chronic frontal sinusitis
Introduction
Introduction to chronic frontal sinusitis Acute sinusitis remains 30 days after the onset of inflammation, known as chronic frontal sinusitis. Often under certain conditions, acute attacks are often accompanied by chronic ethmoid sinusitis. In the sinus, the anatomy of the ethmoid sinus is the most complicated, especially the semilunar hole at the opening of the anterior ethmoid sinus and its nearby uncinate process and sieve funnel. It is a small protrusion and groove-like gap in the middle nasal passage, called sinus nose. Road complex. This is where the nasal inhalation airflow is impacted, and it is also the most invasive part of bacteria, viruses, and inhaled antigens (allergens). Regardless of infection or allergic reaction, it begins with swelling of the mucosa, ciliary movement stops, ethmoid sinus ventilation and drainage are blocked, and then spread to other sinuses. Because the ethmoid sinus drainage is not smooth, if the inflammation is not easy to dissipate, it is easy to prolong to become chronic. basic knowledge The proportion of sickness: 0.01%-0.05% Susceptible people: no specific population Mode of infection: non-infectious Complications: osteomyelitis
Cause
Cause of chronic frontal sinusitis
1. Acute frontal sinusitis is not treated or treated improperly, causing severe damage to the mucosa, loss of normal function, and becoming chronic inflammation.
2. Allergic frontal sinusitis, nasal frontal mucosal edema, decreased cilia transport function, which makes the drainage of acute inflammation blocked, and becomes chronic inflammation.
3. The nasal septum is high, the middle turbinate is hypertrophy, the nasal polyps, and the nasal sinus complex is blocked.
4. Pneumatic damage, such as airborne downhill, swimming and diving, diving operations, can cause chronic infection of the frontal sinus.
5. Systemic factors such as reduced immune function, diabetes, malnutrition, vitamin deficiency, etc.
Prevention
Chronic frontal 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
Chronic frontal sinusitis complications Complications osteomyelitis
Loss of olfactory, if there is frontal osteomyelitis, can form the frontal purulent sputum tube, mostly located in the front wall of the frontal sinus and its bottom, where the bone wall contains bone marrow.
Symptom
Chronic frontal sinus symptoms Common symptoms Morning forehead pain, relieve pus secretion in the afternoon, nasal flow, nasal congestion, nasal congestion, nasal mucosa, swelling, yellow nose, sinus, tenderness, turbinate, swelling, nasal bleeding, posterior hemorrhage
(a) anterior nasal examination
Visible mucosal congestion, purulent secretion in front of the middle nasal passage, the pus of the maxillary sinusitis is mostly in the lower back of the middle nasal passage, sinusitis can be seen in the middle nasal passage and the olfactory fissure have purulent secretion, can be identified .
(2) Head position test
When there is no purulent secretion in the anterior nasal examination, the middle turbinate and the middle nasal mucosa can be contracted with 1% ephedrine, and then the head is kept in the median position for 5 minutes. The nasal cavity is checked again to see if there is pus in the middle nasal passage. In maxillary sinusitis, the maxillary sinus can be washed first, the pus is removed, and then the head drainage is performed to determine the presence of frontal sinusitis.
(3) Frontal sinus X-ray film
Take the nasal frontal position and lateral position, compare the bilateral frontal sinus transmittance, determine the lesions, bilateral frontal sinus size asymmetry is normal, and has no relationship with the diagnosis of frontal sinusitis, well-developed frontal sinus may have bone septum, also It is normal.
(four) CT scan
Coronal and axial scans were used to show the size and extent of the frontal sinus. There was no thickening in the anterior and posterior fascia.
Pathological changes are similar to chronic maxillary sinusitis, with mucosal thickening, cilia disappearing, sinus cavity empyema, allergic inflammation in patients with mucosal edema, polyposis, and different, chronic frontal sinusitis due to poor drainage, It is prone to osteitis and osteomyelitis. It can produce fistulas on the anterior wall and bottom, and continuously discharges the pus. The pupils are mostly on the inner upper wall of the iliac crest, and scar formation can be seen in the upper eyelid.
The forehead is swelled and the affected side is more obvious. If the frontal sinus drainage is blocked, headache may occur. There may be a reflex headache in the trigeminal nerve distribution area. The nasal congestion is obvious. It is often heavier in the morning, and there may be persistent ipsilateral nasal congestion. The substance is purulent or purulent, more in the morning, often associated with head drainage, olfactory sensation, if there is frontal bone osteomyelitis, can form the frontal purulent sputum tube, mostly located in the front wall of the frontal sinus and its bottom, The bone wall contains bone marrow.
Examine
Chronic frontal sinusitis check
(A) anterior nasal examination showed mucosal congestion, purulent secretion in front of the middle nasal passage, the pus of maxillary sinusitis was mostly in the lower back of the middle nasal passage, and the sinusitis was seen in the middle nasal passage and the olfactory fissure. Sex secretions can be identified.
(B) Before the head position test, no pus secretions were found in the nose. The 1% ephedrine can be used to shrink the middle turbinate and the middle nasal mucosa. Then, the head is in the middle position for 5 minutes. Check the nasal cavity again to see if there is any middle nasal passage. When pus appears, accompanied by maxillary sinusitis, the maxillary sinus can be washed first, the pus is removed, and then the head drainage is performed to determine the presence of frontal sinusitis.
(3) Frontal sinus X-ray film takes the nasal frontal position and lateral position, compares the bilateral frontal sinus transmittance, judges the lesions, and the bilateral frontal sinus size is asymmetrical. It has nothing to do with the diagnosis of frontal sinusitis. The frontal sinus may have a bone septum, which is also a normal phenomenon.
(4) The CT scan uses coronal and axial scans to show the size and extent of the frontal sinus. There is no thickening in the anterior and posterior sinus mucosa.
Diagnosis
Diagnosis and diagnosis of chronic frontal sinusitis
It is differentiated from chronic rhinitis, acute sinusitis, chronic ethmoid sinusitis and chronic sphenoid sinusitis.
