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Sinusitis
(Novolat. sinusitis, from Lat. sinus – sinus and Lat. -itis – suffix meaning inflammation; synonym: sinusitis) – inflammation of one or more paranasal sinuses, occurs as a complication of acute runny nose, flu, measles, scarlet fever and other infectious diseases diseases.
Types of sinusitis
- According to the nature of the flow:
- Acute;
- Chronic.
- According to the form:
- Exudative
- Serous
- Catarrhal
- Purulent
- Productive
- Parietal-hyperplastic
- Polyposis
- By etiological factor:
- Traumatic
- Viral (develops after ARVI)
- Bacterial
- Fungal (usually as a superinfection)
- Mixed
- Allergic
- According to the location they are distinguished:
- Sinusitis – inflammation of the maxillary paranasal sinus
- Frontitis – inflammation of the frontal paranasal sinus
- Ethmoiditis – inflammation of the cells of the ethmoid bone
- Sphenoiditis – inflammation of the sphenoid sinus
If all the sinuses of one half of the face are involved in the inflammatory process, the disease has a name – hemisinusitis, and both halves of the face – pansinusitis.
Predisposing factors
- Congenital disorders of the development of anatomical structures of the nasal cavity.
- Polypous growths in the air passages.
- Allergic rhinitis.
- Deviation of the nasal septum.
- Acute respiratory viral infection (ARVI).
The symptom is sinusitis
- Unpleasant sensations appear in the nose and paranasal area, bridge of the nose or above the eye, which gradually intensify. The pain is less pronounced in the morning and increases in the evening. Gradually, the pain “loses” a certain place, and the patient begins to have a headache. If the process is unilateral, then pain is noted on one side.
- Difficulty in nasal breathing. The patient has a stuffy nose. The voice takes on a nasal tone. As a rule, both halves of the nose are blocked. Difficulty in nasal breathing is constant or with slight relief. Alternate congestion of the right and left halves of the nose is possible.
- Runny nose. In most cases, the patient experiences mucous (transparent) or purulent (yellow, green) discharge from the nose. This symptom may not exist if the nose is very stuffy, since the outflow from the sinus is difficult (this was mentioned above).
- Increase in body temperature to 38° and above. As a rule, this symptom is observed in acute sinusitis. In a chronic process, body temperature rarely rises.
- Malaise. This is expressed by fatigue, weakness, patients refuse food, and their sleep is disturbed.
Types of sinusitis
Sinusitis
Sinusitis (maxillitis) – inflammation of the maxillary (maxillary) paranasal sinus, occurs as a complication of acute runny nose, flu, measles, scarlet fever and other infectious diseases.
The paranasal sinuses are formations in the form of small caves that communicate with the nasal cavity. Another name for this formation is the maxillary sinus, or maxillary sinus (novolat. sinus Highmori).
The main cause of sinusitis is infection – bacteria or viruses penetrate the maxillary sinus through the nasal cavity, through the blood, and most often due to pathological processes in the periapical areas of the upper teeth and cause an inflammatory process.
Ethmoiditis
Acute ethmoiditis with damage to the bone walls is observed mainly in scarlet fever. Unfavorable outflow conditions due to swelling of the mucous membrane can lead to the formation of empyema. The disease of the anterior cells of the ethmoid labyrinth usually occurs simultaneously with damage to the maxillary and frontal sinuses, and the posterior cells – with inflammation of the sphenoid sinus.
If the outflow of pus is obstructed, the inflammatory process can spread to the orbital tissue. In such cases, the eyelids swell and the eyeball deviates outward (empyema of the anterior ethmoid cells) or protrudes and deviates outward (empyema of the posterior ethmoid cells).
Sphenoiditis
Sphenoiditis is rare and is usually caused by the spread of the inflammatory process from the ethmoid labyrinth – its posterior cells.
Headache is most often localized in the crown area, deep in the head and back of the head, and in the orbit. With chronic lesions, pain is felt in the crown area, and with large sinuses it can spread to the back of the head. With unilateral sphenoiditis, unilateral lateral pharyngitis is observed.
Sometimes patients complain of a rapid decrease in vision, which is associated with the involvement of the optic chiasm in the process. Chronic sphenoiditis can also occur with mild symptoms. X-ray examination is of great importance in the diagnosis of sphenoiditis.
Frontite
Front – inflammation of the frontal paranasal sinus. The reasons are the same as for inflammation of the maxillary sinus. It is much more severe than inflammation of other paranasal sinuses. Insufficient drainage of the frontal sinus, caused by hypertrophy of the middle concha, curvature of the nasal septum, contributes to the transition of acute frontal sinusitis to a chronic form.
Characterized by pain in the forehead, especially in the morning. The pain is often unbearable and becomes neurological in nature. In severe cases, there is pain in the eyes, photophobia and decreased sense of smell. The headache subsides after the sinus is emptied and resumes as the outflow becomes more difficult.
In acute influenza frontal sinusitis, the body temperature is elevated, sometimes the color of the skin over the sinuses is changed, swelling and swelling in the forehead and upper eyelid are noted, which are a consequence of local circulation disorders (collateral edema).
Sometimes the inflammatory process spreads to the periosteum and bone with its necrosis and the formation of sequesters and fistulas. Necrosis of the posterior sinus wall may result in extradural abscess, brain abscess, or meningitis.
Diagnosis of sinusitis
The diagnosis is made on the basis of anamnesis, clinical examination and the results of additional research methods, in particular radiography or computed tomography of the paranasal sinuses.
Prognosis for sinusitis
Conditionally favorable, if adequate treatment is started in a timely manner, the disease is cured without consequences, and the ability to work is completely restored. In the absence of adequate medical care, life-threatening complications may develop.
Treatment of sinusitis
Treatment is carried out under the supervision of an ENT doctor.
Conservative therapy for sinusitis
Drug treatment of sinusitis must necessarily be based on local procedures – the use of drops, sprays, inhalers that can eliminate swelling of the mucous membrane.
Vasoconstrictor drugs include: naphazoline (“Naphthyzin”, “Sanorin”), tetrizoline (“Tizin”), xylometazoline (“Galazolin”, “Dlyanos”), oxymetazoline (“Nazol”, “Nazivin”). For sinusitis, it is necessary to adhere to certain rules for pouring medicinal liquids into the nose. Only after using these drops can you instill others that have an antibacterial, anti-inflammatory or analgesic effect.
Antibacterial drugs (preferably cephalosporins) and antihistamines (Claritin, Telfast, etc.) are also used in treatment. Rinse the nose with antiseptic solutions (for example, furatsilin, sodium hypochlorite). Physiotherapy procedures include such techniques as ultraviolet irradiation of the nasal cavity, UHF on the paranasal sinuses, etc.
Surgical treatment of sinusitis
A puncture (puncture) is done in order to pump out pus from the sinus, rinse the sinus, and then inject antibiotics and anti-inflammatory drugs into it. This procedure is accompanied by unpleasant sensations, but its effectiveness is very high.
Currently, after a puncture, special tubes are installed in the sinus – catheters, through which the sinus can be washed daily. When using this method, the patient recovers very quickly. But everything has its own indications, and in the initial stages of sinusitis it is not always necessary to perform a puncture; you can get by with rinsing the nose.
Resection of the posterior end of the middle concha is indicated in some cases of sphenoiditis.
Prevention of sinusitis
Prevention of sinusitis should be aimed at treating the underlying disease (influenza, acute runny nose, measles, scarlet fever and other infectious diseases, dental damage), eliminating predisposing factors (deviated nasal septum, atresia and synechia in the nasal cavity, etc.). Systematic hardening of the body plays an important role.