Inflammatory diseases of the paranasal sinuses
Diseases of the paranasal sinuses – Elite Treatment in Europe
ENT Diseases -2005
Acute and chronic inflammation of the mucous membrane and bony walls of the paranasal sinuses are found in 25-30% of cases.
The most commonly occurs in inflammation of the maxillary – the maxillary sinus – sinusitis. This is due to the fact that the evacuation of the contents of the sinuses is difficult due to the location of junction with the nasal cavity in the upper third of the medial wall, as well as the fact that inflammation of the posterior roots of the four upper teeth can move to his bosom. In addition, the maxillary sinuses are the largest and are located below the other.
The second highest frequency is inflammation of the ethmoidal labyrinth cells – ethmoiditis for those frontal sinuses – frontal and sphenoid sinuses – sphenoiditis.
However, inflammation often affects less than one, but several of the sinuses – appears polisinuit. The most common blend is combined sinusitis and etmoidita. In some cases there is inflammation of the paranasal sinuses – pansinuit, or sinuses, located on a right or left side – gemisinuit.
The causes of acute inflammation of the sinuses are most often:
- acute respiratory infections
Acute rhinitis is usually accompanied by acute inflammation of the paranasal sinuses.
Chronic sinuity result from prolonged or frequent repetition of the current acute process under the influence of various general and local adverse factors, such as the lowering of the reactivity and the general weakening of the body, impaired drainage of the sinuses, a deviated septum, as well as diseases of the teeth.
In the etiology and pathogenesis of essential role played by pathogenic microflora, although in some cases are reported aseptic sinuity. Purulent form of the disease is most often caused by streptococci and staphylococci, pneumococci sometimes, fungi and other microflora.
In odontogenic antritis pathological discharge from the sinuses, usually contains a microflora, whereas allergic, vasomotor, hyperplastic, serous forms are usually aseptic discharge. Purulent discharge with chronic sinus problems sometimes do not contain microflora.
The inflammatory process can penetrate through the bony wall of the vessels and sinuses okolososudistym spaces. Most infections occur due to the introduction thrombosing veins, perforating the bone wall. After melting the thrombus and the vessel appeared granulation and osteoclasts, which break down bone, forming a perforation of the wall. Penetrating through these perforations, the infection causes a local and general complications – phlegmon of the orbit, subperiosteal and extradural abscess.
The spread of infection from the sinuses and possibly multiple venous anastomoses, which explains, in some cases of severe intraorbital and intracranial complications.
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