Catarrhal rhinosinusitis is an inflammatory process in the mucous membranes of nasal passages and paranasal sinuses, characterized by the absence of a purulent secretory discharge. Pathology occurs against the background of acute respiratory infections and, in rare cases, can be complicated by the attachment of bacterial infection. Application of rhinoviruses, adenoviruses, andvirus parainfluenza and influenza on the surface of epithelial mucous membranes, in most cases, occurs by aerosol. Nevertheless, the introduction of infectious agents is also possible by contact, hematogenous or lymphogenic methods.
The name of the disease is formed from the obsoleteThe term "catarrh" is an inflammatory process in the upper respiratory tract (ARVI), with the addition of the medical term "rhinosinusitis", which indicates the inflammation of the nasal sheaths and the minimum of one nasal sinus. Thus, catarrhal acute rhinosinusitis is nothing but a viral rhinitis. complicated by inflammation of the paranasal sinuses. For which the presence of abundant secretory secretions of mucous or serous characters is characteristic.
Causes and symptoms of catarrhal sinusitis
Viral rhinosinusitis develops as a consequenceuntreated episodes of catarrhal sinusitis. The trigger mechanism of mucosal inflammation, as a rule, is a virulent infection. Due to the spread of this, there are edematous-catarrhal lesions of the epithelial membranes, which cause obstruction of the sinus anastomoses. In this case, viral sinusitis is rarely complicated by the attachment of a bacterial infection.
Medical Statistics: viral sinusitis passes into a bacterial rhinitis in children in 5-10% of all episodes. In adults, catarrhal acute sinusitis is complicated by the addition of bacterial infection in only 0.2-2% of clinical cases.
The main symptoms of a viral rhinitis include the following symptoms:
- loss of smell;
- common intoxication;
- severe deterioration of nasal respiration;
- hyperemia and swelling of the mucous membranes of the paranasal sinuses;
- presence of a secretory detachable from nasal passages and paranasal sinuses;
- sensation of dryness, tickling and burning in the nasal passages (at the first stages of development of the pathological process).
Symptoms such as: headaches, lack of appetite, sleep disturbance, fever - arise due to toxic damage to the body, under the influence of viruses and products of their vital activity. In addition to the fact that the described symptoms significantly impair the quality of life of patients, catarrhal acute sinusitis is fraught with multiple complications, including: abscesses, meningitis, pharyngitis, upper and lower respiratory tract diseases and so on.
Classification of viral infections in the paranasal sinuses
The duration of the disease is viralsinusitis is divided into acute and chronic forms. In acute viral sinusitis, symptoms manifest spontaneously, with a marked disruption of nasal respiration. This development of the disease is due to the presence of edematous catarrhal phenomena in the mucous membranes, as well as the peculiarities of the anatomical structure of the nasal cavities.
Medical information: all the paranasal sinuses are connected with the nasal cavity by means of the sastia. The presence of edematous inflammatory processes leadsto obstruction of nasal sinuses. As a result, the outflow of the secretory secreted from the paranasal sinuses ceases. That, in turn, leads to accumulation of mucous secretions and development of stagnant processes in the paranasal sinuses.
Chronic viral sinusitis is a consequence ofuntreated episodes of acute sinusitis, and can also develop against the background of protracted allergic manifestations. At the same time throughout the course of the disease, the symptoms can periodically worsen.
The localization of the pathological process of viral sinusitis is usually divided into the following types:
- Catarrh of the maxillary sinusitis
- Catarrhal frontal
- Catarrhal ethmoiditis
- Catarrhal sphenoiditis
In this case, viral sinusitis can beone-sided or two-sided. And in the pathological process, one as well as several paranasal sinuses can be involved. Therefore, the diagnosis should be made on the basis of anamnesis of the patient, as well as in the conduct of a number of clinical studies. In this case, the treatment of viral sinusitis should be complex and, first of all, should be aimed at eliminating acute symptoms and the causes of the disease.
How to treat catarrhal (viral) sinusitis correctly?
Effective treatment of viral sinusitis - quitedifficult task. This situation, primarily due to the complexity of virological diagnosis, as well as the presence of more than 300 types of possible infectious agents. Moreover, domestic otolaryngologists, unlike Western clinicians, do not have any clear recommendations on the use of antiviral medicines for the treatment of ENT organs. Nevertheless, catarrhal (viral) rhinosinusitis involves complex treatment, which includes the following stages:
- Removal of mucous discharge.
- Elimination of the phenomena of acute intoxication.
- Treatment with systemic antiviral drugs.
- Improvement of aeration and drainage in the paranasal sinuses.
- Improving the patency of nasal sinuses and nasal passages.
Antiviral treatment is based on the admission of suchpreparations, such as Anaferon and Arbidol. These medications are prescribed to the patient when the first symptoms of the disease manifest themselves and are taken up to a complete clinical recovery.
How to treat catarrhal sinusitis?
With all forms of viral sinusitis treatmentantibiotics is not applied. Since they not only do not affect the virulent infection, they also do not alleviate the acute symptoms of the disease. In this case, an active expectant management is recommended until the appearance of suspicion of joining a bacterial infection or the occurrence of a risk of complications.
Thus, treatment with antibiotics is prescribed exclusively by the treating ENT doctor, on the basis of a laboratory study of the biomaterial from the paranasal sinuses or in the event of complications. Self-treatment with antibiotic drugs for catarrhal sinusitis is unacceptable! As it leads to the emergence of resistant strains of the disease, as well as to the development of superinfection.
To improve aeration and drainage in nasalSinus patients suffering from catarrhal sinusitis are prescribed daily and systematic nasal rinsing. The procedure can be carried out using the Proetz method (cuckoo) or using an electric pump. If viral sinusitis sided, it recommended alternate irrigation treatment: first washed with one half of the nose, then - another. Nasal lavage helps to clear the nasal passages and sinuses of secretory discharge, and significantly accelerates the effect of topical drugs.
For elimination of edematous catarrhal processesDecongestants of local or systemic influences are applied. At the same time, the opinion of many otolaryngologists diverges in terms of preferences for topical or systemic vasoconstrictors. Some experts tend to believe that local decongestants can better control the symptoms of nasal obstruction.
Other ENT doctors express the opinion that the topicalvasoconstrictor, in contrast to systemic medicines, have a short therapeutic effect and lead to the formation of the mechanism of habituation with prolonged use. Nevertheless, most practitioners of otolaryngologists agree that topical drugs can be administered for no more than five to seven days, with concurrent administration of corticosteroids.
Treatment with analgesics and antihistamine medicines
Treat catarrhal sinusitis with antihistaminedrugs is also inappropriate, as well as treat the disease with antibiotic drugs. On the one hand, antihistamines have a drying effect on the epithelial membranes of the nasal sinuses, and on the other, lead to a deterioration in the escalation of mucous contents from the paranasal sinuses. Reasonable treatment with antihistamine drugs is allowed only in cases when an infection of bacterial origin is diagnosed.
If the pain symptoms are pronounced and this significantly affects the quality of life of the patient, the use of analgesics is recommended. Pain relief should be carried out with the help ofnon-steroidal anti-inflammatory drugs, including, among others, "Ibuprofen" and "Paracetamol." The most optimal is the taking of analgesics no more than twice a day, with a course of three or four days.