Frontal sinusitis - causes, symptoms and treatment of frontal sinusitis in adults. Frontitis: features of the course, clinical signs, diagnosis and treatment

The paranasal sinuses are cavities filled with air. In total, humans have four pairs: frontal, maxillary, ethmoid and sphenoid.. Inflammation of the mucous membrane inside any of them is generally called sinusitis. But our conversation today will be about the inflammatory process in the frontal sinuses or, as it is called in medical practice, frontal sinusitis. Details about the symptoms and treatment of frontal sinusitis in adults, what to do when the first signs appear and whether you need to go to the hospital right away.

Symptoms of the disease

The clinical picture of frontal sinusitis will depend primarily on the form of the disease. The course of the acute period is characterized by pronounced symptoms and general changes in the patient’s condition. Chronic frontal sinusitis has a milder course, but it is the one that is more dangerous, as it poses a threat in terms of the risk of developing complications.

Acute frontal sinusitis is characterized by the following symptoms:

Frontal sinus pain, that is, severe headaches concentrated in the frontal part. With any impact in the sinus area (pressure or light tapping), the pain intensifies.
Patients complain of discomfort in the inner corner of the eye. With unilateral frontal sinusitis, pain occurs on the corresponding side of the face (right-sided frontal sinusitis - the pain symptom is present on the right, and vice versa).
Stings in the eyes, tearing.
Severe nasal congestion, difficulty breathing, and possible complete loss of smell.
Throughout the entire period of the disease, nasal discharge is profuse. The first few days the mucus is liquid and transparent, then it thickens, and a purulent infection may develop. With a unilateral inflammatory process, discharge is observed only on one side of the nasal cavity.
Swelling of the upper half of the face, redness of the skin in the frontal sinuses.

In addition, the characteristic symptoms of frontal sinusitis can be supplemented by signs of general poisoning of the body. Body temperature can be increased from 37.7 0 to 39 0.

In acute frontal sinusitis, the pain is cyclical and intensifies in case of stagnation of mucous contents, for example, in the morning after sleep. Freeing the sinuses and getting rid of mucus allows you to temporarily reduce pain.

Chronic frontal sinusitis is an advanced form of the disease that develops due to the lack of adequate treatment 1-2 months after the onset of the inflammatory process. This form of the disease is characterized by the following symptoms:

Aching pain of low intensity, concentrated in the area of localization of the inflammatory process. When tapping in the area of the frontal sinuses, the discomfort may intensify.
Sharp painful sensations radiating to the inner corners of the eyes can be observed when performing pressure manipulations on the frontal sinuses.
The discharge of purulent contents from the nose acquires a sharp, unpleasant odor. The greatest amount of mucus is observed in the morning.
A cough with purulent sputum may appear.

If at the initial stage the patient was bothered only by left-sided frontal sinusitis, then it is most likely that in an advanced form the inflammatory process is localized in two sinuses. With a long course of chronic frontal sinusitis, symptoms of purulent inflammation may appear, as well as signs of a breakthrough of purulent contents into the brain or orbit.

Therapeutic measures: drug therapy

Treatment of frontal sinusitis will depend on many factors. When selecting therapeutic agents, the form of the disease, the nature of the inflammatory process and the cause of this inflammation are taken into account. Therefore, to avoid complications and surgical intervention, It is necessary to begin treatment of frontal sinusitis with a consultation with an otolaryngologist and a thorough diagnosis.

Nasal drops and sprays

At home, without hospitalization, treatment with anti-inflammatory drugs can be used to treat inflammation of the frontal sinuses of allergic origin, as well as acute symptoms that arise against the background of viral infections such as influenza and ARVI. Ibuprofen-based products are often prescribed for this purpose.. They relieve inflammation and have an analgesic effect. In addition to this, the use of nasal medications that improve the outflow of mucous contents is mandatory.

Vasoconstrictor drugs:

Nasonex. Nasal spray. The active ingredients are corticosteroids in a minimal dosage. Helps improve nasal breathing by eliminating swelling of the mucous membrane.
Rinofluimucil. The drug relieves swelling of the mucous membrane, reduces the amount of purulent discharge and facilitates its discharge. It can also be purchased in pharmacies in spray form.

Vasoconstrictor drops to relieve nasal congestion can be used for no longer than three days. With longer use, the mucous membrane may become accustomed, which will lead to the opposite effect.

In addition to the above drugs, it is recommended to treat frontal sinusitis in adults with drugs that stimulate the discharge of mucous contents, for example, Sinupret or Sinuforte. The active components are extracts from medicinal plants, which have a powerful anti-inflammatory effect. Both drugs can only be used in the complex treatment of frontal sinusitis. As independent means they are ineffective.

Antibacterial therapy for frontal sinusitis

With a viral etiology of the disease, treatment of frontal sinusitis with antibiotics is inappropriate. Antibacterial therapy is prescribed only if there is purulent inflammation due to the addition of bacterial microflora.

What antibiotics are best to take for frontal sinusitis and sinusitis? According to studies, drugs such as Amoxiclav and Augmentin have shown the greatest effectiveness in the treatment of purulent sinusitis. In case of an allergic reaction to penicillin antibiotics, Clarithromycin or Ciprofloxacin is prescribed.

The course of antibiotic treatment is 10-14 days. If there are no visible improvements after 4-5 days of taking the tablets, the treatment is reviewed and a stronger medicine for frontal sinusitis is selected.

During pregnancy, antibiotics, like all other drugs, are prescribed after assessing the benefit to the mother and the risk to the fetus.

Treatment of chronic inflammation

Before starting treatment, a thorough diagnosis is always carried out. In the presence of foci of inflammation without the growth of polyps, conservative therapy is prescribed, including the complex treatment described above. If a large amount of purulent content accumulates in the nasal sinuses or polyps are detected on an x-ray, the patient is indicated for surgical intervention. Of course, such an advanced form is treated in a hospital.

Traditional medicine

The use of home treatment methods for frontal sinusitis is possible only at the initial stage of the disease. All manipulations can only be an addition to the main therapy and should be discussed with the attending physician.

It is forbidden to treat purulent frontal sinusitis by heating the frontal area, since such actions can lead to the spread of the purulent process to nearby tissues.

Inhalations

Inhaling steam helps thin mucus secretions, making it easier to remove from the sinuses. It is necessary to inhale the steam by bending your head over a container with a decoction. It is recommended to additionally cover your head with a towel or blanket.

The most popular inhalation recipes for frontal sinusitis:

Boil the potatoes in their skins without peeling them and mash them.
Brew chamomile color. Add eucalyptus or tea tree essential oil to the prepared decoction.
Brew bay leaf. To do this, take 10-14 bay leaves per 1 liter of water. Boil them over low heat for 5-7 minutes.
Pour the same amount of apple cider vinegar into a glass of boiling water and add chopped 6-8 cloves of garlic. Inhalation time – 15 minutes. If necessary, you can add hot water.
Five-minute inhalation with a “star”. Add a little “Star” balm to boiling water and breathe, remembering to cover your head with a towel.

Washing

Nasal rinsing is an effective procedure for any nasal disease, be it bilateral frontal sinusitis or a common runny nose.. For maximum effect, 10-15 minutes before, it is necessary to clear the nasal passages of mucus and drip a vasoconstrictor. The prepared solution should be injected into the nasal cavity under pressure. To do this, use a bulb or syringe without a needle.

Recipes for solutions:

Grate or chop one onion in a blender. Pour boiling water over it. After the infusion has cooled to room temperature, add honey and stir well to dissolve. Strain the prepared onion infusion and can be used for rinsing up to 4 times a day. The product has antibacterial, anti-inflammatory and immunomodulatory effects, helps remove accumulated pus in the frontal sinuses. Not used in the treatment of allergic sinusitis.
Take 1 tsp per glass of water. salt, dissolve it. Add a little baking soda and a couple of drops of tea tree ether. The solution has antiseptic, anti-inflammatory and antiviral effects.
A good antiseptic is chamomile decoction. Use for rinsing every 2-3 hours. Before use, cool the broth and strain.
Effective in the fight against pathogenic microflora and chlorophyllipt. Buy an alcohol tincture at the pharmacy and add 1 tbsp. l. per 0.5 liters of warm boiled water.
If you don’t have any of the above remedies on hand, prepare a regular saline solution at the rate of 1 tsp. per liter of warm water.

Drops

Juices of medicinal plants perfectly help suppress the activity of pathogenic microorganisms and normalize the condition of the mucous membranes. For beneficial substances to penetrate to the source of inflammation, it is necessary to clear the nasal passages of mucus. Therefore, before instillation, be sure to rinse the nasal cavity with one of the solutions.

Treatment of frontal sinusitis with useful herbal remedies:

Black radish juice. To prepare it, peel the root vegetable and chop it on a grater. Wrap the pulp in gauze and squeeze out.
Cyclamen juice. Chop the peeled tubers and squeeze the juice from them. To prepare drops, use it in proportions with water 1:4 (one part juice to four parts water). Use 2 drops on each nostril before bed. After instillation, it is recommended to massage the frontal area.
Aloe or Kalanchoe juice. Before using, a leaf of one of these plants should be kept in the refrigerator for 3-5 days. Mix the squeezed juice with water in a ratio of 1:2.
Prepare separately infusions of chamomile, St. John's wort and dried herbs. Strain the prepared infusions and can be used for instillation three times a day. Before use, mix 5 drops from each glass.
Mix chamomile juice and celandine juice in equal proportions. To treat frontal sinusitis, it is enough to instill a couple of drops into each nasal passage.

For frontal sinusitis of allergic origin, the use of herbal preparations is contraindicated.

Anti-inflammatory ointments

Homemade ointments in some cases are more effective than pharmaceutical preparations. But this does not negate the presence of contraindications. That's why Before using any of these remedies, consult your doctor:

Antiseptic and absorbable agent. Take pork fat and kerosene in a 4:1 ratio. Rub the prepared ointment externally into the frontal sinuses 2 times a day. As an alternative, you can use cotton strands soaked in the composition. Insert them into the nasal passages for 2-3 hours once a day. The finished product should be stored refrigerated.
Antiseptic and anti-inflammatory ointment. Melt half a piece of laundry soap in a water bath. Add 1 tsp. vegetable oil, the same amount of honey, alcohol and milk. The finished product is used to impregnate the bundles. The duration of the course is 10-14 days. The procedure should be carried out three times a day for 15 minutes.
Mix natural honey, aloe juice, cyclamen and onion in equal quantities. Add the same amount of Vishnevsky ointment. Soak the tourniquets with the prepared ointment and place them in the nasal passages once a day for half an hour. The duration of treatment is 14-21 days.
Anesthetic ointment. To prepare it, mix butter and chopped garlic. Apply ointment to the frontal area before bed to relieve pain in the frontal sinuses.

Warming in the treatment of frontal sinusitis

The feasibility and safety of heating in the treatment of sinus inflammation is questionable. On the one hand, the thermal effect on the frontal sinuses will help to liquefy the mucus, which will facilitate its removal. But in other way, in the presence of a purulent inflammatory process, this can lead to a deterioration in the patient’s condition. So, it is prohibited to use thermal procedures without consulting a doctor. But if we are talking about the initial stage of the disease and no purulent foci are found during the examination, this method can be used as an addition to the main treatment.

For this procedure, white clay, boiled egg or warm salt compresses can be used.. The warmth should be comfortable. Therefore, be sure to make sure that the temperature of the compress is not too high so that the treatment does not end in facial burns.

Frontal sinusitis is a serious disease. And it is impossible to cure it in two days. So it’s better to take care of preventing inflammation in advance by starting treatment for the next runny nose on time. This will be enough to prevent the development of many complications.

In addition to the ethmoid labyrinth, sphenoid and maxillary sinuses, the paranasal sinuses also include the frontal sinuses. All these air cavities are also called paranasal sinuses. A distinctive feature of the frontal sinuses is their absence at the time of birth. They develop only by the age of eight and are fully formed only after puberty.

The frontal sinuses are located in the frontal bone behind the brow ridges. These cavities are paired and have the shape of a triangular pyramid. The inner surface is covered with mucous membrane. They are formed by several walls:

front or front;
posterior or cerebral;
bottom;
internal or intersinus septum.

The internal divides the frontal bone into two parts - left and right. Most often they are not symmetrical, since the bony septum is deviated to one side from the midline. The base of the sinus is the upper wall of the orbit, and the apex is located at the junction of the anterior wall with the posterior one. With the help of the frontonasal canal, also called the anastomosis, each frontal sinus opens into the nasal passage.

The anterior wall of the sinus is the thickest - we can feel it by running our hand over the forehead just above the eyebrows. In its lower part, between the superciliary arches, there is a bridge of the nose, and a little higher are the frontal tubercles. The back wall is connected to the bottom at a right angle.

However, the structure of the sinuses is not always the same as described above. There are rare cases when the internal partition separating the sinuses is located not vertically, but horizontally. In this case, the frontal sinuses are located one above the other.

There are other deviations in the structure of cavities. For example, inside them there may be incomplete septa - peculiar bone ridges. Such a sinus consists of several bays or niches. Another, more rare anomaly is complete septa - they divide one of the cavities into several, forming multi-chamber frontal sinuses.

Functions of the frontal sinuses

Along with other paranasal cavities, the frontal sinuses serve for the efficient functioning of the body. Given the fact that they are absent at birth, there is a hypothesis that The main function of the frontal sinuses is to reduce the mass of the skull. In addition, the frontal cavities:

act as a kind of shockproof “buffer” that protects the brain from injury;
participate in the breathing process: air from the nasal passages enters the cavities, where, interacting with the mucous membrane, it is additionally moistened and warmed;
take part in the formation of sounds and increase vocal resonance.

Diseases of the frontal sinuses

Considering that the frontal sinuses are hollow structures lined with mucous membrane, they can be affected by viral or bacterial infections. Pathogenic microbes penetrate along with the inhaled air. When the body's resistance is low, an inflammatory process may occur.

Frontit

Inflammation “originates,” as a rule, on the nasal mucosa, and then spreads through the nasolacrimal duct to the frontal sinuses. Swelling occurs, as a result of which the canal is blocked, and the outflow of fluid from the sinuses becomes impossible. This is how frontal sinusitis develops. The isolated environment that has formed is ideal for the proliferation of bacteria and the formation of pus.

Frontal sinusitis is mainly treated with medications. In this case, complex therapy is prescribed: vasoconstrictors, anti-inflammatory and antibacterial agents are used. Physiotherapy may be performed as prescribed by a doctor. An operation to open cavities is required only in cases where treatment does not lead to recovery and there is a possibility of complications.

Unlike others, the thinnest posterior wall is formed not by bone tissue, but by spongy tissue. Therefore, even with minor inflammatory processes, it can collapse and allow the infection to spread to other organs..

Frontal sinus cyst

A frontal sinus cyst is a small spherical container filled with fluid and having thin, elastic walls. The size and location of such a neoplasm may vary. This tumor occurs under the same circumstances as frontal sinusitis.

As a result of inflammation, the outflow of fluid is disrupted, but mucus continues to be produced and accumulated. And since it has nowhere to go, over time a cyst forms. The treatment for this disease is surgery.

Diagnosis of sinus diseases

The symptoms of diseases of the frontal sinuses, be it frontal sinusitis or a cyst, are the same. The only difference is that a cyst, if it is small in size, may not show any signs at all for quite a long time. In addition, minor neoplasms are not always detected during routine examinations by an ENT specialist.

Symptoms of diseases

The main symptoms of frontal sinus disease are:

pain in the forehead, which intensifies with pressure and fatigue;
purulent nasal discharge, often odorless;
disruption of normal breathing, usually from the affected cavity;
swelling and redness of the skin at the site of the inflamed sinus;
a sharp increase in body temperature;
general weakness.

Survey

If there is even the slightest suspicion that frontal sinusitis or a cyst is developing, you should immediately contact an otolaryngologist. This doctor, after interviewing the patient, will perform a rhinoscopy - examination of the nasal cavity and paranasal cavities. To confirm the diagnosis, as well as to determine the presence and level of pus, an x-ray may be prescribed.

In particularly advanced cases, a computed tomography scan is performed. This type of study also makes it possible to determine how large the frontal sinuses are and the presence of additional septa in them, which is important when performing surgery. To identify the causative agent of the disease, microbiological studies of secretions are carried out.

X-rays are often used if the maxillary sinuses are inflamed - the frontal cavities are also clearly visible in the images. This type of study is ineffective for diagnosing other sinuses, since they are poorly visible on the image.

Possible consequences and prevention

In cases of incomplete recovery or with advanced frontal sinusitis, the disease can take a chronic form. This is dangerous due to frequent relapses of the disease and other serious consequences in the form of meningitis or inflammation of the brain.

To prevent illness, try to avoid hypothermia, harden the body, promptly treat acute respiratory diseases and runny nose. And then you won’t have to study the frontal sinuses, their structure and functions with the help of photos, consult an otolaryngologist and carry out treatment.

Frontal sinusitis is one of the varieties of such a dangerous disease as sinusitis, in which the pathological inflammatory process is localized in the sinuses located in the superciliary region, in other words, above the eyes.

Like almost all other diseases, it can occur in acute and chronic forms. It is on this that depends how to treat the disease frontal sinusitis, the choice of therapy that will be the most effective and will lead to a speedy recovery.

If the development of sinusitis is only supposedly associated with atmospheric pollution, then this relationship has been proven in the occurrence of frontal sinusitis. After all, the diagnosis of frontal sinusitis is most often made to people living in the area of industrial enterprises.

Like sinusitis, frontal sinusitis is caused mainly by staphylococci, but streptococci, Haemophilus influenzae, some fungi and anaerobic microorganisms can also act as causative agents of inflammation. The inflammatory process provoked by them can be of varying intensity, while pus often accumulates in the sinuses.

Frontal sinusitis is characterized by not only local, but also general symptoms. This:

elevated temperature (up to 40°C), which is a consequence of poisoning of the body;
diffuse headache that appears as a result of liquor-dynamic disturbance and blood circulation;
terrible weakness;
pathological sensitivity to light;
pain in the ears and teeth;
difficulty in nasal breathing;
blurred vision;
headache concentrated in one place;
lacrimation;
dizziness;
swelling of the eyelids and skin above the bridge of the nose;
snot of various colors, but usually it is yellow or green;
hyposmia/anosmia, etc.

If at least some of these signs appear, you must immediately contact an otolaryngologist, since the inflammatory process can spread to nearby organs and cause meningitis and other equally dangerous pathologies.

Headache with frontal sinusitis usually occurs before other symptoms. It is localized between the eyebrows.

With a unilateral acute process - from the side of the inflamed sinus, with a bilateral one - in the entire area, and with a chronic process it is diffuse. The mechanism of its appearance is quite complex, since the trigeminal nerve is involved.

Other reasons for a headache, especially in the morning, are:

decreased pressure in the inflamed sinus due to oxygen resorption;
dilation of the arteries and the resulting painful pulsation;
increased pressure due to the accumulation of pus in the sinus;
exposure to metabolic products of microorganisms.

Attention! A typical headache may disappear, but this is not always a sign of final recovery, since it can disappear only when the outflow of pus improves.

Both with acute inflammation and the next exacerbation of chronic discomfort in the forehead becomes bursting, the intensity of which increases significantly with any eye movements, with bowing of the head and with percussion of the forehead.

In addition, an extraordinary heaviness appears, felt as if behind the eyes.

Patients feel worst in the morning, which is due to the complete filling of the affected sinus with mucus/pus and a decrease in outflow from it.

Patients often complain of feeling pain not only in the eyebrow, but also in the temporo-parietal or temporal regions, and with unilateral damage, discomfort will also be present only on one side.

In people diagnosed with chronic frontal sinusitis, during periods of remission, the severity of pain is significantly reduced, but they are still constantly present and have a clear localization. It is dull, pressing, sometimes pulsating, intensifies in the evenings, after prolonged tilting of the head or physical stress.

At the same time, most patients can know in advance that an exacerbation is approaching by the appearance of a “tide” in the forehead, both when bending over and when completely at rest. Deterioration of the condition usually occurs in such cases within the first 24 hours. Source: website

Frontitis: drugs for treatment. Scroll

Since bacteria are almost always the causative agents of the disease, its treatment is carried out mainly with antibiotics.

Ideally, nasal discharge is initially examined and it is found out which microorganism caused the inflammatory process, as well as how sensitive it is to various antibiotics.

Until the results of this analysis are received, the patient is prescribed amoxicillin in combination with clavulanic acid. There are a number of drugs on the market containing these substances, these are:

Augmentin SR;
Amoklavin;
Flemoklav Solutab;
Amoxiclav and others

Subsequently, this penicillin antibiotic is replaced by another, to which the causative agents of the disease have shown greater sensitivity. Although, if frontal sinusitis occurs without the presence of discharge, it is fought with the medications presented above. In addition to penicillins, cephalosporins and macrolides can be used, in particular:

Cefaclor;
Summed;
Cefuroxime;
Azithromycin;
Ceftriaxone;
Macropen;
Cefotaxime, etc.

If acute frontal sinusitis is just beginning, you can try to cope with it with local antibiotics, for example:

Isophroy;
Polydexa;
Bioparox;
Levomicol.

In addition, the following are often prescribed:

Decongestants.

These drugs are classified as vasoconstrictors and are necessary to eliminate swelling. Initially, patients are recommended to use mild agents, for example, ephedrine solution or phenylephrine in combination with dimethindene.

In the future, the use of oxymetazoline drugs may be recommended ( Nazivin, Knoxprey, Nazol etc.), naphazoline ( Naphthyzin, Sanorin etc.), xylometazoline ( Galazolin, Xylobene, For the nose and so on.).

Decongestants. Prescribing Furosemide or intravenous administration of a 1% CaCl solution to patients is necessary in the absence of any discharge.

Antihistamines. Zyrtec, Ebastine, Loratadine and others are also necessary to eliminate swelling of the mucous membrane, which significantly complicates breathing.

Homeopathy. Lymphomyosot, the popular Sinuforte, Echinacea compositum are used for exacerbation of chronic sinusitis and the acute form of the disease.

Antipyretic. Paracetamol and ibuprofen are used for fever above 38.5°C and severe, persistent headaches.

Patients are often prescribed Erespal, and also rinsing the nasal cavity is indicated. In case of frontal sinusitis, it is recommended to carry out this procedure in a clinic.

Its essence is to administer, using a conventional blood transfusion system, 100–200 ml of saline solution heated to body temperature with lactoglobulin or an antibiotic, to which the pathogens have been found to be hypersensitive.

The patient is seated, his head is tilted so that the auricle touches the shoulder. The tip of the system is inserted into the nasal passage, which is on top, and the solution is poured in at a speed of about 40 drops/min. An indicator of the correctness of the procedure is pouring the solution from the opposite nostril.

Treatment at home is allowed only for mild cases of the disease. Patients receive a list of necessary medications and strict recommendations for their use.

In addition to the doctor's prescription, patients can rinse their nose and do inhalations.

But you cannot decide to warm your forehead on your own, even if certain folk methods recommend it.

This is explained by the fact that pathogenic microflora from the affected sinuses can spread to others, as well as penetrate into the brain and other organs, which will lead to the development of complications.

What folk remedies can be used for frontal sinusitis?

Traditional medicine offers many methods for treating this type of sinusitis. This:

Inhalations. The simplest way is to inhale the vapors over freshly boiled potatoes. To enhance the effect of steam, you can breathe over a hot decoction of medicinal herbs, for example, chamomile, bay leaf, adding a couple of drops of essential oil. It is best to give preference to tea tree or eucalyptus oils.

Washing. The onion is crushed and 200 g of boiling water is poured. Add a spoonful of honey to the cooled mixture and rinse your nose three times a day. You can also use chamomile decoction or saline solution prepared at home for this purpose. To do this, add a spoonful of salt and a couple of drops of essential oil to a glass of cooled boiled water.

Drops. Juice is squeezed out of peeled and grated black radish, which is instilled up to 4 times a day. You can also use the juice of cyclamen tubers, but only after preliminary dilution with water in a ratio of 1:4.

But you can start treatment with any folk remedies only with the permission of an ENT specialist, and exclusively as a supplement to antibacterial therapy.

Frontitis complications and consequences of the disease.

In the absence of complete treatment of the acute inflammatory process, chronic frontal sinusitis develops.

If even after this the patient does not take any action, the disease can cause very unpleasant consequences.

Possible complications after frontal sinusitis include:

meningitis;
other sinusitis;
otitis;
phlegmon of the orbit;
swelling of the eyelids;
sepsis;
neurological disorders, in particular pathologies of the facial nerves;
brain abscess, etc.

Puncture with frontal sinusitis

How to treat frontal sinusitis depends on the severity of its course. If the course is persistent, treatment of frontal sinusitis with a puncture is required. If the sinuses are medium or small in size, they are cleaned by piercing their lower wall. The puncture is performed using a special device or, in extreme cases, a needle for blood transfusion.

In other situations, carry out trephine puncture. The essence of the procedure is to insert a cannula through a hole made in the anterior (facial) wall of the sinus.

Every day, the sinuses are thoroughly washed, after which solutions of the selected antibiotic and hydrocortisone are infused. All manipulations are performed under local anesthesia.

Quite often, pain in the frontal sinuses is mistaken for a headache. You need to know what frontal sinusitis is and what symptoms it manifests itself!

Anatomically, the frontal sinuses belong to the accessory formations, due to which the level of pressure in the nasal passages is regulated. If the frontal sinuses hurt, it is assumed that you have sinusitis. This is an inflammatory process of the mucous membrane that lines the inner surface of each section of the paranasal sinuses. Mucosal epithelial cells have the ability to resist the penetration of pathogenic microflora and produce secretory fluid, which has an immunomodulatory effect. Pneumatic gasket in the form of frontal sinuses prevents hypothermia of the brain.

For the development of the disease, the weakening of the body’s immune defense and the presence of chronic diseases of the nasal mucous membranes are crucial. Most often, the infection enters these compartments through the ascending route. Treatment is long and complex due to the anatomical distance of the frontal sinuses from the nasal passages. A puncture is often used to rinse with antiseptic solutions. Antibacterial therapy is more effective at the early stage of the disease. Therefore, when the first symptoms of frontal sinusitis appear, you must consult an otolaryngologist.

Causes

The main reasons include the presence of a chronic inflammatory process in the upper respiratory tract. Gradually, as the disease progresses, the immune barrier between the bacterial flora and the internal sinuses weakens. Pathogenic microflora penetrates the mucous membranes and an inflammatory process develops. Inflammation of the frontal sinuses has a wave-like course, can quickly become chronic and go away on its own without specific treatment. However, the disappearance of frontal sinus symptoms does not mean that a complete cure has occurred. Most likely, the process has turned into a chronic, sluggish form.

Prerequisites for the development of inflammation may be:

colds suffered “on your feet”;
long-lasting runny nose;
stressful situations;
hypothermia in general or hypothermia of the legs;
head blows to the forehead.

In the pathogenesis of development, the infectious agent is of great importance. These can be pathogenic bacteria and viruses. The ciliated epithelium with cilia, which is located on the mucous membrane of the frontal sinuses, is initially not susceptible to the penetration of pathogenic microflora. Infection is possible only when the protective function is weakened, which is expressed in a change in the acid-base balance of the mucous secretion. Many scientists agree that the reason for this may be long-term use of drops based on vasoconstrictor substances.

After the onset of the inflammatory process, swelling and hyperemia of the mucous membranes develop. This leads to the separation of a large amount of secretory fluid with difficulty in its outflow. Oxygen stops penetrating into the frontal sinuses. Internal pressure gradually increases, which causes severe headaches in the forehead.

Clinical picture of inflammation in the frontal sinuses

Symptoms are divided into two groups - local and general signs of the disease. When diagnosing frontal sinusitis, symptoms and treatment are differentiated from other causes of headaches and general intoxication. Local forms of the disease are manifested by the following symptoms:

pressing and throbbing pain in the forehead above the eyebrows;
the pain intensifies when the head is tilted forward;
copious purulent discharge from one or both nasal passages;
flow of mucus into the oropharynx;
lack of nasal breathing.

Symptoms of general intoxication may also develop:

increase in body temperature to a level of 37 - 37.5 degrees;
aches in large joints and bones;
hyperemia of the skin, especially in the area above the affected frontal sinus;
headaches, muscle weakness;
fatigue and drowsiness.

To prescribe treatment, additional diagnostic methods are necessary. In particular, with the help of radiography, the lesion and the degree of the inflammatory process are established. Using culture of purulent discharge, the pathogen and its sensitivity to antibacterial therapy are identified. Rhinoscopy and magnetic resonance computed tomography can also be used.

Trepanopuncture is used only in cases where the diagnosis has already been previously confirmed by radiography and requires a puncture for the purpose of therapeutic manipulation. In all other cases, this is avoided.

What treatment is needed?

Both drug and surgical treatment are used. A puncture of the frontal sinus is required only in severe cases of the disease, when the separation of mucus from the internal cavity is difficult. The puncture is done on an outpatient basis using local anesthesia.

Common treatments for frontal sinusitis include:

use of an antibacterial agent in tablets after establishing the sensitivity of the microflora;
drugs to reduce the production of secretory activity of the mucous membranes (nazivin, naphthyzin, galazolin, sinupret, sanorin, otrivin);
drugs to strengthen the vascular wall (ascorutin, vitamin C, rutin).

Warming the frontal sinuses using physiotherapy methods is useful. If the temperature rises, paracetamol may be prescribed. In the first 5-7 days of the disease, strict bed rest is required. Sick leave is issued for a period of 10 days. Discharge is made after receiving normal results of a general blood test.

Prevention

For the purpose of prevention, it is necessary to avoid long-term sinusitis and rhinitis. If your runny nose does not go away after 3 days of self-treatment, consult a doctor immediately. It is possible that you will need specific treatment. You should also use hardening and general physical strengthening techniques to maintain your immune system in excellent condition. In the autumn, vitamin therapy and the use of drugs to prevent viral diseases are recommended. And, of course, it is necessary to monitor the cleanliness of the nasal passages and freedom of nasal breathing. The nasal mucosa neutralizes pathogenic bacteria and viruses that enter our body from the surrounding air.

If you experience pain in the frontal sinuses, consult a doctor immediately. Timely treatment will help prevent the chronic form of the disease.

Origin. The frontal sinuses are two hollow formations in the form of voids located above the eye sockets and communicating with the nasal cavity through the nasolacrimal (frontonasal) canal.

Predisposing factors

Acute rhinitis
Acute ethmoiditis
General viral infection
Acute respiratory diseases
Hypothermia of the body
Frontal bone injuries

How does infection affect the frontal sinuses?

Pathogenic bacteria and viruses enter the nasal cavity along with the inhaled air. The inside of the nasal cavity is covered with a mucous membrane equipped with ciliated epithelium (epithelial tissue with cilia), which play an important role in neutralizing the air entering the nasal cavity. But, as soon as the body’s overall resistance decreases, the bacteria begin to “attack.” This is how inflammation of the nasal mucosa occurs. The inflammatory process can spread from the nasal mucosa to the mucous membrane of the nasolacrimal duct, and then to the mucous membrane of the frontal sinus. Swelling of the sinus mucosa occurs. Its walls swell and become bright red. The walls of the frontonasal canal also become swollen, the lumen of the canal narrows greatly, up to its complete closure.

The mucous secretion produced by the mucous membrane of the frontal sinus becomes more viscous and ceases to be evacuated from the sinus into the nasal cavity. Oxygen does not enter the sinus. Consequently, the ventilation of the frontal sinus is impaired. All the necessary conditions for the growth and further development and reproduction of bacteria arise in the sinus. The waste products of bacteria are toxins that, penetrating into the blood, can cause intoxication of the body. Soon all the mucus accumulated in the frontal sinus turns into pus. Due to the fact that the lumen of the frontolacrimal canal is closed, removal of pus from the frontal sinus becomes impossible. The content and activity of microorganisms contained in the purulent mass of the frontal sinus increases significantly. Accordingly, the amount of toxins they produce also increases, which leads to a deterioration in the general condition of the body. When pus no longer fits into the cavity of the frontal sinus, it is able to break into the surrounding tissues and even into the periosteum and bone formations.

Clinical manifestations of frontal sinusitis

Local manifestations:

Pain in the forehead or diffuse headache. More often the pain is aching or pressing in nature. The intensity of pain varies depending on the stage of the process. Characterized by increased pain when touched and pressed in the area of the frontal sinuses, as well as with overwork.

Purulent nasal discharge, usually odorless.
Impaired nasal breathing from the damaged sinus
Swelling and redness of the skin in the area of the projection of the damaged frontal sinus, which can spread to the inner corner of the orbit and the upper eyelid
Sometimes morning expectoration of sputum occurs (as a result of mucus draining into the nasopharynx at night during sleep)

General manifestations:

A sharp increase in body temperature to febrile levels
General weakness
Bad feeling
Decreased performance

Instrumental and laboratory methods for diagnosing frontal sinusitis

Rhinoscopy. Rhinoscopy reveals purulent discharge from under the anterior end of the middle concha. The maximum thickening (swelling) of the mucous membrane and its redness are also determined there.
X-ray of the frontal sinuses. Allows you to determine the presence and level of pus in the frontal sinus.
CT scan.
Microbiological studies of nasal secretions. This procedure is necessary to determine the causative agent of the disease.
Probing. Insertion of a special cannula into the frontonasal canal to probe the frontal sinus. This procedure is performed relatively rarely due to the large curvature of the canal.
Aspiration technique. Designed to detect the contents of the frontal sinus.
Trepanopuncture of the frontal sinus. This method of diagnosing frontal sinusitis is also an effective way to treat it.

Principles of treatment of frontal sinusitis

In most cases, frontal sinusitis is treated with medication. And in cases where the course of the disease is protracted or intraorbital, intracranial and general complications of the disease appear, urgent surgical treatment is necessary in order to evacuate the purulent contents of the sinus and restore the patency of the nasolacrimal duct.
Anemizing drugs: solution