Sinusitis is an inflammation of the mucous membrane of the sinuses. Among the various types of sinusitis, maxillary sinusitis is the most common, followed by inflammation of the septal sinus, frontal sinus and pterygoid sinus. Sinusitis can occur singly or in multiple cases. Normal sinuses open in the nasal cavity and communicate with the outside world through the nasal cavity.
The main cause of sinusitis is the blockage of the sinus openings due to various causes such as nasal polyps and anomalies of the sinus orifices, which prevent them from communicating with the outside world and thus cause sinus infections. Sinusitis is usually treated from this aspect as well. In addition, allergic reactions and changes in air pressure can easily induce sinusitis, and infection of the teeth can cause odontogenic maxillary sinusitis.
Chronic sinusitis, the main symptoms of the nose, nasal congestion, loss of smell, headache, memory loss, the course of the disease is usually long.
Broadly speaking, treatment can be divided into non-surgical and surgical therapies.
Non-surgical treatment mainly includes the following: (1) local nasal medication: using hormonal drugs and decongestants such as hydroxymethoxazole hydrochloride nasal drops (BITON), ephedrine drops nasal cavity to open the sinus opening. Nasal drops should pay attention to the body position. Generally, the patient should be placed in a supine position with the nostrils facing upward. After the drops should stay for 5-8 minutes before getting up and gently blowing out the medicine and nasal snot, or after sucking to the mouth and then spitting. Do not pinch the bilateral nostrils and blow hard, as this will press the snot through the pharyngeal canal toward the middle ear, thus causing otitis media. This type of nasal decongestant may lead to drug rhinitis if used for a long time, so the medication should not be used for more than 7 days in general. The concentration of medication for children must be reduced accordingly. If chronic sinusitis is accompanied by allergies and nasal mucosal edema is more pronounced, anti-allergic nasal sprays may be applied. The medication should be used under the guidance of a physician.
(2) Oral medication: Oral antibiotics should be based on bacterial culture and drug sensitivity test, and the duration of medication is usually 4-6 weeks. Commonly used drugs include amoxicillin, azithromycin, erythromycin, cephalosporin, etc. If accompanied by allergies, you can also add some anti-allergy drugs, such as: kairetan, paracetamol, etc. Some proprietary Chinese medicines are also effective in the treatment of chronic sinusitis, such as Sinusitis Oral Liquid, which can be applied with antibiotics.
(3) positive and negative pressure replacement method: suitable for chronic whole group boundary sinusitis, is a simple and effective method. During treatment, the nurse has the patient lie flat on the treatment bed with a small pillow under the shoulder and the head tilted back and down. First, put 1% ephedrine saline drops into the nasal cavity to fully constrict the nasal cavity and open the sinus opening, then insert an olive head outside the suction tube into one nostril, pinch the opposite nostril, open the suction device, and ask the patient to intermittently make the “open an open an open-…” sound, nasal cavity The pus in the sinus will be sucked out and the sinus will become negative pressure. Then the antibiotic drops will be put into the nasal cavity and the medicine will enter the sinuses. If you repeat this many times, the pus in the sinuses will be discharged and the medicine will be replaced to achieve the purpose of treatment. Usually 1 time a day, 10 days a course of treatment.
(4) Maxillary sinus puncture rinse: a special puncture needle is used to puncture the maxillary sinus from the lower nasal tract, extract the pus, rinse with saline until the pus is drained, and then inject antibiotic solution. This method is only suitable for maxillary sinusitis.
Surgical therapy is considered if the condition does not improve in adults after systematic treatment with non-surgical therapy or if CT shows irreversible lesions in the nasal cavity and sinuses.
Preoperative CT sinus radiographs are routinely performed to clearly show which sinuses are involved in the lesion, whether the sinus openings are obstructed, and whether the structures in the nasal cavity are abnormal. Combining the history, examination and changes in the sinus CT, the rhinologist will decide whether the patient needs surgical treatment.
Endoscopic nasal and sinus surgery is now used by a wide range of rhinologists. With the aid of an endoscope, the physician can operate under direct vision, thus removing diseased tissue and preserving normal structures.
Nasal endoscope:It is a fiber optic device with its own light source, which can examine the nasal cavity in detail, with an angle ranging from 0 to 90 degrees. It is an important means to diagnose sinusitis and nasal polyps, and through the supporting surgical instruments, it can also provide fine treatment for sinusitis and nasal polyps, reaching areas that cannot be reached by traditional surgery and preserving the normal mucosa and structures of the nasal cavity and sinuses as much as possible, raising the safety, controllability and functionality of nasal and pharyngeal disease treatment to a new level.