Sinusitis, symptoms and treatment of sinusitis 47623 12

Etiology and pathogenesis

Acute G. often develops after influenza, acute catarrh of the upper respiratory tract, rhinitis, measles, scarlet fever and certain other diseases, as well as in inflammatory diseases of the teeth. Less commonly, acute G. develops with injuries to the upper jaw, operations on the alveolar process or in the nasal cavity. The provoking factor may be hypothermia against the background of decreased reactivity of the body. Hron, inflammation of the maxillary sinuses is usually a consequence of acute inflammation, especially under unfavorable conditions for the outflow of patol secretions accumulated in them. This can be facilitated by thickening of the nasal mucosa, hypertrophy of the conchae, curvature of the nasal septum, closing or narrowing the outlet openings of the maxillary sinuses.

During bacterial examination, streptococci, staphylococci, diplococci and other microorganisms are found in the contents of the sinuses or rinsing waters. In some cases, bacterioscopy reveals yeast-like fungi.

During an influenza outbreak, viruses are detected, and less often antibodies to them.

Taking into account the routes of infection, they distinguish between rhinogenic (usually in adults), hematogenous (mainly in children), odontogenic and traumatic. There are also special forms of G. - vasomotor and allergic. Vasomotor hypertension develops in people with an unstable nervous system, when, under the influence of negative emotions, vasodilation occurs, causing swelling of the mucous membranes of the nose and paranasal sinuses. Allergic G. is based on an allergic reaction in the tissues of the maxillary sinus.

Treatment of the disease

The initial stage of the disease is best treated. The detection of pathology at the initial stage has increased with the advent of high-tech diagnostic methods:

• MRI;
• RCT;
• endoscopy.

Treatment of sinusitis in adults includes the following conservative methods of therapy:

• medication;
• physiotherapy.

Drug therapy

To treat sinusitis, the doctor selects an individual regimen using:

• antibiotics;
• corticosteroids;
• antihistamines;
• decongestants (vasoconstrictors).

In order to improve the outflow of sinus contents, drops with anti-edema and vasoconstrictor properties are used. To eliminate pathogens, drops with an antibacterial effect are prescribed. In adult patients, self-washing of the sinuses is not prescribed, as it is ineffective and can lead to compression of the vertebral artery.

Antibiotics for sinusitis are selected by the doctor. They are administered in the form of rinsing solutions, drops or injections. Antibiotics in the treatment of pathology of the maxillary sinuses are prescribed after determining the type of pathogen and determining its sensitivity to the drug.

To facilitate expectoration of secretions flowing into the oropharynx, the ENT doctor may prescribe mucolytic drugs. Treatment must be comprehensive, phased, and regular.

Physiotherapy

Physiotherapy enhances the effect of drug therapy and reduces treatment time. The complex prescribes:

• electrophoresis;
• magnetic therapy;
• UHF.

Warming up the sinuses is dangerous during a purulent process.

Surgical exposure

Surgical treatment of sinusitis is prescribed if maxillary sinusitis is chronic, recurrent. Today the operation is performed using minimally invasive methods. Access to the sinus can be performed not only through the nasal passages, but also through a micro-incision in the upper jaw.

After the operation, the cavity is washed with antiseptics. Radical maxillary sinusotomy is prescribed only as a last resort and is performed less and less today.

Traditional methods of treating sinusitis

Folk remedies are used in complex therapy of pathology or as support after sinusotomy. Treatment of sinusitis at home should be carried out under the supervision of a doctor and in compliance with his recommendations. The patient must do:

• rinsing the nasal passages with a salt solution, decoctions and infusions of plants;
• nasal instillation with sea buckthorn or rosehip oil;
• warming with dry heat - bags of salt, boiled egg;
• hot foot baths;
• applications made of clay, paraffin, wax.

Treatment of sinusitis at home is carried out outside the period of exacerbation and at the initial stage of the pathology. Folk remedies can cause nosebleeds and the spread of infection if used without consulting a doctor.

Pathological anatomy

Acute G. occurs in the form of catarrhal (serous) and purulent inflammation. Sometimes these are stages of the same process. Microscopically, the phenomena of alteration, proliferation and exudation are detected. Depending on the predominance of a particular process, the macroscopic picture can be extremely diverse. With serous inflammation, the mucous membrane is thickened, infiltrated, and can fill the entire lumen of the sinus. Its surface becomes lumpy. The cylindrical ciliated epithelium lining the sinus is often preserved, and sometimes partial rejection is observed. Infiltration of the mucous membrane with cellular elements, mainly lymphocytes and polynuclear cells, is characteristic. Often in its thickness, cavities of various sizes are formed, filled with exudate, which can also fill the remaining lumen of the sinus. The vessels are sharply dilated, and cellular infiltration is noted around their lumen. When the process becomes purulent, the mucous membrane becomes covered with purulent deposits, and the exudate becomes purulent. Hemorrhages are often found, which can be numerous with influenza, the exudate in this case takes on a hemorrhagic character.

With chronic G. pathological changes are even more diverse. Usually there are catarrhal, purulent, polypous, purulent-polypous forms. Changes in chronic, catarrhal and purulent G. are similar to those in acute, but more pronounced. In the catarrhal form, the process in the mucous membrane often reaches the deep layers, sometimes cysts and diffuse hypertrophies are observed. With purulent inflammation, the mucous membrane is swollen and thickened, cavities (pseudocysts) are found due to the expansion of lymphatic fissures and effusion. The formation of true cysts is noted due to compression of the ducts of the mucous glands.

Hyperplasia and serous impregnation lead to diffuse hypertrophies and the formation of polyps. The polyp tissue is swollen; plasmacellular or lymphoid infiltration is noted; the presence of eosinophilia indicates the allergic nature of the polyp. Depending on the predominance of glandular or granulation tissue, adenomatous or granulation polyps may occur. A sign of G. of allergic origin is an increase in the number of mast cells (see), which are concentrated mainly around the vessels and glands. Mast cells are also found in polyp fluid, and their number reflects the severity of the allergic process.

With chronic G. the lumen of the sinus is often filled with exudate, which can be serous, purulent, or contain cholesteatoma masses (false cholesteatoma). Thickening of the mucous membrane is accompanied by infiltration of all its layers and fibrosis. There is disintegration, loosening and fragmentation of the subepithelial basement membrane. The content of neutral and acidic mucopolysaccharides, especially hyaluronic acid with the phenomena of its depolymerization, changes, the framework of argyrophilic fibers and membranes of blood vessels is disrupted. When the periosteum and bone walls are involved in the process, destructive and hyperplastic processes are found in the latter. When destruction predominates, thinning, decay and sequestration of bone walls are observed.

Clinical picture

Acute G. is characterized by chills, increased body temperature, poor general health, and headaches of varying intensity, often radiating to the forehead, root of the nose, and teeth. Pain in the area of ​​the affected maxillary sinus intensifies when pressing on its facial wall. The nature of the pain is sharp, intense and constant, accompanied by a feeling of fullness, intensified by tilting the head, coughing and sneezing. Photophobia and lacrimation sometimes occur. The nose is stuffy, runny nose (often one-sided) with copious mucous discharge (catarrhal G.), mucopurulent, purulent in nature (purulent G.). On the side of the injured sinus, the sense of smell is reduced. When the periosteum is involved in the process, swelling of the cheek and swelling of the lower and sometimes upper eyelid are observed.

During rhinoscopy (see), swelling and hyperemia of the mucous membrane of the nasal cavity are noted, the middle nasal meatus is narrowed, and a characteristic strip of mucus or pus is visible in it. If the patient's head is tilted down and to the side, with the affected sinus upward, then discharge of discharge from the sinus is observed - the Zablotsky-Desyatovsky symptom.

For chronic G. is characterized by general weakness, malaise, fatigue, headache (usually in the evening), and nasal congestion. Nasal discharge can be mucous, serous, or purulent. The sense of smell decreases, and anosmia often occurs (see). During rhinoscopy, in addition to inflammatory changes in the mucous membrane, which are manifested by swelling, thickening, cyanosis, hypertrophy of the lower and middle turbinates is often noted. A strip of discharge is observed in the middle nasal meatus. In polypous forms, polyps can fill the entire nasal cavity and descend into the nasopharynx (choanal polyp). Vasomotor and allergic G. is characterized by a wave-like course with periodic remissions. The exacerbation clinic is characterized by the same symptoms as in acute G.

Bacterial sinusitis

Usually this is a complication of a poorly treated viral infection, but sometimes it can occur as an independent disease. The reasons for this are:

• Injuries
• Tumors
• Dental problems
• Anatomical defects
• Cyst or polyp

Differences from viral

If a person is diagnosed with bacterial sinusitis, the symptoms will be the same as when infected with a virus, only in a more pronounced form and for a much longer time, without relief. The discharge is opaque, greenish or yellowish in color, thick and foul-smelling. The patient feels severe pain in the sinus area, especially at the beginning of the infection.

The fever becomes threatening, and the body temperature can already reach 40 degrees. Severe intoxication from bacterial waste products appears: chills, weakness, increased sweating.

This is a more serious disease, since it has a chronic form, the course of which lasts for many years. And even a common cold can cause an exacerbation and lengthen your sick leave.

It is worth noting that its pathogens are completely different:

• Staphylococcus
• Moraxella
• Haemophilus influenzae
• Pneumonia streptococcus

Exotic cases are sometimes encountered inside hospitals, the causative agents of which may be:

• Enterobacteriaceae
• Escherichia coli
• Proteus
• Klebsiella
• Pseudomonas aeruginosa

Treatment

Therapy should be aimed at clearing thick secretions, reducing intoxication of the body and destroying the pathogen. Depending on the latter, the necessary course of medications will be selected.

The main means of control are antibiotics, and this type of treatment cannot be neglected. Usually these are Amoxiclav, Levofloxacin, Cefixime and other modern analogues. In addition to antibiotics, vasoconstrictors and saline solutions described above are used. They relieve swelling, congestion, reduce inflammation, and improve the outflow of mucus.

General measures may include quitting smoking, eating a balanced diet, applying compresses, and ventilating rooms.

To relieve pain, painkillers are used. You should not take antihistamines, as they will not provide relief, but will only dry out the mucous membranes once again.

There is an opinion among experts that intranasal corticosteroids are also effective in alleviating the patient’s condition.

Drainage

In severe cases, they resort to various methods of drainage of the sinus cavities, which are divided into non-puncture and puncture.

One of the effective non-puncture methods is the well-known “cuckoo” (Proetz rinsing). This method is used if the functions of the anastomosis are not impaired, but the disease does not recede.

The patient lies on his back and catheters are inserted into the nostrils. The drug is injected into the first, and vacuum drainage is carried out through the second using a pump. The procedure got its name due to the fact that it is necessary to prevent the solution from entering the respiratory tract and to pronounce “ku-ku” all the time. After the first procedure, relief from headaches and runny nose occurs. In total, about five of them need to be carried out.

Puncture methods are more effective, but also quite traumatic. Using a puncture and an irrigator, complete cleansing of the sinuses is achieved, and material is taken for culture to determine the resistance of the pathogen to antibiotics. The method is indicated for chronic disease and frequent relapses. If the patient, for example, is in intensive care and suffers from other ailments, then surgical drainage is performed to prevent blood poisoning.

Complications

Sometimes with acute, but more often with chronic. G., in both adults and children, intracranial complications occur in the form of edema of the meninges, serous or purulent meningitis (see), meningoencephalitis, phlebitis of the dural sinuses with the development of rhinogenic sepsis (see), pachymeningitis (see), rhinogenic brain abscess (see Brain, abscess), rhinogenic arachnoiditis (see). They are most common during an influenza epidemic. There may be orbital complications: reactive swelling of the tissue of the orbit and eyelids, retrobulbar abscess, osteoporosis of the orbit, phlegmon, thrombosis of the veins of the orbit, etc. Periostitis of the upper jaw is also found.

Sinusitis – symptoms, symptoms, diagnoses

Sinusitis

– maximums kabynu (maximals adneha) sine.

Murynny tynys aluyndagi qiyndyktarmen үylesedі, mucopurulentіn muryn ағуы, murynғa zhane қannattaryn katty auyrsynu, cheeks қәне қabout ісі well, no matter the temperature of the son’s koterilui.

Erte emdeu eleuli askynulary boldyrmauga komektesedi: otitis media, meningitis, midline abscesses, koz rosetkasy phlegmon, osteomyelitis, myocardium is not blocked.

Sinusitis

Sinusitis

– maximaldy kabynu (maximally adnekha) sine.

Murynny tynys aluyndagy qiyndyktarmen үylesedі, mukopulentің muryn ағуы, murynға ұантагғы қаnatalын қатты уырсіні, cheeks қңянѓңяғынңісіnu And more, today the temperature of the son’s koterilui.

Erte emdeu eleuli askynulary boldyrmauga komektesedi: otitis media, meningitis, midline abscesses, koz rosetkasy phlegmon, osteomyelitis, myocardium is not blocked.

Sinusitis is not a problem. Halykaralyk medical statistics derekteri boyynsha, Zhedel sinusitis zhane baska sinusitpen auyratyn 10 adam zhyl sayyn auyrady% damygan elderdin turgyndary. Auru әr zhastagy adamdarғa әser etedi. 5 zhaska deyіngі balalar sinusitis eshkashan bolmaidy, oytkenі os zhasta paranasalda sinustar zhetildirilmegen.

Sinusitis in the lady mechanism

Gaimorova (zhogargy zhak) sine – Maximumdagy aua toly kuysy. Maxillary sinus celestial anatomy kurylymdar bar zhalp suyek kabyrgalary bar: zhogargy zhagynda – Orbit bar, Tomende – auyz kuysy, ishinen – muryn kuysy bar.

Baska paranasaldi sinustarmen qatar (ekі frontaldy, ekі tor zhane bіr son) tömengі funktáláry kelesí funktálílardy oryndaida:

• syrtky atmospherelyk kysymga katysty bas suyek kabygynyn kysymyn retteuge katysady;
• zhyly zhane tazalaytyn auany tazalanyz;
• dybystyn zheke dybysyn kalyptastyrady.

Barlyk sinusyn muryn kuysymen kishkene sanylaular arkyly baylanystyrady. Eger kanday da bir sepeptermen bul tesikter zhabylsa, auany zheldetu zhane tazalauda toktatady. Mikrobtardyn kuysynda zhinalada, kabynu damida.

Sonday-ak okynyz Talvara bezinin abscesses

Sinusitis sepsiptery men kauip factorlars

Sinusitis streptococcus sebep boluy mumkin, staphylococcus, chlamydia, hemophilia tayaksha, sanyraukulaktar, virustar men mycoplasma.

Eresekterde sinusitis cobinese virus, Haemophilus influenzae and Streptococcus pneumoniae. Balalarda sinusitis qozdyrgyshtary live chlamydia and mycoplasma bolíp tabylady.

Zardap shekken naukastarda zhane immuntіn buzylulary bar naukastarda sinusitis sanıraukulak pen sastrofiyalyk microfloramen tuyndauy mumkin.

Kauiptі factorlar — bul aura men zhagday, maximaldy sinus kalypty zheldetuge kedergi keltiredi zhane sinus kuvysyna infektsionnѣ enuіn zheldetedi:

• ZHRVI, kez-kelgen etiological otkir zhane sozylmaly rhinitis;
• balalardagy adenoidter;
• sozylmaly tonsillitis and not sozylmaly pharyngitis;
• Zhogary zhogary molars, surgery, zhogary zhaktyn testers nemes alveolarly uderisinde oryndalady;
• tua bitken tar muryn otui;
• Muryn sektumynyn kisayuy.

Antidti damytu kaupi kys mausymynd zhane kuzde immunitytabigi mausymdyk tomendeuine baylanysty artady.

Sinusitis

Sinusitis whenever there is a problem. Catarrhal sinus sinus maximaldy sinus sygaru aseptically most tabylada, irindi – kuramynda microflora bar. Infectious diseases of the hematogends (zhii balalar), rhinogends (adette heresekterde), odontogendik (microbtar irgeles molardan zhogary zhakty sinus engіzedі) and traumatic sinusitis.

Morphology ozgeristerdin sipatyna baylanysty sozylmaly istitanyn kelesі formalari bolinedi:

• Exudatica (iriny or irritating sinusitis). Dominants of the process – іріңді каліптасиру.
• Onimdilik (irinary polyplasts, polypals, necrotitis, atrophy, hyperplasia, sinusitis, etc.). The dominant process is zhogargy shekti shyryshty kabatynyn ozgerui (polypter, atrophy, hyperplasia, etc.).

Sozylmaly sinusada shyryshty bezderdin beteluina baylanysty kobinese shynay kistalar men maximaldy sinustyn kishi pseudokissi zhii kalyptasady.

Sozylmaly antriddin polipaly zhane polipo-irindi turleri keninen taralgan. Paraetalds hyperplastikalyk zhane cataralds allergiyalyk nysandar az, ote sirek – body, cholesteatoma, sozylmaly antrizdin ozeoticalyk zhane nekrotikalyk tүrleri.

Sinusitis belgileri

Sonday-ak okynyz kyuyu ondirisi

Auru dereu bastalada. As of today, the temperature is 38-39C, the temperature is irritated, the veins are wet. Caber zhagdaylarda naukastyn dene temperature kalypty nemse subfebrildi bolu mumkin.

Sinusitpen auyratyn naukas zardap sheken en zhogargy sinus aymagynda auyrsynumen auyrada, cheek suyegi, manday zane tamyr. Palpation of aursynu artada. Gibadathanaga nemes adamny n tiisti zhartysyn saulelenu mumkin.

Keybir naukastar turli karkyndylyktyn diffusionalyk bastaryn damytady.

Zakymdalgan zhagynan murynnyn tynysy buzylgan. Ekti zhakty sinusannan bastap, muryn tundyruy naukasty auzynan dem aluyna mәzhbur edі. Kade lacrimaldy arnanyn beteluine baylanysty, zhyrtylu. Serozdyn basynda muryn aguy, suyyktyk, sodan kein tutkyr bigyz, balshyk, zhasyl tusti.

• Sozylmaly sinusitis belgileri

If you have a sinusitis, then you will have sinusitis. Remission in case of patient's complaints. Shieleniste zhalpy uyttanu belgileri payda bolganda (alsizdik, bass aura, syngan) temperature febrile nemes subfebrile dein koterilui mumkin.

Sozylmaly istitanyn exudatsiyalyk tүrlerіne ағу arқылы sipаtаlаdy, оlardyң sаnа artuy kezenіnde artyp, naukastyn zhaғdayyn zhaқаrtу kezіnde eleusіz bolada. Synraldyn sinusyn suyyktyktyn aguymen, serozdyk, zhagymsyz andispen. Aurydyn irindi túrimen auyrsynu kalyn, sargysh zhasyl. they say shyryshty agyzu paida bolady, bul құрғақ zhәne muryn kuysynda kyrtystardy kalyptastyrady.

Bass auras, erezhe boyynsha, sozylmaly protivoterdin orshu kezenderinde nemese maximaldy sinusynan agyp ketudin byzyluymen gana paida bolada. Bass auras bassylyp nemese ortenip ketedi, naukastardyn aytuynsha, live localization of the language “kozdin artynda”, infraoritaldy audandarda kabaqtyn ulgayuy men kysymy artada. Ұқықынң зәне затип жътқaddle азаяди (relief qoldenң kүyde ystyғy aғyp ketuіne baylanysty).

Kobіnes conjured sinusitis bar naukastar tungі zhotelge stephymdanady, bul adettegi emdeuge zhatpaydy. You are welcome to share your information with us, please contact us.

Sozylmal sinusitis bar naukastarda teri zakimdary muryn kuysynyn karsanynd zhii aniqtalada (zharyktar, Isіnu, Mastery, zhibіtu). Kөptegen patient berlesken conjunctivitis and jasaida keratitis.

Sonday-ak okynyz Ұyyktau shaldyguy

Sinusitis diagnostics

Diagnosis naukastyn shagymdaryna negіzdelgen, kozben sholu derekteri (infraoritaldi aimaktyn teri tamyrlarynyn reflexorlyk keneyy anaktaldy), muryn shyryshty karau (kabynu, Ісіnu, sinus ashudan irіңdi category). Maxilar sinus radiographs of karangy bolds. Baska zertteu adіsterіnің ақрараттилыгы зекілікзіз Bolgan zhagdayda maximaldy sinus tesu zhuzege asyrylady.

Sinusitis

Shyryshty kabykshalardyn іsіnuіn azaytu zhane sinus kalypty zheldetudi kalpyna kaltyru ushіn vakokonstruktsy darі-dәrmekterdi koldanynyz (nefazolin, nefazolin, xylometazoline hydrochloride) 5 knnen aspaityn merzimge.

Aytarlyktay hyperthermiamen birge antigasivti drugtar tagayyndalady, auyr uyttanumen – antibioticter. Whenever possible, you will need to prepare the preparations for the burns, shake them thoroughly, use antibiotics, and use cold water.

Temperatures kalypka keltirgennen kein physiotherapy usynilady (Sollux, UHF).

• Sozylmaly sinusitis emdeu

For sinusitis, therapeutic treatment is needed for the treatment of sinusitis, which may be caused by burns as soon as possible (adenoid, ENT, aurular, muryn sektumynyn kisayuy, zhaman tester men ton. d.). Auyrlau kezeninde zhergіlіktі vasoconstruction agents agenter қысқаша рустад қладилади (шыршты adroфіяня ўулірмау үшін).

Ensure sinus drainage. Sinus zhuu adisi boyynsha zhuzege asyrylada “kukus” nemese sinusyn evacuationlau. Use disinfection agents (firacilin, potassium permanganates).

Proteolytic fermenter men antibiotics sheshіmder kuyska engіzіledi. Physiotherapy adisterin koldanynyz (demmen zhutu, diathermy, hydrocortisone phonophoresis, UHF).

Speleotherapy for sinusitis bar naukastar ushіn paidaly.

Іріңді polypti, polypals, body, joints gerrit cholesteotomy or necrotic surgery or surgery. En zhogargy sinus ashu - chemmorotomy.

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Treatment

With acute G. and exacerbation of chronic. G. is prescribed antipyretics, sulfonamide drugs, antibiotics, hyposensitizing agents, and vitamins. Vasoconstrictors are used locally (3% solution of ephedrine, naphthyzine, etc.), which can be used in the form of drops, for spraying, lubricating, or introducing into the nasal cavity on cotton swabs. Physiotherapeutic agents include sollux, diathermy, and ultra-high-frequency currents; when the process becomes chronic, you can use microwave therapy, electrophoresis of various medicinal substances (antibiotics, hormones, etc.), diadynamic currents, diadynamophoresis, mud therapy, paraffin baths, inhalations and aerosols. For the treatment of chronic G. of allergic origin use means of nonspecific hyposensitization (calcium chloride preparations, antihistamines, prednisolone, cortisone, ACTH, histoglobin, etc.) and specific desensitization (small doses of allergens, vaccines and autovaccines). For fungal G., antifungal drugs (nystatin, levorin, etc.) per os are indicated, as well as for administration into the sinus.

Rice. 1. Position of the needle in the nasal cavity during puncture of the maxillary sinus. Rice. 2. Caldwell-Luke operation: 1 - incision along the transitional fold of the vestibule of the oral cavity; 2 — exposure of the anterior wall of the maxillary sinus; 3 - the maxillary sinus is opened.

A puncture of the maxillary sinus is performed both for diagnostic and therapeutic reasons. target with a special needle or various trocars. You can use a needle for a spinal tap. After local anesthesia (lubrication of the mucous membrane with a 1-2% solution of dicaine or 5-10% solution of cocaine with the addition of adrenaline), a puncture is made through the lower nasal passage (Fig. 1), 1.5-2 cm from the anterior end of the inferior nasal turbinate, at the place of its attachment. Patol, the contents are removed from the sinus by suction and rinsing. For washing, use warm solutions of boric acid, potassium permanganate, furacilin, rivanol, romazulan and other disinfectants. After removing the rinsing fluid, antibiotics (depending on the sensitivity of the microflora to them), hormonal drugs, and proteolytic enzymes (can be combined) are injected into the sinus. For continuous drainage of the maxillary sinus, catheters, polyethylene and metal tubes are used, which is especially convenient in pediatric practice, as it helps to avoid repeated punctures. If the effect of conservative treatment does not occur or there is a threat of intracranial or orbital complications, they resort to surgical intervention (sinusrotomy), the purpose of which is to remove the patol. sinus contents. Methods of surgical interventions are divided into intranasal - resection of the nasal wall of the sinus in the middle and lower nasal passages, facial - opening of the sinus through the front wall; combined or radical - resection of the anterior wall with simultaneous resection of the nasal wall.

The most common radical operations are Caldwell-Luc and A.F. Ivanov. The incision is made along the transitional fold of the vestibule of the mouth. The soft tissues are separated along with the periosteum, the anterior wall of the sinus is exposed and opened (Fig. 2). The sinus is opened with a chisel, chisel or... Using a trephine and a sharp spoon, remove the patol and its contents. Caldwell and Luke (GW Caldwell, HP Luc) propose removing the entire mucous membrane, A.F. Ivanov - only its altered areas. They create a connection with the nasal cavity through the lower nasal passage. Catgut sutures are applied to the wound, sometimes limited to a pressure bandage.

Treatment of sinusitis

It is a rather difficult and time-consuming process. Treatment of acute inflammation of the paranasal sinuses involves the following:

• intensive antibacterial therapy. At first, it is selected blindly, but after receiving the results of the smear culture, the most optimal drug is recommended to the patient;
• carrying out detoxification measures;
• anti-inflammatory drugs;
• instillation of special drops into the nose that reduce swelling and inflammation;
• in case of severe purulent process, the maxillary sinus is punctured with a special needle. Next, the contents of the cavity are sucked out, and an antibacterial agent is introduced instead;
• When the inflammatory process has completely subsided, physiotherapy is indicated.

It should be remembered that throughout the entire treatment period (especially if it occurs during the cold season), the patient should wrap his face high with a scarf to prevent hypothermia. The full course of therapy for an acute process can last up to 2 months.

Chronic sinusitis is quite difficult to treat due to the fact that microbes have acquired a certain resistance after a long stay in the body, and therefore their response to medications is significantly reduced. Antibiotics in this case are prescribed only after culture. In the future, various biological additives, vitamins and other stimulants of the body’s defenses can be used. Treatment using a laser may also be useful: it leads to the final subsidence of the inflammatory process.

The main pharmacotherapy of allergic sinusitis is the use of antihistamines, glucocorticoids, etc.

For both acute and chronic sinusitis, the patient undergoes outpatient treatment (i.e. at home).

It is important to remember that in case of acute inflammation of the paranasal sinuses, strict bed rest is recommended. This will help prevent many life-threatening conditions.

Technique for puncture of the maxillary sinus

Since this manipulation is extremely common among ENT doctors, we will briefly summarize the main stages of its implementation.

To ensure that the patient does not experience any pain at all, the puncture is performed after the administration of a local anesthetic. The puncture is carried out through the nasal passage by puncturing a thin bone plate.

In cases where it is necessary to repeatedly administer drugs into the maxillary sinus or extract pus from it, the ENT doctor may recommend the installation of microscopic tubes through which inflammatory fluid flows out, which helps speed up the recovery process.

It is also worth clarifying that the puncture is also diagnostic, since the resulting contents of the maxillary sinus are sent for analysis to the laboratory.

Possible complications of puncture:

• headache, which sometimes lasts several days;
• discharge of a small amount of blood from the nose.

It is also worth debunking the most common misconception among ordinary people that a puncture performed once implies its constant implementation. In fact, a complete cure can occur after performing it once. It is only important that the patient consult a specialist at the very beginning of the disease.

Local antibacterial agents

In addition to the medications that are recommended for patients orally, it is also possible to prescribe pharmacological drugs locally. Most often they are used in the form of drops or special sprays.

They contain the following ingredients:

• vasoconstrictors, which reduce swelling of the mucous membrane and facilitate nasal breathing;
• anti-inflammatory;
• enhancing local immune defense;
• antiseptic;
• glucocorticosteroids;
• antiallergic.

It is better to give preference to sprays, as they are more comfortable to use and provide a more uniform distribution of the drug in the nasal cavity.

Forecast

The prognosis for acute G. is usually favorable. Recovery in most cases occurs within a period of several days to 2-3 weeks. In people who are exhausted, with reduced reactivity, or who have just suffered severe infectious diseases, acute G. may drag on and take a chronic course. With chronic G., occurring without complications, the prognosis is usually favorable and depends on the morphology, changes and duration of the process. In the presence of complications, the prognosis is acute and chronic. G. is determined by the nature of the complication.

Reasons for the development of sinusitis

The main causes of sinusitis are associated with:

• Bacterial or viral infections of the nasopharynx and mouth
• Untreated caries, periodontal disease
• Acute and chronic rhinitis
• Tonsillitis (inflammation of the tonsils)
• Chronic pharyngitis
• Allergies
• Deviation of the nasal septum.

The infection enters the maxillary sinus from the nasal cavity or along with the bloodstream. The sinus outlet becomes clogged as a result of swelling, and pus formed as a result of inflammation accumulates in its cavity.

Sinusitis odontogenic

Rice.
3. The relationship between the bottom of the maxillary sinus (black) and the roots of the teeth of the upper jaw. According to V. M. Uvarov (1951), G. V. Starenkova (1956), Odontogenic G. make up approx. 20 - 25% of all G. The relatively high percentage of odontogenic G. can be explained by the anatomical proximity of the bottom of the maxillary sinus to the apices of the roots of the teeth of the upper jaw (Fig. 3). Thus, the root of the second small molar and the roots of the first and second large molars are separated from the bottom of the maxillary sinus by a thin layer of bone tissue. Sometimes the bottom of the maxillary sinus borders on the roots of the third major molar, and in front - on the roots of the first small molar and even the canine; in these cases, the roots of these teeth can stand in the sinus; they are separated from the latter only by the periosteum and a layer of mucous membrane. Inflammatory processes in the area of ​​the apexes of the roots of these teeth can easily spread to the mucous membrane of the maxillary sinus. A breakthrough of pus into the maxillary sinus can also occur during suppuration of a dental cyst of the upper jaw (see Dental cyst). Inflammatory processes around impacted teeth (see), as well as remnants of tooth roots can serve as a source of infection. G. is one of the complications of osteomyelitis of the upper jaw. G. often develop as a result of perforation of the bottom of the maxillary sinus during tooth extraction. Sometimes perforation may be accompanied by the pushing of a tooth or its root into the maxillary sinus. Thus, odontogenic G. can occur without violating the integrity of the bottom of the maxillary sinus and when it is violated - the so-called. perforated G.

Clinical picture

odontogenic G. without communication of the maxillary sinus with the oral cavity is not much different from rhinogenic G. Odontogenic G. can often be accompanied by acute toothache, more often in the second small and first large molars of the upper jaw, which leads to erroneous diagnosis and unjustified interventions, including tooth extraction.

With perforated G., a communication is formed between the oral and nasal cavities. Typically, patients complain that liquid food pours out of the nose when the head is in a normal position. The flow of fluid from the nose increases when the head is tilted forward and stops when the head is tilted back. Subsequently, symptoms of acute inflammation of the maxillary sinus appear (fever, loss of appetite, copious discharge of pus from the fistula).

Diagnosis

Odontogenic G. is diagnosed on the basis of anamnestic data, examination, rhinoscopy, probing, and radiography.

Treatment

acute and chronic, odontogenic G. without violating the integrity of the bottom of the maxillary sinus does not differ from the treatment of rhinogenic G.
Fig.
4. Plastic closure of the opening of the bottom of the maxillary sinus: on the left - with a flap from the vestibular surface of the alveolar process; on the right - a flap from the sky. For perforated odontogenic G., a Caldwell-Luc procedure is performed; after this, plastic closure of the hole is performed by moving local tissues from the vestibular surface of the alveolar process or from the palate (Fig. 4). After the operation, the bandage is fixed with a protective plate. The first dressing is done after 6 - 7 days. From the 5th - 6th day for a week, the maxillary sinus is washed daily through the formed anastomosis.

Prevention

odontogenic G. comes down to sanitation of the oral cavity (see). If odontogenic inflammatory foci are detected in a patient with G. treatment (conservative or surgical) should be preceded by thorough sanitation of the oral cavity. Teeth that cannot be treated conservatively must be removed.

Bibliography:

Vernadsky Yu. I. and Zaslavsky N. I. Odontogenic sinusitis, M., 1968, bibliogr.; Bokshtein F. S. Intranasal surgery, M., 1956; Korneev S. T. A gentle method of drainage of the maxillary sinus, Vestn, otorinolar., 6, p. 82, 1972; Kunelskaya V. Ya. Clinic, diagnosis and treatment of fungal sinusitis, ibid., No. 4, p. 49, 1970; Likhachev A. G. and Goldman I. I. Chronic allergic rhinosinusitis, M., 1967; Multi-volume guide to otorhinolaryngology, ed. A. G. Likhacheva, vol. 4, p. 7, M., 1963; Potapov I. I., Pogosov V. S. and Shevrygin B. V. Treatment of rhinitis and rhinitis in adults and children, M., 1968; Preobrazhensky B. S. et al. Allergic diseases of the upper respiratory tract, M., 1969; Guide to surgical dentistry, ed. A. Evdokimova, p. 192, M., 1972; Var about V.I. Odontogenic sinusitis, L., 1962, bibliogr.; Griinberg H. Die prima-chronische Sinusitis maxillaris irn endor-skopischen Bild, Z. Laryng. Rhinol., Bd 50, S. 813, 1971; Hellmich S.u. H e rb erh o 1 d C. Technische Verbesserungen-der Kieferhohlen-Endoskopie, Arcli. klin. exp. Ohr.-, Nas.-, u. Kehlk.—Heiln. Bd 199 S. 678, 1971; K aise rM ei k., hardt I. Atlas der Ohren, Nasen- und Halskrankheiten sowie deren Grenzgebiete, Lpz., 1965; Schwab W. Die Operati o-nen an Nase, Mund und Hals, Lpz., 1964.

I. B. Soldatov; P. V. Naumov (ostomy).

Balalardagy sinusitis

Murynnan su agyp, zhalpy konil-kuydin nasharlauy, den kyzuynyn koterilui – ZHRVI men ZHRA tan belgiler. Bіrak keide olar balada sinusitis bolú yktimaldygyn da bildiredi.

Eger uaqytyly durys diagnosis koylsa, auras satti emdeuge bolady zhane ol eshbir askynulara akep soktyrmaidy, al ata-analar dәrigerdin usyngan emdeu tartibi men kenester That's just what the installation says.

Aura askynyp ketse, qiyn zhagdaylar oryn alady, ony emdeu ushіn uzak uaqyt dәrіmen emdelu kazhet bolady.

Sinusitis degenimosis not

The maxillary sinus is not in the same place as zhogargy zhak kuystary – zhoghargy zhak suyekterinin terenіndegі murynny sol zhane on zhagynda ornalaskan kіshі kuystar. Ish zhakta olardyn shyryshty kabaty bar, ol zherde shyryshty shygaratyn bezder bolady. Zhogargy zhak kuystary muryn kuysymen kishkentay taramdar arkyly kosylady.

Highmore kuystary uryktyn lady kezenindegi ushіshі aidan bastap kalyptasada, berak naresta tuylgan kezde kolemi ote kishkentai bolada. Burns as a result of the infection caused by keratinosis.

Gaimar kuystary omіrdің alғashky 3-5 zhyl aralyғynda keneyye bastaydy zhane kalyptasu tek zhasospіrіmdіk shakta gan ayaktalada.

Round 3 astan askannan kein balada sinusitis paida boluy mүmkіn zhane kobіne aura zhiі tumau men baska respirator infectionlardan tuyndauy ktimal.

Highmore kuystary anatomyalyk zhagynan muryn zholdarymen baylanysty, sondyktan muryn arkyly ogan infection onai enip kete alada. Sinusitis kezinde vyryshty kabyrgalar kabynyp, іsіp ketedі.

Please pay attention to the problem.

Oz keseginde suyyktyktyn zhinala take bacteriayk ortan damuyn keremet negіz bolada, sol septen de cataraldyk sinusitis onyyn auyr tïrі – irіndіdі turіne onay inalada.

Balalardagy sinusitis belgileri

3 astan zhane odan askan balalarda zhiti damytyn sinusitis belgileri bolyp mynalar tabylada:

• Shyryshty zhane irindi bolinuler baikalatyn murynny n betelou;
• Today is the 38th day, the type is given and the fire of the katerilui;
• Alsizdik, tabettin nasharlauy, ashushandyk, ұyқынѣ ұзіліуы, бастѣ уыруы руыыы рулінінін ағзанѣулан belГілері.
• Kozdin zhasaurauy, kozdin astynyn, muryn ainalasynyn isinuy;
• Manqalanu nemese dauystyn kyryldauy.

5 astan askan balalar ata-analaryn kay zherleri mazalap turganyin tussindire alada. Bala tomendegilerge step by step:

• Basty tomen karai igende, basty qatty auyruyna;
• Shainagan kezde katty baikalatyn tis aurularyna;
• The heat of the moment is hot.

Eger muryn-erin katparlarynyn ustіnen bassanyz da auyr sezimderі baikalada. In order to avoid any problems, you will have to pay attention to the situation, and you will lose all your money.

Aura kezіnde mіndetti tүrde barlyk zhogaryda atalgan ozgerіster bіlіne bermeuі de mүmkіn. Balalarda murynnan shyryshtyn cheese akpauy da mumkin, sebe paida bolgan isik shyrshtyn kabyngan kuystan kuystan zhel bermeida.

Balalardagy sinusitis and rhinitis, rhinopharyngitis and laryngitis will cause a lot of virus infection. Muryn kuystary kabynuynyn algashky belgilerin ata-analar respirator infectionlers emdegennennen kayin gana bykaydy.

Balalardagy sozylmaly sinusitis belgileri

Balalardagy sinusitis kuystarynyn sozylmaly kabynu arketteri – zhiі sinusitis saldarynan nemes kazhetti therapy kabyldamagannan oryn alada. Kobіne adenoidta ulkeygen, muryn doңesі қisaygan, immunity tоmen balalarga, establish the diagnosis of koyylada.

The pathological results of this period of life were as follows: Alaida, ata-analar tomendegilerdi baykauy mumkin:

• Balanin үnemi alsіrep zhuretіnі zhane tez sharshap kaluy;
• Kozinin astynda kara daktardyn paida boluy;
• Murynnan anda-sanda tussiz nemese zhasyl-sary shyrishtyn shyguyn;
• Murnymen demaludyn qiyndygyn;
• Is sesuin tomendeuin.

Ylkendeu balalar sozylmaly sinusitis kezinde bastaryn auyratyndaryna, auyzdan zhagymsyz damnin bilinetine, kozderinin zhii zhasauratyna, murynny zhagymsyz kernep auyratyna on shagymdanady.

Balalardagy sinusitis sebepteri

Balalardagy zhiti sinusrittin basty sebepteri mynalar:

• Allergic rhinitis. Muryn kuysyna enіp ketetin allergender shyryshty kabattyn іsіnuіn thudyrady, búl oz kúzeginde қuystardan bolіnetіn secretion basad. Wasps ozgeristerdin ayasynda bacteriayk infection onay damida, bul sinusitis akelip soktyrady;
• Respiratory infection. ZHRVI zhane ZhRA kezderinde murynnan su agu infectiousny negizgі belgіleri bolyp tabylada, al ol paida bolganda shyrishtyn aguy buzylada. Eger baladagi rhinitis emdemese, sinusitis suyk tiyudin askynuyna deyin zhetkіzedі;
• Murynnyn zharakattanuy. Zharakkat alu shemirshek kurylymdar men suyekterdin zhylzhyp ketuine akelip, kuystarda aura tudyratyn microagazalardyn kobeyuine arnalgan keremet orta paida bolada;
• Muryn kurylymynyn tua bitken akaulary;
• Infectious askyngan kozderi. Bul adenoidtar, tis zhegi, periodontitis, non-sep shygaru zholdarynyn aurulary. Zhakyn ornalaskan infection kozderinen aura tudyratyn microagzalar murynnyn kuysy men zhұtқynshak zhane auyz kuysyn zhalgastyratyn zholdar arkyly enіp ketedi. Buyrek aurulary kezinde bacteriyalar kanmen birge enuі mүmkin;
• Kantamyrlaryn buzyluy. Kantamyrlaryn tomen tonus muryn kuysyndagy kan ainalymyn nasharlatuy mumkin, son natizhesinde zhergilikti immunity tomendep, ulpalar ozderine kazhetti korektik elementterd and ala almaydy. Yaғni, kabynu reactionlaryn zhaily zhaғday tuyndaida.

Sinusitis beyim bolatyn factorlar mynalar:

• Immundyk zhuye zhumysynyn buzyluy;
• Kazhetti microelements men dәrumenderdin tusuin qamtamasyz ete almaytyn tengerimsіz tamak;
• Suyktau;
• Kuizelis aseri.

Balalardagy sinusitis turleri

Balalardagy sinusitis turleri mynadai bolada:

• Life. Aurudyn barlyk nakty belgileri zhane ulana belgileri de anak baikalady;
• Sozylmaly. Aura askynu kezenderinde zhane belgilerinin alsireoui kezinde korinedi. Sozylmaly sinusitis negіzgі kaupi – murynnyn shyryshty kabattaryn kaytadan kalpyna kelter almaisyz, bu korganysh kasietterinіn aytarlyktay tomendeuine әkeledi.

Sinusitis in the future:

• Bіr zhakty – as soon as the current flows;
• Ekі zhakty – infection of қуыстѣ екі қавіргасына а а таралади.

In order to react to the problem of sinusitis, we will give you the best treatment:

• Kataraldyk. In order to remove the drainage from the battery, it will be necessary to change the drainage time. Isik zhane shyryshtyn kyzaruymen, shyryshtyn paida boluymen sipattalada;
• Basty. Kataraldyk kabynu ayasynda bacterium orta kosylgannan keyin irindi turі porida bolada. Ulanudyn basty belgіlerіnіn bilіnuіmen, sary-zhasyl shirysh turindegi irinіnіn payda boluymen sipattalada.

Balalar sinusitis diagnosticau

Sinusitis teq arnay diagnosticalyk әreketter arkyly anyktauga bolada. Balany our nadai tekseristerden otkіzedі:

• Muryn kuysyn tekseru;
• You are looking for X-rays;
• Diaphanoscopy. Kuystardy arnay kuralmen ashyp tekseredi. Eger kuysta irin turindegi shirysh bolsa, ol kara dak sekildi bolyp korinedi;
• Zhalpy kan taldauy;
• Sinusitis is a common allergen;
• CT. Computed tomography as it turns out.

Balalar sinusitis emdeu

Balalar sinusitis emdeumen ENT dariger ainalysady. In this case, as a result of the operation of the heat exchanger, the audio signal is generated in the aynaluyna mukkіndik tyrady. Preparation balanyn zhagdayina, pathology belgіlerіne, baska aurularyna karai tandalady. Sinusitis emdeudin barlyk turi bir mezgilde bernesh tapsyrmany sheshuleri it seems.

Dariger tagayindagan emdeu tasilderinen mindetti tүrde оtu kerek. Antibiotics 7-10 kunge beredi, olardy kabyldau uzaktygyn azaytuga bolmaidy, tіptі algašky belgilerі masalamas yes. Dene kyzuy koterilse, kyzu tүsіretіn dәrіler beredi.

Emdeu kezeninde balaga dәrumenge bai durys tamak take kerek. Auyryp zhatkan balalar In tobynyn kazhetti kolemdegi dәrumenderin, ascorbine kyshkylyn, And dәrumenіn alulary tiіs.

Bul dәrumender immunodyk zhuyenі nygaytatady, zakymdangan shiryshty kabyktardy kalpyna kaltyrudy zhedeldetedі zhan tynys alu organdarin mushelerіne zhagymdy aser edі.

Balaga mүmkіndіgіnshe kΩp сұйықтиқ ішкізу ерек – суйыктиқпн қатар жінақан howl toxinder de аgаzаn shyғyp kеtedі.

Balalardagy sozylmaly sinusitis emdeu

The aurudyn conjured up the current situation when it comes to life as soon as possible. Degenmen, balaga arnalgan antibiotic bacterium infection degen sezimtaldyg anyktalgannan kein gana tandap alynady, ol ushіn mikrotardyn turin anaktauga arnalgan murynnan zhakpa alynady.

Mindetti is completely different from therapy, such as pain relief, infectious diseases, physical therapy and treatment. Eshbіr aser bolmagan zhagdayda, kuysty antisepticak erіtіndіlermen әrі karay zhuu arkyly kuystar punctures tagaiyndalady.

Balalar sinusitis askynuy

Zhіti zhәne sozylmaly sinusitis tomendegilerge әkelip soqtyrady:

• Tonsillitis – badamsha bezіnіn kabynuyna;
• Bronchitis;
• Kulak kabynuyna;
• Barlyk muryn kuystaryn kamtityn ote zhogary kabynuga;
• Myocarditis – zhurek bulshyketinin kabynuyna;
• Jade – buyrekterdin zakymdaluyn;
• Sepsis is an infectious disease;
• Meningitis – mi kabyrshaktarynyn kabynuyna;
• Buyndardyn kabynuyn.

Prevention

Kez kelgen tumau, suyk tiyu aurular tolyk zhane uakytyly emdeu sinusitis aldyn alu bolyp tabylada.

Infection saktalu kozderin uakytyly zhoyyp, agzanyn қorganys kushterin zhoғarylatyp, anatomyalyk kemіstіkterdіzhoyyp otryru kerek, bul muryn doңesіnіn қsayuyn dein zhetkisetin adenoidtar bolyp tabylada.

Balalards korshagan ortany as zhagymsyz aser etetin faktorlarynan, onyin ishinde temek tutininen, kuye, allergenderden korgau kerek.

Ata-analarga kenes

Sinusitis kezinde balanyan sauyguyyn zhyldatuga, aurudyn sozylmaly turin Boldyrmauga zhane askynudyn oryn almauyn emdeu-preventive treatment Doromarin Onimin kabyldau komektesedi, ony ң ққұramында қана багиғы құramdas bolіkter bar.

Take care of the DoroMarine cache in the old days in order to protect the mechanism. About us:

• Very high kelp angustata as well as microelements for men and women. Laminaria әserimen қatar bir uakytt Imminda Zhyeje Zhamysy Zhasarady, bacteriyalan Men Virustarga Karsylysu Khsheyedi, Shyryshtyn Syuluy Zhyldamdap, oonya Kyustan nygyyna skal;
• Teniz trepanginen alyngan syғyndy zhinalyp qalgan kaldyktardyn shyguyyn ezdetedi, almasu oreketterin zhaksartady, osynyn arkasynda zhergiliktі immunity nigayady, al kuys k abyrgalarynyn shyryshty kabattary ozderine kazhetti korektik zattardy alada. Demek, zhasushalardyn kalpyna kelu әreketi kalypty bolyp, kusheyedi;
• Calcium tensity increases the pain of calcification;
• Zhemis syryny Doromarin dәrumendik keshenіne tek zhagymdy dәm berip qana kojmai, agzana paidala dәrumendermen odan sayyn bayyta tүsedі.

Doromarindi sinusitis kez kelgen satysynda ishuge bolada. Emdeu-prophylactic treatment on the other hand, zattarmen durys uylesip kan koymaidy, olardyn terapiyalyk aserin kusheytedi. The pathological sozylmaly turinde wasps onimdi ishu aurads tes arad zhenuge komektesedi.

Doromarin kauipsiz, ony balalarga ush aidan bastap beruge bolada. Onіmdі kurspen kabyldau tek zhaksy immunity qamtamasyz etіp kan koymaidy, somenen birge balalardyn durys damuy men barlyk organdaryn zhaksy qyzmetіn qamtamasyz etedi.

Balalardagy sinusitis – dariger Komarovsky mektebi

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