People quite often suffer from inflammatory processes in the nasal cavity caused by viral, bacterial or even fungal activity. Usually the situation does not go further than a runny nose. However, unfavorable circumstances and some factors (such as hypothermia) contribute to the development of complications - for example, the paranasal sinuses are affected and some type of sinusitis develops.

Most often, inflammation occurs in the maxillary and frontal sinuses, resulting in sinusitis and sinusitis. We need to talk in more detail about how these diseases manifest themselves, how they differ and what should be done if there is suspicion of their development.

For proper treatment it is important to distinguish sinusitis from sinusitis

Statistics say that approximately 20 percent of all diseases suffered by modern population, represented by sinusitis.

Frontal sinusitis and sinusitis occur among them in 4 and 12 percent of cases, respectively.

The symptoms of these ailments are largely the same:

• feeling unwell;
• lack of concentration;
• swelling of the face (specifically, cheeks);
• deterioration of sense of smell;
• development of fever;
• painful sensations radiating from front and back;
• cracks near the nasal passages;
• presence of nasal discharge.

How does one of these inflammations differ from the other? With an inflammatory process in the maxillary sinuses:

• at night, mucus accumulates in the nasopharynx;
• nasal passages are blocked;
• rhinitis develops;
• the upper jaw hurts, as well as the upper side of the cheeks;
• V oral cavity feels dry;
• When breathing, an unpleasant odor is emitted.

With frontal sinusitis there is severe pain in the area of ​​the eyebrows

If the frontal sinuses are inflamed:

• In the area of ​​the eyebrows, as well as in the lower part of the forehead, pain is felt that is paroxysmal in nature.
• When a person stands, yellow-green mucus is intensely released from the nose. When he lies down, he suffers from a slight runny nose.
• Lacrimation develops.
• The eyes react painfully to light.
• The upper eyelids become red and swollen.

You should not make a diagnosis yourself - this is the prerogative of a qualified otolaryngologist. But observing the above signs, you can suspect that you are developing one (or two) of these inflammations, after which you need to see a doctor.

Possibility of complications

Both frontal sinusitis and sinusitis most often begin due to negative impact viruses or pathogenic bacteria.

Usually the inflammatory process begins after common cold or any other ARVI. However, allergic reactions, injured frontal sinuses, caries (improper dental treatment) and measles cannot be ruled out as a stimulating factor.

Moreover, the matter may not stop with inflammation of the maxillary and frontal sinuses. Often the disease is complicated by damage visual organs, auditory tubes and even the brain.

Diagnostics

To begin treatment of the diseases described, they must first be diagnosed based on the existing symptoms.

A blood test allows us to understand the nature of the inflammatory process

The doctor sees the general clinical picture, having examined the patient, and, in addition, may prescribe additional examinations:

• Blood test– in order to determine the culprit of the disease, it is studied leukocyte formula. This will make it possible to understand, for example, what the nature of the inflammatory process is: if it is bacterial, then it needs to be treated with antibiotics.
• X-ray– helps to determine the affected area (in the picture it is a darkened area).
• Computed tomography– quite accurately determines where exactly the infection is localized, allowing the doctor to get acquainted with the anatomical specifics of the sinuses.

Be prepared to also undergo rhinoscopy, thermography, ultrasound, punctures and some other research options.

Allergy tests help diagnose the disease in cases where its source is an allergy.

Treatment process

The treatment of sinusitis and frontal sinusitis must be approached with all responsibility. Sinusitis usually does not go away on its own. Treatment course prescribed by a doctor, not independently.

Conservative therapeutic methods usually assume:

• washing;
• taking antibacterial agents;
• undergoing physiotherapeutic procedures;
• relief from symptoms;
• antihistamines.

With sinusitis and frontal sinusitis, rinsing helps

However, sometimes these methods are not as effective as we would like. In such a case, techniques that are considered more radical are used:

• Classic maxillary sinusotomy– involves the use of anesthesia, since open access to those sinuses that are inflamed is necessary. Main disadvantage such a procedure - long recovery, swelling and the likelihood of damage to healthy tissue.
• Laser maxillary sinusotomy- in essence, classic operation, at which, however, less likely tissue traumatization. And it doesn’t take that long to recover.
• Endoscopic maxillary sinusotomy– the presented method is considered optimal. The mucous membranes are practically not injured, recovery occurs relatively quickly, swelling is not pronounced, and general anesthesia not needed. The procedure is usually performed on an outpatient basis.

Laser maxillary sinusotomy is used to treat sinusitis

When treating frontal sinusitis, first of all, they strive to eliminate the cause of the inflammatory process and normalize air exchange, the location of which is the frontal sinuses.

If the course of the disease is not complicated by anything, vasoconstrictors and antiallergic drugs are needed. Physiotherapy may also help antibiotic drugs(only if, of course, the bacterial nature of the disease is confirmed).

But if nothing meaningful can be achieved by all these methods, rinsing will be required.

Purulent inflammation can be treated with surgical intervention. Most often they resort to trepanopuncture, which is performed using local anesthesia. Before this procedure is performed, an X-ray with contrast is taken (this allows you to determine which points can serve as the best access to the affected areas).

X-rays are usually taken before surgery

To carry out drainage, make an appropriate hole (for this purpose, a long needle with adjustable dimensions is used). Then a plastic guide must be inserted into the puncture to guide the cannula inside frontal sinus. The cannula is fixed with adhesive tape and left for several days (but no more than five, so that the tissue then quickly recovers).

True, treatment of frontal sinusitis and sinusitis through trephine puncture is contraindicated for those who suffer from meningitis, thrombophlebitis, cranial osteomyelitis, or suffer from purulent abscesses. In general, there may be other contraindications - this is decided by the doctor.

Main differences

Naturally, the symptoms of sinusitis and sinusitis differ in many ways. Even the localization of inflammation is different:

• When sinusitis affects upper jaws and the area below the eyes.
• With frontal sinusitis, damage occurs to any of the sinuses, the location of which is the frontal region.

From the very beginning of the development of sinusitis, nasal discharge is present

But the differences associated with immediate symptoms:

• Nature of pain. With frontal inflammation, the forehead and just above the bridge of the nose hurt the most. Unilateral character implies dominance of pain on one side. In the case of inflamed maxillary sinuses, the cheekbones and sides of the nose hurt, and subsequently the pain moves to the temple. Inflammation of the frontal sinuses involves pain with any movement of the head. If they are inflamed maxillary sinuses, a feeling of heaviness appears as soon as you tilt your head.
• Nasal discharge. In the case of frontal sinusitis, the nose is initially stuffy (due to swelling) and, therefore, there is no mucus secretion, but sinusitis involves transparent mucus at the very beginning and it acquires a yellowish tint later (as pus accumulates).
• External swelling. If a person is sick frontal sinusitis, swelling upper eyelid, forehead and area above the eyebrows. Maxillary inflammation is associated with swelling of the lower eyelid and the area below the eyes.

If you study the symptoms of sinusitis, you should know that pain with sinusitis is often confused with dental pain (as a result of which they mistakenly go to the dentist), but frontal sinusitis can at first be confused with a regular migraine.

What is the difference between these diseases? When the frontal sinuses become inflamed:

• Photophobia develops, that is, it is difficult to look at any light source. The fact is that the eyeballs are located close to the frontal sinus.
• Appears It's a dull pain, you just need to tap your knuckles a little on your forehead.
• The pain becomes stronger if you press on the area above the eyebrows.

Symptoms of frontal sinusitis may differ from frontal sinusitis and other types of sinusitis as follows:

• The pain becomes more intense if you tilt your head or turn your torso.
• The voice changes and becomes nasal.
• The transition of the inflammatory process to the area of ​​the ethmoid sinuses negatively affects appetite.

But it is important not to confuse, because maxillary inflammation can cause periodontal disease, caries, incorrectly placed fillings and other dental problems.

In general, the doctor must find out the original cause by examining the patient and, if necessary, familiarizing himself with the results of the examinations.

Pain in the maxillary region can be caused by dental problems

Similarity of symptoms

About the similarity of the symptoms of frontal sinusitis and sinusitis (as a result of which it is necessary accurate diagnosis, before starting treatment) also needs to be said.

• Constriction of blood vessels and the development of swelling, due to which the purulent secretion cannot come out and accumulates, the nerve endings are irritated, and the cavities burst.
• The active proliferation of bacteria is associated with intense intoxication, as a result of which the temperature rises, appetite decreases, lethargy and migraines appear. If the course of the disease is mild, the intoxication syndrome is not particularly pronounced, and it can be mistaken for a common ailment.
• Breathing is difficult and mucus is produced. Ventilation is poor, which gives rise to a host of other problems.

Which disease is worse?

Which of the described diseases is worse? The course of frontal sinusitis is considered more severe, since pus accumulates in the frontal sinuses and practically does not come out. The likelihood of complications associated with damage to parts of the brain increases.

But these diseases are treated approximately the same:

• physiotherapy;
• warming up;
• punctures and so on.

Can symptoms of frontal sinusitis and sinusitis be observed in a patient at the same time? Quite. Combined inflammation of the maxillary and frontal sinuses directly leads to the development of the inflammatory process in the frontal sinus. Accordingly, coping with this problem will be much more difficult.

Neglected diseases are high probability complications that are dangerous not only to health, but also to life. The following may suffer from this:

• respiratory organs;
• gastrointestinal system;
• brain and visual organs.

The course of frontal sinusitis is considered more severe

So, when you get sick, you should not think that “everything will work out on its own” - by thinking this way, you are entering the road leading to negative results.

In addition, it should be taken into account that these diseases are very prone to relapse, that is, they easily develop again soon after recovery if the rules for their prevention are not followed.

Prevention

Separately, we should talk about the prevention of all types of sinusitis, including sinusitis or sinusitis. Of course it is better to prevent the disease or stop it at the first stage than to subsequently waste time and energy fighting it.

Here are a few rules, the observance of which reduces the likelihood of developing the described ailments:

• Don’t get too cold: dress warmly if it gets cold, don’t sit in drafts.
• Maintain a normal rest and work schedule. Sleep at least 8 hours every day.
• Do regularly physical exercise, but do not overexert yourself.
• Breathe fresh air more often.

To keep your immune system strong, you need to sleep at least 8 hours a day.

As soon as the first suspicion of any of these inflammations appears, immediately contact an otolaryngologist so that he can accurately diagnose and prescribe suitable treatment. In this case, the likelihood of subsequent complications is significantly reduced.

From this article you will learn:

• frontal sinusitis - symptoms and treatment in adults,
• acute and chronic sinusitis: treatment at home.

Frontitis is an inflammation of the frontal sinuses. The frontal sinuses are one of four pairs of paranasal sinuses (there are also the maxillary, ethmoid and sphenoid sinuses). The frontal sinuses are located in frontal bone, just above the eyes (Fig. 1).

The paranasal sinuses (including the frontal sinuses) are cavities that are filled with air and lined from the inside with mucous membrane. Through small openings, the frontal sinuses are connected to the upper nasal passages. The sinuses are involved in filtering and humidifying the air, and also give strength to the skull.

Often inflammation of the sinuses is called the general term “sinusitis” (from the word “sinus” - sinus, and the ending “-itis” - inflammation). “Sinusitis” can be understood as inflammation of any of the four pairs of paranasal sinuses -

Frontitis: symptoms

The main signs of frontal sinusitis in adults are listed below -

• headaches (pain when touching the forehead is also possible),
• feeling of pressure above the eyes,
• impaired sense of smell,
• cough that gets worse at night
• malaise, fatigue, weakness,
• elevated temperature,
• sore throat,
• unpleasant or sour smell from the mouth.

With long-term chronic purulent or polypous frontal sinusitis, the patient may experience purulent abscesses on the forehead, swelling and abscess formation in the eyelid area, symptoms characteristic of a breakthrough of pus from the sinus into the eye socket or brain may appear.

Chronic purulent sinusitis: photo

Reasons for the development of frontal sinusitis -

Below we list the main reasons for the development of sinusitis, as well as risk factors that do not themselves cause, but nevertheless contribute to the development of inflammation in the sinuses.

• Acute frontal sinusitis develops most often against the background of ARVI and influenza –
  in most cases, inflammation of the frontal sinuses occurs precisely against the background of a cold ( viral nature). When you have a cold, swelling of the nasal mucosa and the mucous membranes of the paranasal sinuses occurs. Swelling of the mucous membrane can lead to the fact that the openings through which the sinuses communicate with the nasal cavity become blocked.

  This creates conditions under which the outflow of mucus and inflammatory exudate into the nasal cavity is disrupted from the sinuses. At this first stage of inflammation in the frontal sinuses there is still no associated bacterial infection, i.e. there is no pus. However, in the absence timely treatment, in a closed cavity in the absence of outflow of inflammatory exudate and mucus, bacterial inflammation will inevitably develop with the formation of pus.

• Chronic inflammatory diseases nose –
  This is the second most common cause of frontal sinusitis, in which a lot of pathogenic bacteria and fungi accumulate in the nasal passages. Chronic inflammation also promotes swelling of the mucous membrane, which disrupts the outflow of mucus from the sinuses and contributes to the development of inflammation. In this group of patients, frontal sinusitis usually has chronic course, and develops with enviable regularity.

• Allergic rhinitis –
  Allergic rhinitis is also often the cause of inflammation of the frontal sinuses. With such rhinitis occurs sharp increase secretion of mucus in the sinuses and nasal mucosa. In this case, swelling of the mucous membrane occurs, which disrupts the removal of mucus from the sinuses into the nasal cavity. Swelling of the mucous membrane is also aggravated by the fact that patients take antihistamines, which are generally contraindicated for inflammation of the paranasal sinuses.

Risk factors that contribute to the development of frontal sinusitis –

• frequent colds,
• allergic rhinitis,
• deviated nasal septum,
• frequent/continuous use of runny nose sprays, antihistamines,
• smoking (disturbs the mechanism of mucus outflow from the sinuses into the nasal cavity),
• enlarged tonsils, presence of adenoids,
• weak immunity,
• fungal infections.

Diagnosis of acute frontal sinusitis –

The ENT doctor will check the nasal cavity for inflammation, the growth of polyps, the presence of adenoids, and examine the tonsils. Ideally, your doctor will take a sample of mucus from your nose at microbiological examination to determine which microorganisms caused the development of frontal sinusitis (viruses, bacteria or fungi). The latter is especially important if you have chronic diseases nose/throat, or if sinus inflammation happens to you with enviable consistency.

Additional research methods –
1) microbiological examination of mucus (see above),
2) X-ray of the frontal sinuses, or even better CT (computed tomography),
3) allergy test (since allergic rhinitis can cause sinusitis),
4) Maybe general analysis blood.

Frontitis on x-ray and computed tomography: photo

Frontitis: treatment

How to treat frontal sinusitis will depend primarily on the form of the disease (acute or chronic), as well as the nature of the inflammatory process (serous, purulent or polypous). It is also important to understand the cause of inflammation (allergies, viruses, bacteria, fungi), because the list of prescribed medications and procedures will depend on this.

That is, if you don't want to improper treatment frontal sinusitis has become chronic purulent form which requires mandatory surgical intervention, consult an ENT doctor from the very beginning. The doctor will examine you, refer you for examinations if necessary, and then you can calmly take pills and put drops into your nose at home (website).

1. Treatment of acute sinusitis -

Acute frontal sinusitis arising against the background of ARVI and influenza, or allergic rhinitis It is quite possible to treat with anti-inflammatory drugs based on ibuprofen, which will relieve pain and reduce inflammation. And also with special drops in the nose - to create an outflow of mucus and inflammatory secretions from the sinuses into the nasal cavity.

Those. the most important thing in treatment is to create a good outflow of exudate and mucus from the sinuses into the nasal cavity. Most symptoms acute sinusitis begin to disappear within a few days of treatment, but you need to complete the entire course of treatment prescribed by your doctor.

Drops to relieve nasal congestion –
keep in mind that traditional vasoconstrictor drops for a runny nose, do not use for sinus inflammation for more than 2-3 days. This is due to the fact that after this period they begin to have the opposite effects (due to addiction) and worsen the condition of the mucous membrane. To relieve nasal congestion during frontal sinusitis, it is optimal to use the following drugs:

Drugs to stimulate the release of mucus from the sinuses –
These drugs can be in the form of drops or dragees. They consist entirely of herbal ingredients, which should be nice for people looking for folk methods treatment. Let us say right away that such drugs can only be auxiliary therapy, but not the main method of treatment.

The herbal components of the following drugs cause increased function of the ciliated epithelium of the mucous membrane (so to speak, cilia), which promotes the removal of mucus and exudate from the sinuses into the nasal cavity through small openings between them.

Antibiotics for frontal sinusitis -

As we wrote above: acute frontal sinusitis most often develops against the background of acute respiratory viral infections and influenza, and antibiotics, as is known, do not act on viruses. Taking antibiotics for acute frontal sinusitis only makes sense if a bacterial infection occurs and develops purulent inflammation, but this does not happen immediately.

If there are indications for taking antibiotics, then the drug of first choice is Amoxicillin in combination with Clavulanic acid. Preparations that contain this combination: “Augumentin”, “Amoxiclav”. If the patient is allergic to antibiotics of the penicillin group, then it is better to use -

• antibiotics of the fluoroquinolone group (for example, Ciprofloxacin),
• macrolides (Clarithromycin, Azithromycin).

Antibiotics for frontal sinusitis are prescribed for approximately 10-14 days. However, after 5 days from the start of treatment, it is necessary to evaluate the effectiveness of therapy. If significant improvement is not achieved, then it is best to prescribe a more potent antibiotic.

2. Treatment of chronic frontal sinusitis –

If frontal sinusitis has a chronic course, then it is necessary first of all to conduct a microbiological examination of mucus from the nose and an endoscopic examination, as well as computed tomography. This will make it possible to determine the type of inflammation and make a choice between conservative and surgical treatment.

In the case of a chronic purulent course, or in the presence of polyps in the sinuses/nasal passages, surgical intervention in a hospital setting will be required to remove polyps and inflamed mucous membrane from the sinuses. The same operation can also be used to treat a deviated nasal septum.

Possible complications –

Complications arise, as a rule, only as a result of the patient’s self-medication and late consultation with a doctor. The most harmless complication would be the transformation acute frontal sinusitis into chronic purulent or polypous, with the need for surgical intervention. Among more serious complications may be: brain abscess, orbital abscess and loss of vision, thrombophlebitis of facial veins, sepsis... We hope that our article on the topic: Frontitis symptoms and treatment at home was useful to you!

The paranasal sinuses, which are located in the frontal part of the head, behind the brow ridges are called the frontal sinuses. They are integral part nasal cavities and are responsible for the functioning of important components of the paranasal air cavities. In addition to protecting the body from harmful bacteria and infections, this area is responsible for organizing stable breathing and speech.

Therefore, if your frontal sinus hurts, this indicates inflammation, which can be quite serious due to the proximity of the brain.

Allergic reactions

Another reason for pain may be allergic reaction for medicines or seasonal allergies. In addition, inflammation of the frontal sinus is observed when bronchial asthma and rhinitis. In that case reason inflammation is a blockage of the nasal opening, which usually provides the exit of mucus.

Benign formations

Nasals– another common cause of inflammation.

Polyps are considered benign formations various shapes. They are formed due to inflammation of the mucous membrane.

In this case, swelling of the mucous membrane and breathing problems are noted.

Nose trauma

The cause of inflammation of the frontal sinuses can be traumatization sinuses. This disease can be either domestic or mechanical.

If the nose is injured, a bruise or hematoma can provoke a contusion of the brain or skull. In this case, trauma causes swelling and poor circulation.

In addition, in case deviated nasal septum pain also appears in the frontal part of the head.

In the case of a congenital change or as a result of an injury during life, a damaged septum causes severe disturbances.

Hitting someone else's body

The latter cause of inflammation usually occurs most often in children.

Availability foreign body in the nasal passages not only causes deterioration in breathing, but also greatly harms the condition of the body.

If small parts are found, you must immediately contact the nearest emergency room.

Conclusion

It is important to understand that the functioning of the nasal mucosa is easily disrupted. Therefore, with inflammation, sinusitis, or even due to an untreated runny nose, inflammation of the frontal sinuses can occur.

In addition, the disease can be caused by hypothermia or strong nose blowing, as well as long-term use antibiotics and other medicines. Watch your health and avoid complications.

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 completely functional structures, having a volume of 6-7 ml and playing important role in nasal breathing, 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 when severe swelling 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 frequent illnesses paranasal sinuses - these are their inflammations caused by penetration into the nasal cavity and further into the sinuses of pathological microflora. 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 pathological process in the accessory cavities of allergic origin.

In terms of frequency, various inflammations of the maxillary sinuses are in first place, frontal sinuses are in second place, and ethmoiditis and sphenoiditis (lesions of the ethmoid and sphenoid sinuses) are more rare.

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 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 flow 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 a breakthrough of the contents into the orbital cavity or damage 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 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 definitive data for the diagnosis of inflammation of the frontal, maxillary and other cavities, additional instrumental study. 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, to clear the maxillary or frontal accessory sinuses, it happens enough conservative methods therapy. This means that the use of certain medications 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 temperature body, 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 blockade 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.

A frontal sinus cyst is an abnormal cavity that forms in the frontal paranasal sinus, called the frontal sinus, located in the frontal bone, behind the brow ridges.

Has internal contents (unlike: sterile mucus - mucocele, serous fluid– hydrocele, purulent secretion – pyocele, rarely – air (pneumocele).

Features of the frontal sinus cyst:

• does not transform into a cancerous tumor;
• extremely rarely resolves on its own or under the influence of drugs;
• may burst or fester;
• more often diagnosed in patients 10–20 years old, sometimes in age group 50 – 60 years, in children younger age and in old people, cystic growths in the frontal nasal sinuses are practically not observed.

Among all cystic nodes of the nasal air cavities, a frontal sinus cyst is found in 70–80% of medical reports. This is explained by the fact that this paranasal sinus located in the frontal part of the head:

1. It has a tortuous and long anastomosis - a canal connecting the nasal cavity with the frontal sinus, which is more likely than others to be susceptible to swelling and obstruction (obstruction).
2. More often injured by falls or blows.
3. In addition, the frontal sinuses are asymmetrical with respect to the midline, which is reflected in a shift of the bony septum between them.

The exact reasons for the development of cystic forms in the frontal sinus have not been fully identified.

A frontal sinus cyst is considered as a retention cavity structure, the formation mechanism of which is associated with obstruction of the ducts of the mucous glands, complete or partial.

The secretion produced by the glands actively moisturizes and protects the nasal cavities from dust, allergens, toxins and microorganisms. With stably functioning excretory ducts mucus from the frontal sinuses is discharged into the nasal cavity. It has been established that disturbances in the functioning of the ducts in the sinus occur with the development of abnormal processes, such as: edema, thickening or proliferation of the mucous membrane, compression of the duct by swelling tissue.

Such pathological events lead to the accumulation of mucus, stretching of the walls of the excretory canal and the formation of a round cavity, which begins to grow, gradually filling with secretions.

The causative factors that create conditions for abnormal growth and swelling of the mucous membrane are:

• frequent acute or long-term and sluggish inflammation in the air sinus - primarily frontal sinusitis (inflammation in the frontal sinus);
• chronic rhinitis and sinusitis, including their allergic forms;
• anatomical deformities: narrow frontonasal canal, displacement hard palate, nasal septum;
• degenerative changes in the mucous membrane;
• swelling and separation of submucosal tissue.

Symptoms

There is a direct connection between symptoms and treatment of a cyst in the frontal sinus. Typically, signs of pathology do not appear in early period its growth, which can last several years. A small nodule is discovered accidentally during an X-ray or tomography of the head, prescribed for the purpose of diagnosing other diseases.

However, the symptoms of a cyst in the frontal sinus become pronounced when the abnormal growth reaches 0.8 - 1 cm and fills a significant volume of the sinus.

The main ones:

• a feeling of congestion, difficulty breathing, which can intensify with exercise and sleep;
• pain of different nature and intensity in the frontal part of the head - above the bridge of the nose, above the eye sockets, especially during flights, deep water immersion, bending;
• depending on the location of the cyst, the pain may be concentrated on the right or left side;
• discomfort when moving eyeball, muscle tension, blinking;
• periodic exacerbations of frontal sinusitis, sinusitis, accompanied by mucopurulent discharge;
• loss or decrease in smell sensitivity (anosmia and hyposmia, respectively).

Symptoms of the late phase of the disease are expressed in the following conditions:

Complications

If timely diagnosis and subsequent treatment was not carried out, the growth of an abnormal formation can cause serious consequences: penetration of the capsule contents through the fistula into adjacent tissues and anatomical structures– eye sockets and organs of vision, cranial cavity and brain tissue. If a purulent secretion (pyocele) has accumulated in the cyst, such an abnormal condition leads to the development of:

• endophthalmitis – acute suppuration of the internal tissues of the eyeball;
• panophthalmitis - severe purulent inflammation of all tissues and membranes of the eye;
• thrombophlebitis of the veins of the orbit and phlegmon of the orbit - serious inflammatory process in the fatty tissue surrounding the eye;
• suppuration and death of tissue of the bones of the nose and orbit;
• meningitis and encephalitis (rare, but similar cases have been recorded).

Such local complications of cystic nodes in the frontal sinus are difficult to treat with medications, so it is necessary to complex operation, in which the tissue of the eyeball is partially or completely excised.

Diagnostics

Since the cyst in the frontal sinus grows slowly, without giving severe symptoms, instrumental diagnostic methods are needed to determine the diagnosis.

X-rays are most often used, since X-rays can be taken in almost any clinic and medical center. But small cystic nodes, covering no more than a third of the frontal sinus, do not show themselves on an x-ray.

If a cystic lesion of the frontal sinus is suspected, a computed tomography (CT) scan or MRI is most often prescribed. The localization of the cystic capsule is clarified by performing CT scans in axial and coronal projections, which provides more accurate information.

To additional diagnostic methods include:

Differential diagnosis of a cystic node is necessary to distinguish it from pathologies such as frontal sinusitis, a tumor of any origin, a dermoid type cyst.

Treatment

Cystic cavities in any organ, including the frontal sinus, cannot be treated with medications or folk remedies. While the pathology does not manifest itself with severe symptoms, we limit ourselves to observing it.

If signs of growth of the anomaly become noticeable (or the development of complications is suspected), it is necessary to remove the cyst.

Medication

Drug treatment, although it has only an auxiliary value for such a disease, helps to significantly alleviate the patient’s condition and achieve specific therapeutic results:

• liquefaction of viscous secretions;
• elimination of inflammation and swelling;
• natural expansion of the frontonasal anastomosis of the frontal sinuses;
• flushing out bacterial organisms and toxins from the sinus cavity;
• restoration of air exchange in the sinuses;
• slowing down the growth of the mucous membrane;
• elimination of headaches and local pain.

Main medicinal groups:

1. Antibiotics.

Prescribed if inflammation (frontitis) caused by bacteria develops in the sinuses, in order to relieve foci of suppuration. Locals help in the early phase antimicrobials in the form of solutions, drops, aerosols.

Used: Dioxidin (1% and 0.5%), Framinazine, Bioparox, Sialor, Framacetin, Isofra, Mupirocin, Fusafyungin, Polydexa, Umkalor - a herbal antibiotic and anti-inflammatory drug (from 12 months).

For severe sinusitis it is prescribed antibacterial tablets: Macropen, Azibiot, Leflobact, Zitrolide, Amoxiclav, Cefepime.

1. Mucolytics.

Increases fluidity and outflow of secretions. The most active: Rinofluimucil, Sinuforte, Fluditek, Sinupret, Mucodin, Vicks-Active Sinex, Nazivin.

1. Vasoconstrictors.

Relieves swelling by restoring air circulation in the sinuses. Popular light remedies include: Galazolin, Sanorin, Otrivin, Xylene. Drops with pronounced and long-term action: Afrin, Midrimax, Nazivin, Vicks Active, Irifrin, Adrianol, Nazol.

1. Moisturizing sprays.

Partially relieve swelling, wash away thick secretions, allergens, microbes, and increase tissue immunity. Work well: Goodvada, Dolphin, Aquamaris, Humer, Quicks, Vivasan, Otrivin-more, Salin, Allergol Taisa, Aqualor.

Surgical

The operation to remove the cyst is performed by frontotomy and endoscopy.

During frontotomy, the operation is performed open method what causes the typical disadvantages of this type of intervention: bleeding, prolonged healing, adhesions, risk of infection.

Today they most often resort to endoscopic removal cysts from the frontal sinus, since this is a much safer, painless and gentle method that can be practiced in an outpatient setting.

For visual and neurological disorders, headaches and facial pain, an examination by an ophthalmologist or neurologist is required.