What good for sinus headache: Sprays, Irrigation and Other Treatments

29.09.197026.07.2021 by alexxlab

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Sprays, Irrigation and Other Treatments

Your clogged sinuses can give you pain and pressure above your nose and between your eyes, but the right treatment can bring relief. First, you need to find out if a sinus headache is the cause of your discomfort.

Symptoms

These headaches may give you:

Pain and pressure around the sinuses — in the forehead, especially behind and between the eyes, and above the nose. These areas may be tender to the touch.
Pain that gets worse with movement, like bending over or lying down.

If pain is your only symptom, you probably don’t have a sinus headache. Those usually have other symptoms as well, including:

Treatments

Your doctor may suggest treating the pain and the underlying causes of your sinus headache at the same time.

You might try:

Over-the-counter painkillers. Drugs like acetaminophen, ibuprofen, or naproxen sodium may help. Always read and follow the label, and don’t use them for more than 10 days at a time without talking to your doctor.

Decongestants. These medicines, which you can buy without a prescription, help open your blocked sinus cavities. They do this by curbing the swelling and mucus in your nasal passages.

Follow the instructions carefully. You shouldn’t use nasal decongestant sprays for more than 3 days in a row, or it could make your congestion worse. And don’t use oral decongestants for more than 7 days. If you also take a pain medicine, make sure the decongestant doesn’t have it as well, so you don’t accidentally get too much.

Nasal steroid sprays. In some cases, your doctor may prescribe these sprays and other drugs to reduce your congestion and pain.

Antihistamines. These drugs may help if allergies cause your sinus problems.

Think moist. Dry air can irritate your sinuses, so use a humidifier or vaporizer. Other options include holding a warm, wet towel over your face for a few minutes or using a saline solution nasal spray.

Use salt water. Get a bulb syringe or neti pot and flush out your sinuses with salt water. It moistens and helps clear mucus from your nasal passages, which cuts down on the pressure.

Always use distilled, sterile, or previously boiled and cooled water. Rinse the neti pot after each use and let it air dry.

You can also try saline (salt water) nasal sprays to flush out your stuffy nose.

Avoid irritants. Perfume, cigarette smoke, and certain chemicals can irritate your nasal passages and worsen your symptoms.

If home treatments don’t work — or if you have a fever, pain, or swelling of your face or eyes, redness around your eyes or cheeks, severe headache, confusion, or a stiff neck — see your doctor right away.

If your headaches and other sinus problems keep coming back, surgery can sometimes help if nothing else does. Your doctor can tell you if you’re a good candidate, what the risks and benefits are, and what to expect.

Sinus headaches – Diagnosis and treatment

Diagnosis

The cause of headaches can be difficult to determine. The doctor will question you about your headaches and do a physical exam.

Your doctor may perform imaging tests to help determine the cause of your headache, including:

CT scan. CT scans use a computer to create cross-sectional images of your brain and head (including your sinuses) by combining images from an X-ray unit that rotates around your body.
Magnetic resonance imaging (MRI). With MRIs, a magnetic field and radio waves are used to create cross-sectional images of the structures within your brain.

Treatment

Most people who assume they have sinusitis actually have migraines or tension-type headaches.

Migraines and chronic or recurrent headaches may be treated with prescription medication that is either taken every day to reduce or prevent headaches or taken at the onset of a headache to prevent it from getting worse.

To treat these types of headaches, your doctor may recommend:

Over-the-counter pain relievers. Migraines and other types of headaches may be treated with over-the-counter medications, such as acetaminophen (Tylenol, others), naproxen sodium (Aleve) and ibuprofen (Advil, Motrin IB).
Triptans. Many people with migraine attacks use triptans to relieve pain. Triptans work by promoting constriction of blood vessels and blocking pain pathways in the brain.
Medications include sumatriptan (Imitrex, Tosymra, others), rizatriptan (Maxalt), almotriptan, naratriptan (Amerge), zolmitriptan (Zomig), frovatriptan (Frova) and eletriptan (Relpax). Triptans are available as tablets, nasal sprays and injections.
A single-tablet combination of sumatriptan and naproxen sodium (Treximet) has proved to be more effective in relieving migraine symptoms than either medication on its own.
Ergots. Ergotamine and caffeine combination drugs (Migergot, Cafergot) are less effective than triptans. Ergots seem most effective in those whose pain lasts for more than 72 hours.
Ergotamine may cause worsened nausea and vomiting related to your migraines and other side effects, and it may also lead to medication-overuse headaches.
Dihydroergotamine (D.H.E. 45, Migranal) is an ergot derivative that is more effective and has fewer side effects than ergotamine. It’s available as a nasal spray and in injection form. This medication may cause fewer side effects than ergotamine and is less likely to lead to medication-overuse headaches.
Anti-nausea medications. Because migraines are often accompanied by nausea, with or without vomiting, medication for nausea is appropriate and is usually combined with other medications. Frequently prescribed medications are chlorpromazine, metoclopramide (Reglan) or prochlorperazine (Compazine).
Glucocorticoids (dexamethasone). A glucocorticoid may be used in conjunction with other medications to improve pain relief. Because of the risk of steroid toxicity, glucocorticoids shouldn’t be used frequently.

Preparing for your appointment

You’re likely to start by seeing your family doctor or a general practitioner. You may be referred to a neurologist who specializes in headaches and migraines.

Here’s some information to help you get ready for your appointment and to know what to expect from your doctor.

What you can do

Be aware of pre-appointment restrictions. When you make the appointment, ask if there’s anything you need to do in advance, such as restricting your diet.
Write down any symptoms you’re experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
Write down key personal information, including major stresses or recent life changes.
Make a list of all medications, vitamins and supplements you’re taking.
Take a family member or friend along, if possible. Someone who accompanies you can help you remember what your doctor tells you.
Write down questions to ask your doctor.

Preparing questions will help you make the most of your time with your doctor. For sinus headaches, some basic questions to ask include:

What is likely causing my symptoms or condition?
Are there other possible causes for my symptoms or condition?
What tests do I need?
Is my condition likely temporary or chronic?
What is the best course of action?
What are the alternatives to the primary approach you’re suggesting?
I have these other health conditions. How can I best manage them together?
Are there any restrictions I need to follow?
Should I see a specialist?
Is there a generic alternative to the medicine you’re prescribing?
Are there brochures or other printed materials I can take with me? What websites do you recommend?

Don’t hesitate to ask any other questions you may have.

What to expect from your doctor

Your doctor is likely to ask you questions, such as:

When did you first experience your headache, and what was it like?
Has your headache been continuous or occasional?
Has anyone in your immediate family had migraines?
What seems to improve your headaches?
What appears to worsen your headaches?

April 21, 2020

Show references

Patel ZM, et al. Evaluation and management of “sinus headache” in the otolaryngology practice. Otolaryngology Clinics of North America. 2014;47:269.
Sinusitis. The Merck Manual Professional Edition. http://www.merckmanuals.com/professional/ear_nose_and_throat_disorders/nose_and_paranasal_sinus_disorders/sinusitis.html?qt=sinus%20headache&sc=&alt=sh. Accessed Jan. 23, 2015.
Levine H, et al. Why the confusion about sinus headache? Otolaryngology Clinics of North America. 2014;47:169.
Sinus infection (sinusitis). Centers for Disease Control and Prevention. https://www.cdc.gov/antibiotic-use/community/for-patients/common-illnesses/sinus-infection.html. Accessed March 13, 2018.
Bajwa CH, et al. Evaluation of headache in adults. https://www.uptodate.com/contents/search. Accessed March 13, 2018.
Sinus headaches. American Academy of Otolaryngology — Head and Neck Surgery. http://www.entnet.org/content/sinus-headaches. Accessed March 13, 2018.
Swanson JW (expert opinion). Mayo Clinic. April 2, 2020.
Headache information page. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/All-Disorders/Headache-Information-Page. Accessed March 13, 2018.
Bajwa ZH, et al. Acute treatment of migraine in adults. https://www.uptodate.com/contents/search. Accessed March 13, 2018.
Bajwa ZH, et al. Preventive treatment of migraine in adults. https://www. uptodate.com/contents/search. Accessed March 13, 2018.
Headache: Hope through research. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Headache-Hope-Through-Research#3138_10. March 13, 2018.
Schreiber CP, et al. Prevalence of migraine in patients with a history of self-reported or physician-diagnosed “sinus” headache. Archives of Internal Medicine. 2004; doi:10.1001/archinte.164.16.1769.

Ear, Nose & Throat Doctors

If you’re suffering from headaches, they could have several different causes, including congestion in your sinuses. You may feel pain and pressure in your face due to sinusitis (sinus infection), and the first step toward effective treatment is an accurate diagnosis.

In this blog, board-certified ear, nose, and throat specialist Dr. Cecil Yeung will explain more about these types of headaches as well as sinus headache treatment.

What is a sinus headache?

A sinus headache is caused by swelling and pressure in your sinuses. These air-filled cavities usually allow mucus to freely drain and air to easily circulate throughout the nasal passages. When they become inflamed, however, mucus becomes trapped and isn’t able to properly drain. This condition is known as sinusitis, and it can be caused several things, including a cold, flu, or allergies.

As pressure builds up, it causes pain that feels like a headache.

What are the symptoms of a sinus headache?

Sinus headaches often cause the following symptoms:

Pressure and pain in your face or head (often in one specific area, such as behind your eyes, in your cheekbones or forehead, or at the bridge of your nose)
Pain that gets worse when you bend over, move suddenly, or lie down
Pain that’s worse in the morning
Pain that gets worse when you’re exposed to sudden temperature changes
Swelling in your face
Congested or runny nose
Fever
A sore throat and postnasal drip (the feeling of mucus dripping down the back of your throat)
Yellow or green nasal discharge
Fatigue
Pain in your upper teeth

How is a sinus headache diagnosed?

A sinus headache can sometimes be confused with a migraine or tension headache. If you’ve recently had a cold, allergies, or other symptoms that are usually associated with sinusitis that can indicate that your pain may be from a sinus headache. But if pain is your only symptom, it’s probably not a sinus headache.

If an underlying issue is causing your sinusitis and sinus headaches, your doctor may recommend more testing. For example, if allergies are causing your issues, allergy testing may be recommended.

What are some options for sinus headache treatment?

You can try some at-home lifestyle remedies, including drinking more fluids, using a humidifier or vaporizer to moisten the air, and using a saltwater nasal spray. You may also want to try applying a warm, wet towel to your face to help provide some relief.

In addition, the following are some common types of sinus headache treatment:

Antihistamines – These can help if your sinus headaches are caused by allergies, since they reduce or block histamines and help reduce inflammation and swelling. They are available over-the-counter and also by prescription and come in tablet or nasal spray form.
Decongestants – These oral or nasal medications can help reduce the amount of swelling and mucus in your nasal passages. They shouldn’t be used in the long-term, however.
Nasal steroid sprays – These are available by prescription or over the counter and can help reduce pain and congestion.
Antibiotics – These can be used if your doctor thinks your sinusitis is caused by a bacterial infection. Most infections, however, are viral, and if this is the case, antibiotics won’t help.
Pain medication – Medications such as ibuprofen, acetaminophen, or naproxen sodium can be used.

If medications don’t improve your symptoms, your doctor may recommend surgery depending on the exact cause of your sinusitis and sinus headaches. The goal of surgery is to correct the underlying issue to provide long-term relief.

Surgical options can include the following:

Where can I find the best sinus headache treatment in Housto

Houston ear, nose, and throat specialist and surgeon Dr. Cecil Yeung has more than 20 years of experience in diagnosing and treating chronic sinusitis, which causes sinus headaches. At Houston Sinus Surgery at the Yeung Institute, he has pioneered endoscopic sinus surgery in the area, performing more than 4,000 sinus surgeries with a re-do rate that’s far less than average. He’s a board-certified physician who is known as a leader in his field as well as for his professionalism and precision.

Dr. Yeung will correctly diagnose the cause of your sinus headaches and sinusitis and recommend the most minimally invasive treatment possible that will yield the results you want.

To get relief from the pain and other symptoms of sinus headaches, contact Houston Sinus Surgery at the Yeung Institute today!

Sinus Headaches: Treatment, Symptoms & Causes

Overview

Location of frontal and maxillary sinuses shown on face

What are sinuses?

Sinuses are a series of connected, hollow spaces behind your cheekbones, forehead and nose

(see illustration). The sinuses produce thin mucus. As air travels through the sinuses to your lungs, the mucus traps harmful particles like dust, pollutants and bacteria. The mucus drains out through your nose.

What is a sinus headache?

About 80% of the time, what people call a sinus headache is actually a migraine with nasal symptoms. A true sinus headache develops because of a sinus infection (sinusitis). The infection causes pain and pressure in the sinuses.

How common are sinus headaches?

Sinus headaches are very common with an infection. You can also feel like you have a sinus headache when you have migraines, which affect 12% of people.

Symptoms and Causes

What causes sinus headaches?

Sinus infections cause sinus headaches. Anything that makes mucus buildup in the sinuses can lead to a sinus infection, such as:

The common cold is most often to blame.
Seasonal allergies trigger mucus production.
Nasal polyps, abnormal growths in the nose or sinuses. Nasal polyps can block mucus from draining.
Deviated septum, which is when the line of cartilage and bone down the center of the nose isn’t straight. A deviated septum can prevent mucus from properly draining.

Too much mucus gives germs an opportunity to grow. As germs build up, they irritate the sinuses. In response, sinus tissue swells, blocking the passage of mucus. Swollen, irritated sinuses filled with liquid make your face feel tender and achy.

Do allergies cause sinus headaches (allergy headaches)?

Allergies themselves don’t cause headaches. However, allergies can cause sinus congestion (stuffy nose), which can lead to sinus pressure, pain and infection. If you have seasonal allergies (allergic rhinitis), you’re 10 times more likely to suffer from migraines, too.

What does a sinus headache feel like?

When you have a sinus headache, your face hurts. Typically, pain gets worse when you move your head suddenly. Depending on the sinus affected, you may feel a constant dull ache behind the eyes or in your:

Cheekbones.
Forehead.
Bridge of the nose.

What are the other symptoms of sinus headaches?

Besides facial pain, sinus headaches cause other symptoms, including:

Fever.
Stuffy nose.
Thick, colored mucus discharge from the nose.
Feeling of fullness in the ears.
Swollen or puffy face.

Can you have a sinus headache without being congested?

If you don’t have congestion, it’s probably not a sinus headache. The pain in your face is more likely due to a migraine (severe headache) or tension headache.

What’s the difference between a sinus headache and a migraine?

It’s easy to confuse the two, since migraines can also cause facial pain, nasal congestion and a runny nose. With a migraine, nasal discharge is clear. If you have a real sinus headache — caused by a sinus infection — you’ll also have a fever and thick, discolored nasal mucus.

Diagnosis and Tests

How are sinus headaches diagnosed?

Most of the time when people diagnose themselves with a sinus headache, it’s really a migraine. So, it’s important to see your healthcare provider to get an accurate diagnosis and appropriate treatment.

Your healthcare provider will perform a physical exam and ask about your symptoms. If your symptoms are severe or ongoing, you may also need imaging tests. A magnetic resonance imaging (MRI) test can rule out serious brain conditions. Multiple imaging tests can reveal sinus blockages and include:

X-rays.
Computed tomography (CT) scan.
Nasal endoscopy (a thin, flexible tube with a tiny camera that views inside your nose and sinus).

Management and Treatment

How do I get rid of a sinus headache?

To get rid of a sinus headache, you have to treat the underlying cause. But you can take steps to ease sinus pressure and pain at home:

Apply a warm compress to painful areas of the face.
Use a decongestant to reduce sinus swelling and allow mucus to drain.
Try a saline nasal spray or drops to thin mucus.
Use a vaporizer or inhale steam from a pan of boiled water. Warm, moist air may help relieve sinus congestion.

Sinus infection

Viruses, bacteria and sometimes fungi cause sinus infections. Viral infections often go away on their own. But if your infection is bacterial or fungal, you need antibiotics or antifungal medications. Your healthcare provider may also recommend other medications to ease discomfort, such as:

Antihistamines to prevent allergy symptoms.
Decongestants to reduce swelling in the nose and sinuses.
Pain relievers to ease headache pain.
Steroids to reduce inflammation.

Migraines with sinus symptoms

Sinus headaches that are actually migraines need a different type of treatment. The first step is to relieve your pain. You should know that frequently using over-the-counter medications when you have a headache can cause even more headaches (rebound or medication overuse headaches).

Your provider may recommend prescription medication for migraine pain. You may also need a preventive medication that helps you have fewer migraine attacks.

Prevention

How can I prevent a sinus headache?

You can prevent recurring sinus infections (chronic sinusitis) by treating the root cause. For allergies, seeing an allergy specialist for treatment can help. For a deviated septum, your healthcare provider may need to perform surgery. If you have nasal polyps, you may need a procedure to remove them.

Outlook / Prognosis

How long do sinus headaches last?

Viruses cause most sinus infections. A viral sinus infection typically resolves on its own. Similar to how the common cold clears up by itself, your sinus headache should feel better within about a week. If it doesn’t go away, see your healthcare provider. You may have a bacterial or fungal sinus infection that requires medication.

Living With

What can I do about recurring sinus headaches?

Many sinus headaches, especially those that recur, are actually migraines. But it’s smart to see your healthcare provider to figure out the cause of your headaches.

You may find that the best long-term solution is figuring out what triggers your migraine headaches so you can avoid them. It’s helpful to keep a headache diary to track potential triggers. Triggers you can control include:

Alcohol.
Caffeine.
Specific foods, such as chocolate, red wine or strong cheese.
Lack of sleep.
Stress.

A note from Cleveland Clinic

People often mistake migraines for sinus headaches. But treatment for those two conditions is very different, so it’s important to pinpoint the real problem. If you’ve had more than one sinus infection or get frequent sinus headaches, seek medical care. Getting to the bottom of what’s going on will help you find a successful treatment.

Sinus Headaches: Treatment, Symptoms & Causes

Overview

Location of frontal and maxillary sinuses shown on face

What are sinuses?

Sinuses are a series of connected, hollow spaces behind your cheekbones, forehead and nose

What is a sinus headache?

How common are sinus headaches?

Sinus headaches are very common with an infection. You can also feel like you have a sinus headache when you have migraines, which affect 12% of people.

Symptoms and Causes

What causes sinus headaches?

Sinus infections cause sinus headaches. Anything that makes mucus buildup in the sinuses can lead to a sinus infection, such as:

The common cold is most often to blame.
Seasonal allergies trigger mucus production.
Nasal polyps, abnormal growths in the nose or sinuses. Nasal polyps can block mucus from draining.
Deviated septum, which is when the line of cartilage and bone down the center of the nose isn’t straight. A deviated septum can prevent mucus from properly draining.

Do allergies cause sinus headaches (allergy headaches)?

What does a sinus headache feel like?

Cheekbones.
Forehead.
Bridge of the nose.

What are the other symptoms of sinus headaches?

Besides facial pain, sinus headaches cause other symptoms, including:

Fever.
Stuffy nose.
Thick, colored mucus discharge from the nose.
Feeling of fullness in the ears.
Swollen or puffy face.

Can you have a sinus headache without being congested?

If you don’t have congestion, it’s probably not a sinus headache. The pain in your face is more likely due to a migraine (severe headache) or tension headache.

What’s the difference between a sinus headache and a migraine?

Diagnosis and Tests

How are sinus headaches diagnosed?

X-rays.
Computed tomography (CT) scan.
Nasal endoscopy (a thin, flexible tube with a tiny camera that views inside your nose and sinus).

Management and Treatment

How do I get rid of a sinus headache?

To get rid of a sinus headache, you have to treat the underlying cause. But you can take steps to ease sinus pressure and pain at home:

Apply a warm compress to painful areas of the face.
Use a decongestant to reduce sinus swelling and allow mucus to drain.
Try a saline nasal spray or drops to thin mucus.
Use a vaporizer or inhale steam from a pan of boiled water. Warm, moist air may help relieve sinus congestion.

Sinus infection

Antihistamines to prevent allergy symptoms.
Decongestants to reduce swelling in the nose and sinuses.
Pain relievers to ease headache pain.
Steroids to reduce inflammation.

Migraines with sinus symptoms

Your provider may recommend prescription medication for migraine pain. You may also need a preventive medication that helps you have fewer migraine attacks.

Prevention

How can I prevent a sinus headache?

Outlook / Prognosis

How long do sinus headaches last?

Living With

What can I do about recurring sinus headaches?

Many sinus headaches, especially those that recur, are actually migraines. But it’s smart to see your healthcare provider to figure out the cause of your headaches.

Alcohol.
Caffeine.
Specific foods, such as chocolate, red wine or strong cheese.
Lack of sleep.
Stress.

A note from Cleveland Clinic

What to do about sinusitis

A step-by-step approach to treating and preventing sinusitis starts with a simple nasal wash.

If you’ve ever had a cold that just wouldn’t go away, chances are it was sinusitis — an inflammation of the paranasal sinuses, the cavities within the bones that surround the nose. The sinuses are lined with a thin membrane that produces mucus, which is normally swept along by hair cells and drains through small openings into the nasal cavity. Sinusitis (also called rhinosinusitis) starts when this drainage system becomes blocked, usually from swelling due to inflammation caused by infection or allergy. Soon, your head hurts, you feel facial pressure or pain, and thick mucus clogs your nose. The symptoms may clear on their own, but often they persist or repeatedly return.

Several years ago, Dr. Ralph Metson, a sinus specialist at Massachusetts Eye and Ear Infirmary in Boston, conducted a study of the effects of chronic sinusitis on daily functioning. Dr. Metson says he and his colleagues undertook the research because so many of his patients felt that no one understood how miserable sinusitis could be. Comparing the impact of chronic sinusitis with that of other chronic illnesses — including heart failure, back pain, and chronic obstructive pulmonary disease — the Harvard researchers found that sinusitis sufferers reported the highest levels of pain and the lowest levels of social functioning, as well as significant problems with work, energy, and mental health.

Anatomy of the paranasal sinuses

The paranasal sinuses comprise four pairs of sinuses that surround the nose and drain into the nasal cavity by way of narrow channels called ostia (singular: ostium). Mucus leaving the frontal (forehead) and maxillary (cheek) sinuses drains through the ethmoid sinuses (behind the bridge of the nose), so a backup in the ethmoids is likely to clog the other two types of sinuses. The sphenoid sinuses are located deep in the skull, behind the eyes. Sinusitis develops when one or more sinuses become blocked.

There are millions of bacteria in our noses, and most of the time, they’re harmless. Even when a few creep into the sinuses, they don’t cause trouble, as long as they keep draining into the nose along with mucus. But if sinus drainage is blocked, glands in the sinuses continue to produce mucus, and the resulting pool of backed-up mucus provides what Dr. Metson calls “the perfect culture medium.” The bacteria grow out of control, causing infection, and the immune system kicks off an inflammatory response. The result: swelling, which causes headache and facial pain; mucus buildup, which produces congestion; and an influx of white blood cells to fight the bacteria, which thickens the mucus and may tint it yellow or green. Other symptoms include loss of smell or taste, cough, bad breath, fever, toothache, and fullness in the ears.

Sinus blockage can have a variety of environmental, anatomical, and genetic causes, but the main culprit is swelling of the nasal passages produced by the common cold or allergies. More serious sinusitis can result from structural problems, such as a deviated septum (a crook in the partition that separates the right from left nasal cavities) or nasal polyps (small, grapelike growths in the lining of the sinus cavity).

First line of defense against sinusitis: Nasal irrigation

One of the simplest, cheapest, and most effective ways to prevent and treat sinus problems is nasal irrigation. Using a homemade solution, you can often relieve sinusitis symptoms, reduce reliance on nasal sprays and antibiotics, and improve your quality of life. At least once a day, follow these steps:

Stir ½ teaspoon of non-iodized salt and ½ teaspoon of baking soda into 2 cups of lukewarm distilled or previously boiled water (as recommended by the American Academy of Otolaryngology).
Fill a small bulb syringe with the saltwater solution. (If you prefer, you can use a small pitcher called a neti pot to stream the solution through your nose. )
Lean over your bathroom or kitchen sink, insert the tip of the syringe just inside one nostril, and gently squeeze the bulb. The water will run back out the nostril (or possibly the opposite nostril) and into the sink. Use at least one full bulb of solution.
Repeat the procedure in the other nostril. (If the salt solution stings your nose, use less salt.)
Thoroughly rinse (with distilled or cooled boiled water) and dry the bulb syringe or neti pot after each use.

Treating sinusitis

Sinusitis is classified by how long it lasts. “Acute” sinusitis lasts a month or less; “subacute” sinusitis, a month to three months; and “chronic” sinusitis for longer than that (sometimes for years). If several acute attacks occur within a year, it’s called “recurrent.” Treatment begins with simple remedies, such as nasal irrigation (see the box above) and, if necessary, progresses to more advanced strategies, such as prescription drug therapy or surgery.

Most people with acute sinusitis get better without treatment, although you can ease the symptoms and reduce the likelihood of needing stronger medicine if you keep your nasal passages clear with a few low-tech preventive techniques (see “Preventing sinusitis”). It’s hard to predict who will develop chronic sinusitis but knowing more about the two main types can help you decide how to treat your symptoms and when to see a clinician. Here are the basics:

Acute sinusitis. Acute sinusitis usually starts with a cold. Viruses, not bacteria, cause colds, so it’s useless to treat them with antibiotics. But when a cold turns into sinusitis, it means that blocked nasal passages have set off a secondary infection caused by bacteria and you may eventually need an antibiotic. Rarely, especially in people with weakened immune systems, a fungal infection is the cause.

If symptoms are severe and last for more than a week, you may want to see your primary care clinician. Based on your symptoms and a look inside your nose with a small flashlight, she or he can usually tell whether sinusitis has settled in. If you do have sinusitis, you may be prescribed an antibiotic, especially if preventive drainage strategies aren’t helping.

For the pain, try a warm compress on your face, or inhale steam (see “Preventing sinusitis”). An over-the-counter pain reliever such as aspirin, ibuprofen, or acetaminophen can also relieve facial pain, as well as headache and fever.

Chronic sinusitis. If symptoms linger or keep returning, you may have chronic sinusitis, a more complex disorder that calls for evaluation by an ear, nose, and throat (ENT) specialist (also called an otolaryngologist). She or he will order a CT scan of your nose and sinuses and examine the nasal cavity with a thin lighted tube (endoscope) to look for causes of the blockage. Blood and allergy tests and bacterial cultures may also be needed.

Nasal irrigation and decongestants can help in the treatment of chronic sinusitis by keeping mucus loose and nasal passages clear. The mucus-thinning agent guaifenesin (Mucinex) is another option. (Be sure to drink a full glass of water when you take it.) Nasal steroids such as fluticasone (Flonase) or beclomethasone (Beconase) may be added to help counter inflammation.

Sometimes the main problem is anatomical, such as nasal polyps, a deviated septum, congenitally narrowed paranasal passages, or tissue thickened by years of infection. In this case, minimally invasive surgery may help, reducing the number and severity of sinus infections and sometimes restoring normal sinus function. Surgery isn’t a cure-all: polyps, for example, may grow back. Every situation is different, so it’s important to discuss the options with an ENT specialist.

Preventing sinusitis

There are many things you can do to reduce your chance of developing sinusitis or to relieve early sinusitis symptoms. One of the most important is to promote drainage and keep nasal passages clear. Here are some suggestions:

Bathe your nasal passages daily. Run water gently into the nasal passages to help clear excess mucus and moisten membranes. (See “First line of defense: Nasal irrigation.”) Good times to do it are in the morning and at night, when you brush your teeth. “Brush, then flush,” is Dr. Metson’s motto. During the day, use nasal saline spray to moisten nasal passages.
Drink lots of water. Good hydration helps keep the mucus thin and loose. Have a bottle of water at your desk at work or put a glass near the kitchen sink to remind you to drink water throughout the day.
Inhale steam. Linger in a hot shower. Or bring water to a boil and pour it into a pan; place a towel over your head, and carefully bend over the pan to inhale the steam. To avoid burns, keep your distance at first and move in gradually to a comfortable zone.
Avoid dry environments. A humidifier in your home (in particular, by your bed) and where you work can help prevent nasal passages from drying out. Keep humidifiers clean and free of bacteria and mold.
Sleep with your head elevated. Mucus pools in your sinuses at night when your head is down, so have your head propped up with pillows or a wedge during sleep.
Be nice to your nose. Blow your nose gently, one nostril at a time. Forceful blowing can irritate the nasal passages and propel bacteria-laden mucus back up into your sinuses.
Avoid antihistamines unless prescribed. Antihistamines make mucus thick and hard to drain. But if your sinusitis is triggered by allergies, your clinician may still want you to take an antihistamine along with other medications.
Be careful with decongestants. Tablets containing pseudoephedrine act on blood vessels to shrink membranes and keep nasal passages open. Nasal sprays containing phenylephrine or oxymetazoline also work well — and quickly. But using topical nasal decongestants for more than a day or two runs the risk of setting off a spiral of dependency as a result of rebound — increased swelling after the medication wears off. (According to Dr. Metson, a shorter-acting spray, such as 0.25% or 0.5% Neo-Synephrine, is less likely to cause rebound than longer-acting ones like Afrin.) Oral decongestants can cause jitters and increase blood pressure, so if you have high blood pressure, don’t use them without consulting a clinician first.

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Identifying Sinus Congestion vs. Head Congestion

Identifying Head Congestion

These questions and answers can help you learn more about head congestion from a common cold.

What is Head Congestion?

Head congestion refers to the pressure and discomfort you feel from a runny or stuffy nose caused by a cold.

How Do You Get Head Congestion?

Head congestion, or colds, are caused by different types of viruses, with the rhinovirus being the most common.

What Are the Symptoms of Head Congestion?

Symptoms of head congestion usually include a stuffy or runny nose, sneezing, coughing, headaches and body aches.

Where Do You Feel Head Congestion Symptoms?

Naturally, the discomfort felt from head congestion is, well, in your head.

Identifying Sinus Congestion

The following questions and answers can help you identify and determine the causes of your sinus congestion.

What is Sinus Congestion?

Sinus congestion is the “fullness” you feel in various places across your head and neck caused by a blockage of sinus cavities.

How Do You Get Sinus Congestion?

Sinus congestion occurs when the mucus in your nasal passageways doesn’t drain normally, causing a build-up that blocks your sinuses.

What Are the Symptoms of Sinus Congestion?

The mucus that builds up in sinuses causing sinus congestion also results in sinus pain and pressure. You may feel a sinus headache, have a stuffy or runny nose and experience pressure across your cheeks or other areas of your face.

Where Do You Feel Sinus Congestion Symptoms?

Pressure and pain from sinus congestion can be felt behind the forehead, eyes, cheeks or jaw, depending on which types of sinuses are affected.

How to Tell the Difference Between Sinus Congestion and Head Congestion

The main difference between sinus congestion and head congestion is the duration of symptoms. Sinus congestion may cause a sinus infection, which comes with symptoms lasting up to four weeks. Talk to your doctor if you think you may have a sinus infection. Head congestion as part of a cold is usually gone in seven to 10 days.

How to Relieve a Head Cold and Sinus Congestion

Though there are some differences between head congestion and sinus congestion, the following tips can help provide relief from your symptoms. Be sure to talk to your doctor if you have any questions or concerns.

Drink plenty of water: Water can help thin mucus, which is more likely to drain.
Make a wrap: Applying a warm towel to your head to ease swollen tissues and relieve pressure.
Get steamy: Inhaling steam helps keep nasal passages moist and assists with drainage.
Find relief with SUDAFED®: SUDAFED PE® Head Congestion + Pain can help relievethe pain and pressure associated with head congestion while SUDAFED PE® Sinus Pressure + Pain with acetaminophen can help provide relief from sinus pain and pressure.

90,000 Signs and symptoms of sinusitis in adults. How to recognize the disease in time?

Inflammation of the maxillary sinuses immediately makes itself felt. Anyone can compare the description of the disease with their own feelings and, on this basis, “diagnose themselves.” But only a doctor can prescribe adequate treatment. This requires appropriate education, experience and diagnostic equipment.

What is sinusitis?

Sinusitis is an inflammation of the maxillary sinuses of the nose.It usually develops as a complication of the common cold. The most characteristic signs:

the temperature rises to 37 – 37.5 C;
stuffy nose;
yellow-green nasal discharge appears;
the bridge of the nose, cheeks at the wings of the nose and temples hurts;
headache worsens in the evening;
the sense of smell disappears;
voice becomes nasal;
feeling of general weakness.

With inflammation of the maxillary sinuses, a person quickly gets tired, it is difficult for him to concentrate, memory weakens.It is very difficult to work with sinusitis, so it is better to take a sick leave.

Sinusitis can be acute or chronic.

Causes of sinusitis

The disease often occurs in the cold season in people with weakened immunity, but this is not the only reason. Inflammation of the maxillary sinus can develop due to:

complications of the common cold;
curvature of the nasal septum;
damage to the nasopharynx;
adenoiditis;
infections and bacteria;
allergies;
too dry indoor air;
work in hazardous production;
poor condition of the upper teeth;
injuries of the mucous membrane of the maxillary sinus.

Diagnosis of sinusitis

Treatment of sinusitis will be effective if the patient turns to the ENT on time, a specialist will diagnose and prescribe treatment. The survey includes a number of procedures:

examination of the nasal cavity;
palpation or feeling around the nose and under the eyes;
clinical blood test;
X-ray of the paranasal (paranasal) sinuses – according to indications;
computed tomography of the sinuses of the nose.

X-rays can detect accumulation of mucus in the sinuses and swelling of the sinus mucosa. With sinusitis, darkening will be visible in the picture, since mucus and tissue edema in the cavities does not allow X-rays to pass through.

CT scan of the paranasal sinuses is necessary to detect polyps, cysts, and anatomical changes. The examination is painless and lasts no more than 5 minutes.

If, when you tilt your head down, you feel heaviness, and the discomfort subsides some time after you raise your head, contact the ENT.Self-medication with folk remedies, randomly selected antibiotics and nasal drops causes serious complications. Sinusitis can become chronic and cause more serious diseases: otitis media, meningitis, brain abscess, phlegmon of the orbit (inflammation of the tissues around the eyeball).

Treatment of sinusitis

Depending on the patient’s condition and the course of the disease, the doctor prescribes therapy and selects antibacterial, decongestant and anti-inflammatory drugs.Treatment can be conservative or surgical.

Conservative treatment

In case of mild sinusitis, in addition to drug treatment, according to indications, they wash the nasal cavity according to Proetz, or “cuckoo”. A special solution is injected into the nose of the patient lying on his back. It passes through the nasal cavity, sinuses, after which it is pumped out with a vacuum pump. “Cuckoo” is carried out in a course of 2 to 10 procedures.

With a moderate and severe course of the disease, antibiotics are prescribed in the form of tablets, solution for injection or inhalation.

Surgical treatment (puncture of the maxillary sinus)

With severe purulent sinusitis or lack of effect from conservative therapy, a puncture is used. This allows you to quickly remove pus from the sinus, cleanse it and treat it with an anti-inflammatory drug. Sometimes it is required to carry out several such manipulations. Punctures are done under local anesthesia.

When sinusitis does not respond to treatment or is in an advanced stage, surgery is performed under general anesthesia. The recovery period after surgery can take up to two weeks.

Prevention of sinusitis

In order to avoid sinusitis, you should:

spend enough time outdoors;
strengthen the immune system;
eat right;
take vitamins;
dress for the weather;
Seek medical help on time.

If you have discovered the first symptoms of sinusitis and are looking for a qualified specialist who will diagnose and help you cope with the disease, call the phone number listed on the website, or leave a request in the feedback form.The staff of the medical center “Admiralty Shipyards” will answer your questions and carry out all the necessary examinations within one working day. Let’s take care of your health together!

90,000 From runny nose to migraine

Otorhinolaryngologist-surgeon, Doctor of Medical Sciences, Professor, Honored Doctor of the Russian Federation, Deputy Chief Physician of the Scandinavia Clinic Alexei Vasilyevich Gaivoronsky tells about the successful treatment of migraine by surgery.

There are many causes of headaches, each doctor can, without hesitation, name more than thirty.One of them is chronic and recurrent sinusitis. Up to 88% of patients with recurrent sinusitis suffer from migraine headaches.

Unexpected reason

“It is she, she again, invincible, terrible disease of hemicrania, in which half my head hurts. There is no money from it, there is no salvation “- this is how Bulgakov described migraine, who himself suffered from this disease for many years. Migraine is one of the most common neurological disorders these days. It is included by the World Health Organization in the list of 19 diseases that most violate human social adaptation.Migraine affects from 3 to 16% of the population of Europe and North America, this ailment is more common than asthma, epilepsy and diabetes combined. But it turns out that there is a remedy for migraine! “The main thing is to correctly determine the cause of its occurrence,” says Aleksey Vasilyevich, who has helped hundreds of his patients. As a result of surgical intervention, patients forget forever about the debilitating attacks of migraine headaches. But they all had a history of sinusitis – acute, chronic or latent (latent).

Many-sided sinusitis

It’s worth starting with anatomy. The system of air cavities in the facial region of the human skull appeared in the course of evolution in order to facilitate an overly heavy skull. “Having risen from four limbs to two, in addition to a host of advantages, a person acquired some negative properties. The maxillary sinus of a person in connection with his transition to the erect state, in contrast to the four-legged creature, has become less functional. After all, the outlet of the paranasal sinuses has become a very narrow neck, and even located on top.Therefore, a person has many more predisposing factors than an animal, so that he begins to have inflammation of the paranasal sinus. This inflammatory process is called acute sinusitis or acute sinusitis, sometimes acute sinusitis. Most often, sinusitis involves inflammation of the maxillary sinus, the same notorious sinusitis, which we are talking about. It can be of a viral, bacterial or allergic nature, ”says Aleksey Vasilyevich.

A banal runny nose during ARVI, if not treated or treated incorrectly, can lead to sinusitis.According to medical statistics, rhinosinusitis develops in 1-8% of patients with ARVI. It also causes 40-50% of all hospitalizations of ENT patients. In 10-15% of cases, rhinosinusitis becomes chronic.

“Harmless” runny nose

“Chronic sinusitis is characterized by the duration of an incessant inflammatory process (at least 3 months). Among the main signs of the disease are: profuse purulent-mucous discharge, prolonged intoxication syndrome (weakness, malaise, sweating, increased body temperature up to 37-37.9 degrees) and, of course, persistent pain syndrome (headaches).From 20 to 27% of all chronic sinusitis is latent sinusitis, which proceeds asymptomatically or with mild symptoms, for a long period of time, without clear signs of alternating periods of relapse or remission, ”explains Alexey Vasilyevich.

Studies using computed tomography revealed signs of sinusitis in 95% of cases of ARI with nasal congestion.

Hidden enemy

How to recognize latent sinusitis? First of all, symptoms such as a sluggish runny nose, persistent unmotivated headaches in the absence of purulent nasal discharge, deterioration of smell, visual impairment, low-grade fever (about 37 C) should be alerted.The drainage of mucus along the back of the pharynx is also a characteristic symptom of latent and chronic sinusitis. “Persistent edema of the sinus mucosa in latent and chronic sinusitis causes a vascular response in the form of spasm. If a vegetative-vascular component joins the edema, a typical picture of migraine arises: photophobia, intense headaches, nausea and vomiting, which do not always give relief, a complete lack of effect from anti-inflammatory therapy. The origin of these pains is based on a sluggish inflammatory process in the sinuses with exacerbations after hypothermia, overwork, stay in poorly ventilated “stuffy” rooms, “adds Alexey Vasilyevich.

Deformation disease

In addition, the development of latent sinusitis is most often caused by the peculiarities of the anatomical structure of the structures of the nasal cavity, which arise during the growth of the facial skeleton. They lead to a violation of the drainage function of the paranasal sinuses. According to the expert, “in 100% of cases, there is a correlation between headaches and curvature of the nasal septum. Most often, these features are determined genetically, therefore, latent sinusitis can be called a “family” diagnosis. “

Radical Solution

Complex surgical correction (CCC) of the structures of the nasal cavity will help to treat headaches caused by sinusitis. This is an operation on the nasal septum, plastic of the lower and middle turbinates, endonasal polysinusotomy (surgery for polyposis or purulent inflammation in the paranasal sinuses using the technique of minimally invasive surgery). As a result of surgical treatment, nasal breathing and aeration of the paranasal sinuses are restored, the focus of a sluggish inflammatory process or a congenital anatomical defect is eliminated. “Among 3400 patients with latent and chronic sinusitis that I operated on who complained of headaches, a positive result was achieved in 100% of cases. Full recovery was observed in 85% of patients. In the remaining 15%, the result of surgery was an improvement, a decrease in the intensity of headaches. As for those suffering from migraine headaches, among my operated 284 patients aged 16 to 48 years, a positive result was achieved in 100% of cases.More precisely, the disappearance of pain was observed in 94.7% of patients, and a decrease in the intensity of headaches with the disappearance of seizures was observed in 5.3%. ”

Three thousand years after the description of migraine conditions in the ancient Egyptian papyri and two thousand years after the Roman physician Galen, who studied that very hemicrania in detail, contemporaries describe their torment in much the same way. Splitting headache is caused by an abnormal interaction between the structures of the skull and the trigeminal nerve, which is located in the deep regions of the brain, passes through the eye socket and enters the area on the forehead above the eyebrows. The trigger for an attack can be any sudden change in the environment – light, loud sounds, smells, tastes, changes in sleep patterns. Migraine is characterized by a wide range of symptoms: from acute headache to visual impairment, nausea and vomiting, and loss of coordination. Migraine attacks cause the patient to lie motionless in a darkened room, sometimes for several days.

Date of publication: 16.02.16

90,000 Treatment and surgery to remove the maxillary cyst – Dr. Korenchenko’s clinic

A cyst of the maxillary sinus or a maxillary cyst is one of the most frequently detected benign neoplasms of the ENT organs.It is found in about 10% of the adult population, and in some cases it becomes an accidental diagnostic finding. But, despite the benign nature and the possibility of a low-symptom course, the cyst in the sinus requires surgical treatment. Such an operation in modern ENT clinics is carried out in a minimally invasive way, using endoscopic equipment.

A true cyst of the upper jaw is a benign neoplasm, which is actually a congested gland of the mucous membrane in the maxillary sinus.Its inner epithelial lining continues to secrete mucus, which contributes to the gradual growth of the cyst.

Less common are cysts of odontogenic (“dental”) origin, which are inflamed sinus tissues with a focus of purulent fusion. Their appearance is due to the penetration of infection through the periodontium with complicated caries, abnormal position of molars, or overly traumatic dental intervention.

A small cyst in the sinus may not show clear symptoms.But as it grows, it usually becomes the cause of various disorders that significantly reduce the patient’s quality of life. A sinus cyst can lead to nasal congestion, headache, blurred vision, and other symptoms. It predisposes to chronic infectious and inflammatory processes and complicates the course of other ENT diseases.

It is impossible to completely eliminate the emerging symptoms without getting rid of the neoplasm in the sinus. Therefore, a cyst in the nose requires treatment by a competent ENT doctor, even if it has become an accidental diagnostic finding when examining the structures of the skull and brain.

Treat conservatively or remove?

Traditionally, the treatment of formation in the upper jaw is divided into conservative therapy and surgical interventions. Expectant tactics are often used, with dynamic control of the size of the cyst and the appointment of remedies to correct symptoms and reduce inflammation. But this approach in most cases does not live up to the expectations placed on it and does not lead to the patient’s cure.

Conservative therapy is not able to lead to the reverse development of an already formed cystic formation, although it helps to cope with infectious and inflammatory reactions. Therefore, the only really effective and prognostically justified method of treatment is radical surgical removal of the cyst in the maxillary sinus. In this case, preference is given to minimally invasive techniques.

Properly performed endoscopic removal of jaw cysts helps to cope with nasal congestion, pain and other symptoms. Such an intervention does not provoke scarring, helps to restore the adequate functioning of the sinus, and does not leave external traces.

How to get rid of a cyst. Step-by-step action plan

Removal of a cyst in the nose

Surgical intervention under the control of an endoscope

Local anesthesia

Intervention time 20-40 minutes

Time spent in the clinic – 1.5 hours

Free observation – 3 months

Cost 26,000 rubles

Operation on a cyst in the nose is performed on an outpatient basis and requires a preliminary examination. The basic action plan includes:

Preliminary examination (CT scan of the paranasal sinuses, complete general blood count, coagulogram, HIV tests, viral hepatitis B and C, syphilis). Such diagnostics can be performed at the place of residence and the results can be provided to the doctor, the shelf life of the tests is 2 weeks.
A preliminary consultation with an ENT doctor at the clinic is carried out on the eve of the planned operation. The specialist evaluates the results of the examination, if necessary, prescribes additional tests (if they were not submitted in advance, expired or have clinically significant deviations).
Operation to remove a cyst in the maxillary sinus. It is carried out endoscopically, under local anesthesia, using a laser. Such removal of the sinus cyst does not require incisions and sutures, all manipulations are carried out through the sinus junction with the nasal cavity. The operation lasts no more than 20-40 minutes, after the completion of the main stage, the patient is under observation in the clinic for 1 hour.
Postoperative follow-up examination. It is carried out in the clinic the next day, which is included in the total cost of the operation.The doctor assesses the general condition of the patient, examines the nasal cavity and paranasal sinuses using an endoscope, and gives recommendations for the recovery (rehabilitation) period.

The total duration of treatment in the clinic is 3 days. The rehabilitation period after endoscopic removal of the maxillary cyst is usually 3-7 days. During this time, it is necessary to follow the doctor’s recommendations, which does not require repeated visits to the ENT clinic.

Where to contact

Endoscopic removal of a cyst in the maxillary sinus is a minimally invasive and well tolerated procedure, with a low risk of complications and a short recovery period.

ENT Clinic of Dr. Korenchenko is a specialized modern medical center in St. Petersburg. For the examination and treatment of patients, our specialists use only proven highly effective techniques with a high safety profile, giving preference to endoscopy and other minimally invasive modern technologies. This makes it possible to increase the effectiveness of therapeutic and diagnostic manipulations, minimize the discomfort experienced by the patient, shorten the rehabilitation period and improve the prognosis.

The effectiveness of the operation largely depends on the qualifications of the doctor and the quality of the endoscopic equipment used. Therefore, the choice of a clinic should be approached thoughtfully, giving preference to specialized, well-equipped institutions with experienced specialists.

Removal of the cyst of the maxillary sinus in the ENT Clinic of Dr. Korenchenko gives a low percentage of relapses and complications. Each patient receives individually compiled recommendations and is provided with free observation (condition monitoring) for the next 3 months.If necessary, our specialists develop a plan for further treatment to eliminate other identified ENT diseases.

Nonresident patients can also receive specialized treatment in the ENT Clinic of Dr. Korenchenko, having signed up for a preliminary consultation by phone through the administrator or by e-mail.

Cyst in the maxillary sinus symptoms and causes of formation

There are diseases that patients do not suspect for years.Slowly developing and suddenly declaring themselves with a bouquet of unpleasant sensations, they become a complete surprise for their owners. One of these insidious ailments is a cyst of the maxillary sinus. What is it, how dangerous and how is it treated correctly?

On both sides of the nose we have two bony cavities called the maxillary (or maxillary) sinuses. The membrane lining them from the inside has many glands that constantly secrete mucus. If for some reason the gland duct becomes clogged, it begins to fill with its own product.As a result, the “ball” that inflated is the maxillary cyst.

No one can say for sure why cysts appear. But the list of “suspects” is very wide. The first places in it are occupied by:

chronic sinusitis,
allergic reactions,
curvature of the nasal septum,
nasal polyps,
injuries.

In these conditions, the exchange of air between the sinuses and the nasal cavity is disrupted, which in turn leads to the development of inflammatory processes and excessive activity of the glands.

Headache – cyst is to blame

Small cysts in the maxillary sinuses do not manifest themselves. The patient can find out about them only by chance, for example, during an examination for sinusitis.

Growing education is another matter. Reaching the size of the nasal sinus, the cyst rests against its walls and squeezes the nerve endings. The patient begins to complain of facial pains radiating to the temples, eyes and teeth. Often, not understanding what the matter is, a person first turns to a dentist or ophthalmologist.

Further – more. Going beyond the maxillary sinus, the cyst compresses the trigeminal nerve, which causes severe headaches. Swelling appears on the face. Due to the displacement of the nasal wall, breathing on the affected side becomes difficult. In the worst case, it can end with otitis media, bronchitis and meningitis.

What to do?

When deciding on the treatment of a cyst, the ENT specialist usually takes a wait-and-see approach. The fact is that the growth of education has been going on for decades. Therefore, as long as it is small and does not cause any discomfort, it is not necessary to touch it.In addition, albeit infrequently, a sinus cyst can empty on its own. There is no pain in this case, and the contents of the “ball” flows out through the nose.

But if a pathology is a concern, then the only effective way to treat it is surgery. Many patients, fearing surgery, are trying to get rid of the problem with the help of traditional medicine: they wash, instill herbal decoctions in the nose, or lubricate the mucous membranes with them. There is no sense in such procedures, since they only temporarily facilitate breathing, but do not reduce the size of the formation.

Removal of maxillary sinus cysts: without blood and pain

There are various methods for removing sinus cysts. The classic version looks like this: the surgeon makes an incision under the patient’s upper lip, opens the wall of the bone cavity with a chisel and excises the cyst. The disadvantages of such an intervention are that it is quite traumatic and requires a long period of rehabilitation.

In our clinic, operations on the cyst of the maxillary sinuses are performed using endoscopic technologies.Under visual control, the doctor makes a small (several millimeters in size) puncture in the gum and removes the pathological formation through it. No “hammering” manipulations are performed in this case. The entire intervention lasts no more than 20 minutes.

The recovery of the body after endoscopy is very fast, so we do not hospitalize patients. It is allowed to leave the clinic on the same day.

Forewarned is forearmed

Adherence to simple preventive measures will help to avoid the appearance of cysts in the right or left maxillary sinus:

Monitor the state of immunity, try to catch colds. In frosty weather, refrain from going to the pool and exercising outdoors.
Disease of ARVI, do not let the disease take its course. It is viral diseases that become the main cause of chronic sinusitis, and after them – and cysts.
See your dentist regularly. Sometimes the inflammation from the roots of the teeth spreads to the sinuses.
Cysts may reappear after treatment. To prevent relapse, see your otolaryngologist regularly.Find out what is causing the problem. You may need to correct a deviated nasal septum or get rid of polyps.

And remember, a specialist should treat any pathology. Home treatment is ineffective and has serious consequences.

90,000 Allergic sinusitis in adults: description of the disease, causes, symptoms, cost of treatment in Moscow

Allergic sinusitis is not rare and is associated with the fact that due to edema of the mucous membrane at the time of exposure to an irritant, there is a violation of the outflow of mucus from the paranasal sinuses, from which the inflammatory process develops. Many complications that appear with this pathology are deadly. Because of this, it is highly discouraged to delay treatment or to carry it out on your own without the involvement of a doctor. Allergic sinusitis is rare in children, but adults are often faced with this problem.

The disease develops gradually if the effect of allergens on the nasal mucosa is prolonged and it is constantly edematous. Short-term edema and short-term blockage of the nasal sinus duct do not lead to the development of pathology.

Inflammation of the mucous membrane under the influence of allergens occurs due to the fact that white blood cells (immune cells) try to attack and suppress particles of the allergen. As a result of their activity, an inflammatory process develops, which, in case of bacterial and viral infections, due to a local increase in temperature, helps to eliminate the pathogen. With allergens, this method of body defense does not work, and chronic pathological inflammation develops. It is because of him that the paranasal sinuses begin to suffer.In medicine, it is no coincidence that a special connection between allergies and sinusitis of any localization is constantly distinguished.

Major disease provocateurs

Allergic sinusitis occurs when the body is attacked by allergens. Doctors distinguish several types of basic irritants. Depending on which of them affects the body, the rate of development of sinusitis also changes.

1. Mold fungus. This is one of the main reasons why allergic sinusitis develops.Molds appear on walls in damp rooms. If the problem is not solved, then due to the constant exposure to spores after 1 or 2 years, depending on the individual characteristics of the organism, persistent allergic sinusitis occurs. The treatment of such a pathology is difficult and time-consuming due to the ability of fungi to create colonies even inside the human body, and it is not easy to destroy them.

2. Seasonal allergens. In this case, inflammation of the paranasal sinuses, like allergies, is seasonal.Most often, the problem develops in the spring and early summer, when there are large amounts of pollen in the air. Usually the maxillary sinuses are inflamed, which, due to their location, especially suffer from swelling of the nasal mucosa.

3. Dust mites. The dust that is present in the air and accumulates in bedding, if not properly cared for, is filled with microscopic mites, which are the strongest allergens. When they get on the nasal mucosa, inflammation and edema quickly develop.Sinusitis develops quickly enough – in the period from 6 months to a year.

4. Animal hair. It is also a fairly common provocateur of allergies, accompanied by swelling of the nasal mucosa and the development of sinusitis. In this case, the irritant is wool scales, which mix with dust and, when breathing, enter the nasal cavity. The severity of such an allergy and sinusitis against its background is very different. It is not uncommon to observe intolerance only to the wool of one of the animal species, and the patient can calmly keep others in his house.

5. Food allergens. Allergic sinusitis can also occur if a person often eats foods that are allergens to him. Most often, citrus fruits, fish, honey, nuts and dairy products act as provocateurs of the problem. In children, this phenomenon is often observed due to the intolerance of the chemical components of various sweets.

In exceptional cases, allergic sinusitis may appear due to the effects on the body of a number of drugs, some of which are intolerable to the body.In such a situation, it is required to cancel the drug that causes the allergy and replace it with another drug. In some situations, it turns out to be impossible to cancel the allergen, and then it is shown in parallel to use antihistamines.

Which doctor to contact

Allergist and otolaryngologist should deal with the treatment of allergic sinusitis in parallel. Without a collaborative approach to solving the problem, it will not work to fix it. The allergist helps determine which allergen is causing the problem and prescribes the necessary treatment to eliminate the body’s overreaction to the irritant.The otolaryngologist deals directly with therapy, which helps relieve the inflammation in the paranasal sinuses. Treatment of the inflammatory process in emergency cases, when the likelihood of complications is too high, or if there is no effect from drug therapy, surgery is performed.

Forecast

The prognosis is good in most cases. If the patient strictly adheres to all medical recommendations and starts treatment in a timely manner, then the allergic sinusitis goes away completely.When complications have already begun to develop, the prognosis changes to serious or even bad in severe cases. A person’s condition is especially serious if there are complications affecting the brain or sepsis develops. In such a situation, it is not always possible to save the patient even in the conditions of modern medicine.

Diagnostics

Most often, it is not difficult to make a correct diagnosis. Symptoms of allergic sinusitis are clear, and the main task of the doctor is to correctly determine which sinus is affected and how severe the inflammation is.It may be somewhat more difficult to identify the allergen that caused the negative reaction of the body and, as a result, sinusitis.

At the first appointment, the otolaryngologist collects an anamnesis of the disease and learns the patient’s complaints about certain symptoms. To finally assess the patient’s condition, the following diagnostic procedures are assigned to him:

swab from the nasal mucosa – the material is required for inoculation on a nutrient medium. This procedure allows you to determine whether or not there is additional bacterial infection, as well as whether antibiotics are required;
magnetic resonance imaging or computed tomography of the head – performed to determine which sinuses are affected and to assess the general condition of the nasal cavity;
analysis of venous blood – it is needed in order to identify allergens that provoke inflammation in the paranasal sinuses. Also, during the analysis, studies are carried out to determine the general condition of the patient’s body;
general urine analysis – is necessary to assess the degree of the inflammatory process and general indicators of the functioning of the body. For research, you need morning urine;
immunogram – required to determine the state of the immune system and the severity of its reaction to the action of the allergen.

Based on the results of the examination, the treatment of allergic sinusitis in adults, which was prescribed initially, can be adjusted or remain unchanged.

Prevention

In order to reduce the risk of developing allergic sinusitis, it is necessary to exclude the effects of the allergen on the body. Without this, it will not be possible to normalize the patient’s condition. It is also important with a doctor to choose a treatment that will help prevent the appearance of edema in case of allergies. Additionally, it will improve the general condition of the body and a correct lifestyle.

Headaches. Migraine. Headache treatment, symptoms, causes, diagnosis

Headache Video

Headache.FAQ
Subject: Q&A
Headache
Topic: Encyclopedia of Diseases

From time to time, almost everyone, young and old, experiences headaches. According to experts, up to 15% of the population experience 90,369 headaches 90,370 quite often. Headache can be chronic, sometimes debilitating, which can significantly reduce the quality of life (affect the ability to work, relationships with loved ones, etc.).etc.).

Although, in most cases, it is possible to find out the true cause of the headache, often errors occur in determining the genesis. The fact that it is obvious that the headache is real and the existing methods of treatment help, if not control, then at least reduce it. Science is the key to solving the headache problem.

Types of headaches

Primary headaches

Headaches are the main symptom of the primary disease and have no other etiology.The pain and other symptoms caused by the headache are not the result of another disease in the body. The main types of primary headache include:

Cluster headaches
Migraine
GBN (tension headache)

Secondary headache

These headaches occur as a symptom of another pathological condition. There are over 300 organic causes of headache (tumors, infections, trauma, hypertension, etc.)Some of the most common types of secondary headaches are:

Post-traumatic headache
Reactive headache
Abuse headache
Headache with sinusitis

Cluster headaches

While migraine is much more common in women, men are more likely to have cluster headaches. The term “cluster” is used to describe paroxysmal, short, unilateral headache attacks.These attacks can occur many times during the day, sometimes lasting for weeks and then suddenly disappear for a period of time.

Cluster headaches can look like migraines and be just as intense. In fact, patients with severe headaches sometimes even have suicidal ideations. Without proper diagnosis and treatment, headaches can be troubling for years. The provoking factors can be substances that cause the expansion of the vessels of the brain (alcoholic beverages, nitroglycerin, etc.)etc.).

Types of cluster headache

According to the International Headache Society (IHS), there are two types of cluster headaches: episodic and chronic (about 10%).

Episodic cluster headaches – in patients with episodic cluster pains, exacerbations, lasting from one day to several months, alternating with periods of remission varying in duration (from one month to one year).

Chronic cluster pain – characterized by the absence of remission within one year. Often, episodic CBs smoothly turn into chronic ones and vice versa.

Reasons

Cluster pain is more common in men than in women (in a ratio of 7/1).

Cluster pain can occur at any age, but usually begins between the ages of 20 and 40.

The exact causes of cluster headaches are not fully understood. However, excessive activity of the hypothalamus and triggers of the “trigeminal autonomic reflex” was found. The manifestation of this reflex complex is sweating in the forehead, tearfulness, redness of the eyes, congestion in the nose and throat on the side of the headache.

Hypothalamus. Many researchers believe that during a cluster headache, an area of the brain called the hypothalamus is activated. The hypothalamus is responsible for controlling body functions such as hunger and thirst, sleep and wakefulness, and sexual instincts. It also acts on the autonomic nervous system like a light switch (turning it on and off). During a cluster headache, the hypothalamus triggers certain processes that lead to headaches and autonomic manifestations.

Autonomic nervous system. The autonomic nervous system performs adaptive and protective functions. It helps the body be prepared for stress, fear, and pain. It also returns the body to its original state. During cluster pain, vegetative manifestations are on the side of the pain. But this is not a normal response of the autonomic nervous system. Medical scientists continue to research the reasons that the hypothalamus activates vegetation.

Trigeminal nerve. The trigeminal nerve is responsible for sensation (sense of touch, pain, thermoreception) and movement of the muscles in the face, mouth and front of the head. This nerve is divided into three main branches. The upper part of the nerve is the orbital. It provides sensitivity to the eye, forehead, scalp and front of the nose. During an attack of cluster headache, a person has pain in the face and head and autonomic disorders in the innervation of the orbital branch of the trigeminal nerve.

Substances that provoke headache attacks. Some substances with the ability to dilate blood vessels can provoke cluster pain during an exacerbation. For example, drinking alcoholic beverages (wine, beer, spirits) or smoking can cause headaches. Nitroglycerin and histamine can also trigger an attack. But these substances do not cause seizures during remission.

Symptoms

Typical manifestations of a cluster headache attack:

The intensity of the pain is very pronounced – the pain can be sharp, burning, pulsating or constant.
Most headache attacks occur on only one side of the head. Pain can be localized in the following areas: inside and around the eye, in half of the head or face.
Seizures usually occur on the same side. The frequency of attacks can be up to 8 times a day and the average duration of an attack is 15 minutes to 3 hours.
Most cluster headache attacks last 15 minutes to three hours. Taking medication shortens the duration of pain attacks.
Frequency – Although typical cluster headache attacks occur without a prodrome, it is noted that they occur more often at the same time of day and have a certain seasonality. Some patients feel anxious before the onset of pain.

Diagnostics

In the presence of a headache, it is necessary to consult a doctor in order to make an accurate diagnosis. A doctor’s consultation is also necessary in cases where changes have occurred against the background of the prescribed treatment.

Basic questions of interest to the doctor:

Did the headache first appear?
If pains have been repeatedly, what has changed in the nature of pains in localization or additional symptoms have appeared?

The physician will perform a physical examination and check the neurological status. If necessary, the doctor will order an examination (blood tests, CT, MRI). Based on the examination data, the doctor will be able to diagnose and prescribe treatment.

Treatment

Methods for the complete cure of cluster headaches do not yet exist. But if left untreated, cluster headaches significantly impair quality of life. In most cases, seizures are controlled by taking drugs and by eliminating provoking factors. But in some cases, medications are ineffective, and you have to resort to minimally invasive methods of treatment (blockade or peripheral nerve stimulation).

Due to the strong intensity of pain, doctors adhere to active treatment tactics.The main treatment strategy is a combination of preventive therapy and abortive therapy.

Treatment depends on the type (episodic or chronic) and drug sensitivity.
Once the pain has begun, it can become very intense within a few minutes and, therefore, steps must be taken to quickly minimize the pain.

Abortive treatment

Abortive drugs should be fast-acting and should be prescribed immediately after the onset of a painful attack.They help shorten the duration and intensity of the attack (abort the attack). The drugs can be given as a spray, injection, or sublingual tablet. The most commonly used drugs are:

Oxygen – Breathing pure oxygen through the mask helps relieve headaches, especially if the attack occurs at night. In addition, oxygen causes the blood vessels in the brain to constrict.
Lidocaine – This local anesthetic is used as a spray or drops.It is introduced in the position of the head thrown back and turned to the side opposite the painful side. Lidocaine is injected into the nostril on the side of the headache.
Rapid-Acting Opioids – Helps block pain perception (eg herd spray or fentanyl under the tongue). The use of opiates is severely limited due to the potential for rapid addiction.
Ergotamines – help relieve pain due to vasoconstriction in the brain. Ergotamines are contraindicated in pregnancy and lactation.
Triptans (5-HT1 receptor agonists) are sometimes also prescribed to relieve pain (they, like ergotamines, constrict blood vessels). But their application should be individual. They should not be prescribed in the presence of coronary artery disease or other heart disease.
Conventional NSAIDs (indomethacin, ibuprofen) ointment (Zotrix) are also used to relieve seizures.

Preventive drug therapy

If abortive drugs are prescribed directly during an attack, then the task of preventive drug therapy is to prevent the onset of pain attacks and shorten exacerbations.

Verapamil is a drug from the group of calcium channel antagonists (used in cardiology to treat hypertension of angina pectoris). It turned out that this drug is very effective for the prevention of cluster pain and is the drug of choice.

Steroids – in tablets can be used for a short time to shorten the period of exacerbation of cluster pain. Steroids should be used no more than once a year to avoid serious side effects.In addition, the effect of steroids is not persistent.

Lithium preparations – sometimes used in prophylactic treatment. But they have a lot of side effects and require careful monitoring of the function of the hematopoietic organs and the urinary system.

Anticonvulsants. They were originally used to treat epilepsy. But drugs such as Neurontin and Topamax are also used to treat cluster headaches.

A large occipital nerve block is sometimes used to relieve pain, especially in cases where medications are not effective.Usually, a steroid is given with a local anesthetic (lidocaine).

Acupuncture.

Thanks to the effect on biologically active points, it is possible to restore balance in the peripheral system, and quite often this method significantly lengthens the periods of remission:

Massage: This method can help relieve stress and relax tension in the muscles of the head, neck and shoulders. In addition, by improving the blood supply to the muscles, it helps the tissues to clear of metabolic products.
Gymnastics (qi-gong, yoga) helps the body to relax and switch attention from pathological sensations and especially expectations. In addition, exercise increases the production of endorphins, which contributes to less pain perception.

Migraine

In the past, migraine was considered a vascular disease. It was assumed that with a sharp expansion of the vessels of the brain, irritation of the receptors occurs and thus a painful attack occurs. However, recent studies have shown that migraine is associated with a disorder in the central nervous system. These disorders cause a cascade of biochemical changes that both affect the vessels and lead to symptoms (including pain).

Each vessel is innervated by nerves responsible for constriction and dilation, depending on the needs of the body. It is believed that a failure in the central nervous system causes pathological impulses and unnecessary vascular stimulation. This in turn leads to migraine pain and other symptoms. There is a whole group of factors provoking a migraine attack:

Certain drugs and chemicals.
Products that contain various additives and preservatives, alcoholic beverages, especially beer and wine, expired too sweet or
products subject to enzymatic processing.
In women, the first migraine attack may be associated with the first menstruation or with the last (in menopause).
Wrong way of life
Uneven food intake
Overflow
Ambient atmosphere – smoke, odors, flickering light.

Signs and Symptoms

A migraine attack can be divided into four phases. But patients may not have all phases (only one or two phases). Moreover, with each attack, the course may be different.But in classic cases, these are 4 phases:

Prodromal phase
Aura
Headache phase
Postdromal phase

Prodromal phase may appear hours or days before the onset of a migraine attack. The following symptoms may appear: irritability, depression, a feeling of fatigue, general weakness, frequent yawning, pallor of the skin, a feeling of coldness, hyperactivity, impaired concentration, frequent urge to urinate, impaired appetite, constipation or diarrhea, increased sensitivity to light and sounds.

Aura. The aura phase appears 20-60 minutes before the migraine attack. The aura is a disturbance in the sense organs (sight, speech, smell). There may be one or more sensory impairments. Each symptom develops gradually from 5 minutes to an hour. Most common visual disturbances appear:

Increased sensitivity to light; spots or zigzag lines in front of the eyes; sparkling moving figures or distorted objects.
Sensory disorders – sensitivity to smells and sounds; tingling or numbness in one part of the face or half of the body.
Speech disorders – inability to speak normally.

The misconception that the aura necessarily precedes the “with aura” migraine. Sometimes it happens with other types of headache, or it can be without a headache.

Headache phase begins with or without an aura. The most common symptoms include:

Headache that usually lasts four to 72 hours. (The duration of the headache may be shorter with an effective drug. )
Pulsating pain, the intensity of which ranges from moderate to intense.
Pain in the front of the head (in adults, pain is usually on one side).
Nausea, vomiting or diarrhea.

Headache worse with normal exertion (walking up stairs) Sensitive to light, sound, smell or touch.

Feeling of tiredness, irritability, dizziness, impaired coordination of movements is possible.

Postdromal phase recovery period after a headache attack. After a severe migraine attack, people often feel tired or squeezed lemon, irritable and lethargic. In addition, there may be the following symptoms:

Difficulty concentrating and thinking.
Weakness and soreness in muscles.
Increased or decreased appetite.
Hyperactivity or euphoria.

Diagnosis

Questions that can be asked by the doctor:

Did the headache first appear?
If pains have been repeatedly, what has changed in the nature of pains in localization or additional symptoms have appeared?

The physician will perform a physical examination and check the neurological status. If necessary, the doctor will prescribe an examination (blood tests CT, MRI, ultrasound).Based on the examination data, the doctor will be able to diagnose and prescribe treatment.

Forecast

Migraine is very often not diagnosed and sometimes very difficult to treat. Sometimes it takes months to find the right combination of treatments. As soon as it is possible to find the necessary combination, the symptoms are sharply reduced.

There are currently no methods that guarantee a cure for migraine. Modern scientific research helps to better understand the causes and, accordingly, propose methods of treatment for this disease.For example, the fact that disorders in the central nervous system are a trigger for vasodilation and proves the effectiveness of the use of triptans (aborts migraine attacks without aura).

Treatment

Many types of drugs are used to reduce pain and prevent the frequency of attacks. Some drugs help prevent pain, while others are used directly during an attack. And some drugs are used in both cases.

Preparations for relief of an attack (abortive)

These medications constrict the vessels of the brain and interrupt the painful attack.The faster they enter the bloodstream, the shorter the pain attack will be. Therefore, these drugs are used as sprays (endonasal) sublingually tablets or as an injection.

Corticosteroids – These drugs (including prednisolone and dexamethasone) help relieve severe and prolonged migraine attacks. They are used for no more than a week. Long-term use of steroids can lead to complications such as osteoporosis and Itsenko-Cushing’s syndrome.

Ergotamines preparations containing ergot alkaloids (ergotamines) are used in combination with caffeine (Migranal).They are accepted only when necessary. Taking these drugs should be no more than twice a week, since more frequent use can lead to an abusal headache.

Triptans – These medicines such as Sumatriptan (Imitrex), Naratriptan (Amerge), Rizatriptan (Maxalt) and Zolmitriptan (Zomig). They are often used in the treatment of migraines and have fewer side effects than ergotamines.

Lidocaine – This local anesthetic is used as a spray or drops.It is introduced into the position of the head thrown back and turned to the side opposite to the localization of pain. Lidocaine is injected into the nostril on the side of the headache. Usually, the effect of lidocaine lasts no more than 10-15 minutes.

Combined analgesics – a combination of an analgesic with caffeine or another drug that enhances the analgesic effect. Opiates – or narcotic drugs are used only when other drugs do not help. They relieve pain well, but due to possible addiction, their use is sharply limited.

Preventive treatment

The objective of preventive therapy is to reduce the frequency and intensity of attacks. A number of drugs are currently used for this:

Anticonvulsants. They were originally used to treat epilepsy. But drugs such as Neurontin and Topamax are also used for the preventive treatment of migraines.

Antidepressants – These drugs were originally used to treat depression and related conditions.However, studies have shown their effectiveness in preventing migraines. There are several types of antidepressants: tricyclic antidepressants (amitriptyline), selective serotononin reuptake inhibitors (Prozac, fluoxetine), and serotonin norepinephrine reuptake inhibitors (venlafaxine).

Beta Blockers – These medicines are commonly used to treat cardiovascular diseases such as arrhythmias and hypertension. Beta blockers such as anaprilin and atenolol are used to treat migraines.

Calcium channel blockers – These medicines are commonly used to treat cardiovascular diseases such as angina pectoris and hypertension. For the treatment of migraines, drugs such as verapamil or isoptin are very often used.

Serotonin antagonists – the mechanism of action of these drugs is not clear but, nevertheless, have a good effect (Sancert). These drugs should not be taken for longer than 4-6 months due to side effects.

Neuroleptics – their main application in the treatment of mental illness and borderline conditions. But they help relieve nausea and vomiting during attacks (droperidol, haloperidol).

Magnesium sulfate – Some medical researchers believe that a lack of magnesium can be the cause of the development of migraines, especially in women (in the postmenstrual period).

Exercise has proven to be quite effective in preventing migraine headaches.Exercise helps to improve not only the musculoskeletal system, but also normalizes the cardiovascular system and the work of all internal organs (including the vessels of the brain). In addition, the production of endorphins increases as a result of exercise. These endogenous opiates help reduce pain perception.
Exercises can be both weighted (simulators) and (aerobic).
Also recommended:

Brisk Walk
Cycling
Pool

Acupuncture: The method of acupuncture invented in China many thousands of years ago is quite effective for the preventive treatment of migraines.By acting on certain biologically active points, IRT helps to restore balance in the transmission of nerve impulses along nerve fibers.

Massage: This method can help relieve stress and relax tension in the muscles of the head, neck and shoulders. In addition, by improving the blood supply to the muscles, it helps the tissues to clear of metabolic products.

Gymnastics (qi-gong, yoga) help the body to relax, and switch attention from pathological sensations and especially expectations.In addition, exercise increases the production of endorphins, which contributes to less pain perception.

Post-traumatic headache

Post-traumatic headache (PTH) is common in people after head and neck injuries. PTH can occur after minor, moderate, or severe injury. In most cases, the headache appears within a week of the injury and disappears as you recover. In such cases, the use of conventional pain relievers is sufficient. However, neck and head injuries can often cause chronic headaches or worsen existing ones.

Medical scientists consider PTH as secondary, since the main cause of headaches is not primary. PTH results from direct or vector effects on the head or neck (such as a concussion of the brain or cervical spine). The main causes of injury are:

Falls
Traffic accidents
Collision with a moving or stationary object (e.g. collision on a bicycle)
Fighting injury
Sports injuries
Explosions in war zones (the most common cause of traumatic brain injury in military personnel)
Headache may result from cerebral edema and hemorrhage and pressure on the meninges.

In order to avoid the appearance of PTH, it is necessary to find out the cause and, accordingly, eliminate it. Most likely post-traumatic symptoms:

Headache, neck and shoulder pain
Sleep disorders
Disorders of concentration and thinking
Changes in mood and behavioral reactions
Dizziness with or without disturbance of statics

Diagnostics

The diagnosis is made by a physician based on the medical history of the medical examination and the study of the neurological status.If necessary, X-rays may be prescribed to rule out fractures, or CT or MRI may be prescribed for a clearer picture of the presence of soft tissue damage.

Based on the data of the examination of the neurological status of the instrumental research methods, the doctor will conclude what the headaches are associated with (with the vessels of the brain, muscle damage to the nerves or brain tissues) and will diagnose the Prognosis.

In most cases, headaches disappear after the injury is healed.The duration of the headache depends on the severity of the injury. In the presence of chronic headaches, long-term treatment may be required, which will have to be adjusted periodically.

Treatment

Treatment of post-traumatic headaches depends on the trauma and nature of the headaches. With a low intensity of headaches, the use of conventional analgesics is sufficient. And, for example, with a neck injury, it may be necessary to prescribe both analgesics and muscle relaxants, physical procedures or manual manipulations.

Most often, post-traumatic pain of muscle origin and treatment is similar to the treatment of “muscle tension” headaches. But sometimes, post-traumatic pain can be a sign of serious problems. For example, a head injury can cause migraine attacks in people who have not had a migraine before. In addition, headaches can be associated with problems in the temporomandibular joint or intracranial hemorrhage. What it is?

Reactive headaches

Reactive means the body’s response to the environment or changes in the body.Reactive headaches can be caused by a variety of reasons (hundreds). The most common reasons are as follows:

Allergy to dust, pollen, food, food preservatives and other allergens
Dehydration
Lack of sleep and too long sleep
Hormones (estrogen)
Infectious diseases (acute respiratory infections, influenza encephalitis, etc.)
Alcohol (beer, wine, spirits) or caffeine
Medical procedures such as cerebral angiography
Diseases of the body, such as renal failure, brain tumors, trigeminal neuralgia
Medication – mainly occurs with the daily intake of certain drugs

Symptoms

Headache can be part of an allergic reaction to various allergens and disappears in the absence of triggers.The same is true for other causes of reactive headache.

Diagnostics and treatment

As a rule, it presents certain difficulties if they are associated with taking medications or with allergic reactions. In order to find out the substance that is the trigger, it is necessary to keep a headache diary. By figuring out what the trigger is, you can easily get rid of the headaches. In case of somatic diseases, the correction of the underlying disease leads to a regression of headaches.For pain associated with allergies, it is possible to take antihistamines.

Headache with sinusitis

The most frequently misdiagnosed. Up to 80% of people who think that their headaches are associated with sinusitis actually suffer from some form of migraine. This is due to the fact that the feeling of pressure in the sinus area occurs not only during sinusitis, but also during a migraine attack or other type of headache. In addition, in the treatment of sinusitis, drugs are used to relieve pain in other types of pain, which further convinces the patient of the primary cause of the pathology of the paranasal sinuses.

Rhinosinusitis

Rhinosinusitis is an inflammation and irritation of the mucous membranes of the nose and paranasal sinuses. Most often occurs with hypothermia or as an allergic reaction. Perhaps, both an acute form and a chronic form of rhinosinusitis. Sinus headache in the presence of a respiratory infection is most often associated with sinusitis and is sometimes the leading symptom.

Paranasal sinuses

The paranasal sinuses are cavities inside the facial bones filled with air.There are four pairs of sinuses: maxillary frontal ethmoid and wedge-shaped.

Each sinus is lined with epithelium with small cells that remove dust and microbes with mucus through tiny openings connected to the nasal cavity.

In case of acute respiratory infections or an allergic reaction, swelling of the nasal mucosa occurs and these openings are sharply narrowed, and the passage of air is disrupted, the outflow of pus mucus. The accumulated mucus pus begins to press on the walls of the sinuses, which is the reason for the appearance of headaches.

Symptoms

A dull aching pain in the front of the head in the face area is usually characteristic, sometimes radiating to the ears and teeth. The intensity of pain can be low or high. Headaches usually appear with acute symptoms of sinusitis or with exacerbation of a chronic one. The pain decreases when the outflow from the sinuses is restored (this is especially clearly seen after puncture of the maxillary sinuses).

Rhinosinusitis is usually accompanied by general symptoms (fever, sweating and general malaise).
The diagnosis is made on the basis of examination of the nasal cavity by the ENT doctor and radiography or CT of the nasal sinuses.
If the pain persists after 7 days of rhinosinusitis treatment, another cause of the pain should be assumed.

Tension headaches

Tension headaches, especially episodic ones, are often confused with other types of headaches and diseases. Many experts believe tension headaches are simply a milder form of migraine with similar headache triggers.And therefore, treatment can be very similar to migraine treatment. In addition, it is necessary to take into account the possibility of abusal headaches arising from prolonged use of analgesics.

Reasons

The exact causes of HDN are not fully understood, but some factors provoking their appearance are known:

Anxiety, stress and depression
Lifestyle changes (dietary changes in sleep disorders)
Alcohol, caffeine or smoking
Muscle spasms in the cervical spine and head
Analgesic abuse
Posture disorders and prolonged static loads (working at a computer) or prolonged immobility of the head – an uncomfortable posture during sleep.

Symptoms

Symptoms include:

Pain on both sides of the head – dull, non-throbbing pain. The intensity does not increase with normal exercise (walking up stairs).

Mild to moderate pain intensity (appears both in the morning and during the day).

The nature of the pain, constricting the entire head (forehead, temples, nape of the neck).

Pains are episodic or chronic. Episodic events occur rarely and last from several hours to several days.Chronic pain occurs almost daily and does not completely disappear.

Hypersensitivity to light or sounds (and not simultaneously to both stimuli). In chronic HDN, nausea is possible instead of hypersensitivity.

Diagnostics and treatment

The diagnosis of tension headaches is based on clinical findings and differentiation with other types of headaches. If necessary, instrumental examination methods are prescribed (CT MRI ultrasound).

Treatment is very similar to migraine treatment (antidepressants, anticonvulsants, muscle relaxants).In addition, acupuncture, massage, various types of gymnastics, biofeedback, psychotherapy have a preventive effect.

Abuse headache

Abuse headache is known as medication overuse pain. It is associated with long-term use of analgesics and other drugs prescribed for the treatment of headaches. This type of headache is quite common. Studies have shown that overuse of medication was the cause in 73% of patients with chronic headache.Abuse headache can occur with excessive use of analgesics and drugs that reduce headache (more often than prescribed or at a higher dosage). The most common abusal headaches occur when taking the following drugs:

Common analgesics – aspirin, acetaminophen, ibuprofen, naproxen.
Combined analgesics, which include drugs that enhance the analgesic effect (a combination of analgesics with phenobarbital caffeine codeine).
Opioid analgesics – meperidine, hydrocodone, oxymorphone, morphine. These drugs are sometimes prescribed to relieve severe migraine attacks.
Ergotamines.
Triptans such as Sumatriptan (Imitrex) and Naratriptan (Amerge).

Symptoms

Symptoms of abusal headache are similar to those of migraine and tension headache, but there are some peculiarities:

The need for daily medication at a specific time.
Lack of effect from preventive therapy.
Dependence of the appearance of a headache on the time elapsed since the last drug intake.
The appearance of headaches at the same time (which was not observed before).

Diagnostics

When referring to a doctor with an alleged worsening of the disease, patients are sometimes surprised that the cause of decompensation is excessive medication. The diagnosis of abusal headache is based on symptoms and medication information (especially if the patient keeps a headache diary).

Treatment of abusal headache consists in a gradual reduction in the dosage of drugs and removal of intoxication. It is possible to use antipsychotics, antidepressants, anticonvulsants.

The treatment process for an abusal headache can take up to several months.

Physical exercises, massage, acupuncture are very useful.

Treatment of headaches.

Headaches are very common; in fact, nearly every person will have episodes of headaches during their lifetime.Headaches have been known since Babylon. Migraine headaches are even described in the Bible. Some very famous personalities in history (like Napoleon) suffered from severe headaches. Scientific studies do not always explain the causes of pain in the same way, but they agree on the need for further research on this problem.

Headaches are difficult to investigate due to the following reasons:

People experience pain in different ways (in other words, a headache in one person corresponding to 10 points on a scale may be experienced by others by only 5 points).
Pain measurement is carried out in a standard way, which is very subjective and cannot be quantified objectively.
Research is limited to studying only humans (not experimental animals).

Although headaches may rarely be due to infection or disease, most headaches are likely the result of an innate defense mechanism that responds to environmental influences.Headaches can be divided into 2 broad categories: primary headaches and secondary headaches.

Primary headaches are not associated with problems with internal diseases and structural changes in the body or with bacteria, viruses, or other pathogenic organisms. Migraines, tension headaches, cluster headaches are types of primary headaches.

Secondary headaches are caused by structural or organic diseases of the body.

Several observations support this division.When a person is in conditions of very high or low temperatures, headaches similar to those of migraines may occur. These headaches can also occur suddenly in some people after not getting enough sleep or nutrition. And in migraine, headache triggers include high fever, exertion, and lack of sleep or food. Not every headache patient is sensitive to these triggers, but virtually all people with migraines have external triggers for pain attacks.Approximately 70% of migraine patients have a first-degree relative (parent, brother, sister, or child) with a history of migraine. People with a genetic determinism of headaches react much faster to external factors than other people. Some experts therefore suggested that headache is an adaptive mechanism for responding to changes in the external environment. Most primary headaches develop slowly (from a minute to an hour). The pain experienced with a headache is transmitted along the slowest of all nerve fibers without the myelin sheath (these fibers without the protective myelin sheath transmit nerve impulses slowly).

Treatment of migraine headaches.

Avoid factors that cause migraine attacks (for example, lack of sleep, fatigue, physical overload, certain foods, drugs with vasodilating effects).

Provide treatment for anxiety (depression or anxiety).

Oral contraceptives may increase the frequency of headaches in a woman. Women may be advised to stop taking oral contraceptives for a period of time in order to determine if they are the trigger.

Abortive treatment

Abortive treatment quickly relieves symptoms of migraine attacks. Currently, there are many drugs for the relief of migraine attacks. The purpose of these drugs is to relieve headaches quickly and effectively. The most effective drugs for stopping migraine attacks are triptans, which target serotonin receptors. They are all very similar in chemical structure and action:

Sumatriptan (Imitrex Imigran)
Zolmitriptan (Zomig)
Naratriptan (Amerge Naramig)
Rizatriptan (Maxalt)
Almotriptan (Aksert)
Frovatriptan (Frowa)
Eletriptan (Relpax)

Other nontriptan drugs also act on serotonin receptors.They also act on several other receptors, most likely the dopamine and norepinephrine receptors. Sometimes, they are more effective than triptans.

Ergotamine tartrate (Cafergot)
Dihydroergotamine (injectable and nasal – Migranal).
Acetominophen-isometeftene-dichlororalphenazone (Midrin).

The following drugs are used when migraine headaches are accompanied by nausea and vomiting. In some cases, they help relieve headaches.

Prochlorperazine (Compazin).
Promethazine (Penegran).

Combinations, a combination of an analgesic with caffeine or codeine (Fiorecet Fiorinal or Tylenol), are pain relievers and are used in the treatment of many types of pain and can help reduce any kind of pain to a certain extent, while the triptans ergotamines and midrin are used only for certain types of headaches. pain relief and do not help relieve arthritis pain, back pain, or PMS.

The tactics of treatment for migraine is more successful with an individual approach to each patient and early treatment.

For patients with severe nausea and vomiting, intravenous prochlorperazine is advisable. In addition, these patients may be dehydrated and therefore need to consume a sufficient amount of fluids.

Vasoconstrictors (medicines that constrict blood vessels), such as ergotamines or triptans, should not be given to patients with complicated migraines without consulting a neurologist.Instead, acute attacks can be treated with NSAIDs or prochlorperazine.

Moderate to rare seizures may not always require the use of ergotamines or triptans and may be treated with drugs such as Tylenol NSAIDs or propoxyphene (Darvon Darvocet) or a combination of these drugs.

In 40% of cases, migraine attacks cannot be stopped (neither ergotamines nor triptans have an effect) and then, if it is not possible to relieve the attack within 72 hours, short-term hospitalization and treatment with intravenous infusions is necessary.

Preventive treatment for migraine.

Patients who have frequent migraine attacks and these attacks disrupt quality of life should consider preventive therapy as an adjunct to the treatment they are using to relieve the attacks.

The goal of preventive therapy is to reduce the frequency and severity of attacks and improve quality of life. Patients with complex forms of migraine who develop neurological symptoms during attacks are the first candidates for preventive therapy.For such patients, even a single episode of migraine with neurological manifestations is an indication for preventive therapy. The tactics of preventive treatment should be determined individually, taking into account the presence of concomitant pathology, such as the presence of depression, excess weight, bronchial asthma, planned pregnancy, etc. All drugs have a number of side effects and this must be taken into account when prescribing them.

Prophylactic drugs include beta blockers, tricyclic antidepressants, certain anticonvulsants (anticonvulsants), calcium antagonists, ciprophetadine (Periactin), and NSAIDs such as naproxen (Naprosyn).In contrast to triptans and ergotamines, these drugs are intended for the treatment of other diseases and their use as preventive therapy has had empirical experience. The following medicines also have a preventive effect; unfortunately they also have more side effects:

Metisergide maleate (Sancert): This drug has many side effects.
Lithium (Escalit Lithobid): This drug has many side effects too.
Metindol (Indomethacin): This drug may cause psychosis in some patients with cluster headaches.
Steroids: Prednisone (Deltazone Meticorten) can be extremely effective in some patients when other therapies are proving. The duration of preventive therapy depends on the results of the use of certain drugs and the dosage of drugs should be reduced.

Treatment of tension headaches.

Tension headaches (HDN) occur most often. In essence, tension headaches are the body’s response to mental tension, which may be accompanied by a spasm of the muscles of the head (pericranial muscles – frontal, occipital, temporal).Often, the appearance of tension headaches is promoted by prolonged static loads of a professional nature (working at a computer, driving a car for a long time). Therapeutic measures for HDN begin with preventive actions. A correct daily routine, with adequate sleep and rest, and normal ergonomics are often just as effective as medication. There are differences in the management of episodic and chronic tension headaches; if headache episodes are rare, analgesics or tranquilizers may be sufficient.If these episodes are accompanied by muscle spasm, then it is advisable to prescribe muscle relaxants (mydocalm, sirdalud, baclofen) in conjunction with analgesics. The appointment of long-term preventive drug therapy for rare episodes is impractical. Possible short courses of benzodiazepines (clonazepam or alprozole for 2-3 weeks) A good effect is given by the use of massage, exercise therapy.

Treatment of chronic headaches currently involves the mandatory use of tricyclic antidepressants (for example, amitriptyline) or more modern drugs – serotonin reuptake inhibitors.These drugs have fewer side effects and are as effective as tricyclic antidepressants. Such drugs include seratalin, fluoxetine, paroxfin. The analgesic effect of antidepressants is explained by reducing depression and stimulating the production of endogenous active peptides with an analgesic effect. Moreover, the analgesic effect of the use of antidepressants in HDN occurs much faster than the actual effect on depression. In addition to drug treatment, it is advisable to conduct courses of massage, exercise therapy, acupuncture, treatment of biofeedback.Courses of non-drug treatment and medication should be long enough (3-4 months).

Treatment of cluster headaches.

Cluster headaches are often called histamine cephalalgia, Norton’s neuralgia, or erythromelagia. The causes of cluster headaches are currently unknown and the mechanisms behind cluster headaches are not known, but cluster headaches have been associated with smoking, alcohol use, or a history of head trauma.Treatment of cluster headaches is divided into abortive and preventive.

Most of the drugs used in the treatment of migraine are also effective in cluster headaches (triptans, ergotamines, NSAIDs, antidepressants, etc.). It is assumed that the mechanism of migraine and cluster pain headaches is similar and the treatment is very similar. Oxygen therapy: This is the preferred treatment for acute cluster headache (safe and effective). Early application of oxygen through a mask not only reduces pain, but also often relieves the attack.The mechanism of the therapeutic action of oxygen is not clear. Injection of a steroid (methylprednisolone) into the occipital nerve can interrupt a cluster headache attack. Preventive treatment for cluster headaches is similar to that for migraines.

Treatment of secondary headaches.

Secondary headaches (symptomatic) are associated with physical problems and include the following:

Decreased intracranial space: headaches associated with intracranial tumors are manifested initially by a convulsive syndrome and caused by an increase in intracranial pressure.The classic manifestation of such pain is when the patient wakes up from a severe headache, accompanied by vomiting. Over time, the headache appears with the slightest exertion and actions that increase intracranial pressure. Treatment of such pains is usually prompt or, if surgical treatment is impossible, is aimed at reducing intracranial pressure.
Meningeal irritation: Meningitis, especially chronic forms (tuberculous, fungal), can irritate the pia mater and lead to persistent headaches.Headaches are often diffuse. Treatment is aimed at eliminating the infectious agent and reducing the inflammatory process (NSAID antibiotics).
Post-traumatic headache: Headache may be part of post-contusion syndrome Patients may complain of headaches of an uncertain nature, memory impairment, irritability. Symptoms can persist for a long time (months, years). Treatment for this type of pain is aimed at improving the metabolism of the head brain and is symptomatic (vascular drugs, nootropics, neuroprotectors, NSAIDs).
Temporal arteritis: This is an inflammation of one of the extracranial arteries. The headache is one-sided. Treatment is symptomatic.
Post-dural puncture headache: A lumbar puncture may cause headache that worsens with changes in body position. With such pain, drinking enough fluids and caffeine is good.
Reflected headache: Headache can be a form of reflected pain from adjacent anatomical structures.Diseases of the teeth, problems in the sinuses, in the jaw joint or problems in the cervical spine (osteochondrosis, arthritis) can cause headaches. Treatment is aimed at compensating for the disease that caused the headache (treatment of osteochondrosis, treatment of arthritis, etc.).
Idiopathic intracranial hypertension: This disorder occurs most often in young women, due to an increase in intracranial pressure that occurs without structural changes in the brain and cerebral fluid.Treatment is aimed at reducing intracranial pressure during seizures (diuretics, analgesics).
Cardiovascular diseases such as hypertension, atherosclerosis are often accompanied by headaches. In addition, severe headaches accompany strokes, cerebral hemorrhage. Treatment is aimed at compensating for the disease (antihypertensive drugs, statins, etc.) and, if necessary, surgical treatment (removing blood in case of cerebral hemorrhage).

Secondary headaches occur with many infections, with an increase in temperature, but tend to disappear as the temperature recovers and decreases.

90,000 Sinusitis treatment with modern methods on new equipment

Sinusitis (and as one of its manifestations, sinusitis) is an inflammatory disease of the paranasal sinuses associated with infection or allergic reactions.

The incidence of sinusitis among the population of our country is 40%.

Depending on the localization of inflammation, sinusitis is divided into:
Acute sinusitis – damage to the maxillary sinuses of the nose.
Acute ethmoiditis is a lesion of ethmoid cells.
Acute frontal sinusitis is a lesion of the frontal sinuses.
Acute sphenoiditis is a lesion of the sphenoid (main) sinus.

Etiology of sinusitis

The main source of sinusitis is infection of the sinuses with various microflora.

For acute sinusitis monoculture is characteristic (infection with one type of bacterial pathogens): pneumococci, streptococci, staphylococci; viral infection (influenza virus, parainfluenza, adenoviruses).

For chronic sinusitis , a mixed microflora is characteristic: more often staphylococcus, Pseudomonas aeruginosa, Proteus, Escherichia coli, fungal infection (fungi of the genera Aspergillus, Penicillium, Candida).

Previous acute respiratory viral infection; tamponade of the nose with nosebleeds; traumatic damage to the tissues of the nasal cavity is often the cause of the subsequent development of sinusitis of a particular localization.

Risk factors leading to the development of sinusitis

Burdened allergic history.
Immunodeficiency states.
Diseases of the dentoalveolar system.
Bathing in polluted water.

Routes of infection in the nasal sinuses

Rhinogenic (through the natural fistulas of the sinuses)
Hematogenous (infection through blood).
Odontogenic (in the presence of chronic foci of infection in the dentoalveolar system.
For injuries of the sinuses of the nose.

Clinical manifestations
General symptoms:

Nasal congestion.
Headache.
Temperature rise.
Nasal discharge.
Cold symptoms.

Symptoms characteristic of acute sinusitis and ethmoiditis:

Nasal congestion.
Feeling of heaviness., Tension in the cheek area on the affected side, especially when the trunk is tilted forward.
Sensation of pressure on the eyes.
Pain in the teeth on the affected side.
Headache of uncertain localization.
Nasal discharge of a mucopurulent or purulent character.
Deterioration of smell.
Lachrymation (due to impaired patency of the nasolacrimal canal)

For acute frontal sinusitis, a characteristic symptom is a headache in the forehead, especially intense in the morning (due to the difficulty of outflow from the sinus when the patient is in a horizontal position).

Acute sphenoiditis is manifested by the following symptoms:

Headache in the occiput;
Pain in the depths of the eye;
Runoff of purulent discharge from the nasopharynx along the back of the pharynx;
Unpleasant odor.

Complications.

In the absence of timely treatment, the following complications may occur:

Optic neuritis;
Orbital periostitis.
Panophthalmos (inflammation of all tissues and membranes of the eye) – very rare.
Meningitis;
Arachnoiditis;
Extra- and subdural abscesses;
Brain abscess;
Thrombophlebitis of the cavernous sinus;
Thrombophlebitis of the superior longitudinal sinus;
Septic cavernous thrombosis.

With proper, timely treatment and prevention of complications, the prognosis is favorable In chronic sinusitis, the prognosis can be favorable if an allergen is identified and good drainage is ensured using a sinus puncture or yamik procedure.