The diagnosis is confirmed by data transillumination, medical imaging (see sinuses, X-ray diagnosis), ultrasound (see Ultrasound diagnosis). Widely used diagnostic puncture sinus, allows to define the presence of exudate and its character.
Treatment is usually outpatient. It is important to ensure a good flow of content from the affected sinus. In severe and complications hospitalization is shown. In acute exacerbation of chronic sinusitis and sinusitis prescribe antipyretics, sulfa drugs, antibiotics, hyposensitizing, vitamins. Locally applied vasoconstrictors (naphazoline, etc.) that can be used in the form of drops, spray lubrication.
In acute sinusitis use SoLux, diathermy, ultra-high frequency currents, the chronic course - microwave therapy, electrophoresis of drugs (antibiotics, hormones, etc.), diadynamic currents diadynamophoresis, mud, paraffin baths, inhalations and aerosols. For the treatment of chronic sinusitis allergic origin use the tools of non-specific (calcium chloride, antihistamines, etc.) and specific (small doses of allergens, vaccines and autovaccine) desensitization.
Puncture of the maxillary sinus was performed as a diagnostic and therapeutic purposes with a special needle after local anesthesia. Exudate from the sinuses drained and then washed it with using a warm solution of potassium permanganate, Frc, rivanola, romazuoana and other disinfectants. After removal of the washing liquid in the bosom injected antibiotics including sensitivity to them microorganisms, hormones, proteolytic enzymes.
For continuous drainage of the maxillary sinus using various catheters. If conservative treatment is ineffective or there is a risk of complications, have resorted to surgery (maxillary sinusotomy), which aims - to delete the contents of the pathological sinus. Surgical intervention may be intranasal (resection of the medial wall of the sinus in the middle and lower nasal passages), facial (opening in the front wall of the sinuses), combined, or radical (resection of the anterior and medial wall).
The prognosis of acute sinusitis is usually favorable. Recovery in the majority of cases occur in a period of a few days to 2-3 weeks. In chronic sinusitis, uncomplicated, prognosis is generally favorable, depending on the morphological changes and the duration of the process. If there are complications prognosis is determined by the nature of complications.
Prevention is to improve the body's defenses, tempered. To this end, recommended physical education and sports, walking in the fresh air, water treatment. The important role played by treatment of diseases of the nose, nasal congestion associated with impaired (curvature of the nasal septum, chronic rhinitis), dental health. Patients with acute rhinitis should be explained that a strong hit of blowing the nose helps the nasal mucus in the maxillary sinus.
Sinusitis - inflammation of the mucous membrane of the maxillary (maxillary) sinus. There are acute and chronic sinusitis. In children, more frequent acute sinusitis.
Etiology and pathogenesis. Acute sinusitis develops as a complication of acute rhinitis, post-influenza, measles, scarlet fever and other infectious diseases, as well as due to inflammatory diseases of the teeth (odontogenic sinusitis). Precipitating factor may be hypothermia against decrease in reactivity.
Chronic inflammation of the maxillary sinus is usually the result of acute inflammation, especially under adverse conditions to drain accumulated in these pathological secretion. Can contribute to the thickening of the mucous membranes of the nose, nasal turbinate hypertrophy, curvature of the nasal septum, closing or narrowing outlet of the maxillary sinuses - maxillary cleft. Given the penetration of infectious agents, distinguish rhinogenous (mostly adults), hematogenous (mainly in children), and traumatic odontogenic sinusitis.
Funds are also special forms of sinusitis - vasomotor (predominantly in patients suffering from autonomic disorders, characterized by swelling of the mucous membranes of the nose and paranasal sinuses) and allergic.
The clinical picture. For acute sinusitis is characterized by chills, fever, poor general health, headache of varying intensity, often radiating to the forehead, nose and the root of the teeth. Pain in the sinus increases with pressure on its front wall.
By the nature of pain is intense and constant, accompanied by tearing, increased at an inclination of the head, coughing and sneezing. Sometimes join photophobia and excessive tearing. The nose is stuffed up, there is plenty of mucous secretions (catarrhal sinusitis), mucopurulent, purulent character (purulent sinusitis). On the side of sinus reduced sense of smell. With involvement of the periosteum marked swelling and edema of the lower cheek, and sometimes the upper eyelid. Were characterized by the chronic fatigue, malaise, fatigue, headache (usually in the evening), nasal congestion. The sense of smell can be reduced.
For vasomotor and allergic sinusitis is characterized by an undulating course with periodic remissions.
The clinical picture of acute characterized by the same symptoms as in acute maxillary sinusitis.
Complications. Sometimes acute, but more often observed in chronic sinusitis intracranial complications - swelling of the meninges, serous or purulent meningitis, meningoencephalitis, phlebitis sinus dural rhinogenous with the development of sepsis, pachymeningitis, rhinogenous brain abscess - rhinogenous arachnoiditis. They are most frequent during the flu epidemic. Can be observed and complications such as swelling of the fiber jet orbit and eyelids, retrobulbar abscess, osteoperiostity orbit, orbital venous thrombosis, etc. There is also a periostitis of the upper jaw.
The diagnosis of sinusitis is based on clinical picture and data rhinoscopy.
In acute sinusitis detect edema, hyperemia of the mucous membranes of the nose, the middle nasal passage is narrowed, it is visible characteristic strip of mucus or pus. G. In chronic inflammatory changes in addition to the mucous membranes, which are manifested by edema, thickening, cyanosis, often marked hypertrophy of the lower and middle turbinates.
Treatment is usually outpatient. It is important to ensure a good flow of content from the affected sinus. In severe and complications hospitalization is shown. In acute exacerbation of chronic sinusitis and sinusitis prescribe antipyretics, sulfa drugs, antibiotics, hyposensitizing, vitamins. Locally applied vasoconstrictors (naphazoline, etc.) that can be used in the form of drops, spray lubrication.
In acute sinusitis use SoLux, diathermy, ultra-high frequency currents, the chronic course - microwave therapy, electrophoresis of drugs (antibiotics, hormones, etc.), diadynamic currents diadynamophoresis, mud, paraffin baths, inhalations and aerosols. For the treatment of chronic sinusitis allergic origin use the tools of non-specific (calcium chloride, antihistamines, etc.) and specific (small doses of allergens, vaccines and autovaccine) desensitization.
Puncture of the maxillary sinus was performed as a diagnostic and therapeutic purposes with a special needle after local anesthesia. Exudate from the sinuses drained and then washed it with using a warm solution of potassium permanganate, Frc, rivanola, romazuoana and other disinfectants. After removal of the washing liquid in the bosom injected antibiotics including sensitivity to them microorganisms, hormones, proteolytic enzymes.
For continuous drainage of the maxillary sinus using various catheters. If conservative treatment is ineffective or there is a risk of complications, have resorted to surgery (maxillary sinusotomy), which aims - to delete the contents of the pathological sinus. Surgical intervention may be intranasal (resection of the medial wall of the sinus in the middle and lower nasal passages), facial (opening in the front wall of the sinuses), combined, or radical (resection of the anterior and medial wall).
The prognosis of acute sinusitis is usually favorable. Recovery in the majority of cases occur in a period of a few days to 2-3 weeks. In chronic sinusitis, uncomplicated, prognosis is generally favorable, depending on the morphological changes and the duration of the process. If there are complications prognosis is determined by the nature of complications.
Prevention is to improve the body's defenses, tempered. To this end, recommended physical education and sports, walking in the fresh air, water treatment. The important role played by treatment of diseases of the nose, nasal congestion associated with impaired (curvature of the nasal septum, chronic rhinitis), dental health. Patients with acute rhinitis should be explained that a strong hit of blowing the nose helps the nasal mucus in the maxillary sinus.
Sinusitis - inflammation of the mucous membrane of the maxillary (maxillary) sinus. There are acute and chronic sinusitis. In children, more frequent acute sinusitis.
Etiology and pathogenesis. Acute sinusitis develops as a complication of acute rhinitis, post-influenza, measles, scarlet fever and other infectious diseases, as well as due to inflammatory diseases of the teeth (odontogenic sinusitis). Precipitating factor may be hypothermia against decrease in reactivity.
Chronic inflammation of the maxillary sinus is usually the result of acute inflammation, especially under adverse conditions to drain accumulated in these pathological secretion. Can contribute to the thickening of the mucous membranes of the nose, nasal turbinate hypertrophy, curvature of the nasal septum, closing or narrowing outlet of the maxillary sinuses - maxillary cleft. Given the penetration of infectious agents, distinguish rhinogenous (mostly adults), hematogenous (mainly in children), and traumatic odontogenic sinusitis.
Funds are also special forms of sinusitis - vasomotor (predominantly in patients suffering from autonomic disorders, characterized by swelling of the mucous membranes of the nose and paranasal sinuses) and allergic.
The clinical picture. For acute sinusitis is characterized by chills, fever, poor general health, headache of varying intensity, often radiating to the forehead, nose and the root of the teeth. Pain in the sinus increases with pressure on its front wall.
By the nature of pain is intense and constant, accompanied by tearing, increased at an inclination of the head, coughing and sneezing. Sometimes join photophobia and excessive tearing. The nose is stuffed up, there is plenty of mucous secretions (catarrhal sinusitis), mucopurulent, purulent character (purulent sinusitis). On the side of sinus reduced sense of smell. With involvement of the periosteum marked swelling and edema of the lower cheek, and sometimes the upper eyelid. Were characterized by the chronic fatigue, malaise, fatigue, headache (usually in the evening), nasal congestion. The sense of smell can be reduced.
For vasomotor and allergic sinusitis is characterized by an undulating course with periodic remissions.
The clinical picture of acute characterized by the same symptoms as in acute maxillary sinusitis.
Complications. Sometimes acute, but more often observed in chronic sinusitis intracranial complications - swelling of the meninges, serous or purulent meningitis, meningoencephalitis, phlebitis sinus dural rhinogenous with the development of sepsis, pachymeningitis, rhinogenous brain abscess - rhinogenous arachnoiditis. They are most frequent during the flu epidemic. Can be observed and complications such as swelling of the fiber jet orbit and eyelids, retrobulbar abscess, osteoperiostity orbit, orbital venous thrombosis, etc. There is also a periostitis of the upper jaw.
The diagnosis of sinusitis is based on clinical picture and data rhinoscopy.
In acute sinusitis detect edema, hyperemia of the mucous membranes of the nose, the middle nasal passage is narrowed, it is visible characteristic strip of mucus or pus. G. In chronic inflammatory changes in addition to the mucous membranes, which are manifested by edema, thickening, cyanosis, often marked hypertrophy of the lower and middle turbinates.
No comments:
Post a Comment