acute suppurative sinusitis
Introduction
Introduction to acute suppurative sinusitis Acute suppurative sinusitis (acutepurulentsinusitis) is an acute suppurative inflammation of the sinus mucosa, which can affect the bone. The maxillary sinus cavity is larger, the sinus floor is lower, and the sinus ostium is higher, easy to accumulate, and is located below each sinus, easy to be infected by inflammation elsewhere, so the incidence of maxillary sinusitis is the highest, ethmoid sinusitis In addition, frontal sinusitis is second, sphenoid sinusitis is the least. The main symptoms of acute suppurative sinusitis are nasal obstruction, excessive purulence, local pain and headache. Nasal obstruction: due to congestion and swelling of the nasal mucosa and accumulation of secretions, there may be persistent nasal obstruction on the affected side and temporary dysosmia. More purulent sputum: There are more purulent or purulent secretions in the affected side of the nose. When starting, the sputum may have a little blood, and the dentate maxillary sinus has odor. Local Pain and Headache: Acute sinusitis often has more severe headaches than inflamed nasal pain. basic knowledge Sickness ratio: 0.05% Susceptible people: no special people Mode of infection: non-infectious Complications: retrobulbar optic neuritis autonomic dysfunction
Cause
Causes of acute suppurative sinusitis
Nasal disease (20%):
Often secondary to respiratory infections or acute rhinitis, high nasal septum deviation, middle turbinate hypertrophy, nasal polyps, nasal tumors, foreign bodies or tamponade for too long, can hinder sinus drainage and cause disease, diving or diving when swimming improperly It can cause sewage to enter the sinus through the nasal cavity and cause disease.
Odontogenic infection (10%):
The second double canine and the root of the first and second molars are located on the bottom wall of the maxillary sinus. When the root infection occurs, the sinus wall may be worn, or the sinus wall may be damaged when the tooth is extracted. Sexual maxillary sinusitis.
Air pressure change (10%):
During aviation, diving, and mountaineering, it may cause damage due to sudden changes in air pressure and negative pressure in the nasal cavity. It is called baro-traumatic sinusitis.
Trauma (20%):
The antrum of the anterior group, especially the maxillary sinus and frontal sinus, is superficial and vulnerable to trauma and fracture. The bacteria can invade the sinus from the skin or nasal mucosa, and can also cause infection due to foreign matter such as shrapnel and dust.
Other factors (15%):
Excessive fatigue, malnutrition, vitamin deficiency, allergic constitution, endocrine disorders, and suffering from various chronic diseases such as anemia, tuberculosis, diabetes, chronic nephritis, etc., weakened body resistance, also the cause of sinusitis, can also be secondary After an acute infectious disease such as influenza.
Prevention
Acute suppurative sinusitis prevention
1. Strengthen physical exercise, enhance physical fitness, and prevent colds.
2. Active rhinitis (cold) and toothache should be actively treated.
3. Do not force the nose when there is secretion in the nasal cavity. It should block one side of the nostril and clean the nasal secretions, and then block the other side of the nostrils to clean the nasal secretions.
4. Timely and thorough treatment of acute inflammation of the nasal cavity and correction of nasal deformity, treatment of chronic rhinitis.
Complication
Acute suppurative sinusitis complications Complications Posterior optic neuritis autonomic dysfunction
1, posterior optic neuritis, leading to decreased vision.
2, pharyngeal infection.
3, bronchitis, bronchiectasis, can lead to bronchial asthma.
4, gastrointestinal irritation, more common in young children, children with purulent sputum and bacteria are swallowed gastrointestinal, causing gastrointestinal disorders, causing loss of appetite, stomach pain, diarrhea or constipation, similar to ulcer disease symptoms.
5, heart disease: can cause endocarditis, pericarditis or myocarditis, autonomic dysfunction, can cause tachycardia, bradycardia, angina and so on.
6, can cause arthritis, rheumatic fever, chorea, nephritis, pyelitis, cystitis, osteomyelitis.
Symptom
Acute suppurative sinusitis symptoms Common symptoms Olfactory disorders Purulent secretions Nostrils pus inflammation Nasal root edema Nasal vestibular skin redness and pain
1. Nasal obstruction: due to congestion and swelling of the nasal mucosa and accumulation of secretions, there may be persistent nasal obstruction on the affected side and temporary dysosmia.
2. More purulent sputum: There are more purulent or purulent secretions in the affected side of the nose. When starting, the sputum may have a little blood, and the dentate maxillary sinus has odor.
3. Local pain and headache: Acute sinusitis often has more severe headaches than inflamed nasal pain. This is caused by swelling of the sinus mucosa and leakage of secretions or negative pressure after the secretions are emptied, stimulating the trigeminal nerve endings. The antrum of the anterior group is close to the surface of the skull. The headache is mostly in the forehead and the affected side. The sinus in the posterior group is deep in the skull. The headache is mostly at the top of the head, the ankle or the occiput.
Examine
Examination of acute suppurative sinusitis
1. Local redness and tenderness: The acute sinusitis in the former group may be red and swollen due to the surface of the skull. The skin and soft tissues of the lesion may be red and swollen. Because the inflammation affects the periosteum, there is tenderness in the corresponding part of the sinus cavity. The acute sinusitis in the posterior group is deep. No redness or tenderness on the surface.
2. Nasal examination: nasal mucosa congestion and swelling, especially in the middle turbinate, middle nasal passages and olfactory sulcus, etc., the sinusitis in the former group can be seen in the middle nasal passage, and the sinusitis in the posterior group can be seen in the sinus.
3. Position drainage: If suspected of sinusitis, no pus is found in the nasal passages, and a postural drainage test is available to aid diagnosis.
4. X-ray sinus film: X-ray nasal and nasal position film is helpful for diagnosis. In acute sinusitis, the sinus mucosa can be swollen, the sinus cavity is turbid, the transmittance is weakened, and sometimes the liquid level is visible.
Diagnosis
Diagnosis and diagnosis of acute suppurative sinusitis
Diagnose based on
1. The condition is often secondary to acute rhinitis, upper sensation, and acute infectious diseases.
2. Have the above symptoms and signs.
3. X-ray film sinus phase showed lesions of sinus turbidity, mucosal thickening or liquid level.
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.
