Many people know firsthand the negative feelings that appear from time to time in the upper respiratory tract. Hyperplastic sinusitis is a chronic disease that develops against the background of abnormal proliferation of epithelial tissues of the nasal cavity.
Hyperplastic sinusitis: features of the disease in adults, children and pregnant women
Under this type of disease understand a special type of inflammatory process that affects the epithelial layer of the paranasal paranasal sinuses. It has a direct connection with the increased proliferation of cellular structures lining the perinal cavity (usually one of them) and, as a consequence, an increase in the production of mucous secretion. This can provoke the formation of volumetric folds and polyps on the inner surface of the sinuses, which impede the natural circulation of air and complicate the breathing process.
One of the features of the pathological condition is that hyperplastic sinusitis in children and adults, even during remission, is characterized by a narrowing of the excretory orifice of the paranasal sinus. Also, the hallmark of this type of respiratory disease is that it is not a separate disease, but consists of a whole complex of pathological conditions. They have a direct connection with the excessive formation of new epithelial cells lining the inner surface of various air-cavities.
Not only the name of the disease, but also its negative symptoms depend on the location of the localization of the inflammatory process:
- Sinusitis, which developed as a result of the growth of mucous structures, is associated with lesions of the maxillary sinuses and in medical terminology is called hyperplastic maxillary sinusitis. This form of the pathological condition occurs most often, and its distinguishing feature is the localization of painful sensations in the cheekbones, molars of the upper jaw, eyes and nose.
- Frontline With this type of respiratory disease, hyperplasia develops in the frontal air-cavities, which, respectively, is characterized by the appearance of sharp pains in the forehead, upper eyelids and the middle part of the superciliary arches.
- Etmoiditis. Hyperplastic inflammation affects the sinuses located in the ethmoid bone. The soreness at it appears at the root of the nose and in the bridge of the nose, and can also be felt on the inner edge of the orbit.
- Sphenoiditis is the rarest type of pathology and consists of hyperplasia of the mucous membrane covering the sphenoid sinus. Its peculiarity is the appearance of aching headaches, which do not have an exact localization site, as well as those that cannot be stopped by painkillers.
Malfunctions in the regeneration of epithelial tissues covering the inner surface of the paranasal sinuses lead to the replacement of normal cells with damaged cell structures. The consequence of this is the development of quite serious complications that can affect the brain.
Important! Hyperplastic sinusitis is most dangerous in pregnant women in the third trimester, since natural hormonal disruptions occur at this time, provoking the appearance of puffiness on the mucous membrane of the pneumatic sinuses. Strengthening due to the development of hyperplasia of the pathological process threatens the health and functioning of the fetus, which is associated with the development of hypoxia (oxygen starvation).
Classification of hyperplastic sinusitis
In order to avoid possible complications, all ENT diseases should be subject to adequate therapy. It is possible to choose the correct treatment only in the case when all the immediate features of the disease are known. The classification of sinusitis, one of the most serious pathological conditions of the upper respiratory tract, is based on factors such as the nature of the inflammatory process, its localization and etiology. But the most important in the appointment of a therapeutic course is the identification of the form of the disease. Here, specialists primarily distinguished acute hyperplastic sinusitis. It is associated with the occurrence of excessive proliferation of epithelial tissues due to infection of the upper respiratory tract by pathogenic microorganisms. An attack of this form of hyperplasia lasts approximately 20 days and can disappear without a trace if there is adequate therapy.
But, for the most part, people who have undergone the development of this disease are diagnosed with its recurrent type. This is usually a chronic fungal sinusitis of the hyperplastic type. In this case, hyperplasia of the mucous paranasal structures is associated with the germination of the mycelium of pathogenic fungi in them. It is impossible to completely get rid of this form of the disease, since it proceeds with constant exacerbations during which the bacterial microflora joins the main pathological process. It provokes the appearance of suppuration in the paranasal sinuses and the development of serious, often life-threatening, complications.
Causes of hyperplastic sinusitis
Although this disease has been known for hundreds of years, its exact mechanism of development has not been studied well enough. Still, experts note that those people who have congenital or acquired curvature of the nasal septum are susceptible to the occurrence of a pathological condition.
Among the potential prerequisites for the development of hyperplasia in the paranasal sinuses, the following negative factors are also noted:
- allergic reactions accompanied by edema and irritation of the mucous membrane of the paranasal sinuses;
- inadequate or impaired therapy for respiratory diseases;
- pathological conditions occurring directly in the lymphatic system;
- tendency to frequent infections of the upper respiratory tract;
- living or working in an environmentally hazardous area;
- exposure to addiction such as smoking;
- chronic rhinitis and sinusitis;
- genetic factor (heredity);
- serious violations of immunity.
The listed causes of hyperplastic sinusitis contribute to the active support of the chronic inflammatory process occurring in the nasopharynx, therefore, hyperplasia of epithelial structures covering the surface of the paranasal sinuses is further enhanced.
Symptoms and signs of hyperplastic sinusitis
In the inflammatory process associated with hyperplasia of nasal labyrinths and sinuses, the course is far from ambiguous. At each stage of the disease, he undergoes a certain increase in negative symptoms. Symptoms of hyperplastic sinusitis are directly related to the stage at which they appear.
The main manifestation of them is as follows:
- The easy course of the disease. At this stage, the negative clinical symptoms are almost completely absent. Only implicit specific signs are noted – low-grade body temperature of the body, not exceeding 37.2-37.5 ° C, mild headaches, slight nasal congestion and discharge of light-colored semi-fluid mucous exudate.
- Moderate severity. Symptoms at this stage are amplified and manifestations of intoxication join the common signs. Acute headaches begin to torment a person, the temperature varies between 38-38.5 ° C, nasal congestion and mucus separation from it are significantly increased, and reactive phenomena appear – pronounced puffiness of soft tissues that are in close proximity to the affected sinuses.
- Severe form of the pathological condition. The characteristic signs of hyperplastic sinusitis at this stage are greatly enhanced and begin to be accompanied by a manifestation of pronounced intoxication, consisting in general weakness and breakthrough vomiting. Also at this stage of the disease, patients complain of excruciating headaches, localized in the immediate vicinity of the sinuses affected by hyperplasia and inflammation, very high, often reaching critical marks body temperature and the appearance of purulent exudate from the nostrils. Such secretions in hyperplastic sinusitis provoke the occurrence of quite serious complications.
Important! This symptom, even perceived by a person in a mild form, is very dangerous, since it indicates the development of a life-threatening condition. Otolaryngologists strongly recommend that all people who feel the appearance of such warning signs urgently contact a specialist and take emergency measures to stop them. Only timely treatment of the pathology can prevent the development of severe purulent complications of the disease.
Diagnosis of the disease
Detection of the pathological condition of the paranasal sinuses triggered by the hyperplasia of their epithelial tissues is complicated by the asymptomatic initial period of the disease. The specific signs that best characterize this ailment manifest themselves in the final stages, when it acquires a chronic, practically non-curable course, and is also complicated by severe purulent pathologies of the brain or eye orbits.
To make a correct diagnosis, the diagnosis of hyperplastic sinusitis should be carried out by collecting a full history based on the patient’s complaints and conducting an objective examination using the following additional research methods:
- Diaphanoscopy. Assessment of the condition of the paranasal air-cavities by radiography of the sinuses inserted in the mouth with a light bulb. This procedure is carried out in a dark room.
- Sinuscopy Endoscopic examination of the upper paranasal sinuses for detection in pathological changes difficult to reach for examination by traditional methods of the posterior sinuses.
- X-ray. It is carried out in three projections (nasopodborodochnaya, fronto-nasal, side) and is the most informative, inexpensive and common research.
- CT and MRI. Specifying diagnostic measures, carried out mostly in cases where a specialist has a suspicion of the development of purulent complications of the disease.
In identifying the form and stage of the disease, a number of laboratory tests are performed without fail, namely, blood, urine and nasal exudate are studied. All the results of the diagnostic measures taken, depending on what symptoms of hyperplastic sinusitis are present in a person, help the specialist to choose the right course of therapy. It aims not only to alleviate the general condition of the patient, stopping all the negative manifestations of the pathological condition in him, but also contributing to the transition of the disease into a long period of remission.
How and what to treat hyperplastic sinusitis in adults and children?
Therapy for this type of pathological condition associated with hyperplasia of the epithelial layer of the paranasal sinuses is very different. It directly depends on the specific reason that provoked the development of the disease and the symptoms that accompany it. Treatment of hyperplastic sinusitis, as a rule, can be medication and surgery. First of all, complex therapy is used, which basically consists in the elimination of the causes that provoked the pathological condition.
In the case of the presence of an allergic factor, experts apply antihistamine therapy, in which the drugs of choice are: Tavegil, Suprastin, Claritin.
When the development of the disease is influenced by bacterial microflora, an antibacterial course is prescribed by Amoxiclav, Sumamed or Flemoxin Solutab. Any antibiotic for hyperplastic sinusitis should be recommended only by a qualified technician. This is especially important when children are treated. They are mainly prescribed drugs in suspension.
The following therapeutic measures are also taken to eliminate negative symptoms:
- The conclusion of the pathological exudate by systematic rinsing of the nose (furacelin or self-prepared saline solution) and inhalations, for which use Interferon, Sinupret, Chlorophyllipt. Also, for this purpose, acceptable physiotherapy is used in this pathological state.
- Relief of swelling of the paranasal sinuses. For this purpose, vasoconstrictor nasal drops and sprays are used (Tizin Ksilo, Nazivin, Xylen and others as an expert’s choice).
Special care and attention of the attending physicians are necessary in the case when such complex treatment is carried out in pregnant women. The reason for this is their interesting position, in which the unborn baby is most susceptible to the negative effects of certain drugs.
In case of failure of conservative therapy, surgical interventions are applied. Most often, patients are prescribed minimally invasive surgeries performed with an endoscope, namely, endoscopic functional rhinosinusosurgery, which gives the specialist the opportunity, sparingly and without any injury, to open the pathologic sinuses. During surgery, altered epithelial structures are completely removed from the affected sinuses and at the same time the conditions for their normal aeration are restored.
Complications and effects of hyperplastic sinusitis
Hyperplasia, which affected the mucous epithelial tissue of the paranasal paranasal sinuses and developed as a result of its inflammation, is quite dangerous and requires urgent elimination. We should not forget that the procedures for stopping the pathological condition must be approached very carefully and fully comply with all prescriptions of the attending physician, since inadequate treatment of hyperplastic sinusitis or its complete absence can cause serious consequences. A disease that lasts for an indefinite period almost always becomes an active focus of infection, capable of infecting neighboring tissues and causing their damage, not only for health but also for a person’s life.
The following serious complications of hyperplastic sinusitis are noted:
- Intracranial – meningoencephalitis, swelling of the meninges, cellulitis or abscesses of the soft tissues of the brain, purulent or serous forms of meningitis.
- Orbital – retrobulbar abscess (limited purulent damage to the orbital tissue), thrombosis of the eye veins, reactive edema of the eyelid tissue structures.
These complications arising from the development of hyperplasia and the subsequent inflammation of the paranasal sinuses are quite serious and in most cases result in the death of the patient. To eliminate them, full and long-term therapy is required, which is often carried out through surgical intervention.
Prevention of hyperplastic sinusitis is aimed at the treatment of infectious diseases that provoke it (scarlet fever, measles, influenza), as well as the complete elimination of the immediate predisposing factors.
Also effective preventive measures include:
- control of the occurrence of allergic reactions by eliminating the negative effects of allergens with properly selected medication for this purpose;
- regular hardening of the body through water and air procedures;
- increased physical activity and long walks in the fresh air;
- maintaining a healthy lifestyle and a complete rejection of bad habits.
Important! Due to the fact that the hyperplastic form of sinusitis always occurs in a chronic form and is almost an incurable disease, increased attention should be paid to preventive measures. They allow you to extend the period of remission for the longest time possible. In order to prevent the occurrence of frequent exacerbations of the disease, it is recommended to monitor the normal functioning of the immune system, using, if necessary, immunomodulating agents, as well as to maximize the fortification of the diet with fresh vegetables and fruits.