sinusitis
Introduction
Introduction to sinusitis Inflammation of one or more sinus is called sinusitis, and the involved sinuses include: maxillary sinus, ethmoid sinus, frontal sinus and sphenoid sinus, which is a disease with a high incidence in the population, affecting the quality of life of patients. . Sinusitis can be divided into two types, acute and chronic sinusitis. Acute sinusitis is caused by upper respiratory tract infection, and bacterial and viral infections can be concurrent. At present, CT examination has become an important means of diagnosing sinusitis. It is also one of the series of examinations that must be done before sinusitis surgery. CT scan is divided into coronary scan and horizontal scan. Sinusitis often coexists with nasal polyps. CT can show nasal polyps and sinuses. The range of inflammation clearly shows the fine structure of each sinus and its adjacent areas, which provides an important basis for doctors to diagnose and treat sinusitis. It also helps to distinguish sinusitis from other diseases such as sinus cancer through CT. basic knowledge Sickness ratio: 0.5% Susceptible people: no special people Mode of infection: non-infectious Complications: rhinitis, purulent sinusitis
Cause
Cause of sinusitis
1. Reduced body resistance, such as excessive fatigue, cold and dampness, malnutrition, vitamin deficiency, and poor living environment.
2. Allergic constitution, systemic diseases such as anemia, insufficient endocrine function (such as thyroid, pituitary and gonads), acute infectious diseases such as flu, measles, scarlet fever, diphtheria, etc. can induce this disease.
3. Some diseases of the nasal cavity, such as nasal septum deviation, middle turbinate hypertrophy, nasal polyps, allergic rhinitis, nasal foreign body or nasal tumors, can also cause sinusitis.
4. Adjacent lesions, such as tonsillitis or adenoid hypertrophy, the second maxillary canine and the infection of the first and second molars, the injury of the maxillary sinus wall or the fall of the molar roots into the maxillary sinus can also lead to sinusitis. .
5. Others, such as sinus fractures; improper diving posture during swimming (such as vertical diving), or improper swimming and swimming, nose, nose, sewage into the sinus; nasal tamponade retention time is too long; high altitude flight rapidly decline, sinus cavity A negative pressure is formed opposite to the outside world, and inhalation of nasal secretions into the sinus can also cause disease.
Prevention
Sinusitis prevention
1, usually pay attention to nasal hygiene.
2, the posture should be correct when swimming, try to make the head out of the water.
3, people with dental problems, to be completely treated.
4. Follow the doctor's advice and use the medicine in time.
5, chronic sinusitis, treatment should have confidence and perseverance, pay attention to strengthen exercise to enhance physical fitness.
6, smoke, alcohol, spicy food is strictly prohibited.
7, keep the temperament and cheerful, mentally avoid the stimulation, and at the same time pay attention not to overwork.
8, usually can do a nose massage.
Complication
Sinusitis complications Complications rhinitis purulent sinusitis
The nasal cavity and sinus are located under the brain, located above the throat and the mouth, between the two eyelids. They are adjacent to each other and closely related. The nasal cavity and sinus lesions often spread to nearby tissues, thus causing various kinds of concurrency. If it extends to the brain, it can cause serious death. The penetration of the throat and eyelids can also cause various diseases. Especially for children, complications will affect the development of body and intelligence, rhinitis and sinusitis. There are multiple ways of complications:
1 direct infection: the nasal cavity and the mouth, the throat and the lower respiratory tract directly communicate with the digestive tract, rhinitis, sinusitis secretions downward drainage, directly stimulate these tissues, causing various lesions.
2 destruction of bone wall infection: sinus inflammation If the sinus bone wall is destroyed, inflammation often extends to other tissues, because the sinus position is different, so the complications are also different, such as frontal sinusitis easily cause intraorbital or intracranial complications; ethmoid sinusitis Destruction of the apical wall, invasion of the anterior cranial fossa, penetration of the lateral wall, intra-orbital complications, sphenoid sinus destruction of the skull base can cause different complications in the brain, can also cause posterior optic neuritis, maxillary sinusitis can cause intraorbital Complications and complications such as alveolar slime.
3 infection by blood: nasal cavity and sinus have a rich network of blood vessels, and with the sputum, the intracranial complex, so rhinitis and sinusitis bacteria and toxins, first destroy the intima of the blood vessels to form a thrombus, embolus with blood to the line Other organs cause complications.
4 lymphatic infection: lymphatic vessels in the nasal cavity or sinus directly spread inflammatory substances to other organs or tissues.
5 Anatomical access: There are many normal channels in the sinus bone wall. For example, there are many small holes in the upper wall of the ethmoid bone. It is called the mesh hole. It is mainly the olfactory nerve fiber leading to the intracranial hole. The inflammation can be transmitted from the mesh to the intracranial disease. In addition, many blood vessels of the nasal cavity and sinus are directly connected to the iliac crest, and the intracranial communication, inflammation can cause complications along the vascular channel.
6 sinus trauma: causing fractures, perforation or surgical injury, etc. due to bone wall fracture, tissue destruction, making infection easy to invade and disease.
Symptom
Symptoms of sinus symptoms Common symptoms Pus sputum increased and not easy to eliminate paroxysmal nasal congestion Proliferative gland hypertrophy nausea appetite, nasal congestion, discharge of purulent or... Nasal congestion and reflex headache, maxillary sinus cyst morning or morning headache, dizziness
1. Sinusitis is often secondary to upper sensation or acute rhinitis. At this time, the original symptoms are aggravated, chills, fever, loss of appetite, constipation, general discomfort, etc., vomiting, diarrhea, cough and other symptoms may occur in children.
2. More can occur - side persistence, occasionally bilateral persistent nasal congestion.
3. The patient has increased purulent sputum and is not easy to exhaust. For example, when flowing backward into the pharynx and lower respiratory tract, it stimulates the pharynx and throat mucosa, causing hair loss, coughing and coughing, and even nausea.
4. Forehead pain, light in the morning, heavy in the afternoon, may also have pain in the cheeks or pain in the upper molars, mostly maxillary sinusitis.
5. In the morning, the forehead hurts, and the Zhejiang is aggravated. It is relieved in the afternoon and disappears in the evening. This may be frontal sinusitis.
6. The headache is mild, limited to the internal hemorrhoids or the base of the nose, and may also radiate to the top of the head, caused by worm sinusitis.
7. Pain in the deep eye, can be radiated to the top of the head, but also to see the morning light, heavy headache in the afternoon, may be sphenoid sinusitis.
8. In addition to nasal congestion, runny nose, headache and other symptoms, chronic sinusitis has the following characteristics:
(1) The headache is light, and it is generally dull and dull.
(2) The sense of smell is reduced or disappears.
(3) headache can be alleviated after rest, nasal drops, steam inhalation or nasal ventilation.
(4) Coughing, bowing, bending over, and aggravating headache when exerting force.
(5) Smoking, drinking, and excitement can aggravate headaches.
(6) Sometimes it can cause mental fatigue, sleepiness, dizziness, memory loss, inattention and so on.
Examine
Sinusitis check
CT examination has become an important means of diagnosing sinusitis. It is also one of the series of examinations that must be done before sinusitis surgery. CT scan is divided into coronary scan and horizontal scan. Sinusitis often coexists with nasal polyps. CT can show nasal polyps and sinusitis. The scope clearly shows the fine structure of each sinus and its adjacent areas, which provides an important basis for doctors to diagnose and treat sinusitis. It also helps to distinguish sinusitis from other diseases such as sinus cancer through CT.
Diagnosis
Diagnosis and identification of sinusitis
Differential diagnosis
(1) Identification with chronic rhinitis: Chronic rhinitis is not greenish and purulent, and there is no odor. Therefore, observing the nature of the sputum is the key to identification; the X-ray examination can be accurate and accurate, and the chronic rhinitis lesion is confined to the nasal cavity. Chronic sinusitis can be seen in the sinus.
(2) Identification with neurological headache: Some patients with neurological headache can have headaches for many years, repeated attacks, and often mistaken for sinusitis, but this patient has basically no nasal symptoms, so from the performance and taking X-ray film Can be identified.
