General Practice 2022

Chronic sinusitis: what é, symptoms and treatment

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Chronic sinusitis: what é, symptoms and treatment
Chronic sinusitis: what é, symptoms and treatment

Chronic sinusitis, which is inflammation of the lining of the sinuses, is characterized by the persistence of sinus symptoms, such as pain in the face, headache and cough, for at least 12 consecutive weeks. It is usually caused by resistant bacteria, previous overuse of antibiotics or improper treatment of sinusitis, as well as poorly controlled allergic rhinitis, airway changes such as a deviated septum, or weakened immunity.

Its treatment includes nasal washing with saline solution and the use of medicines such as antibiotics, anti-allergic or corticosteroids, prescribed by the ENT, according to the cause of the inflammation. In some cases, surgery to drain accumulated mucus and either correct nasal septum changes or remove nodules may be recommended to allow the disease to heal.

It is very important that sinusitis is treated properly, as there is a risk of complications such as asthma attacks, pneumonia, meningitis, eye infections or even brain abscesses.

Main symptoms

Symptoms of chronic sinusitis last longer than 12 weeks, and may occur after 1 or several episodes of acute sinusitis, where there is fever, body pain, and severe nasal discharge. In the chronic phase, the main symptoms are:

  • Pain in the face or headache worse when lowering head or lying down;
  • Persistent pain located in the cheekbones, around the nose and around the eyes;
  • Nose secretion, yellowish or greenish;
  • Bleeding through the nose;
  • Sensation of pressure inside the head,obstruction of nose and ear and dizziness;
  • Chronic cough, worse when lying down;
  • Bad breathconstant.

In addition, when sinusitis has an allergic cause or occurs in people with a history of allergy or rhinitis, there may be asthma attacks, itchy nose and throat, in addition to worsening symptoms when in contact with substances such as dust.

How the treatment is done

To treat chronic sinusitis, the ENT may indicate the use of remedies such as:

  • Antibiotics, such as Amoxicillin/Clavulonate, Azithromycin or Levofloxacin, for example, are only used for cases of bacterial infection. They are usually done for 2 to 4 weeks, as in chronic sinusitis the infection is usually resistant;
  • Mucolytics and decongestants, such as Ambroxol, to decrease the viscosity of secretions;
  • Anti-inflammatory drugs or corticosteroids, such as Nimesulide or Prednisone, help reduce inflammation and local swelling;
  • Antiallergics, such as Loratadine, more indicated for sinusitis in people with allergies;
  • Nose Corticosteroids, such as Budesonide, Fluticasone and Mometasone, help fight inflammation and allergy in the airways;
  • Nose wash with saline solution or water and s alt preparations. Check out the recipe to prepare a homemade saline solution for sinusitis;
  • Nebulization with water vapor or saline solution to fluidize secretions;

The use of nasal decongestants that contain Naphazoline, Oxymetazoline or Tetrahydrozoline, such as Sorine, for example, should be done with caution, for less than 3 weeks, as they cause rebound and dependence.

During the treatment of chronic sinusitis, follow-up with the ENT is recommended to investigate the cause of inflammation. Thus, although the diagnosis of acute sinusitis is made through the clinical evaluation of the physician and does not require tests, in chronic sinusitis, exams such as computed tomography of the face, nasal endoscopy and collection of samples of nasal secretions may be necessary to identify the microorganism and the exact cause of the problem.

Home remedies options

A great way to help eliminate nasal secretions, as a complement to doctor-oriented treatment, in addition to nasal washing with saline solution, is the inhalation of steam from plants such as eucalyptus or chamomile, for example. Learn how to make these homemade treatments in the following video:

When surgery is indicated

The purpose of surgery is to expand or clear the natural drainage channels of the sinuses, which may be closed and preventing the drainage of secretions, which accumulate and stimulate the proliferation of fungi and bacteria.

In addition, the procedure can also be combined with the correction of some defect in the anatomy of the nose, which may also be making it difficult to cure the infection, such as correction of the septum, removal of adenoids or reduction in the size of the turbinates, which are the spongy tissues inside the nose.

Learn more about how sinus surgery is done, risks and recovery.

Possible complications

Chronic sinusitis, when not properly treated and controlled, can worsen over time and cause secretion to accumulate, forming an abscess, and inflammation and infection can reach organs close to the nasal cavities, such as the eyes or nose. brain.

The infection can also trigger asthma attacks, especially in children, and pneumonia, or even reach the bloodstream and cause a generalized infection.

Main causes

Chronic sinusitis is more common in people who:

  • Did incorrect treatment of other acute sinusitis;
  • Used antibiotics wrongly over and over again;
  • Have severe or poorly controlled asthma or allergic rhinitis;
  • Have reflux gastroesophageal reflux;
  • They have a weakened immunity, such as HIV carriers, chronic use of corticosteroids or uncontrolled diabetics;
  • Have been hospitalized or had recent surgeries;
  • Suffered a blow to the face;
  • Have airway changes, such as deviated septum, nasal polyps, or hypertrophy of the turbinates of the nose.

So, in order to avoid chronic sinusitis or to treat it properly, it is very important to resolve these situations.

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