretory ducts.
Therefore, first of all, etiotropic treatment is prescribed, aimed at the infectious pathogen or allergic agent (antibiotics or antihistamines), then vasoconstrictor nasal drugs (Galazolin, Nazol, Naphthyzin) strictly according to medical recommendations, and in case of intoxication, antipyretic drugs.
If the patient does not have elevated body temperature, then it is very useful to do physiotherapy. For inflammation of the frontal or maxillary sinuses, UHF, HF, local and general warming procedures are very effective.
If these methods fail to remove the persistent blockade of the frontonasal duct, then the doctor has to resort to more radical methods. Depending on the patient’s condition, the form and severity of the disease, it is recommended to perform lavage using the YAMIK sinus catheter, puncture of the frontal sinus using an endoscope through the drainage canal, or transosseous puncture of its anterior or lower wall with further rinsing and sanitation of the cavity.
Cleansing the frontal sinuses with frontal sinuses of any origin is the leading direction in therapy. It is important to choose the most optimal method for the patient and perform cleansing procedures in a timely and correct manner.
In addition to the ethmoid labyrinth, sphenoid and maxillary sinuses, the paranasal sinuses also include the frontal sinuses. All these air cavities are also called paranasal sinuses. A distinctive feature of the frontal sinuses is their absence at the time of birth. They develop only by the age of eight and are fully formed only after puberty.
The frontal sinuses are located in the frontal bone behind the brow ridges. These cavities are paired and have the shape of a triangular pyramid. The inner surface is covered with mucous membrane. They are formed by several walls:
- front or front;
- posterior or cerebral;
- bottom;
- internal or intersinus septum.
The internal divides the frontal bone into two parts - left and right. Most often they are not symmetrical, since the bony septum is deviated to one side from the midline. The base of the sinus is the upper wall of the orbit, and the apex is located at the junction of the anterior wall with the posterior one. With the help of the frontonasal canal, also called the anastomosis, each frontal sinus opens into the nasal passage.
The anterior wall of the sinus is the thickest - we can feel it by running our hand over the forehead just above the eyebrows. In its lower part, between the superciliary arches, there is a bridge of the nose, and a little higher are the frontal tubercles. The back wall is connected to the bottom at a right angle.
However, the structure of the sinuses is not always the same as described above. There are rare cases when the internal partition separating the sinuses is located not vertically, but horizontally. In this case, the frontal sinuses are located one above the other.
There are other deviations in the structure of cavities. For example, inside them there may be incomplete septa - peculiar bone ridges. Such a sinus consists of several bays or niches. Another, more rare anomaly is complete septa - they divide one of the cavities into several, forming multi-chamber frontal sinuses.
Functions of the frontal sinuses
Along with other paranasal cavities, the frontal sinuses serve for the efficient functioning of the body. Given the fact that they are absent at birth, there is a hypothesis that The main function of the frontal sinuses is to reduce the mass of the skull. In addition, the frontal cavities:
- act as a kind of shockproof “buffer” that protects the brain from injury;
- participate in the breathing process: air from the nasal passages enters the cavities, where, interacting with the mucous membrane, it is additionally moistened and warmed;
- take part in the formation of sounds and increase vocal resonance.
Diseases of the frontal sinuses
Considering that the frontal sinuses are hollow structures lined with mucous membrane, they can be affected by viral or bacterial infections. Pathogenic microbes penetrate along with the inhaled air. When the body's resistance is low, an inflammatory process may occur.
Frontit
Inflammation “originates,” as a rule, on the nasal mucosa, and then spreads through the nasolacrimal duct to the frontal sinuses. Swelling occurs, as a result of which the canal is blocked, and the outflow of fluid from the sinuses becomes impossible. This is how frontal sinusitis develops. The isolated environment that has formed is ideal for the proliferation of bacteria and the formation of pus.
Frontal sinusitis is mainly treated with medications. In this case, complex therapy is prescribed: vasoconstrictors, anti-inflammatory and antibacterial agents are used. Physiotherapy may be performed as prescribed by a doctor. An operation to open cavities is required only in cases where treatment does not lead to recovery and there is a possibility of complications.
Unlike others, the thinnest posterior wall is formed not by bone tissue, but by spongy tissue. Therefore, even with minor inflammatory processes, it can collapse and allow the infection to spread to other organs..
Frontal sinus cyst
A frontal sinus cyst is a small spherical container filled with fluid and having thin, elastic walls. The size and location of such a neoplasm may vary. This tumor occurs under the same circumstances as frontal sinusitis.
As a result of inflammation, the outflow of fluid is disrupted, but mucus continues to be produced and accumulated. And since it has nowhere to go, over time a cyst forms. The treatment for this disease is surgery.
Diagnosis of sinus diseases
The symptoms of diseases of the frontal sinuses, be it frontal sinusitis or a cyst, are the same. The only difference is that a cyst, if it is small in size, may not show any signs at all for quite a long time. In addition, minor neoplasms are not always detected during routine examinations by an ENT specialist.
Symptoms of diseases
The main symptoms of frontal sinus disease are:
- pain in the forehead, which intensifies with pressure and fatigue;
- purulent nasal discharge, often odorless;
- disruption of normal breathing, usually from the affected cavity;
- swelling and redness of the skin at the site of the inflamed sinus;
- a sharp increase in body temperature;
- general weakness.
Survey
If there is even the slightest suspicion that frontal sinusitis or a cyst is developing, you should immediately contact an otolaryngologist. This doctor, after interviewing the patient, will perform a rhinoscopy - examination of the nasal cavity and paranasal cavities. To confirm the diagnosis, as well as to determine the presence and level of pus, an x-ray may be prescribed.
In particularly advanced cases, a computed tomography scan is performed. This type of study also makes it possible to determine how large the frontal sinuses are and the presence of additional septa in them, which is important when performing surgery. To identify the causative agent of the disease, microbiological studies of secretions are carried out.
X-rays are often used if the maxillary sinuses are inflamed - the frontal cavities are also clearly visible in the images. This type of study is ineffective for diagnosing other sinuses, since they are poorly visible on the image.
Possible consequences and prevention
In cases of incomplete recovery or with advanced frontal sinusitis, the disease can take a chronic form. This is dangerous due to frequent relapses of the disease and other serious consequences in the form of meningitis or inflammation of the brain.
To prevent illness, try to avoid hypothermia, harden the body, promptly treat acute respiratory diseases and runny nose. And then you won’t have to study the frontal sinuses, their structure and functions with the help of photos, consult an otolaryngologist and carry out treatment.
The nasal cavity has paranasal sinuses, which communicate with various nasal passages (Fig. 50). Thus, the body cavity of the main bone and the posterior cells of the ethmoid bone open into the upper nasal meatus, the frontal and maxillary sinuses, the anterior and middle cells of the ethmoid bone open into the middle nasal meatus. The lacrimal duct drains into the lower nasal meatus.
Rice. 50.
A - the outer wall of the nasal cavity with openings into the paranasal sinuses: 1 - frontal sinus; 3 - opening of the frontal sinus; 3 - opening of the anterior cells of the ethmoid bone; 4 - opening of the maxillary sinus; 5 - openings of the posterior cells of the ethmoid bone; 6 - main sinus and its opening; 7 - pharyngeal opening of the auditory tube; 8 - opening of the nasolacrimal duct. B - nasal septum: 1 - crista galli; 2 - lamina cribrosa; 3 - lamina perpendicularis ossis ethmoidalis; 4 - opener; 5 - hard palate; 5 - cartilago septi nasi.
Maxillary sinus(sinus maxillaris Highmori) is located in the body of the upper jaw. It begins to be created from the 10th week of embryonic life and develops until 12-13 years of age. In an adult, the volume of the cavity ranges from 4.2-30 cm 3, it depends on the thickness of its walls and less on its position. The shape of the sinus is irregular and has four main walls. The anterior (in 1/3 of cases) or anterior outer (in 2/3 of cases) wall is represented by a thin plate corresponding to fossa canina. On this wall there is n. infraorbitalis along with the blood vessels of the same name.
The upper wall of the sinus is also the lower wall of the orbit. In the thickness of the wall there is a canalis infraorbitalis, containing the mentioned neurovascular bundle. At the site of the latter, the bone may be thinned or have a gap. In the presence of a gap, the nerve and vessels are separated from the sinus only by the mucous membrane, which leads to inflammation of the lower orbital nerve during sinusitis. Typically, the upper wall of the sinus is located at the same level as the upper part of the middle meatus. N. N. Rezanov points to a rare variant when this wall of the sinus is low and the middle nasal meatus is adjacent to the inner surface of the orbit. This determines the possibility of a needle penetrating into the orbit during puncture of the maxillary sinus through the nasal cavity. Often the dome of the sinus extends into the thickness of the inner wall of the orbit, pushing the ethmoid sinuses upward and backward.
The lower wall of the maxillary sinus is represented by the alveolar process of the jaw and corresponds to the roots of the 2nd small and anterior large molars. The area where the roots of the teeth are located can protrude into the cavity in the form of an elevation. The bone plate separating the cavity from the root is often thinned and sometimes has a gap. These conditions favor the spread of infection from the affected tooth roots to the maxillary sinus and explain cases of tooth penetration into the sinus at the time of its extirpation. The bottom of the sinus may be 1-2 mm above the bottom of the nasal cavity, at the level of this bottom, or below it as a result of the development of the alveolar bay. The maxillary cavity rarely extends under the bottom of the nasal cavity, forming a small depression (buchta palatina) (Fig. 51).
Rice. 51. Paranasal sinuses, maxillary sinus.
A - sagittal cut: B - frontal cut; B - structural options - high and low position of the lower wall: 1 - canalis infraorbitalis; 2 - fissura orbitalis Inferior; 3 - fossa pterygopalatina; 4 - maxillary sinus; 5- cells of the ethmoid bone; 6 - eye socket; 7 - processus alveolaris; 8 - inferior nasal concha; 9 - nasal cavity; 10 - buchta prelacrimalis; 11 - canalis infraorbitalis (devoid of a lower wall); 12 - buchta palatina; 13 - buchta alveolaris; G - frontal sinus on a sagittal cut; D - variants of the structure of the frontal sinus.
The inner wall of the maxillary sinus is adjacent to the middle and lower nasal passages. The wall of the lower nasal passage is solid, but thin. Here it is relatively easy to puncture the maxillary sinus. The wall of the middle nasal passage has a membranous structure over a considerable extent and an opening connecting the sinus with the nasal cavity. Hole length 3-19 mm, width 3-6 mm.
The posterior wall of the maxillary sinus is represented by the maxillary tubercle, which is in contact with the pterygopalatine fossa, where n. infraorbitalis, ganglion sphenopalatinum, a. maxillaris with its branches. Through this wall you can approach the pterygopalatine fossa.
Frontal sinuses(sinus frontalis) are located in the thickness of the frontal bone, corresponding to the superciliary arches. They look like triangular pyramids with the base pointing down. The sinuses develop from 5-6 to 18-20 years. In adults, their volume reaches 8 cm3. The sinus extends upward slightly beyond the superciliary arches, outward to the outer third of the upper edge of the orbit or to the superior orbital notch and descends down into the nasal part of the bone. The anterior wall of the sinus is represented by the superciliary tubercle, the posterior one is relatively thin and separates the sinus from the anterior cranial fossa, the lower wall is part of the upper wall of the orbit and at the midline of the body is part of the nasal cavity, the inner wall is a septum separating the right and left sinuses. The top and side walls are absent, since its front and rear walls meet at an acute angle. There is no cavity in approximately 7% of cases. The septum separating the cavities from each other does not occupy a median position in 51.2% (M. V. Miloslavsky). A cavity opens through a canal (canalis nasofrontalis) extending up to 5 mm into the middle nasal passage, in front of the opening of the maxillary sinus. In the frontal sinus, the canalis nasofrontalis is formed at the bottom by a funnel. This helps drain mucus from the sinuses. Tillo points out that the frontal sinus can sometimes open into the maxillary sinus.
Ethmoid sinuses(sinus ethmoidalis) are represented by cells corresponding to the level of the superior and middle nasal conchae; they form the upper part of the lateral wall of the nasal cavity. These cells communicate with each other. On the outside, the cavities are delimited from the orbit by a very thin bone plate (lamina papyrocea). If this wall is damaged, air from the cells of the cavity can penetrate into the fiber of the periorbital space. The resulting emphysema causes protrusion of the eyeball - exophthalmos. From above, the sinus cells are delimited by a thin bone septum from the anterior cranial fossa. The anterior group of cells opens into the middle nasal meatus, the posterior group opens into the upper nasal meatus.
Main sinus(sinus sphenoidalis) is located in the body of the main bone. It develops between the ages of 2 and 20 years. The septum along the midline divides the sinus into right and left. The sinus opens into the upper nasal meatus. The hole lies 7 cm from the nostril along a line running through the middle of the middle turbinate. The position of the sinus made it possible to recommend that surgeons approach the pituitary gland through the nasal cavity and nasopharynx. The main sinus may be absent.
Nasolacrimal duct(canalis nasolacrimalis) is located in the area of the lateral border of the nose (Fig. 52). It opens into the lower nasal meatus. The opening of the canal is located under the anterior edge of the inferior turbinate on the outer wall of the nasal passage. It is 2.5-4 cm from the posterior edge of the nostril. The length of the nasolacrimal canal is 2.25-3.25 cm (N. I. Pirogov). The canal passes through the thickness of the outer wall of the nasal cavity. In the lower segment it is limited by bone tissue only on the outer side; on the other sides it is covered with the mucous membrane of the nasal cavity.
Rice. 52. Topography of the lacrimal ducts.
1 - fornix sacci lacrimalis; 2 - ductus lacrimalis superior; 3 - papilla et punctum lacrimale superior; 5 - caruncula lacrimalis; 6 - ductus et ampula lacrimalis Inferior; 7 - saccus lacrimalis; 8 - m. orbicularis oculi; 9 - m. obliquus oculi inferior; 10 - sinus maxillaris; 11 - ductus nasolacrimalis.
A - cross section: 1 - lig. palpebrale medialis; 2 - pars lacrimalis m. orbicularis oculi; 3 - septum orbitale; 4 - f. lacrimalis; 5 - saccus lacrimalis; 6 - periosteum
Frontit(frontal sinusitis) - inflammation of the frontal paranasal sinus. Over the past decade, sinusitis (inflammation of the sinuses) has been considered one of the most common diseases in the world. Today, about 10-15% of the population suffers from them. A tenth of patients with sinusitis are diagnosed with acute or chronic sinusitis. Over the past 5 years, the incidence of frontal sinusitis has tripled and continues to increase. In Russia, the number of people suffering from manifestations of frontal sinusitis reaches 1 million people per year. Among those hospitalized, there are more males, and among those treated on an outpatient basis, females are more common.
Anatomy of the frontal sinuses
Adjacent to the nasal cavity are the paranasal sinuses:
- two maxillary (maxillary)
- two frontal
- two lattice mazes
- one wedge-shaped (main)
- humidify and warm the inhaled air
- makes the skull bones lighter
- isolate the roots of teeth and eyeballs from temperature fluctuations
- act as a buffer for facial injuries
- act as a vocal resonator
There are four walls of the frontal sinus:
- inferior (orbital)– the thinnest
- front– the strongest and thickest
- back– separates the sinus from the cranial fossa
- internal, aka partition– divides the cavity into right and left halves
The frontal sinus (like the other sinuses) is lined from the inside with a mucous membrane, which is a continuation of the nasal mucosa. But it is much thinner and does not contain cavernous tissue. The sinus is connected to the nasal cavity by a narrow, winding canaliculus, which opens with a small hole in the front of the nasal passage.
Causes of frontal sinusitis
With frontal sinusitis, inflammation of the mucous membrane that lines the sinus occurs. The causes of frontal sinusitis can be varied, often depending on the form and severity of the disease.Infection
Most often, sinusitis occurs as a result of infection from the nasal cavity. In this case, inflammation can occur in parallel in both the maxillary and frontal sinuses. In this case, the patient is diagnosed with sinusitis and frontal sinusitis. The cause of the disease can be influenza, ARVI, diphtheria, scarlet fever.The most common causative agents of viral frontal sinusitis are:
- adenoviruses
- coronaviruses
- rhinoviruses
- respiratory syncytial viruses
- Streptococcus pneumoniae
- Haemophilus influenzae
- Pyogenes
- Staphylococcus aureus
The cause of inflammation of the frontal sinus can also be a fungal infection. In some cases, infection with bacteria and fungi can occur through the blood (hematogenous). This happens if there are foci of infection in the human body: carious teeth, abscesses.
Allergy
Bronchial asthma and prolonged allergic rhinitis (vasomotor rhinitis) cause inflammation and swelling of the mucous membrane. This closes the hole that allows fluid to exit the frontal sinus.Nasal polyps
Nasal polyps are benign, round-shaped formations that arise as a result of degeneration of the mucous membrane. In this case, there is swelling of the mucous membrane, difficulty breathing, and the outflow from the nasal sinuses is blocked. Injuries to the nose and paranasal sinuses
Inflammation can result from trauma to the skull bones. A bruise causes tissue swelling and disruption of normal blood circulation in the mucous membrane of the nose and paranasal sinuses.Deviation of the nasal septum and hypertrophy of the nasal turbinates
The curvature can be a congenital anomaly, the result of injury or previous diseases. A deviated nasal septum can also impair the free flow of mucus and germs from the sinuses.Foreign bodies
Prolonged residence of foreign bodies in the nasal passages causes inflammation, which spreads to the nasal cavity and sinuses. Especially often small objects (beads, construction parts) cause frontal sinusitis in children.Symptoms and signs of frontal sinusitis
Frontal sinusitis is a serious disease that is more severe than other forms of sinusitis. According to the nature of the course, there are two forms of frontal sinusitis: acute and chronic. Each of them has its own characteristics and characteristics. Acute frontal sinusitis
In the acute form of the disease, the following complaints arise:- sharp pain in the forehead, aggravated by tapping or pressing on the anterior wall of the frontal sinus (forehead area above the bridge of the nose)
- discomfort occurs in the area of the inner corner of the eye
- eye pain, lacrimation, photophobia
- nasal congestion and difficulty breathing through the nose
- copious discharge from the nose, at first it is transparent, mucous, but over time it can turn purulent
- with right- or left-sided frontal sinusitis, discharge from the corresponding half of the nose;
- swelling of the face, especially at the inner corner of the eye
- the color of the skin over the sinus may be changed
- temperature rises to 39°, but in some cases the temperature may be low;
- feeling of weakness, weakness as a result of general intoxication of the body
- When examined by an ENT specialist, mucopurulent discharge, redness and swelling of the nasal mucosa are detected
Pain in acute frontal sinusitis is cyclical. During periods when the outflow of mucus from the frontal sinus is disrupted, the pain intensifies. This stagnation causes the condition to worsen in the morning. The pain becomes severe, radiating to the eye, temple, and the corresponding half of the head. After the sinus is freed from the contents, the pain subsides.
Chronic frontal sinusitis
Acute frontal sinusitis becomes chronic 4-8 weeks after the onset of the disease. This can happen as a result of incorrectly selected treatment or complete ignorance of the manifestations of the disease.
The symptoms of chronic frontal sinusitis are somewhat less pronounced than acute ones:
- aching or pressing pain in the frontal sinus area, which intensifies with tapping
- when pressing, sharp pain in the inner corner of the eye
- profuse purulent discharge from the nose in the morning with an unpleasant odor
- a large amount of purulent sputum in the morning
Diagnosis of frontal sinusitis
An experienced otolaryngologist (ENT) will quickly make the correct diagnosis based on the patient’s complaints. Additional studies are needed to clarify the severity of the disease and the correct selection of treatment regimens. The main research methods are described below.| Type of diagnosis | Purpose of diagnosis | How it is produced |
| History taking | Collect complaints, clarify symptoms, determine the cause and moment of onset of the disease | The doctor asks questions regarding the course of the disease |
| Rhinoscopy |
| Nasal speculums (dilators) and a nasopharyngeal speculum are used |
| Ultrasound of the paranasal sinuses | Identify the extent of inflammation and monitor the effectiveness of treatment | The study of the frontal sinuses is carried out with ultrasonic linear sensors with a frequency of 8 to 10 MHz. As a result, an image of the source of inflammation appears on the monitor screen |
| Nasal endoscopy |
| A thin flexible tube with a microscopic camera is inserted into the sinus through the frontonasal canal. The image is displayed on the screen |
| Diaphanoscopy (transillumination) | Allows you to identify developmental abnormalities and areas of inflammation | Transillumination of the sinuses with a bright beam of light from the tube of the device. Produced in a dark room |
| Thermal imaging (thermography) | Allows you to get a picture of temperatures in different parts of the body | The thermographic camera records thermal radiation. Based on the results, you can determine where the hotter areas are. They are foci of inflammation |
| X-ray of sinuses |
| A picture of the head is taken using an X-ray machine |
| Bacteriological study of secretions from the nasal cavity | Determine which microorganisms cause inflammation and their sensitivity to antibiotics and other drugs | During the examination, the doctor makes a smear. In the laboratory, a sample of mucus is inoculated onto nutrient media, the type of microorganism and the means to effectively combat it are determined. |
| Cytological examination of the contents of the nasal cavity | Determine which cells are present in the mucus. This is necessary in order to find the cause of the disease | A sample of nasal contents is taken and examined under a microscope. |
| Computer tomogram | One of the most informative and reliable methods. Allows you to determine the presence of inflammation, its stage, structural features of the skull bones | The study is carried out using a computed tomograph. The method involves the use of x-rays |
Types of frontal sinusitis
There are several classifications of frontites. Let's take a closer look at them.Classification according to the form of the inflammatory process
| Type of frontite | Cause of occurrence | Optimal Treatment Methods | |
| Acute frontal sinusitis | Severe headaches that get worse with tapping and pressure. |
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| Chronic frontal sinusitis |
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Classification by type of inflammatory process
| Type of frontite | Symptoms and external manifestations | Cause of occurrence | Optimal Treatment Methods |
| Exudative frontal sinusitis | |||
| a) Catarrhal frontitis |
| Occurs as a consequence of infection and inflammatory processes in the nasal mucosa |
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| b) Purulent frontal sinusitis |
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| Productive frontitis | |||
| Polypous, cystic frontal sinusitis |
| Pathological proliferation of mucous tissue lining the sinus. Cyst formation | Opening the frontal sinus, removing cysts and polyps |
| Parietal-hyperplastic frontitis caused by an overgrowth of the sinus mucosa |
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Classification by process localization
| Type of frontite | Symptoms and external manifestations | Cause of occurrence | Optimal Treatment Methods |
| Unilateral frontal sinusitis | |||
| Headache and mucopurulent discharge from one nostril Body temperature 37.3-39°C | Caused by bacteria, viruses, fungi, allergens. It can also be a consequence of injuries and decreased local immunity | The choice of treatment method depends on the cause of the disease. Use:
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| Bilateral frontitis | |||
| Double-sided form | Pain occurs symmetrically on both sides. It can radiate to different parts of the head. Discharge from both nostrils. | The causes of inflammation are the same as for unilateral frontal sinusitis. | Drug treatment with appropriate drugs. Surgical methods of treatment |
Treatment of frontal sinusitis
Traditional methods of treating frontal sinusitis
Treatment of frontal sinusitis at home is allowed for mild forms of the disease. Treatment prescribed by a doctor can be supplemented with inhalations, ointments and warming agents. Traditional methods can help cope with the disease more effectively and quickly. However, it is necessary that the results of treatment are monitored by an ENT specialist.
There is an indication that this treatment method is right for you. If after the procedure tapping on the central area of the forehead does not cause pain, this means that the frontal sinus has been freed of mucous contents and microorganisms.
There is only one limitation: you must remember that under no circumstances should you heat your forehead if you have purulent frontal sinusitis. This can lead to the spread of pus into surrounding tissues.
Inhalations for the treatment of sinusitis
- Boil the potatoes in their skins, drain the water. Mash the potatoes and breathe in the steam over the pan. For greater effect, cover your head with a terry towel.
- Brew chamomile flowers, add a few drops of tea tree or eucalyptus essential oil to the hot broth. Breathe steam over the mixture.
- Bring one and a half liters of water to a boil, throw in 7-10 bay leaves. Turn the heat to low and breathe steam over the pan for five minutes.
- Grind 4 cloves of garlic, add half a glass of apple cider vinegar and half a glass of boiling water. Breathe over the solution for 15 minutes, 3 times a day, covered with a towel. Add hot water as it cools.
- Boil water in a saucepan and add a small amount of “Star” balm or dry menthol. Remove from heat and breathe in the steam for five minutes, covering your head with a towel.
Solutions for rinsing the nose for sinusitis 
Washing is a mandatory procedure for any form of frontal sinusitis. In order for it to bring maximum benefit, before rinsing it is necessary to clear the nose and drip vasoconstrictor drops (Naphthyzin, Farmazolin, Noxprey). This will help open the gaps in the paranasal sinuses. Then you need to lean over the sink, while keeping your head straight. Using a small rubber bulb or a special bottle, the liquid is poured under pressure into one nostril. The rinsing solution, along with mucus from the sinuses, is poured out of the other nostril. After this procedure, significant relief occurs.
- Grind one medium onion on a grater or in a blender and pour a glass of boiling water. When the mixture has cooled, add a teaspoon of honey. Strain and rinse your nose with this mixture three to four times a day. This remedy kills bacteria, helps relieve inflammation and improve local immunity. Not suitable for frontal sinusitis caused by an allergic reaction.
- In one glass of warm boiled water you need to dissolve one teaspoon of salt, a pinch of soda and three drops of tea tree oil. Use for rinsing 3-4 times a day. This composition disinfects the nasal cavity and has a strong antiviral and anti-inflammatory effect.
- Prepare a decoction of chamomile flowers; this is a strong antiseptic and antimicrobial agent. Cool, strain and use for rinsing every two hours.
- Dissolve a tablespoon of chlorophyllipt alcohol solution in half a liter of warm boiled water. It has an antibacterial effect and fights even those microorganisms that have developed resistance to antibiotics. The solution is used for washing 3-4 times a day.
- It is also effective to rinse your nose with saline solution. You can make it yourself (one teaspoon of salt per liter of boiled water) or buy it ready-made at the pharmacy. This product cleanses well of mucus, germs and allergens without irritating the mucous membrane.
Drops for the treatment of sinusitis
Traditional medicine uses juices and decoctions of medicinal plants to treat sinusitis and other sinusitis. In order for them to have the maximum effect, you must first clear it of its contents - blow your nose well and rinse with saline solution. After instillation, lie down for a few minutes with your head thrown back so that the medicine is evenly distributed throughout the nasal passages.- Take black radish, peel and grate. Squeeze the juice and use for instillation 3-4 times a day. The juice contains a large amount of essential oils and helps clear mucus from the sinuses.
- Wash the cyclamen tubers thoroughly, chop them and squeeze out the juice. It must be diluted with water (one part juice to four parts water) and strain well. At night, place two drops in each nostril and massage the sinuses well. Cyclamen is considered a remedy that helps defeat the disease at any stage.
- Pluck large Kalanchoe leaves and keep in the refrigerator for three days. After this, grind them and squeeze out the juice using gauze. Dilute the liquid twice with water and drop it into the nose 2-3 times a day. Kalanchoe helps to liquefy nasal contents and facilitate their rapid elimination.
- Place a small piece of propolis in the freezer for several hours. After this, quickly pound it in a mortar and pour in refined vegetable oil. Let it brew for three days in a dark place. The product helps fight inflammation and soothes the nasal mucosa. Do not use if you have an allergic rhinitis.
- Take 10 g of chamomile flowers, 10 g of marsh grass, 15 g of St. John's wort. Brew the components separately with a glass of boiling water, cool and strain. Place 5 drops in each nostril 3 times a day. This composition helps relieve inflammation and open clogged frontal sinuses.
- Mix equal parts of celandine juice and chamomile juice. Place 1-2 drops in each nostril. This composition effectively fights frontal sinusitis caused by polyps.
Ointments for frontal sinusitis
- Take 4 parts pork fat and one part kerosene. Mix and store in the refrigerator. Rub the ointment into the forehead and wings of the nose several times a day. You can insert cotton swabs soaked in this ointment into your nose. The procedure lasts 3 hours once a day. The product disinfects and dissolves adhesions.
- In a water bath, melt crushed laundry soap (1/2 piece), a teaspoon of vegetable oil, 70% alcohol, honey and milk. Cool and soak cotton wool with ointment. Apply 3 times a day for 15 minutes. The course of treatment is two weeks. If necessary, repeat the course after 10 days. The ointment disinfects, cleanses and relieves inflammation.
- Prepare an ointment from equal parts of honey, aloe juice, onion juice, cyclamen juice, and Vishnevsky ointment. Mix all ingredients thoroughly until smooth and store in the refrigerator. Turunda soaked in ointment are placed in the nose for 30 minutes. The course of treatment is three weeks.
- Crush the garlic clove and mix with an equal amount of butter. Store this ointment in the refrigerator and lubricate your forehead before going to bed. Garlic phytoncides penetrate deeply into tissues and help get rid of the disease.
Medical white clay is suitable for these purposes. It must be diluted with water or chamomile decoction to the consistency of a thick dough. The cake should be warm, about 1 cm thick. Apply this compress in the evening, while lying in bed, for two hours. Repeat for 14 days.
It is worth noting that treatment of frontal sinusitis with folk remedies should complement the measures prescribed by the doctor. This will protect against repeated inflammation in the frontal sinus and the disease becoming chronic. At the first signs of an allergy, it is worth stopping the use of traditional medicine and replacing them with others.
Dry heat treatment
- Heat 3-5 tablespoons of sand or salt in a frying pan. Pour into a fabric bag and apply to the forehead in the frontal sinus area. The duration of the procedure is 20-30 minutes.
- Boil an egg and apply to your forehead. While it is too hot, you can wrap it in a handkerchief. Keep it until it cools down.
- Wear a wool bandage on the forehead. This warming up can last for several hours. After the procedure, it is important to avoid hypothermia outdoors.
Drug treatment
When should you start taking antibiotics?
To the question “When should you take antibiotics for frontal sinusitis?” Only the attending physician can give an answer. For inflammation of the frontal sinuses caused by allergies or viruses, antibiotics will not help. They can only worsen the situation: lead to dysbiosis and decreased immunity. Therefore, you cannot take them on your own, without a doctor’s prescription.The indication for the use of antibiotics for frontal sinusitis is purulent discharge. They mean that bacteria have settled in the sinus. The doctor should take a sample of the discharge for laboratory analysis. Using this, it is possible to determine which microorganisms caused the inflammation and their sensitivity to antibiotics. This is the key to successful treatment. For chronic frontal sinusitis, this procedure is mandatory.
Indications for the use of antibiotics for frontal sinusitis are: severe general condition of the patient and severe headache, as well as if more gentle treatment has not brought results.
What antibiotics are usually prescribed for frontal sinusitis?
In milder cases, topical antibiotic spray Bioparox, Isofra and Polydex drops are prescribed. Antibiotics are also prescribed in the form of tablets Augmentin, Cefazolin, Ceftriaxone, Sporidex.The most effective is intramuscular or intravenous administration of antibiotics. If necessary, an antibiotic solution is injected directly into the frontal sinus through a hole made in the frontal bone.
In case of acute frontal sinusitis, broad-spectrum antibiotics are prescribed, for example Sumamed 500 mg per day.
In the treatment of chronic frontal sinusitis, when the sensitivity of bacteria to antibiotics is determined, narrowly targeted drugs are prescribed. If the cause is Haemophilus influenzae, then Ampicillin and Amoxiclav are prescribed.
Administered intramuscularly or intravenously in a daily dose of 200-400 mg. Tetracycline antibiotics are used against pneumococcus: Abadox, Biocyclinde, Medomycin, Doxacin, Doxylin, Extracycline, Isodox, Lampodox. The daily dose for adults is 0.2 g.
The course of antibiotic treatment should be at least 7-10 days.
What other medications are taken to treat frontal sinusitis?
Antiallergic drugs are often prescribed in parallel: Suprastin, Tavegil, Diazolin, Diphenhydramine. They relieve allergies and reduce nasal swelling.In cases where it is necessary to remove thick pus from the frontal sinus, ACC-long (600 mg) is prescribed, 1 tablet once a day.
To maintain intestinal microflora, probiotics are taken: Lactobacterin, Probiovit, Bifikol, Linex. They help maintain the balance of beneficial microorganisms and support immunity.
Homeopathic remedies. Sinuforte – has an anti-inflammatory effect and promotes the opening and ventilation of the sinuses. Cinnabsin – facilitates nasal breathing, relieves swelling, improves immunity. Sinupret - thins the thick contents of the sinuses, relieves inflammation.
To combat infection without antibiotics, sulfonamide drugs Sulfadimezin, Norsulfazol, Etazol are also used.
To reduce headaches, the following are prescribed: Analgin, Amidopyrine, Nurofen.
Physiotherapeutic procedures
In a clinic or hospital, the “cuckoo” procedure is used to rinse the nose. As a result of such rinsing with furatsilin or another solution of drugs, it is possible to cleanse the sinuses well.To speed up recovery, the following physiotherapeutic procedures are prescribed: electrophoresis with 2% potassium iodide, laser therapy, Sollux, UHF therapy. They are aimed at warming the frontal cavity, ensuring free outflow of its contents, relieving inflammation, and improving blood circulation.
When is a puncture done for frontal sinusitis?
A puncture for frontal sinusitis or a puncture of the frontal sinus is prescribed only when it is not possible to alleviate the patient’s condition with the help of medications.Pus in the sinus, severe headaches and lack of outflow, cysts in the sinus cavity - these are the signs that indicate the need for a puncture in frontal sinusitis.
When preparing for a puncture, the most important step is an X-ray examination of the structure of the frontal sinuses. This is necessary to accurately determine the puncture site for frontal sinusitis.
There are several puncture techniques:
- through the lower thin wall of the frontal sinus (through the nasal cavity)
- through the anterior wall of the frontal sinus (through the forehead)
Complications with frontal sinusitis
If treated incorrectly, it is possible to develop serious complications with frontal sinusitis:- The inflammatory process can spread to adjacent paranasal sinuses. This leads to sinusitis, ethmoiditis, sphenoiditis
- Intraorbital complications (edema of the eyelids and orbital tissue, orbital phlegmon, eyelid abscess)
- Intracranial complications (meningitis, brain abscesses)
- In severe cases, blood poisoning is possible - sepsis
Prevention of frontal sinusitis
Among preventive measures, special attention is paid to timely and adequate treatment of colds. They are the main cause of frontal sinusitis. It is also necessary to take care of strengthening the immune system and hardening the body, avoiding hypothermia and leading an active lifestyle. Following these simple recommendations is the key to your health.
What is the difference between frontal sinusitis, sinusitis, ethmoiditis, sphenoiditis, sinusitis?
Sinusitis- general term. It refers to inflammation of any paranasal sinuses (another name for sinuses is sinuses). Sinusitis– inflammation of the maxillary, or maxillary sinuses. Ethmoiditis- inflammation lattice labyrinth(cells of the ethmoid bone). Sphenoiditis– inflammatory process in the sphenoid sinus. The symptoms of these two diseases can be very similar, which sometimes makes it difficult to diagnose the disease.At neuralgia of the first branch of the trigeminal nerve I am worried about attacks of headaches, pain occurs when pressing in the eyebrow area, where the indicated branch of the nerve enters the face.
What kind of procedure is this - “cuckoo”?
“Cuckoo” is a nasal rinsing method developed by the American doctor Arthur Proetz. It is used for frontal sinusitis, ethmoiditis, and sinusitis. During the procedure, the patient lies on the couch with his head hanging and tilted at approximately 45°. A warm antiseptic solution is poured into one nostril, and through the other it is pumped out along with the pus. A “seething stream” seems to be created in the patient’s nose.
While rinsing the nose, the patient must constantly say “ku-ku,” which is how the method got its name. When pronouncing these syllables, the soft palate is pressed against the back of the throat, thereby closing the communication between the nose and throat.
Thanks to the constant flow of antiseptic and the pronunciation of the syllables “ku-ku”, negative pressure is created in the nasal cavity. Pus and other pathological contents come out of the paranasal sinuses into the nasal cavity.
Typically, rinsing continues for 10-15 minutes. It can be carried out in a clinic or hospital setting. After the procedure, it is not recommended to go outside for 30 minutes in the warm season, and for 1-2 hours in cold weather.
Possible complications of the procedure:
- sneezing due to irritation of the nasal mucosa;
- nose bleed;
- slight headache;
- burning in the nose;
- redness of the eyes.
The frontal sinuses are an integral part of the system of paranasal air cavities and perform a number of functions related to the protection of the body, the organization of normal breathing and speech. They are located in close proximity to the brain membrane, so their diseases can lead to serious complications.
Structure and functions of front cameras
The frontal sinuses, like the maxillary sinuses, in their location belong to the anterior voids, which communicate with the nose through the tortuous and long middle frontonasal passage. This anatomy predetermines much more frequent infectious diseases of the anterior cavities.
The frontal chambers are a paired organ located deep in the frontal bone.
Their size and configuration can vary markedly from person to person, but on average each frontal sinus has a volume of about 4.7 cubic centimeters. Most often, it looks like a triangle, lined inside with mucous membrane, with four walls:
- The orbital (lower) is the thinnest, most of its area is the upper wall of the orbit, with the exception of the edge adjacent to the ethmoid bone. On it there is a canal anastomosis 10-15 mm long and up to 4 mm in diameter, opening into the nasal cavity.
- The facial (front) is the thickest, represented by the outer part of the frontal bone, which has a thickness of 5 to 8 mm.
- Medullary (posterior) - consists of a thin but strong compact bone, bordered by the anterior cranial fossa and the dura mater.
- The inner (medial) divides the two chambers; in its upper part it can deviate to the left or to the right.
A newborn child does not have frontal sinuses; they begin to form only at 3-4 years of age and finally develop after puberty.
They appear at the upper inner corner of the orbit, consist of cells of the ethmoid bone, and the nasal mucosa grows into them. In parallel with this, the process of resorption of the spongy bone, which is located between the inner and outer plates of the frontal bone, occurs. In the vacated space, frontal voids are formed, which can sometimes have niches, bays and internal partitions in the lumen. The blood supply comes from the ophthalmic and maxillary arteries, and the innervation comes from the ophthalmic nerve.
The cavities are most often unequal, since the bone plate separating them is usually not located exactly in the center, sometimes it may be absent, then the person has one large cavity. In rare cases, the dividing bone is not located vertically, but horizontally, and the chambers are located one 
over the other. According to various studies, 5-15% of people have no frontal sinuses at all.
The main functions of front cameras today are:
- protecting the brain from injury and hypothermia (acting as a “buffer”);
- participation in the formation of sounds, enhancing vocal resonance;
- regulation of pressure levels in the nasal passages;
- warming and humidification of inhaled air;
- reduction in the mass of the skull during its growth.
Acute frontal sinusitis: etiology and symptoms
Since the paranasal compartments are covered inside with mucous membranes, the main disease is the inflammatory process in them. If we are talking about the frontal sinuses, then their inflammation is called frontal sinusitis. The inflammation has a wave-like course, can quickly move from the acute stage to the chronic stage and then be asymptomatic or go away without treatment.
The main cause of the disease, as a rule, is an inflammatory process in the upper respiratory tract, from where it spreads to the frontal compartments in an ascending manner.
If treatment is untimely or insufficient due to changes in the pH of the secretion, the immune barrier from the ciliated epithelium weakens, and pathogenic microflora penetrates into the chambers, covering the mucous membranes. Many doctors are of the opinion that the acid-base balance of mucus can be disrupted by drops with a vasoconstrictor effect, which are used for a long time.
The main prerequisites for the development of the disease:
- long lasting runny nose;
- colds that have been poorly treated or suffered “on your feet”;
- hypothermia of the body, in particular the legs;
- stress;
- injuries to the front of the head.
The inflammatory process is accompanied by hyperemia and swelling of the mucous membranes, resulting in increased secretion while simultaneously impeding the outflow of fluid. The supply of oxygen is sharply limited or completely stopped. Gradually increasing internal pressure is the cause of severe pain in the forehead area.
Symptoms of the disease are divided into general and local, which together give a characteristic clinical picture of acute frontal sinusitis. 
Local signs:
- complete absence or severe difficulty in nasal breathing;
- throbbing and pressing pain above the eyebrows, which intensifies when you tilt your head forward or press your hand on your forehead;
- copious purulent discharge from the nasal passages (one or both);
- secretion flowing into the oropharynx;
- Swelling may spread to the upper eyelid or the corner of the orbit of the eye.
Simultaneously with the local ones, general signs indicating intoxication of the body also increase:
- temperature rise to 37.5-39 degrees, chills are possible;
- blood reaction (increased ESR, leukocytosis);
- muscle weakness;
- diffuse headaches;
- hyperemia of the skin in the projection of the affected organ;
- aches in bones and joints;
- fatigue and drowsiness.
Diagnosis and conservative treatment of frontal sinusitis
To study the clinical picture and make the correct diagnosis, you need to contact an otolaryngologist. The ENT doctor interviews the patient, after which he performs rhinoscopy - a visual examination of the nasal cavities and paranasal sinuses in order to determine the location of pus and the condition of the mucous membranes. Palpation and percussion (tapping) help to identify pain in the anterior wall of the forehead and the corner of the eye on the affected side.
To confirm the suspected diagnosis, the patient donates blood for analysis, and also undergoes radiography (in lateral and direct projections) or computed tomography.
These methods best allow us to determine the lesion, the amount of accumulated pus, the depth and shape of the chambers, and the presence of additional partitions in them. The mucus released undergoes microbiological examination to determine the pathogen and prescribe adequate treatment.
In most cases, conservative treatment is used, including anti-inflammatory therapy, unblocking of the frontonasal canal and restoration of drainage of the cavity. The following medications are used:
- broad-spectrum antibiotics in the presence of high temperature (Klacid, Avelox, Augmentin) with subsequent correction if necessary;
- analgesics (askofen, paracetamol);
- antihistamines (claritin, suprastin);
- drugs to reduce mucous secretion through high adrenalization (sanorin, nazivin, galazolin, sinupret, naphthyzin);
- means for strengthening the walls of blood vessels (vitamin C, rutin, ascorutin).
In the absence of severe intoxication of the body, physiotherapy (laser therapy, UHF, compresses) is highly effective. A YAMIK sinus catheter is also used, which allows the chambers to be flushed with medicinal substances.
If conservative treatment is ineffective (persistence of high fever, headache, impaired nasal breathing, secretion of thick mucus or pus) for three days, as well as if pus in the cavities is detected using X-rays or computed tomography, sinus trephine puncture is prescribed. Today this is a very effective technique that provides a high level of recovery. This is a fairly simple operation that is well tolerated by patients, regardless of their age.
The essence of the operation is to penetrate the bone tissue mechanically in order to:
- removal of purulent contents;
- restoration of drainage through the connecting channel;
- reducing swelling of the membranes;
- suppression of pathogens that cause inflammation.
To carry out surgical intervention, a hand drill no more than 10 mm long with a penetration depth limiter and a set of plastic or metal cannulas for rinsing are used.
When determining the optimal entry point, special calculations are used, which are confirmed by x-rays in different projections.
Trepanopuncture is performed in the inpatient department of the hospital, and local infiltration anesthesia (ledocaine, novocaine) is mainly used. Using a drill, a hole is made in the thick anterior wall of the bone, through which the entire organ is probed. A special cannula is inserted and secured into the hole, through which medications are administered over the next few days. In addition, the sinus and connecting canal are washed with antiseptic solutions, followed by the evacuation of blood clots, polyps, cystic formations, and granulation tissue.
Less commonly, otolaryngologists use the method of punching the bone with a chisel. The resulting vibration is contraindicated for:
- meningitis;
- abscesses;
- osteomyelitis of the cranial bones;
- thrombophlebitis.
There is also a technique that is widely used in practice for puncturing the lower wall of the cavity, which is much thinner than the front, with a sharpened special needle. In this case, a thin subclavian catheter is inserted into the lumen of the needle, which is fixed to the skin after the needle is removed and serves as a passage for washing and delivering medications into the chamber. However, this operation is considered less preferable and more difficult due to the presence of the orbit in close proximity.
Due to the location of the meninges near the lesion, delaying contact with a doctor or attempting self-medication can lead to serious consequences, including death. Complications of frontal sinusitis can include diseases such as purulent inflammation of the orbit, meningitis, osteomyelitis of the cranial bones, etc.
Traditional methods of treatment and prevention of frontal sinusitis
Traditional recipes are mainly aimed at reducing swelling and removing mucus; their use should be coordinated with your doctor:
- Boil bay leaves (5-10 pcs.) in a saucepan, transfer to low heat and breathe, covered with a towel, for five minutes. Repeat for several days in a row, this promotes the outflow of pus.
- A teaspoon of salt, a little baking soda and three drops of tea tree oil are mixed in a glass of warm water. Clean your nose, then, tilting your head forward, use a small syringe to pour the solution under pressure into one nostril so that it flows out of the other. Repeat 2-3 times a day, then apply drops for a runny nose.
Prevention of the disease is as follows:
- timely treatment of rhinitis and sinusitis; if the runny nose does not go away within three days, you should contact the clinic;
- strengthening the immune system through hardening and physical exercise;
- vitamin therapy in autumn and spring;
- control of cleanliness of the nose and free nasal breathing.
Sources: medscape.com,
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