bacterial sinusitis

The sinus inflammation is very common during upper respiratory infections - up to 90% - showing radiological signs, but only 0, 5-2% are complicated by bacterial infection. Acute bacterial sinusitis is defined as a sinus inflammation of the bacterial nature.
The bacterial sinusitis is bacterial superinfection consequence that follows after a viral nasopharyngitis trivial of upper respiratory tract, that affects in most cases, as previously mentioned, and sinus mucosa.
Aggression bacterial of at the level sinusal epithelium determine disappearance of ciliary movements, which, in normal, continuously evacuates mucus with bacteria present at this level. This situation favors the adherence and multiplication of bacteria at the level of epithelium, causing inflammation with edema of the lining and the obstruction of sinus drainage. The bacterium proliferates further and appear acute purulent sinusitis.

Besides upper tract viral infections, bacterial sinusitis can appear as a result of infection of dental origin and may be favored by other factors:
• sinus tumors
• foreign bodies
• malformations
• septal deviations
Antibiotic treatment for bacterial sinusitis lasts 10 days and is usually empirically.
It is administered mainly:
• For localized maxillary sinusitis - amoxicillin - clavulanic acid, second generation cephalosporins (cefuroxime), third-generation cephalosporins (ceftriaxone), telithromycin
• for frontal sinusitis, ethmoid, sphenoid may be administered the above antibiotics or quinolone active on the pneumococcus, such as the levofloxacin, moxifloxacin
For sphenoidal sinusitis, which has severe evolution, is indicated association of injectable antibiotic with antistaphylococcal activity. In the absence of amelioration with antibiotic treatment is indicated surgical intervention for evacuation of pus.
In general, bacterial sinusitis evolves favorably under treatment with symptom control in 2-3 days.
Other means of treatment:
• steroidal anti-inflammatory
•-steroidal anti-inflammatory especially indicated in obstructive sinusitis (prednisone, prednisolone) in the short cure of a few days
• Pain Relievers
• sinus drainage by puncture - in case failed antibiotic treatment, with the persistence of radiological signs

allergic sinusitis

Low temperatures and shorter days signaled installation of seasons when affections related respiratory tract become prevalent. Like spring, autumn give birth or worsens respiratory allergies, or allergic rhinitis, which, though are milder and can be different from allergies in the spring and is manifested by:
- Sneezing;
- Headaches;
- Runny nose;
- Nasal congestion;
- Itchy eyes and watery them.
Untreated properly, the above symptoms may be associated with signs what can suggest and occurrence of sinusitis.
You must be careful not to confuse manifestations of respiratory allergy type with of the flu. One can talk about allergy if:
- Symptoms persist for more than a week, which is the usual duration of a cold.
- Symptoms are more severe in a certain place or season, and less severe in others.
- Runny nose and mucous secretions are clear and abundant.
- Gradual onset of symptoms, including attacks of sneezing, itchy eyes, nasal or "palate".
- Fever, muscle aches and malaise are usually present.
It can be a cold if:
- Symptoms include fever, muscle aches, malaise and sore throat.
- Symptoms remitted after 7-10 days.
- Runny nose and mucus secretions become more consistent and is get a yellowish color.

sinusitis in children

Sinusitis is a condition characterized by sinus infection of children and occurs most often as a result a cold or flu. It is a frequent affection that does not always require medical treatment, but which may create complications if not diagnosed and properly cared for. If your child laments that he got a headache, exhibit symptoms of colds and feel pain and pressure in the forehead, above the eyes, it is possible to suffer from sinusitis.
Causes of sinusitis in children
Sinuses are localized at the cranial level and represents four cavities or spaces full of air. They are lined with a mucous membrane. The mucus that flows through them are by consistency of nasal and is designed to clean and remove bacteria from the air we breathe. When these places become infected, sinuses become inflamed and causes the sinusitis. The causes are either bacterial or viral.
The most common cause of the disease is the bacterial infection. For that bacterium to grow and multiply in sinuses, there must be an enabling environment. Therefore, we believe that sinusitis is often triggered by a cold when sinuses are vulnerable to infection.
Colds determine inflammation of the nasal mucosa and fluid or mucus remains captive in the sinuses. Bacteria grow and multiply in a moist environment and causes sinusitis.
Exists and several risk factors that can cause sinusitis in children:
exposure to irritating chemicals (the swimming pool);
- runny noses;
- polyps big or large allow blocking the tract of nasal sinuses;
- passive smoking.
Symptoms of sinusitis in children
Symptoms are very similar to those of a cold, but there are several features which betray him. If your child manifests 1-2 symptoms from the following list is likely to have the sinusitis:
- stuffy nose (breathing through the mouth);
- thick nasal secretions,yellow or green;
- facial pain or sensation of pressure in the forehead (especially in the area above the eyes - frontal sinuses - or in the space between the eyebrows);
- swelling of the area beneath and above the eyes;
- headache;
- halitosis or bad breath;
- possible toothache;
- fever, especially to bacterial sinusitis.
Treatment of sinusitis in children
Most cases of sinusitis in children does not require any kind of treatment. Pain and inflammation go by itself within a few days later from the trigger of symptoms.
When symptoms persist and the child's condition is worsening, it is advisable to interfere therapeutically.
The therapeutic conduct aims especially reducing inflammation, treating infection , drainage and maintaining open sinuses.
Treatment prescribed depends almost entirely of the cause that triggered the disease - virus or bacterium.
In case of bacterial sinusitis the doctor prescribes antibiotics, but the viral cannot be cured in the same way. In addition to antibiotics, doctors could prescribe a series of antihistamines and decongestants in order to relieve symptoms that cause strong discomfort to child.
In the situation where the sinusitis of child  has a viral cause, the therapeutic purpose is to relieve discomfort and ameliorate symptoms. Therapeutic measures are similar to those for colds, children needing rest, intense hydration, painkillers to pain, hot compresses or decongestants.

acute rhinosinusitis

Sinusitis is an important public health problem, which has a growing incidence and prevalence in developed countries. Sinusitis is an inflammation of the nasal mucous membrane covering the nose and paranasal sinuses.
Although traditionally is only called sinusitis, this inflammatory process is often preceded by rhinitis. Then expands and to mucosa paranasal sinuses , which is why recommend it using of the rhino-sinusitis term  .
Signs and symptoms
Major criteria by which is diagnosed are:
Pressure and facial pain (suggestive of rhino-sinusitis, only associate with other major criterion), nasal obstruction, nasal discharge / pus drip, Disorders of smell (hyposmia / anosmia) Fever (acute rhinosinusitis only). Minor criteria consist of headache, fetid halitosis, fatigue, coughing, and accusing ear (otalgia, autofonie, tinnitus).
In acute rhinosinusitis the fever, facial pressure isolated are not elements of positive  diagnosis in the absence of other signs or symptoms nose. Diagnosis of acute bacterial rhinosinusitis is established if symptoms of a viral infection worsens after 5 days, if symptoms persist after 10 days of onset of symptoms or the presence particularly pronounced for typical viral infection. Subacute rhinosinusitis shows complete revolution after effective medical treatment. In chronic rhinosinusitis the facial pain is not a symptom suggestive in the absence of other signs or symptoms nose. No sign or symptom is not specific and sensitive for the diagnosis of rinosinuzitei exactly.
How diagnose rhinosinusitis?
The Non-invasive methods diagnostic of rinosinusitis are classic radiography, sinus echography, computed tomography and magnetic resonance imaging (RMN). Nasal endoscopy and paranasal sinuses and sinus puncture (maxillary sinus) are invasive methods diagnostic of rinosinusitis, but and therapeutic methods by draining of sinus secretions. Spectrum of pathogens include viruses addition, aerobic bacteria (Haemofilus influenzae, Streptococcus pneumonia, Moraxella catarrhalis, streptococci, staphylococci), rarely anaerobic bacteria and fungi. Unlike acute sinusitis where are frequently isolates only one bacterium,  in chronic sinusitis predominates polymicrobial associations.
Methods of treatment
The antibiotic treatment has an optimal duration of 10-14 days. Using the estimation of Marchant type, antibiotics were ordered in a scale of effectiveness, predictive  estimated to in adults patients with acute bacterial rhino-sinusitis.
Also, are indicated additional treatments:
Nasal irrigation with saline solution (normal saline or hypertonic solution);
Humidification of inspired air (hot vapor inhalations);
Mucolytic;
Topical decongestants (optimal duration of treatment is 5-7 days to reduce the risk of dependence);
Antihistamines and topical corticoids.
Surgery. Establishing indications for surgical treatment has been hampered by the lack of uniform criteria for defining of chronic rhino-sinusitis,  the lack of an unanimously accepted staging system of rhino-sinusitis.
Absolute indications for surgical treatment:
Complications;
Chronic rhino-sinusitis with mucocel / mucopiocel;
Invasive fungal rhino-sinusitis.
Relative indications for surgical treatment:
The chronic rhino-sinusitis to adult which necessitated various medical treatments for the symtomatic control of sinus suffering and who have not obtained the marked improvement;
Recurrence episodes of acute rhino-sinusitis. The failure of medical treatment represents the indication for surgical treatment.  Can occur the complications its. Some of these are the affecting of other sinuses   (poly / pansinusitis), conjunctival complications, orbital-ocular complications, otitis tongue / suppurated, endocranial complications (meningoencephalitis, superior longitudinal sinus thrombophlebitis, thrombophlebitis cavernous sinus).

sinusitis - natural remedies

Chronic sinusitis affects millions of people annually and is one of the most frequent chronic affections. Symptoms may include headache, breathing difficulties nasal, sensitivity to the cheeks, pain behind the eyes,  runny nose or post nasal leaks, sinus congestion.
Acute sinusitis lasts less than 4 weeks. In most cases, this is caused by a virus and is preceded by a common cold  .
Chronic sinusitis may be caused by upper respiratory tract infections, allergies, deviated septum or other anatomical conditions, fungi and is recurrent and lasts more than 12 weeks.

If a person has symptoms characterstics sinusitis, it is important to undergo a medical practitioner. This disease untreated can lead to serious or chronic infections.
The diet
This is a zone of debate. Many adherents of conventional medicine considered that some food sensitivities does not determine sinus congestion or sinusitis, although this is an often seen approach to alternative medicine practitioners.
Targeted food can be the milk, oranges, sugar and wheat, because they consider that these foods stimulate mucus formation. About sugar, these medicine experts, say that is a food negative with effect on body function.
Nasal irrigation
The nasal irrigation, rinsing of sinus or sinus lavage is a simple alternative procedure recommended by practitioners to ameliorate chronic sinusitis. Nasal irrigation is a procedure that can be done at home and involves the use of a salt water (of sea) for rinsing and emptying of nasal cavites.
Although nasal irrigation is often recommended by doctors especially in the case post-nasal leakage and to prevent allergic rhinitis (often called high fever or allergies) and sinus infections; is also used and in alternative medicine for the same affections being a general practice for preventing and cleaning.
Fortunately, there are immediate measures as safe and natural alternative to use medicines.
1. Studies have demonstrated that up to 70% of patients with chronic sinusitis have environmental allergies. So it is logical to try to avoid, if possible, passive smoking, the gases of traffic, dry air and chemical substances from own house or workplace. Should be removed the dust particles from the house by vacuuming frequently carpets.
2. Moderate physical exercises help to boost immunity. Even walking for 30 minutes by 3-4 times a week can be very efficient - although it should avoided walks outdoors when in the environment quantity of pollen is raised because this factor may exacerbate the problem.
3. Eliminate from diet,  the foods with potential allergen and which favors the creation of mucus, like eggs, fried or fatty foods, sugar, pasta,  beer, chocolate and any other food which have in composition additives.
4. Consume more products that clear the sinuses and helps liquefy mucus. These include foods like fresh fruits and vegetables, salads, fish and chicken broth hot. Foods that are known to be highly beneficial are garlic, onion, chilli, ginger, horseradish, mustard and pineapple.
5. Drink daily 2-3 liters of mineral or flat water, hot herbal teas and drinks which have in composition lemon.
6. For fast ameliorate of symptoms, mix one teaspoon of fresh grated horseradish or root with the lemon juice, hot water and the sweeten up with little honey,  drink the mixture slowly.
7. Inhalation is a practiced way and tested to unclog the blocked sinuses. Add 10 drops of Olbas Oil to a bowl of water having the temperature similar to the one of boiling, cover your head with a towel, close your eyes and inhale the steam emitted,  for 10 minutes.
8. The nasal washing is an old treatment. It dissolves half of a teaspoon of salt in a cup of hot water, keep covered one of the nostrils, and then try to pull the fluid on the opposite nostril. Repeat then the operation and use other nostril.

pansinusitis polyposis

What is the nasal polyposis?
It represents a Oedematous degeneracy of nasal lining as a result of some allergic phenomena. Polyps produce the obstruction of nasal cavities  resulting impossibility  of nasal respiration, loss of smell, nazonata voice , cephalalgia. Sometimes it can super-infect causing the appearance a purulent nasal secretions.
The nasal Polyposis may also to appear as phenomenon  accompanying in a series of other diseases: rinosinusale infections, tumors with the rinosinusala location and some systemic diseases: mucoviscidosis, Widal syndrome, etc.
How  manifest the nasal polyposis?
- In polyposis of allergic cause :the nasal obstruction is bilateral with the present in nasal cavities of some cystic formations translucent with aspect of bunch of grapes
- In polyposis of infectious cause: the nasal obstruction is unilateral usually, accompanied by the unilateral mucopurulent rhinorrhea.
- At children may be a severe form of allergic polyposis: The deforming nasal polyposis that leads to widening of the nasal pyramid in sideways and on the height because the bones of face are still in period of growth.
Which is the treatment of nasal polyposis?
Consists in removing the polyps of endonazalis for the restoration of nasal air lane . Most times, however, the polyps reoccur if are not associated whit  efficient treatment of cause  (allergy, infection, sinusitis, etc.)
- For the allergic polyposis: must do practiced polypectomy, followed by the allergy treatment. Performing a simple computed tomography can show the polyposis extension in the maxillary and ethmoidal sinuses, which requires surgical treatment there of simultaneously or successively. The most extensive form of  disease is the bilateral  polyposis pansinusitis , requiring a radical surgical intervention with opening all of face sinuses.
- For deforming nasal polyposis first are treated the rinosinusala infectious which caused the appearance of the polyps and then to realized the polypectomy
- For the deforming nasal polyposis of child the treatment is addressed to the allergy, followed by polypectomy, but the polyps relapse frequently.

chronic maxillary sinusitis

 Chronic maxillary sinusitis is a chronic inflammation of the lining of the maxillary sinus with an evolution of more than 3 months. Factors that cause chronic maxillary sinusitis include:
- Rhinology factors (causes of chronic nasal obstruction)
- Environmental factors (pollution) contaminant, dust, smoke
- Infectious factors
- Dental outbreaks that may cause odontogenic maxillary sinusitis
- Traumatic factors
- Tumor factors
- Lowered immunity due to various reasons.
Symptoms of chronic maxillary sinusitis are:
- Feeling of pressure, tension in the cheek
- pain of lower intensity
- Nasal obstruction
- Rhinorrhea (runny nose) mucopurulent, sometimes foul-smelling
- Disorders of smell
- Morning cough with expectoration
When examining ENT it is found the submit purulent of secretions in the nasal cavities, which can be sometimes fetid and the nasal mucosa is congestive.
Is necessary to conduct investigations such as the:
- X-ray of anterior and posterior facial sinuses
- Nasal endoscopic examination
- MRI
- examination Computed tomography: of the lining sinus can appears modifications, liquidian level, polyps, obstruction ostiomeatal, calcification, etc..
- Bacteriological and mycological examination of secretion with anti-biograma
- Dental checkup and dental radiography if it is a suspected a cause dental of sinusitis.
- Allergy testing
- Biopsy examination (if applicable)
- Sometimes sinus puncture
How to treat chronic maxillary sinusitis?
The prophylactic treatment is very important and consists in treating all factors that determine the nasal obstruction such as a deviated nasal septum, chronic hypertrophic rhinitis, nasal polyps, etc.
Curative treatment for this disease is medically and surgically.
Medical treatment is the first choice in chronic maxillary sinusitis and consists in the administration of:
- Broad spectrum antibiotic for several weeks
- Aerosol with anti-inflammatory substances
- Dezobstruante nasal vasoconstrictor
- Vitamins and minerals
- mucolytics
- inhalations
The surgical treatment is reserved for patients who have not responded to medical treatment correctly.
The surgical treatment in chronic maxillary sinusitis aims at draining of  maxillary sinus, this can be done by endoscopic (meatotomie medium) or the classic way  depending on each patient.
Pre-operative must be performed the following analyzes:
- Complete blood counts
- Tests of liver
- coagulogram
- Tests of renal
- C.T.sau R.M.N.
- glucose

- Pulmonary Radiography, EKG and cardiology checkup if intervention takes place in general anesthesia
It is very important to know before surgery if the patient follows chronic medical treatments or is allergic to some medicine.
Also, before surgery, must be obtained the consent of the patient.
Post-operatively the patient remains with nasal swab  about 24 hours with special buffers nasal type Merocel, after of-buffer (removing nasal swab) will practice daily nasal toilet with aspiration of secretions and crusts, followed by tables nasal vasoconstrictor solutions.
The post operative checks  are mandatory and consist in grooming of nasal cavities, daily initially and then at 3-4 days until healing. These controls postoperative are essential for the therapeutic success long-term.