Frontalitis is an inflammation of the frontal sinuses. The frontal sinuses are one of the four pairs of paranasal sinuses (there are still maxillary, ethmoid and sphenoid sinuses). The frontal sinuses are located in the frontal bone, immediately above the eyes (Fig. 1).
The accessory sinuses (including the frontal sinuses) are cavities that are filled with air and lined from the inside with a mucous membrane. Through the small openings, the frontal sinuses are connected to the upper nasal passages. Sinuses are involved in filtration and moistening of air, as well as give strength to the skull.
Often the inflammation of the sinuses is called the generalized term "sinusitis" (from the word "sinus" - sinus, and the end "-it" - inflammation). Under "sinusitis" can be understood inflammation of any of the four pairs of paranasal sinuses -
- frontal sinusitis (inflammation of the frontal sinuses)
- sinusitis (inflammation of the maxillary sinuses),
- ethmoiditis (inflammation of the ethmoid sinuses),
- sphenoiditis (inflammation of the sinus).
The main signs of frontitis in adults are listed below.
- headaches (pains are also possible when touching the forehead),
- feeling of pressure over the eyes
- violation of smell,
- cough worse at night
- malaise, fatigue, weakness,
- high temperature
- sore throat,
- unpleasant or sour bad breath.
With a long-term chronic purulent or polypous frontier, a patient may experience purulent abscesses on the forehead, swelling and abscessing in the area of the eyelids, symptoms may occur, characteristic of a pus outbreak from the sinus to the eye socket or brain.
Chronic suppurative frontitis: photo
Causes of frontal sinusitis -
Below we list the main causes of the development of frontal sinusitis, as well as risk factors that do not cause themselves, but nevertheless contribute to the development of inflammation in the sinuses.
- Acute frontal disease develops most often against the background of ARVI and flu -
in most cases, inflammation of the frontal sinuses occurs precisely against the background of a cold (viral nature). With a cold swelling of the mucous membrane of the nose, the mucous membranes of the paranasal sinuses. Swelling of the mucous membranes can lead to the fact that the holes through which the sinuses communicate with the nasal cavity - overlap.
This creates conditions under which outflow of mucus and inflammatory exudate into the nasal cavity is disturbed from the sinuses. At this first stage of inflammation in the frontal sinuses, there is still no adherent bacterial infection, i.e. pus missing. However, in the absence of timely treatment, in a closed cavity in the absence of outflow of inflammatory exudate and mucus, bacterial inflammation with the formation of pus will inevitably develop.
- Chronic inflammatory diseases of the nose -
This is the second most frequent cause of the development of frontal sinusitis, in which many 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, the frontal sinusitis has, as a rule, a chronic course, and develops with enviable regularity.
- Allergic rhinitis -
Allergic rhinitis is also often the cause of inflammation of the frontal sinuses. With this rhinitis, there is a sharp increase in mucus secretion in the sinuses and nasal mucosa. This causes swelling of the mucous membrane, which violates the output of mucus from the sinuses into the nasal cavity. Swelling of the mucosa is also aggravated by the fact that patients take antihistamines, which are generally contraindicated in inflammation of the paranasal sinuses.
Risk factors that contribute to the development of frontal sinusitis -
- frequent colds
- allergic rhinitis,
- curvature of the nasal septum,
- frequent / constant use of cold sprays, antihistamines,
- smoking (violates the mechanism of mucus outflow from the sinuses into the nasal cavity),
- enlarged tonsils, the presence of adenoids,
- weak immunity,
- fungal infections.
Diagnosis of acute frontal sinusitis -
ENT doctor will check the nasal cavity for inflammation, proliferation of polyps, the presence of adenoids, inspect the tonsils. Ideally, a doctor will take a sample of mucus from the nose for a 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 of the nose / throat, or if the inflammation of the sinuses happens to you with an enviable constancy.
Additional research methods -
1) microbiological examination of mucus (see above),
2) x-ray of the frontal sinuses, and even better CT (computed tomography),
3) an allergy test (because allergic rhinitis can cause frontalitis),
4) possible complete blood count.
Front on radiographs and computed tomography: photo
How to treat frontal disease - 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 (allergy, virus, bacteria, fungi), because the list of prescribed drugs and procedures will depend on it.
That is, if you do not want, because of improper treatment, the frontal sinusitis has passed into the chronic purulent form, which requires mandatory surgical intervention, contact your ENT doctor from the very beginning. The doctor will examine you, refer you for examinations if necessary, and then you will have to calmly drink pills at home and drop nasal drops (24stoma.ru).
1. Treatment of acute frontal sinusitis -
Acute frontalitis that has arisen on the background of acute respiratory viral infections and influenza, or allergic rhinitis is quite possible to cure with ibuprofen-based anti-inflammatory drugs, which will reduce pain and reduce inflammation. As well as 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 sinus into the nasal cavity. Most of the symptoms of acute sinusitis begin to disappear within a few days of treatment, but you must complete the entire course of treatment prescribed by the doctor.
Drops to relieve nasal congestion -
Keep in mind that traditional vasoconstrictive drops from a cold cannot be used for sinus inflammation for more than 2-3 days. This is due to the fact that after this period they begin to have opposite effects (due to addiction) and worsen the condition of the mucous membrane. To relieve nasal congestion in the face of frontalitis, it is best to use the following drugs:
- Spray "Rinofluimucil" (Italy, costs about 250 rubles) -
The spray consists of two active components, one of which reduces the secretion of mucus and pus, and also facilitates their discharge, and the second removes swelling from the nasal mucosa. This spray will be perfectly combined with drugs (such as "Sinupret", "Sinuforte"), which stimulate the withdrawal of inflammatory exudate from the sinuses.
- Spray "Nasonex" (Belgium, from 500 rubles) -
active ingredient - low dosage of glucocorticoids. It perfectly relieves nasal congestion, and it can be used for a long time (courses of 2-3 months), which is important for chronic inflammation of the sinuses, nasal passages, with allergic rhinitis. This drug will also be well combined with stimulants for mucus discharge from the sinuses (Sinupret or Sinuforte).
Preparations for stimulating the discharge of mucus from the sinuses -
these drugs can be in the form of drops or drag. They consist entirely of herbal ingredients, which should be pleasing to people looking for traditional healing methods. We immediately say that such drugs can only be an auxiliary means of therapy, but not the main method of treatment.
The plant components of the below listed drugs cause an increase in the function of the ciliated epithelium of the mucous membrane (cilia, so to speak), which contributes to the removal of mucus and exudate from the sinuses into the nasal cavity through small openings between them.
- The drug "Sinupret" (Germany) -
produced by the famous company "Bionorica" in the form of drops and dragee. Contains extracts of medicinal herbs with anti-inflammatory effects, as well as facilitating the removal of mucus and inflammatory exudate from the sinuses. The cost of 350 rubles.
- The drug "Sinuforte" (Spain) -
release form - in the form of drops of the nose day. Made on the basis of an extract of a medicinal plant. as well as the previous preparation, it also promotes the removal of mucus and inflammatory exudate from the sinuses. The cost of about 2300 rubles.
Antibiotics at the front -
As we wrote above: acute frontal disease most often develops against the background of acute respiratory viral infection and influenza, and antibiotics, as we know, do not act on viruses. It is sensible to drink antibiotics for acute frontal disease only if a bacterial infection joins and purulent inflammation develops, 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. Drugs that contain this combination: "Augumentin", "Amoxiclav". If the patient is allergic to antibiotics of the penicillin group, then it is better to use -
- fluoroquinolone antibiotics (for example, Ciprofloxacin),
- macrolides ("Clarithromycin", Azithromycin ").
Antibiotics at the front are prescribed for about 10-14 days. However, after 5 days from the start of treatment, it is necessary to evaluate the effectiveness of therapy. If a significant improvement is not achieved, then it is best to prescribe a more potent antibiotic.
2. Treatment of chronic frontal sinusitis -
If the frontal course has a chronic course, it is first necessary to conduct a microbiological study of nasal mucus and 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 treatment is required in the hospital to remove the polyps and the inflamed mucosa from the sinuses. The same operation can be simultaneously used for the treatment of a curved nasal septum.
Possible complications -
Complications arise, as a rule, only as a result of the patient’s self-treatment and late treatment by a doctor. The most harmless complication is the transformation of acute frontal sinusitis into chronic purulent or polyposis, with the need for surgical intervention. Among the more serious complications can be: brain abscess, eye socket abscess and loss of vision, facial vein thrombophlebitis, sepsis ... We hope that our article on the topic: Frontal symptoms and treatment at home - turned out to be useful to you!
Author: dental surgeon Kamensky KV, 19 years experience.