How to treat sinusitis in a child at home. Sinusitis in children: symptoms and treatment. Residual effects after sinusitis. How to treat sinusitis in children at home? Puncture of the maxillary sinuses: is it really necessary?

Sinusitis is a pathology based on unilateral or bilateral inflammation of the maxillary sinus. Sinusitis in children is a common and insidious pathology. There is no point in over-diagnosis of this disease, but knowing what sinusitis in children really is, symptoms and treatment is certainly necessary in order to start treatment on time and not lead to the development of complications, for example, the development of adenoids or otitis media.

This disease most often occurs in children aged 3-6 years, and before 2 years of age, the occurrence of sinusitis is casuistic, since complete pneumatization of the sinuses (sinuses) has not yet occurred.

Causes

Sinusitis in children is usually a consequence or complication of other diseases. So, sinusitis in a child can occur due to:

• persistent cold (ARVI);
• allergic or acute rhinitis;
• tonsillitis (tonsillitis);
• infectious pathology – scarlet fever, measles;
• pathologies of the dentition and oral cavity - caries, stomatitis;
• nasal septum injuries.

Predisposing factors for the appearance include reduced immunity, underdevelopment of the nasal sinuses, a tendency to allergies in general, the spongy structure of the sinuses, a deviated nasal septum, and nasal polyps.

The immediate cause of the development of this pathology is infectious agents. Thus, in children under 2 years of age, these are most often staphylococci; at the age of 3 years, other bacteria join them; the main role is played by pneumococci, as well as streptococci and Haemophilus influenzae (influenza bacillus). In preschool children, sinusitis most often develops due to viral agents.

Pathogenesis

The maxillary sinus is a cave, the upper wall of which is the lower wall of the orbital cavity, the lower wall is the wall of the hard palate, and the inner wall is the lateral wall of the nasal cavity.

The maxillary sinuses are paired and communicate with the nasal cavity through small tubules and openings. Through these tubules and openings, the infection enters the sinus and can also spread from it, causing complications. Main function maxillary sinuses is to humidify, purify and warm the air that we inhale. If the openings or tubules are blocked, the communication between the sinus cavity and the nose is disrupted, the secretion from the sinus does not find a way out, as a result of which inflammation develops.

Classification

There are several types of sinusitis based on the reason that caused it:

• rhinogenic (due to colds and rhinitis);
• hematogenous (infection from the foci enters the sinuses through the bloodstream);
• odontogenic (due to dental diseases);
• traumatic (as a result of nasal injuries).

Symptoms of sinusitis in children

Sinusitis in children 1 year old will not have any specific differences from a runny nose, since any touch to the area near the nose can cause pain, and, as a result, the child will respond to this by screaming (crying).

Let's take a closer look at the clinical manifestations of sinusitis in children, which can clearly show where it hurts (starting from preschool age).

Early symptoms and signs of sinusitis in children will become noticeable on the seventh day of a cold. Against the background of previous recovery, a sharp deterioration in the child’s condition is observed and the following signs appear:

1. Fever (temperature rise to 39 degrees), symptoms of general intoxication.
2. Headache, most often localized in the frontal and temporal regions.
3. Nasal congestion.
4. Purulent or mucopurulent discharge from the nasal cavity.
5. Pain in the area of ​​the inflamed maxillary sinus, which becomes stronger with pressure and percussion.
6. Decreased sense of smell.
7. Loss of appetite.

Additional symptoms of acute sinusitis in children include:

• swelling in the area of ​​the cheek and lower eyelid on the affected side (if the process has spread to the area of ​​the upper jaw and orbit of the eye);
• photophobia (if there is a blockage of the nasolacrimal duct);

Sinusitis in a child can be distinguished from a common runny nose; you just need to carefully analyze his complaints:

• Nasal congestion will, as a rule, be observed on one side (as opposed to a runny nose - usually breathing is difficult on both sides);
• The presence of pain in the area of ​​the maxillary sinus will also signal sinusitis; in addition, after blowing your nose, the pain does not go away (with a normal runny nose there are no such symptoms);
• Purulent discharge in combination with high fever is a reason to urgently contact an ENT doctor.

Chronic form of sinusitis

Predisposing factors for the development of the chronic form of the disease are: hypo- and vitamin deficiency, decreased immunity, the presence of adenoids, and a deviated nasal septum.

The main symptom of this form will be persistent, constant nasal congestion in the child. All other symptoms of sinusitis in children described above become less pronounced or disappear completely.

The chronic form of sinusitis in children is divided into 3 types: catarrhal, purulent and polypous.

1. The catarrhal form is characterized by viscous and thick discharge from the nose.
2. The purulent form is characterized by a foul odor and there may be scanty purulent discharge from the nasal cavity.
3. The polypous form is characterized by the formation of polyps - outgrowths from the mucous membrane of the nasal canals. Polyps reduce the lumen of the nasal passages, as a result of which the outflow of mucus is disrupted. It is considered the most advanced form of sinusitis.

Complications and consequences of sinusitis in children

If treatment for sinusitis is not started on time or is inadequate, a number of serious complications can arise. All of them are not accidental and develop in nearby organs and tissues through infection from the maxillary sinus.

When the infection spreads to other sinuses, sinusitis of other localizations or pansinusitis may develop, meaning that in pathological process all sinuses are involved.

If the inflammatory process penetrates into neighboring tissues, an abscess (ulcer) of the periosteum may appear or even a fistulous tract of the fundus may form. oral cavity.

Due to the close location of the tonsils, chronic sinusitis can lead to the development of tonsillitis or adenoiditis (if the baby has adenoids).

Due to flow down back wall pharynx of purulent discharge, sinusitis can cause pathologies such as tracheitis, bronchitis and even pneumonia.

If the infection spreads to the eye area, an inflammatory process may occur in it, which can even cause partial loss of vision.

Sinusitis can cause diseases such as:

• myocarditis;
• arthritis;
• rheumatism.

Diagnosis of sinusitis

The diagnosis of sinusitis is established on the basis of:

• the above-described complaints from the child;
• examination by a doctor (tapping on the sinuses will cause pain);
• laboratory data: in the CBC (general blood test), leukocytosis will be observed with an increase in the percentage of band neutrophils, accelerated ESR;
• instrumental data: an X-ray of the paranasal sinuses is performed, the fluid level will be visible on the image (X-ray positive, that is white), in difficult cases uses CT or MRI;
• additional data: puncture is performed in rare cases, starting from the age of 7 years and only under local anesthesia.

Sinusitis in children treatment

The treatment of sinusitis in a child must be approached in a differentiated and comprehensive manner. So, the acute form requires treatment for 7-14 days, while the chronic form requires treatment for 3-4 weeks. The child’s regimen can be outpatient or inpatient, it all depends on the severity of the condition.

Treatment of sinusitis in children has several goals: eliminate the cause of the disease, eliminate swelling of the mucous membrane of the nasal passages, normalize the outflow of pathological secretions, eliminate the child’s symptoms that cause severe discomfort.

To solve these problems, the following drugs are used in the treatment of acute sinusitis in children:

Drops

Vasoconstrictor drops (“Nazivin”, “Vibrocil”), which reduce swelling of the mucous membrane and make breathing easier. A feature of such drops is the pronounced development of tolerance, which can result in mucosal atrophy or allergic rhinitis, so you must strictly adhere to the recommendation to use the drops for no more than one week.

Solution

Irrigation with saline or antiseptic solutions (Furacillin, Avamaris, Salin or saline solution prepared at home). The use of such solutions improves the flow of discharge from the nose, since the salt attracts water to itself, and also slightly reduces swelling.

The procedure is recommended to be carried out after preliminary instillation of vasoconstrictor drops; it is performed using a syringe small quantities. Doesn't have side effects, and therefore the required amount of time can be used.

Antibiotics

Treatment uses drugs for oral and local administration. Ideally, a culture should be carried out from the nasal discharge and cultured for sensitivity; this will allow the antibacterial agent to be used purposefully with guaranteed treatment success. However, if this is not possible, then antibiotics are prescribed empirically. wide range, namely:

penicillins:

• amoxicillin;
• amoxiclav;
• augmentin;

cephalosporins:

• (cephalexin;
• ceftriaxone;
• cefatoxime;

macrolides (as reserve drugs in case of allergies to the previous two groups):

• azithromycin;
• clarithromycin;
• doramycin.

Thus, Augmentin is given to children from 3 months to 12 years in the form of a suspension depending on the child’s weight, and to children over 12 years old 1 tablet 3 times a day.

Azithromycin is also given to children from 6 months to 12 years in the form of a suspension (10 mg per 1 kg of weight).

For local use they use bioparox and isophra. Such drugs create a high concentration of antibiotic directly at the site of the lesion and have fewer adverse reactions.

1. Antihistamines (fenistil, suprastin) are advisable for use in children, as they relieve swelling of the mucous membrane, especially if the child’s sinusitis occurs against the background of previous allergic rhinitis.
2. Antipyretics and anti-inflammatory drugs are considered symptomatic therapy and should be used for severe symptoms. So, if the child’s temperature is 38.5 degrees or higher, it must be brought down with antipyretics (for example, paracetamol). For severe pain in the sinuses, NSAIDs (for example, ibuprofen) may be prescribed.
3. Therapeutic and diagnostic puncture (puncture) is used in advanced cases. Under local anesthesia, a special needle is inserted into the sinus, and the sinus cavity is washed with an antiseptic.
4. Nasal rinsing according to Proetz. Only carried out by a doctor. The essence of the method is that a solution is poured into one nasal passage for a child lying on his side and removed from the other nasal passage using an electric aspirator. At the same time, the child must pronounce “ku-ku”: this is necessary so that the solution does not pour into the oral cavity. This procedure is absolutely painless.
5. Physiotherapy (UHF, laser therapy, magnetic therapy) helps reduce inflammation and swelling of the mucous membrane. Used during the recovery phase.

Treatment of chronic sinusitis

Since the development of the chronic form of the disease is always based on some factors, treatment should be primarily aimed at eliminating them.

So, if it is odontogenic sinusitis, treatment of the dentition is necessary; if it is polyposis, antihistamine therapy is required; if it is adenoids, their removal is necessary. For chronic sinusitis, antibacterial agents are prescribed strictly after bacterial culture of nasal contents and determination of sensitivity to AB. IN cold period(period of remission) physiotherapy and sanatorium treatment are indicated.

Treatment of sinusitis in children using traditional methods

Inhalations

You need to take 1 tsp. chamomile flowers, calendula and sage leaves and add 1 cup (250 ml) water. This mixture should be placed on the stove and brought to a boil and used as a solution for inhalation.

Propolis

It is necessary to dip 2 turundas twisted from cotton wool in propolis and insert into each nostril, leaving for 5 minutes.

Additional treatments

Such methods include acupressure and breathing exercises.

Acupressure

It is necessary to carry out acupressure clockwise for 30 seconds each in the following places: the inner corner of the eyebrow, the lower inner part of the orbit, the point between the eyebrows, the midpoint in the nasolabial fold. If movements cause pain in your child, this is normal.

Breathing exercises

It consists of breathing alternately with the left and right nostrils for 5-7 seconds, while the other nostril must be closed with your finger. Repeat this exercise 10 times.

Prevention

TO preventive measures Sinusitis in children includes the following:

• creating the correct microclimate in the children's room (ventilation, maintaining the temperature up to 22 degrees, humid air);
• hardening the child;
• timely treatment infectious diseases (viral and bacterial);
• timely sanitation of the oral cavity;
• balancing nutrition;
• dosed physical activity;
• breathing exercises when early symptoms appear.

Sinusitis in children - infectious inflammation mucous membrane of the maxillary sinus (maxillary), located above upper jaw on the sides of the nose inside the skull. The sinus has a free space covered with mucous membrane, it is separated from the maxillary teeth by a thin plate, and the sinus is connected to the nose using a thin anastomosis. It is this location of the sinus that causes the development of inflammation and the spread of infection.

Sinusitis can be cured using traditional medicine and folk remedies, it is only necessary to correctly determine the source of the disease and direct all efforts to destroy it.

What causes the pathology?

Like any disease, sinusitis in children has its own causes. The causative agents are viruses and bacteria of acute respiratory diseases.

Viruses:

1. influenza and parainfluenza;
2. coronaviruses;
3. adenoviruses;
4. respiratory syncytial virus;
5. rhinovirus;
6. metapneumovirus.

Bacteria:

1. Pneumococcus;
2. hemophilus influenzae;
3. moaxella.

In the chronic course of the disease, other pathogens are added: Klebsiella, Staphylococcus aureus, anaerobes, Streptococcus pyogenes. It is also possible for a child to develop the disease with a mixed infection: bacteria and viruses.

Caries in a child can cause the development of sinusitis

Predisposing factors

The development of sinusitis in children does not occur spontaneously, but against a background of weakened immunity, due to previous or existing diseases:

• vasomotor rhinitis;
• chronic tonsillitis;
• being in a draft;
• deviated nasal septum;
• severe hypothermia;
• hypertrophy of the nasal concha;
• trauma to the nasal mucosa;
• weak immune system;
• adenoids;
• allergic predisposition;
• caries.

If there are predisposing factors, be sure to carry out prevention. If you don’t want to take medications, turn to folk remedies.

If your child has carious teeth, be sure to treat them, even if the baby teeth are damaged (which “will then fall out and there will be no caries”). Caries is caused by infections that can penetrate through a thin plate into the sinus and cause inflammation there!

Pathogenesis of the disease

Symptoms of the disease directly depend on how the disease progresses!

The infection, entering through the nasal or oral cavity of the child, causes inflammation. The vessels in the mucous membrane fill with blood, causing nasal congestion. Due to the inflammatory response, thickening of the membrane and disruption of cell function, the amount of mucus produced increases. It cannot freely leave the sinus, as a result of which catarrhal sinusitis develops, most often caused by viruses.

The addition of bacteria causes the accumulation immune cells, during the fight against infection, pus is formed, accumulating in the free space of the sinus. Purulent sinusitis occurs. Ineffective or incorrect treatment ensures the development of chronic sinusitis.

The listed factors cause swelling and accumulation of pus, which can spread to other sinuses and lead to complications, so treatment of sinusitis in children must be carried out in a timely manner!

How does sinusitis manifest?

Signs of sinusitis in children have both features characteristic only of it and common features with other diseases.

Symptoms characteristic of sinusitis:

1. headache, intensifying when the head is tilted, radiating to the cheek or temple, due to the pressure of accumulated pus or mucus on the inner surface of the skull;
2. copious discharge from the nose of light-colored (mucus) or yellow-green (pus) fluid;
3. lack of fluid and nasal congestion due to blockage of the anastomosis between the sinus and the nasal passage;
4. violated nasal breathing and sense of smell;
5. swelling of the face, especially the eyelids;
6. change in voice, its nasality;
7. pain in the projection of the maxillary sinus;
8. impossible to breathe through the nose;
9. pain when tapping on the upper jaw;
10. temperature rise to 38 C due to bacterial infection;
11. In children under one year of age, light pressure on the maxillary sinus area will cause crying.

Symptoms of intoxication in severe cases of the disease:

• fatigue;
• general weakness;
• sleep and appetite are disturbed;
• headache;
• the child is naughty.

Chronic course

It is important to know that a viral infection takes more than ten days to treat, and ineffective treatment of sinusitis in children contributes to the chronicity of the inflammatory process for 8-12 weeks. Clinical manifestations varied - from rare exacerbations to constant nasal discharge. The patient will be tortured following symptoms: headaches that get worse in the evening, pain and discomfort in the maxillary sinuses, constantly stuffy nose, changed voice, decreased sense of smell. Exacerbations can occur several times a year.

In the chronic form of the disease, the risk of infection in the meninges is increased, so be vigilant!

You cannot constantly use drugs to treat rhinitis; over time, they stop working, and the infection spreads through the child’s sinuses. If you cannot overcome rhinitis, then contact your doctor and ask to change your therapy.

How to fight the disease?

Treatment of sinusitis in children should begin immediately when the first symptoms appear.

Traditional treatment is aimed at getting rid of infection in the nose, large amounts of pus and mucus - rinsing the nose is done by slowly instilling medicinal solution(antiseptic, saline solution) into the nostril on which the sick child lies.

To relieve symptoms of edema, take vasoconstrictor drops, which should be prescribed by a doctor, since they have many contraindications. For example: “Xilen” nasal drops can be used by those over two years old, but “Dlyanos” is contraindicated for children under six years of age. If an allergy is suspected, antihistamines are prescribed.

They use physiotherapeutic methods to combat the disease: electrophoresis, phonophoresis, laser therapy - treatment cannot be limited to just this, complex therapy is necessary. The widely used method of heating the nose with hot potato, egg and salt is only possible during the convalescent stage. Treat these folk remedies with caution!

Do not warm your nose during the acute phase of the disease, this will spread the infection throughout the body and intensify the symptoms!

Sinusitis in children caused by bacteria is treated with antibiotics: ampicillin, amoxicillin, cephalexin, stronger ones - macropen, zitrolide. The doctor chooses which antibiotics to take after determining the sensitivity of the bacteria to them and assessing allergic history child.

If conservative treatment is ineffective, the doctor performs a puncture of the maxillary sinus in order to free the sinus from pus. It is possible to use anesthesia for the baby.

Painkillers may be given to relieve symptoms of pain.

• "Ketanov" and "Ketoral" should not be given to children and adolescents under 16 years of age.
• Ibuprofen tablets should not be taken by children under six years of age; with a doctor’s recommendation – by children under 12 years of age.
• Ibuprofen suppositories can be used for children from three months to two years.
• "Nurofen" suppositories can be given to children under 1 year of age.

Many procedures are performed in a hospital, so you and your baby may be admitted as a day patient or a permanent patient.

Treatment with folk remedies

There are many popular folk remedies to combat the disease, but be sure to combine them with traditional medicine.

Propolis is a strong disinfecting bactericidal folk remedy that can be used along with antibiotics. You can buy it at the pharmacy water solution and put it in your nose. Prepare an ointment from propolis and lubricate the nasal cavity. Melt propolis in hot oil, soak a cotton swab in the solution and insert it into your nose.

Essential oils: eucalyptus, pine, tea tree - good for inhalation; this is a good folk remedy for disinfecting the nasal passages and respiratory tract.

A complication of sinusitis is damage to the meninges, which leads to irreparable consequences.

Strengthen your baby's immunity, do not stop treatment immediately after the signs of the disease disappear, complete the course of treatment completely, and the baby will be healthy!

Content

Infectious diseases are often diagnosed in children and adults, but young patients suffer from such ailments much more often. Sinusitis in children - symptoms and treatment, refers to an inflammatory disease that affects the mucous membrane of the maxillary sinus. Pathology is classified into several types, has certain symptoms and causes. Diagnosis of the disease and its treatment in children should be carried out exclusively by a qualified physician in order to avoid complications.

What is sinusitis in children

One of the types of sinusitis, the peculiarity of which is inflammation of the maxillary (maxillary) sinus, is sinusitis. The sinuses are located in the thickness of the maxillary bone; they have common walls with the oral, nasal cavities, and orbits. Often this disease is triggered by an infection in the respiratory system. According to medical statistics, children are more likely to suffer from the disease than adults. Infants under one year old, as well as from 1 to 3-4 years old, do not develop this disease. This fact can be explained very simply: babies’ skulls and maxillary sinuses have not yet been formed.

Various viruses play an important role in the development of sinusitis in a child. The disease “activates” during the cold season, when the immune system is especially weakened and the infection easily enters the body. The disease develops as follows: the virus destroys the protection of the nasal mucosa, causing it to swell. As a result, an obstacle appears to the normal outflow of fluid from the maxillary sinuses. It accumulates inside and causes a pathological process.

Signs

In order to recognize the disease in time and avoid complications, it is necessary to familiarize yourself with its signs in advance. The symptoms are often confused with the classic cold, but when it begins to actively develop, obvious symptoms appear. specific symptoms. The first signs of inflammation of the maxillary sinuses and age-dependent symptoms are described below.

First signs

According to statistics, initial signs Childhood sinusitis does not immediately appear. They can be noticed when the disease has already developed significantly. The main initial “signals” of inflammation of the maxillary sinuses are:

• pain near the nasolabial fold with slight pressure on it or when tilting the head;
• pain in the inner corner of the eye when gently pressing on a point in the center of the cheek;
• one-sided or two-sided nasal congestion;
• noticeable swelling lower eyelids, cheeks;
• inflammatory process on the eyelids, tearing;
• toothache;
• pus and mucus in the sinuses (they may not come out);
• increase in body temperature;
• drowsiness, lethargy, general malaise.

Signs of sinusitis in children aged three to five years:

• severe intoxication of the body;
• partial or total loss appetite;
• whims, apathy, decreased activity;
• another symptom - copious discharge pus from the sinuses;
• swelling of the cheeks, upper and/or lower eyelids on the side of the inflammatory process.

Symptoms between the ages of five and seven years:

• pain radiating to the eyes, forehead, bridge of the nose, teeth, eye sockets, eyebrows;
• significant headache, sometimes caused by bright light or tilting the head to the side;
• mucous discharge from the nasal cavity or, on the contrary, its absence;
• how to recognize sinusitis in a child - coughing, attacks of which often worsen at night;
• partial or complete loss of smell.

Symptoms of chronic sinusitis

The acute form turns into chronic after frequent relapses of the disease, adenoiditis, deviated nasal septum, weakened immunity, illiterate treatment of the inflammatory disease. The main symptoms of chronic sinusitis may include:

• weakness, fast fatiguability;
• difficulty breathing in and out of air through nasal cavity;
• watery, mucous or purulent discharge from the sinuses;
• there may be a feeling unpleasant odor;
• another symptom is headaches in the forehead;
• the temperature in children with chronic sinusitis may be normal or rise to low levels;
• Another sign of the disease is a feeling of fullness or pressure near the inflamed maxillary sinus, with strong pressure There is significant discomfort in this area.

Causes

There are a number of main reasons that provoke the development of the disease and its symptoms in children:

1. Runny nose caused by allergies. As a rule, irritating substances cause allergic rhinitis, which develops into sinusitis. In most cases, the disease causes significant swelling of the maxillary sinus.
2. ARI, ARVI, influenza. If a child has a cold, then the outflow of mucus becomes problematic. An infection enters the nose, which provokes the development of sinusitis.
3. Malfunction of blood vessels. Sometimes the cause of inflammation of the sinuses is decreased vascular tone. Blood circulation in the respiratory tract is disrupted and infection develops.
4. Genetic pathologies of the sinuses.
5. Diseases in the mouth (caries, stomatitis).
6. Injuries, bruises, fractures of the nasal septum and similar injuries.
7. Inflammation of the adenoids also often causes the development of the disease.
8. A weak immune system is ideal for attacking viruses that cause illness. The body is deprived of protection, so the disease develops very actively.

Kinds

The classification of types of sinusitis and its symptoms depend on several factors. The main ones will be discussed below. So, the disease according to its stage is as follows:

1. Acute sinusitis in children. It has vivid symptoms, especially pain.
2. Chronic form of the disease. To prevent the acute form from progressing to this stage, it is necessary to carry out timely treatment. The symptoms in this case are less pronounced, remissions alternate with relapses. The main danger of a chronic type of disease is irreversible changes in the nasal mucosa, due to which it loses its protective abilities.

According to the localization of the inflammatory process, the disease is:

• unilateral (only one sinus is inflamed);
• bilateral (infection occurs in both nasal sinuses).

The classification of sinusitis in a child according to the type of inflammation looks like this:

1. Catarrhal type of disease. This stage is acute; in some cases, the inflammatory process affects the bone, periosteum or bone tissue. The main difference between catarrhal is the absolute absence of pus in the sinuses.
2. Purulent stage. The name speaks for itself. The nasal mucosa becomes very inflamed, and pus is discharged profusely from the nose.

Diagnostics

Before treating sinusitis in a child, you need to see a doctor who will prescribe all the necessary diagnostic measures and prescribe medications for effective treatment diseases. As a rule, to make a correct diagnosis in children, the following methods are used:

1. Inspection of the nasal openings.
2. Research to identify the allergic nature of the disease.
3. General blood analysis.
4. X-ray of the nose. This method allows you to see the disease, as indicated by darkening in the image.
5. Diaphanoscopy is the examination of the maxillary sinuses using a special electric lamp. If one or both sinuses are filled with pus, then diaphanoscopy will help to quickly identify this.
6. CT ( CT scan) provides a chance to study the nasal passages in detail. CT scan can reveal early symptoms sinusitis or signs of its chronic form.
7. Another diagnostic method is examination of nasal discharge, which determines the causative agent of the infection.

Treatment of sinusitis in children

Before prescribing therapy, a qualified specialist always finds out the causes of sinusitis in children and assesses the severity of the disease. Today, conservative and surgical treatment methods are used. The first option involves using medical supplies, physiotherapy and so on. Surgery for sinusitis in a child is carried out in the most critical situation. The main medications for the treatment of inflammation of the maxillary sinuses are the following:

1. Antihistamines. They are able to remove swelling and significantly enhance the effect of antibiotics on the body. The most popular antihistamines are Diazolin, Suprastin, Tavegil, Loratadine, Diphenhydramine.
2. Anti-edema medications effectively facilitate breathing and eliminate swelling of the mucous membrane. Among them are Zestra, Orinol, Koldakt, Fervex, Flukold.
3. Vasoconstrictors accelerate the release of mucus from the sinuses, which has a positive effect on breathing through the nose. These include Rinazolin, Nazivin, Farmazolin, Sanorin, Naphthyzin.
4. Antiseptics are also used for treatment. Drugs such as Protargol, Collargol prevent an increase in the amount of pus in the maxillary sinuses.
5. To make mucous and purulent discharge come out of the nose more easily, doctors prescribe special thinning medications. For example, Ambroxol, Bromhexine, ACC-long.
6. If the body temperature rises too high, then it is worth using antipyretic drugs (Paracetamol, Nurofen, Ibuprofen).

Sinus rinsing

Treatment of sinusitis at home in children involves not only the use of medications, but also special rinses. This procedure can be done at home. To cleanse the maxillary sinuses during sinusitis, use a syringe with a pre-made solution (100-250 ml is administered at a time). Several washes per day will be required. The course of treatment is approximately one to two weeks. The healing solution is made from the following means(1 glass of purified warm water + 1 teaspoon of medicine):

• potassium permanganate;
• saline solution made from regular or sea salt;
• chamomile decoction;
• green tea;
• tinctures of string, calendula, St. John's wort;
• medicines Furacilin, Rotocan, Elekasol, Decamethoxin.

You need to know how to properly rinse your baby so as not to worsen the situation. A syringe with a solution is carefully inserted into the nostril about 1 centimeter. The patient's head is tilted slightly forward, pouring in the medicine in small doses. The jet pressure must be gradually increased. In between infusions, the child should try to blow his nose well.

Use of antibacterial drugs

Another important stage in the treatment of childhood sinusitis is taking antibacterial agents. They cope well with inflammation, helping to defeat the disease faster. The most popular and effective antibiotics Isofra, Augmentin, Amoxicillin, Azithromycin, Bioparox are considered. The specifics of their use are indicated in the instructions, and the duration of the course of therapy is prescribed by the attending physician. The most effective are injections with antibiotics, the second most effective are drops, suspensions, and tablets.

Physiotherapy

To successfully combat the inflammatory process, accelerate the flow of mucus and pus from the sinuses, and improve blood circulation and lymph flow, the doctor may prescribe physical therapy. The most well-known methods are considered to be laser therapy, magnetic therapy, ultrasound and UHF (ultra-high frequency treatment). Each method is prescribed by a physiotherapist. All contraindications and other nuances are taken into account, only after that the optimal procedure is selected.

Treatment of chronic sinusitis in children

In the chronic form, treatment depends on the factor that became the “catalyst” of the chronic inflammatory process. For each individual option, a specific type of therapeutic effect is prescribed:

1. Moderate surgical intervention, depending on the patient’s age and condition, is necessary in the presence of adenoids, chronic rhinitis, and a deviated nasal septum. These problems prevent the normal secretion of secretions from the sinuses, so the chronic form begins.
2. Antibiotics are also prescribed, but only after the pathogen and its sensitivity level have been identified.
3. If sinusitis and its symptoms are caused by problems in the oral cavity (for example, caries, stomatitis), then mandatory sanitation of the oral mucosa is necessary. After this, antibiotics are prescribed.
4. When sinusitis in children is in remission, it is recommended to strengthen the immune system with vitamins and exercises, attend physiotherapy, massage, and go to the sea.
5. The use of antihistamines is advisable in the case of the development of hyperplastic and polypous forms.

Folk remedies

Sometimes conservative methods are combined with traditional recipes to increase the effectiveness of the treatment process. Before starting a natural treatment option, a parent should definitely discuss this issue with a doctor to avoid unfavorable prognosis. Popular folk remedies for sinusitis in children:

1. Take one large raw carrot. Washed and peeled. Apply freshly squeezed vegetable juice to the nose three times a day. It is better to dilute a few drops of concentrated juice with a little water to avoid an allergic reaction.
2. Fresh viburnum juice is combined with honey (1:1). The resulting mixture is slightly heated. The medicine is taken orally, 1 tablespoon before meals.
3. You need to purchase ointment with propolis. Dip a cotton swab into it and insert it into the nostril as carefully as possible. Hold for 3-5 minutes.

Complications

The consequences that may appear after the disease can be divided into two types. The first of these is complications of the respiratory system:

• tonsillitis (inflammation of the tonsils);
• bronchitis (inflammation of the bronchi);
• chronic form;
• otitis;
• pneumonia;
• frontal sinusitis, ethmoiditis (inflammatory process in other sinuses).

Other consequences:

• myocarditis (pathologies in the heart);
• sepsis (blood poisoning);
• intracranial complications (meningitis, brain abscess);
• nephritis (kidney damage);
• The result can be a variety of joint pathologies.

Prevention

To avoid the occurrence of sinusitis and its symptoms in children, you should follow simple but effective rules. Prevention of the disease includes:

• regular visit dental office;
• strengthening immune system(correct diet, hardening);
• elimination of anatomical defects (adenoids, curved nasal septum etc.);
• competent treatment of colds;
• maximum possible protection of children from negative factors environment(dust, cigarette smoke, exhaust fumes).

Video: how to find out if a child has sinusitis

Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient.

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It is very important to know how sinusitis manifests itself in children in order to begin treatment on time and prevent it from becoming chronic. In addition, the disease is dangerous due to complications, so you should not self-medicate.

Inflammatory foci that are localized in the paranasal sinuses of the nose cause this. This disease is a form of sinusitis. Childish look sinusitis before the age of 12 has some differences from the course of the disease in adulthood. This is due to the physiological characteristics of the development of nasal structures.

Many parents are concerned about the age at which sinusitis can develop and whether it occurs in newborns. In children under three years of age, the maxillary sinuses are located slightly higher than the usual position and represent a small gap. It is up to this age that sinusitis in children can develop very rarely. As they grow older, the holes increase in size and at the age of 12 they become almost the same size as in adults.

The maxillary sinuses contain many important functions. They protect the face from injury upon impact, participate in the formation of speech timbre, and prevent cooling of neighboring facial structures (eyes, teeth).

Any inflammatory processes occurring in the nasal cavity can cause sinusitis. In young children under six years of age, the infection spreads faster, so even a simple runny nose must be treated.

The main cause of the disease before the age of 10 is the penetration of the virus into the nasopharynx. Other causes of sinusitis are allergic runny nose, proliferation and inflammation of the adenoids, the presence of polyps, defects in the structure of the nose. Less commonly, inflammation occurs due to trauma to the nose, infections in the oral cavity and disturbances in the functioning of internal organs.

In a 4-year-old child, the catarrhal form of sinusitis is more common, when the disease proceeds without the formation of purulent secretion. Preschoolers over five years of age may be diagnosed with purulent form. The illness can last up to 2 months.

How does sinusitis manifest, acute stage?

The common cold can easily be confused with sinusitis in children under 8 years of age. The first signs of sinusitis in children appear on the 6th day after the disease. At this time, the condition worsens sharply, the temperature with sinusitis rises again, and breathing becomes difficult again.

Can infants have sinusitis? Even though the sinuses are not developed in babies, inflammation can still occur. Symptoms of sinusitis in children under 1 year of age:

• in newborns, the temperature with sinusitis can rise to low levels on the thermometer;
• the child refuses to suck milk and often spits up;
• in a baby you can observe swelling and redness of the cheek, nose, eyelids;
• newborns become capricious, sleep poorly, and constantly ask to be held;
• with purulent sinusitis in children, purulent discharge from the nasal cavity is observed.

To recognize sinusitis in children in the first 9 months of life, as well as in children 2 years old, it is enough to apply slight pressure on any area near the nose. If there is an inflammatory focus in the maxillary sinuses, the baby begins to cry, feeling pain.

Sinusitis in a 2-year-old child appears as a result of severe infectious diseases (influenza, scarlet fever). Against the background of fever, purulent nasal discharge may appear, the cheek and eyelids on the affected side may swell, and the nose is constantly stuffy

Symptoms of sinusitis in children 3 years old are no different from other ages. Sinusitis in a 3-year-old child is manifested by difficulty breathing, severe pain in the head, and increased body temperature. The disease at 3 years of age becomes the result of a prolonged runny nose. Nasal discharge may be thick and green or brown in color.

Signs of sinusitis in children 4 years of age are more varied. In children, symptoms may occur suddenly. The body temperature rises, the nose becomes stuffy, the voice becomes nasal, and the head hurts severely.

The following developing symptoms will help identify sinusitis in a child over 6 years of age.

• The patient's temperature rises with sinusitis, he looks lethargic, drowsy, and has chills.
• Pain appears in the bridge of the nose, between the eyebrows, in the forehead area, which intensifies when walking, bending forward, sneezing or coughing, as well as when pressing on the bridge of the nose and the corners of the eyes. When lying down, the pain subsides a little.
• Acute sinusitis manifests itself strongly painful sensations in the nose, which radiate to the upper jaw area. Therefore, the child refuses to eat, as the pain intensifies when chewing.

• The voice becomes nasal and hoarse. Breathing through the nose is difficult. During sleep, snoring is disturbing, and a cough may occur.
• Sinusitis in a 7-year-old child may be accompanied by thick, brown mucus discharge from the nose.
• Swelling can lead to decreased sense of smell.
• In bright light, lacrimation occurs.

The occurrence of sinusitis in children 11 years of age is more common. By this age, the sinuses have almost completed their formation. For any respiratory disease Mucus can accumulate in the sinus and the risk of inflammation increases.

How to determine chronic sinusitis

The development of chronic sinusitis is associated with decreased immunity and lack of vitamins. Other reasons why it develops chronic stage, can be attributed to:

• improper treatment of the acute form;
• untreated infections in the nasopharynx;
• the duration of a runny nose is longer than 10 days;
• disruption of the outflow of mucus from the sinuses due to adenoids, curvature of the cartilaginous plate.

Chronic sinusitis in children proceeds in the same way as the acute form of the disease. At the same time, the signs of sinusitis in a child are less pronounced. The temperature with sinusitis of this form rarely rises to high numbers, the paranasal pain is dull and not constant, and a headache is often bothersome. Nasal discharge can vary in color and consistency.

The chronic stage is dangerous due to complications.

Polyps, cysts form, benign tumors. Therefore, as soon as the first symptoms and treatment are detected, it should be started as quickly as possible.

How to cure sinusitis in a child

Treatment of sinusitis in children depends on its age and condition, as well as on the stage of the disease. How long treatment lasts depends on timely diagnosis and initiation of treatment. On average, the terms range from 2.5 to 4 weeks.

First of all, what to do for sinusitis is to moisturize and rinse the nasal passages. The following methods will help restore breathing:

• For inflammation in the sinuses at 3 years old, regular sea salt without unnecessary additives will do. A single dosage is 150 ml of salt water. Rinsing should be done with a syringe without a needle.
• For sinusitis in a 5-year-old child, drugs such as Salin, Aqualor, and Aquamaris help to moisturize the inner surface of the nose, reduce swelling, and remove pathogenic microbes.
• In patients over 8 years of age, rinsing with antiseptic medications such as Miramistin, Furacilin helps. Their use is not recommended during the purulent course of the disease in order to avoid infection in neighboring organs.

The nasal rinsing procedure is carried out under the guidance of an adult. The child stands over the sink, tilts his head to the side and pours the solution into one nostril, and the mixture should pour out of the other nostril. Together with the medicine, the sinuses will be cleared of accumulated mucus and pus. As a result, swelling is eliminated and nasal breathing becomes easier.

There is another way to treat sinusitis - rinsing the nose using the method of moving fluid (popularly this method is called Cuckoo). It is carried out only in the doctor's office, starting from the age of three. The child is asked to lie down on the couch, the prepared solution is poured into one nostril, and the liquid is drawn out of the other using a special pump. To prevent the solution from getting into the mouth, the patient must repeat “cuckoo” all the time.

In small children under two years of age who cannot blow out snot themselves, the sinuses are cleaned using an aspirator. It can be bought at a pharmacy. The aspirator is a rubber bulb with a soft tip. Before the procedure, it is recommended to instill saline solutions.

Drug therapy

If a child has sinusitis, the attending physician, based on additional examinations, prescribes comprehensive treatment. The causative agent of the disease will determine what medications will be prescribed.

• Antiseptic drugs Protargol or Chlorophyllipt can be used for instillation.
• Vasoconstrictor drops (Nazivin, Nazol Baby, Vibrocil, Rinonorm) relieve swelling and eliminate inflammation. But they cannot be dripped for more than 5 days.
• In children, treatment is accompanied by taking antihistamines. They help reduce swelling, relieve itching and discomfort in the nasal cavity. Drugs such as Fenistil, Cetrin, Loratadine, Suprastin may be prescribed.

• Bacterial sinusitis must be treated with antibiotics. Isofra, Bioparox, Albucid, and Polydexa drops are suitable for topical use. Medicines in tablets for systemic action can be prescribed: Amoxiclav, Augmentin, Azithromycin.
• If the appearance of sinusitis is caused by viruses, then prescribe antiviral drugs: Viferon, Tsitovir, Cycloferon.
• To help the mucus come out faster, doctors prescribe mucolytic medications: Ambroxol, Bromhexine.
• If the temperature during sinusitis is above 38.5 degrees, then you need to give the child an antipyretic drug: Nurofen, Ibuprofen.

Treatment can be accompanied by the compositions offered traditional medicine. Aloe or Kalanchoe juice helps a lot. The juice of these plants disinfects the surface, prevents the spread of infection, cleanses the sinuses, and relieves swelling. Before instillation, be sure to dilute with water. Carrot, beet and onion juice also helps.

How long it takes to treat chronic sinusitis depends on the accompanying complications. It may be necessary to remove the adenoids and undergo surgery to correct the septum. Often, treatment is accompanied by antibiotics. During the period of remission, physiotherapeutic procedures and massage are effective.

Sinusitis in children is a fairly common problem. Often parents are afraid of this diagnosis, considering the disease to be serious and even dangerous. However, experts say that with timely and competent treatment, in most cases it is possible to cope with inflammation of the maxillary sinuses quite quickly. A prerequisite is that throughout the entire illness the child must be under constant medical supervision. Only a doctor will be able to select the most effective drugs to fight infection in the sinuses, eliminate symptoms, and decide whether surgical intervention, carrying out physiotherapeutic procedures, etc.

At the same time, inadequate therapy - for example, treatment of sinusitis in children at home without consulting a doctor, uncontrolled use traditional methods- is fraught with very serious consequences, including the death of the baby. It must be remembered that dangerous complications, such as damage to the membranes of the brain (meningitis, encephalitis), the spread of infection throughout the body (sepsis), due to the physiological characteristics of a child, often develop much faster than in an adult.

In this article we will talk about what to do if a child has sinusitis, its symptoms and treatment in children, methods of diagnosis and prevention, and we will also try to answer the questions that parents most often ask.

Most of the methods listed in the table are aimed at eliminating acute process in the maxillary sinuses: these are measures that help cope with the infection, help remove mucus and pus from the sinuses, and eliminate inflammatory manifestations. At the same time, techniques that allow you to restore the integrity of the mucous membrane and normalize local immunity in the nasal cavity and sinuses (items 7 and 8 of the table) are the most important stages of therapy, since they help prevent relapses, that is, the return of the disease.

Antibacterial therapy

How to cure sinusitis in a child? In most cases, the use of antibacterial drugs is basic. It is the timely and competent prescription of these medications that allows you to quickly cope with an infection in the sinuses and avoid complications. Antibiotics allow you to destroy pathogens directly at the source, blocking their growth and reproduction. The decision on the choice of drug, its dosage and course can only be made by the attending physician - taking into account the age of the child, the specifics of the process, the presence of concomitant diseases, and a history of allergic reactions.

In some cases, with timely initiation of therapy and mild degree severity of the process - when treating sinusitis in a child, local antibiotics are prescribed. These can be drops or sprays that contain one or another antibacterial drug. The advantage of using such forms is the absence of systemic effects on the body and complications, such as intestinal dysbiosis, etc. The disadvantage of such drugs is the difficulty in their penetration into the source of infection - the maxillary sinus, especially if there is a disruption in communication between the sinus or nasal cavity due to swelling of the mucous membrane or due to an anatomical defect.

It must be said that not all doctors, when treating sinusitis in a child, believe necessary application local antibacterial agents. In particular, the famous pediatrician E.O. Komarovsky, in his speeches and works, points out that the use of antibiotics in the form of drops or sprays does more harm than good. This is due to the fact that, on the one hand, this approach is characterized by low efficiency - after all, the drugs do not penetrate directly from the nasal cavity into the sinuses, or reach them in a minimally low concentration, insufficient to eliminate the infectious process. On the other hand, even this small dose of antibiotics prescribed for local treatment, is sometimes enough to cause bacteria to develop resistance to the drug. As a result, the effect of the use of antibacterial drugs, which are prescribed in the form of tablets or injections, is also significantly reduced.

Therefore, in the vast majority of cases, when sinusitis is detected in children, treatment begins with the prescription of antibiotics that have a systemic effect on the body. For mild or medium degree severity of the disease, as a rule, antibacterial drugs are prescribed in the form of tablets, capsules, suspensions, syrups. If the course of the disease is severe (especially if the condition requires hospitalization of the child), antibacterial drugs are administered intramuscularly and sometimes (especially on initial stages therapy) intravenously.

How does a doctor choose an antibacterial drug to treat sinusitis in a child? The most pronounced effect is obtained by prescribing drugs based on bacteriological testing. The laboratory determines the sensitivity of pathogens obtained from nasal secretions or sinus contents to certain drugs. However, such a technique takes time - several days are needed for single microbes sown on nutrient media to form colonies suitable for antibiotic sensitivity tests. Therefore, this technique is most often used in hospitals in patients resistant to traditional antibiotic therapy.

In most cases, the specialist prescribes antibacterial drugs that affect precisely those pathogens that are most often responsible for the occurrence of sinusitis in children. According to Russian and foreign researchers, sinusitis in children is traditionally caused by the following microorganisms:

All these pathogens are present in the respiratory tract of a child from the first year of life and under normal conditions do not have a pathogenic effect. Their pathogenic properties manifest themselves in a situation where defense mechanisms are weakened: when, due to some factors (viral infection, hypothermia, stress, injury, etc.), a decrease in general and local immunity occurs.

It is on the basis of these data regarding the most common pathogens of sinusitis in children that specialists usually prescribe basic antibacterial therapy. Traditionally, the following groups of antibiotics are used in the treatment of sinusitis in children:

Penicillins. Antibiotics penicillin series disrupt the synthesis processes of the bacterial cell membrane, which leads to its death. Penicillins are used to treat bacterial infections many decades, and therefore many microorganisms have developed protective mechanisms (for example, the synthesis of special β-lactamase enzymes) that contribute to the destruction of the active components of penicillins. Therefore, the latest generations of penicillin drugs include substances (for example, clavulonic acid) that block the effects of bacterial enzymes.

A positive aspect of the use of drugs of this group in the treatment of sinusitis in children is the minimal number of side effects associated with their use (although digestive disorders, microflora disorders, allergic dermatitis). However, these drugs affect a very narrow range of microorganisms, as a result of which they may not be effective in the treatment of sinusitis in children, especially with severe course diseases.

Macrolides– antibiotics that act by disrupting protein synthesis in the microbial cell. They are often prescribed when a child is allergic to penicillin drugs. Macrolides are considered antibiotics with the least toxicity. In addition to antibacterial effects, they have some anti-inflammatory and immunostimulating effects. As a rule, antibiotics of this group are prescribed for mild to moderate severity of the disease.

Cephalosporins The mechanism of action on bacteria is similar to penicillin antibiotics: they destroy the cell wall of the microbe. It is the drugs of this group that are considered the most effective against those microbes that cause inflammation in the sinuses. At the same time, the use of cephalosporins is fraught with the development of pronounced side effects, primarily the development of intestinal dysbiosis and disruption of the digestive system. Therefore, cephalosporin antibacterial drugs are prescribed for the treatment of moderate and severe sinusitis in children.

In some cases, doctors prescribe antibacterial drugs of other groups (aminoglycosides, tetracyclines, chloramphenicol) - the decision is made based on clinical and laboratory research. However, some antibiotics of these groups have a toxic effect on the child’s body, so their use in the treatment of sinusitis in children should be extremely justified. For example, they can be used in situations where the pathogen that caused inflammation is insensitive to most antibiotics traditionally used in the treatment of sinusitis, if the data bacteriological research showed sensitivity to one or another drug from the above groups. In such situations, the specialist conducting the treatment compares the benefits of taking them (elimination of the source of infection, especially in severe cases of the disease and the development of complications) and possible harm, due to the likelihood of toxic effects, and based on the analysis makes a decision on prescribing these drugs.

Often, to increase the effectiveness of treatment, specialists simultaneously prescribe both local antibiotics and systemic antibacterial drugs. It is very important that throughout the entire course of antibacterial therapy, the child should be under constant supervision of a doctor who will be able to assess the effectiveness of the prescribed treatment, make a decision to change the drug if there is no result, promptly notice signs of the development of allergic reactions, complications and, if necessary, refer the child to hospital

Sometimes, when the child’s condition improves due to antibacterial therapy, parents voluntarily decide to stop treatment with these drugs. However, in such cases, there is a high probability that the inflammatory process in the sinuses will not be completely eliminated, which is fraught with the development of a relapse or the disease becoming chronic. In addition, an incomplete course of antibacterial therapy is fraught with the development of bacterial resistance both to this drug and to other antibiotics with a similar mechanism of action. A full course prescribed by a doctor allows you to destroy the vast majority of microbes that cause the disease. If the duration of therapy is insufficient, or the dosage is lower than necessary, then a certain number of microorganisms that are genetically resistant to the drug survive. Subsequently, these bacteria pass on this resistance to other generations. Inflammatory processes in the sinuses or other organs caused by such microbes are very difficult to treat with antibacterial drugs of the group to which resistance has developed.

Complications and side effects of antibacterial therapy for sinusitis in children

When taking antibacterial drugs in children, various complications can occur. Side effects of antibiotic therapy include:

• Allergic reactions - most often they occur when taking penicillin drugs. These may be skin manifestations (rashes, hives), swelling - for example, swelling of the airways, leading to asthma-like conditions with attacks of difficulty breathing. In addition, it is possible to develop such severe and life-threatening complications as Quincke's edema and anaphylactic shock. It is precisely in connection with the threat of complications, especially in preschool children, that treatment with antibiotics should be carried out under the supervision of a doctor who can promptly identify signs of the development of allergic reactions, change the drug, and also prescribe therapy aimed at eliminating allergic manifestations. If threatening symptoms appear - difficulty breathing, clouding or loss of consciousness, it is necessary to urgently call emergency assistance. If a child has previously had allergic reactions to taking certain antibiotics, before starting therapy it is necessary to inform the attending physician about this, and also consult on how to behave in case of development severe complications.
• Toxic reactions. Some antibacterial drugs have toxic effects on various organs. There are antibiotics that affect the functioning of the central nervous system - their use can lead to deterioration of vision, hearing loss, impairment respiratory function. Some drugs have a toxic effect on the bone marrow, which leads to disruption of hematopoiesis, cardiovascular system, kidneys, and liver. It is important to know that almost all modern drugs that are prescribed by specialists for the treatment of sinusitis in children do not have pronounced toxic effects, and those side effects that are observed during their use are corrected by prescribing appropriate drugs (for example, probiotics for disorders intestinal microflora and so on.).

Currently, doctors most often have to deal with the manifestation of the toxic effects of antibiotics in situations where parents independently decide whether to treat their child with one drug or another.

• Side effects from gastrointestinal tract. These include bowel disorders (constipation or diarrhea), decreased appetite, and nausea. These manifestations most often occur during antibiotic therapy for sinusitis in children. Often, during treatment with antibiotics, children develop intestinal dysbiosis - this is due to the fact that the drugs have a systemic effect on the body, leading to a disruption in the composition of the intestinal microflora. That is why, against the background of antibacterial therapy and after it, experts prescribe probiotics to children, which help protect beneficial bacteria, creating conditions for the restoration of normal flora after the end of antibiotic treatment.
• The addition of other infections during and after the end of the course of antibacterial therapy (superinfections). Due to a disruption in the composition of normal microflora that occurs while taking antibiotics, as well as a weakening of the immune system caused by an infectious process, conditions may be created in the child’s body for the activation of opportunistic microflora. This means that microorganisms that were previously present in the body, but did not show their pathogenic properties, can become more active and cause an inflammatory process. The most common example is the development of candidiasis, that is, lesions caused by fungi of the genus Candida (up to 30 species can be present in the body). That is why, in some cases, against the background of antibacterial therapy, candidiasis of the intestines and genital organs can develop. Children with weakened immune systems may develop candidal sepsis, a condition when fungi enter the blood, spread throughout the body and cause inflammation of various organs. If signs of a superinfection - fungal or bacterial - appear, the specialist conducting the treatment adjusts the therapy, prescribes antifungal drugs, and determines further tactics for managing the child.

Antibacterial therapy is the most important part of the treatment of sinusitis in children, allowing you to solve the main problem: to cope with infection in the sinuses. However, it must be remembered that along with taking antibiotics, other therapeutic measures must be carried out. The fact is that eliminating infection in the maxillary sinuses is not the key to recovery if the problem of eliminating the contents of the sinuses is not resolved. Even if there is no infectious focus, but the outflow is not restored, then there is a high probability of re-infection and the development of relapse of the disease. This problem is especially relevant in childhood, since the sinuses and sinuses of a child are narrower than those of an adult, so it can be more difficult to restore the outflow.

Therefore, when sinusitis is detected in a child, treatment necessarily includes not only antibiotics, but also drugs and procedures that help restore the patency of the anastomosis, eliminate exudate from the sinuses, restore respiratory function - only with such a complex effect is the effect of complete cure of sinusitis in a child achieved.

Vasoconstrictor drugs (adrenergic agonists)

The most important element of complex therapy for sinusitis in children is the use of local vasoconstrictor drugs (adrenergic agonists). The components contained in these drugs contribute to the constriction of blood vessels due to their effect on alpha-adrenaline receptors in their wall. As a result, the so-called process of anemization (“bleeding”) of the mucous membrane occurs and swelling phenomena decrease, and nasal breathing is restored.

When treating sinusitis in children, experts recommend using vasoconstrictors, produced in the form of sprays. Ordinary drops flow down the mucous membrane and have an effect only within the nasal cavity. When sprayed, particles of the spray penetrate into the tubules connecting the nasal turbinates and the maxillary cavity - and it is precisely the elimination of edema in this area that is the primary task. As a result, conditions are created for the outflow of inflammatory contents from the sinuses. In addition, adrenergic agonists are recommended to be used before using local antibacterial drugs, as this facilitates their access to the site of inflammation.

However, it must be remembered that drugs in this group, when used for a long time, cause addiction that is difficult to cure - in order for the blood vessels to become toned, constant artificial stimulation of adrenaline receptors begins to be required. Therefore, vasoconstrictors in the treatment of sinusitis in children are not recommended for use for more than five days.

Like any other medicines, vasoconstrictor drugs can cause allergies - in this situation, the attending physician decides to replace the medicine or exclude drugs from this group from therapy. In addition, adrenergic agonists should be used with caution in children suffering from cardiovascular diseases and diabetes mellitus.

Antihistamines (antiallergic) drugs

Often, sinusitis in children occurs against the background of allergic rhinitis. This leads to worsening swelling of the nasal mucosa, anastomosis and sinuses. Therefore, to achieve an effect, complex therapy for diseases in children often includes antihistamines. Their use along with vasoconstrictors will help reduce swelling and create conditions for improved drainage of mucus and pus from the sinuses. Today there are antiallergic drugs that have a minimal effect on the nervous system (that is, do not cause such side effects such as lethargy, drowsiness). Decision on the need for appointment antihistamine, its choice, dosage, and duration of treatment regimen are decided by the attending physician - he focuses on the child’s age, condition, the presence of allergic reactions in the child in the past, as well as other concomitant diseases. The specialist also monitors therapy - he determines the timing of treatment and, if necessary, decides to replace the drug.

Anti-inflammatory drugs

To relieve the symptoms of sinusitis in children, such as pain in the sinuses, headache, fever, specialists often include medications that have an analgesic and anti-inflammatory effect in the treatment regimen. Typically used non-steroidal anti-inflammatory drugs(based on acetylsalicylic acid, paracetamol, ibuprofen, nimesulide), which are available in the form of tablets, powders, syrups. Before using them, it is necessary to consult a doctor, since there are a number of contraindications and side effects of using non-steroidal anti-inflammatory drugs. Thus, drugs that include aspirin, ibuprofen, paracetamol, have Negative influence on the condition of the mucous membrane of the gastrointestinal tract. Therefore, in children with gastritis, gastric and duodenal ulcers, such medications can provoke an exacerbation of the disease and lead to the development of bleeding. Aspirin-based medications can negatively affect the condition of the vascular wall, increase its fragility and provoke bleeding. Drugs that contain nimesulide can adversely affect liver function with long-term use. Therefore, the decision to include non-steroidal anti-inflammatory drugs in complex therapy, the dosage and permissible duration of their use should be made by the attending physician.

In special cases, the specialist may decide to include in the treatment regimen hormonal drugs with pronounced anti-inflammatory and anti-edematous effects. Their prescription may be justified in case of a pronounced allergic component, persistent inflammatory process in the sinuses, or the presence of polyps in the nasal passages and sinuses. More often in such situations, drops and sprays are used: with local exposure, the active components of such drugs have less systemic effect on the body. However, even with their local application complications may develop - nosebleeds, ulcers on the mucous membrane. It must be remembered that taking hormonal drugs can only be carried out according to the decision of a doctor and only under his close supervision. Self-medication of sinusitis in children with medications of this group is fraught with the development of not only local, but also general complications, dysfunction of the adrenal glands, which leads to the failure of hormonal processes and the development of metabolic disorders.

Drugs that reduce mucus viscosity (mucolytics)

Mucolytics make an important contribution to restoring the function of the mucous membrane of the nasal cavity and maxillary sinuses. These drugs contain enzymes (for example, N-acetylcysteine), which reduce surface tension and have a pronounced diluting effect on mucous and purulent discharge, which creates conditions for its removal from the nose, restoration of patency of the anastomosis, and cleansing of the sinuses. They also help restore mucociliary clearance, that is, the movement of cilia, which are equipped with epithelial cells of the nasal passages - thus normalizing physiological process cleansing the nasal cavity from mucus, toxins, pathogenic microorganisms, dust particles, etc.

Mucolytics are especially indicated for prolonged sinusitis in children, accompanied by the formation of a large amount of viscous, thick discharge. They can also significantly alleviate the condition in the presence of crusts in the nasal cavity, which impede breathing and cause discomfort in the child. Currently, combination drugs are produced, in which the mucolytic component is combined with a vasoconstrictor or local antibacterial drug. The attending physician will help you choose a medicine based on the characteristics of the process, the age of the child and other significant factors.

Immunomodulatory drugs

When treating inflammation of the maxillary sinuses in children, it is necessary to solve many problems, so the range of drugs prescribed by a specialist can be very wide and depends on the characteristics of the specific inflammatory process, the condition of the child, his age and other nuances. What else is used to treat sinusitis in children? So, in last years The regimen often includes bacterial lysates - components of inactivated (neutralized) bacteria that help restore local immunity in the nasal passages and stimulate the production of antibodies to the most common pathogens. Medicines from this group are used, as a rule, after the acute manifestations of the disease have been relieved to speed up the healing process, as well as to prevent rhinitis and sinusitis.

In addition, preparations containing probiotic components are used to help restore the composition of normal microflora in the upper respiratory tract, which also helps restore local immunity. Solutions of bacteriophages are also used, which have antibacterial properties and help cope with the infectious process in the nasal cavity.

Also, in the treatment of sinusitis in children, various drugs can be used, the effect of which can be aimed at improving regeneration processes and solving other problems that are relevant after the acute manifestations of sinusitis have been relieved. Including drugs based herbal ingredients, for example, containing cyclamen juice, which has the ability to thin mucus and increase secretion (mucus secretion), and also include various oils and herbs. In the arsenal modern medicine there are many means available to provide positive influence on the patient’s condition at various stages of the disease. However, only the attending physician can draw up a competent scheme for their use.

Physiotherapy in the treatment of sinusitis in children

Nasal rinsing

One of the most important techniques used in the treatment of sinusitis in children is nasal rinsing. It helps solve such important problems as the evacuation of mucous and purulent contents from the sinuses and nasal passages (thus eliminating the conditions for maintaining the septic process), restoring the function of the ciliated epithelium, which ensures constant cleaning of the nasal cavity from foreign agents. There are different methods of rinsing the nose for inflammation of the maxillary sinuses, most of which should be carried out in a hospital or treatment room of a clinic or medical center. According to doctors, only such procedures, carried out by specialists (a doctor or a qualified nurse), can fully solve the problem - emptying the sinuses of contents. The main methods include nasal lavage using the “cuckoo” method and the method of using the YAMIK sinus catheter.

Nasal rinsing using the “cuckoo” method

How is the “cuckoo” procedure performed for a child? The essence of the method is to create variable negative pressure in the sinuses and nasal cavity, which helps soften mucus and pus. In this case, a warm disinfectant solution is poured into the nasal passages and then (along with the discharge) is removed using an electric suction. In this case, the patient lies with his head tilted back 45 degrees and repeats the syllable “ku” - this is necessary to compress the muscles of the soft palate in order to create alternating negative pressure in the nasal cavity, as well as to prevent liquid from entering the throat. You can read more about the methodology for carrying out the procedure. This method has been used for the treatment of sinusitis since 1926 - it was developed and introduced into practice by the American doctor Arthur Walter Proetz. Therefore, another name for “cuckoo” is Proetz nasal lavage; in addition, it is also called nasal lavage using the displacement method.

“Cuckoo” is contraindicated for children under 5 years of age, since before this age the formation of sinuses is not yet complete. It is also not recommended for children suffering from increased fragility of the vascular walls, so as not to provoke nosebleeds.

Despite the safety of the “cuckoo” method, this procedure is accompanied by a feeling of discomfort for the child: discomfort in the nose, choking, fear of choking. Therefore, each upcoming procedure (and they usually need to be performed 5 to 10 times) can cause increasing resistance on the part of the young patient. It is important to say that nasal rinsing according to Proetz also has complaints from doctors: the fact is that this technique does not completely clear the sinuses of contents. In addition, during its implementation it is impossible to obtain bacteriological material for research, and this is sometimes necessary to determine the tactics of antibacterial therapy when pathogens are resistant to traditional regimens of antibacterial therapy for sinusitis in children. Therefore, at present, the “cuckoo” is gradually giving way to more modern techniques, such as YAMIK and .

Nasal lavage using a YAMIK sinus catheter - a technique developed by Russian scientists - is one of the most preferred procedures aimed at clearing the sinuses of contents in childhood. It allows you to answer the question - how to cure sinusitis in a child without a puncture. The essence of the procedure is to insert a special catheter made of soft latex into the sinuses - through it, mucus and pus are evacuated from the sinuses, and also inserted antiseptic solutions and others medicinal substances. You can read more about this procedure.

The YAMIK method is non-traumatic, painless, and, unlike the “cuckoo” method, it allows you to completely clear the sinuses of contents, and also allows you to obtain material for bacteriological research without puncture. The procedure for children is no different from that for adults - the doctor only needs to select a catheter of the required diameter that matches the size of the nasal passages.

In addition, parents and specialists must competently prepare the child for the procedure and, if possible, explain the essence of the method in a language he understands. This is especially important before the first manipulation, since the prospect of inserting a catheter into the nose can cause fear in a child, especially preschool age. As a rule, subsequently, having made sure that the method is painless and feeling relief after the procedure, the child calmly agrees to undergo YAMIK.

Contraindications for the procedure are the child’s tendency to nosebleeds and the presence of multiple polyps in the nasal cavity.

Nasal rinsing at home

When treating sinusitis in a child, it is permissible. However, it must be remembered that this method is much less effective than procedures carried out by specialists in an outpatient clinic or hospital (YAMIK, “cuckoo”). The fact is that when you rinse your nose yourself, it is possible to eliminate discharge only from the nasal passages - it is impossible to remove pus and contents from the sinuses in this way. However, rinsing helps to facilitate nasal breathing, creating conditions for restoring the function of the ciliated epithelium of the nasal mucosa, which is also important for accelerating the healing process. It is very important to carry out the procedure correctly, since if the technology is violated, complications may develop, for example, fluid reflux into the eustachian tubes with subsequent development of otitis. Therefore, a preliminary consultation with a doctor is necessary, who will decide on the need for the procedure and inform about the technology for its implementation, according to the age and condition of the child.

Technology for washing a child’s nose at home

To rinse the nose, a saline solution is most often prepared - 1 teaspoon of sea or table salt diluted in 1 liter of water. In addition, decoctions of herbs such as chamomile, calendula, sage, St. John's wort can be used - they have anti-inflammatory, disinfectant, and soothing properties. For one procedure you will need 100-200 ml. solution or decoction.

The child's head is tilted over the sink (at an angle of approximately 45 degrees) and asked to open his mouth. Water is introduced into the nasal passages under slight pressure - a syringe or disposable syringe without a needle - and pours out through the mouth or the other nostril. 10 minutes before the procedure, it is recommended to drop vasoconstrictor drops into the child’s nose. You can also use special devices (for example, Dolphin) to rinse the child’s nose - in such situations, the procedure is carried out according to the instructions.

Puncture of the maxillary sinus

Sometimes, if use is ineffective traditional methods To clean the sinuses from pus, when treating sinusitis, specialists resort to puncture (puncture) of the maxillary sinuses. This procedure allows you to quickly and effectively cleanse the sinuses of mucus and pus, rinse them with a disinfectant solution, and administer medications. In addition, the puncture also has diagnostic value: when performing it, the specialist obtains material (purulent contents) that contains pathogens - this is sometimes necessary for bacteriological research, especially in situations where the disease turns out to be resistant to traditional antibacterial therapy.

The very essence of performing a puncture of the maxillary sinuses in children does not differ from a similar procedure in adults: you can read more about the essence of the intervention.

The procedure must be performed by a highly qualified specialist. It is necessary to carry out thorough psychological preparation of the child - despite the fact that the puncture is carried out using local anesthetics, the peculiarities of the procedure (insertion of a needle into the nasal cavity, the crunch that occurs when the sinus wall is punctured) cause fear in children, especially if we are talking about a preschool child age. Therefore, if necessary, a small patient may be prescribed sedatives, allowing to reduce excitability and create a favorable background for manipulation.

Complications of the procedure include the development of an allergic reaction to drugs used for local anesthesia, as well as drugs that are administered during the puncture. Currently, specialists are trying to less often resort to such a procedure as puncture of the maxillary sinus. Non-invasive methods are preferable, first of all, YAMIK - a non-traumatic procedure that allows you to achieve a similar therapeutic and diagnostic result.

Prevention of sinusitis in children

As you know, it is easier to prevent any problem than to treat it. How can sinusitis be prevented in children?

Prevention of colds. As is known, inflammation of the maxillary sinuses in the vast majority of cases develops against the background of respiratory diseases caused by viruses. Therefore, the main method of preventing sinusitis in children is proper organization child's life, strengthening the immune system. This and rational mode day, and good sleep, and regular walks and sports. In addition, it is very important to harden the child or cold therapy - you can read more about how to harden yourself correctly.

To prevent colds and sinusitis in children, it is very important to create the correct microclimate in the room where the child lives. It is necessary to carry out wet cleaning regularly, and also take care to create optimal humidity (50-70%) and temperature (18-20 C). Dry air is one of the factors weakening local immunity in the respiratory tract, reducing resistance to pathogenic microorganisms. This is due to drying out of the mucous membrane, thickening of the mucus and the formation of mucous crusts. In turn, this leads to disruption of the movement of cilia, which are equipped with epithelial cells that cleanse the nasal cavity of foreign particles and microorganisms. All this helps create conditions for the development of infectious processes in the nasal cavity.

The most important nuance in the prevention of colds and sinusitis in children is a balanced diet. One of the most effective methods is the use protein-free diet, which involves limiting or temporarily excluding foods rich in animal proteins from food. Reducing the protein load on the body creates optimal conditions for the functioning of the immune system, harmonizes metabolic processes, and reduces the formation of toxins.

A protein-free diet is especially indicated during periods of epidemics of influenza and colds, as well as in the spring, when there is a weakening of protective mechanisms associated with the insufficient presence of vitamins in food and a lack of sunlight. In addition, a protein-free diet is recommended by experts as part of complex therapy for sinusitis in children. Limiting the protein load on the body throughout the course of the disease allows you to quickly cope with the infectious process in the sinuses and achieve a speedy recovery. You can read more about the protein-free diet.

Prevention of allergic diseases. Allergic rhinitis is one of the risk factors for the development of sinusitis in children. In this situation, it is necessary, first of all, to prevent allergies - the specialist sends the child for a comprehensive examination, which allows identifying the causative allergens, and prescribes appropriate treatment.

Elimination of foci of chronic infection. The cause of recurrent colds and chronic sinusitis in a child may be foci of infection in the nasopharynx - adenoids, chronic tonsillitis, dental problems. Therefore, the most important stage in the prevention of inflammation in the maxillary sinuses is the examination and elimination of sources of infection: sanitation of the oral cavity, conservative treatment or removal of adenoids, etc.

Answers to frequently asked questions:

Is it possible to treat sinusitis in children with folk remedies at home?

Experts believe that there are no effective methods for treating sinusitis in children using folk remedies. Purulent process in the maxillary sinuses - a condition that requires mandatory observation by a specialist, the appointment of antibacterial therapy and other therapeutic procedures that allow influencing various parts of the pathological process. Self-medication in the vast majority of cases leads to the development of complications.

For example, some parents try to warm the nose with salt when a child has sinusitis, use a boiled egg or other means for hot applications. At the same time, experts say that heating the sinus, which contains pus, is fraught with a breakthrough of the contents into neighboring organs and the development of a situation critical to the health and life of the child.

Also, when parents ask how to treat sinusitis in children using inhalations, experts answer that this technique does not bring any effect in the treatment of sinusitis - even if the steam contains ingredients that can have some healing effect, their concentration there is negligible. The only benefit that can be expected from this procedure is some softening of the crusts in the nose that make breathing difficult, but it can be achieved by other methods, for example, humidifying the air in the room and maintaining an adequate drinking regime. At the same time, inhalation over hot steam often leads to burns of the mucous membrane of the nose and respiratory tract and, in addition, is fraught with burns and injuries associated with an accidentally overturned pan of boiling water.

However, some folk remedies for sinusitis in children can be used in complex therapy. This could be, for example, rinsing the nose with herbal decoctions (chamomile, sage, etc.), but making a decision about the possibility of using this or that remedy should be entirely within the competence of the attending physician!

What happens if sinusitis in a child is not treated?

Lack of treatment for sinusitis in children is fraught with the development of severe consequences. Due to physiological and anatomical features, complications in a child develop much faster than in an adult. The purulent process from the maxillary sinuses can spread to neighboring organs - abscesses in the eye area and neuritis occur. The most severe complications include intracranial complications - inflammation and abscesses of the meninges and brain, vascular thrombosis. Their occurrence often leads to severe disability and death of the child. In addition, against the background of reduced immunity, a child may develop sepsis - spread

infections with blood throughout the body and with damage to various organs and systems. Thus, a disease that, with proper treatment, usually goes away quickly and without consequences, if left untreated, can become the cause of a real tragedy.

A child is 2 years old - can he have sinusitis?

Here we return again to the question - at what age can children have sinusitis? In order to answer it, let's remember at what age the maxillary sinuses are formed in children. At the time of birth, the maxillary sinuses are very poorly developed; they finish forming only by the age of five to seven years. Therefore, sinusitis does not occur in infants, and this disease also practically does not occur in children under five years of age: of sinusitis at this age, only inflammation of the ethmoid sinuses is diagnosed - ethmoiditis.

Is sinusitis contagious for children?

Patient with inflammatory process in the sinuses can be a source of infection for others if we are talking about viral sinusitis. In this situation, pathogens can be transmitted to other people, primarily by airborne droplets. A purulent process that develops against the background of a viral infection is usually caused by bacteria that are already present in the child’s body and become more active against the background of changes caused by viruses. At this stage, the patient does not pose a threat to others.

List of used literature:

1. Beloborodova N.V. On the issue of antibiotic injections in the practice of a local pediatrician. Children's Doctor, No. 4, 1999
2. Bogomilsky M.R. Diagnosis and empirical treatment of acute sinusitis in children. Attending physician, No. 1, 2000.
3. Bogomilsky M.R. Basic principles of treatment of sinusitis in children. Attending Physician, No. 8, 2001.
4. Garashchenko T.I., Bogomilsky M.R., Strebkova O.A. Algorithms for rational antibiotic therapy for complicated sinusitis in children. Russian rhinology. 2002
5. Garashchenko T.I., Bogomilsky M.R., Radtsig E.Yu., Skvira I.E., Strebkova O.A., Yagolnikova O.V. Prevention and treatment of upper respiratory tract infections in children. Attending Physician, No. 10, 2001.
6. Deryugina O.V., Chumakov F.I. Orbital and intracranial complications of inflammatory diseases of the nose and paranasal sinuses in adults and children. M.: MONIKI, 2001
7. Marushkina G.I., Malyuzhinskaya N.V. Rational antibiotic therapy for rhinosinusitis in children. Ross. otorhinol. 2009
8. Sergeev D.V., Yanov Yu.K., Strachunsky L.S. and others. Pharmacoepidemiological assessment of the use of antibiotics in the treatment of acute sinusitis in a clinic and hospital. Ross. otorhinol. 2005
9. Sinopalnikov A.I., Klyachkina I.L. The place of mucolytic drugs in the complex therapy of respiratory diseases. Russian Medical Bulletin. No. 4
10. Strachunsky L. S., Bogomilsky M. R. Antibacterial therapy of sinusitis in children. Children's Doctor, No. 1, 2001
11. Strachunsky L. S., Kamanin E. I. Antibacterial therapy of infections in otorhinolaryngology. RMJ, vol. 6, no. 11, 1998

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