Symptoms, differences, treatment of sinusitis and sinusitis. Frontit. Causes, symptoms and signs, diagnosis and treatment of the disease. Methods of treating frontal sinusitis: traditional methods, medicines, antibiotics. Types of frontal sinusitis: right-sided, left-sided, catarrhal

You caught a cold, were treated for the required time, but did not receive proper relief. You are tormented by headaches that become stronger when bending forward and the slightest effort, there is pounding and throbbing in your temples, it is very difficult to think, the temperature rises, and the discharge from the nose has become unpleasant, purulent, with disgusting smell. All this may indicate the development of inflammation of the frontal sinuses.

The bones of the human skull have a porous structure and are equipped with several sinuses, which are lined with mucous membrane on the inside. This is intended by nature for a reason, but in order to perform protective functions, trapping mechanical particles and various microorganisms that can become pathogens of various diseases. However, when immunity declines, the body’s resistance decreases and microorganisms easily enter the human body.

Since the nasal and frontal sinuses communicate with, when severe inflammation develops, pathogens penetrate them and become the cause of development, or provoke inflammation of the frontal sinuses - frontal sinusitis.

Hypothermia, strong and improper frequent blowing of the nose, lack of treatment for the underlying disease or stopping it prematurely, the use of inappropriate medications and non-compliance with a full treatment regimen (neglect) contribute to the spread of infection. medical recommendations about the need surgical intervention, leaving for work before full recovery and so on).

Signs of the disease

Frontitis provokes abundant mucous or mucous purulent discharge from the nose, since this disease usually involves and, severe discomfort, headache, which may be accompanied by spasms when trying to blow the nose or with a sudden change in body position, especially when bending over.

Patients complain of a feeling of heaviness in the head, throbbing pain in the area of ​​the frontal sinuses, which can radiate to the temples. If the disease is started, it can quickly become complicated and cause very dangerous condition- meningitis, or inflammation of the meninges. This is due to the fact that the bones of the facial part of the skull are thin and porous, they have a number of cavities and channels through which the infection can penetrate into the brain and other vital organs.

Outside in the area of ​​the frontal sinuses, areas of swelling and slight redness may appear, which may be greater on the more inflamed and “clogged” side. Swelling may affect the orbital part and the corner of the eye, which is located closer to the source of infection.

As the disease develops, the patient experiences severe weakness, chills, and increased pain.

The presence of pus in the frontal sinuses is due to infection, mainly of a bacterial nature.Since the canal connecting the sinuses with the nasopharynx is very narrow and tortuous, severe inflammation of the mucous membranes can actually “clog” the frontal sinuses and interfere with the free release of purulent contents. The patient's situation is aggravated by the presence of different origins - hereditary or acquired as a result of injury.

Diagnosis of pathology

External manifestations of the disease can be noticeable to the naked eye (puffiness of the face, local swelling and redness of the skin with “swimming” of the eye from the side of the more inflamed sinus). Also, inflammation of the frontal sinuses in an acute state is quite easily determined by palpation and tapping - the patient winces from touch, percussion causes increased pain, as does finger pressure on the forehead.

Anterior rhinoscopy demonstrates the presence of copious purulent discharge, severe hyperemia of the mucous membranes, their swelling and thickening.More accurate and full information X-rays in frontal and lateral projections, as well as computed tomography, provide information about the condition of the sinuses.

Obtaining data helps to better assess the patient’s condition and take correct solution about the type of treatment required.

A blood test allows you to see an acute inflammatory process, which is manifested by leukocytosis, a shift in the blood count to the left and an increase in ESR. If the collected data is insufficient to obtain an accurate diagnosis, a diagnostic trephine puncture of the frontal sinuses may be prescribed.

Types of medications and their use

In uncomplicated cases of the disease, conservative treatment is usually used using several types of treatments and a variety of drugs.

To reduce swelling and reduce mucus formation, so-called high adrenalization of the mucous membranes is performed. To do this, they are often and generously lubricated or irrigated with the following drugs: Galazolin, Ephedrine or Adrenaline. Adrenaline-based drugs are also prescribed for instillation into the nose. As a result of their use, the thickness and looseness of the mucous membrane of the nose and sinuses decreases, a huge amount of mucus stops being produced and the patient feels relief from his condition.

A whole range of drugs is prescribed internally to the patient:

• Broad-spectrum antibiotics, especially during development purulent infection, for example, Claforan, Klacid and others.
• Analgesics that help reduce pain if there is inflammatory process.
• Antihistamines that alleviate the patient’s general condition (Tavegil, Suprastin, Claritin and others).

For frontal sinuses, warming and other physiotherapeutic procedures, for example, warm ones on the frontal sinus area, UHF sessions, laser and infrared therapy, are very helpful. Only a doctor prescribes such manipulations and only if they cannot worsen a person’s condition.

More information about frontitis can be found in the video:

If all conservative efforts do not produce results, and drug treatment does not bring relief, then the doctor recommends trepanopuncture, that is, of the frontal sinus in order to cleanse it of its contents and cure sinusitis.

When diagnosing frontal sinusitis in a pregnant woman, only a specialist can make a decision on drug treatment. He evaluates possible risks both for the health of the pregnant woman and for the development of the fetus. Based on his conclusions, he makes a decision. In most cases, treatment of frontal sinusitis in pregnant women comes down to rinsing the nasal cavity and warming it up, as well as using some harmless physiotherapeutic procedures. In rare cases, a puncture is prescribed

Recipes for nasal rinsing

The presence of a large amount of contents in the sinuses and nasal cavity creates serious discomfort for the patient and interferes with normal breathing, and this, in turn, causes a lack of oxygen, increased headaches and worsening of already poor health.

In order to remove mucous and purulent discharge and reduce inflammation of the frontal sinuses, the following is used:

• The solution most often used for rinsing is sea ​​salt. It has several advantages: salt promotes quick withdrawal swelling, disinfects well and soaks possible crusts of dried pus, relieves pain and has antimicrobial effect due to the content of iodine and other healing trace elements. After such rinsing, the patient feels much better, his nose is freed and air flows freely. In addition, this procedure helps reduce headaches due to decreased pressure in the sinuses.
• You can also rinse your sinuses with alkaline mineral water without gas. It should be warm. This water contains soda, which has a softening effect on irritated and inflamed mucous membranes. By alkalizing nasal mucus, it helps reduce the amount of discharge and makes breathing easier.
• Rinse the nose with decoctions of various medicinal herbs. Chamomile is especially good and gentle. With its warm decoction you can quickly rinse the nasal passages, relieving inflammation and swelling of the mucous membrane and thereby simplifying the release of pus from the frontal sinuses. To prepare such a decoction, you usually take a tablespoon of dried chamomile flowers and pour a glass of boiling water. You need to leave for about an hour, then strain well and cool to a pleasant temperature.

The addition of infection and the appearance of purulent contents means the development of an acute infectious inflammatory process. You can cope with this condition only with the help of powerful ones.

If possible, it is highly advisable to conduct a sensitivity test to determine which group of bacteria caused the inflammatory process. In this case, it will be much easier to choose the ideal antibacterial drug, whose action will specifically “hit” the bacteria that cause the disease.However, such a study often takes too much time, and if the patient is unwell, it is contraindicated to hesitate.

Therefore, in acute frontal sinusitis, strong antibiotics are most often used. general action Claforan type.

The duration of treatment and dosage, as well as the drug itself, are chosen by the attending physician. It is very risky to interfere with the treatment regimen he has adopted, since an advanced disease becomes chronic and can threaten with numerous dangerous ones.

Folk recipes

Among the people, inflammation of the frontal sinuses is often treated with heating:

• To do this, you can use the usual chicken egg, hard-boiled. It is first wrapped in cotton cloth and applied to the affected area. As the egg cools, unwrap it and begin to “roll” it frontal part sinuses. This procedure is especially well received by young children. They do not regard it as a treatment, and after warming up they experience relief.
• It is also good to warm your forehead with bags of rock salt or coarse sand. They are made small and sewn from thick fabric. A heated bag is placed on the frontal sinus area and the inflammation is thoroughly warmed up. Since sand and salt retain heat well, the procedure is long and effective.

Surgery

If none of the methods of conservative and medicinal treatment has the expected effect, the doctor prescribes trephine puncture of the frontal sinus. This operation can be carried out in two ways:

• Through the frontal surface of the frontal bone.
• Through the orbital wall of the frontal sinus.

The second method is used much less frequently due to the high risk of deep perforation of the orbital socket and penetration of infection into it.

To perform this, special markings are used, which are performed using an x-ray of the skull in order to determine the thinnest area of ​​the frontal bone above the sinus. It is in this place that a special mark is placed into which the drill is placed and a hole is made. A special cannula is inserted into it, the contents of the sinus are drained and it is washed. Through the same cannula, medications are injected into the cavity. Treatment usually lasts from 3 days to a week, rarely a little longer.

Surgical treatment is combined with medication to speed up recovery and completely eliminate the source of infection.

To speed up the healing of the injury, the patient is recommended to have a high-calorie diet high in vitamins and microelements. After recovery, the patient needs to observe for some time special precaution and avoid hypothermia and colds.

Possible complications and prevention

Inflammation of the frontal sinuses is dangerous because the source of infection is located close to vital organs. And since the bones of the facial part of the skull are porous and contain many different sinuses and cavities, the penetration of pus into them can lead to very dangerous infections and the spread of infection to the ears, eyes, and mouth.

The most dangerous complication of frontal sinusitis is the occurrence of meningitis, or inflammation of the meninges. It develops very quickly and can lead to disability and even death.

When infection enters the bloodstream, another deadly threat can arise - sepsis, or blood poisoning.

If frontal sinusitis is not completely cured in time, it can become a chronic disease.

To ensure that inflammation of the frontal sinuses never gives you unpleasant moments, you need to have good health and a strong immune system. To do this, you need to play sports, harden yourself, avoid overheating and hypothermia, eat properly and balanced, preferring plant foods, take vitamins, follow a daily routine, and in case of epidemics, use individual means protection, and also avoid places where large numbers of people gather.

When the disease begins, you need to immediately consult a doctor and strictly follow all his instructions, then the disease will not have a chance, you simply will not give it the opportunity to develop and “strangle” it in the initial stages of development. Optimism and cheerfulness help to resist illness; it has been noted that cheerful and active people get colds much less often than pessimists.

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:

1. inferior (orbital)– the thinnest
2. front– the strongest and thickest
3. back– separates the sinus from the cranial fossa
4. internal, aka partition– divides the cavity into right and left halves

The frontal sinus (like the other sinuses) is lined from the inside with 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

Infection

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

Nasal polyps

Injuries to the nose and paranasal sinuses

Deviation of the nasal septum and hypertrophy of the nasal turbinates

Foreign bodies

Symptoms and signs of frontal sinusitis

Acute frontal sinusitis

• 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

The symptoms of chronic frontal sinusitis are somewhat less pronounced than acute ones:

• aching or pressing pain in the area of ​​the frontal sinus, which intensifies when tapping
• when pressed sharp pain in inner corner eyes
• profuse purulent discharge from the nose in the morning with an unpleasant odor
• a large number of purulent sputum in the morning

Diagnosis of frontal sinusitis

Types of frontal sinusitis

Classification according to the form of the inflammatory process

Treatment of frontal sinusitis

Traditional methods of treating frontal sinusitis

There is an indication that this method treatment is suitable 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

1. 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.
2. Brew chamomile flowers, add a few drops of essential oil to the hot broth tea tree or eucalyptus. Breathe steam over the mixture.
3. 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.
4. Grind 4 cloves of garlic, add half a glass 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 more hot water as it cools.
5. 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

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.

1. 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 product kills bacteria, helps relieve inflammation and improve local immunity. Not suitable for frontal sinusitis caused by an allergic reaction.


2. 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.


3. Prepare a decoction of chamomile flowers, it is a strong antiseptic and antimicrobial agent. Cool, strain and use for rinsing every two hours.


4. Dissolve a tablespoon of chlorophyllipt alcohol solution in half a liter of warm boiled water. He has antibacterial effect and fights even those microorganisms that have developed resistance to antibiotics. The solution is used for washing 3-4 times a day.


5. 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

1. Take black radish, peel and grate. Squeeze the juice and use for instillation 3-4 times a day. The juice contains a large amount essential oils and helps cleanse the sinuses of mucus.


2. 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.


3. 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.


4. 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 dark place. The product helps fight inflammation and soothes the nasal mucosa. Do not use when allergic rhinitis.


5. 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.


6. 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

1. 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.


2. In a water bath, melt crushed laundry soap (1/2 piece), a teaspoon at a time 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.


3. 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.


4. 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.

For these purposes, medical White clay. 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

1. 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.
2. 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.
3. 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?

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 collateral 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 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?

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 fight infection without antibiotics is also used sulfa drugs Sulfadimezin, Norsulfazol, Etazol.

To reduce headaches, the following are prescribed: Analgin, Amidopyrine, Nurofen.

Physiotherapeutic procedures

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?

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 for precise definition puncture sites 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

• 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 Possible blood poisoning - sepsis

Prevention of frontal sinusitis

It is also necessary to take care of strengthening the immune system and hardening the body, avoiding hypothermia and maintaining active image life. Following these simple recommendations is the key to your health.

What is the difference between frontal sinusitis, sinusitis, ethmoiditis, sphenoiditis, sinusitis?

At neuralgia of the first branch 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”?

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.

Frontitis is an inflammatory process that affects the mucous membrane of the frontal sinus. Although it occurs less frequently than ethmoiditis, it is more severe, with severe headache and intoxication. With frontal sinuses it is disrupted general health, purulent discharge forms, without treatment there is a high risk of serious complications.

If you do not consult a doctor in a timely manner and undergo an examination, there is a high probability of transformation acute form into chronic. Inflammation of the frontal sinuses of the chronic type is fraught with many dangerous complications and can even be fatal.

Frontit: what is it?

Frontal sinusitis is an inflammation of the mucous membrane of the frontal sinuses, which are the paranasal sinuses. The formation of inflammation occurs in the mucous membrane, which is located in the frontal sinus. This disease has another name – frontal sinusitis. Of all the types, it has the most severe form currents.

ICD code:

• ICD-10: J01.1
• ICD-9: 461.1

The development of frontal sinusitis begins as an acute process due to a viral or microbial infection, or as inflammation as a result of injury to the frontonasal canal and frontal bone.

Types of disease

By localization:

• Left-handed
• Right-handed
• Bilateral

With the flow:

• Acute frontal sinusitis
• Chronic frontal sinusitis

By form:

Exudative:

• Catarrhal sinusitis;
• Purulent frontal sinusitis

Productive frontitis:

• Polypous, cystic
• Parietal-hyperplastic

By etiology:

• Allergic
• Traumatic
• Viral frontal sinusitis (influenza, measles, adenoviruses, etc.),
• Bacterial (staphylococcus, streptococcus, hemophilus influenzae, other microbial flora),
• Fungal
• Mixed
• Medication.

Causes

With frontal sinusitis, inflammation of the mucous membrane that lines the sinus occurs. The reasons can be varied, often depending on the form and severity of the disease.

There are the most common causes of the formation of this pathology:

• Long-term infectious or allergic nature.
• Congenital or acquired curvature of the nasal septum.
• A source of infection formed due to infection with staphylococci, streptococci and other bacteria.
• Allergic reaction - bronchial asthma and contribute to the formation of edema of the mucous membrane. The result of this process is the closure of the hole, which facilitates the entry of fluid from the frontal sinus.
• Nasal polyps.
• Foreign bodies.

The most common causative agents of viral frontal sinusitis are:

• adenoviruses
• coronaviruses
• rhinoviruses
• respiratory syncytial viruses

Symptoms of frontal sinusitis in adults

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: acute and chronic. Each of them has its own characteristics and characteristics.

Photo of frontal sinusitis on an x-ray

The first signs of the condition general arise as a result of disturbances in blood flow in the human body or intoxication of his body. Common signs include:

• pain in the forehead, sometimes in the eyes, temples, most often manifested in the morning;
• difficulty breathing through the nose;
• nasal discharge, often with an unpleasant odor, clear in the initial stages, then purulent;
• morning expectoration of sputum.

Acute frontal sinusitis

Pathogenic microorganisms multiply in the nasal cavity and frontal sinuses. In acute cases, the inflammatory process is localized in the mucous membrane, goes away on its own or in the process of adequate treatment after 10-14 days.

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

Just because the symptoms have become weaker does not mean that there has been an improvement. On the contrary, chronic frontal sinusitis can lead to serious consequences and life-threatening complications.

Chronic frontal sinusitis

In the chronic form of sinusitis, only one sinus is affected. Deformation processes caused by the pressure of pathogenic contents may be observed in the nasal cavity. When the disease becomes chronic, the clinical picture is much less pronounced. Symptoms may appear and then disappear.

Highlight following signs Chronic frontal sinusitis:

• decreased sense of smell, sometimes the patient cannot recognize odors at all;
• conjunctivitis;
• There may be no nasal discharge;
• in the morning, the eyelids are slightly swollen, which indicates the spread of inflammation to the walls of the eye sockets;
• persistent cough, which cannot be stopped with any antitussives or expectorants;
• severe weakness that prevents you from performing normal household chores;
• With chronic frontal sinusitis, polyps and neoplasms grow in the nasal cavity, which cause breathing problems.

IN medical practice frontal sinusitis without nasal discharge refers to chronic type diseases.

Complications

Complications of frontal sinusitis that occur in both acute and chronic processes can be dangerous.

These include:

• transfer of infection to the bone walls of the sinus, necrosis and formation of a fistula with the release of fluid,
• transfer of infection to the orbital area with the formation of abscesses and phlegmon,
• transition of inflammation to the posterior wall with the formation of a brain abscess or meningitis,
• sepsis.

Lack of optimal treatment leads to partial or complete loss of smell. The inflammatory process can impair eye function and significantly reduce visual acuity. Granulations and polyps form within the frontal sinuses. This is fraught with the appearance of fistulas in the orbital area and disruption of the integrity of the bony septa of the sinus.

Diagnostics

Frontal sinusitis often begins without nasal discharge, so the onset of the disease can only be diagnosed by examination by an otolaryngologist. 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.

Diagnosis of frontal sinusitis includes the following methods:

• Taking anamnesis;
• X-ray of sinuses;
• Rhinoscopy;
• Ultrasound of the paranasal sinuses;
• Nasal endoscopy;
• Computed tomography (CT);
• Diaphanoscopy (transillumination);
• Thermal imaging (thermography);
• Bacteriological study of secretions from the nasal cavity;
• Cytological examination of the contents of the nasal cavity.

Treatment of frontal sinusitis

Treatment must be entrusted to a qualified medical professional. However, on initial stage You can cure frontal sinusitis on your own. In most cases, at the initial stage there is no need to take special drugs. It is enough to rinse the nasal cavity several times a day. Rinsing will clear the cavity of mucous formations. However, it is not always possible to determine frontal sinusitis at the initial stage. Few people pay attention to headaches.

How to treat acute frontal sinusitis?

To treat the acute form of frontal sinusitis, when corresponding symptoms occur, drugs are prescribed to narrow blood vessels. Basically, these are nasal sprays. They provide high-quality elimination of nasal swelling, and also restore the full outflow of the contents of the nasal sinuses. For such purposes, medications based on phenylephrine, oxymetazoline, and xylometazoline are used.

Basic principles of treatment of acute frontal sinusitis:

• Creating conditions for normal sinus drainage.
• Antibacterial and anti-inflammatory treatment.
• Increasing the body's defenses.
• Prevention of recurrent exacerbations.

How to treat chronic frontal sinusitis?

For chronic frontal sinuses, the following is carried out:

• nasal rinsing saline solutions;
• nasal sprays with steroid hormones (substances with anti-inflammatory effects). The drugs have proven their effectiveness and safety in numerous studies around the world: they are practically not absorbed into the blood and do not affect hormonal levels;
• long courses of macrolide antibiotics in low doses (drugs of the antibiotic group, the least toxic to the human body, have antimicrobial, anti-inflammatory, and immunomodulatory properties)
• Complete treatment of other inflammatory/infectious diseases;
• Find out the reasons for the development of allergies and get rid of the irritant - only in the case of the development of chronic frontal sinusitis against the background of an allergic rhinitis.

Medications

Before using any drug, be sure to consult an ENT doctor.

Antibiotics for sinusitis

If there are indications for taking antibiotics, then the drug of first choice is Amoxicillin in combination with Clavulanic acid. Preparations that contain this combination: “Augumentin”, “Amoxiclav”. If the patient is allergic to antibiotics of the penicillin group, then it is better to use -

• antibiotics of the fluoroquinolone group (for example, Ciprofloxacin),
• macrolides (Clarithromycin, Azithromycin).

Antibiotics for frontal sinusitis are prescribed for approximately 10-14 days. However, after 5 days from the start of treatment, it is necessary to evaluate the effectiveness of therapy. If significant improvement is not achieved, then it is best to prescribe a more potent antibiotic.

Anti-edema medications

Homeopathic remedies are also used in the treatment of frontal sinusitis.

• Sinupret: used to relieve inflammation, dilutes the contents of the sinuses.
• Sinuforte: relieves inflammation, promotes ventilation and opens the sinuses.
• Cinnabsin: relieves swelling, facilitates breathing and helps strengthen the immune system.

To reduce swelling of the mucous membranes, they are also prescribed antihistamines– Suprastin, Tavegil, Cetirizine.

Antipyretics are used for elevated temperature, many drugs have analgesic and anti-inflammatory effects. Medicines with paracetamol (Efferalgan and Panadol), ibuprofen (Nurofen) reduce the temperature.

Drops

To relieve swelling and improve drainage of the affected sinus, lubricate the mucous membrane under the middle turbinate with vasoconstrictors - adrenaline, ephedrine, naphazoline, xylometazoline. For the same purpose, instillation of drops with a similar effect is prescribed 3 to 4 times a day. These are the well-known drugs Naphthyzin, Sanorin, Galazolin, Nazivin, Nazol and others.

Physiotherapy

UHF therapy

Treatment with an electromagnetic field with a wavelength of 1–10 nm. The plates are applied to the area of ​​the frontal sinuses. The UHF field produces heat, reduces swelling, and activates regeneration processes.

Cuckoo method

It involves inserting a thin tube into one nasal passage through which special diluting and antibacterial drugs. Another tube is inserted into the second passage to pump out purulent mucus. Sinus rinsing is carried out using solutions such as Chlorophyllipt and Furacillin.

Rinsing for inflammation of the frontal sinuses, carried out at home, is less effective compared to similar procedures in a medical facility. But, nevertheless, you should not refuse them.

Washing of the nasal passages is carried out:

• Saline solution. To prepare it, you need to dilute a small spoon of salt in a glass. warm water. For acute frontal sinusitis, it is recommended to add 3-5 drops of tea tree ether to this solution.
• Decoctions of herbs - calendula, sage, chamomile flowers.

Puncture

Often, a puncture for frontal sinusitis is used if treatment with medications does not help. Also, when the disease is accompanied by headaches, there is a pathological cavity in the tissues and suppuration. Initially, an x-ray must be taken to determine the puncture site. The procedure can be performed through the nose or forehead under local anesthesia.

With an uncomplicated course, the prognosis is favorable, possibly complete cure, in advanced cases, a transition to a chronic course with periods of exacerbation is possible.

Folk remedies for frontal sinusitis

It is not always possible to completely cure frontal sinusitis using traditional methods; however, it is possible to significantly speed up the healing process at home by additionally using medications.

1. Dissolve in 500 ml. warm boiled water, a tablespoon of alcohol solution of chlorophyllipt. 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.
2. Take equal amounts of aloe juice, onion juice, honey, cyclamen root juice, Vishnevsky ointment. Mix everything well and keep in the refrigerator in a sealed jar. Before use, steam until the temperature reaches thirty-seven degrees. Apply the ointment to cotton wool and inject it into both nasal passages for half an hour. Course 3 weeks.
3. Frontal sinusitis can be treated with the plant cyclomen.. The juice of this plant is diluted with boiled water in a ratio of 4:1, the solution is dripped three times a day, two drops each.
4. Rosehip decoction(2 tablespoons per glass of water, boil for 10 minutes, steep for 20 minutes), add viburnum juice or raspberry syrup/jam to regular tea. You can make the following mixture with general strengthening effect– take 3 walnuts, hazelnuts and cashews per glass of honey, leave for 24 hours and consume half a teaspoon three times a day.
5. Bay leaf . Throw a few leaves into boiling water, simmer for 10 minutes, and then breathe over the steam. Perform the procedure in the morning, and in the evening you can leave the same decoction, warm it up and breathe again.

Prevention

High-quality prevention of frontal sinusitis in people involves treatment of the primary disease. It has great importance general strengthening immune system, involving hardening and water procedures, eating vitamins, as well as fresh fruits and vegetables.

The main goal of preventing frontal sinusitis is to increase the body's protective properties, treat viral diseases, and regularly visit an otolaryngologist.

People quite often suffer from inflammatory processes in the nasal cavity caused by viral, bacterial or even fungal activity. Usually the situation does not go further than a runny nose. However, unfavorable circumstances and some factors (such as hypothermia) contribute to the development of complications - for example, the paranasal sinuses are affected and some type of sinusitis develops.

Most often, inflammation occurs in the maxillary and frontal sinuses, resulting in sinusitis and sinusitis. We need to talk in more detail about how these diseases manifest themselves, how they differ and what should be done if there is suspicion of their development.

For proper treatment, it is important to distinguish sinusitis from frontal sinusitis.

Statistics say that approximately 20 percent of all diseases from which the modern population suffers are represented by sinusitis.

Frontal sinusitis and sinusitis occur among them in 4 and 12 percent of cases, respectively.

The symptoms of these ailments are largely the same:

• feeling unwell;
• lack of concentration;
• swelling of the face (specifically, cheeks);
• deterioration of sense of smell;
• development of fever;
• painful sensations radiating from front and back;
• cracks near the nasal passages;
• presence of nasal discharge.

How does one of these inflammations differ from the other? With an inflammatory process in the maxillary sinuses:

• at night, mucus accumulates in the nasopharynx;
• nasal passages are blocked;
• rhinitis develops;
• the upper jaw hurts, as well as the upper side of the cheeks;
• V oral cavity feels dry;
• When breathing, an unpleasant odor is emitted.

If the frontal sinuses are inflamed:

• In the area of ​​the eyebrows, as well as in the lower part of the forehead, pain is felt that is paroxysmal in nature.
• When a person stands, yellow-green mucus is intensely released from the nose. When he lies down, he suffers from a slight runny nose.
• Lacrimation develops.
• The eyes react painfully to light.
• The upper eyelids become red and swollen.

You should not make a diagnosis yourself - this is the prerogative of a qualified otolaryngologist. But observing the above signs, you can suspect that you are developing one (or two) of these inflammations, after which you need to see a doctor.

Possibility of complications

Both frontal sinusitis and sinusitis most often begin due to negative impact viruses or pathogenic bacteria.

Usually the inflammatory process begins after a common cold or any other acute respiratory viral infection. However, it cannot be ruled out as a stimulating factor. allergic reactions, injured frontal sinuses, caries ( incorrect treatment teeth) and measles.

Moreover, the matter may not stop with inflammation of the maxillary and frontal sinuses. Often the disease is complicated by damage to the visual organs, auditory tubes and even the brain.

Diagnostics

To begin treatment of the diseases described, they must first be diagnosed based on the existing symptoms.

The doctor sees the general clinical picture after examining the patient, and, in addition, may prescribe additional examinations:

• Blood analysis– in order to determine the culprit of the disease, the leukocyte formula is studied. This will make it possible to understand, for example, what the nature of the inflammatory process is: if it is bacterial, then it needs to be treated with antibiotics.
• X-ray– helps to determine the affected area (in the picture it is a darkened area).
• CT scan– quite accurately determines where exactly the infection is localized, allowing the doctor to get acquainted with the anatomical specifics of the sinuses.

Be prepared to also undergo rhinoscopy, thermography, ultrasound, punctures and some other research options.

Allergy tests help diagnose the disease in cases where its source is an allergy.

Treatment process

The treatment of sinusitis and frontal sinusitis must be approached with all responsibility. Sinusitis usually does not go away on its own. The treatment course is prescribed by a doctor, and not independently.

Conservative therapeutic methods usually involve:

• washing;
• taking antibacterial agents;
• undergoing physiotherapeutic procedures;
• relief from symptoms;
• antihistamines.

However, sometimes these methods are not as effective as we would like. In such a case, techniques that are considered more radical are used:

• Classic maxillary sinusotomy– involves the use of anesthesia, since open access to those sinuses that are inflamed is necessary. The main disadvantage of this procedure is long recovery, swelling and the likelihood of damage to healthy tissue.
• Laser maxillary sinusotomy- in essence, a classic operation, in which, however, there is less likelihood of tissue trauma. And it doesn’t take that long to recover.
• Endoscopic maxillary sinusotomy– the presented method is considered optimal. The mucous membranes are practically not injured, recovery occurs relatively quickly, swelling is not pronounced, and general anesthesia is not needed. The procedure is usually carried out in outpatient setting.

When treating frontal sinusitis, first of all, they strive to eliminate the cause of the inflammatory process and normalize air exchange, the location of which is the frontal sinuses.

If the course of the disease is not complicated by anything, vasoconstrictors and antiallergic drugs are needed. Physiotherapy and antibiotic medications can also help (only if, of course, the bacterial nature of the disease is confirmed).

But if nothing meaningful can be achieved by all these methods, rinsing will be required.

Purulent inflammation can be treated through surgery. Most often they resort to trepanopuncture, which is performed using local anesthesia. Before this procedure is performed, an X-ray with contrast is taken (this allows you to determine which points can serve as the best access to the affected areas).

To carry out drainage, make an appropriate hole (for this purpose, a long needle with adjustable dimensions is used). Then a plastic guide must be inserted into the puncture to guide the cannula into the frontal sinus. The cannula is fixed with adhesive tape and left for several days (but no more than five, so that the tissue then quickly recovers).

True, treatment of frontal sinusitis and sinusitis through trephine puncture is contraindicated for those who suffer from meningitis, thrombophlebitis, cranial osteomyelitis or suffer from purulent abscesses. In general, there may be other contraindications - this is decided by the doctor.

Main differences

Naturally, the symptoms of sinusitis and sinusitis differ in many ways. Even the localization of inflammation is different:

• Sinusitis affects the upper jaws and the area below the eyes.
• With frontal sinusitis, damage occurs to any of the sinuses, the location of which is the frontal region.

But the differences associated with immediate symptoms:

• Nature of pain. With frontal inflammation, the forehead and just above the bridge of the nose hurt the most. Unilateral character implies dominance of pain on one side. In the case of inflamed maxillary sinuses The cheekbones and sides of the nose hurt, and subsequently the pain goes to the temple. Inflammation of the frontal sinuses involves pain with any movement of the head. If the maxillary sinuses are inflamed, a feeling of heaviness appears as soon as you tilt your head.
• Nasal discharge. In the case of frontal sinusitis, the nose is initially stuffy (due to swelling) and, therefore, there is no mucus secretion, but sinusitis involves transparent mucus at the very beginning and it acquires a yellowish tint later (as pus accumulates).
• External swelling. If a person has frontal sinusitis, the upper eyelid, forehead and area above the eyebrows swell. Maxillary inflammation is associated with swelling of the lower eyelid and the area below the eyes.

If you study the symptoms of sinusitis, you should know that pain due to sinusitis is often confused with dental pain (as a result of which they mistakenly go to the dentist), but frontal sinusitis can at first be confused with a regular migraine.

What is the difference between these diseases? When the frontal sinuses become inflamed:

• Photophobia develops, that is, it is difficult to look at any light source. The fact is that the eyeballs are located close to the frontal sinus.
• A nagging pain appears, all you have to do is tap your forehead a little with your knuckles.
• The pain becomes stronger if you press on the area above the eyebrows.

Symptoms frontal sinusitis may differ from frontal sinusitis and other types of sinusitis as follows:

• The pain becomes more intense if you tilt your head or turn your torso.
• The voice changes and becomes nasal.
• The transition of the inflammatory process to the area of ​​the ethmoid sinuses negatively affects appetite.

But it is important not to get confused, because maxillary inflammation can cause periodontal disease, caries, incorrectly placed fillings and other dental problems.

In general, the doctor must find out the original cause by examining the patient and, if necessary, familiarizing himself with the results of the examinations.

Similarity of symptoms

It also needs to be said about the similarity of the symptoms of frontal sinusitis and sinusitis (as a result of which an accurate diagnosis is needed before starting treatment).

• Constriction of blood vessels and the development of swelling, due to which purulent secretion cannot escape and accumulates, nerve endings become irritated, and the cavities burst.
• The active proliferation of bacteria is associated with intense intoxication, as a result of which the temperature rises, appetite decreases, lethargy and migraines appear. If the course of the disease is mild, the intoxication syndrome is not particularly pronounced, and it can be mistaken for a common ailment.
• Breathing is difficult and mucus is produced. Ventilation is poor, which gives rise to a host of other problems.

Which disease is worse?

Which of the described diseases is worse? The course of frontal sinusitis is considered more severe, since pus accumulates in the frontal sinuses and practically does not come out. The likelihood of complications associated with damage to parts of the brain increases.

But these diseases are treated approximately the same:

• physiotherapy;
• warming up;
• punctures and so on.

Can symptoms of frontal sinusitis and sinusitis be observed in a patient at the same time? Quite. Combined inflammation of the maxillary and frontal sinuses directly leads to the development of the inflammatory process in the frontal sinus. Accordingly, coping with this problem will be much more difficult.

Neglected diseases are high probability complications that are dangerous not only to health, but also to life. The following may suffer from this:

• respiratory organs;
• gastrointestinal system;
• brain and visual organs.

So, when you get sick, you should not think that “everything will work out on its own” - by thinking this way, you are entering the road leading to negative results.

In addition, it should be taken into account that these diseases are very prone to relapse, that is, they easily develop again soon after recovery if the rules for their prevention are not followed.

Prevention

Separately, we should talk about the prevention of all types of sinusitis, including sinusitis or sinusitis. Of course, it is better to prevent the disease or stop it at the first stage than to subsequently waste time and energy fighting it.

Here are a few rules, the observance of which reduces the likelihood of developing the described ailments:

• Don’t get too cold: dress warmly if it gets cold, don’t sit in drafts.
• Maintain a normal rest and work schedule. Sleep at least 8 hours every day.
• Exercise regularly, but do not overexert yourself.
• Breathe fresh air more often.

As soon as the first suspicion of any of these inflammations appears, immediately contact an otolaryngologist so that he can accurately diagnose and prescribe suitable treatment. In this case, the likelihood of subsequent complications is significantly reduced.

Frontitis is an infectious-inflammatory process localized in the frontal sinuses. Although it occurs less frequently than sinusitis and ethmoiditis, it is more severe, with severe headache and intoxication. Treatment presents certain difficulties, since puncture of the frontal sinus using intranasal access is often impossible due to the complex connection of the frontal sinus with the nasal cavity.

How does frontal sinusitis occur?

The frontal (frontal) sinus is a paired cavity located in the frontal bone directly above the orbit. At the back, the frontal sinus borders the anterior cranial fossa, in which the frontal lobes of the brain are located. The volume of each sinus in adults is about 4 ml.

Like other paranasal sinuses, the frontal sinus performs the function of warming the inhaled air, a resonator function (forms the timbre of the voice). Approximately 10% of the population has no frontal sinuses (both or one). They are also underdeveloped in children under 6 years of age, so frontal sinusitis practically does not occur in preschool children.

Normally, the frontal sinuses constantly cleanse themselves due to the functioning of ciliated epithelium mucous membrane, mucus exits them into the nasal cavity through the frontonasal canal 1.5-2.5 cm long.

The first most common cause of frontal sinusitis is an infection that comes from the nose during a runny nose or flu. Less commonly, the pathogen enters the sinuses from the bloodstream when infectious diseases. There is also post-traumatic frontal sinusitis.

Once in the sinus, microbes find favorable conditions there for further reproduction (warmth, humidity). In response to infection, the mucous membrane responds with increased mucus production, and mucous or catarrhal inflammation occurs. If the drainage from the sinus occurs normally, it may go away on its own.

But when certain conditions are combined, the outflow of pathological secretions is disrupted, pus accumulates in the sinus, large cluster pus presses on the walls of the sinus and symptoms of frontal sinusitis occur. What are these conditions??

• Decreased general and local protection (frequent respiratory infections, severe chronic somatic diseases)
• Persistent runny nose.
• Improperly treated runny nose.
• Anatomical anomalies that obstruct the outflow from the frontonasal passage (overgrown, hypertrophied turbinate, deformation of the nasal septum, polypous growths)
• Allergic swelling of the nasal mucosa.

Frontitis is often combined with others, mainly with and .

According to the type of inflammation, frontal sinusitis can be catarrhal and purulent.

Frontitis can be acute and chronic. In acute cases, the inflammatory process is localized in the mucous membrane, goes away on its own or in the process of adequate treatment after 10-14 days.

Chronic frontal sinusitis develops with inadequate treatment, prolonged course, when pathological process passes to the submucosal layer, periosteum and bone. Such an inflammatory process is very difficult to cure with conservative methods.

Symptoms of sinusitis

At chronic course signs of the disease may be somewhat erased, the headache is not as pronounced as in an acute process, it does not appear constantly, there is no fever. Therefore, chronic frontal sinusitis cannot always be diagnosed immediately; sometimes patients are treated by neurologists with trigeminal neuralgia or other pathology.

At severe course frontal sinusitis possible complications:

• Spread of purulent inflammation to the orbit with the development of phlegmon, thrombosis of the retinal arteries.
• When the posterior wall of the frontal sinus melts, intracranial complications occur in the form of purulent brain abscess.

• Melting of the anterior wall of the sinus with the formation of a fistula of the frontal bone.
• Sepsis.

Diagnosis of frontal sinusitis

The diagnosis of frontal sinusitis is established on the basis of:

This is usually enough to make a diagnosis. In doubtful cases, CT or MRI of the sinuses, endoscopic examination, culture of purulent discharge are performed to determine the pathogen and correct purpose antibiotics.

Diagnosis of acute frontal sinusitis usually does not cause difficulties. It is more difficult with the chronic course of the disease. With him there is no such bright clinical picture and a clear connection with the common cold. It must be remembered that for any headaches in the forehead, it is necessary to exclude frontal sinusitis.

Treatment of frontal sinusitis

Basic principles of treatment of acute frontal sinusitis:

• Creating conditions for normal sinus drainage.
• Antibacterial and anti-inflammatory treatment.
• Increasing the body's defenses.
• Prevention of recurrent exacerbations.

Treatment of acute frontal sinusitis is mainly conservative. In severe cases, hospitalization is necessary. During periods of rising temperature it is advisable bed rest within a few days. For mild to moderate severity, it is possible to treat frontal sinusitis at home under regular medical supervision.

Restoring the normal outflow of sinus contents is the main goal of treatment. If this can be done at the very beginning of the disease, cure is possible without the use of antibiotics.

To relieve swelling and improve drainage of the affected sinus, lubricate the mucous membrane under the middle turbinate with vasoconstrictors - adrenaline, ephedrine, naphazoline, xylometazoline. For the same purpose, instillation of drops with a similar effect is prescribed 3 to 4 times a day. These are drugs known to everyone Naphthyzin, Sanorin, Galazolin, Nazivin, Nazol and others.

Drops should be instilled with your head tilted towards the diseased sinus, or even better, with your head down. You can also use - Rinofluimucil(vasoconstrictor phenylephrine and acetylcysteine, which thins viscous mucus), Polydexa(antibiotics polymyxin and neomycin + phenylephrine + hormone dexamethasone). Good effect has a preparation containing cyclamen extract – Sinuforte.

When it comes into contact with the mucous membrane, it causes reflex irritation of the mucous glands and copious secretion of mucus, due to which the viscous inflammatory secretion liquefies and comes out more easily.

When adequate drainage of the sinus is achieved and in the absence of symptoms of intoxication, physiotherapy is prescribed - UHF, warm compresses, endonasal FU and laser therapy.

Anti-inflammatory treatment is used both general and local. 5-10 minutes after the start of action vasoconstrictor drugs It is advisable to rinse your nose with saline solution and apply antiseptic drops Dioxidin, Miramistin, Chlorophyllipt or local antibiotics Isofra, chloramphenicol drops, spray Bioparox.

The introduction of various medications into the nasal cavity can also be carried out through inhalation through nebulize R. The nebulizer atomizes the medicine to the smallest particles. In this way, you can administer anti-inflammatory solutions, drugs that thin the mucus, and also irrigate the mucous membrane with saline solutions to cleanse and moisturize.

In cases of purulent frontal sinusitis with symptoms of intoxication, there is no need to delay the prescription of systemic antibiotics. Before treatment, it is necessary to culture the purulent discharge to identify the pathogen and determine sensitivity to antibiotics. This is done in order to prescribe the correct treatment if the antibiotic prescribed from the first days of illness does not have an effect within 3-4 days.

Antibiotics are prescribed that act on most pathogens. These are mainly aminopenicillins ( Amoxiclav, Flemoxin, Augmentin), 2nd or 3rd generation cephalosporins Cephalexin, Cefazolin, Durocef, Ceftriaxone, Cifran, macrolides Clarithromycin, Azithromycin. At mild flow and in moderate cases, antibiotics can be prescribed in tablets; in severe cases, intramuscular or intravenous administration is immediately prescribed. The duration of antibiotic therapy is 7-10 days. If within 3-4 days there is no effect from the use of an antibiotic, the drug should be changed to another, taking into account the sensitivity of the microflora according to culture data.

To reduce swelling of the mucous membranes, antihistamines are also prescribed - Suprastin, Tavegil, Cetirizine.

To liquefy the secretion accumulated in the sinus and facilitate its discharge, mucolytics are prescribed - Acetylcysteine, Fluimucil, Gelomirtol, Sinupret, Cinnabsin.

For pain relief, analgesics and non-steroidal anti-inflammatory drugs are used - Ibuklin, Nurofen, Nise.

During the period of resolution of the inflammatory process, electrophoresis is prescribed to the sinuses with calcium chloride or potassium iodide.

Hardware methods for treating frontal sinusitis

In specialized departments, non-puncture methods of sinus sanitation can be used. These are the “cuckoo” method and the method of flushing with a sinus catheter.

Cuckoo method

The cuckoo method can be used for any sinusitis. Its essence is that an antiseptic solution is poured into one half of the nose, and at the same time, the other half is sucked out along with the pathological contents of the sinuses. To prevent liquid from entering the larynx and trachea, the patient must constantly say “ku-ku”, hence the name of the method.

When performing the “cuckoo”, the head should be thrown back with a slight tilt back. Before washing, the mucous membrane is lubricated with a vasoconstrictor. Solutions of Furacillin, Chlorhexidine, Miramistin are usually used. After the procedure, you need to lie down with your head down so that all the solution comes out of your sinuses.

This procedure is not very pleasant and causes some discomfort, but most patients feel relief after the first session. For full course 6-7 procedures are required. Having a certain mood and desire, “cuckoo” can be performed at home, using a syringe for the solution and a rubber bulb for suction.

Treatment with sinus catheter “Yamik”

The use of the YAMIK sinus catheter is more comfortable than the “cuckoo” catheter. YAMIK is a system of tubes and balloons for creating controlled pressure in the nasal cavity. One balloon moves into the nasopharynx, inflates and closes the outlet of the nasal cavity, the second inflates in the vestibule of the nose and obstructs the inlet. Thus, in the nasal cavity it is created closed space, communicating with external environment using one channel (tube).

Using a syringe connected to this channel, you can create negative pressure in the nasal cavity. According to the laws of physics, contents from the paranasal sinuses rush into the rarefied air zone, which is sucked out with a syringe. The movement of the syringe piston creates pressure fluctuations, which promotes better cleansing of the sinuses.

After the pus is sucked out, an antiseptic solution is moved into the nasal cavity, which enters the sinuses. At the end of the procedure, the solution is sucked off along with the remaining discharge.

Recently, an innovative method has become known that can cure frontal sinusitis in two days. This method is called balloon sinuplasty. The essence of the method is to eliminate the block of the frontonasal canal. Under the control of an endoscope, a flexible guide catheter is inserted into it, and a special balloon is inserted along the guide. The balloon is inflated with air or filled with liquid and increases in diameter, thereby expanding the blocked anastomosis. The pathological contents come out of the sinus, the sinus is washed with an antiseptic.

The procedure is performed on an outpatient basis under local anesthesia and takes about half an hour. The effect is noticed immediately. The rehabilitation period is 1-2 days. The speed, high efficiency, and minimal trauma of such an operation make this method very attractive. But the method is new, it requires highly qualified and the doctor’s experience, is currently performed only in a few clinics in Moscow and St. Petersburg. In addition, this procedure is quite expensive; purchasing a cylinder alone will cost 60 thousand rubles.

Surgical methods for treating frontal sinusitis

If ineffective conservative treatment within 2-3 weeks, severe purulent frontal sinusitis with severe symptoms To avoid intoxication and the risk of developing complications, surgical methods are used for chronic frontal sinusitis.

Because the main objective treatment of any sinusitis - ensuring outflow and sanitation of the sinus itself, it is necessary to somehow get into this sinus. There are two ways: directly from the nasal cavity through natural communication and from the outside. Probing the frontal sinus from the nasal cavity is very difficult, since the structure of the frontonasal canal has several anatomical variations. An attempt to probe it can lead to injury to the walls of the canal, which will subsequently lead to scarring and complete obstruction.

The oldest and most frequently used to this day The surgical method for treating frontal sinusitis is trephine puncture of the frontal sinus. The operation is quite simple and can be performed in any ENT department. After an incision in the skin above the eyebrow, a hole is drilled in the frontal bone above the eyebrow using a special drill, a cannula is inserted and fixed into the hole, through which the frontal sinus is washed with antibiotic solutions for 3-7 days.

The sinus can also be punctured through the supraorbital wall. Here the thickness of the bone plate is less, and it can be pierced with a special needle.

Functional endoscopic surgery of the nose and paranasal sinuses

Despite the simplicity and accessibility of trepanopuncture, many patients are afraid and do not agree to such, in their words, a “barbaric” method. This is understandable, not everyone wants to walk around for a whole week with a hole in their forehead. Therefore, they are gaining more and more popularity functional endoscopic operations for sinusitis (FESS-surgery).

Under the control of a microendoscope, the natural anastomosis of the affected sinus is expanded, sometimes a part is removed for this purpose bone wall. Rehabilitation after such an operation takes 3-5 days. Such operations are usually paid.

If there are persistent anatomical obstacles to the natural outflow from the sinus, correction of these conditions is carried out. This can be due to deformation of the septum, trimming of a thickened nasal concha, or removal of adenoids.

Traditional methods of treating frontal sinusitis

Folk remedies for frontal sinusitis can be used in case of mild disease, only as an addition to the main treatment prescribed by the doctor. You can use compresses, inhalations, and instillation of herbal drops into the nose.

The most famous and effective folk remedies:

• Heat salt or sand in a frying pan, pour into a bag and apply to the sinuses for 5-10 minutes. Dry rice can also be used for this purpose. Before warming up, you need to instill drops that reduce swelling - Sanorin or Naphthyzin. Do not warm up the sinus area if there is an elevated body temperature and severe headache.
• Rinse your nose with a saline solution (1 teaspoon of sea or table salt per glass of water) using a rubber balloon, a syringe, or simply by sniffing it through your nostrils. A salt solution of this concentration is hypertonic and promotes the release of pathological secretions from the sinuses.
• Inhalations with a decoction of bay leaves. Boil 5-7 bay leaves in 1 liter of water, turn it off and breathe over the steam for 5-10 minutes.
• Grind Kalanchoe leaves, squeeze out the juice, dilute 1:1 with water. Drop a full pipette 3 times a day. Can be used by pregnant women. You can moisten a gauze turunda with this juice and insert it into your nose for half an hour.
• Mix freshly squeezed celandine juice with chamomile decoction 1:1. Instill or insert into the nose turundas moistened with this mixture.

• Inhalations with the addition of essential oils (mint oil, eucalyptus oil, pine oil). Drop 7-10 drops of oil or a piece of “Star” balm the size of a match head into boiling water and breathe in the steam for 5-10 minutes.
• Being in an enclosed area with high humidity (humidifiers are used for this) also helps to liquefy and remove mucus from the sinuses.
• The method gives a good effect for sinus diseases breathing exercises according to Buteyko.

Prevention of frontal sinusitis

Prevention of frontal sinusitis, as well as other sinusitis, includes:

1. Timely treatment of acute respiratory diseases. There is no need to rely on the fact that a runny nose will “go away on its own.” Active treatment of nasal congestion is necessary, and not only with vasoconstrictor drops, but also with distracting procedures (foot baths, mustard plasters, inhalations), rinsing the nasal cavity with saline solutions, and using anti-inflammatory drops and sprays.
2. Surgical correction of various anatomical defects that impede the outflow of secretions from the sinuses - removal of part of the turbinate when it is hypertrophied, removal of polyps and adenoids.
3. Hardening the body.
4. Healthy lifestyle, giving up bad habits.

Video: frontit, “About the most important thing”