Chronic sinusitis - symptoms and treatment in adults

Chronic sinusitis in the modern world is becoming more and more common. A distinctive feature of this form of the disease is that the inflammatory process develops and lasts for more than two months. In itself, sinusitis is an inflammation of the sinuses located in the thickness of the wing of the upper jaw.

Chronic sinusitis symptoms and treatment of which we consider may develop from the acute form of the disease, if therapy was not given enough attention. In addition, it can be a complication of diseases such as measles, influenza, rhinitis, scarlet fever and some other infectious diseases.

How does the disease develop

When the infection falls on the nasopharynx, it begins to spread in the maxillary sinuses, inflammation may occur, in severe cases, swelling.

The mucosa connects the nasal cavity with the maxillary sinuses, while it is very swollen, because of this, the air does not flow well and the mucus does not flow well. In the mucus that accumulates, a variety of microorganisms begin to multiply, which increase the inflammatory process.

Most often only one sinus can be involved, very rarely can there be bilateral chronic antritis.


When chronic sinusitis develops, the causes are in violation of the protective properties of the body, the penetration of infection into the upper respiratory tract as a result of pathological processes that occur in the pharynx, nasal cavity and mouth.

Most often provoke the development of chronic sinusitis pathology such as:

  • a consequence of acute inflammation, especially if unfavorable conditions are created for the outflow from the maxillary sinuses of the pathological secretion;
  • curvature of the nasal septum;
  • too narrow nasal passages;
  • close contact of the lateral wall of the nose with the middle nasal conch;
  • polyps and adenoids;
  • granuloma in the tooth root.

Contributing factors are adverse conditions that prevent the outflow of pathological secretions from the maxillary sinuses. Quite often, the inflammatory process, which is one-sided, moves to another sinus, in which case chronic bilateral sinusitis develops.

It is also known that chronic odontogenic sinusitis, as a rule, develops immediately in a chronic but sluggish form. Because of this, a person suffering from this type of sinusitis may not notice any symptoms for quite a long time, but if the inflammatory process is activated, the patient will also need advice from an otolaryngologist and a dentist.


There are several types of this disease:

  • Purulent - when this form of nasal discharge is thick, they have a yellowish-brown color and a rather unpleasant odor;
  • Catarral - characterized by abundant and liquid secretions, in addition, with this form of the disease there is a pronounced local swelling of the face;
  • Chronic polyposis - changes in the state of the mucous membranes, as well as the growth of polyps;
  • Odontogenic - the cause of its development lies in inflammation in the jaw or in the teeth;
  • Allergic - characterized by serous or clear secretions and occurs due to exposure of the allergen to the patient;
  • Mixed polypous cystic;
  • Caseous - when this form is observed quite abundant discharge, cheesy nature;
  • Necrotic - is quite rare and is accompanied by necrotic changes;
  • Rinogenic - begins as an inflammation of the mucous membrane of the nasal passages;
  • Chronic hyperplastic - usually occurs in severe form and is difficult to treat.

Depending on the form of chronic sinusitis, the symptoms and aspects of the treatment of the disease in adults will differ.

Symptoms of chronic sinusitis

In adults during periods of remission of chronic antritis, symptoms are mild, in most cases the patient complains of:

  • nasal congestion;
  • violation of smell;
  • change of voice timbre;
  • aching pain in the nose.

In addition, this is characterized by general weakness, a feeling of tiredness, lethargy, a decrease in working capacity, distraction of attention. During periods of remission of the disease, it may not be accompanied by pain.

Symptoms of exacerbation

In the chronic form of antritis, the symptoms can be mild and clearly manifest only during periods of exacerbation of the disease. At this time, the person appears severe symptoms:

  • weakness, general malaise;
  • fever (usually up to 37.5 ° C), chills;
  • pain in the head of the arching nature, concentrated in the forehead, eyes and aggravated by
  • tilting the head forward when coughing, sneezing;
  • severe nasal congestion;
  • coughing (especially at night, when lying down);
  • swelling of the face;
  • increased sweating;
  • difficulty smelling;
  • restless sleep.
  • the appearance of thick nasal discharge, often purulent;
  • hoarseness, nasal voices;

With the exacerbation of chronic sinusitis, as a rule, there is a deterioration of health, severe headache, increased body temperature, the appearance of edema on the cheeks and eyelids, increased outflow of pus from the nasal passages when the head is tilted. Discharge from the nasal passages can provoke swelling and redness of the mucous membrane, its pathological growth and the appearance of polyps.


As a rule, the doctor makes a diagnosis of chronic sinusitis, based on the symptoms and results of the examination, which is carried out using an endoscope (allows you to study the nasal mucosa and nasal openings).

A thorough diagnostic examination should be performed to rule out any factors that influence the occurrence of the disease, including allergies, asthma, and any immune problems. If the primary disease that provoked chronic sinusitis is not defined, then it is only possible to control the course of the illness. The recovery of the patient depends on the accuracy and time of diagnosis.

Puncture (puncture) of the maxillary sinus is the most reliable diagnostic method, but it does not always give complete information about the process.

How to cure chronic sinusitis without surgery

In the case of chronic sinusitis, treatment differs from the treatment of a common disease in that it should not be ignored even during a lull. After all, the frequency and severity of the course of the disease in the acute phase depends on how well prevention and treatment will be carried out.

To cure chronic sinusitis without surgery, you need to completely adhere to a clear scheme, which includes:

  • reduction of inflammation in the sinuses;
  • restoration of the nasal passages;
  • elimination of the cause of chronic antritis;
  • decrease in the number of emerging sinusitis.

During remission, physiotherapy is widely used:

  • speleotherapy (microclimate treatment of salt caves);
  • ultrasound on the region of the maxillary sinuses;
  • electrophoresis with lidazy on the sinus area;
  • UHF on the sinus area;
  • magnetic therapy on the pharynx area;
  • phonophoresis with cortisone;
  • laser therapy.

In case of severe disease, a maxillary sinus puncture may be prescribed. This procedure allows you to remove the pus in a short period of time. But it does not serve as a "substitute" for antibiotics and other drugs, but it greatly facilitates the "work" of tablets.


Treatment of chronic antritis with antibiotics is carried out in the case when there is a bacterial infection. If the sinusitis is caused by any other reasons, then the use of antibiotics will not bring any results.

Most often prescribed such drugs:

  • doxycycline;
  • amoxicillin;
  • trimethoprim sulfamethoxazole.

When using antibacterial drugs is extremely important to undergo the entire course of treatment. In most cases, this means that medications will have to be taken 10-14 days or more, depending on when the patient's condition begins to improve. If you stop taking them in a few days, the symptoms will soon return.

Maxillary sinus puncture

Puncture of the maxillary sinus is one of the most common methods of treatment of chronic antritis. During this procedure, a pus can be pumped out of the sinus with a syringe, washed with an antiseptic solution and injected an antibiotic or other drug into the cavity. Most often for washing the maxillary sinus using furatsilina solution or physiological solution of sodium chloride.

  • As an alternative to punctures, at this point in time there is a procedure such as the installation of a YMIK-catheter. This procedure is practically painless, as it is performed under local anesthesia, and there is no need to make a puncture.

Sometimes puncture of the maxillary sinus is the only treatment for sinusitis. In addition, the puncture of the maxillary sinus allows you to quickly remove the pus, which is especially important during pregnancy, in violation of the outflow of pus from the sinuses and with existing associated diseases.

There is also an opinion that if a puncture was made once, then they will have to be repeated until the end of life. This statement is absolutely not true - the puncture does not apply to the causes of sinusitis.


If we talk about prevention, the most effective method is to adequately and competently treat the disease at the initial stage, when a mild runny nose begins.

That is why people who know that they have such a disease, it is important not to let it flow. The less hypothermia, the more tempering procedures are carried out, the more balanced and more rational nutrition is, the easier the disease will flow.

Watch the video: Management of Chronic Rhinosinusitis (April 2020).


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