The cause of bad breath is not always found in the mouth. Especially when the most common causes, for example, pathology of the oral cavity or stomach, have already been excluded - perhaps the source of the unpleasant odor is located deeper.
It is purulent inflammation that often leads to the formation of a “bad” odor. If it is in the mouth, the cause is usually discovered quickly. On the other hand, in the case of inflammation outside the mouth, additional diagnostics may be required to find the cause of bad breath.
Does inflammation in the sinuses lead to bad breath?
Since the air is exhaled through the nasal cavity, it physiologically communicates with the paranasal sinuses; in the event of their purulent inflammation, an unpleasant odor is mixed with the inhaled portion of air. Sanitation of the oral cavity or treatment of stomach problems will not help in this case, since the source of the odor is outside the oral cavity.
Inflammation in the antrum of the maxillary sinus is caused by recurrent bacterial infections. Quite often, staphylococcus becomes such a “bad-smelling” agent.
The cause of the smell is a foreign object in the nose
Sometimes parents notice that their child’s snot flows from only one nostril, and after a while the nose begins to smell unpleasant.
Such symptoms appear when a foreign object is in the baby’s nose for a long time. Children 3-6 years old are very inquisitive. They actively explore the world and sometimes, out of interest, stick a bead, a leaf, or a small toy into their nose. Usually the child inserts a foreign body into one nostril. After a few days, an object located in the nasal cavity provokes the development of inflammation of the mucous membrane. Bacteria begin to multiply in the nose, and an unpleasant odor appears. If there is an object of plant origin in the nasopharynx, the smell may be more intense due to its rotting.
Features of treatment in this situation.
Brushing your teeth only eliminates the odor for a short time. With chronic inflammation of the paranasal sinuses, bad breath is usually not the only problem. Inflammation of the paranasal sinuses also causes other symptoms, such as pain in the affected sinus area and postnasal drip. Thus, for more effective help, the possibility of surgical treatment of inflamed paranasal sinuses should be considered, if conservative treatment methods are ineffective. If the inflammation is eliminated, bad breath usually goes away on its own.
The main goal in the surgical treatment of chronic sinusitis is to normalize the anatomy of the nasal cavity and restore the aerodynamics of the nasal cavity and paranasal sinuses. Corrective operations in the nasal cavity are performed: septoplasty, vasotomy with lateroposition, bullotomy cf. turbinates. The natural openings of the paranasal sinuses expand, allowing pus and mucus to leak out, and sinus ventilation is restored.
Restoring normal air exchange prevents the resumption of inflammation. In addition, as part of the operation, the affected sinus is washed out. The pus is removed, which usually eliminates the odor immediately. If secondary infection does not occur after surgery and healing proceeds normally, then the symptoms of halitosis disappear completely.
3. Symptoms and diagnosis
There are several stages of development and several degrees of severity of ozena. The initial stage in most cases occurs in early school age and is manifested by increased and almost constant secretion of viscous mucous substances from the nasal passages, and this symptom does not respond to standard methods of treating the runny nose.
Later, an intense putrefactive odor appears, due to the predominance of decay products of dying cell masses in the discharge.
The stench is clearly distinguishable from a distance and unpleasant for others, but the patient himself practically does not feel this smell, since as the atrophy of the mucous membranes progresses, anosmia (lack of smell) develops relatively quickly.
The classic clinical picture of ozena includes the formation of large amounts of viscous, quickly drying and crust-forming exudate (however, crusts are not always found), a feeling of dryness and congestion in the nose, difficulty in nasal breathing, and sometimes nosebleeds.
The process can be unilateral or bilateral, focal or generalized.
Nonspecific symptoms associated with difficulties in nasal breathing include headaches, sleep disturbances, decreased intellectual productivity, fatigue, and lethargy.
The constant stench creates serious socio-psychological problems, leading to social isolation of the patient and disorders of the depressive-neurotic register. Some sources mention gastritis, chronic sinusitis (sinusitis, sinusitis, ethmoiditis), and hearing loss among the long-term consequences of ozena.
Diagnosis is carried out based on the study of complaints, anamnesis, clinical manifestations and their dynamics, the results of rhino- and pharyngoscopy, microscopic and bacteriological analyses. Establishing a diagnosis in the initial stages is very problematic. Additionally, radiographic and tomographic examinations and PCR may be prescribed. Differential diagnosis is necessary with banal (not ozenous) atrophic rhinitis and some other diseases, in which thinning of the mucous membranes, drying out and abnormal expansion of the nasal passages are also observed.
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Bad breath: a case for the dentist or ENT specialist?
Depending on where the cause of bad breath is located, the treating specialist is either a dentist or an ENT specialist. Typically, in multidisciplinary clinics, these specialists work in close cooperation, so if the dentist cannot identify the causes of the constantly occurring unpleasant odor from the oral cavity, then you should consult an otolaryngologist.
In addition to inflammation of the antrum of the maxillary sinus or other paranasal sinuses, chronic tonsillitis can cause bad breath. Also, general diseases of internal organs can be a trigger for bad breath, for example, in the gastrointestinal tract.
Purulent nasal discharge
The appearance of purulent nasal discharge can occur for various reasons. But regardless of them, you need to contact an otolaryngologist, and if this is not possible, then a therapist. We do not recommend trying to get rid of the problem yourself.
The discharge is yellow-green in color and has an unpleasant odor. Additionally, discharge of pus from the nose may be accompanied by headaches, general malaise, chills, itching and pain in the nose.
Causes of purulent nasal discharge
The cause of pus in the nose is considered to be damage to the paranasal sinuses. A blockage occurs, and a mucous secretion accumulates in the sinuses, which can later become inflamed. Additional reasons may be the consequences of injury or the occurrence of an abscess in the nasal cavity.
But the main cause of pus is considered to be diseases of the nasal cavity. To eliminate them, you need to consult a doctor who will prescribe treatment and give recommendations. Therapy for adults and children is almost the same. If you consult a doctor in time, the treatment will not be long and surgical intervention will not be required.
At the initial stage of the disease, the pus has a liquid structure and white color. The volume of discharge is small, it can flow down the back wall of the throat. If the viscous structure predominates, this means that the purulent process has entered an advanced stage and urgent treatment is required.
Diseases accompanied by the discharge of pus
To determine the cause and diagnose the disease, it is necessary to consult an otolaryngologist, and at the diagnostic stage it is already possible to distinguish:
- sinusitis;
- nasal polyps;
- nasopharyngitis;
- ozena.
Purulent discharge may be the result of bacterial infections or complications after injury or surgery. Mostly children are susceptible to bacterial infection due to insufficiently strong immunity. In adults, this is rare and occurs only when the immune system is severely weakened and the body is weakened.
Sinusitis
The development of sinusitis is one of the main reasons for the appearance of pus from the nose. With this pathology, inflammation of the maxillary paranasal sinuses is observed. Purulent discharge has a greenish color, sometimes it can turn brown due to inclusions of blood. The development of sinusitis can be triggered by the presence of carious teeth in the upper jaw.
The following symptoms are noted for sinusitis:
- elevated temperature (from 38°C);
- constant headache that cannot be relieved with medications;
- feeling of heaviness in the head;
- loss of smell;
- general weakness and decreased performance;
- sleep problems.
The occurrence and development of sinusitis can occur not only due to diseased teeth. The cause of the occurrence and development of the disease can be an untreated runny nose, injury, decreased immunity and hypothermia.
When you notice the first symptoms of the disease, you should seek medical help and not try to cure yourself. If not treated correctly, the disease can have serious consequences. If you have had sinusitis once, the risk of the disease recurring will be higher than for a person who has not had sinusitis.
Nasal polyps
Polyps are benign growths and often appear in the nose. But with further growth in the mucous membrane, chronic nasal congestion may occur, a nasal voice may appear, and the sense of smell may decrease. The development of polyps may be accompanied by frequent headaches.
Excessive enlargement of polyps disrupts the proper functioning of the nasal cavity, and the outflow of mucus is disrupted. Inflammatory processes begin to develop in it, which leads to the formation of pus.
The problem cannot be solved with medication; surgery will be required. But even removing polyps does not guarantee that they will not appear again in the future.
Rhinopharyngitis
The disease is accompanied by a simultaneous inflammatory process in the nasal cavity and larynx. The emergence and development of the disease occurs after viral diseases (ARD, ARVI). Symptoms include:
- itching and burning in the nasopharynx;
- disturbances in breathing through the nose;
- change in voice (nasality);
- discharge of mucus and pus from the nose, sometimes the color may turn brown due to the presence of blood;
- swelling of the nasopharynx;
- temperature increase.
To eliminate the problem, it is necessary to carry out complex treatment. If you postpone it, then nasopharyngitis will provoke irreversible changes in the body. In an advanced stage, changes in the tissue of the pharyngeal tonsils may occur, which will require their removal.
Ozena
Ozena is sometimes called atrophic rhinitis. When the disease occurs, damage occurs to the nasal mucosa, accompanied by an unpleasant odor. When the first signs appear, you must consult a doctor and undergo urgent treatment.
Symptoms of the disease:
- purulent nasal discharge, which has a strong and pungent unpleasant rotten odor;
- the sense of smell disappears;
- Dry crusts constantly form in the nasal cavities.
The development of ozena can occur after prolonged chronic rhinitis. This is especially noted in the case when rhinitis was not treated and became chronic. The initial signs are the presence of a large amount of transparent discharge. At first they have a watery structure, but later atrophy of the mucous cavity occurs. After some time, the inflammatory process enters a critical stage, and pus begins to discharge from the nose.
Discharge of pus from the nose can occur due to injury or surgery. The situation is also possible if a bacterial infection has occurred. The appearance of pus indicates that the treatment was carried out incorrectly, or there was non-compliance with the doctor’s recommendations in the postoperative period and infection in the operated area.
What you need to know about purulent nasal discharge
If purulent discharge is detected, you should seek medical help and not self-medicate. Timely treatment will have a positive effect, quickly get rid of the problem and avoid complications. If treatment is neglected, the risk of complications increases and surgery may be required. The longer you wait to see a doctor, the more effort and time it will take for a full recovery.
How is the treatment carried out?
There are two methods used to treat nasal discharge of pus. This includes medication and surgery. Drug treatment uses antibiotics to help the body cope with the disease. But they contain components that can affect the intestinal microflora. To level out the effects on the body, probiotics are prescribed to help avoid intestinal problems.
Additionally, the doctor may prescribe the use of vasodilators, which help reduce swelling of the mucous membrane and improve the outflow of contents of the paranasal sinuses. Sometimes it is recommended to take painkillers and antipyretics. If the separation of mucus from the nasal cavity is associated with difficulties, then rinsing the nose with an isotonic saline solution is prescribed.
Surgery may be required when polyps are present in the nasal cavity and there is an urgent need to clear pus from the paranasal sinuses. The operation does not require hospitalization and is performed under local anesthesia. After the intervention, the doctor will give recommendations that should be strictly followed to avoid complications.
The postoperative period is accompanied by a mandatory course of antibiotics, which reduces the risk of purulent complications and maintains the body's protective functions.
If you notice purulent nasal discharge, you can call our clinic and make an appointment. After the examination, the doctor will prescribe treatment and give recommendations on further prevention from the development of the disease. If necessary, our doctors will perform an operation and help resolve the problem. After the procedure, the patient can stay in a free hospital for several hours. This will help him recover from the effects of anesthesia, and the doctor will be able to monitor his well-being.
Author
Sadrtdinov Alik Gadelyanovich
otorhinolaryngologist (ENT)
Candidate of Medical Sciences
25 years of experience
+7
Algorithm for patients in case of persistent bad breath.
In this situation, some features of the actions of patients in the absence of oral pathology should be considered.
- If a consultation with a dentist does not reveal inflammation in the oral cavity, a consultation with an ENT doctor is necessary.
- During the initial examination, several chronic diseases of the ENT organs may be identified, which can contribute to unpleasant odor from the oral cavity: tonsillitis, sinusitis, nasal polyps, rhinitis, etc.
- In case of sinusitis and other sinusitis, endoscopic examination of the nasal cavity may be required.
- In addition to general diagnostics, the doctor may prescribe another examination: CT scan, x-ray (panoramic image), etc.
- As a rule, in the presence of a persistent unpleasant odor, conservative therapy is ineffective. Therefore, surgery should be considered as the most optimal solution to this problem - endoscopic sinus surgery.
If you have any questions about the specifics of the treatment or want to get advice, then I am available in WatsApp chat at this number. The addresses of medical institutions in Moscow where I receive appointments are located on the page: “Contacts”.
Sincerely, otorhinolaryngologist surgeon candidate of medical sciences Boklin A.K.
1.General information
The diagnosis of “ozena” (fetid runny nose) implies not only the unpleasant odor of nasal discharge. The key, syndrome-forming point is the presence of a chronic progressive atrophic process in the mucosa involving the deeper bone tissues of the nose.
Currently, ozenous runny nose is apparently much less common than in ancient times; on the other hand, this can be explained by the fact that at the dawn of medicine, any disease accompanied by foul-smelling nasal discharge (leprosy, syphilis, tuberculosis, etc.) was classified as ozena. The frequency of occurrence of true, genuine ozena is estimated today in hundredths of the total volume of registered ENT pathology. Various studies have noted certain regional, ethnic, and gender dependencies.
Children and young people are more likely to get sick; Women predominate among those affected.
A must read! Help with treatment and hospitalization!
Why is the formation of fungus in the maxillary sinus dangerous?
How can the growth of a fungal colony be dangerous? In any case, it’s not very pleasant when some kind of parasite, mold, or fungus lives in you. This is really a parasite that lives in the cavity of the maxillary sinus and feels great there. In addition, mycetoma is dangerous because the blood supply and oxygen supply to the brain deteriorates, since the function of nasal breathing is disrupted. A person simply begins to experience partial oxygen starvation due to mycetoma.
Plus, the waste products of the fungus in the maxillary sinus flow into the nasopharynx, which can additionally lead to additional complications, including the development of allergies and provoking respiratory diseases. And, of course, chronic sinusitis.
The role of CT in the study of mycetoma
Of course, a good computed tomogram gives a complete picture of the maxillary sinuses and is the main tool in diagnosing “mycetoma” when examining a patient. A CT scan of the maxillary sinus shows the location, size, and volume of mycetoma damage (local volume or total fungal infection of the cavity).
In fact, computed tomography is the gold standard for diagnosing mycetoma today.
Is wax in the ear normal or pathological?
Purulent, mucous, or other discharge may appear in the ear. As for the organ of hearing, another secret is added to this list - the mass of sulfur. The latter is the most common form of ear discharge.
Wax is formed in the external auditory canal. The latter extends from the visible part of the ear to the middle ear. The skin in this area contains certain glands that produce sulfur. After leaving the glands, the wax slowly moves to the visible part of the ear and either on its own or leaves the ear during washing.
The ear glands constantly produce wax, so there is always enough wax in the ear canal.
Earwax performs several important functions.
- It moisturizes the skin of the ear canal, preventing the ear from drying out.
- Contains chemicals that destroy harmful microbes and protect us from infection.
- Sulfur is a kind of shield erected between the outside world and the internal structures of the ear. When dust, dirt and other unwanted particles enter the ear, wax absorbs them and prevents them from penetrating deep into the ear. So her disappearance cannot bring anything good. Therefore, it is a mistake to inexorably fight sulfur - you cannot get rid of it, and there is no need for this.
Regular washing is enough to keep your ear clean. You can also clean the outer ear with a towel to remove wax. But under no circumstances use cotton swabs or other long objects - the hearing aid and membrane are very soft and easily damaged.
In addition, pressure can cause wax to penetrate deeper into the ear. Be careful: While wax is designed to prevent harmful particles from getting deep into the ear, you'll be doing the opposite if you're extra active.
Sulfur plug
Some people's ears produce large amounts of wax. When sulfur accumulates in excess or is too thick to be removed naturally, a sulfur blockage forms.
Sulfur plug
It may also be that the blockage is caused by trying to clear the ear with a cotton swab or other object. In this case, the wax not only cannot come out, but also penetrates deeper into the ear, so it is much more difficult to expel.
Sulfur plug is manifested by the following symptoms:
- Earache;
- Feeling of fullness, swelling on the affected side with hearing impairment;
- Tinnitus (tinnitus);
- Dizziness.
If you experience these symptoms, consult your doctor.
Note. Similar clinical signs are characteristic of a number of ear diseases. You cannot determine whether the cause of your complaints is sulfur blockage or another pathology; this is the prerogative of the doctor, so do not try to solve the problem yourself.
Removing excess wax is also best left to a doctor - your attempts may rupture the eardrum and cause serious complications. Your doctor will prescribe a medicine that softens the wax and helps get rid of it.
If treatment with ear drops does not help, irrigation (rinsing) is performed. This is an invasive procedure performed by a doctor.
If wax blockage occurs frequently, special drops may also be prescribed for preventive purposes, although at present there is no way to completely prevent the problem from recurring.
