Dr. Komarovsky about sinus

The diagnosis of "sinusitis" sounds for most moms and dads ominously. In the parental consciousness, the tendency that sinusitis is a very dangerous disease has become firmly established, and it is incredibly difficult and dangerous to treat it. Is this true, says authoritative children's doctor, author of books on children's health and TV host Yevgeny Komarovsky.

In the people there is a rather vague concept of sinus. It is often mistakenly attributed to all sorts of problems with nasal breathing, which, in fact, are allergic rhinitis or a type of sinusitis. Sinusitis is also a type sinusitis, but only maxillary sinuses (paranasal sinuses) suffer from it (inflamed). These sinuses are located on both sides of the nose in the maxillary bone. Because of the mucus accumulated in the sinuses, a narrow canal blockage that connects them to the nose can occur, and the inflammatory process of the membrane begins.

The maxillary sinuses in newborns are very small, they grow with the baby, and normal sizes are acquired only by 4-5 years. It is for this physiological reason that sinusitis does not occur in children up to 3-4 years.

There is a widespread opinion that sinusitis is the cause of a little cured or improperly cured acute respiratory viral infection, influenza and a number of other respiratory infections that are accompanied by a runny nose. Dr. Komarovsky has his own opinion, different from the standard one.

Thus, if a child has a nasal discharge from the nose, then he has not only acute viral rhinitis, but also acute viral sinusitis. This statement Komarovsky considers true in relation to 100% of children with ARVI. And parents should understand that this is perfectly normal.

The situation becomes abnormal if the inflammatory process in the maxillary sinuses persists after the main signs of a viral infection pass. Usually the child's body copes with the virus in 5-7 days. If the disease as a whole has subsided, and the symptoms of sinusitis remain, doctors talk about bacterial sinusitis. In the acute period, the viral ailment led to a large secretion of mucus that accumulated in the sinuses. And bacteria began to multiply actively in it. This leads to the formation of pus. According to Yevgeny Komarovsky, the probability of a bacterial complication of ordinary viral sinusitis during ARVI is about 2-3%.

Understand that a child has sinusitis, quite simple, says Yevgeny Komarovsky. This ailment has rather classical and specific signs and symptoms:

• Nasal congestion;
• Violation of the smell, up to the complete inability to recognize and feel odors;
• The presence of pain in the region of the maxillary sinuses is obligatory (with a mandatory increase when the head is tilted forward);
• Weakness, feeling of "brokenness";
• Increase in body temperature to 37.5-38.0 degrees;
• Headache;
• A clear feeling of "pressure", fullness in the region of the maxillary sinuses;
• Cheek enlargement on the affected side, asymmetry of the face (visually noticeable).

If we are talking about chronic sinusitis (more than three weeks), the symptoms will not be so severe, and it will be much more difficult to recognize it.

In chronic disease, body temperature does not rise.

Allergic antritis also has a chronic course and is rather difficult to treat with drugs. It has almost all the characteristic symptoms, with the exception of yellow-green nasal discharge.

With suspicion of sinusitis parents should consult a otolaryngologist. The specialist will give direction to diagnostic studies. Usually, the disease is perfectly visible on the x-ray of the sinuses as a darkening, the picture is complemented by a blood test with a modified formula. Komarovsky reminds that X-rays will show not only bacterial, but also viral sinusitis, and the ENT will simply be required to prescribe antibiotics to the child when making such a diagnosis based on the picture.

Therefore, if there is no pain and signs of a bacterial infection, Yevgeny Komarovsky advises not to take the child on an x-ray. By the way, this method of research is not used anywhere in the world as the main one for making the diagnosis of "sinusitis".

Acute viral sinusitis in a child, according to Yevgeny Komarovsky, does not need special treatment. In most cases, both in adults and in children, it passes when the immunity is completely “cracked down” on an alien agent that has entered the respiratory system and has caused ARVI.

Indoors, it is necessary to create conditions favorable for recovery: air humidity is 50-70%, air temperature is 18-20%, air must be clean.

A complication in the form of bacterial sinusitis needs medical assistance in treatment. Antibiotics are used to neutralize the activity of bacteria, antiedematics, washing and drops are used to reduce edema. The child should also be given more to drink, he must breathe the "right" in humidity and temperature with air. The average course of antibiotics for treating this disease, according to Komarovsky, is 10-14 days.

Antibacterial drugs are ineffective against viruses, and even more so do not reduce the risk of bacterial complications. Moreover, the risk to get purulent discharge on the contrary increases.

There is another danger in the prophylactic use of antibiotics for acute sinusitis. While the child is taking them, bacteria begin to multiply in the maxillary sinuses, which, due to drug support, are very resistant to antibiotics. The purulent sinusitis will start anyway, but it will be very difficult to treat.

The allergic form of the disease is not even treated with medication, but with the search and elimination of the antigen that causes allergy in the child. If the allergist was unable to find the "culprit" of swelling of the maxillary sinuses with the help of special tests and tests, then parents should avoid contact with any allergens - pollen, household dust, household chemicals, especially chlorine-based ones, and actively moisten the air in the apartment. In a severe form of the disease, the doctor may prescribe antihistamines.

Such a radical method, as a puncture in the inner part of the nose with the needle penetrating into the sinus and pumping out the accumulated pus and mucus from it, can be an adequate prescription of a quite adequate doctor, Komarovsky says. Folk myths and legends, which say that made a puncture once, will do it more than once, does not stand up to criticism and is not explained in any way by medicine.

In most developed countries with no less developed medicine, the procedure for puncturing the maxillary sinus is often used not only as a medical procedure, but as a diagnostic manipulation, the purpose of which is to take some of the contents of the sinus and find out what kind of microbe caused this condition.

This does not mean that puncture is a measure that can be recommended to everyone. Komarovsky emphasizes that there are hard indications for the procedure:

• The nature of the inflammatory process is unknown, the diagnosis did not provide an answer to this question;
• Antibiotics do not work, inflammation does not decrease;
• Acute pain and high fever, treatment failure.

On the Internet you can find many popular recipes for the treatment of sinusitis. Moreover, even if the mother does not climb into the Internet to look for a panacea, then she is more likely to be helpfully prompted by the next “effective way” of the neighbor, grandmother, and friend. Evgeny Komarovsky urges parents to refrain from treatment of sinusitis folk remedies.

The viral form of the disease is not treated, neither drugs, nor folk remedies. And bacterial curing with onion juice and honey is simply dangerous. The doctor warns that any warming up of purulent sinusitis, any warming compresses contribute to even more inflammation, since bacteria multiply much faster in a warm environment.

The common advice to breathe with this disease over hot milk or herbal decoctions is also considered dangerous by Komarovsky. The fact is that the effectiveness of inhalation of steam in the inflammation of the maxillary sinuses is minimal, and the risk of respiratory tract burns is very high.

One of the effective ways to prevent antritis is vocal training. While singing, breathing becomes more intense.

If the house is not air humidifier, Komarovsky recommends that parents put the water in the basins so that it evaporates freely, equip heating radiators with special valve-taps to regulate the intensity of heating in the winter.

In case of sinus, if there is no temperature, the child may well live a normal life - go to the pool, walk, even in winter, attend school or kindergarten, play sports.

More information about antritis will tell Dr. Komarovsky in the video below.