chronic sinusitis

Sinusitis can be chronic with repeated acute inflammation, and especially frequently for a prolonged inflammation of the maxillary sinuses, as well as chronic rhinitis. A certain role is played by a deviated septum, close contact with the secondary shell lateral nasal wall, congenital narrowness of the nasal passages. Odontogenic sinusitis from the beginning is often a sluggish chronic. Distinguish exudative forms of inflammation (purulent, catarrhal), productive forms (polypous, Parietal-hyperplastic, holesteatomnaya, caseous, necrotic, atrophic). It also occurs vasomotor and allergic sinusitis, which occurs simultaneously with the same phenomena in the nasal cavity. When atrophic processes in the upper respiratory tract and Ozen and developing atrophic maxillary sinusitis. Necrotizing sinusitis is usually a complication of severe infectious diseases.

Symptoms depend on the form for the disease. In exudative forms of ballroom on the main complaint profuse discharge from the nose. At the complicated outflow of secretions from the sinuses nasal discharge almost no patients complain of dryness in the throat, coughing up large amounts of phlegm in the morning bad breath. Pain in the affected sinus is usually not, but it may appear at an exacerbation of the process or a loss of fluid outflow. In such cases determined by tenderness of the anterior wall of the sinus and orbit verhnevnutrennego angle on the affected side. Often there are headache and nervous system disorders (fatigue, inability to concentrate). At an exacerbation may experience swelling of the cheeks and swelling of the eyelids. Sometimes there are cracks and abrasions of the skin at the entrance to the nose. The presence of nasal discharge during an average is an important feature. For its detection is often necessary to lubricate the mucous membrane of the middle nasal passage vasoconstrictor. Characterized as hypertrophy of the mucous membrane and the appearance of edematous polyps. The course of the disease for a long period. Often the process of ckudnoy symptoms remain undiagnosed.

Diagnosis is based on history, these front and rear rhinoscopy, diaphanoscope, X-ray examination, and proof puncture.

Treatment should be complex, it is aimed at addressing the causes which supports inflammation in the sinus (adenoid growths, deviated septum, polypous changes in the average sink, carious teeth), ensuring adequate drainage of the pathological secretion (systematic lubrication vasoconstrictor middle nasal passage). Widely used solljuks, diathermy, currents UHF, inhalation. In many cases it gives positive results sinus puncture antiseptic lavage solutions (furatsilin et al.) Followed by proteolytic enzymes and antibiotics. In the treatment of allergic sinusitis used cortisone, ACTH, and their derivatives. In the absence of effect of conservative treatment (mainly in purulent polypous forms) produce radical surgery on the maxillary sinus.