chronic suppurative sinusitis
Introduction
Introduction to chronic suppurative sinusitis Chronic suppurative sinusitis is the most common disease in nasal diseases, often formed by acute sinusitis that has not been completely cured or recurrent. Chronic suppurative sinusitis can be a single sinus, but often multiple. Anyone with inflammation on one or both sides of the sinus is called total sinusitis. Treatment of this disease should pay attention to the treatment of allergic causes, remove the source of infection; improve ventilatory drainage, maintain physiological functions and appropriate surgery. Due to the repeated recurrence of acute suppurative sinusitis, it is caused by prolonged recurrence, so its etiology and pathogenic bacteria are similar to those of acute suppurative sinusitis. In addition, atopic physical constitution is closely related to the disease. The disease can also be chronic (such as odontogenic maxillary sinusitis). basic knowledge Sickness ratio: 0.05% Susceptible people: no special people Mode of infection: non-infectious Complications: posterior optic neuritis
Cause
Causes of chronic suppurative sinusitis
Acute sinusitis (35%)
Due to the improper treatment of acute sinusitis, or it has not been completely treated, resulting in repeated episodes, prolonged unhealed, and turned into chronic suppurative sinusitis, which is the primary cause of this disease.
Nasal obstruction (25%)
It is an important cause of this disease. Obstructive diseases in the nasal cavity, such as nasal polyps, turbinate hypertrophy, nasal calculi, nasal septum deviation, nasal tumors, nasal tamponade and other obstruction of nasal sinus ventilation drainage, or foreign body invasion hinder nasal sinus ventilation drainage, can cause the disease.
Odontogenic infection (10%)
Because the root of the upper molar is adjacent to the bottom of the maxillary sinus, if the tooth disease is not cured, it is easy to become odontogenic chronic maxillary sinusitis, and the lesion may cause the disease.
Anatomical factors of the sinus (10%)
Due to the special or abnormal anatomy of each sinus, it is not conducive to ventilating drainage, and it is also a self-factor that cannot be ignored.
Other factors (10%)
Including a variety of chronic diseases, malnutrition, excessive fatigue caused by low body resistance. At the same time, there are various allergic factors and the causes induced by bronchiectasis.
Prevention
Chronic suppurative sinusitis prevention
1. Patients with chronic sinusitis are often accompanied by general malaise and irritability due to long-term illness. The indoor air should be kept fresh. The temperature change should not be too large in winter. Pay attention to rest and adhere to treatment. Children should be treated on time. The patient is doing a bow, and the side is moving, so that the purulent sinus is discharged, the nasal cavity is cleaned, the accumulated purulent sputum is removed, and the nasal cavity is kept smooth.
2, actively prevent colds, timely treatment in the upper respiratory tract infection, because "upper sense" treatment is not thorough, often the cause of chronic rhinitis and chronic sinusitis.
3, working environment dust, heavy pollution, should wear a mask to prevent bacteria from entering the nasal cavity.
4. Actively treat chronic rhinitis.
5, pay attention to no need to force the nose, pus, more people can first drop the drug, then rub the nose, so as not to cause a single sinusitis due to improper nose, the pus will press other sinuses and lead to multiple sinus inflammation.
6, fasting spicy, fatty and irritating food, quit smoking and alcohol.
Complication
Chronic suppurative sinusitis complications Complications posterior optic neuritis
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
Chronic suppurative sinus symptoms Common symptoms Nasal flow, pus, nasal congestion, dull pain, tinnitus, deafness, olfactory disorder, upper toothache
Clinical manifestations:
1, purulent sputum: most of the nasal discharge is purulent or purulent, yellow or yellow-green, the amount of uncertainty, more flow to the throat, unilateral smell, more common in odontogenic maxillary sinusitis.
2, nasal congestion: light and heavy, mostly due to congestion and swelling of the nasal mucosa and increased secretions, nasal congestion can often cause temporary dysosmia.
3, headache: chronic suppurative sinusitis generally obvious local pain or headache, if there is headache, often manifested as dull pain or heavy head, heavy during the day, nighttime light, the former group of sinusitis more than the forehead and nasal root swelling Pain or sorrow, the headache of the posterior group of sinusitis is at the top of the head, the ankle or the posterior occipital region. When suffering from odontogenic maxillary sinusitis, it is often accompanied by ipsilateral upper toothache.
4, other: due to purulent flow into the pharynx and long-term mouth breathing, often accompanied by chronic pharyngitis symptoms, such as phlegm, foreign body sensation or dry throat, etc., if it affects the eustachian tube, there may be tinnitus, deafness and other symptoms.
Examine
Examination of chronic suppurative sinusitis
1. Nasal examination: the lesions are mainly changed in the upper part of the nasal cavity. The middle turbinate edema or hypertrophy, polypoid changes, and some polyps. Some sinusitis in the anterior group can be attached to the surface of the middle nasal and inferior turbinate. Group of sinusitis can be seen in the olfactory sulcus and the back of the middle nasal passages have sticky pus.
2. Postural drainage: When there is suspected chronic suppurative sinusitis and there is no pus in the middle nasal passage or olfactory sulcus, the positional drainage can be checked.
3. Maxillary sinus puncture washing: maxillary sinus puncture washing is not only a diagnostic method for maxillary sinusitis, but also a treatment measure. The flushing liquid should be used for aerobic bacterial culture.
4. X-ray sinus film: for patients with unclear diagnosis or suspected other lesions, can help diagnose.
5. Examination of the teeth: In the case of suspected odontogenic maxillary sinusitis, the relevant teeth should be examined.
Diagnosis
Diagnosis and diagnosis of chronic suppurative sinusitis
(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.
