Symptoms remained after treatment of frontal sinusitis. Frontitis: symptoms and treatment in adults. Conservative treatment of frontitis

Frontitis is a serious pathology of the nasal cavities. In adults, it manifests itself with symptoms of megrinous pain and requires mandatory treatment.

Sinusitis (frontal sinusitis) is an inflammation of the mucous membrane of the frontal nasal cavity, which is located in close proximity to the orbits of the eyes and the fossa that contains the frontal parts of the brain.

Kinds

Pathologies of the frontal cavities are divided into types:

• by placement;
• development;
• by sight;
• for reasons.

By placement:

• inflammation of the left half of the sinus;
• frontitis of the right half of the sinus;
• binary frontit.

By development:

• fast paced process
• protracted form of frontitis.

By type:

• with fluid accumulation (exudative);
• with inflammation of the mucous membranes only (catarrhal);
• with the formation of tissue decay products (purulent);
• with the formation of neoplasms (productive);
• with the growth of tissues in the sinus region (polypous);
• with thickening of the walls and blocking the exit of the liquid (hyperplastic).

For reasons:

• immunological;
• post-traumatic;
• due to the presence of viruses in the body;
• due to infections;
• complications of mycoses;
• combined;
• drug.

The reasons

Frontitis (symptoms and treatment in adults are described below) has its own causes.

As a rule, this is a consequence of other health problems:

• acute respiratory infection;
• acute respiratory viral infection;
• cold;
• allergic prolonged rhinitis;
• nose and head injuries;
• fungal infections;
• bend in the nose plate;
• a consequence of strong cooling;
• chronic inflammatory pathologies in the body;
• autoimmune processes.

Frontitis symptoms in adults

Frontitis (symptoms and treatment in adults are described in many medical reference books) has the following manifestations:

• Pain in frontal part of head after sleep.
• Nasal congestion.
• Putrid discharge from nasal passages.
• Viscous liquid in the morning, after sleep in the nasopharynx.
• Pain in superciliary arches that are not relieved by NSAIDs.
• Fever.
• swollen upper eyelid on one or both sides.
• Redness of the eyes or one eye (it all depends on the location of the inflammation).

The manifestation of acute frontitis

Acute frontal sinusitis is a rapidly developing pathology in the frontal cavity, which has a number of manifestations:

• a sharp decline in strength;
• an increased level of thermometer readings up to 39-40 degrees Celsius;
• migraine pain in the forehead, which increases when turning the head;
• lack of nasal breathing;
• separation of products of purulent inflammatory process;
• blenorrhea;
• increased sensitivity of the eyes to light;
• eye redness;
• swelling of the eyelids;
• decreased perception of odors;
• increase in inflammatory parameters in the clinical analysis of blood.

Symptoms of chronic frontitis

Any long-term inflammatory pathologies cause a negative impact on all systems and organs in the human body.

Symptoms of frontal sinusitis and methods of its treatment in adults are described in detail in the article.

The manifestations of a chronic process in the frontal sinus include:

• periodic fever with an increase in body temperature;
• chills;
• migraine pain;
• prostration;
• exhaustion;
• lethargy;
• inability to breathe through the nose;
• feeling of shooting from the side of the affected sinus;
• purulent discharge from the nasal openings;
• or vice versa - overdried nasal mucosa.

Complications

Frontitis (symptoms and treatment in adults should be known to the otolaryngologist) with the wrong attitude to the doctor's prescription or ignoring general condition can lead to complications.

What threatens untreated sinusitis:

• inflammation of the cerebral cortex;
• inflammatory process in the eyeballs;
• abscess of the eyelids;
• ulcers in the central nervous system;
• poisoning the body with decay products of the disease process.

Diagnostics

In order to determine the cause of the unsatisfactory state of the body, with the above symptoms, it is necessary to choose the right specialist. Only an otolaryngologist can make a diagnosis of "Frontitis". During the appointment, the specialist will do a rhinoscopy - this is an internal examination of the nasal cavity with the help of special medical instruments.

Based on what the doctor sees, he will prescribe additional examinations:

• ultrasound examination of the frontal sinuses;
• using an endoscope to look at the inside of the nose;
• illuminate the sinus of the forehead with a special lamp;
• prescribe infrared thermography;
• prescribe a tank culture from the nasal cavity;
• do a biopsy inner fabric nose
• will appoint clinical analysis blood.

Based on the collected examinations, the doctor will be able to determine the diagnosis and prescribe the correct treatment.

Frontitis treatment

Treatment of inflammation of the frontal sinuses is not an easy task.

In order to achieve a positive result, it is necessary to comply general recommendations, which contain the following rules:

• relieve congestion of the sinuses;
• it is necessary to remove purulent fluid from the nasal cavity;
• kill bacteria, germs and fungi (if any);
• contribute to the good functioning of the nasal cavities;
• increase the overall resistance of the body;
• stimulate the immune system.

How to treat frontal sinusitis in acute form

Frontitis (symptoms and treatment in adults may be different) is eliminated by carrying out certain activities, which can help to extinguish a strong, abruptly started pathological process in the body:

• relieve acute pathological inflammation in the forehead cavity;
• weaken the manifestations of swelling in the nose;
• to resume the movement of fluid in the nasal passages;
• conduct antibiotic therapy;
• it is necessary to apply physiotherapy procedures;
• general strengthening therapy with vitamins and immunostimulants.

How to treat chronic sinusitis

For the treatment of chronically flowing pathology of the frontal sinuses, you will have to be patient. The disease for a long time destroyed the body, in particular - the nasal cavities, nerve endings on the face, there was a general intoxication of the whole body.

Therefore, first of all:

• to resume the outflow of secretory mucus from the forehead cavity;
• get rid of pus in the nasal cavity;
• help immune processes fight disease.

How to treat catarrhal frontitis

Catarrhal sinusitis is an inflammatory process in the frontal cavity, which is initial stage manifestations of the disease.

The primary methods of treatment of this pathological condition include:

• elimination of hyperemia;
• the use of antihistamines (if the disease is provoked by allergies);
• rinsing the nose with special therapeutic fluids;
• antibacterial therapy;
• inhalation of complex medicinal aromas.

How to treat frontitis in pregnant women

Self-medication for sinusitis in pregnant women is unacceptable.

Therapeutic measures for inflammation of the frontal cavities during pregnancy are possible subject to certain rules:

• antibacterial agents only local;
• inhalation of complex drugs essential oils(if there is no allergy);
• washing the nose with medicinal liquids;
• at high temperature, it is necessary to take NSAIDs;
• apply a quartz lamp to the nose and cavities;
• dressings and applications with medicines on the forehead;
• moving the drug along the Proetz;
• inhalation of vapors of warm liquid with the addition of medicines.

Antibiotics for frontitis

Antibacterial agents are widely used for inflammation in the body, unless they are of viral or fungal etiology.

For the treatment of inflammatory processes in the nasal cavities Pharmacological industry produces many types of medicines:

• penicillin antibiotics;
• beta-lactam antibacterial agents;
• macrocyclic antibacterial agents.

If the causative agent of pathological inflammation in the forehead cavity is bacteria, then it is necessary to prescribe:

1. Antibacterial agents of the penicillin series: Medoklav; Amoxil; Panklav.
2. Beta-lactam antibacterial agents: Abitrax; Ceftriaxone; Lavaxon.
3. Macrocyclic antibacterial agents: Azimed; Azithromycin; Ziomycin.

Antibacterial agents for frontal sinusitis should be used in the form of inhalations, injections, insolations, rinses, instillations and tablets.

homeopathic remedies

homeopathic medicines must be taken in the treatment of inflammatory diseases of the sinuses. With advanced processes, it can be combined with traditional medicines.

The pharmacological industry for the treatment and prevention of frontal sinusitis presents the following drugs:

• Aqua Maris.
• Nazomarin.
• Sinuforte.

Homeopathic preparations should be used for rinsing, instillation, inhalation, oral administration, resorption, in the form of ointments and applications.

Vasoconstrictors

Medicines: drops, sprays that have vasoconstrictor effect should be used in the treatment of sinusitis. Drugs with this action relieve congestion in the nose, which contributes to nasal breathing and normal processes between the nose and its cavities (sinuses).

Such medicines include:

• Vibrocil.
• Xymelin extra;
• Septanazil.

Antipyretics

Medicines that affect the regulation of heat transfer in the body should be taken in the treatment of sinusitis only if the level of the thermometer has risen above 38.1 degrees Celsius.

The pharmaceutical industry produces a huge number of drugs with a similar effect.

For example:

• Nimid.
• Ibuprofen.
• Indomethacin.

All of these drugs have the ability not only to restore the normal level of body temperature, but also relieve inflammation in the body.

Mucolytics

Medications that have a mucolytic effect help thin congested mucus in the nasal cavity and sinuses. The preparations of this group are oral and are a good addition in the combined treatment of frontal sinusitis.

The pharmaceutical industry produces the following mucolytic agents:

• Abrol.
• Fluimucil.
• Evkabal.

Anti-inflammatory drugs

Medicines with anti-inflammatory effect are needed as an additional, aid in the complex therapy of sinusitis. Means of this group are both oral and for local application, but all have one goal - to suppress the synthesis of eicosanoids that cause inflammation in the body.

Drugs with this effect include:

• Erespal.
• Amispirone.
• Metaspray.

Physiotherapy

used in the treatment of sinusitis different methods and funds.

The complex methods include physiotherapy procedures, which have a positive result in the treatment of inflammation of the nose:

• sonophoresis - the combination of ultrasound and medication;
• drug administration by means electric current- electrophoresis;
• inhalation of liquid or vapor in the form of medicinal inhalations;
• microwave radiation to the sinus area;
• ultrahigh-frequency therapy on the area of ​​the affected cavities;
• phototherapy of inflammation of the nose;
• treatment of pathologies of the nasal sinuses by the glow of an electric discharge in a gas;

All of the above procedures cannot be used in acute period illness.

Cuckoo method

The "Cuckoo" method, or in another way the method of introducing medicinal liquid according to the method of the developer Proetsu, is very effective way treatment of all forms of sinusitis.

The "Cuckoo" process is based on the introduction of a drug into one nasal opening with simultaneous suction of the drug and the pathological contents of the sinus and nasal cavity through another nasal opening, by means of a pulling device.

During the procedure, you need to breathe calmly, lie on your back, lift your head up and say "ku-ku, ku-ku, ku-ku." The duration of the procedure is up to 20 minutes.

YAMIK - method

YAMIK is a catheter that must be inserted into the sinus cavities. In this case, no puncture is made. This method affects all nasal cavities at once. Before starting therapy, you need to inject an anesthetic into the nasal cavity local drug. The patient sits on a chair, the head of the affected sinus looks up. Yamik is injected into nasal cavity.

Using an injection syringe, the cylinders of the device are filled with air. The patient lowers his nose down and in the opposite direction of the affected cavity at the same time. The pathological fluid is aspirated. Next, the patient lies on his side, the nose hangs down in the direction where there is damage.

The specialist pours the medicine into the YAMIK - a catheter - the sinus cavities are filled with medicine. Next, remove the air with a syringe from the catheter balloons. YAMIK is removed from the nasal cavity. The duration of therapy is about 25 minutes at a time. The course is designed for 10-12 drainages.

Hirudotherapy for frontal sinusitis

With frontal sinusitis, treatment with leeches is mainly aimed at restoring the relationship between blood and lymphatic vessels. Which in turn helps with congestion of the nose and cavities.

Leeches in their secret have many enzymes that help relieve swelling and improve the outflow of pathological fluid from the sinuses and nasal cavities.

In the treatment of sinusitis, freshwater worms are fixed on damaged frontal cavities. It is necessary to put two worms, which will be symmetrical to one another. The number of procedures required for nasal pathologies is up to 10 times, at intervals of 48 hours.

Nasal lavage

One of the most well-known methods of treating sinusitis at home is rinsing (washing) the nasal cavities and sinuses with medicines.

The sequence of actions is determined by which sinus needs to be washed. With frontitis - the head must be thrown back up, in the direction of damage. With a children's rubber pear or injection syringe, inject the medicinal liquid into one nasal opening, drawing it in slightly with the nose and exhale (push the liquid out) through the other nostril.

With experience, the liquid will itself flow from one nostril to the other and out. The main condition is the correct tilt of the head. You can flush your sinuses at home with hypertonic saline, a solution of nitrofural, a weak solution of potassium permanganate.

Inhalations for the treatment of frontal sinusitis

Inhalation is a method of inhaling moist or dry air. Action this method in the treatment of frontitis is based on the positive effect of inhaled vapors of liquid or air enriched medicines.

In this case, inhalations have a positive effect:

• moisturize the nasal mucosa affected by the inflammatory process;
• dissolves purulent and stagnant formations;
• makes it easier to breathe through the nose.

At home, you just need to hold your head over the dishes with warm medicinal liquid and breathe through your nose. The duration of this procedure is about 10 minutes.

Folk remedies for frontitis

Treatment of frontal sinusitis in adults and the removal of symptoms can be carried out with the help of folk methods and funds.

There are many recipes that must be used in home therapy for frontal sinusitis:

Operating method

Surgical intervention in the treatment of frontitis is an extreme measure, which is necessary in the absence of the effect of drug treatment and a strong accumulation of purulent fluid.

There are several methods of surgical intervention.

1. The doctor makes a hole in the region of the frontal cavity. This procedure helps to drain the purulent contents of the sinus.
2. Performing surgical manipulations using a light-conducting device - an endoscope.
3. Surgical intervention in an open way. The specialist cuts the affected cavity, frees it from the inflammatory formation.

What is the difference between frontitis and sinusitis

Sinusitis and frontal sinusitis are pathological processes in the human body with a common name - sinusitis. But the nasal cavity has its own structural features. What is located to the right and left of the wings of the nose are the maxillary cavities. It follows that their inflammation is called sinusitis. The cavity on the forehead is the frontal sinus and its inflammation should be classified as frontal sinusitis.

In the symptoms of frontal sinusitis in adults, it is not always possible to recognize serious illness. But the sooner the diagnosis is made, the sooner treatment and a speedy recovery will begin, bypassing complications.

Video about sinusitis, its causes, symptoms and treatments

What is dangerous frontitis:

A fragment of the program "Live healthy" about the front:

Perhaps, none of the patients of ENT doctors belongs to the category of lucky ones. Those who suffer from various inflammations of the paranasal ligaments are especially in dire need of our sympathy. It is painful and very unpleasant, but it is quite curable if you follow all the doctor's recommendations.

The most famous inflammation is, of course, sinusitis. Unfortunately, there are no less insidious diseases. One of them is the front. The symptoms of this disease are much more severe than with other types of inflammation of the paranasal sinuses. In addition, in the treatment of frontitis is too capricious.

Anatomical features of the disease

Frontal sinusitis is an inflammation of the frontal paranasal sinuses. For the past few years, this disease has been very common in the world. Almost 10-15% of the world's inhabitants suffer from it. At the same time, sinusitis, frontal sinusitis are often diagnosed in a rather complicated stage. Over the past five years, the incidence of diseases has increased dramatically. Only in Russia, almost one million inhabitants a year suffer from manifestations of frontal sinusitis.

Let's delve into the anatomical structure to understand what frontitis is. Causes, treatment are directly related to localization dangerous disease. The nasal cavity includes the paranasal sinuses. These are 2 maxillary, 2 frontal, 2 ethmoid labyrinths and one wedge-shaped. These cavities, small in size, open passages to the nose. In a healthy person, they are filled with air. The sinuses perform a number of important functions:

• lighten the weight of the skull;
• warm and humidify the air inhaled by a person;
• isolate eyeballs and tooth roots from temperature extremes;
• are a buffer during facial injuries;
• act as a vocal resonator.

The frontal sinuses are lined from the inside with a mucous membrane. This cover is very thin. The sinus is connected to the nose by a tortuous narrow canal. The latter opens with a small opening located in front of the nose.

Causes of the disease

When an inflammatory process of the mucous membrane lining the sinus occurs, frontal sinusitis is diagnosed. The causes of the disease are varied. But it is they who determine the severity and form of the disease. The main sources of the disease include the following:

• Infection. When viruses enter the nasal cavity, inflammation can proceed in parallel both in the maxillary sinuses and in the frontal ones. This is one of the complex forms of the disease. In this case, the patient is given two diagnoses: sinusitis, frontal sinusitis. SARS, influenza, scarlet fever, diphtheria can provoke the development of the disease. Sometimes the inflammation is caused by a fungal infection. Infection can occur hematogenously - through the blood. Often this happens through abscesses, carious teeth.
• Allergy. Bronchial asthma and vasomotor rhinitis provoke the development of inflammation of the mucosa. Prolonged allergic rhinitis, causing swelling, blocks the exit of fluid from the frontal sinus.
• Nasal polyps. Benign formations, which are the result of a degenerate mucous membrane, block the outflow. In this case, swelling of the mucosa is characteristic, breathing is significantly difficult.
• Injuries. As a result of bruising of the bones of the skull, inflammation may develop. Injuries disrupt blood circulation and provoke swelling.
• Curvature of the septum. It may be a congenital anomaly. Sometimes this is the result of an injury or illness. Regardless of the cause, a deviated septum prevents the free flow of microbes and mucus from the sinus.
• Foreign bodies. Staying small objects in the nasal cavity for a long time can provoke the development of inflammation. This is one of the common causes of frontal sinusitis in babies, because they can stick small objects up their noses.

Symptoms of the disease

Frontit is classified as a very serious illnesses. It is much more difficult to tolerate other sinusitis. There are two forms of leakage: chronic and acute. Accordingly, each of them has different signs characteristic of such a serious illness as frontal sinusitis. Symptoms, treatment of both forms are characterized by their own characteristics.

Acute frontal. In a patient, this form causes the following symptoms:

• sharp pain in the forehead, aggravated by pressure or tapping on the area above the bridge of the nose;
• nasal congestion, difficulty breathing;
• pain in the eyes, photophobia, lacrimation;
• discomfort in the inner corners of the eyes;
• discharge (copious) from the nose, initially transparent, but eventually turning into purulent;
• characteristic puffiness of the face, most noticeable in the area of ​​\u200b\u200bthe inner corners of the eyes;
• change in skin tone in the sinus area ( this symptom may be missing);
• an increase in body temperature (sometimes quite a bit, and in some cases up to 39 degrees);
• weakness, weakness due to intoxication of the body.

Pain is cyclical. In the morning, when the outflow of mucus long time was disturbed, the patient experiences increased discomfort. These are quite characteristic, if frontitis occurs, symptoms. Stagnation of mucus causes a deterioration in well-being. The pain spreads to the temple, eye, part of the head (if the disease is not bilateral). Having freed the sinus, the person feels relief. The pain starts to subside.

Chronic frontitis. If the disease, which occurs in an acute form, received the wrong treatment or was generally ignored, then the consequences are sad. As a rule, after 4-8 weeks, the patient is diagnosed with chronic frontal sinusitis.

Symptoms of this stage are less pronounced:

• pressure on the frontal bone causes pain in the eye;
• copious mucus in the morning from the nose, which has bad smell;
• pain in the frontal region (may be pressing or aching), aggravated by tapping;
• unpleasant purulent sputum in the morning.

It should be understood that the patient's condition did not improve with the easing of symptoms. Rather, on the contrary, it is the chronic form that can provoke serious complications, often life-threatening.

Complications of frontitis

This disease is considered a great threat to life. Quite often there is purulent frontal sinusitis. There is a risk of developing unpleasant consequences. Purulent inflammation can spread to neighboring organs and tissues. Needless to say, how close is the brain? This is what puts the disease in a number of dangerous ailments.

Consequences of frontitis:

• abscess of the orbit or brain;
• meningitis;
• phlebitis of the sinuses of the brain;
• osteomyelitis of the forehead bone;
• sepsis.

Therapy

The question arises of how to treat frontal sinusitis. The main thing is not to deal with the problem on your own, because the disease is really very serious. At the first symptoms, you should immediately contact the ENT. Treatment of the disease is based on medications.

Doctors prescribe drops that help reduce swelling. This allows you to improve the outflow of mucus. For this, vasoconstrictor drops "Nafthyzin", "Sanorin", "Farmazolin" are used. After that, after a few minutes, it is advisable to irrigate the nasal cavity with an aerosol preparation such as "Bioparox", "Kameton", "Proposol".

In the acute stage, antibiotics are connected. As a rule, such drugs are prescribed by a doctor, depending on the severity that frontal sinusitis acquires. Treatment (antibiotics should be selected exclusively by a doctor) is designed for 7-10 days.

For the effectiveness of the fight against the disease, they resort to additional funds, allowing to reduce swelling, relieve pain and inflammation. The course of treatment includes homeopathic and antihistamine preparations.

Often medical methods supplemented by physiotherapy. Warming up, prescribed by the attending doctor, allows you to get rid of some of the symptoms of the disease. These methods increase blood circulation, dilate blood vessels, stimulating the body's defenses.

The washing of the nose, called the "cuckoo", performs well. For these purposes, special solutions are used ("Furacilin" or "Chlorophyllipt"), which have anti-inflammatory and antimicrobial properties. However, the "cuckoo" is only suitable for mild forms of frontitis.

If medical treatment is not effective, resort to surgical intervention. As a rule, the diagnosis of "purulent frontal sinusitis" requires a puncture of the frontal cavity. The outflow of the contents of the cavities does not exit through the natural mouth. This provokes severe headaches. Often this procedure it is necessary to repeat, because it is not possible to remove all the pus at a time. The procedure is rather unpleasant and painful, but in general it is very effective.

home treatment

It is worth noting immediately that the expediency of being in a hospital should be determined only by a doctor. And if he recommends treatment in the hospital, do not ignore his advice. Be sure to consult with a specialist about how neglected your frontitis is. Treatment at home is allowed only for mild forms of the disease. At the same time, you should not refuse prescribed medications. But supplementing them with traditional medicine will be very useful. The main thing is not to forget that only an ENT can exercise the necessary control over your treatment.

You should be very careful about the disease if you are diagnosed with purulent frontal sinusitis. Treatment should completely exclude warming up. In this case, this can provoke the spread of pus into neighboring tissues, which is extremely dangerous.

Therapeutic inhalations

This method is widely used in traditional medicine. In the fight against the disease, he showed excellent results. It is important to understand that any steps should be initially discussed with the attending physician, this is the only way to overcome frontal sinusitis. Treatment with folk remedies is quite effective only with the interaction of the patient and the doctor.

Recipes for inhalation:

1. Boil potatoes in uniforms. Drain the water and crush the tubers. Covered with a terry towel, breathe over the steam.
2. Boil dry chamomile flowers. Pour a couple of drops of tea tree oil (eucalyptus) into the hot broth. Inhale the vapor of the resulting mixture.
3. Boil water - 1.5 liters. Add ten bay leaves to it. Leave the liquid on low heat. Breathe deeply in the steam.

Washing the nasal cavity

Any form of frontitis needs this procedure. AT stationary conditions it is carried out by the above "cuckoo" method. But if you produce (only when the ENT controls how the frontitis proceeds) treatment at home, you can use traditional medicine recipes. Be sure to thoroughly clean the nasal cavity before washing.

1. Dissolve a teaspoon of ordinary rock salt in warm boiled water, add a pinch of soda. Pour three drops of tea tree oil into this mixture. With this solution, you should rinse your nose up to 4 times throughout the day. The composition perfectly disinfects the nasal cavity, has anti-inflammatory and antiviral effects.
2. Prepare 500 ml warm boiled water. Add a tablespoon of Chlorophyllipt solution. The resulting product has antibacterial action. Allows you to fight a large number microorganisms, including those that are resistant to antibiotics.

home drops

In folk medicine, decoctions and juices are widely used. Before instillation, the nasal cavity must be cleared of the contents. After the procedure, it is advisable to lie down a bit so that the drops evenly penetrate the nasal passages.

1. Grate black radish. Squeeze out the juice from the resulting mass. It is he who must be instilled into each nostril up to 4 times a day. This product is different high content essential oils. It is great for cleansing the nasal cavities.
2. Rinse the cyclamen tubers. Grind them thoroughly and squeeze out the juice. Be sure to dilute the resulting composition with water. The proportion is as follows: 4 parts of liquid are needed for 1 part of cyclamen juice. These drops are very successful in the fight against the disease. Cyclamen is suitable for the treatment of any stage of the disease.
3. Put a small piece of propolis in the freezer for several hours. After removing it, quickly grind in a mortar. Pour propolis with vegetable (refined) oil. The mixture should be infused for 3 days, always in a dark place. These drops perfectly help relieve inflammation, soothe the mucosa. It is important to know that with an allergic rhinitis, you can not use such a remedy.

Folk ointments

Don't forget about pretty effective procedure. Ointments are amazing. They are quite effective in the fight against such an ailment as sinusitis. Treatment with ointments is an excellent addition to medication.

1. Take in equal proportions honey, Vishnevsky ointment, aloe juice, cyclamen and onion. Mix all the ingredients thoroughly to get a homogeneous mass. This ointment should be stored exclusively in the refrigerator. Saturate the turundas with the resulting composition and put in the nostrils for half an hour.
2. Melt laundry soap in a water bath (half of a regular piece). Add a teaspoon of alcohol (70%), vegetable oil, milk and honey. After cooling the product, soak cotton flagella with it and put it in the nasal cavity for about fifteen minutes. Ointment great way cleanses, relieves inflammation, disinfects the mucosa.
3. Finely chop one clove of garlic, mix with the same amount butter. This ointment should be applied to the forehead at night. The healing components of garlic perfectly penetrate deep into the tissues, helping to get rid of the disease.

Disease prevention

The main activities are aimed at strengthening the body's defenses, strengthening immunity. You should not wait until the frontitis makes itself felt. Symptoms of the disease are painful and unpleasant, and the consequences are sometimes deplorable. Therefore, it is better to prevent the disease than to seek effective treatment methods.

The complex of preventive measures includes:

• Hardening of the body. A variety of water procedures, sports, preferably on fresh air, long walks.
• Timely and complete treatment any viral disease.
• Prevention of hypothermia.
• Sanitation of the focus of chronic infection.
• Treatment of adenoids.

It is very important to follow all preventive measures those patients who have already suffered frontal sinusitis once. The consequences of the disease are severe, so it is important to prevent a relapse.

Conclusion

No matter how severe frontitis may seem, proper and timely treatment can save you from the disease. If you notice the symptoms described above, be sure to go to an appointment with an ENT. Only effective treatment will protect you from chronic frontal sinusitis, which may not go away for years and bring very serious complications.

Frontitis is a disease in which an inflammatory process develops in the mucous membrane of the frontal (frontal) sinus of the nose.

The frontal sinuses are paired cavities located in the frontal bone of the skull on either side of the midline. The size and configuration of the sinuses have different people individual characteristics. In some cases, the frontal sinuses may be undeveloped or completely absent. The proximity of the frontal sinuses to the anterior cranial fossa and eye sockets is fraught with serious complications of inflammation.

All age groups are equally susceptible to the disease, men suffer from frontal sinusitis more often than women.

Frontitis is an inflammatory process in the mucous membrane of the frontal sinus of the nose.

Causes and risk factors

The most common cause of occurrence acute frontitis is an infectious process that has spread to the mucous membrane of the frontal sinus from the nasal cavity in acute respiratory infections, as well as other infectious diseases. The causative agents can be viruses, bacteria or microscopic fungi.

Risk factors for frontal sinusitis include:

• injuries of the nose and / or paranasal sinuses;
• congenital or acquired curvature of the nasal septum;
• respiratory failure through the nose (polyps, adenoids, vasomotor rhinitis, etc.);
• weakened immunity;
• foreign bodies in the nasal cavity.

Chronic sinusitis develops against the background of incorrect or untimely treatment of the acute form of the disease, it is facilitated by the features of the anatomical structure of the paranasal sinuses and / or nasal septum.

The chronic form of frontal sinusitis can take a persistent course with periodic relapses.

Forms of the disease

Depending on the nature of the pathological process, frontitis is divided into acute, recurrent, subacute and chronic.

By prevalence:

• one-sided (left- or right-handed);
• bilateral.

Depending on the etiological factor:

• bacterial;
• viral;
• fungal;
• allergic;
• traumatic;
• mixed.

On the path of infection:

• rhinogenic - develops against the background of rhinitis;
• hematogenous - the pathogen penetrates into the frontal sinus with blood flow;
• traumatic - occurs as a result of damage to the skull in the region of the frontal sinuses.

According to the nature of inflammation:

• catarrhal;
• serous;
• purulent;
• polyposis (cystic).

The purulent form of frontitis is the most dangerous, since with inadequate or insufficient treatment it can cause serious complications.

Frontitis symptoms

In acute frontal sinusitis, patients complain of sharp pain in the superciliary region, which is aggravated by tilting the head, during sleep, during palpation, it can radiate to the temporal region and is not stopped by taking analgesic drugs. Also, symptoms of frontal sinusitis can be headaches of other localization, unpleasant bursting sensations in the bridge of the nose, photophobia, pain in the eyes, copious discharge from the nose, odorless or with an unpleasant odor and particles of pus (with purulent frontal sinusitis), difficult nasal breathing. These phenomena are accompanied by an increase in body temperature, a cough with sputum in the morning, a deterioration in the general condition, and sleep disturbance.

The clinical picture of chronic frontal sinusitis in adults is less pronounced compared to acute. As a rule, the chronic form of the disease is accompanied by inflammation of other paranasal sinuses, especially the ethmoid sinus (ethmoiditis). The pain in the forehead is aching, aggravated by pressure, its intensity changes during the day. Discharge from the nose often has an unpleasant odor, there is a decrease in the sense of smell up to a complete loss. Edema of the eyelids indicates the spread of the pathological process to the orbit. Chronic sinusitis is characterized by alternating periods of exacerbation and remission. Signs of frontitis during remission can be a feeling of heaviness in the superciliary region, decreased sense of smell, nasal discharge.

Features of the flow of frontal sinusitis in children

In children under 5-7 years old, the frontal sinuses are not developed, so they do not suffer from frontal sinusitis, the disease is detected in primary school and adolescence. Isolated inflammation of the frontal sinuses is rare in children, much more often frontal sinusitis in this age group is diagnosed as a component of pansinusitis.

The causative agents of sinusitis can be viruses, bacteria or microscopic fungi.

In general, children tend to severe course frontitis with bilateral sinus lesion, clinical picture similar to acute respiratory infections, however, it is alarming in relation to inflammation of the paranasal sinuses, first of all, the duration of the disease is longer than that of acute respiratory infections. To specific symptoms frontitis in children include:

• persistent headache, aggravated by head movements;
• pain in the projection of the frontal sinuses, aggravated by pressure;
• purulent discharge from the nose;
• nasal voice;
• lacrimation;
• cough in the morning;
• stuffy nose and ears.

In some cases, conjunctivitis develops against the background of frontal sinusitis in children.

There is also a number non-specific signs diseases:

• rise in body temperature (rarely above 38.5 ° C);
• pallor of the skin;
• difficulty or complete impossibility of nasal breathing;
• puffiness;
• loss of appetite;
• weakness, fatigue;
• irritability;
• sleep disorders.

Frontitis in children is prone to spread to other paranasal sinuses (in the event that it was isolated), as well as to a rapid flow into a chronic form.

Diagnostics

The diagnosis is made on the basis of the results of the following studies:

• collection of anamnesis (the presence of a previous respiratory disease, sinusitis of other localization, duration of manifestations, etc.);
• objective examination;
• rhinoscopy (helps to determine the presence of an inflammatory process in the nasal cavity);
• bacteriological examination discharge from the nose (makes it possible to identify an infectious agent, determine its sensitivity to antibacterial drugs);
• general and biochemical blood test, urinalysis (determines signs of an inflammatory process, allows you to assess the general condition of the body);
• x-ray examination (allows to carry out differential diagnosis purulent frontal sinusitis and non-purulent forms of the disease, lesions of other sinuses, to establish the presence of deviated nasal septum);
• magnetic resonance or computed tomography (help to identify anatomical features nose and paranasal sinuses and the prevalence of the pathological process).

If necessary, additional studies can be applied:

• cytological analysis of the contents of the nasal cavity;
• scintigraphy;
• thermography;
• diaphanoscopy, etc.

All age groups are equally susceptible to the disease, men suffer from frontal sinusitis more often than women.

Differential diagnosis of frontal sinusitis with inflammatory diseases of other paranasal sinuses, trigeminal neuralgia, inflammation of the meningeal membranes, etc. is necessary.

Frontitis treatment

Treatment of frontal sinusitis is selected depending on the form of the disease, the prevalence of the pathological process, age, general condition of the patient and other factors.

Acute frontal sinusitis is an indication for hospitalization in an otolaryngological hospital.

To reduce swelling of the nasal mucosa and paranasal sinuses in order to create conditions for the outflow of pathological contents from the inflamed frontal sinuses, local vasoconstrictors are used to lubricate the mucous membranes of the nasal cavity (these drugs are also used in the form of drops and sprays). After removing the edema, antiseptic, anti-inflammatory drugs are injected into the sinuses.

The general therapy of acute frontal sinusitis consists in the use of broad-spectrum antibacterial drugs, antihistamines and anti-inflammatory drugs.

In addition to drug treatment frontal sinusitis, physiotherapeutic methods such as laser therapy, UHF therapy, electrophoresis with drugs, etc. can be used.

The purulent form of frontitis is the most dangerous, since with inadequate or insufficient treatment it can cause serious complications.

With the ineffectiveness of conservative treatment, the appearance of complications and a pronounced deterioration in the patient's condition, surgical intervention (trepanopuncture) is indicated. With trepanopuncture, penetration into the frontal sinus is carried out through a section of the frontal bone of the smallest thickness. Manipulation can be done in two ways - by piercing bone tissue or drilling. After removing the pathological secret, the sinus is washed with an antiseptic solution, treated with an antibacterial and anti-inflammatory drug. With proper care of the puncture site, the puncture heals without a scar or scar. In some cases, surgery is performed endoscopic method. If all other methods are ineffective, they resort to trepanation of the frontal sinus: after cutting the skin with a scalpel, the sinus is opened, washed with an antiseptic, installed in the channel connecting the frontal sinus with the nasal cavity, a plastic tube for drainage, then the incision is sutured.

In the treatment of chronic frontal sinusitis, in general, the same approach is used, however, the antibacterial drug is selected taking into account the sensitivity of the infectious agent to it, anti-inflammatory therapy is carried out with the help of glucocorticoid drugs. Vitamins and other drugs are prescribed to strengthen the immune system. A positive effect is also provided by physiotherapy (magnetotherapy, UV radiation, etc.).

Treatment of acute frontal sinusitis lasts from several days to a week, chronic - 1-2 weeks or more.

Possible complications and consequences

In the absence of the necessary treatment, acute frontal sinusitis can turn into a chronic form - this is the most common complication. Also, frontitis can be complicated by the following conditions:

• atrophy of the mucous membrane of the nasal cavity;
• conjunctivitis;

  Forecast

  With timely and adequate treatment, the prognosis is favorable. The chronic form of frontal sinusitis can take a persistent course with periodic relapses.

  Intracranial complications of frontal sinusitis are characterized by an unfavorable prognosis and can lead to death.

  Prevention

  1. Timely treatment of respiratory diseases.
  2. Rejection of bad habits.
  3. Avoid hypothermia.

  Video from YouTube on the topic of the article:

If an inflammatory process begins in the mucous membrane of the frontal sinuses of the nose, then this pathological condition of the nose is called frontal sinusitis (the second name is frontal). Of all known species it is the frontal sinusitis that has the most severe form of the course and causes a number of complications.

To start on time necessary treatment and to prevent serious consequences, you need to be able to identify the symptoms of frontal sinusitis and not confuse its manifestations with other pathologies of the nasopharynx.

Frontitis (frontal sinusitis) - an inflammatory process in the mucous membrane of the frontal sinuses of the nose

Why does frontit appear

Frontitis occurs and develops in adults most often due to viral or bacterial infections(SARS, influenza, etc.), immune system disorders, or against the background of other diseases:

• allergic or asthma;
• Untreated caries;
• Infections;
• cystic fibrosis;
• Chronic vasomotor;
• Kartagener's syndrome;
• Tumor formations of the nasal cavity and paranasal sinuses.

Important! and frontitis occur for similar reasons, but the symptoms of the latter appear more acutely and rapidly, which can lead to complications, life threatening patient (for example, to).

Other causes provoking the occurrence may be:

• Dust and general air pollution;
• Frequent stay in smoky, gassed rooms;
• Swimming lessons (especially frequent diving);
• Injuries to the nose and curvature of the nasal septum;
• General depletion of the body;
• Professional barotrauma;
• Incorrect blowing of the nose;
• Individual structure of the nasal sinuses (large length and narrowness of the fronto-nasal canal);
• Frequent hypothermia of the head.

How does the frontitis develop? A feature of the anatomical structure of the frontal sinus is a rather narrow, curved canal between the nasal cavity and the sinus (in the photo you can see the structure of the sinuses). With a strong mucosal edema, communication between the cavities is disrupted, and the inflammatory fluid cannot enter the nasal passage, accumulating in the frontal sinus. This creates favorable conditions for the development of the inflammatory process.

Acute frontal sinusitis develops in most cases against the background of damage to the cells of the ethmoid labyrinth or maxillary sinuses. Therefore, the disease is characterized by a complex and severe course.

Chronic frontal sinusitis is formed due to a protracted acute form, due to concomitant conditions- violations of drainage (mucus outflow) of the frontal sinus, suppression of the immune system against the background of the disease.

In the chronic form, the inflammatory process often extends not only to the frontal sinuses, but also to neighboring areas (paranasal sinuses). In this case, the disease is not only protracted, but also has a very severe course.

Symptoms of types of frontitis

The most common signs of frontal sinusitis are the appearance of pain around the eyes and nose, accompanied by swelling. Pain increases when the patient bends down and during sleep. Such symptoms are the main difference between frontal sinusitis and, in which pain, on the contrary, weakens at night and in the supine position.

Acute sinusitis

Acute frontal sinusitis is characterized by the presence of local inflammatory signs and symptoms of general intoxication.

How frontal sinusitis manifests itself in acute form:

• Excruciating headaches (caused by the accumulation of pus in damaged sinuses).
• Feelings of a "bursting" character in the region of the nose. During the day, the pain increases and becomes more noticeable when the head is tilted forward.
• Manifestations of strong tension in the inflamed frontal sinus. Such sensations in advanced cases may increase in the temporo-occipital and occipital parts.
• A sharp rise in temperature to high performance(38.5-39 degrees).
• Discharge from the nose, having an unpleasant "pustular" smell. In appearance, they are transparent, in rare cases contain particles of pus. With complete nasal congestion, nasal discharge may be completely absent.
• Lacrimation, photophobia.
• that appears at night.
• Loss of strength, apathy, fatigue, poor appetite and restless sleep.

Note! The peculiarity of pain in the acute phase of frontal sinusitis lies in their cyclicity: pain (sometimes unbearable) occurs at the moment when the outflow of fluid is disturbed, when the sinus is released from mucus, the pain subsides.

According to the type of inflammation, frontitis is divided into two subspecies:

1. Purulent frontitis. A large number of pus accumulates in the frontal sinuses, which leads to a serious condition (up to).
2. Catarrhal frontitis. There is severe nasal congestion and a feeling in the frontal part. With proper treatment, it proceeds without complications, if the problem is ignored, it passes into a purulent phase.

If the therapeutic measures are chosen incorrectly, or the symptoms of frontal sinusitis are simply ignored, the acute phase of the disease flows into the chronic form.

Chronic sinusitis

The main symptom of chronic frontal sinusitis is a constant runny nose, which is almost impossible to eliminate by everyone. available means. The mucus secreted from the nose has a sharp repulsive odor and a purulent character.

In the chronic form, the inflammatory process is observed in one of the sinuses (acute frontal sinusitis often affects both sinuses), where pus is concentrated.

Chronic sinusitis begins to manifest itself with the following symptoms:

• Decreased sense of smell (inability to smell and recognize a smell);
• Swelling of the eyelids in the morning (inflammation affects the region of the eye sockets);
• severe fatigue and weakness;
• Permanent, which is not stopped by drugs;
• The growth of polyps (neoplasms) in the nasal cavity, which causes breathing problems.

The chronic form is difficult to diagnose, the disease can be recognized only in stationary conditions after laboratory research and radiographs.

Important! The occurrence of a runny nose that does not go away for more than seven days is a reason to turn to Laura.

The most harmless complication of the disease is the gradual flow of acute frontal sinusitis into a chronic polyposis form, in which surgical intervention may already be required. But more dangerous conditions can also occur: abscess of the eye sockets, face, brain abscess, loss of vision.

Medical therapy

Diagnosis of frontal sinusitis is not difficult - the doctor determines the disease based on clinical manifestations. Usually, an x-ray of the frontal sinuses is additionally prescribed to confirm the diagnosis.

Treatment in adults of frontal sinusitis is aimed at eliminating inflammatory processes in the frontal part, eliminating puffiness, suppressing infection and restoring the discharge of pus from the mucous membranes.

To do this, use the following drug groups drugs:

• antibiotics;
• Homeopathic remedies;
• Antipyretics;
• Vasoconstrictor drugs.

Antibiotics

Antibiotics, both topical and internal use. Before treating sinusitis, the doctor must make sure that the sinusitis is bacterial in nature (viruses cannot be eliminated with antibiotics).

If a bacteriological study is not done for some reason, then broad-spectrum antibiotics are prescribed - a group of penicillins, macrolides and cephalosporins.

Antibiotics for internal use:

• Macrolides (Azithromycin, Spiramycin, Macropen);
• Penicillin (Ampisid, Aoxicillin, Augmentin);
• Cephalosporins (Axetil, Ceftriaxone, Cefataxime).

Local antibiotics can be in the form of nasal sprays, drops, aerosols:

• Bioparox;
• Isopra;
• Polydex.

Bioparox is one of the best drugs for the treatment of frontitis

If the outflow of purulent contents can be normalized at the very beginning of treatment, then antibiotics for frontal sinusitis may not be needed at all.

Homeopathy

Homeopathic remedies for frontal sinusitis show excellent results and are often included in complex treatment. Homeopathy can be used at any stage of the disease and with different types frontitis.

Preparations:

• Sinuforte- eliminates inflammation, stimulates ventilation and opening of the nasal sinuses;
• Sinupret–. relieves the inflammatory process, liquefies the contents of the mucosa;
• cinnabsin- relieves puffiness, strengthens, facilitates breathing.

If the disease is not pustular in nature and there are no polyposis formations, then frontitis can be cured only with homeopathic preparations, without resorting to antibiotics.

Vasoconstrictor drugs

They contribute to the removal of puffiness in the nasal concha and on the mucous membrane, relieve nasal congestion and normalize nasal breathing.

Popular means:

• Vibrocil;
• Naphthyzin;
• Galazolin;
• Nazivin.

Any remedy should not be used for more than five days.

Antipyretic drugs

They are used if the temperature indicators have exceeded 38 degrees, or with a pronounced deterioration in well-being (, fever, weakness). The child most severely tolerates signs of intoxication, so children must be prescribed antipyretics.

Antipyretics:

• Panadol;
• ibuprofen;
• Efferalgan;
• Nurofen.

If the body temperature exceeds 38 degrees during frontitis, it is necessary to take antipyretic drugs.

Without consulting a doctor, these drugs should not be used for more than three days.

Acute forms of frontal sinusitis are usually treated in a hospital under the supervision of a physician; in the chronic form, treatment can be carried out at home.

Other treatments

Drug therapy is usually not enough to quickly and successfully get rid of frontal sinusitis, so additional methods are used: inhalation and washing of the sinuses, physiotherapy, and surgery.

Physiotherapy

They are prescribed in the absence of high temperature and signs of severe intoxication.

Possible procedures:

• UHF - up to 12 sessions;
• Warming compresses (sollux) on the forehead area - up to 10 procedures;
• Endonasal sounding;
• Quartzization of the nasal cavity - up to 10 sessions;
• Cleaning the nasal cavity "Dolphin".

Microwave and UHF sessions are carried out only after the outflow of mucus is normalized, otherwise physiotherapy will only aggravate inflammation.

In chronic frontal sinusitis, laser therapy can be prescribed if there are no polyps.

Inhalations

Treatment of frontal sinusitis at home involves inhalation:

• Boil potatoes in their "uniform". Slightly crush and breathe steam over a saucepan, wrapping a towel around your head for a greater effect.
• Boil chamomile flowers. Drop a couple of drops of tea tree or eucalyptus oil into the broth. Breathe in the steam.
• Boil 1.5 liters of water, throw in a dozen bay leaves. Reduce the heat and breathe over the steam (without removing from the fire).
• Add the Asterisk balm to the hot water at the tip of a knife. Breathe in the steam, covering your head with a towel.

Washing

How to treat sinusitis at home by washing:

1. Before the procedure, the sinuses should be cleaned as much as possible and drip vasoconstrictor drops into the nostrils.
2. Using a rubber bulb (or a special bottle), pour the prepared liquid into one nostril under pressure.
3. The head must be held in such a position that the liquid flows out of the other nostril.

Recipes:

• Pour a teaspoon of salt into slightly warm water (room temperature), add 2-4 drops of tea tree oil. Rinse 3-4 times a day.
• Dissolve a small spoonful of chlorophyllipt (alcohol solution) in 500 ml of water. Rinse throughout the day (up to four times).
• Chamomile decoction. Rinse in the same way as other methods.

Note! Treatment with folk remedies is unacceptable in the acute phase of frontal sinusitis, because. it threatens with intracranial and ophthalmic complications.

Surgery

A puncture with frontal sinusitis (trepanopuncture) is done in severe forms of frontal sinusitis, when methods conservative therapy powerless. In the frontal bone to the frontal sinus, a puncture is made to suck out pus and wash the sinuses with antiseptics.

Surgery can be done with an endoscope (a more modern operation) or by opening the frontal sinus to drain pus from the sinus area.

Treatment of frontal sinusitis usually has a favorable prognosis and is not aggravated by pathologies. Complications can arise only as a result of self-treatment of the patient and late access to doctors. It is necessary to start fighting the disease in the first stages, when the symptoms of frontal sinusitis are just beginning to make themselves felt.

is an inflammation of the mucous membrane of the frontal sinus. The main signs of the disease are a headache with an epicenter in the eyebrow and spreading to the parietal, temporal region, discharge of purulent or mucous exudate from the nose, intoxication syndrome, loss of smell. Diagnosis is based on the results of the history taking, general inspection, rhinoscopy, radiography or computed tomography, sinus endoscopy. The treatment program includes antibacterial drugs, detoxification therapy, anemization of the nasal mucosa, surgical drainage of the sinus, physiotherapy procedures.

General information

Frontitis is a widespread otorhinolaryngological disease. From 24 to 32% of all episodes of hospitalization in the otolaryngological hospital due to pathologies of the paranasal sinuses. At the same time, about 14% of the total adult population suffers from different forms sinusitis. Up to 3-5% of inflammatory processes in the sinuses are frontal sinusitis, which ranks second in the structure of morbidity among all sinusitis variants. On the territory of the CIS countries, the disease is observed annually in approximately 1-1.3 million people. Acute forms of pathology occur 2-5% more often than chronic ones. The main group of patients are young and middle-aged people - from 16 to 35 years. In males, frontal sinusitis is diagnosed somewhat more often - 55-58% of total number cases.

Causes of frontitis

In etiology acute inflammation frontal sinus plays a leading role ARVIcaused by rhinoviruses, adenoviruses, coronaviruses or respiratory syncytial infection. In chronic forms, bacteria, representatives of the coccal microflora (Staphylococcus aureus, Streptococcus pneumoniae) in association with Moraxella catarrhalis and Haemophilus influenzae, often act as an infectious agent. Less common pathogens are pneumococci, pseudodiphtheria bacillus, pathogenic fungi. There are a number of factors contributing to the development of frontitis:

• Diseases of the upper respiratory tract. Include acute and chronic rhinitis, adenoiditis, pharyngitis, tonsillitis, sinusitis, tubo-otitis and other pathologies that are a potential source pathogenic microflora. In addition, this group includes pronounced growths of adenoid vegetations and benign tumors that overlap the lumen of the mouth of the sinus canal.
• immunodeficiency states. The occurrence of frontal sinusitis may be due to a decrease in the reactivity and resistance of the body, observed in AIDS, malignant tumors, massive antibacterial, radiation or cytostatic therapy, hemoblastosis, genetic abnormalities, diabetes mellitus, hypothyroidism, autoimmune pathologies.
• Traumatic injuries. Injuries or surgical interventions can contribute to inflammation of the frontal sinus, resulting in deformation or blockage of the excretory duct or narrowing of the frontal sinus. This also includes developmental anomalies that lead to similar changes - curvature of the nasal septum, deformation of the ethmoid labyrinth and middle nasal concha.

Pathogenesis

The starting factor for inflammation of the sinus is a violation of its normal ventilation caused by swelling of the mucous membrane of the turbinates, deformation or obstruction of the excretory canal. In this case, the air flow from laminar turns into turbulent and constantly injures the mucous membrane. Total blockage of the mouth is the reason for the complete cessation of drainage, aeration, provokes the accumulation of mucous secretions. Arteries and veins pass through the mouth, providing blood supply to the tissues of the sinus. Their compression underlies local dystrophic reactions.

The oxygen remaining in the sinus is gradually absorbed by the mucous membrane, the partial pressure in the sinus decreases. During hypoxia, the process of anaerobic glycolysis starts, and underoxidized metabolic products accumulate. This creates an acidic environment acid-base balance, which interferes with mucociliary clearance and further exacerbates sinus drainage disorders. Under conditions of metabolic acidosis, the effect of lysozyme is completely leveled. Combination listed factors creates the most favorable conditions for the reproduction of pathogenic microflora, inflammatory reactions such as edema and mucoid swelling.

Classification

Various variants of frontal sinus lesions are classified based on the nature of the inflammatory reaction, morphological changes, duration and activity of the disease. The introduction of gradations in clinical practice allows you to select the optimal therapeutic tactics, decide on the need for early surgical treatment. Taking into account the characteristics of the course of the disease, the following forms are distinguished:

• Acute. It is characterized by the persistence of clinical manifestations of the disease for up to 12 weeks. With quality treatment, a complete recovery occurs without residual effects.
• Recurrent. This option is characterized by the occurrence of 1 to 4 episodes of exacerbations within 1 year with intervals between them of at least 2 months, during which there are no symptoms of pathology and no need for treatment.
• Chronic. Manifestations of the disease persist for more than 12 weeks even against the background of ongoing conservative therapy. Relief of symptoms is achieved after surgical treatment.

To assess the morphological features of the lesion of the frontal sinus, a modified classification presented by B. S. Preobrazhensky is used. According to her, the following types of chronic frontitis are distinguished:

• Exudative. Accompanied by exudate different nature, because of which it has subspecies: catarrhal, serous (idiopathic or as dropsy of the sinus with blockage of the excretory duct) and purulent.
• Productive. There are hyperplastic processes on the part of the sinus mucosa. There are the following options: parietal-hyperplastic (wall thickening), polyposis (formation of polyps), cystic (formation of cysts).
• Alternative. This species is characterized by destructive changes in the anatomical sinuses. Given the nature of the process, they are divided into cholesteatoma, caseous, necrotic, atrophic.
• Mixed. A variant of the disease in which the previously named forms are combined: purulent-polypous, serous-catarrhal, serous-polypous, parietal-hyperplastic-polypous, etc.
• Vasomotor and allergic. Types of disease associated with vasomotor rhinitis and allergic reactions. Morphological changes and the nature of pathogenetic processes correspond to the main pathologies.

Frontitis symptoms

The clinical picture depends on the severity of the disease. In mild forms, predominantly local manifestations are observed, combined with signs of viral rhinitis: worsening of nasal breathing and smell, moderate headache in the superciliary region, the presence of discharge from the nose of a mucous or purulent nature. Some patients complain of discomfort or pain in the medial corner of the eye. Depending on which sinus is involved in the pathological process, the symptoms are more pronounced on the right, left, or evenly on both sides. Intoxication syndrome is usually absent. The clinic persists for up to 5 days, after which it disappears simultaneously with the symptoms of acute respiratory viral infections or persists, which indicates the addition of the bacterial flora.

Moderate frontal sinusitis is characterized by local severe pain of a bursting, pulsating nature in the right or left superciliary region. The pain syndrome increases with the movement of the eyeballs, tilting the head forward or backward. If the patient prefers to sleep on his back, a sharp exacerbation of pain is observed in the morning, which is associated with the accumulation of pathological masses. Often the pain radiates to the temporo-parietal region, accompanied by a feeling of pressure “behind the eyes”. A general intoxication syndrome is revealed, manifested by an increase in body temperature to 38.0-39.0 ° C, weakness, malaise, increased fatigue, loss of appetite and sleep disturbance. The severe form is characterized by severe, sometimes unbearable pain, severe systemic intoxication, reactive eyelid edema, redness and swelling of the skin in the frontal sinus projection area, and puffiness of the face. In patients, photophobia, lacrimation, blurred vision are more common.

In the chronic form in the stage of remission, the symptoms of the disease are absent or are represented by the release of a small volume of pathological masses from the nose from the side of the affected sinus and a low-intensity periodic diffuse headache without a clear localization. An early sign of an exacerbation is a sensation of "rush" or "heat" in the forehead. Then there is a constant pain syndrome with an epicenter over the affected sinus of a dull, compressive nature. The pain may intensify at the end of the working day, after a long tilt of the head, physical activity, sometimes accompanied by a sensation of pulsation. Intoxication syndrome during exacerbations is mild.

Complications

Complications of the disease are associated with untimely or inadequate treatment, the presence of severe immunodeficiency. Most often, the infection spreads to other paranasal sinuses, provoking the development of bilateral frontal sinusitis, sinusitis, ethmoiditis, sphenoiditis. As a result of the destruction of the lower wall of the frontal sinus, the process passes to the tissues of the orbit, which leads to orbital complications: reactive edema of the tissue, abscess and phlegmon of the eyelid or orbit, osteoperiostitis of the orbit. Without timely treatment these complications can provoke compression and ischemia ophthalmic nerve, and, as a result, permanent visual impairment up to blindness.

With caries of the posterior or upper wall of the sinus, intracranial complications develop due to the penetration of purulent masses and pathogenic microorganisms into the anterior cranial fossa. Can form arachnoiditis, meningitis, encephalitis, abscesses of brain tissue, thrombosis of the venous sinuses. In severe cases, hematogenous dissemination of bacteria and their metabolic products occurs, causing sepsis, the formation of metastatic foci of infection in other organs - the liver, lungs, etc. All rhinogenic intracranial complications and septic conditions are associated with a high risk lethal outcome require treatment in the resuscitation and intensive care unit.

Diagnostics

The diagnosis is made on the basis of anamnestic information, the results of a physical examination, general clinical laboratory tests, bacteriological analysis and beam methods diagnostics. When interviewing a patient, an otolaryngologist details the complaints made by the patient, finds out diseases or circumstances that preceded the development of current symptoms, trauma, operations in the nose and forehead. For the purpose of a detailed examination, the following are carried out:

• Physical examination. A visual examination of the brow area is determined by hyperemia, moderate swelling. With pressure or percussion of this zone, the patient notes an increase in pain. During the tilt of the head, in addition to changing the intensity of the pain syndrome, nasal discharge intensifies.
• Examination of the nasal cavity. Rhinoscopy allows you to identify the characteristic symptom of a "purulent strip" - a small amount of purulent exudate flowing from the anterior part of the middle nasal passage. The visible mucous membrane is somewhat hyperemic, edematous.
• Radiography. X-ray of the paranasal sinuses is the leading diagnostic method. To obtain the most informative x-ray picture, the study is carried out in the lateral, direct and posterior axial projection. Darkening of the cavity, uneven contours of the sinus, a decrease in its pneumatization, and the presence of defects in the bone walls indicate frontal sinusitis.
• CT scan. CT scan of the paranasal sinuses is prescribed for low diagnostic value of radiography, suspicion of the development of orbital or intracranial complications. The tomogram clearly shows all the existing changes bone structures and input channel.
• Endoscopy of the frontal sinus. If it is impossible to reliably determine the nature of the pathological process in the frontal sinus and conduct a full-fledged differential diagnosis by other methods, a visual examination of the inlet canal and the sinus cavity is performed using a flexible endoscope.
• bacteriological research. It is used when empirical evidence is ineffective antibiotic therapy. As biological material use sinus tissue samples obtained during its puncture or trepanation, less often - nasal discharge. Bacterial culture allows you to accurately determine the pathogen, assess its sensitivity to the main groups of antibiotics.

Frontitis treatment

Moderate and severe forms of pathology require constant monitoring of medical personnel, so patients are hospitalized in the otolaryngology department. With frontal sinusitis of mild severity, outpatient treatment is possible. The main goals of the therapy are the restoration of drainage and aeration of the sinus, the removal of pathological masses, and the prevention of complications. The treatment plan includes:

• Medications. As a starting antibiotic therapy, protected aminopenicillins are used, less often - cephalosporins of the II-III generation. In the future, it is possible to change medications in accordance with the results of antibiotic sensitivity tests. Non-steroidal anti-inflammatory drugs, decongestants, antihistamines, local antiseptics, vitamin complexes. With intoxication syndrome, infusion therapy with plasma substitutes, sorbents is indicated.
• Operational intervention. It consists in probing the sinus after anemization of the nasal mucosa, trepanopuncture of the sinus through the lower wall with washing of its cavity and drainage, endonasal opening using rigid endoscopes. Carry out if necessary open operations through the anterior wall or by expanding the fronto-nasal canal with resection of the anterior group of ethmoid cells.
• Physiotherapy, conservative measures. Physiotherapeutic procedures for frontal sinusitis are represented by electrophoresis with local anesthetics, phonophoresis with corticosteroids and antibiotics on frontal wall the affected sinus. Regularly performed anemization of the nasal mucosa with vasoconstrictor drops, washing with water-salt solutions or local antiseptics.

Forecast and prevention

With early full treatment sinusitis, the prognosis for the health and life of the patient is favorable, with the formation of intracranial complications, the development of sepsis is doubtful. Specific preventive measures for this pathology have not been developed. Nonspecific prevention is based on the rational treatment of rhinitis, other forms of sinusitis and pathologies of the respiratory tract, adequate therapy for acute respiratory viral infections, timely correction of developmental anomalies, defects in the nasal cavity and sinus ducts, relief of immunodeficiency conditions, prevention of traumatic injuries of the facial area and superciliary zone.