The frontal sinus is developed. Inflammation of the frontal sinuses: types of sinuses, etiology and clinical picture

The second largest in size after the maxillary paranasal cavities are the frontal sinuses, otherwise called the frontal sinuses. They are located in the thickness of the frontal bone immediately above the bridge of the nose and represent a paired formation, divided by a septum into two parts. However, not all people have frontal sinuses; about 5% of the population do not even have their rudiments.

Normally, the final formation of the frontal sinuses ends by 12-14 years. It is by this age that they become fully functional structures, having a volume of 6-7 ml and playing an important role in nasal breathing, the formation of the voice and facial skeleton. This fact explains the absence of pathology of the frontal cavities in children - from 2 to 12 years old, they may develop diseases of only the maxillary paranasal sinuses.

The frontal sinuses are lined with mucous membrane, the epithelium of which constantly produces a small amount of mucus.

Through the narrow frontonasal duct, which opens under the middle turbinate, the sinuses are cleansed of mucus - with it, microorganisms and dust particles that have entered them are removed from the sinuses.

The presence of this channel, under certain conditions, can greatly complicate drainage, since with severe swelling of the mucous membrane, the duct is blocked, and cleansing the frontal sinuses becomes impossible. Such persistent blockade of drainage does not occur, for example, in diseases of the maxillary sinuses, which are connected to the nasal cavity not by a canal, but in most cases by an opening. This is important to remember when prescribing treatment for pathologies of the frontal cavities.

In what cases is it necessary to cleanse the frontal sinuses?

The most common diseases of the paranasal sinuses are their inflammations caused by the penetration of pathological microflora into the nasal cavity and further into the sinuses. In most situations, sinusitis (inflammation of the sinuses) becomes a complication of a runny nose of an infectious nature, but cases of isolated damage to the paranasal sinuses are also recorded, as well as a pathological process in the accessory cavities of allergic origin.

With frontal sinusitis (inflammation of the frontal sinuses) of an infectious or allergic nature, swelling of the mucous membrane of the sinuses and the frontonasal duct always occurs. In this case, the epithelium begins to produce an increased amount of mucus, which is a protective reaction.

Its significance lies in the removal of harmful viruses and bacteria, their toxins, decay products, destroyed epithelial cells, and allergic agents with mucus. If the inflammation is infectious in nature, then the abundant contents of the frontal cavities are a mixture of mucus and pus. If allergic, then the discharge does not contain a purulent component.

Cleansing the frontal sinuses is necessary for any form of inflammatory process, since the mass discharged during persistent blockage of the frontonasal canal by the swollen mucous membrane cannot drain independently. Its accumulation causes a characteristic clinical picture of frontal sinusitis.

These are symptoms of intoxication (with infectious inflammation) with an increase in body temperature to 38-39 degrees, severe and excruciating pain in the forehead and eye sockets, nasal congestion, copious discharge of mucus and pus from it (when drainage is restored), impaired sense of smell and timbre of voice.

It is also necessary to clean the frontal sinuses in a timely manner due to the risk of serious complications. Thus, when a huge amount of mucus and pus accumulates in them, a “melting” of the bone wall of the sinus can occur and the contents can break into the orbital cavity or damage the meninges, which is very dangerous for the patient’s life.

Therefore, when symptoms of frontal sinusitis appear, you do not need to take any independent steps in treatment; you must immediately contact a doctor who will diagnose the pathology and prescribe therapeutic measures to clean and sanitize the frontal cavities.

What methods of cleansing the frontal sinuses exist?

When a patient seeks help, all necessary diagnostic measures are prescribed to determine the form of inflammation, as well as to differentiate frontal sinusitis from diseases of the maxillary sinuses or from other sinusitis. Using the methods of anterior and posterior rhinoscopy, the ENT doctor notes changes in the nasal cavity, the presence of hyperemia in a certain area and the nature of the contents.

By tapping, you can find out the location of the pain, and using a blood test, you can determine infectious or allergic inflammation. To obtain final data for the diagnosis of inflammation of the frontal, maxillary and other cavities, additional instrumental research is necessary. This includes diaphanoscopy, radiography, computed tomography, ultrasound.

Using these methods, it is possible to determine whether there is an accumulation of contents in the sinus, whether it is draining, or whether there is a blockage of the frontonasal canal. These data determine which method of cleansing the frontal sinuses will be chosen by a specialist, conservative or surgical.

In most situations, conservative methods of therapy are sufficient to cleanse the maxillary or frontal paranasal sinuses. This means that the use of certain medications is quite capable of both reducing the production of mucopurulent discharge and restoring normal cavities by eliminating swelling of the mucous membrane of the excretory ducts.

Therefore, first of all, etiotropic treatment is prescribed, aimed at the infectious pathogen or allergic agent (antibiotics or antihistamines), then vasoconstrictor nasal drugs (Galazolin, Nazol, Naphthyzin) strictly according to medical recommendations, and in case of intoxication, antipyretic drugs.

If the patient does not have elevated body temperature, then it is very useful to do physiotherapy. For inflammation of the frontal or maxillary sinuses, UHF, HF, local and general warming procedures are very effective.

If these methods fail to remove the persistent blockage of the frontonasal duct, then the doctor has to resort to more radical methods. Depending on the patient’s condition, the form and severity of the disease, it is recommended to perform lavage using the YAMIK sinus catheter, puncture of the frontal sinus using an endoscope through the drainage canal, or transosseous puncture of its anterior or lower wall with further rinsing and sanitation of the cavity.

Cleansing the frontal sinuses with frontal sinuses of any origin is the leading direction in therapy. It is important to choose the most optimal method for the patient and perform cleansing procedures in a timely and correct manner.

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 the 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.

Frontitis

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 discharge from the nose, 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 such as meningitis or inflammation of the brain.

To prevent illness, try to avoid hypothermia, harden the body, treat acute respiratory diseases and runny nose in a timely manner. 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.

The frontal sinuses are an integral part of the system of paranasal air cavities and perform a number of functions related to the protection of the body, the organization of normal breathing and speech. They are located in close proximity to the brain membrane, so their diseases can lead to serious complications.

Structure and functions of front cameras

The frontal sinuses, like the maxillary sinuses, in their location belong to the anterior voids, which communicate with the nose through the tortuous and long middle frontonasal passage. This anatomy predetermines much more frequent infectious diseases of the anterior cavities.

The frontal chambers are a paired organ located deep in the frontal bone.

Their size and configuration can vary markedly from person to person, but on average each frontal sinus has a volume of about 4.7 cubic centimeters. Most often, it looks like a triangle, lined inside with mucous membrane, with four walls:

The orbital (lower) is the thinnest, most of its area is the upper wall of the orbit, with the exception of the edge adjacent to the ethmoid bone. On it there is a canal anastomosis 10-15 mm long and up to 4 mm in diameter, opening into the nasal cavity.
The facial (front) is the thickest, represented by the outer part of the frontal bone, which has a thickness of 5 to 8 mm.
Medullary (posterior) - consists of a thin but strong compact bone, bordered by the anterior cranial fossa and the dura mater.
The inner (medial) divides the two chambers; in its upper part it can deviate to the left or to the right.

A newborn child does not have frontal sinuses; they begin to form only at 3-4 years of age and finally develop after puberty.

They appear at the upper inner corner of the orbit, consist of cells of the ethmoid bone, and the nasal mucosa grows into them. In parallel with this, the process of resorption of the spongy bone, which is located between the inner and outer plates of the frontal bone, occurs. In the vacated space, frontal voids are formed, which can sometimes have niches, bays and internal partitions in the lumen. The blood supply comes from the ophthalmic and maxillary arteries, and the innervation comes from the ophthalmic nerve.

The cavities are most often unequal, since the bone plate separating them is usually not located exactly in the center, sometimes it may be absent, then the person has one large cavity. In rare cases, the dividing bone is not located vertically, but horizontally, and the chambers are located one over the other. According to various studies, 5-15% of people have no frontal sinuses at all.

The main functions of front cameras today are:

protecting the brain from injury and hypothermia (acting as a “buffer”);
participation in the formation of sounds, enhancing vocal resonance;
regulation of pressure levels in the nasal passages;
warming and humidification of inhaled air;
reduction in the mass of the skull during its growth.

Acute frontal sinusitis: etiology and symptoms

Since the paranasal compartments are covered inside with mucous membranes, the main disease is the inflammatory process in them. If we are talking about the frontal sinuses, then their inflammation is called frontal sinusitis. The inflammation has a wave-like course, can quickly move from the acute stage to the chronic stage and then be asymptomatic or go away without treatment.

The main cause of the disease, as a rule, is an inflammatory process in the upper respiratory tract, from where it spreads to the frontal compartments in an ascending manner.

If treatment is untimely or insufficient due to changes in the pH of the secretion, the immune barrier from the ciliated epithelium weakens, and pathogenic microflora penetrates into the chambers, covering the mucous membranes. Many doctors are of the opinion that the acid-base balance of mucus can be disrupted by drops with a vasoconstrictor effect, which are used for a long time.

The main prerequisites for the development of the disease:

long lasting runny nose;
colds that have been poorly treated or suffered “on your feet”;
hypothermia of the body, in particular the legs;
stress;
injuries to the front of the head.

The inflammatory process is accompanied by hyperemia and swelling of the mucous membranes, resulting in increased secretion while simultaneously impeding the outflow of fluid. The supply of oxygen is sharply limited or completely stopped. Gradually increasing internal pressure is the cause of severe pain in the forehead area.

Symptoms of the disease are divided into general and local, which together give a characteristic clinical picture of acute frontal sinusitis.

Local signs:

complete absence or severe difficulty in nasal breathing;
throbbing and pressing pain above the eyebrows, which intensifies when you tilt your head forward or press your hand on your forehead;
copious purulent discharge from the nasal passages (one or both);
secretion flowing into the oropharynx;
Swelling may spread to the upper eyelid or the corner of the orbit of the eye.

Simultaneously with the local ones, general signs indicating intoxication of the body also increase:

temperature rise to 37.5-39 degrees, chills are possible;
blood reaction (increased ESR, leukocytosis);
muscle weakness;
diffuse headaches;
hyperemia of the skin in the projection of the affected organ;
aches in bones and joints;
fatigue and drowsiness.

Diagnosis and conservative treatment of frontal sinusitis

To study the clinical picture and make the correct diagnosis, you need to contact an otolaryngologist. The ENT doctor interviews the patient, after which he performs rhinoscopy - a visual examination of the nasal cavities and paranasal sinuses in order to determine the location of pus and the condition of the mucous membranes. Palpation and percussion (tapping) help to identify pain in the anterior wall of the forehead and the corner of the eye on the affected side.

To confirm the suspected diagnosis, the patient donates blood for analysis, and also undergoes radiography (in lateral and direct projections) or computed tomography.

These methods best allow us to determine the lesion, the amount of accumulated pus, the depth and shape of the chambers, and the presence of additional partitions in them. The mucus released undergoes microbiological examination to determine the pathogen and prescribe adequate treatment.

In most cases, conservative treatment is used, including anti-inflammatory therapy, unblocking of the frontonasal canal and restoration of drainage of the cavity. The following medications are used:

broad-spectrum antibiotics in the presence of high temperature (Klacid, Avelox, Augmentin) with subsequent correction if necessary;
analgesics (askofen, paracetamol);
antihistamines (claritin, suprastin);
drugs to reduce mucous secretion through high adrenalization (sanorin, nazivin, galazolin, sinupret, naphthyzin);
means for strengthening the walls of blood vessels (vitamin C, rutin, ascorutin).

In the absence of severe intoxication of the body, physiotherapy (laser therapy, UHF, compresses) is highly effective. A YAMIK sinus catheter is also used, which allows the chambers to be flushed with medicinal substances.

If conservative treatment is ineffective (persistence of high fever, headache, impaired nasal breathing, secretion of thick mucus or pus) for three days, as well as if pus in the cavities is detected using X-rays or computed tomography, sinus puncture is prescribed. Today this is a very effective technique that provides a high level of recovery. This is a fairly simple operation that is well tolerated by patients, regardless of their age.

The essence of the operation is to penetrate the bone tissue mechanically in order to:

removal of purulent contents;
restoration of drainage through the connecting channel;
reducing swelling of the membranes;
suppression of pathogens that cause inflammation.

To carry out surgical intervention, a hand drill no more than 10 mm long with a penetration depth limiter and a set of plastic or metal cannulas for rinsing are used.

When determining the optimal entry point, special calculations are used, which are confirmed by x-rays in different projections.

Trepanopuncture is performed in the inpatient department of the hospital, and local infiltration anesthesia (ledocaine, novocaine) is mainly used. Using a drill, a hole is made in the thick anterior wall of the bone, through which the entire organ is probed. A special cannula is inserted and secured into the hole, through which medications are administered over the next few days. In addition, the sinus and connecting canal are washed with antiseptic solutions, followed by the evacuation of blood clots, polyps, cystic formations, and granulation tissue.

Less commonly, otolaryngologists use the method of punching the bone with a chisel. The resulting vibration is contraindicated for:

meningitis;
abscesses;
osteomyelitis of the cranial bones;
thrombophlebitis.

There is also a technique that is widely used in practice for puncturing the lower wall of the cavity, which is much thinner than the front, with a sharpened special needle. In this case, a thin subclavian catheter is inserted into the lumen of the needle, which is fixed to the skin after the needle is removed and serves as a passage for washing and delivering medications into the chamber. However, this operation is considered less preferable and more difficult due to the presence of the orbit in close proximity.

Due to the location of the meninges near the lesion, delaying contact with a doctor or attempting self-medication can lead to serious consequences, including death. Complications of frontal sinusitis can include diseases such as purulent inflammation of the orbit, meningitis, osteomyelitis of the cranial bones, etc.

Traditional methods of treatment and prevention of frontal sinusitis

Traditional recipes are mainly aimed at reducing swelling and removing mucus; their use should be coordinated with your doctor:

Boil bay leaves (5-10 pcs.) in a saucepan, transfer to low heat and breathe, covered with a towel, for five minutes. Repeat for several days in a row, this promotes the outflow of pus.
A teaspoon of salt, a little baking soda and three drops of tea tree oil are mixed in a glass of warm water. Clean your nose, then, tilting your head forward, use a small syringe to pour the solution under pressure into one nostril so that it flows out of the other. Repeat 2-3 times a day, then apply drops for a runny nose.

Prevention of the disease is as follows:

timely treatment of rhinitis and sinusitis; if the runny nose does not go away within three days, you should contact the clinic;
strengthening the immune system through hardening and physical exercise;
vitamin therapy in autumn and spring;
control of cleanliness of the nose and free nasal breathing.

Sources: medscape.com,

Mucocele(pyocele) of the frontal sinus is a cyst-shaped expansion of the frontal sinus, resulting from its distension by accumulated serous fluid (mucocele) or pus (pyocele). Mucocele of the frontal sinus is accompanied by gradually increasing pain in the forehead, above the orbit and around the eye; the appearance of a protrusion in the inner corner of the eye; exophthalmos and downward displacement of the eyeball; impaired visual acuity and color perception; lacrimation and diplopia. To diagnose mucocele of the frontal sinus, rhinoscopy, radiography, ultrasound, CT, MRI and diaphanoscopy, diagnostic puncture and probing of the frontal sinus are used. All patients with mucocele of the frontal sinus are subject to surgical treatment.

General information

The frontal sinus is located in the medial part of the frontal bone behind the brow ridges. Its lower wall is also the upper wall of the orbit; the posterior wall separates the frontal sinus from the brain. The right and left frontal sinuses are located next to each other and are separated from each other by a thin septum. Through the frontonasal canal, the frontal sinus is connected to the middle meatus of the nasal cavity. Inside, the frontal sinus is lined with a mucous membrane, the cells of which produce a special fluid. The outflow of this fluid occurs through the frontonasal canal. Violation of the outflow leads to the accumulation of fluid in the sinus cavity and the formation of a mucocele of the frontal sinus. When the accumulated secretion suppurates, it is called a pyocele.

Mucocele of the frontal sinus is most often observed at school age. Due to the fact that the formation of the frontal sinuses begins after the birth of a child and ends at the age of 6-7 years, mucocele of the frontal sinus does not occur in preschool children. The slow growth of mucocele of the frontal sinus leads to the fact that the first clinical symptoms of the disease may appear several years after the onset of pathological changes in the frontal sinus. In otolaryngology, there is a known case where a mucocele of the frontal sinus was diagnosed in an adult patient 15 years after the nasal injury that provoked its development.

Causes of mucocele of the frontal sinus

The development of mucocele of the frontal sinus is associated with complete obstruction or partial disruption of the patency of the frontonasal canal. A deviated nasal septum, foreign bodies in the nose, exostoses and tumors, and nasal injuries, which result in the development of periostitis, can lead to the appearance of a mucocele in the frontal sinus. The frontonasal canal can be blocked by adhesions and scars that form as a result of sinusitis of the frontal sinus.

Infection of the mucocele fluid of the frontal sinus with the appearance of pyocele can occur when the infection spreads from the nasal cavity, as well as by hematogenous or lymphogenous route. In this case, the source of infection is primarily infectious and inflammatory diseases of the nasopharynx: rhinitis, sinusitis, pharyngitis, tonsillitis, chronic tonsillitis, laryngitis.

Symptoms of mucocele of the frontal sinus

Mucocele of the frontal sinus is characterized by a long asymptomatic course. Before the first clinical signs appear, a mucocele can exist for 1-2 years or longer. Mucocele of the frontal sinus begins to manifest itself with a gradually increasing headache in the frontal region. Then pain appears above the orbit and around the eyeball, and a rounded protrusion appears in the inner corner of the eye. Pressing on this protrusion is usually painless and produces a characteristic sound resembling a cracking or crunching sound. Strong pressure can cause the formation of a fistula, through which viscous mucous (with mucocele) or purulent (with pyocele) fluid begins to emerge.

Over time, with a mucocele of the frontal sinus, the lower wall of the frontal sinus lowers, resulting in a downward and outward displacement of the eyeball. Double vision (diplopia), impaired color perception, and decreased visual acuity often occur. When the lacrimal ducts are compressed, patients with mucocele of the frontal sinus experience lacrimation.

The accumulation of a large amount of fluid in the mucocele of the frontal sinus can cause its breakthrough with the formation of a fistula in one of the walls of the frontal sinus. The outflow of pus through the fistula into the structures adjacent to the frontal sinus leads to the development of purulent complications.

Complications of mucocele of the frontal sinus

Complications arising from mucocele of the frontal sinus are associated with suppuration of its contents and the spread of the purulent process to anatomical formations adjacent to the sinus. Most often, pus breaks through the lower wall of the frontal sinus. The introduction of a purulent infection into the orbital cavity can lead to the development of panophthalmitis, endophthalmitis and orbital phlegmon. In rare cases of mucocele of the frontal sinus, the formation of a fistula in the posterior wall of the sinus with the occurrence of meningitis is observed.

Diagnosis of mucocele of the frontal sinus

Mucocele of the frontal sinus is diagnosed by an otolaryngologist. If there are complications from the eye, consultation with an ophthalmologist is necessary; if meningitis is suspected, a consultation with a neurologist is necessary. Diagnosis of mucocele of the frontal sinus is based on the patient's complaints, examination, rhinoscopy and examination of the paranasal sinuses. Rhinoscopy in patients with mucocele of the frontal sinus may not reveal any pathological changes. Sometimes during rhinoscopy, a small smooth protrusion is visualized in the area of the middle nasal meatus.

X-ray examination of a mucocele of the frontal sinus reveals an increase in the size of the sinus, stretching of its bottom, and a decrease in transparency. It is possible that the septum between the frontal sinuses may bulge in the healthy direction. Discontinuous contours of the frontal sinus may indicate the presence of a fistula. A more accurate and informative study is a CT scan of the frontal sinus. Ultrasound and frontotomy can be used) is made after a skin incision along the length of the eyebrow. Then the sinus cavity is cleared of mucus and pus, and drainage is installed. In adults and older children, the operation can be performed under local anesthesia. Postoperative drainage of the sinus is carried out for a long time (for 2-3 weeks) until scars form. This is necessary to create a stable connection between the frontal sinus and the nasal cavity.

Simultaneously with surgery, drug treatment of mucocele of the frontal sinus is carried out. The patient is prescribed antibiotics, anti-inflammatory and decongestants.

Forecast and prevention of mucocele of the frontal sinus

With timely surgical treatment, mucocele of the frontal sinus has a favorable prognosis. The development of complications worsens the prognosis. Prevention of mucocele of the frontal sinus consists of the effective treatment of infectious and inflammatory diseases of the nasopharynx, prevention of injury to the nose and hypothermia, correction of the nasal septum in case of its curvature, removal of tumors and foreign bodies of the nose.

You caught a cold, were treated for the required time, but did not receive proper relief. You are tormented by headaches that become stronger when bending forward and the slightest effort, there is pounding and throbbing in your temples, it is very difficult to think, the temperature rises, and the discharge from the nose has become unpleasant, purulent, with a disgusting odor. All this may indicate the development of inflammation of the frontal sinuses.

The bones of the human skull have a porous structure and are equipped with several sinuses, which are lined with mucous membrane on the inside. This is intended by nature for a reason, but in order to perform protective functions, trapping mechanical particles and various microorganisms that can become pathogens of various diseases. However, when immunity declines, the body’s resistance decreases and microorganisms easily enter the human body.

Since the nasal and frontal sinuses communicate with, when severe inflammation develops, pathogens penetrate them and become the cause of development, or provoke inflammation of the frontal sinuses - frontal sinusitis.

Hypothermia, strong and incorrect frequent blowing of the nose, lack of treatment of the underlying disease or its termination prematurely, the use of inappropriate medications and non-compliance with a full treatment regimen (neglecting medical recommendations about the need for surgical intervention, going to work until complete recovery, and so on) contribute to the spread of infection.

Signs of the disease

Frontal sinusitis provokes abundant mucous or mucopurulent discharge from the nose, since this disease usually involves severe discomfort, headache, which may be accompanied by spasms when trying to blow the nose or with a sudden change in body position, especially when bending over.

Patients complain of a feeling of heaviness in the head, throbbing pain in the area of the frontal sinuses, which can radiate to the temples. If the disease is neglected, it can quickly become complicated and cause a very dangerous condition - meningitis, or inflammation of the meninges. This is due to the fact that the bones of the facial part of the skull are thin and porous, they have a number of cavities and channels through which the infection can penetrate into the brain and other vital organs.

Outside in the area of the frontal sinuses, areas of swelling and slight redness may appear, which may be greater on the more inflamed and “clogged” side. Swelling may affect the orbital part and the corner of the eye, which is located closer to the source of infection.

As the disease develops, the patient experiences severe weakness, chills, and increased pain.

The presence of pus in the frontal sinuses is due to infection, mainly of a bacterial nature.Since the canal connecting the sinuses with the nasopharynx is very narrow and tortuous, severe inflammation of the mucous membranes can actually “clog” the frontal sinuses and interfere with the free release of purulent contents. The patient's situation is aggravated by the presence of different origins - hereditary or acquired as a result of injury.

Diagnosis of pathology

External manifestations of the disease can be noticeable to the naked eye (puffiness of the face, local swelling and redness of the skin with “swimming” of the eye from the side of the more inflamed sinus). Also, inflammation of the frontal sinuses in an acute state is quite easily determined by palpation and tapping - the patient winces from touch, percussion causes increased pain, as does finger pressure on the forehead.

Anterior rhinoscopy demonstrates the presence of copious purulent discharge, severe hyperemia of the mucous membranes, their swelling and thickening.More accurate and complete information about the condition of the sinuses is provided by X-rays in frontal and lateral projections, as well as computed tomography.

Obtaining data helps to better assess the patient's condition and make the right decision about the required type of treatment.

A blood test allows you to see an acute inflammatory process, which is manifested by leukocytosis, a shift in the blood count to the left and an increase in ESR. If the collected data is insufficient to obtain an accurate diagnosis, a diagnostic trephine puncture of the frontal sinuses may be prescribed.

Types of medications and their use

In uncomplicated cases of the disease, conservative treatment is usually used using several types of treatments and a variety of drugs.

To reduce swelling and reduce mucus formation, so-called high adrenalization of the mucous membranes is performed. To do this, they are often and generously lubricated or irrigated with the following drugs: Galazolin, Ephedrine or Adrenaline. Adrenaline-based drugs are also prescribed for instillation into the nose. As a result of their use, the thickness and looseness of the mucous membrane of the nose and sinuses decreases, a huge amount of mucus stops being produced and the patient feels relief from his condition.

A whole range of drugs is prescribed internally to the patient:

Broad-spectrum antibiotics, especially when a purulent infection develops, for example, Claforan, Klacid and others.
Analgesics that help reduce pain in the presence of an inflammatory process.
Antihistamines that alleviate the patient’s general condition (Tavegil, Suprastin, Claritin and others).

For frontal sinuses, warming and other physiotherapeutic procedures, for example, warm ones on the frontal sinus area, UHF sessions, laser and infrared therapy, are very helpful. Only a doctor prescribes such manipulations and only if they cannot worsen a person’s condition.

More information about frontitis can be found in the video:

If all conservative efforts do not produce results, and drug treatment does not bring relief, then the doctor recommends trepanopuncture, that is, of the frontal sinus in order to cleanse it of its contents and cure sinusitis.

When diagnosing frontal sinusitis in a pregnant woman, only a specialist can make a decision on drug treatment. He assesses possible risks for both the health of the pregnant woman and the development of the fetus. Based on his conclusions, he makes a decision. In most cases, treatment of frontal sinusitis in pregnant women comes down to rinsing the nasal cavity and warming it up, as well as using some harmless physiotherapeutic procedures. In rare cases, a puncture is prescribed

Recipes for nasal rinsing

The presence of a large amount of contents in the sinuses and nasal cavity creates serious discomfort for the patient and interferes with normal breathing, and this, in turn, causes a lack of oxygen, increased headaches and worsening of already poor health.

In order to remove mucous and purulent discharge and reduce inflammation of the frontal sinuses, the following is used:

Most often, a solution of sea salt is used for rinsing. It has several advantages: salt helps to quickly relieve swelling, disinfects well and soaks possible crusts of dried pus, anesthetizes and has an antimicrobial effect due to the content of iodine and other healing microelements. After such rinsing, the patient feels much better, his nose is freed and air flows freely. In addition, this procedure helps reduce headaches due to decreased pressure in the sinuses.
You can also rinse your sinuses with alkaline mineral water without gas. It should be warm. This water contains soda, which has a softening effect on irritated and inflamed mucous membranes. By alkalizing nasal mucus, it helps reduce the amount of discharge and makes breathing easier.
Rinse the nose with decoctions of various medicinal herbs. Chamomile is especially good and gentle. Its warm decoction can quickly rinse the nasal passages, relieving inflammation and swelling of the mucous membrane and thereby simplifying the release of pus from the frontal sinuses. To prepare such a decoction, you usually take a tablespoon of dried chamomile flowers and pour a glass of boiling water. You need to leave for about an hour, then strain well and cool to a pleasant temperature.

The addition of infection and the appearance of purulent contents means the development of an acute infectious inflammatory process. You can cope with this condition only with the help of powerful ones.

If possible, it is highly advisable to conduct a sensitivity test to determine which group of bacteria caused the inflammatory process. In this case, it will be much easier to choose the ideal antibacterial drug, whose action will specifically “hit” the bacteria that cause the disease.However, such a study often takes too much time, and if the patient is unwell, it is contraindicated to hesitate.

Therefore, in acute frontal sinusitis, strong general antibiotics such as Claforan are most often used.

The duration of treatment and dosage, as well as the drug itself, are chosen by the attending physician. It is very risky to interfere with the treatment regimen he has adopted, since an advanced disease becomes chronic and can threaten with numerous dangerous ones.

Folk recipes

Among the people, inflammation of the frontal sinuses is often treated with heating:

To do this, you can use a regular hard-boiled chicken egg. It is first wrapped in cotton cloth and applied to the affected area. As it cools, the egg is unwrapped and they begin to “roll” the frontal part of the sinus with it. This procedure is especially well received by young children. They do not regard it as a treatment, and after warming up they experience relief.
It is also good to warm your forehead with bags of rock salt or coarse sand. They are made small and sewn from thick fabric. A heated bag is placed on the frontal sinus area and the inflammation is thoroughly warmed up. Since sand and salt retain heat well, the procedure is long and effective.

Surgery

If none of the methods of conservative and medicinal treatment has the expected effect, the doctor prescribes trephine puncture of the frontal sinus. This operation can be carried out in two ways:

Through the frontal surface of the frontal bone.
Through the orbital wall of the frontal sinus.

The second method is used much less frequently due to the high risk of deep perforation of the orbital socket and penetration of infection into it.

To perform this, special markings are used, which are performed using an x-ray of the skull in order to determine the thinnest area of the frontal bone above the sinus. It is in this place that a special mark is placed into which the drill is placed and a hole is made. A special cannula is inserted into it, the contents of the sinus are drained and it is washed. Through the same cannula, medications are injected into the cavity. Treatment usually lasts from 3 days to a week, rarely a little longer.

Surgical treatment is combined with medication to speed up recovery and completely eliminate the source of infection.

To speed up the healing of the injury, the patient is recommended a high-calorie diet high in vitamins and microelements. After recovery for some time, the patient needs to take special precautions and avoid hypothermia and colds.

Possible complications and prevention

Inflammation of the frontal sinuses is dangerous because the source of infection is located close to vital organs. And since the bones of the facial part of the skull are porous and contain many different sinuses and cavities, the penetration of pus into them can lead to very dangerous infections and the spread of infection to the ears, eyes, and mouth.

The most dangerous complication of frontal sinusitis is the occurrence of meningitis, or inflammation of the meninges. It develops very quickly and can lead to disability and even death.

When infection enters the bloodstream, another deadly threat can arise - sepsis, or blood poisoning.

If frontal sinusitis is not completely cured in time, it can become a chronic disease.

To ensure that inflammation of the frontal sinuses never gives you unpleasant moments, you need to have good health and a strong immune system. To do this, you need to exercise, harden yourself, avoid overheating and hypothermia, eat properly and balanced, preferring plant foods, take vitamins, follow a daily routine and, in the event of epidemics, use personal protective equipment, and also avoid places where large numbers of people gather.

When the disease begins, you need to immediately consult a doctor and strictly follow all his instructions, then the disease will not have a chance, you simply will not give it the opportunity to develop and “strangle” it in the initial stages of development. Optimism and cheerfulness help to resist illness; it has been noted that cheerful and active people get colds much less often than pessimists.