Otolaryngology >>>> How to treat frontal sinusitis?

How to treat frontal sinusitis?

Frontitis is a special case of sinusitis, when the mucous membrane of the frontal sinuses is involved in the inflammatory process. As a result of inflammation, the mucous membrane swells and thickens, closing the pathways for the outflow of mucus through the frontal nasal canal. Frontitis can proceed in an acute form or take on a chronic course. Various bacterial or viral infections can give an impetus to the development of inflammation, but often frontal sinusitis occurs as a complication of other diseases: ARVI, Influenza, rhinitis, diphtheria, etc.

Other factors can also be the cause of frontal sinusitis:

Injuries to the nose leading to a change in the shape of the septum,
Congenital anomalies in the location of the septa in the frontal sinus,
Allergic reactions (allergic frontal sinusitis),
Adenoids, which grow, block the frontal-nasal canal.

Frontal sinusitis signs:

Runny nose,
Difficulty or impaired nasal breathing,
Feeling of stuffiness in the ears,
A severe headache develops in the forehead (in the chronic course of the disease, the headache may be absent),
The headache is worse when the head bends downward or forward,
In the projection of the frontal sinuses, one feels heaviness, a feeling of fullness,
Purulent discharge from the nasal passage, may have an unpleasant odor (may be absent with complete nasal congestion),
Drying out of the mucous membrane of the mouth and throat of preferential breathing by the mouth (cough develops),
Swelling of soft tissues adjacent to the nose (swelling of the eyelids, browbones, nose bridge),
Tearing,
Violation of the general condition,
Temperature possible.

The complicated course of acute or chronic frontal sinusitis is often accompanied by the development of periostitis in the region of the lower wall of the sinus, which separates it from the orbit. This will lead to swelling of the upper eyelid, which can sometimes close the eye completely. Purulent contents enters the orbit, breaks through in the inner corner of the eye and forms a fistula.

Diagnosis of frontal sinusitis is often difficult due to the fact that its symptoms are similar to those of respiratory viral infections. The danger of misdiagnosis, incorrect and untimely treatment of frontal sinusitis lies in the possibility of developing another dangerous disease - purulent meningitis, since the frontal sinuses are located close to the membranes of the brain, and periostitis and osteomyelitis can destroy the bone tissue of the septa.

Frontitis treatment :

In the acute form of frontal sinusitis, the patency of the frontal-nasal canal is first restored - vasoconstrictor drugs are instilled (nasal drops or nasal sprays - Xilen, Naphtizin, Galazolin, Tizin, Sanorin, Nazol, etc.), decongestants (Oxymetazoline, Phenylephrine, Pseudoephedrine) and antihistamines are taken (Pipolfen, Suprastin, Diazolin, etc.). It is categorically impossible to warm up the nose and sinuses with a compress, heating pad or other methods, because this will accelerate purulent processes in the sinuses and increase the foci of inflammation. Antibiotic therapy is prescribed for a specified bacterial infection and under the strict supervision of a physician. It is necessary to support the immune system by taking appropriate immunostimulants.

Acute frontal sinusitis complicated by periostitis, sluggish inflammatory processes in frontalitis or chronic forms of frontal sinusitis that do not respond to drug therapy are treated with surgical intervention: trepanopuncture, puncture with a needle, opening the sinuses with an endoscope, or radical surgery under local or general anesthesia.

When trepanopuncture with a special tool trepan, they drill the wall of the frontal sinus, insert a metal cannula into the hole and wash the sinus for a long time, then inject solutions of drugs: antibiotics and enzymes.

With radical surgery, the sinus cavity is opened, freed from purulent exudate, then the anastomosis that connects to the nasal cavity is expanded.