Sinusitis - Causes, Symptoms and Treatment .MF .
Sinusitis - one of the types of sinusitis, which is characterized by inflammation of the maxillary sinus (maxillary sinus).Sinusitis is an acute or chronic inflammation of the maxillary sinus.disease takes its name from the sinuses, which causes loss disease (maxillary sinus medicine called maxillary, these are the sinuses on either side of the nose, just below the eye).The inflammatory process affects one or both maxillary sinuses.
maxillary sinuses lie in the interior of the maxillary bone.In sinus common wall with the oral cavity, nasal cavity, the eye socket.Like all the other paranasal sinuses, the maxillary sinus inside is lined with a thin layer of cells (epithelium, mucous membrane), located on the thin layer of connective tissue adjacent to the bone itself.During acute sinusitis (acute sinusitis) inflammation captures the main layer of epithelial cells and lying underneath the loose tissue and blood vessels.In chronic sinusitis the inflammatory process extends to the submucosa and bone sinus
Sinusitis may develop at any age, including children and there.The incidence of sinusitis is significantly increased during the cold season.
Causes of sinusitis
Sinusitis can be triggered by a number of factors.In its development of the important role played by various upper respiratory tract infection, abnormal processes that occur in the nose, mouth, pharynx.Sinusitis often occurs during acute rhinitis, influenza, measles, scarlet fever and other infectious diseases, as well as due to the root of the disease back four upper teeth.
main cause of sinusitis is infection - bacteria or viruses enter the maxillary sinus through the nasal cavity or through the bloodstream and cause inflammation.The body with a weakened immune system unable to fight such viruses.
Factors predisposing to sinusitis:
- states that violate the nasal breathing: deviated septum, vasomotor rhinitis, hypertrophic rhinitis (nasal turbinate increase) in children - adenoids, allergic diseases of the nose.
- immunity disorders, which result in long-term chronic diseases, parasitosis, allergic conditions, and others.
- untimely or incorrect treatment of the common cold, acute respiratory infections, rhinitis.
- of bacteria (the existence of the body of foci of chronic infections, such as staph).Many of you are familiar with the procedure med.osmotra when doctors take swabs from the nose to the bacteriological crops.Often, the patient discover the so-called staph, which for a long time lives in the nasopharynx of man.The latter had not passed inspection - would not know that he - bacillicarriers.For a long time, these bacteria can not bring serious damage to health.but even the common cold aureus can be activated and show their pathogenic properties.
- Congenital malformations of anatomical structures of the nasal cavity.
- difficulty in nasal breathing due to nasal turbinate hypertrophy, adenoidectomy (in children).
main causes of acute sinusitis - this ARI (influenza, parainfluenza, measles), the spread of infection from diseased teeth (odontogenic sinusitis), allergies (allergic sinusitis), and other viral and bacterial infections.Virtually all viruses affecting the upper respiratory tract (pathogens SARS) can cause sinusitis.The epithelium of the paranasal sinuses is very similar to the airway epithelium, and therefore during the acute respiratory disease and captures this part of the respiratory tract.If the nasal mucous membrane damage causes acute rhinitis and rhinitis, the defeat of the mucous sinus - sinusitis, which is also accompanied by secretions of the mucous fluid.Viral infections (influenza, parainfluenza, adenoviroz) provoke acute forms of sinusitis and never cause chronic disease.The main role in the development of chronic sinusitis plays a bacterial infection (streptococci, staphylococci), as well as chlamydia and mycoplasma.Often a bacterial infection is replacing virus.
Pediatric sinusitis is often caused by mycoplasma or chlamydia infections.This fact should be taken into account in the diagnosis and treatment (particularly in children), since these pathogens are not sensitive to antibiotics of b-lactams (penicillins, cephalosporins), and therefore even after a course of treatment with these antibiotics improve the health status of the patient is observed.Treatment microplasma or chlamydial sinusitis is preferably carried out macrolide antibiotics (azithromycin, Sumamed, Erythromycin, etc..).
Disorders ENT - it is the second leading cause of sinusitis.Acute and chronic rhinitis can lead to sinusitis because of the blockage of the output opening of the maxillary sinus (maxillary sinus cavity connects with the nasal cavity) through which the drainage and cleansing the sinuses.The reason for closing the output openings of the maxillary sinus rhinitis is a swelling of the nasal mucosa.It is for this reason that in the treatment of acute rhinitis (runny nose), it is recommended to use a vasoconstrictor drugs, which not only eliminates the common cold, but also to relieve swelling of the nasal mucosa, which in turn contributes to the normal cleansing of the maxillary sinus and protects it from inflammation.
Chronic tonsillitis may be a source of infection, which is entered in the maxillary sinus with nose blowing nose.Such a relationship of chronic tonsillitis and sinusitis is confirmed by the high incidence of sinusitis in patients with chronic tonsillitis or sore throat with frequent relapses.
chronic pharyngitis, as well as chronic tonsillitis may play the role of the source of infection.
deviated septum can cause sinusitis because of the abnormal narrowing of a new stroke and impaired drainage and ventilation of the maxillary sinus.For sinusitis, arising due to the curvature of the nasal septum is typical for very stubborn and frequent relapses after taking a course of treatment.On the other hand, in patients with a curvature of the nasal septum, the problem can be solved by the operation to restore the normal structure of the nasal septum.
Diseases teeth (caries, pulpitis) can lead to sinusitis in the case of infection of the patient's tooth directly into the maxillary sinus.The pathology of the teeth and the maxillary sinus is closely linked especially in the case of the upper jaw teeth, roots, some people grow directly into the cavity of the maxillary sinus.
allergy is the cause of allergic sinusitis.Typically, this form of the disease occurs in people suffering from hypersensitivity to any allergen.Simultaneously with allergic sinusitis may experience allergic rhinitis, allergic conjunctivitis.
Chronic sinusitis develops due to undertreated acute sinusitis and characterized by long bacterial purulent inflammation of the maxillary sinuses.
Other causes include chronic foci of infection in the mouth and nose (chronic tonsillitis, chronic pharyngitis, adenoids, chronic rhinitis).
The cause of odontogenic sinusitis may be carious teeth of the upper jaw, and granullemy radical cysts, fistulae of the oral cavity in the maxillary sinus through the hole tooth extraction, periodontal disease, sinus foreign bodies (tooth root filling material, and so on. D.).Odontogenic sinusitis often from the very beginning take a sluggish chronic.
As a result of the destruction of the walls of the sinus malignant tumors and subsequent infection is often severe symptoms of chronic sinusitis, which often masks the clinical picture of the tumor itself.Chronic sinusitis often arise as a result of injuries sustained when his bosom get foreign bodies and bone fragments.In recent years, cases of allergic nature of occurrence of sinusitis.
main link mechanism of development of both acute and chronic sinusitis - a blockage of the outlet opening of the maxillary sinus, which leads to its inflammation and accumulation of pus in the sinus.Blockage of the maxillary sinus opening arises, for example, against acute respiratory disease due to swelling and inflammation of the nasal mucosa, or by chronic rhinitis, thickening of the nasal mucosa.
Symptoms of sinusitis
Symptoms of sinusitis can be quite varied and not always suggest an inflammation of the maxillary sinuses, the symptoms of sinusitis depend on the stage and form of the disease.
Symptoms of acute sinusitis
main clinical symptoms in acute sinusitis are: a feeling of pressure and tension in the area of the affected sinus, in more severe cases are joined severe pain, localized often not only within the maxillary sinus, and in the forehead, zygomatic areararely temple, capturing the entire half of the face (at one-sided process) or the entire front surface (at the bilateral process).These symptoms are often joined by toothache in the corresponding half of the maxilla, aggravated by chewing.Pain depends on infectious neuritis of the branches of the trigeminal nerve, and compression of the nerve collateral edema.Patients with sinusitis nasal breathing is disrupted and there nasal discharge.
appears discomfort in the nose and paranasal area, which is gradually increasing.Less pronounced pain in the morning, picking up - by the evening.Gradually, the pain of "losing" a certain place and the patient begins to get a headache.If the process is one-sided, then the pain marked on one side.
One of the classic symptoms of sinusitis is considered headache .The emergence of a headache due to the accumulation of pus in the inflamed sinus.Headache with pressing sinusitis is often located in the forehead, "behind the eyes."Often, patients may describe the pain that increases when pressing on the infraorbital region, or when lifting the eyelids.Another characteristic of the sinus headache is its noticeable relief in the lying position, or through the night, due to the release of pus from the affected sinus.
difficulty in nasal breathing .The patient has a stuffy nose.The voice becomes nasal tone.As a general rule laid down both halves of the nose.The difficulty of nasal breathing or constant with little relief.Available Alternate right and left nasal nose halves.
Runny .In most cases, the patient is slimy (transparent) or purulent (yellow, green), discharge from the nose.This symptom can not be, if strongly stuffy nose, as difficult outflow of sinus (it was mentioned above).
Increase in body temperature up to 38 and above.Usually this symptom is observed in acute maxillary sinusitis.In chronic course of body temperature rises rare.
Another symptom of sinusitis - malaise.This is expressed by fatigue, weakness, patients refuse food, they have disturbed sleep.
There are complaints of symptoms such as photophobia, lacrimation on the affected side, decreased sense of smell.In the early days of the disease, especially in purulent sinusitis and mixed forms, there is an increase in body temperature, chills, general state of disorder.Observed swelling cheek on the affected side, and sometimes collateral edema of the lower eyelid.
In the case of acute respiratory symptoms of sinusitis are superimposed on the symptoms of a respiratory infection, sinusitis triggers development.The first symptoms - fever, malaise, chills, nasal congestion, runny nose, sneezing.Fairly quickly to the described symptoms of sinusitis joins pain in the face, extending to the teeth, the root of the nose, forehead.Pain increases when pressing on the infraorbital area of the face (especially pain in the sinus and one of the symptoms indicative).In some cases, there may be swelling of the eyelids and redness of the eyelids.
course of acute sinusitis takes 2-3 weeks and usually ends in recovery.
Symptoms of chronic sinusitis
Symptoms of chronic sinusitis may be erased and Just noticeable that often delays the diagnosis and treatment of disease.The main symptom - a chronic runny nose, do not respond to conventional treatment.Patients often complain of headaches and pain in the back of the eye sockets.Such pain may be aggravated by blinking and tested in the supine position.A characteristic feature of chronic sinusitis - morning swelling of the eyelids and conjunctivitis (inflammation of the conjunctiva of the eye) - a sign of the spread of an inflammation of the maxillary sinus on the wall of the orbit.
Chronic sinusitis is characterized by recurring dull pain in the infraorbital region, chronic nasal congestion (often unilateral), chronic conjunctivitis, headache (headache settles down in a prone position).An important symptom is considered to be a dry chronic cough not responding to treatment antitussive and expectorant.The occurrence of cough in chronic sinusitis is due to irritating pus flowing from the affected sinus on the wall of the pharynx.
For both types of sinusitis (acute and chronic) is characterized by blunting the sense of smell.The course and prognosis of the disease depends on the quality of treatment and structural changes of the maxillary sinus.
forms of chronic sinusitis
subjective symptoms of chronic sinusitis in many respects depend on the form of sinusitis.In exudative forms one of the main complaints - long single or double-sided cold.Character discharge (pus, mucus, watery discharge) depends thus on the form of sinusitis.When purulent sinusitis discharge often has an unpleasant odor;with scanty feeling sick this odor is the only symptom of the disease.In other cases, mucous discharge, viscous (catarrhal form).
When serous exudate form a watery character.The difficulty of nasal breathing is typical for both productive and for exudative and mixed forms.
special dry throat, frequent expectoration, copious mucous or muco-purulent sputum in the morning and during the day, often retching occur in difficulty outflow of secretion from anterior sinus due to hypertrophy of the anterior end of the middle shell, or the presence of polyps.Pain in chronic cases do not reach the same intensity as in the acute processes.Headaches are often lacking;in cases with persistent nasal congestion, they are more likely to diffuse, uncertain, but may be localized to the affected side - in the area of the jaw sinus, in the temple or eye socket, at least in the area of the forehead - or have the character of trigeminal neuralgia.
with chronic inflammation are associated complaints of memory loss, fatigue, especially in the mental work.The sense of smell can be reduced and even absent.Objectively marked swelling of the cheeks and eyelids.There is a corresponding rinoskopicheskaya picture.
Treatment in mild cases can be conserved in the form of washes after the maxillary sinus puncture from the lower nasal passage and implementation of solutions in the bosom of antiseptics, antibacterials, antifungals, and antihistamines in combination with UHF-therapy or diadynamic current.The basic principle of the surgery in the sinus is the creation of a permanent broad message of the maxillary sinus to the nasal cavity.This can be done either vnenosovym or intranasally.
Underlying retsidirovaniya edematous catarrhal forms after surgery may be an allergic basis in their development.After the operation, over the bandage on his cheek put an ice pack for 1-2 days with breaks in 1 / 2-1 hour to reduce the swelling of the cheeks.Unlike Irrigation washing may reduce a thick consistency nasal secretions, but does not solve the problem with their removal along with harmful bacteria.After irrigation mucous dries quickly, which further aggravates the cold, provokes edema.Modern technique involves rinsing the nasal passages with special antiseptic.For example, the components of the preparation "Dolphin" get to the sinuses, diluting mucus clots and naturally taking them out.