Edema of the mucous membrane of the frontal sinuses
Acute front is an acute inflammation (catarrhal, serous, purulent) of the mucous frontal sinuses.
The cause of acute frontal infection is infection(bacterial, viral, fungal), penetrating into the sinuses from the nose with an acute cold (rhinitis). Most often the acute frontitis develops as a complication against the background of influenza and ARVI, as well as some infectious diseases (scarlet fever, diphtheria, etc.). Among other reasons, the trauma of the nose and paranasal sinuses are important.
Outflow from sinus with edema of the mucosacan quickly be disturbed due to the fact that the frontal-nasal canal is relatively narrow; Separation of the sinus with the nasal cavity leads to an infectious inflammation in it. Etiology, pathogenesis and morphological changes in inflammation of the frontal sinus are similar to those in sinusitis.
with acute frontal pain in the areaforehead; pain can be spontaneous or appear with percussion - an easy tapping of the finger along the frontal bone, the pain can increase with the torso tilted down. A characteristic feature of the disease is a headache that appears in the morning after sleep and decreases in the afternoon, a diffuse or diffuse headache. Patients complain of a feeling of pressure in the eye, lacrimation and photophobia, a violation of the sense of smell and nasal breathing. Discharge from the nose can be mucous, mucopurulent and purulent, usually purulent discharge from the corresponding half of the nose. Discharge from the nose at first are serous, liquid, then get purulent in nature, usually do not have a smell. Breathing through the nose is broken on the side of the affected sinus. Usually patients complain of weakness, poor health. The body temperature at the expressed forms of the disease rises to the febrile figures. In the area of the projection of the sinuses, swelling and hyperemia of the skin sometimes appear, which spread to the inner corner of the orbit and the upper eyelid. Palpation of the lower sinus wall is very painful. The appearance of an abscess in the upper-right corner of the orbit or upper eyelid often indicates the necrosis of the sinus bone wall.
At a rhinoscope the allocation of pus from underthe front end of the middle shell; here there is the greatest thickening of the mucous membrane and hyperemia of it. The X-ray picture is typical for acute rhinitis. It is easier to do under the X-ray screen. For the same purpose, an aspiration technique with the use of the sine-catheter "Yamik" GI Markov-VS Kozlov can be used. For the diagnosis of acute frontal x-ray and treponopuncture of the frontal sinus are used, which is also an effective therapeutic method. On X-rays in the direct and lateral projections, the darkening of the affected sinus is determined, however, it is impossible to attach an absolute value to these data, since the darkening can be caused by other causes, for example, such as thickening of the mucous membrane after a previously transferred frontal sinus, thick sinus walls, swelling on the anterior wall sinuses. Trepanopuncture of the frontal sinus (according to ME Antonyuk) with acute frontitis is used less often than with chronic, indication to it are signs of complication: swelling in the corner of the eye, upper eyelid or forehead, ineffective treatment in the first day, neurological complications. The device for trepanopuncture includes drills, a device that provides manual rotation of the drill and limiting its penetration into the depth of tissues, and a set of special cannula for fixing the hole and rinsing the sinus. Trepanopunculation is performed both in stationary and in polyclinic conditions. The acute frontitis should be differentiated from sinus tumors and intracranial complications, neuralgia of the first branch of the trigeminal nerve, and sometimes from disorders of cerebral circulation and vision.
To reduce the swelling of the mucosanasal cavity and improvement of the outflow of the pathological content of the frontal sinus, vasoconstrictive drops in the nose are used: Naphthysine, Galazoline, Oxymetazoline, Sanorin, Tysin, Pharmazoline. One of these drugs is digested 2-3 drops in each half of the nose 3-4 times a day.
After instilling vasoconstrictive drops, one can make irrigation of the nasal cavity with one of the aerosols: Bioparox, Kameton, Proposol.
With an acute front, antibiotics are prescribed infor 7-10 days, the choice of the drug depends on its tolerability and severity of the disease. The most commonly used drugs are: Augmentin, Flemoxin Solutab, Sumamed, Sporidex (cephalexin), Rovamycin, Ampiox, Durazef, Cefazolinum, ceftriaxone - intramuscularly, Cyphran.
Parallel with antibiotics one of theantihistamines: Suprastin, Dimedrol, Diazolin, Tavegil - 1 tablet 2 to 3 times a day, for 7-10 days. These drugs reduce the swelling of the mucous membrane of the nasal cavity.
To dilute a thick purulent secretion, use ATSTS-long (600 mg) according to 1 tabl. Once a day, the drug contributes to an easier exit of pus from the sinuses.
In complex treatment apply alsohomeopathic remedies (Cinnabsin, Sinupret), they contribute to reducing inflammation in the sinuses, edema, pain sensations. Drugs can be used on their own, if there is an allergy to other medications, or if the disease is easier.
A good effect is obtained by rinsing the nasal cavitymethod of displacement - "cuckoo". For washing use solutions with antimicrobial and anti-inflammatory action - a solution of chlorophyllipt, furacillin, etc.
Surgical intervention - puncture of the frontalsinuses, are performed with ineffectiveness of conservative treatment, as well as in the presence of pus in the sinus and severe headaches, i.e., when the outflow of sinus contents through the natural anastomosis
It is advisable to aspirate the contents from the sinus, wash it and inject anti-inflammatory and antimicrobial drugs with the help of the sinus catheter Yamik.
The area of the frontal sinus is used UHF or UHF only if the outflow of contents from the sinus is good, because otherwise physiotherapy will cause a worsening of the course of the disease.