Ethmoiditis is characterized by inflammation of the epithelium lining the cells of the ethmoid bone. It is often accompanied by sinusitis. The diseases manifest themselves in the same way, so the treatment will be similar.
The ethmoid bone is formed by a ethmoid labyrinth consisting of cells. It is located between the cavities of the skull and nose. The frontal, maxillary, sphenoid sinuses and ethmoid labyrinth are classified as paranasal sinuses. This “neighborhood” provides the characteristic manifestations of ethmoiditis.
The mucous membrane of the cells of the ethmoid labyrinth is similar to the nasal mucosa, but it is thinner. When the inflammatory process begins, it swells in a short period of time and becomes gelatinous. In this regard, inflammation quickly moves to deeper layers. The loose epithelium of the ethmoid bone cells swells easily, forming polyps.
Causes
When suffering from ethmoiditis, symptoms and treatment will depend on the form of the process. There are chronic and acute pathologies.
Her reasons:
- frequent colds
- infections caused by viruses, bacteria, fungi
- allergic runny nose
- complications of runny nose, sinusitis, sinusitis
Ethmoiditis in children, which occurs in acute form, is much more common than in adults. Chronic ethmoiditis develops if the acute form is not treated. As a rule, it appears after 3 months.
The difference between a chronic disease and an acute one is that the pathological process affects not only the epithelium, but also the bone. One of the most serious complications is the destruction of bone tissue. If it is damaged, purulent fluid enters the sphenoid sinus, eye sockets, and brain.
The main provoking factor is poor immunity. This leads to an increase in the amount of opportunistic microflora. The infection begins to spread into the maxillary sinuses and labyrinths of the ethmoid bone.
We answer questions about ethmoiditis: what is it? What are the symptoms and treatment of the disease?
Among diseases of the paranasal sinuses, ethmoiditis is the second most common after sinusitis. Pathology is of considerable relevance, and therefore requires a more detailed consideration.
What are the symptoms and treatment of the disease.
Symptoms of the chronic form
If the disease was not previously diagnosed and treated correctly, then the patient develops chronic ethmoiditis. Often this pathological process is a complication of inflammation of the maxillary sinus (sinusitis), sinusitis or chronic runny nose. The first signs of this disease appear in a person two months after suffering acute ethmoiditis.
With exacerbation of chronic ethmoiditis, the following symptoms are observed:
- the upper eyelid is very swollen;
- there is purulent discharge from the nose;
- Strong headache;
- in the area of the bridge of the nose the patient notes heaviness, which intensifies if he tilts his head;
- pus and mucus flow down the nasopharynx. A lot of discharge accumulates in the morning and the patient coughs it up with great difficulty;
- When moving the eyes, the patient feels severe pain.
This form of the disease is dangerous because the mucous membrane of the middle concha of the nose begins to grow very quickly, and soon closes with the nasal septum. Degenerative changes in it lead to the formation of polyps. If the swelling does not subside, polyposis will occur. Multiple polyps will fill the entire nasal cavity and begin to come out. The nasal septum will be deformed.
The symptoms are pronounced, body temperature rises to high numbers of 39-40 degrees.
What is maxillary ethmoiditis - features, etiology and ICD-10 code
There are three main sinuses (sinuses) in the human body. They are necessary to increase vocal resonance, humidify and warm the inhaled air. Against the background of a cold or infection, inflammation can begin in any of them.
Maxillary ethmoiditis is a pathology localized simultaneously on the mucosa of the ethmoid labyrinth and maxillary (maxillary sinus). The peculiarity of the pathology is the prolonged course of the early stage, which complicates diagnosis. In ICD-10, this type of sinusitis is coded J01.8.
All sinusitis has a multifactorial etiology. As a rule, they develop against the background of several internal and external causes.
Adenoid growths in the nose, which are an increase in lymphoid tissue.
Symptoms
Characteristic manifestations of ethmoiditis: pain, nasal discharge, difficulty in nasal breathing, decreased/absent sense of smell.
Pain
The acute form of ethmoiditis is characterized by pain in the area of the bridge of the nose, forehead, eyes, and head. The pain gets worse at night and causes insomnia. During the day, visual disturbances and photophobia appear.
Chronic ethmoiditis is characterized by a variety of pain. At night, constant pain may appear in the area of the bridge of the nose, radiating to the forehead and eye socket. If the inflammatory process worsens, the pain becomes throbbing. The pain symptom is caused by swelling of the bone, which begins to put pressure on other structures.
Feeling of fullness
A feeling of fullness in the nose is observed in both forms of ethmoiditis; it is caused by swelling of the structures of the labyrinth and the accumulation of pus. The infectious process affects not only the epithelium, but blood vessels.
Due to the fact that the cells of the ethmoid bone are filled with inflammatory fluid, the skin of the bridge of the nose and upper eyelids becomes swollen. If you press on this area, you may feel severe pain.
Difficulty in nasal breathing
Swelling of the epithelium in the cells of the ethmoid bone causes a sharp deterioration in nasal breathing. The nasal mucosa becomes very thick and swollen, as a result of which the nasal passages narrow. In children they are much smaller than in adults, so with ethmoiditis it is impossible to breathe through the nose.
Difficulties with nasal breathing appear very quickly - after several hours from the onset of the pathological process.
Discharge
Another symptom of ethmoiditis is discharge of fluid (mucous, purulent, bloody) from the nose. It accumulates in the cells of the ethmoid bone. From there, the secretions flow into the nasal passages.
The volume and nature of the fluid will depend on the stage of development of the pathology. At the beginning, thick mucous discharge is observed (in small quantities), then it becomes abundant and acquires a greenish color. If the inflammation affects the bone, the mucus begins to smell bad. When blood vessels are damaged, fluid containing streaks of blood is released.
Deterioration of sense of smell
Deterioration of the sense of smell or its complete absence is caused by damage to the olfactory nerve and blockage of the olfactory fissure by secretions. Sometimes a perversion of smell develops. The reason for this is the destruction of the ethmoid bone, which leads to the appearance of a putrid odor.
Symptoms of intoxication
Symptoms of intoxication are more intense in acute ethmoiditis. These include:
- temperature
- weakness
- muscle pain
- vomit
- in babies - regurgitation
Acute ethmoiditis progresses very quickly, especially in newborns. The onset is characterized by a rise in temperature (up to 39-40 ºС). The process may be accompanied by vomiting. Nasal breathing becomes difficult, mucus and pus are released.
Some toxins have a negative effect on the central nervous system, and then neurotoxicosis develops. The patient becomes apathetic, sleepy and lethargic. Severe pain appears in the head. When exposed to toxins in the gastrointestinal tract, intestinal disorders develop.
Symptoms
Ethmoiditis is a disease that can occur in two stages - acute and chronic. The first stage is considered not so dangerous. All symptoms are vivid, they are very easy and quick to identify, so treatment can begin immediately. This allows you to get rid of an unpleasant illness, as well as prevent the development of complications.
But a chronic illness is dangerous because for a very long time you may not even suspect its existence. That is why parents believe that the child has a common cold. Thus, a number of complications arise, which are extremely rarely treated.
The photo shows what ethmoiditis looks like
Symptoms of acute illness
The acute form of the disease is characterized by the following clinical manifestations:
- nasal congestion;
- discharge with purulent content;
- headache at the base of the nose;
- general fatigue and weakness;
- bad dream.
The child often complains of pain that pulsates in the forehead. Often children may vomit, eat poorly and suffer from bowel problems.
Symptoms of a chronic disease
If ethmoiditis is not detected on time, it can become chronic. Defects in the structure of the nose can affect the development of a chronic disease. In addition, the formation of polyps or adenoids is another cause of the inflammatory process.
In the photo - chronic ethmoiditis
The chronic disease occurs in two stages - exacerbation and remission. For remission, symptoms are not pronounced. But the exacerbation stage is characterized by the following manifestations:
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Features of ethmoiditis in children
Ethmoiditis in children manifests itself more clearly than in adults. Characteristic symptoms of etomoiditis in children:
- temperature
- runny nose
- pain when touching the bridge of the nose and the inner corners of the eye sockets
- displacement of the eyeballs
- swelling of the upper eyelids
- vomit
- diarrhea
- the appearance of a fistula (in severe disease)
In older children, ethmoiditis sometimes goes away without swelling of the eyelids. Ethmoiditis in mild form is characterized by a decrease in the intensity of symptoms. If there is no adequate treatment, acute Ethmoiditis becomes chronic.
Diagnostics
The diagnosis of “ethmoiditis” is made based on examination of the patient. In addition, computed tomography or magnetic resonance imaging is performed. MRI is often performed to diagnose the disease in children, since the study does not use radio waves. For adults, x-rays may be prescribed.
During the examination, the doctor may use instrumental methods: rhinoscopy, endoscopic examination. During rhinoscopy, the nose is examined using a special mirror and a speculum. Endoscopic examination is carried out with a probe with an optical system.
Diagnosis and treatment
An otolaryngologist can make an accurate diagnosis only after performing the following procedures:
- examination of the nasal cavity;
- X-ray examination;
- puncture for diagnostic purposes;
- CT scan.
The use of these methods makes it possible to determine the diagnosis, confirm or exclude the development of acute purulent ethmoiditis. Treatment of ethmoiditis involves the use of modern effective drugs and therapeutic methods. Mandatory therapeutic actions include rinsing the sinuses and instilling vasoconstrictor drugs. You may also need to use antibiotics and, in extreme cases, surgery.
For a quick recovery, it is important to correctly follow the sequence of therapeutic actions. First you need to ensure the outflow of mucus, for which a vasoconstrictor is prescribed. To eliminate the pain that occurs during the development of the inflammatory process, painkillers are prescribed. After a few days, when improvements occur, you can speed up recovery with the help of physiotherapeutic procedures.
Surgical treatment involves opening the cells of the ethmoidal labyrinth to remove purulent contents. This procedure is indicated in extremely severe cases, which are observed mainly with purulent ethmoiditis in children. The operation is also indicated for ocular and intracranial complications.
Prevention of the pathological process consists of timely and rational treatment of diseases that cause the development of ethmoiditis.
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Treatment
Therapy for ethmoiditis is conservative and/or surgical. It depends on the cause, symptoms, nature of the disease. Chronic and acute forms are treated differently.
Treatment of acute ethmoiditis with drugs
Acute ethmoiditis is treated with conservative methods. The main goals of treatment measures: elimination of swelling and inflammation of the mucous membrane, relief of pain symptoms, restoration of nasal patency. An infection caused by pathogenic bacteria can be quickly treated with broad-spectrum antibiotics: Roxithromycin, Amoxicillin, Cefazolin and others.
For severe pain, anti-inflammatory drugs are prescribed (Panadol, Paracetamol, Nurofen, Ibuprom). To eliminate nasal congestion, sprays (Rinofluimucil, Nasonex) and mucus stimulants (Sinuforte, Sinupret) are used. It is necessary to rinse the nasal passages with saline solutions.
To improve fluid outflow, it is advisable to sleep with your head elevated. Vasoconstrictor drops (Galazolin, Naphthyzin) are recommended to be used for no longer than 2-3 days. To strengthen the immune system, immunomodulatory drugs (Ribomunil, Immunal) and multivitamin complexes are used.
Treatment of acute allergic ethmoiditis
If the cause of acute ethmoiditis is an allergy, it is necessary to avoid contact with allergens. Comprehensive treatment includes:
- antihistamines
- corticosteroids
- calcium supplements
- antiallergic sprays containing small concentrations of glucocorticoids
Physiotherapy, surgical treatment
When acute symptoms are eliminated, physiotherapy is added to treatment:
- phonophoresis
- electrophoresis
- UHF
- laser
An effective method of treatment is the use of a YAMIK sinus catheter. During the procedure, the doctor removes pus and injects medications into the cavities.
Acute ethmoiditis is treated surgically if warning signs develop: exophthalmos (protrusion of the eyeball), loss of visual acuity, limited eye mobility. The operation is performed through an incision in the corner of the palpebral fissure or through the nasal passages. Provided timely consultation with a doctor and proper treatment, acute ethmoiditis goes away without a trace.
Treatment of chronic ethmoiditis
In order to eliminate the manifestations of chronic ethmoiditis, complex medications are used: Polydexa, Isofra, Bioparox, Rinofluimucil. The products include painkillers, vasoconstrictors, and antibiotics. Patients are also prescribed physiotherapeutic procedures.
For chronic ethmoiditis, surgical treatment is often used, since this form of the disease is characterized by the appearance of polyps in the nasal passages. During the operation, resection of the nasal turbinates is performed, and the cells of the ethmoid bone are opened. After the operation, you need to rinse your nasal passages and cavity with a drug that will be prescribed by your doctor.
Complete recovery from chronic ethmoiditis is impossible. Stable remission is achieved subject to complex therapy and prevention of diseases that cause exacerbation of inflammation in the ethmoid labyrinth.
Home therapy
You cannot treat ethmoiditis at home without seeking the help of a doctor. However, you can strengthen your immune system, which is an excellent preventive measure. You can drip menthol, camphor, and eucalyptus oil into your nose.
After preliminary consultation with a doctor, you can supplement the treatment of ethmoiditis at home with inhalations. However, it is absolutely impossible to treat ethmoiditis by heating the nose. If the condition worsens, you should immediately consult a specialist.
Treatment options
How to treat a child? Treatment of the disease is complex, combining methods of medication, physiotherapy (at the stage of remission), therapy, nasal lavage, and measures aimed at strengthening the child’s immunity.
In some cases, surgical treatment is required.
Medications
Depending on the cause of the disease, the child is prescribed antibacterial or antiviral drugs. In addition, symptomatic drug therapy is necessary, including the use of drugs from the following groups:
- antipyretics if body temperature exceeds 38 degrees, or if the child does not feel well at a lower temperature;
- anti-inflammatory to eliminate swelling and other signs of inflammation;
- vasoconstrictors to restore nasal breathing;
- antihistamines to eliminate the allergic reaction that provoked the development of the disease;
- immunomodulators to restore immunity.
Antibacterial therapy
Taking antibiotics is justified only if the cause of the disease is a bacterial infection.
In all other cases, antibiotics are not prescribed to the child.
ethnoscience
Self-medication using traditional medicine is unacceptable.
Since the main cause of the development of pathology is considered to be viruses or bacteria, treatment should be carried out only with the use of medications prescribed by a doctor.
Traditional recipes can only be used as auxiliary therapeutic measures. Thus, rinsing the nose with herbal decoctions prepared on the basis of sage, chamomile, and fireweed will help speed up the healing process.
Other methods
AT the remission stage, physiotherapy procedures have a positive therapeutic effect, such as:
- phonophoresis and electrophoresis using medications (hydrocortisone, calcium hydrochloride);
- UHF ethmoid sinuses;
- laser treatment of affected areas.
Surgery
Surgery is indicated only if the source of inflammation spreads to the bone tissue located in the immediate vicinity of the ethmoid sinuses.
The operation is performed under anesthesia; during the procedure, an external opening of the cells of the ethmoid bone is performed, after which all inflamed areas of this area are removed.
Prevention
The following measures will help prevent the development of ethmoiditis:
- Strengthening the immune system
- Rejection of bad habits
- Timely treatment of colds and infectious diseases
- Avoid severe hypothermia and minimize contact with people with colds
- It is recommended to carry out wet cleaning and ventilate the premises more often
When outdoors, protect your face from strong winds. If you plan to visit public places, it is recommended to lubricate the nasal passages with antiviral ointment. A good method of strengthening the immune system at home is hardening: dousing with water, contrast shower, wiping. Sun and air baths are useful.
It is important to pay attention to the condition of the nasal mucosa and moisturize it regularly. Dry mucous membrane is a favorable environment for the proliferation of pathogenic microflora. To maintain optimal moisture in the mucous membrane, at home you can rinse your nose with saline solutions or use aerosols. To ensure the required level of humidity in the premises, you can install special devices - air humidifiers.
ethnoscience
Treatment of ethmoiditis with folk remedies can be carried out using nasal instillations, inhalations, rinses, compresses, and massage.
- The solution for rinsing is prepared as follows: mix honey with onion juice (1:1), leave for 3 hours, rinse the nose.
- For inhalation, use dill decoction or fir oil. During this procedure, you must actively breathe through your nose.
- Infusions of St. John's wort, sage, and chamomile are a good anti-inflammatory agent that is suitable for instillation.
- Ethmoidal sinusitis can be treated at home with a salt compress. To do this, rock salt is fried in a frying pan, placed in a fabric bag, and applied to the inflamed area.
- Chinese traditional medicine offers acupressure as a therapeutic measure.
It is important to remember that the advisability of using traditional medicine recipes can be determined solely by the attending physician. Never self-medicate! After all, improper use of warm compresses can cause the transition of serous inflammation to purulent. At the same time, the risks of developing orbital phlegmon, abscess and even meningitis increase.
