Chronic inflammation of the frontal sinuses
Front – Elite Treatment in Europe
ENT Diseases -2005
The most common cause of acute sinusitis in the transition is a chronic persistent violation of the patency of the fronto-nasal canal, lowering the reactivity of the organism, especially since the common infectious diseases. This contributes to hypertrophy of the middle turbinate, significant distortion of nasal septum, narrow and curved fronto-nasal canal polypous process in the nasal cavity.
In most chronic sinusitis combined with chronic etmoiditom (inflammation of the ethmoid sinuses). Acute inflammation of the frontal sinus becomes chronic if it lasts more than a half months. The manifestations and complaints depend on the nature of the disease.
In remission of complaints from the nose may not be. However, in most cases the disease is frequent headache in the forehead, nasal discharge almost always arrives, often has an unpleasant smell, impaired nasal breathing and sense of smell.
At rhinoscopy revealed more mucopurulent, but may be mucous or purulent discharge only. In some cases, it is abundant at times poor. Polypous, serous and catarrhal processes are usually accompanied by a detachable liquid light.
The mucous membrane of the most changed in the middle of the front end of the shell and on the opposite part of the nasal septum – hyperemic, thickened, edematous. Palpation of the frontal sinus walls often painful. In the internal angle of the orbit is often a painful swelling. In some cases, nasal congestion, in the absence of microflora in the sinus leads to accumulation of secretions and the formation of mukotseliya, the content of which is the secret of the mucous glands, goblet cells, lymph.
If there is an infection of the sinus outflow disturbance can lead to the formation of subperiosteal abscess, pus formation of cartilage, usually on the lower wall, usually closer to the inner corner of eye.
When severe symptoms of the disease does not cause diagnostic difficulties. In cases where the picture is unclear, or resorting to sounding trepanopunktsii frontal sinus. Their results, including data contrast radiography, as a rule, help to establish the correct diagnosis.
In the absence of local and general complications of sinusitis treatment should begin with conservative measures. The main ones are to ensure drainage of sinus secretions with the infusion of vasoconstrictive nose drops, and the sounding of the sinus contents with suction, irrigation and the introduction of antibiotics in it.
In chronic purulent sinusitis without polypous changes can assign the UHF or microwave therapy. In those cases where in the middle nasal passage hypertrophy has, impeding the outflow of the sinus should be made to release the nasal aperture fronto-nasal canal from excess tissue, thus improving its permeability.
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