What is the cause of sinusitis?
1, lower systemic resistance, such as overwork, cold and moisture, malnutrition, vitamin deficiency, and poor living environment caused by.
2, allergic reaction physique, systemic diseases such as anemia, endocrine insufficiency (such as hypothyroidism, pituitary gland and gonads), acute infectious diseases such as influenza, measles, scarlet fever, diphtheria, etc. can induce the occurrence of this disease.
3, some diseases of the nasal cavity, such as nasal septal deviation, middle turbinate hypertrophy, nasal polyps, allergic rhinitis, nasal foreign bodies or nasal tumors, can also cause sinusitis.
4, adjacent lesions, such as tonsillitis or adenoid hypertrophy, infection of the maxillary second bicuspid and the roots of the first and second molars, damage to the maxillary sinus wall during tooth extraction or caries residue falling into the maxillary sinus can also lead to sinusitis.
5, other, such as sinus trauma fracture; swimming diving posture improper (such as taking vertical diving), or diving and swimming after blowing the nose improperly, sewage into the sinuses; nasal cavity filler stay too long; high altitude flight quickly fall, sinus cavity and the outside world to form a relative negative pressure, the nasal secretions into the sinuses, etc. can also cause the onset.
Regarding the pathogenesis of sinusitis in Western medicine.
Sinus is a number of air-containing cavities around the nasal cavity in the skull and facial bones, including the superior jaw sinus, frontal sinus, sieve sinus and butterfly sinus. Sinusitis is a purulent inflammation of the mucous membrane of the sinuses caused by infection with purulent cocci, and there is an acute and chronic distinction.
Acute sinusitis is an acute purulent inflammation of the mucous membrane of the nasal cavity, which can develop in one sinus alone or in several sinuses at the same time, and can lead to chronic sinusitis if the acute sinusitis is not treated properly or if it recurs.
The majority of this disease is caused by cold and flu, low systemic resistance, other nasal diseases often have nasal obstruction, swimming, diving methods improper, and rapid changes in air pressure (such as flying, diving, etc.) can lead to the occurrence of this disease.
Maxillary sinusitis caused by the spread of tooth root infection is called odontogenic maxillary sinusitis, which is also a type of sinusitis.
What are the manifestations of sinusitis and how to diagnose it?
1, sinusitis often secondary to upper sensation or acute rhinitis, when the original symptoms aggravate, appear chills, fever, loss of appetite, constipation, peripheral discomfort, etc.. Children may experience vomiting, diarrhea, coughing and other symptoms.
2.Many patients may have persistent nasal congestion on one side or occasionally on both sides.
3.Purulent nasal discharge increases and is not easy to blow. If it flows backward into the pharynx and lower respiratory tract, it will stimulate the mucous membrane of the pharynx and throat, causing hair bank, cough and sputum, and even nausea.
4.Forehead pain, light in the morning and heavy in the afternoon. There may also be swelling and pain in the cheek or pain in the upper molar, mostly maxillary sinusitis.
5.Sense of forehead pain in the morning, gradually Zhe aggravated, after the afternoon to reduce, to the evening all disappear, which may be frontal sinusitis.
6.The headache is mild, limited to the inner canthus or the root of the nose, and may also radiate to the top of the head, which is mostly caused by sieve sinusitis.
7, pain deep in the eye, may radiate to the top of the head, but also outlook morning light, afternoon heavy occipital headache, up to may be the butterfly sinusitis.
8, chronic sinusitis in addition to nasal congestion, runny nose, headache and other symptoms, but also the following characteristics.
(1) headache is lighter, generally more of a dull, dull pain.
(2) The sense of smell is diminished or disappeared.
(3) Headache can be relieved after rest, nasal drops, steam inhalation or nasal ventilation and drainage.
(4) The headache is aggravated by coughing, head bowing, bending, or exertion.
(5) The headache can be aggravated by smoking, drinking alcohol and emotional excitement.
(6) Sometimes, it can cause mental fatigue, easy sleepiness, dizziness, memory loss, concentration problems, etc.
What tests should be done for sinusitis?
CT examination has become an important means of diagnosing sinusitis and is one of the series of tests that must be done before sinusitis surgery. CT scans are divided into coronal scans and horizontal scans. Sinusitis often coexists with nasal polyps, and CT can show the extent of sinusitis with nasal polyps, clearly displaying the fine structure of each sinus and its adjacent areas, providing an important basis for doctors to diagnose and treat sinusitis, and through CT, it also helps to differentiate sinusitis from other diseases such as sinus cancer.
What diseases can sinusitis be easily confused with?
(1) Differentiation from chronic rhinitis: chronic rhinitis is not greenish-purulent and has no odor, so observation of the nature of the nasal discharge is the key to differentiation; X-ray examination is accurate in differentiation, as chronic rhinitis lesions are confined to the nasal cavity, while inflammatory lesions are visible in the sinuses in chronic sinusitis.
(2) Identification with neurological headache: some patients suffering from neurological headache can have headache for years and have recurrent attacks, which are often mistaken for sinusitis, but such patients basically have no nasal symptoms, so they can be identified from their performance and radiographs.
How should sinusitis be prevented?
1, usually pay attention to nasal hygiene.
2, pay attention to the method of blowing snot. If you have a stuffy nose, you should press one nostril and blow it slightly. After that alternate and blow.
3, swimming posture should be correct, try to do the head exposed to the water.
4.People with dental disease should be treated thoroughly.
5.When you have an acute attack, take more rest. The bedroom should be bright and keep indoor air circulation. However, avoid direct blowing wind and direct sunlight.
6.Follow the doctor’s advice to use medication in a timely manner.
7, chronic sinusitis, treatment should have confidence and persistence, pay attention to strengthen exercise to enhance physical fitness.
8, strictly prohibit smoking, alcohol, spicy food.
9, keep a cheerful temperament, avoid mental stimulation, while taking care not to overwork.
10, usually can often do nasal massage.
What diseases can be complicated by sinusitis?
The nasal cavity and sinuses are located below the skull, above the throat and mouth, located between the two orbits, they are adjacent to each other, close relationship. Sinus and nasal cavity lesions often spread to nearby tissues and can lead to a variety of complications. If it extends to the skull, it can cause death in severe cases, and the penetration of the throat and orbits can cause various lesions, especially in children, where complications will affect physical and intellectual development. Rhinitis and sinusitis cause complications in several ways.
① Direct infection: the nasal cavity is directly connected to the oral cavity, throat, and lower respiratory and digestive tracts. The downward drainage of rhinitis and sinusitis secretions directly stimulates these tissues and causes various lesions.
If sinus inflammation destroys the bone wall of the sinus, the inflammation often extends to other tissues. Pterygoid sinusitis can cause different intracranial complications by destroying the skull base and can also cause retrobulbar optic neuritis. Maxillary sinusitis can cause complications such as intraorbital infection and alveolar thinning canal.
③Infection via bloodstream: The nasal cavity and sinuses have a rich vascular network and have a complex connection with the orbit and the skull, so the bacteria and toxins of rhinitis and sinusitis first destroy the endothelium of the blood vessels to form thrombi, and the emboli travel with the bloodstream to other organs, causing complications.
④Infection via lymphatic vessels: the lymphatic vessels of the nasal cavity or sinuses directly transmit inflammatory substances to other organs or tissues for pathogenesis.
⑤ via anatomical channels: sinus bone wall has many normal channels such as the upper wall of sieve bone has many small holes called sieve foramen, which is mainly the orifice of olfactory nerve fibers leading to the cranium, inflammation can be transmitted from the sieve foramen into the cranium to develop. In addition, many blood vessels in the nasal cavity and sinuses are also directly connected to the orbit and the cranium, and inflammation can cause complications along the vascular channels.
(6) Sinus trauma: causes fractures, perforation injuries or surgical injuries due to fracture of the bone wall and tissue destruction, making it easy for infection to invade and develop.
How should sinusitis be treated?
The main symptom of sinusitis is the lack of ventilation, so the treatment of sinusitis should be used to contract the membrane, such as 1% ephedrine or nasal drops, with 0, 15% safranin or 0, 5% chloramphenicol liquid nasal drip anti-inflammatory, the number of dots per day to maintain ventilation as the standard. If ventilation cannot be maintained after medication, surgical treatment such as turbinate removal or electrocautery is required. Sinusitis is a purulent inflammation in the sinuses, dominated by a runny nose and headache, and is treated with antibiotics to eliminate bacterial infection in the sinuses, in addition to drops of nasal taxa constrictors. Nowadays, minimally invasive endoscopic techniques without incision are widely used in clinical practice.
Optional western medicine
1. Acute purulent sinusitis.
(1) antibiotics or sulfonamides: sufficient amount to control the infection and prevent it from turning chronic.
(2) 1% ephedrine saline: nasal drops, 1-2 drops each time, 2 times a day.
(3) Sedative and analgesic drugs: for severe headache.
2. Chronic purulent sinusitis.
Local treatment is the main, you can use vasoconstrictor nasal drops, commonly used 1% ephedrine saline, nasal drops net. Dexamethasone, betamethasone, etc. can be added to the nasal drops. It should be noted that nasal drops should not be used for a long time to avoid drug rhinitis.
According to the recent guidelines on the treatment of rhinosinusitis from the Chinese Medical Association’s Branch of Otolaryngology-Head and Neck Surgery: 1. CRS is not a bacterial infection, but an inflammatory disease. The acute phase can be infected due to the invasion of pathogenic bacteria after mucosal epithelial injury. Cephalosporin II antibiotics are preferred during the infection period, amoxicillin + clavulanic acid, clarithromycin.
2. Treatment.
Small doses of long-term macrolide antibiotics orally (clarithromycin 0, 125, twice a day) and intranasally with glucocorticoids (trimethoprim, budesonide, coleus), both of which should be used for more than twelve weeks.