4 Inflammatory Diseases of Paranasal Sinuses
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Transcript of 4 Inflammatory Diseases of Paranasal Sinuses
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Inflammatory diseases ofparanasal sinuses
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Acute and Chronic Inflammations ofthe Paranasal Sinuses
Inflammatory process of the mucous tunic,
the submucous layer and sometimes of the periosteumand the bone walls of the paranasal sinuses that lasts
more than 2 months or recurs 4 and more times a year
is classified as chronic sinusitis.As a rule, it is a continuation of an acute process.
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A. Exudative forms: catarral; serous; purulent.
B. Productive forms: parietal- hyperplastic; polypous cystic;
C. Alternative forms: cholesteatomic; caseous; necrotic;
atrophic
The
classification of sinusitis byB.S.Preobrazhenskiy
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D. Mixed forms: Purulent-polypous; serous - catarral; serous - polypous; parietal- hyperplastic - polypous, etc.
E. Vasomotor and allergic forms
The classification of sinusitisby B.S.Preobrazhenskiy
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The Most Common Forms of
Sinusitis
purulent purulent polypoid catarral parietal hyperplastic allergic
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What sinuses are affectedmostly?
1. the maxillary sinus (maxillary sinusitis)2. the ethmoidal sinus (ethmoiditis)3. the frontal sinus (frontal sinusitis)
4. the basilar sinus (sphenoiditis)
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Etiology
1)the decrease of the reactivity of the organism;2)the drainage disfunction of the anastomosis (arcuation of the
nasal septum, hypertrophic rhinitis, adenoids);3)disfunction of the mucous tunic of the nose and the paranasalsinuses.4)nflammation of the tooth-maxillary system
The microorganisms that vegetate on the mucous tunic of theupper airways: staphylococcus, streptococcus, blue pus bacillus,Proteus bacillus, colon bacillus, anaerobes, viruses, fungi.
Causally relevant factors of sinusitis
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Pathogenesisthe inflammation of the mucous tunic of the nasal cavity
and the paranasal sinuses
the edema of the mucous tunic
the closing of the natural anastomosisof the sinuses (the drainage disfunction)
the change of the pressure in the sinus (decreasing)
the vasodilatation and the transudation of the fluid
the migration of the neutrophils with the pus formation (incase of the infection)
the development of the sensitizing as a result of theabsorption of the toxins
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Clinical pictureThe clinical picture depends on:
the stage of the disease (remission,exacerbation);sinusitis form; localisation of the process; extent of the affection (one or several sinuses); kind and virulence of the microorganisms; permeability of the natural anastomosis.
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Clinical pictureRise in temperature, headache,
deterioration of the state of health, pain inthe area of the projection of the sinuses,edema of the eyelids, inflammatory shift inblood.
The painful points in theinflammatory diseases of theparanasal sinuses.
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Rhinoscopic picture
polypous purulentsinusitis
purulent sinusitis
polypous sinusitis
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Diagnostics of Sinusitis Anamnesis Diagnostic puncturing of the maxillar sinus X-ray (CT)
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1. Antibacterial therapy2. anti-inflammatory drugs
3. dehydrating therapy4. desensitizing therapy5. symptomatic treatment
6. vasoconstrictors endonasal7. punctures and drainage of the paranasalsinuses
The conservative treatment
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Surgical Treatment
Operations on the the maxillary sinus: Kaldvell - Lukes operation, Rudakovsoperation. Videoendoscopic maxillary sinusotomy
Operations on the ethmoidal sinus:
Endonasal polypusethmoidotomy
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Kaldvell- Lukes operation
1. incision of the
mucous tunic in thearea of thevestibule of the
mouth
2. opening of the
maxillary sinusthrough itsanterior wall
3. application of
the anastomosisbetween the
maxillary sinus andthe inferior nasal
meatus
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Operations on the ethmoidallabyrinth
Polypotomy of the nose