Sinusitis is a condition that often escapes the consciousness of the patient because it is usually a complication of the infection masked with annoying symptoms of a cold or other viral infection that accompanies and which caused them. Acute sinusitis, when it is incorrectly treated (or left untreated), can become chronic and last for many months.
The gulfs are air-filled double spaces
The paranasal sinuses are even - i.e. double and consist of 2 frontal sinuses, 2 maxillary sinuses, labyrinth (sieve cells) and 2 sphenoid sinuses near the ear. Sinus spaces arranged symmetrically around the nose and eyes. As a rule, the sinuses should have good contact with the nasal cavity. In a sense, they are an extension of the nasal cavities.
Diagram of paranasal sinuses
The frontal sinus - are located above the eyes, while the others are deeper behind the base of the nose. (profile - right)
1- bay, 2 - labyrinth (sieve cells),
3 - maxillary bay, 4 - wedge bay. The largest volumes are the maxillary sinuses located on both sides of the nose. Their capacity is about 15 ml, the upper wall is the bottom of the orbita, the anterolateral - lower wall borders on the upper teeth.
Treatment of chronic sinusitis
- pharmacological treatment
- surgical treatment - the latter is used when permanent lesions are found - for example, pathological changes in the sinuses, defects in the construction of the nose and sinuses, etc.
The goal of pharmacological treatment of chronic sinusitis
1. Mastering the infection of microbes, usually pathogenic bacteria,
2. Reducing the swelling of the nasal mucosa and sinuses, which improves nasal breathing and restores the patency of the sinuses of the sinuses to the nasal cavity; the outflow from the sinuses is allowed.
3. Special treatment requires allergy-induced inflammation, asthma, non-invasive lung disease and more.
The basis of pharmacological treatment is antibiotic therapy
However, the duration of use of antibiotics should be longer - up to 4 weeks (due to shorter similar therapy in acute bacterial inflammation). It is advisable to recognize a strain of pathogenic bacteria that infect the sinuses. Antibiotic therapy for chronic sinusitis is most often followed by an incorrectly selected antibiotic and failure of treatment of acute bacterial disease. Antibiogram - is a recommended laboratory test to determine the bacteria present in a nasal sample taken from the patient. This method allows the accurate selection of a new effective antibiotic, without making another mistake in treatment.
Treatment of symptoms of chronic sinusitis
Analogously, as in acute inflammation, the purpose of the treatment is to fight inflammation causing: swelling of the nasal mucosa and sinuses and liquefaction of secretion (phlegm) remaining in the sinuses. In addition, the treatment of sinus pain, headache, fever, etc. symptoms.
Acute rhinosinusitis - course and treatment
Surgical treatment of sinuses - the purpose of treatment:
- removal of diseased tissues, with maximum retention of the remaining segments of the mucous membrane
- creating a good connection between the sinuses and the nasal cavity
- the inclusion of all paranasal sinuses in which the disease process is carried out.
Surgical procedures
In the surgical treatment of chronic sinusitis - alongside classical sinus surgery - intra-nasal microsurgery and the endoscopic technique allow it to be used more and more. These techniques minimize the patient's injuries and shorten the time of rehabilitation.
Surgical treatment of sinuses - first a diagnosis
However, the decision about surgical treatment of the sinuses requires accurate diagnostic imaging.Only a diagnostically valuable image now provides computed tomography (or techniques of similar quality).
Radiographic examination of the sinuses
Traditional radiological photographs of the sinuses provide information about the state of large sinuses: maxillary and frontal sinuses. However, their usefulness is limited because they do not inform about changes in the anterior thrush, which plays a fundamental role in the development of rhinosinusitis. They can only be helpful in diagnosing acute sinusitis, but this is what we usually know earlier.
Computer tomography of the sinuses
The basis for the decision about the surgical procedure and assessment of the sinus level should be computed tomography, which provides information not only about changes in all sinuses, but also allows to assess anomalies in the construction of rush and in the complex of mouth and wire between the nose and the sinus cavities. The basis for the use of computed tomography - in the course of acute sinusitis is: lack of improvement after 48-72 hours of treatment of acute sinusitis with severe course, suspected sinusoidal orbital or intracranial complications.
Ed. Edward Ozga Michalski, MA
Literature:
1. Sinusitis; Dr hab. n. med. Józef Jordan, prof. Medical Academy in Gdańsk, Head of the Otolaryngological Department of the Municipal Hospital in Gdynia; PharmaNet.pl - art. Internet. E-mail: [email protected]
2. Acute sinusitis in children - Dr. med. Teresa Oleniacz; Health Service No. 3-4 (2998-2999); 2001 Department of Audiology, Phoniatrics and Laryngology IP-CZD Warsaw
3. "Laryngological complications of viral infections of the upper respiratory tract"; Dr n. Med. Urszula Samolińska-Zawisza - Central Clinical Hospital of the Medical Academy in Warsaw; Internet
5. Internet: www.zdrowezatoki
6. Child from A to Z - medical guide - Dr. Miriam Stoppard, ed. Athena 1986
