Sinusitis - Causes, symptoms and treatment. MF.
Jun 18, 2018
The mucous membrane of the nasal cavity and its paranasal sinuses carry a number of important functions for the body. This is protection against pathogenic microbes( secretion of mucus, which possesses antimicrobial properties), this removal of microparticles already found( multifunctional ciliated epithelium speeds up excretion of mucus and microbes), and adequate ventilation of the lungs( warming of air and formation of an air stream).However, due to the fact that the mucous membrane is a single functional formation of the nasal cavity and sinuses, and communicating among themselves, the inflammatory process can "wander" from the nasal cavity into the sinuses and back. Most often the maxillary sinuses are affected - the sinusitis develops, which is caused by the structure of the sinuses and their mouths. The second most common sinus disease is the front .Similarly, the inflammatory process can capture cells of the latticed bone( etmoiditis) and the sphenoid sinus( sphenoiditis).All these diseases are classified as sinusitis.
There are inflammation of the mucous membrane of the maxillary( maxillary) sinus - sinusitis, frontal - inflammation of the frontal sinus, etmoiditis - inflammation of the trellis labyrinth and sphenoiditis - inflammation of the sphenoid sinus. The disease can be unilateral or bilateral, with the involvement of one sinus in the process or the defeat of all the paranasal sinuses from one or both sides - the so-called pansinusitis.
General information about sinusitis
Sinusitis is a common name for diseases of the paranasal sinuses. If autonomic inflammation of a particular sinus develops( or two of the same symmetrical from different directions), the diagnosis reflects the name of the affected sinus. Maxillary sinusitis -( maxillary or maxillary sinuses), frontal( frons lat. - forehead).When etmoiditis, air cells of the latticed bone( bone separating the nasal cavity from the cranial cavity) are involved in the process. When sphenoiditis is affected by a wedge-shaped sinus( a small pair space, located between the nasopharynx and the cavity of the skull - this is the "deepest" sinus).Most often in hospitals, inflammation in the maxillary sinus or frontal sinuses is treated, as well as their friendly defeat. This means that sinusitis is the most frequent disease and its relevance is clear to everyone, everyone has this diagnosis on hearing. However, such "combined" diagnoses as haymeroetmoidit, gemisinusit, polisinusit, pansinusit are not uncommon.
In the development of sinusitis, various infections of the upper respiratory tract, various pathological processes occurring in the nasal cavity, mouth, pharynx play an important role. Frontitis and etmoiditis have the same causes as in inflammation of the maxillary sinus. The frontite is much heavier than the inflammation of the other paranasal sinuses. Acute etmoiditis with lesion of bone walls is observed mainly with scarlet fever. Sphenoiditis is rare and is usually associated with disease of the posterior cells of the trellis labyrinth.
Symptoms of sinusitis
Symptoms of catarrhal sinusitis are nasal congestion, heaviness and pain in the head, in the projections of the sinuses. Symptoms of inflammation of the mucous membrane of the maxillary sinuses may be pressing pain in the roots of the teeth of the upper jaw and the feeling of "opening" the orbit( the bottom wall of the sinus is the roots of the teeth, the upper wall of the sinus is also the bottom wall of the orbit).This condition is called catarrhal sinusitis. If the pressing pain is localized mainly over the bridge of the nose, in the forehead area, they speak of a catarrhal frontal( inflammation of the frontal sinus).
Symptoms of purulent sinusitis ( sinusitis including) exactly repeat those with catarrhal sinusitis, but a viscous yellow( purulent) discharge appears from the nose and the body temperature can rise to 37.5-380.
With genyantritis , there is a sensation of tension or pain in the affected sinus, a violation of nasal breathing, discharge from the nose, a sense of smell on the affected side, photophobia and lacrimation. The pain is often spilled, indefinite or localized in the forehead, temple area and occurs at the same time of the day. Body temperature is increased, chills often occur.
When patients are worried, pain in the forehead area, especially in the mornings, impairment of nasal breathing and discharge from the corresponding half of the nose. The pain is often unbearable. In severe cases - pain in the eyes, photophobia and decreased sense of smell. The headache subsides after the emptying of the sinus and resumes as the outflow obstructs.
With acute influenza front body temperature is increased, sometimes the color of the skin over the sinuses is changed, swelling and swelling in the forehead and upper eyelid are noted.
When etmoiditis is concerned with a headache, pressing pain in the root of the nose and nose. Allocations are initially serous, and then purulent. Sharply reduced sense of smell, significantly hindered nasal breathing. The body temperature is increased.
With sphenoiditis complaints of headache. Most often it is localized in the region of the crown, in the depth of the head and occiput, in the orbit. With chronic lesions, the pain is felt in the region of the crown, and with large sinuses it can spread to the back of the head. Sometimes patients complain of a rapid decline in vision.
Development of sinusitis
Sinusitis most often occur when due to edema of the mucous membrane "blocked" sinuses and no adequate drainage occurs. Constantly produced mucus is retained in the sinuses, and then promotes the multiplication of the pathogenic microflora. Usually, sinusitis develops against a catarrhal infection, and as a result, viral damage to the mucous membrane of the sinuses develops. In such cases, the diagnosis is catarrhal sinusitis. In the treatment of a common cold, as a rule, inflammation of the mucous membrane of the nasal cavity is accompanied by inflammation of the mucous sinuses. However, due to a number of peculiarities( the structure of the sinus mouth, virulence( aggressiveness) of the microbe), the development of a secondary( bacterial) microflora begins in the sinuses. The process becomes "heavier" and purulent sinusitis develops.
Separately it is worth mentioning "odontogenic" sinusitis ( the cause of inflammation of the mucous membrane of the maxillary sinus lies in the teeth of the upper jaw).As already mentioned, the wells and roots of the teeth can "protrude" into the cavity of the maxillary sinus. When treating these teeth, it is possible to hit the filling material in the bosom, and in itself the material is a foreign body. There is an inflammatory reaction. With prolonged stays in the sinus cavity, a fungal infection can be attached. Any infectious process in the teeth of the upper jaw( periodontitis) also leads to the development of odontogenic purulent sinusitis .
Diagnosis of sinusitis
Diagnosis of acute catarrhal and purulent sinusitis is quite simple. The doctor should carefully examine the patient, examine the nasal cavity and make a radiographic examination of the paranasal sinuses. The accumulation of fluid( pus) in the maxillary and frontal sinuses on the x-ray looks like a "liquid level".In this situation, it is quite easy to understand.
With the chronic diseases of the sinuses, the situation is slightly more complicated: to determine the foreign body, the polyposis process, cysts and other changes it is necessary to perform computed tomography of the paranasal sinuses.
Treatment of sinusitis
Acute catarrhal( viral) sinusitis can also be treated at home. It is sufficient to use drugs that remove the swelling of the mucous membrane and accelerate the removal of stagnant contents( nasol, otrivin, rhinoflumucil, sinupret).It is worse when purulent inflammation develops and it is necessary to go to the polyclinic regularly or even to be treated in a hospital. In this condition, it is necessary to wash the sinuses( by moving liquids or "puncturing" the maxillary sinuses), monitor the effectiveness of treatment, prescribe antibiotics and other drugs( antiallergic, restorative, detoxification).With adequate treatment with acute sinusitis, more than 10-12 days are not affected.
For chronic sinusitis and frontal sinuses that are not amenable to drug treatment, it is necessary to perform the operation.
For chronic inflammation of the mucous membrane of the maxillary sinuses( chronic sinusitis ) it is necessary to perform the operation. The operation is called maxillary sinusotomy .Its purpose is sanation( cleaning) of the sinus. This can be the removal of foreign bodies or fungal colonies, the removal of polypously altered mucosa, the expansion of the natural or the imposition of artificial anastomosis, for better drainage of the sinus cavity. The amount of surgical intervention depends on the extent of the lesion. Most often the process is localized in the maxillary sinuses, but it may be necessary to open the cells of the latticed bone( with etmoiditis), the sphenoid sinus( with sphenoiditis).Again, there are many different methods, from traditional to innovative( endoscopic) methods. Details on the techniques of conducting operations can be obtained at each particular clinic using one or another method. It should be noted that after such operations, the recovery period is short, complications are extremely rare, and most importantly, the effectiveness of these interventions reaches 95-100%
Complications of sinusitis
Complication of acute sinusitis can be a process chronic, and this in turn leads to frequent exacerbations, a feeling of heaviness in the head, increased fatigue. Running processes lead to the degeneration of the mucosa, it becomes nonfunctional - its protective properties are reduced. The condition continues to worsen, neurological syndromes( head and facial pains) develop, ear diseases develop, intracranial purulent complications develop. That is why it is so important to turn to a doctor in time and start treatment for sinusitis.
Prophylaxis of sinusitis
Prevention of of sinusitis and other sinusitis is the same as with other diseases of the upper respiratory tract. Avoid hypothermia, perform general strengthening procedures( sports, hardening).It is necessary to fight with the already begun illness, to put in order immunity. With a cold, it is necessary to fight with it and take medications that reduce the swelling of the nasal mucosa. The most reliable prevention, obviously, is medical supervision.