Sinusitis -Nasal Sinusitis :What is Sinusitis?
Sinusitis is a non-specific inflammation of the sinus mucosa as a Rhinology common illnesses. Sinusitis is a common disease, can be divided into acute and chronic types, acute purulent sinusitis mostly secondary to acute rhinitis, nasal obstruction, and more purulent nasal discharge, headache as the main feature; often secondary to chronic purulent sinusitis acute purulent sinusitis multi Nongti mainly, stuffy nose, headache and smell disorders may be associated with varying severity. Usually pay attention to exercise, work and rest, modest clothing, and more than a breath of fresh air to avoid a dry nose, not easily drop by intranasal administration. Timely diagnosis and treatment of nasal lesions adjacent focal infection requiring treatment.
One or more sinus inflammation known as sinusitis, sinusitis is an inflammation of the sinus mucosa. Involving the sinuses include: maxillary, ethmoid, frontal and sphenoid sinus, which is a higher prevalence in the population disease that affects the quality of life of the patients. Sinusitis can be divided into two kinds of acute and chronic sinusitis. Sinusitis can be single and also multiple. The most common causes of nasal sinus purulent inflammation secondary to infection. In addition, allergy, mechanical obstruction and air pressure change, etc. easily induced sinusitis, dental infections can cause odontogenic maxillary sinusitis.
Sinusitis can be divided into two kinds of acute and chronic sinusitis. Acute sinusitis <12 weeks duration, mainly sustained heavier upper respiratory infection symptoms, including nasal blockage, purulent nasal discharge, headache. Chronic sinusitis duration> 12 weeks. In addition, the swimming, the sewage into the sinuses, the spread of infection to neighboring organs nasal tumors obstruct sinus drainage, as well as the trauma can be caused by sinusitis.
Sinusitis - PathogenesisSinusitis Sinusitis etiology: mechanical blockage some diseases of the nasal cavity, such as a deviated nasal septum, middle turbinate hypertrophy, nasal polyps, allergic rhinitis, nasal foreign bodies or nasal tumor directly plug the sinus openings caused by sinusitis.
Sinusitis etiology, allergic reactions: allergic rhinitis or other allergic diseases, turbinate the mucosal height edema, edema of the mucosa can cause sinus ostium congestion caused by sinusitis. Sinus mucosal allergic changes, this inflammation is easier to secondary bacterial infection.
Sinusitis etiology, infection: mainly occurs after a cold, not treated in a timely manner, or not thoroughly inflammation from the nasal sinuses and surrounding tissue and spread to the cause. Cold, such as repeated unhealed, and the emergence of a persistent runny nose, nasal congestion, shortness of breath, coughing, headaches, snoring and other circumstances, about a week into acute sinusitis.
Sinusitis - pathophysiologicalEarly the acute catarrhal period, mucosal brief anemia, followed by vasodilation, increased permeability, mucous membrane irritation, epithelial swelling, bradykinesia ciliated epithelial lower polymorphonuclear leukocytes and lymphocytes, secretions of serous or mucinous. Into purulent period after aggravating sinus mucosal edema and blood vessels to dilate, more obvious inflammatory cell infiltration, secretion becomes mucopurulent more time passes, the more severe hyperemia, capillary bleeding, due to edema oppression, lack of blood supply, ciliated epithelial cell necrosis, this time secretions can occur as a yellow pus. The small number of cases the sinus wall osteitis, osteomyelitis and other complications can occur, is generally more common in young children.
Sinusitis - pathogenesisThe sinus of the gas-filled cavity in the skull, these cavities coated mucosa. Sinusitis represents the cavity mucous membrane swelling and inflammation. The most common causes of nasal sinus purulent inflammation secondary to infection. In addition, allergy, mechanical obstruction and air pressure change, etc. easily induced sinusitis, dental infections can cause odontogenic maxillary sinusitis.Sinusitis suffer from factors including the patient's physical, environmental factors, bacteria virulence with genetic traits in patients with sinonasal anatomical structure abnormalities, allergic factors is also one of the important reasons. In a variety of sinusitis, maxillary sinusitis, the most common, followed by the ethmoid, frontal and sphenoid sinus inflammation. The highest incidence of maxillary sinus due to the larger sinuses, sinus floor lower, while higher ostium, easy empyema, and living in the sinus below easily elsewhere inflammation infection, so the maxillary sinusitis. Severe sinusitis can be associated with the corresponding osteomyelitis or orbital and intracranial infection complications, severe cases can even be fatal. Sinusitis can be single and also multiple.
Sinusitis - pathology classificationSinusitis Acute sinusitis often after a cold nose blockage, increased purulent nasal discharge, hyposmia and headache. Headache parts in the former group sinuses (maxillary, frontal, anterior ethmoid) inflammation the forehead; inflammation of the group after sinus (posterior ethmoid and sphenoid) for the top of the head or occipital headache. The different sinus inflammation headache performance different example, the frontal sinus inflammation multi morning not long ago frontal headache, and gradually increased, and the afternoon alleviate. Acute sinusitis patients may be associated with symptoms of fever and general malaise. Visible nose or nasal endoscopy nasal congestion and swelling, purulent secretions in the nasal passages or the olfactory cleft the respective sinus area tenderness, help diagnose sinus X-ray film. Systemic antibiotics and sulfa treatment, intranasal vasoconstrictors, physical therapy, and Chinese medicine treatment has some effect. Maxillary sinus empyema can be used for maxillary sinus puncture, to flush out the pus and injection of anti-inflammatory drugs.
Chronic sinusitis and nasal symptoms like acute sinusitis, but no systemic symptoms, longer duration, can be a headache, there will be no headache. See in the nasal passages or the olfactory cleft nasal examination purulent secretions, mucosal thickening or polypoid changes of the middle turbinate and nasal passages, sinus X-ray film of great help in the diagnosis. Intranasal drops vasoconstrictor favor the of ventilation and Nongti drainage of the sinus, and also in conjunction with oral medicine. Multiple sinusitis can be used for the female pressure replacement therapy for maxillary sinus puncture purulent maxillary sinusitis. Nasal polyps, middle turbinate hypertrophy, deviated nasal septum, adenoidal hypertrophy mechanical obstruction factors, hinder ventilation and drainage of the sinuses, so difficult to cure inflammation, surgical therapy can be used, such as nasal polyp excision, nasal A resection surgery, nasal surgery, adenoid resection. Difficult to cure chronic sinusitis sinus surgery therapy available.
Lung by wind-heat type: card, see the operator plugs, the sticky snot yellow or white, the amount, fever, chills, headache, sore adverse reddish tongue, thin white fur or yellowish, floating pulse.The gall House swelter type: card, see the stuffy nose, snot-yellow cloud viscous samples such as pus, odor, smell, headache, and affected area severe pain and fever, mouth and throat pain, irritability, red tongue, yellow moss, pulse a few strings.Spleen by damp-heat: Certificate see snot yellow while the amount of stuffy nose heavy and sustained, olfactory difference and see the fever, head weight, such as wrap, body tired limbs heavy, chest tightness, abdominal distension, appetite appetite, yellow urine, red tongue, thick yellow greasy moss pulse number or slip number.Lung spleen deficiency type: card, see really plugs heavier, snot sticky white or yellow thick amount, smell, dizziness, Touzhang, short of breath, fatigue, cough and sputum white, eat less bloating, loose stools, pale tongue, white coating weak pulse.Stagnant Heat each node type: card, see the stench nasal congestion, runny turbid nasal discharge, the amount of multi-color yellow, and does not smell grow on trees, with headache, dry mouth, and do not want to drink, greasy yellow tongue coating, slippery pulse number.
Sinusitis - complicationsSinusitis Sinusitis pathogenesis of nasal cavity and paranasal sinuses in the brain following living in the throat and mouth above, is located in between the two eyes of their mutual neighbor relationship. Nasal and sinus disease often spread to nearby tissue, which will cause a variety of complications. Extend the brain, can cause serious death throat orbital penetration, can also cause various diseases, especially for children, complications will affect the physical and mental development. Rhinitis, sinusitis cause complications in a variety of ways:
(1) direct infection: the nose and the mouth, throat, and lower respiratory tract and the digestive tract is directly connected, rhinitis, sinusitis secretions down drainage, directly stimulate these organizations, cause a variety of diseases.
(2) destruction of bone wall infection: sinusitis disease destruction sinus bone wall, inflammation often thus extended to other organizations, because sinuses different positions, it is also different cause complications, such as frontal sinusitis caused by orbital or intracranial complications; ethmoid sinusitis destroy the top wall of the invasive front fossa, through the side wall occurred orbital complications. Sphenoid sinusitis destroy the base of the skull can cause different complications within the brain can also cause retrobulbar neuritis. Maxillary sinusitis can cause complications such as orbital infection and the alveolar thin tube.
③ blood line infections: nasal cavity and sinuses have a rich vascular network, and orbital and intracranial complex, rhinitis and sinusitis bacteria and toxins, and damages the formation of blood clots intimal emboli with hematogenous spread other organs, causing complications.
The ④ via lymphatics infection: nasal or sinus lymphatic direct inflammatory substances spread to other organs or tissues incidence.
⑤ by the anatomical Channel: sinus bone wall many normal channels such as the ethmoid bone on the wall with many small holes, said sieve, mainly the channels leading to intracranial olfactory nerve fibers, the inflammation can be passed from sieve intracranial incidence . In addition, many blood vessels of the nasal cavity and paranasal sinuses directly with orbital and intracranial interlinked, the inflammation can cause complications along the vascular channels.
⑥ sinuses on the wall close to the eyes, when the the sinusitis onset, often cause serious complications of pharynx common orbital apex syndrome, retrobulbar optic neuritis.
⑦ sinus trauma: fracture caused by a fracture, penetrating injury or surgery damage due to bone wall, tissue destruction, and the incidence of invasive infections easy.
The sinusitis - Children sinusitisSinusitis sinusitis in children is the pediatric common, but not typical symptoms of sinusitis in children, the children can not accurately express the disease, as well as inexperienced clinicians, and its diagnostic rate lower than the actual incidence.
First manifested as headache or dizziness, sinus unique anatomical characteristics due to the children, so that part of sinusitis in children even always only headache symptoms atypical of nasal congestion, runny nose, ear fullness. Some children because of their age, will not be an accurate account of the above symptoms, often delay the correct diagnosis and treatment. Parents headache confined to one side, and the continued progress of the children, regardless of the presence or absence of obvious symptoms of Otolaryngology, ENT shall be to conduct detailed inspections, especially intranasal microscopy.
Sinusitis - chronic sinusitis disease IntroductionChronic sinusitis (chornic sinusitis) for chronic suppurative inflammation of the sinuses. More common than acute, often multiple sinus involvement.
Classification of Diseases
A simple chronic sinusitis
1: single sinusitis;
2: multiple sinusitis;
3: the whole group sinusitis.
2, chronic sinusitis and nasal polyps
1: single sinusitis associated with a single nasal polyps;
2: multiple sinusitis associated with multiple nasal polyps;
3: full set of sinusitis associated with multiple nasal polyps.
3, of multiple sinusitis or group of sinusitis associated with multiple, recurrent nasal polyps and / or ethmoid hyperostosis
Pathological classification
Acute sinusitisOften occur after a cold and nasal congestion, purulent nasal discharge increased, hyposmia and headache. Headache parts in the former group sinuses (maxillary, frontal, anterior ethmoid) inflammation the forehead; inflammation of the group after sinus (posterior ethmoid and sphenoid) for the top of the head or occipital headache. The different sinus inflammation headache performance different example, the frontal sinus inflammation multi morning not long ago frontal headache, and gradually increased, and the afternoon alleviate. Acute sinusitis patients may be associated with symptoms of fever and general malaise. Visible nose or nasal endoscopy nasal congestion and swelling, purulent secretions in the nasal passages or the olfactory cleft the respective sinus area tenderness, help diagnose sinus X-ray film. Systemic antibiotics and sulfa treatment, intranasal vasoconstrictors, physical therapy, and Chinese medicine treatment has some effect. Maxillary sinus empyema can be used for maxillary sinus puncture, to flush out the pus and injection of anti-inflammatory drugs.
Chronic sinusitis
Nasal symptoms like acute sinusitis, but no systemic symptoms, long duration, can be a headache, there will be no headache. See in the nasal passages or the olfactory cleft nasal examination purulent secretions, mucosal thickening or polypoid changes of the middle turbinate and nasal passages, sinus X-ray film of great help in the diagnosis. Intranasal drops vasoconstrictor favor the of ventilation and Nongti drainage of the sinus, and also in conjunction with oral medicine. Multiple sinusitis can be used for the female pressure replacement therapy for maxillary sinus puncture purulent maxillary sinusitis. Nasal polyps, middle turbinate hypertrophy, deviated nasal septum, adenoidal hypertrophy mechanical obstruction factors, hinder ventilation and drainage of the sinuses, so difficult to cure inflammation, surgical therapy can be used, such as nasal polyp excision, nasal A resection surgery, nasal surgery, adenoid resection. Difficult to cure chronic sinusitis sinus surgery therapy available.
Sinusitis - hazardSinusitis Sinusitis great harm to the body. It can cause of headache, Touyunnaozhang, insomnia, forgetfulness, upset, easy to get angry, gradual decline in student achievement, drowsiness, apathy, lack of concentration. It can also become a lesion affecting the surrounding tissue inflammation, especially the eye, such as the center of retinitis. Patients with long-term low-grade fever, multi diagnosis and treatment is not effective, after the ENT consultation diagnosed with chronic maxillary sinusitis, were recovered.
Sinusitis relatively large impact on people's daily lives, sinuses like respiratory guards, once a problem will affect the function of the lungs, trachea and lower respiratory tract, but also affect the surrounding tissue, such as the brain, eyes, etc. if the condition is serious, and can also cause complications endanger the lives and safety of people, and the incidence is relatively high, especially large proportion of young people, affect learning and work, should be treated early.
Without formal treatment of acute sinusitis often into chronic sinusitis, acute sinusitis can also outward diffusion caused by otitis media, pharyngitis, tonsillitis, and sometimes cause rare orbital infection. Chronic sinusitis patients often flow purulent nasal discharge, headache, memory loss, causing much inconvenience to the life, work and influence. Pus to spread around, can lead to infection of the surrounding tissue, and even can cause serious consequences such as blindness, meningitis, brain abscess.
Sinusitis If you do not do the processing or processing improper easy concurrent otitis media, sinusitis, bronchitis, maxillary osteomyelitis, orbital cellulitis, meningitis, optic neuritis with severe complications.
Sinusitis is one of the main symptoms of headache. Sinusitis caused headaches multi-attack during the day, headaches location and time of relatively stable, law, early showed diffuse headache, late often with the onset of sinus pain and confined to certain parts. Sinusitis caused headaches often accompanied by nasal congestion, runny nose, olfactory disorders, stoop, bow, turn the body headache obvious change. Patients suffering from sinusitis, especially in patients with acute sinusitis, headache than significant. Because the sinusitis headache caused by the pain caused to the patient is huge, often accompanied by nausea, irritability, mood swings, and other symptoms, persistent or intermittent headaches seriously affect the patient's work and the quality of life.
Sinusitis - diagnosis to identify1. Typical symptomsThe main symptoms: nasal congestion, purulent nasal discharge;Secondary symptoms: head and facial puffiness and oppressive, smell change.2 signs1) local swelling, tenderness: acute sinusitis lesions close to the skull surface, skin and soft tissue lesion may occur redness, inflammation spread to the periosteum, sinus corresponding parts of the surface projection tenderness. After the group of acute sinusitis due to the deeper position, no swelling or tenderness on the surface.2) nasal examination: nasal mucosal congestion and swelling, especially in the middle turbinate in the nasal passages and the olfactory cleft, etc. is obvious. The former group sinusitis can be seen in the nasal passages empyema, sinusitis Visible the olfactory cleft empyema, or pus from the top of the stream to choanal latter group.3. Laboratory examinations1) nasal endoscopy: nasal visible pus, nasal mucosal congestion and edema.2) postural drainage: If suspected sinusitis, nasal passages did not check to see pus feasible postural drainage test to help diagnose.3) X-ray sinus radiography: diagnostic X-line the nose the chin-bit and the nasofrontal bit radiography helps, acute sinusitis sinus mucosal swelling, sinus opacity, transmittance weakened, sometimes visible liquid level. Due to the skull overlap observe ineffective.4) sinus CT: visible the paranasal sinuses fluid plane or soft tissue density. CT because of its high resolution observation of the lesions are more detailed and comprehensive, it is a good indicator for the diagnosis of acute sinusitis.5) sinus MRI: visible the sinuses within long T2 signal, can identify with sinus soft tissue phase.4. Disease identificationMain cause headaches differentiated from other diseases, such as migraine, intracranial tumors; stuffy to be differentiated sinonasal tumors, nasal refurbishment papilloma, nasal squamous cell carcinoma, pathological diagnosis is clear.
To sinusitis - disease treatment
Systemic therapy: sufficient quantities of antibiotics to control infection, mostly bacterial infections, as the drug of choice to penicillins, cephalosporins, medication stressed choose sensitive antibiotics, sufficient amount of use of the full course of treatment. Headache or severe local pain, it may be appropriate to use sedatives or analgesics. General therapy and acute rhinitis. The TCM treatment mainly scattered wind heat, aromatic Tongqiao, supplemented detoxification Quyu.
2. Improve sinus drainage: commonly used drugs intranasally with 1% ephedrine, shrink nasal improve drainage. Acute sinusitis by postural change sinuses and improve the ventilation, drainage and relieve headaches.
Maxillary sinus puncture surgery: acute maxillary Douyan Yi systemic symptoms subsided into effect after local acute inflammation control. After washing injection antimicrobial solution, 1-2 times a week.
4. Sinus replacement therapy: use of sinusitis in children.
5. Odontogenic maxillary sinusitis and dental treatment.
Mucus chelating agent can use improve secretions traits and easy to discharge.
Can be applied nasal topical steroid or systemic corticosteroids to improve the state of local inflammation, enhance drainage.
Surgery: acute sinusitis in drug control are not satisfied or complications of endoscopic sinus surgery can be used, by endoscopic guidance directly to lesions, open sinuses mouth, remove the lesion, and improve local drainage, and thus restore sinus normal physiological function.
9. Surgical treatment1) The intranasal endoscopic sinus surgery: is now the preferred method. Endoscopic sinus photopic completely clear the sinus lesions, fully open the sinus ostium and improve sinus drainage, and sparing normal tissue as much as possible, as far as possible to retain the functionality of minimally invasive surgery.2) other surgical: maxillary sinus nasal fenestration, radical maxillary surgery, intranasal ethmoidectomy, nasal ethmoidectomy, frontal drilling surgery incision, frontal, sphenoid cut The surgery (sphenoidotomy).For patients with a diagnosis of chronic sinusitis, recommended treatment program should be: the first drug treatment (including local and systemic), in the case of drug therapy sinus CT scan, the image changes and indications for surgery, endoscopic sinus surgery.
he sinusitis - Clinical performanceSinusitis patients suffering from sinusitis, the following symptoms occur:1. Sinusitis often secondary to the flu or acute rhinitis, when aggravated existing symptoms, chills, fever, loss of appetite, constipation, aches and discomfort. Can occur in children, vomiting, diarrhea, coughing and other symptoms.2. Multi - side persistence can occur even with bilateral persistent nasal obstruction can occur.3. Increased in patients with purulent nasal and difficult to blow the best, such as backward into the pharynx and lower respiratory tract, stimulate the pharyngeal and laryngeal mucosa, causing hair the library, cough and expectoration, and even nausea.4. Forehead pain, early morning light, weighing afternoon. May also have cheek pain or above molar pain, many maxillary sinusitis.5. Pain, the morning sense forehead Ministry gradually Zhejiang heavier in the afternoon to reduce disappear all night, this may be frontal sinusitis.6. Mild headache confined to the inner canthus or nasion Ministry, may also radiate to the top of the head, buggy ethmoid sinusitis cause.7. Eye depths of pain that may radiate to the head at the top, and also the concept of morning light and heavy afternoon occipital headache, Tat may sphenoiditis8. Chronic sinusitis and nasal congestion, runny nose, headache and other symptoms, have the following characteristics:(1) mild headache, general the mostly Mentong, dull.(2) hyposmia or disappear.(3) rest, intranasal drug, relieve headaches after steam inhalation or nasal ventilation drainage.(4) cough, bow, bend over, and exertion headache heavier.(5) smoking, alcohol consumption, headache emotional dissecting weight.
9. Sinusitis is a common disease, sinusitis If you do not do the processing or handling improperly complicated by otitis media, sinusitis, bronchitis, maxillary osteomyelitis, orbital cellulitis, meningitis, optic neuritis, severe complications.
