Often, sufferers use the term in general, referring to inflammation of the sinuses. The paranasal sinuses are an anatomically defined complex of cavities (and pores) around the nose that contain air.
In addition to the pair of sinuses, there are the frontal sinuses, the wedge-shaped sinuses and the peritoneal cells. All sinuses are connected to the inside of the nose through small openings. Their functions are to warm the inhaled air, to amplify the voice like resonators and to protect the brain, in cases of personal skull injury.
Despite the fact that the nasal cavity is full of germs, the sinuses are sterile germs, probably due to the production of nitric oxide (NO) and their fringes (capillary adhesions of epithelial cells).
What causes sinusitis?
“It could be due to a virus (viral) or a bacterium (bacterial). Factors that predispose to its occurrence are: allergic / non-allergic rhinitis, scoliosis of the diaphragm, swelling of the middle nasal cavity, topical use of drugs for the nose, smoking, diabetes, swimming and diving , mountaineering, dental infections or some dental procedures, mechanical ventilation or intubation, cystic fibrosis, personal skull injuries such as fractures, aspirin allergy, nasal polyps and asthma (Samter trinity), sarcoidosis, common variable, iatrogenic), IgA deficiency, AIDS and fixed fringe syndrome “, explains Mr. Christos Gionis, Director Otolaryngologist at Metropolitan Hospital.
87% of patients with common cold on computed tomography are found with acute (viral) sinusitis. Of these patients, 0.5% -2% of adults and 5% -13% of children then develop bacterial sinusitis as a complication. It has also been found that about 60% of patients with the common cold, whose symptoms do not go away after a week, have a positive culture of fluid obtained by puncture of the sinus.
The initial symptoms of sinusitis are those of the common cold (sneezing, runny nose, nasal congestion, pressure on the face, headache). The following may occur: purulent nasal discharge, toothache, pain or tenderness in the sinus area, possibly tinnitus and hearing loss. Characteristic of bacterial sinusitis is the worsening of these symptoms after an initial improvement. Children also have a cough.
“In severe cases there may be symptoms such as high (> 39 ° C) persistent fever, pericardial edema (swelling around the eye sockets), severe pain in the face or upper jaw teeth, loss of consciousness and diplopia. “that should lead the sick people in search of medical assistance”, the doctor points out.
Diagnosis
The diagnosis is basically clinical (history & clinical picture). The outpatient examination may be: anterior rhinoscopy, sinus ultrasound, sinus radiograph and computed tomography. The sinus of the sinus can also be punctured and fluid for culture can be obtained or material for culture can be obtained from the effluent of the sinus, with a rigid endoscope.
Types of sinusitis and their characteristics
Acute sinusitis is more likely to occur after a common cold and lasts less than four weeks.
• Hypoxia lasts for 4-12 weeks and persistent symptoms that complicate the patient’s daily life.
• The acute recurrent, with 4 episodes per year lasting 7-10 days each, which completely subside with medication.
Chronic, lasting more than 12 weeks, which is more common in people with severe nasal septal scoliosis, severe nasal hypertrophy and people with nasal polyps.
• The acute exacerbation of chronic sinusitis, with sudden exacerbations of chronic, which subside after medication
In all cases, the diagnosis of sinusitis should be individualized and made by a qualified otolaryngologist, so that its etiology can be investigated, its symptoms treated in a timely and effective manner and complications that can be extremely dangerous can be avoided.
What are the complications of sinusitis?
Dangerous complications of sinusitis (which are more common in patients who are late to seek medical help) may be subperiosteal abscess of the eye socket, osteomyelitis of the bones of the skull, thrombosis of the sinus sinus (vascular base of the cranium), , meningitis, encephalitis. Nowadays, however, the above complications are not common precisely because patients, being more informed, do what they need to do, seek medical help in a timely manner.
What is the treatment for sinusitis?
The treatment of sinusitis depends on its type and cause. Includes nasal cleansing with isotonic solutions, use of nasal sprays and medication (analgesics and antibiotics). When this conservative treatment is not effective (symptoms worsen and complications appear), surgical cleaning of the sinuses is performed through endoscopic surgery (FESS: Functional Endoscopic Sinus Surgery).
In endoscopic surgery, thin endoscopes, cameras and a navigator system are used, which provide an improved image and enable the preservation of the normal structures of the nose, as the removal of the pathology of the affected area is achieved. The operation has no incisions, bruising, swelling and is painless, which makes the patient able to return to his activities the very next day, following the doctor’s postoperative instructions and avoiding intense physical activity.
Prevention
“Prevention consists of eliminating some predisposing factors such as smoking (which should be stopped anyway) and adopting some practices that reduce the likelihood of developing sinusitis such as proper hygiene of the upper respiratory tract (eg cleansing). nasal washes), maintaining the normal humidity of the nasal cavity with good quality air conditioning of the space in which we live or work and avoiding our exposure to sudden and large changes in temperature. In case of sudden appearance of symptoms like the ones mentioned above, the timely visit to a specialized ENT is imperative “, concludes Mr. Gionis.
Writes:
Mr. Christos Gionis, Director Otolaryngologist at Metropolitan Hospital
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