Ethmoiditis what is it

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Ethmoiditis

Acute respiratory viral diseases, colds and rhinitis (runny nose) are often accompanied by inflammation of the paranasal sinuses. There are several of them. The common name for their inflammation is sinusitis.

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But the inflammation of each individual sinus has its own unique name. In this article on vospalenia.ru we will look at ethmoiditis.

What is ethmoiditis?

What is it - ethmoiditis (ethmoidal sinusitis)? This is an inflammation of one of the paranasal sinuses, or rather, the cells of the ethmoid bone. It is often a secondary disease that develops against the background of inflammation of the upper respiratory tract. It ranks 5th in terms of the prevalence of diseases that are treated with antibiotics.

The shape of the flow is:

  1. Acute – a bright and sudden manifestation. More often observed in children and adolescents.
  2. Chronic – a consequence of anatomical pathology or untreated acute ethmoiditis.

The following types of ethmoiditis are distinguished:

  1. Together with other departments:
    • Maxillary ethmoiditis is inflammation of the ethmoid bone with the maxillary sinuses.
    • Frontoethmoiditis is a lesion of the frontal sinus along with the ethmoid bone.
    • Rhinoethmoiditis is inflammation of the ethmoid bone together with the mucous membrane of the nasal cavity.
    • Sphenoethmoiditis is inflammation of the ethmoidal labyrinth with the sphenoid sinus.
  2. According to the nature of inflammation:
  • Catarrhal.
  • Polypous.
  • Edema-catarrhal.
  • Purulent.
  1. On the side of inflammation:
  • Right-handed.
  • Left-handed.
  • Bilateral.

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Causes

The causes of ethmoiditis are the following factors:

  • Penetration of infection into the nasal sinus.
  • Complication of other diseases: measles, meningitis, sinusitis, scarlet fever, rhinitis, influenza, encephalitis, sinusitis.
  • Spread of infection from other organs through the blood, for example, with tonsillitis.
  • Decreased immunity.
  • Anatomical pathologies.
  • Injuries to the nasal septum and face.
  • Allergic predisposition.

Symptoms and signs of ethmoiditis of the ethmoid bone cells

The following symptoms and signs of ethmoiditis of the ethmoid bone cells are distinguished:

  • Pain. Localized in the bridge of the nose and fronto-orbital region. Accompanied by headaches, high fever, photophobia, and blurred vision. In the chronic form, insomnia, eye fatigue and swelling are observed.
  • A feeling of fullness in the nasal cavity due to the occurrence of pus and swelling of the cells. Nasal congestion.
  • Difficulty breathing through the nose due to swelling of the mucous membrane. Children may experience complete absence of nasal breathing.
  • Nasal discharge, which characterizes exudate accumulated in inflamed cells. They can be mucous, purulent or bloody. At first they are scanty, and then they become abundant.
  • Partial or complete absence of smell.

These symptoms are characteristic of both acute and chronic forms. The following signs appear clearly only in the acute form of ethmoiditis, and in the chronic form they are weak and unexpressed:

  • Fever.
  • Regurgitation (in children) and vomiting.
  • Malaise.
  • Loss of appetite.
  • Neurotoxicosis.
  • Weakness.
  • Intestinal disorders: as with colitis or proctitis, stool disturbance is observed.
  • Kidney failure.
  • Tearing.
  • Swollen eyelids that are slightly or completely closed. It occurs as a result of the destruction of part of the ethmoid bone and the penetration of exudate into the tissue of the orbit. Here there is deviation, protrusion of the eyeball, decreased vision and pain when moving the eye.
  • Skin is hot and damp.

During remissions in chronic ethmoiditis, symptoms worsen only in intoxication (weakness, fever, decreased performance, headache).

Ethmoiditis in children

Ethmoiditis often occurs in children (more often than in adults). This is due to the anatomical structure and low resistance of the body. It often develops against the background of colds in the winter, when children transmit the infection to each other. It can manifest itself in both newborns and children of primary school age, and especially in adolescents.

Ethmoiditis in adults

Ethmoiditis also occurs in adults, often in winter, when they get colds and do not treat them. The presence of chronic diseases also provokes the transfer of infection to the cells of the ethmoid bone.

Diagnostics

Diagnosis of ethmoiditis consists of a general examination based on the patient’s complaints, from which some manifestations of the disease are already visible, as well as laboratory and instrumental procedures:

  • Rhinoscopy.
  • Blood analysis.
  • X-ray of the nasal sinuses.
  • Endoscopic examination.
  • CT and MRI.
  • Exclusion of dacryocystitis, periostitis of the nasal bones, ostiomyelitis of the upper jaw.

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Treatment

Treatment of ethmoiditis consists of undergoing medication and physiotherapeutic procedures. How to treat inflammation of the cells of the ethmoid area of ​​the nose? The ENT doctor prescribes the following course of medications:

  • Antibiotics and antiviral drugs.
  • Immunostimulating drugs. Immunomodulators.
  • Vasoconstrictor medications.
  • Antipyretic medications.
  • Antihistamines.
  • Non-steroidal anti-inflammatory drugs.
  • Painkillers.
    1. Galazolin.
    2. Xymelin.
    3. Oxymetazoline.
    4. Amoxicillin.
    5. Augmentin.
    6. Cefotaxime.
    7. Bioparox.
    8. Ceftriaxone.
    9. Rinofluimucil.
    10. Paracetamol.
    11. Aqua Maris.
    12. Sinuforte.

At home, the patient must adhere to the following rules:

      • Increase immunity.
      • Ventilate the room and humidify the air.
      • Follow a diet:
        1. Drink plenty of fluids.
        2. Consume vegetables, fruits, dairy products, nuts, meat, cereals, legumes.
        3. Avoid alcohol, fatty, fried and allergy-causing foods.
        4. Use decoctions of herbs, berries and fruits.

      The following are used as physical procedures and surgical interventions:

      • Sinus catheter "YAMIK" rinsing cells with antibiotics.
      • Other types of washing.
      • Electrophoresis with antibiotics.
      • UHF.
      • Phonophoresis with hydrocortisone.
      • Helium-neon laser.
      • Endoscopic removal of exudate.
      • Septoplasty.
      • Resection.
      • Polypotomy.

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      Lifespan

      Ethmoiditis is easily and quickly treated. However, if the patient ignores treatment for the disease, then it reduces the quality of life. How long do patients live? The disease itself does not affect life expectancy, but it provokes several fatal complications:

      • Empyema.
      • Meningitis.
      • Destruction of the ethmoid bone.
      • Encephalitis.
      • Phlegmon of the orbit.
      • Retrobulbar abscess.
      • Arachnoiditis.
      • Brain abscess.

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      Source: http://vospalenia.ru/etmoidit.html

      Symptoms and treatment of ethmoiditis

      Ethmoidal sinusitis is an inflammation of the cells of the ethmoidal labyrinth. In terms of prevalence, this pathology ranks second after sinusitis. Let's look at the main factors that provoke the development of the disease. We will also dwell separately on the description of the characteristic symptoms, diagnostic methods and basic treatment regimens. Let's also consider some traditional medicine recipes that are very effective.

      Causes

      Acute ethmoiditis, as a rule, is a complication of rhinitis, respiratory infections, and influenza. However, not all people develop signs of sinusitis after an acute respiratory infection. The presence of predisposing factors also plays an important role in the development of the disease. Namely:

      • narrow middle nasal passage;
      • deviated nasal septum;
      • adenoid vegetations;
      • anatomical features of the location of the anastomosis of the ethmoid sinus.

      Chronic ethmoiditis occurs as a result of an undertreated or undiagnosed acute process. The development of the disease is also facilitated by frequent infectious diseases, which reduce the state of general and local immunity.

      All this creates unfavorable conditions in which even minor swelling of the mucous membrane significantly impairs drainage. The anatomical and topographic proximity of the outlet openings contributes to the occurrence of combined sinusitis. Pathologies such as frontoethmoiditis and maxillary ethmoiditis are often observed.

      Clinic

      Acute ethmoiditis occurs with characteristic symptoms, which include both local and general symptoms.

      • Increased body temperature.
      • Headaches in the area of ​​the bridge of the nose, orbit, localized on the side of inflammation - with a unilateral pathological process. Bilateral ethmoiditis is characterized by symmetry of the lesion.
      • Weakness.
      • Decreased appetite.

      Local symptoms of ethmoiditis are similar to manifestations that are observed with other sinusitis. As a rule, patients complain of:

      • difficulty in nasal breathing;
      • nasal congestion;
      • mucous or mucopurulent discharge from the nose;
      • impaired sense of smell.

      Chronic ethmoiditis is often asymptomatic. Severe symptoms are observed during exacerbation of the inflammatory process.

      Diagnostics

      The diagnosis of “ethmoidal sinusitis” is based on the collection of characteristic complaints, anamnesis data, and the results of an additional examination.

      With anterior rhinoscopy, doctors determine the following signs characteristic of acute inflammation:

      1. The mucous membrane in the area of ​​the middle concha is swollen and hyperemic.
      2. Exudate can be released in 2 ways. With ethmoid sinusitis (if the anterior cells are involved in the process), mucopurulent discharge drains from under the middle concha. When the posterior cells are damaged, exudate is released from the area of ​​the olfactory fissure.

      If the patient has chronic ethmoiditis, anterior rhinoscopy can reveal:

      1. Hyperplasia of the mucous membrane in the middle tract area.
      2. Polypous degeneration (polyps can even obstruct the nasal cavity, polypous ethmoiditis).
      3. Purulent or mucopurulent discharge.
      4. Bilateral ethmoiditis is characterized by symmetry of the lesion.

      To improve the overview of rhinoscopy, a stage of anemia precedes it (vasoconstrictor drops relieve swelling).

      An endoscopic examination helps to differentiate ethmoidal sinusitis from other diseases, during which it is possible to examine:

      1. The condition of the anastomosis of the ethmoid sinus with the nasal cavity.
      2. Exact localization of the inflammatory process: anterior or posterior cells.
      3. The nature of the separated. Catarrhal ethmoiditis is characterized by the presence of mucous discharge. With purulent inflammation, the exudate is purulent-mucosal.

      Acute ethmoiditis, as well as chronic, can also be determined by CT. The x-ray will show shadows in the area of ​​the ethmoid sinuses.

      The significance of rhinoscopy, endoscopy, and computed tomography is very high, since these are the main methods both when diagnosing “ethmoidal sinusitis” and in determining the form of the disease (purulent or serous ethmoiditis). After all, the topography of the ethmoid sinuses does not allow for diagnostic puncture.

      Treatment of acute inflammation

      Only an otolaryngologist knows how to treat ethmoiditis. Which groups of drugs are prescribed for anti-inflammatory therapy depends on the patient’s condition. In addition, there are cases when surgical intervention is indicated.

      So, treatment of acute ethmoiditis in the absence of complications is carried out conservatively. Vasoconstrictor drops are prescribed locally to relieve tissue swelling. But turundas soaked in an adrenaline solution have the best effectiveness. They are placed in the area of ​​the middle nasal passage.

      The treatment regimen also includes:

      • Combined products in the form of endonasal sprays containing antibiotics, secretolytics, painkillers (Isofra, Rinofluimucil).
      • Physiotherapeutic measures (therapeutic laser, UHF).
      • Acute ethmoiditis is an indication for the use of a sinus catheter, which is used to aspirate the contents of the sinuses and administer drug-based solutions.
      • Antibiotic therapy, which is carried out through the use of drugs such as Augmentin, Klacid.
      • Hyposensitization (Claritin).
      • Prescription of mucolytics.
      • Symptomatic therapy (antipyretic medications).

      In case of complications (subperiosteal abscess, empyema, phlegmon of orbital tissue), surgical intervention is indicated. Together with the opening of the ethmoidal labyrinth (endonasal access is used), the phlegmon of the orbit or eyelid abscess is opened (external or endonasal access is used).

      Treatment of chronic inflammation

      Treatment of chronic ethmoiditis in the absence of complications is carried out conservatively. Let's consider the main components of the treatment regimen:

      1. Antibiotics.
      2. Vasoconstrictor drops (to relieve swelling, improve outflow). Aerosols (Galazolin, Sanorin) can also be used.
      3. Combined medications: antibiotic + vasoconstrictor + analgesic (Isofra, Bioparox).
      4. Physiotherapeutic procedures. UHF up to 7 sessions (in the absence of polyps), endonasal calcium chloride electrophoresis, hydrocortisone phonophoresis (up to 10 times).

      If gentle treatment does not bring the desired effect, the following surgical techniques are used:

      • septoplasty;
      • polypotomy;
      • partial or total opening of the sinus with partial excision of hyperplastic areas (in patients diagnosed with hyperplastic ethmoiditis).

      Also, relapses are often observed in patients after polypotomy surgery. That is why therapy in the postoperative period often includes the use of corticosteroids (Aldecin, Flixonase).

      The effectiveness of ethmoidotomy and polypotomy has increased significantly thanks to the use of microscopes and rigid endoscopes in which the viewing angle can be adjusted. Thus, endonasal surgery with endoscopic control allows for high-quality sanitization of the pathological focus, while the likelihood of developing complications is much lower.

      ethnoscience

      Treatment of ethmoiditis with folk remedies can be carried out using nasal instillations, inhalations, rinses, compresses, and massage.

      1. The solution for rinsing is prepared as follows: mix honey with onion juice (1:1), leave for 3 hours, rinse the nose.
      2. For inhalation, use dill decoction or fir oil. During this procedure, you must actively breathe through your nose.
      3. Infusions of St. John's wort, sage, and chamomile are a good anti-inflammatory agent that is suitable for instillation.
      4. Ethmoidal sinusitis can be treated at home with a salt compress. To do this, rock salt is fried in a frying pan, placed in a fabric bag, and applied to the inflamed area.
      5. Chinese traditional medicine offers acupressure as a therapeutic measure.

      It is important to remember that the advisability of using traditional medicine recipes can be determined solely by the attending physician. Never self-medicate! After all, improper use of warm compresses can cause the transition of serous inflammation to purulent. At the same time, the risks of developing orbital phlegmon, abscess and even meningitis increase.

      Source: http://gaimorit-sl.ru/sinusity/etmoidit-simptomy-i-lechenie.html

      Ethmoiditis: causes, signs, how to treat, antibiotics

      Ethmoiditis is a special form of sinusitis, characterized by the development of a pathological process in the ethmoid labyrinth. It is part of the ethmoid bone, which separates the skull from the nasal cavity. The labyrinth is a paired formation consisting of air cells, the mucous membrane of which becomes inflamed when infected.

      Inflammation of the ethmoid sinuses often develops against the background of acute respiratory infections, rhinitis, sinusitis, frontal sinusitis, adenoiditis, measles or scarlet fever. Ethmoiditis usually affects children of preschool and primary school age. In newborns and adults, pathology is rarely diagnosed. A decrease in the general resistance of the body and frequent viral diseases of the nasopharynx contribute to the development of the disease.

      Etiology and pathogenesis

      Bacterial ethmoiditis is caused by opportunistic microorganisms - representatives of coccal microflora: staphylococci and streptococci. The causative agents of viral ethmoiditis are influenza viruses, parainfluenza, rhinoviruses, adenoviruses, and coronoviruses. The cause of the disease is often pathogenic fungi.

      Often, several pathogenic agents are simultaneously detected in the studied biological material taken from a sick person. In this case, they talk about a mixed infection.

      Dysfunction of the immune system and weakening of the body's defenses contribute to the rapid growth and reproduction of microbes.

      Ethmoiditis in adults is a complication of infectious pathology of the ENT organs: sinusitis or rhinitis. In newborns, the disease develops against the background of a generalized bacterial infection - intrauterine sepsis.

      adenoids and polyps are a possible cause of ethmoiditis

      The main causes of ethmoiditis:

      • Viral, bacterial and fungal infections;
      • Inflammation of the nasal mucosa and paranasal sinuses;
      • Diseases of the nasopharynx;
      • Congenital pathologies of the nose;
      • Allergic rhinitis;
      • Polyps, adenoids;
      • Defects of the nasal septum;
      • Nose fracture;
      • Immunodeficiency.

      Ethmoiditis often becomes a complication of advanced sinusitis, sphenoiditis or frontal sinusitis. The spread of inflammation to the anterior sections of the ethmoid bone leads to the formation of frontoethmoiditis and maxillary ethmoiditis. Simultaneous damage to two or more paranasal sinuses is called pansinusitis or polysinusitis.

      The causes of polypous ethmoiditis are adenoids or polyps - growths present in the nasal cavity. They prevent the normal outflow of mucus from the ethmoid labyrinth and create optimal conditions for the life of microbes. Chronic polypous ethmoiditis can only be treated surgically, allowing the normal functioning of the nose to be restored.

      Classification of ethmoiditis

      1. According to the nature of the course, ethmoiditis is divided into acute and chronic.
      2. Based on the localization of the pathological process, left-sided, right-sided and bilateral ethmoiditis are distinguished.
      3. Based on the nature of the discharge, ethmoiditis is divided into catarrhal, purulent, edematous-catarrhal, and polypous.
      4. The disease can be primary or secondary. Primary ethmoiditis begins acutely with a sharp rise in temperature to significant numbers, the appearance of symptoms of dyspepsia and intoxication. Secondary ethmoiditis is a complication of an existing pathology in the body.

      Clinical picture

      Acute ethmoiditis begins suddenly, is severe and has characteristic symptoms.

      • The pain syndrome is manifested by a pressing headache, the intensity of which increases when the head is tilted.
      • Intoxication syndrome - fever, weakness, fatigue, impaired appetite and sleep, decreased performance.
      • Impaired nasal breathing, manifested by nasal congestion, decreased or absent sense of smell, and serous nasal discharge. When a bacterial infection occurs, the mucus thickens, the discharge becomes yellow-green and acquires an unpleasant odor. This is how purulent ethmoiditis develops.

      The disease, which occurs for the first time, responds well to therapy and resolves without complications. Each subsequent case is much more severe than the previous one, is poorly treated and becomes chronic.

      Symptoms of ethmoiditis in children:

      1. Increase in body temperature to febrile values,
      2. General anxiety
      3. Vomit,
      4. Regurgitation.

      In the absence of timely and adequate treatment, dehydration occurs and neurotoxicosis develops. The disease is often accompanied by symptoms of eye damage: swelling and redness of the eyelids, narrowing of the palpebral fissure, poor mobility of the eyeball, exophthalmos.

      Acute ethmoiditis often becomes chronic. This process is facilitated by decreased immunity and ineffective treatment. In chronic ethmoiditis, exacerbations are replaced by remissions.

      During an exacerbation, patients are concerned about:

      • Pressing and bursting pain near the bridge of the nose;
      • Pain in the inner corner of the eye;
      • Serous or purulent discharge from the nose;
      • Swelling of the eyelids;
      • Decreased sense of smell;
      • Signs of intoxication are low-grade fever and deterioration of general condition.

      During remission, the intensity of intoxication and pain syndrome weakens, and headaches occur periodically. Nasal discharge becomes scanty serous-purulent. Patients complain of stagnation of discharge in the nasopharynx and decreased sense of smell.

      possible ocular manifestations of advanced ethmoiditis

      Chronic ethmoiditis is dangerous because a person does not suspect the presence of a serious illness for a long time and treats a common cold. As a result, the inflammation does not go away, and the risk of developing complications steadily increases every day.

      Complications

      Ethmoiditis is a serious pathology that requires immediate treatment. The acute form of the disease quickly becomes chronic, which is difficult to treat and leads to the development of dangerous complications.

      1. The destruction of the ethmoid labyrinth and the formation of empyema often ends with the breakthrough of pus through the orbit into the cranial cavity. Patients have fever and signs of damage to intracranial structures.
      2. Cellulitis and retrobulbar abscess are formed as a result of the transition of inflammation from the mucous membrane of the ethmoid sinuses to the orbit. Symptoms of these pathologies are severe pain, swelling of the eyelids, changes in the position of the eyeball and decreased visual acuity.
      3. Meningitis, arachnoiditis and brain abscess are intracranial complications of ethmoiditis associated with purulent inflammation of the meninges.

      Features of the disease in children

      In newborns and infants, ethmoiditis is an exclusively independent disease. The frontal sinus in children is finally formed only by the age of 3. The cause of the disease in infants is sepsis. The spread of infection occurs by hematogenous route.

      Preschoolers and schoolchildren are often diagnosed with a combined pathology - sinusitis or frontoethmoiditis. These diseases are manifested by a runny nose, fever, deterioration in general condition, swelling of the eyelids, displacement of the eyeball, pain at the inner corner of the eye, vomiting and diarrhea.

      Diagnostics

      The otorhinolaryngologist, after listening to the patient’s complaints and studying the history of life and illness, makes a preliminary diagnosis and proceeds to a physical examination of the patient.

      Signs of the disease detected during examination of the patient are infiltration of soft tissues in the affected area and swelling of the eyelids.

      Palpation of the medial corner of the eye and base of the nose is moderately painful.

      Additional research methods:
      • Characteristic inflammatory signs are detected in the patient’s blood: neutrophilic leukocytosis with a shift to the left, increased ESR. In the chronic form of the disease, this analysis is not very informative.
      • Anterior rhinoscopy can detect hyperemia, swelling of the nasal mucosa, and narrowing of the nasal passages.
      • X-ray and computed tomography are the main diagnostic methods to detect darkening of the affected sinus.

      ethmoiditis on x-ray

      Treatment

      Drug treatment

      1. The main method of conservative treatment of ethmoiditis is antibiotic therapy. To prescribe an effective drug, it is necessary to determine the causative agent of the disease and its sensitivity to antibiotics. For this purpose, the patient is sent to a microbiological laboratory to have the throat and nasal discharge analyzed for microflora. Good results in the treatment of ethmoiditis are obtained by using broad-spectrum antibiotics - Amoxicillin, Amoxiclava, Cefotaxime, Cefazolin.
      2. Patients with ethmoiditis undergo anti-inflammatory therapy aimed at reducing pain. For this purpose, non-steroidal anti-inflammatory drugs are prescribed - Paracetamol, Cefekon, Ibuklin.
      3. To strengthen the immune system and increase the overall resistance of the body, patients are recommended to undergo a course of treatment with immunomodulators - Ismigen, Imunorix, Immunal.
      4. To reduce swelling of the mucous membrane, it is necessary to use vasoconstrictor nasal drops based on Xylometazoline or Oxymetazoline, combined medications - Polymyxin, Rinofluimucil. Patients are prescribed hyposensitizing drugs for oral administration - “Cetrin”, “Erius”, “Suprastin”.
      5. Rinsing the paranasal sinuses with medications gives good results. The lavage procedure is carried out with a YAMIK sinus catheter, which sucks out the exudate and flushes the sinuses with medicinal substances. The procedure is repeated until a clear liquid appears.

      Physiotherapy

      Physiotherapeutic procedures are carried out after signs of acute inflammation have reduced. Patients are recommended the following types of effects on the affected sinuses: UHF, phonophoresis, electrophoresis, ultrasound with antibiotics or hydrocortisone.

      Surgery

      Surgery is indicated in cases where conservative therapy is ineffective and the patient develops severe complications.

      Endoscopic operations are performed under local anesthesia. To do this, use a flexible probe, which is inserted into the cavity of the ethmoid bone. All manipulations are performed under visual control.

      Chronic ethmoiditis is often treated surgically. Patients undergo septoplasty or removal of polypous growths.

      ethnoscience

      Folk remedies are complementary in the treatment of ethmoiditis.

      • At home, to treat the disease, drops are prepared from onion, aloe and honey, taken in equal proportions. The product is instilled into the nose 3 times a day for a week.
      • Laundry soap is mixed with half a teaspoon of honey and 2 tablespoons of milk. The resulting mixture is heated in a water bath until a homogeneous mass is obtained. These drops are designed to thin and remove mucus from the sinuses.
      • Beetroot, carrot juice and melted honey are mixed in equal proportions and dropped into the nose.
      • A mixture of celandine and cyclamen juice stimulates the sneezing reflex, which clears mucus from the nose and sinuses.

      Prevention

      There is no specific prevention, since the causative agents of etomiditis are very diverse. To prevent the disease it is necessary:

      1. Maintain the immune system at an optimal level,
      2. Take vitamin-mineral complexes and immunomodulators periodically,
      3. Avoid drafts and hypothermia,
      4. Get vaccinated against influenza in a timely manner,
      5. Carefully treat acute sinusitis,
      6. Sanitize existing foci of infection in the body,
      7. When the first signs of an acute runny nose appear, contact a specialist immediately.

      Ethmoiditis. Causes, symptoms, types and treatment of ethmoiditis

      Do you have a sore forehead in the eyebrow area, a headache, a stuffy nose or a decreased sense of smell? This may indicate the presence of sinusitis, one of the types of which is ethmoiditis. In this article, we will look at you, dear readers, what ethmoiditis is, what its symptoms are, its causes, and how to treat ethmoiditis with traditional and folk remedies. So…

      Ethmoiditis (lat. Ethmoiditis) is inflammation of the mucous membrane of the ethmoid sinus, which is the paranasal sinus (sinus).

      Ethmoiditis is part of a group of diseases called sinusitis, and due to its location, it is sometimes called ethmoidal sinusitis.

      The main cause of the inflammatory process in the ethmoid sinuses, as with other types of sinusitis, is mainly infections (viruses, fungi, bacteria) - streptococci, staphylococci and others.

      The main danger of ethmoiditis is the location of the ethmoid labyrinth - the anterior part of the base of the skull, located near the orbit, which is why one of the signs of this disease is swelling/edema of the eyes and upper eyelids. In addition, in this place there are the anterior cranial fossa and the ethmoidal arteries, which are responsible for the blood supply to the orbits with all its appendages.

      In most cases, ethmoiditis does not develop as a disease on its own, but is accompanied by rhinitis and sinusitis. If left untreated, it spreads further to the frontal part, provoking the development of frontal sinusitis, which in turn can lead to meningitis and other diseases dangerous to human health and life.

      To make the picture more clear, look at the picture below, which shows the types of sinusitis, as well as the location of the nasal and paranasal sinuses:

      Ethmoiditis occurs in adults and children at any age.

      Ethmoiditis. ICD

      Causes of ethmoiditis

      The causes of ethmoiditis, as well as the causes of other types of sinusitis, are quite similar. Let's look at them in more detail:

      — infections (viruses, fungi, bacteria) — streptococci, staphylococci, adenoviruses, coronaviruses, hemophilus influenzae and others;

      - nasal injuries, deviated nasal septum and other structural disorders of the nasal and paranasal sinuses;

      - pathological elements that make nasal breathing difficult - polyps, adenoids;

      - complications of various infectious diseases - sinusitis, runny nose, ARVI, influenza, measles, scarlet fever and others;

      - weakening of the immune system;

      — polluted air – gases, dust;

      - foreign objects getting into the nasal passages, which sometimes happens in children - beads, various parts, etc.

      Symptoms of ethmoiditis

      Among the signs of ethmoiditis are:

      - difficulty breathing through the nose;

      - pain in the upper part of the nose, between the eyebrows, and the forehead, especially when pressing on these places;

      - nasal discharge, sometimes with an unpleasant odor, at first the mucous membrane is transparent, but as the disease develops it becomes viscous and has a yellowish-greenish tint;

      - expectoration of sputum, especially in the morning, after sleep.

      In addition, the following symptoms may appear:

      - pain in the eyes, photophobia, increased lacrimation;

      - swelling in the upper eyelids;

      - a certain pressure in the eye area and around them;

      Complications of ethmoiditis

      If you do not pay enough attention to the treatment of ethmoiditis, it can spread to the frontal sinus, causing frontal sinusitis, and there it is not far from the brain. The result can be meningitis, sepsis, eye problems and other pathological conditions dangerous to human health and life.

      Types of ethmoiditis

      Ethmoiditis is classified as follows:

      — Purulent ethmoiditis

    1. Productive ethmoiditis:

      — Polypous, cystic ethmoiditis

      Diagnosis of ethmoiditis

      Diagnosis of ethmoiditis includes the following examination methods:

      • History taking
      • X-ray of sinuses
      • Ultrasound of the paranasal sinuses
      • Rhinoscopy
      • Nasal endoscopy
      • Diaphanoscopy (transillumination)
      • CT scan
      • Thermal imaging (thermography)
      • Bacteriological study of secretions from the nasal cavity
      • Cytological examination of the contents of the nasal cavity

      Treatment of ethmoiditis

      Treatment of ethmoiditis is aimed at:

      - destruction in the sinuses and removal from them of pathogenic microflora - viruses, fungi, bacteria;

      - removal of purulent exudate from the sinuses;

      — normalization of the mucous membrane of the ethmoid sinuses;

      - normalization of nasal breathing.

      To achieve the above goals, the following treatment methods, means and procedures are used:

      1. One of the clinical manifestations of ethmoiditis is nasal congestion. In order to clear the sinus of infection and pus, we need free access to it, then we will be able to deliver the necessary medications to the site of infection.

      To open the ethmoidal sinus, vasoconstrictors are used: “Naphthyzin”, “Oxymetazoline”, “Pharmazolin”, “Sanorin”. After using these products, breathing improves after a short period of time. Use these products 2-3 drops, 3-4 times a day.

      2. We deliver irrigating antimicrobial agents to the open sinuses, which help improve the functioning of the mucous membrane and reduce swelling of the nasal passages: “Bioparox”, “Proposol”.

      3. If the pus is too dense, medications are delivered to the sinuses that can liquefy the pus and quickly remove it from the sinuses: “ACC-long” (600 mg). Use 1 tablet 1 time/day.

      4. If the diagnosis confirms the presence of pathogenic microflora in the sinus, or the disease has an acute form with strong clinical manifestations, antibacterial agents are used: Duracef, Augmentin, Sumamed, Ampiox, Cephalexin. Additionally, the doctor can administer Ceftriaxone intramuscularly. The selection of antibiotic is very important, because its type is used depending on the type of pathogen. The course of treatment is 7-10 days.

      5. To maintain intestinal microflora. In parallel with antibacterial agents, drugs are prescribed that help preserve the beneficial microflora of the digestive system - probiotics: Bifikol, Probiovit, Linex.

      6. To prevent allergic manifestations when using antibacterial agents, antiallergic drugs (antihistamines) are also prescribed - “Diazolin”, “Suprastin”, “Tavegil”. They are used 1 tablet, 2-3 times a day, for 7-10 days.

      Additional remedies and methods for treating ethmoiditis

      Washing. Washing is also useful in the treatment of ethmoiditis. They contribute to the constant sanitization of the ethmoid sinus and the normalization of its performance - air exchange. To do this, you can use solutions of the drug "Furacillin", which is successfully used in such a nasal rinsing procedure as "Cuckoo". After the first such procedure, the condition of all nasal and paranasal sinuses noticeably improves.

      At a temperature. If you are worried about headaches, elevated body temperature and general malaise, you can use anti-inflammatory drugs - Acetylsalicylic acid, Ibuprofen, Paracetamol.

      Additionally, they may prescribe heating of the sinuses, UHF therapy, laser therapy, etc.

      Operation. If the patient’s condition is severe enough, the pus has spread not only to the ethmoidal sinuses, but to other sinuses, the doctor may prescribe surgical intervention (puncture), which is performed under local anesthesia.

      Treatment of ethmoiditis with folk remedies

      Important! Before using folk remedies for treating ethmoiditis, be sure to consult your doctor!

      Treatment of ethmoiditis at home with folk remedies is similar to traditional therapy. At the beginning, a vasoconstrictor is used, which we wrote about above. After this, agents are delivered to the source of the inflammatory process - the ethmoid sinus, which can be in the form of rinsing, inhalation, or drops.

      Washing for ethmoiditis

      Salt, soda, tea tree. Dissolve 1 teaspoon of salt in a glass of warm boiled water. Add a pinch of soda and 2-3 drops of tea tree oil to this. If you don't have tea tree oil, you can do without it. Do rinsing several times a day, for which you can use a syringe.

      Chamomile. Brew chamomile flowers in a glass of boiling water. Let the product sit for several hours until it cools down on its own, strain it and do it several times a day.

      Chlorophyllipt. Alcohol solution of chlorophyllipt, in the amount of 1 tbsp. spoons, dilute with 500 ml of warm boiled water. Use this rinse several times a day.

      Inhalations for ethmoiditis

      Inhalations are best done under a thick towel, or, if possible, use a nebulizer.

      Bay leaf. Fill a dozen dry bay leaves with water and put them on the fire. When the water boils, reduce the heat, and during the minimum boil, begin inhalation. The duration of the nose breathing procedure is 5 minutes. Do this inhalation every day.

      Garlic and apple cider vinegar. Chop 4 cloves of garlic and pour 100 ml of apple cider vinegar and 200 ml of boiling water over the garlic pulp. Inhale the vapors for 15 minutes, 3 times a day.

      Chamomile and tea tree. Brew chamomile flowers, then add 5-6 drops of tea tree oil to the decoction, instead of which you can also use eucalyptus oil. Do inhalation for 7-10 minutes, 3 times a day.

      Drops for ethmoiditis

      After you put the drops in your nose, massage it well, not forgetting about its appendages. To more clearly understand which areas need to be massaged, look at the greenish photo, which shows the location of certain sinuses. After massaging, lie on your back and lie down for a while. This is necessary for the normal distribution of droplets. Blow your nose after instillation.

      Cyclamen. Cyclamen juice is one of the most powerful substances used in the treatment of all types of sinusitis. To prepare it, you need to squeeze the juice out of thoroughly washed cyclamen tubers, for which the tubers are first finely chopped, for example on a grater. Strain the cyclamen juice and dilute it with water in a ratio of 1:4 (juice:water). Place 2 drops of the prepared product into each nostril. The procedure is best done in the evening and at home, because... Heavy discharge may begin.

      Kalanchoe. Kalanchoe is another giant in the fight against various infections that bother nasal breathing. To prepare Kalanchoi drops, you need to put several large leaves of the plant in the refrigerator for 3 days. Then chop them and squeeze out the juice. Strain the resulting liquid thoroughly, dilute with water and apply the prepared drops to each nostril, 2-3 drops, 2-3 times a day.

      Black radish. Take one black radish, wash it thoroughly, chop it, and squeeze out the juice. Next, strain it and put 3-4 drops in your nose, 3-4 times a day.

      Prevention of ethmoiditis

      To prevent the development of ethmoiditis, doctors recommend adhering to the following recommendations:

      - do not leave infectious diseases to chance, treat them to the end;

      — strengthen your immunity;

      - eat food enriched with vitamins and microelements; if this is difficult, try to periodically drink an additional vitamin complex;

      - avoid hypothermia;

      — lead an active lifestyle;

      - do wet cleaning at home at least 2 times a week;

      — when working in places where the air is contaminated with dust, gases or vapors, use protective equipment.

      Which doctor should I contact for ethmoiditis?

      Sinusitis. Video

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      Ethmoiditis: causes, symptoms and treatment

      Many people do not know about a disease such as ethmoiditis, what it is and how to fight it. This is a disease in which the mucous layers in the cells of the ethmoid bone become inflamed. With this disease, both all parts of the bone structure and its individual parts can become inflamed. Together with other forms of sinusitis, ethmoiditis is considered one of the most common ailments.

      Causes

      The lattice labyrinth performs the following functions:

      • reduces the mass of bone structures on the front side of the skull;
      • creates insulation for the nerve endings that are responsible for the sense of smell;
      • creates a so-called buffer zone, which is necessary during strong impacts.

      The mucous layer in the cells contains several different layers. This includes loose connective tissue and stratified epithelium. You also need to take into account the presence of perichondrium and glands.

      Ethmoiditis is classified into acute and chronic forms. The first form usually develops due to bacterial and viral infections, but the chronic form is due to the fact that the acute form of the disease was ignored for a long time.

      The following are the main causes of acute ethmoiditis:

      1. The presence of a primary focus and the transition of pathogens of inflammatory processes to the ethmoid labyrinth. Typically, infectious agents enter this area along with the bloodstream. Bacteria and viruses can also move along with the movement of lymph. Infection sometimes occurs through contact. The primary sites may be the tonsils and lungs. In newborns, an acute form of ethmoiditis often appears against the background of sepsis. In most cases, the causative agents of the disease are streptococci, staphylococci, pneumococci, Haemophilus influenzae, moraxella...
      2. Complications after other infectious diseases. For example, this applies to influenza, scarlet fever, and measles. In some cases, ethmoiditis develops in parallel with meningitis and encephalitis.
      3. A complication that appears due to rhinitis, sinusitis, frontal sinusitis. In this case, inflammatory processes occur in parallel in some paranasal sinuses and the ethmoid labyrinth. The following main combined forms of the disease are distinguished: sphenoethmoiditis, rhinoethmoiditis, frontoethmoiditis, maxillary ethmoiditis.

      The chronic form of ethmoiditis is a complication of an acute illness if it is not treated for a long time. This disease occurs only 3 months after the appearance of the first symptoms of the acute form of the disease. Moreover, infectious agents affect only the anterior cells. A distinctive feature of a chronic disease is that inflammatory processes not only develop in the mucous layers, but also spread to bone structures. Then the infection spreads to the septum and cells that are located behind. One of the most severe complications is the destruction of the bone structure. Then the pus moves into the eye socket, paranasal sinuses and brain.

      It is also necessary to take into account that for the development of ethmoiditis there must be provoking factors. The main one is weakening of the immune system. Because of this, opportunistic microflora is activated.

      Symptoms of the disease

      Catarrhal ethmoiditis and its other forms are characterized by the presence of the following symptoms:

      1. Pain syndrome. In the acute type of the disease, pain occurs sharply. At first it is felt on the bridge of the nose. May spread to the forehead and eyes. Headache occurs periodically. In some cases, it can transform into attacks of paroxysm. This syndrome torments a person all day. This is due to intoxication of the entire body. In addition, the temperature rises. At night, the pain in the bridge of the nose only gets worse. Vision is impaired, fear of light appears. In chronic cases, pain varies. At night they have a dull character, but are constantly present. Felt in the root of the nose. Sometimes the unpleasant sensation radiates to the forehead and eyes. During an exacerbation, the nature of the pain is pulsating. Your eyes get tired faster than usual. The patient suffers from insomnia. This is due to the fact that swelling increases, pus accumulates and all this puts pressure on the bone structures.
      2. Distension in the nasal cavity and forehead. The feeling of pressure torments the patient in both acute and chronic ethmoiditis. This is due to the fact that the bone cells swell. Both mucus and pus accumulate in them. This is due to the activity of pathogenic microorganisms. During inflammatory processes, not only the mucous layers are affected, but also the blood vessels. Their lumens increase, and moisture comes out of them into the intercellular space. It is this fluid that causes swelling. When the fluid also becomes infected with bacteria, purulent masses form. As a result, it is not air that collects in the labyrinth, but an inflammatory fluid. The skin on the bridge of the nose and upper eyelids often swells. If you press on these places, you feel severe pain. There is a constant feeling of fullness in the nasal cavity. It gets stronger towards night.
      3. Difficulty breathing through the nasal passage. Due to the tissue swelling in the area of ​​the ethmoid bone, breathing through the nose becomes more difficult. The mucous membranes of the respiratory channels are loose, so swelling develops quickly here. Then the mucous layers thicken. Due to the thickening, the lumen of the nasal passage becomes narrower, so that air passes through it poorly. In children, due to the peculiarities of the anatomical structure of the nasal concha, breathing through the nasal passages with ethmoiditis will be impossible. Their nasal canals are narrow, and when swelling develops, the mucous membranes completely block them. Breathing difficulties appear quite quickly: usually only a few hours are enough.
      4. Constant discharge. Exudate is released from the nasal passage, and it has a different consistency and shade. This could be mucus, purulent masses or even blood clots. At first the discharge is viscous. Their volume is small. As the disease progresses, more fluid is released, and it has a greenish or gray tint, which indicates a large content of pus. It accumulates in the labyrinth. Purulent masses contain leukocytes and dead bacteria. Because of this, the discharge has an unpleasant specific aroma. From the cells located in front, pus and mucus flow into the nasal passage. The amount of discharge also depends on the form of ethmoiditis. If sinusitis also develops in parallel, the volume of discharge quickly increases. The purulent masses are predominantly green in color. Even if you blow your nose thoroughly, they quickly accumulate.
      5. Deterioration of sense of smell. The sense of smell deteriorates or is completely absent. This is due to the fact that the olfactory openings become clogged. The nerve that controls smell can also become infected. The holes where the nerve endings exit are blocked by pus and mucus, so that the sense of smell gradually deteriorates, and then completely disappears. In addition, the ethmoid bone structure may deteriorate, resulting in a strong stench.

      General symptoms characteristic of inflammation

      Such signs are usually pronounced in the acute form of the disease or during exacerbation of chronic ethmoiditis. Symptoms include a constant feeling of weakness, general malaise, fever, nausea, and neurotoxicosis. Young children may vomit.

      The disease develops quickly. Body temperature immediately rises to 40°C. Nausea and vomiting attacks. Consciousness is confused. At first it is possible to breathe freely through the nose, but after a few hours it is difficult to do this. After this, discharge, muscle weakness appears, and the headache intensifies. All these symptoms appear due to toxins released by bacteria.

      The appearance of a patient with ethmoiditis is as follows. The eyelids swell - first the upper, and then the lower. The eyes are slightly open or completely closed. The light produces tears. The conjunctiva is red. The skin is warm and moist due to the increased temperature.

      Consequences of ethmoiditis

      Various complications can occur with ethmoid sinusitis. They appear if the patient’s condition is ignored and not treated. The most common side effects are:

      1. Chronic ethmoiditis. This complication is the most common, since most patients ignore the symptoms that appear, and after 3 months the disease already enters the chronic stage. Usually the acute form transforms into a chronic form due to weakened immunity and lack of vitamins. At the same time, the signs of the disease themselves remain the same, but their intensity will be less pronounced than in the acute form of the disease. In addition, there is constant pain in the bridge of the nose. I have headaches from time to time. But the main symptom is still a feeling of pressure and fullness in the nasal cavity. Typically, the chronic form of ethmoiditis develops in parallel with other types of sinusitis. Most often it is sinusitis and sphenoiditis. The chronic form of the disease is difficult to cure, as bacteria develop resistance to various antibiotics.
      2. Destruction of the bone of the ethmoid labyrinth. This consequence of ethmoiditis is considered the most dangerous, since the purulent masses that have accumulated will pass through the destroyed bone. They extend into the orbit, paranasal sinuses and skull. Because of this, meningitis, abscess and phlegmon are formed. If the front side of the bone is destroyed, the pus will move to the area behind the eye. In this case, the eyelid swells, exophthalmos develops, that is, the eyeball protrudes. The pain syndrome intensifies. If the cells behind the bone structure are destroyed, the patient’s vision will deteriorate sharply. Sometimes the exudate goes into the skull. In this case, the infection spreads to the membranes of the brain. Because of this, arachnoiditis and meningitis develop. The patient's condition deteriorates sharply. Urgent resuscitation measures are required. To the previous symptoms of ethmoiditis, you can also add dysfunction of the nervous system and general intoxication.
      3. Empyema. Empyema is a phenomenon in which purulent masses accumulate in the ethmoid bone. Because of this, the partition between the cells in the maze is destroyed. For a long time, the course of the disease is hidden, exacerbations do not occur. However, then the bone structures of the nose become deformed, and changes in the location of the eyeball are noticeable (it protrudes outward).

      What is the treatment

      With ethmoiditis, symptoms and treatment are interrelated. Therapy is initially aimed at destroying the infectious agents that cause the disease. This tactic is typical for both acute and chronic course of the disease. However, immunostrengthening therapy is also added here.

      For ethmoiditis, after diagnosis, the doctor prescribes drugs from the following groups:

      • topical agents for blood vessels;
      • drugs with analgesic properties;
      • means for stabilizing body temperature;
      • antibiotics (preferably those that have a wide range of effects).

      The following medications are usually prescribed:

      1. Galazolin in the form of nasal drops. They constrict the blood vessels in this place, due to which swelling quickly disappears and the amount of nasal discharge decreases.
      2. Xymelin. You can use both drops and spray. It also reduces swelling in the nasal cavity and nasopharynx.
      3. Oxymetazoline. Used as a spray or drop. Makes breathing easier, as blood flow in the mucous membranes improves and swelling decreases.
      4. Amoxicillin. Take in tablet form. It is an antibiotic, so it destroys pathogenic bacteria that cause inflammation.
      5. Augmentin. Available in tablet form. This remedy is a combination one. It contains clavulanic acid and amoxicillin. The first has a blocking effect on the enzymes of pathogenic microorganisms, and the second has antibacterial properties, and the product has a wide range of effects.
      6. Cefotaxime. It is administered by injection. It disrupts the production of cellular structures in microorganisms, so that they cannot reproduce.
      7. Ceftriaxone. It also prevents bacteria from multiplying. Has a wide spectrum of action.
      8. Bioparox. Used in aerosol form. Has anti-inflammatory and antimicrobial properties.
      9. Rinofluimucil. Also used in aerosol form. It is a combination remedy. This medicine contains tuaminoheptane and acetylcysteine. The first substance constricts blood vessels and removes swelling, and the second thins mucus, so that phlegm and secretions are easier to remove.
      10. Paracetamol. Take in tablet form. Has antipyretic properties. Relieves pain syndrome.
      11. Sinuforte. This is a medicine that is made from components of plant origin. Its action is aimed at eliminating swelling and removing pus. Completely safe. Is very effective.
      12. Aqua Maris. These are special packets of sea salt. The kit includes a special container that is convenient for rinsing the nasal cavities. The active components of sea salt improve the functioning of the mucous layer, cleanse it of pathological secretions and inflammatory agents. It is recommended to rinse your nose with this substance 1-2 times a week.

      All these drugs are very effective for ethmoiditis, but they can only be used after consulting a doctor.

      Other treatments

      It is imperative to pay attention to the patient’s lifestyle and diet. For ethmoiditis, treatment also takes this into account. You definitely need to follow a diet. You should eat more often fruits and vegetables, as they contain large amounts of vitamins and microelements that are necessary to strengthen the immune system. This will help prevent relapse and complications. Ethmoiditis requires vitamins A, C, E, as well as zinc and calcium. The latter are found in nuts, peanuts, eggs, dairy and fermented milk products, cabbage, spinach, beans, lamb, beef, and cereals. Ascorbic acid can be found in citrus fruits, onions, rose hips, and grapes. Vitamin E is also found in nuts, rose hips, and fish. Vitamin A is found in liver, parsley, fish, and carrots.

      You definitely need to be in a state of calm. The patient must lie down constantly to prevent the infection from spreading to other organs. It is recommended to avoid not only physical activity, but also stress.

      It is also recommended to harden yourself, as this also strengthens the immune system. But hardening should not be abrupt. The basic principles are gradualism, regularity, variety, individual approach, safety and proper distribution of the load. For hardening, air, water and solar radiation are used. You can take a contrast shower, walk in cold water, swim in ice water in winter. Rubbing and dousing are also suitable.

      It is imperative to monitor your drinking regime. You are supposed to drink up to 2 liters of liquid per day. This will help naturally remove bacteria and toxins. Plain and mineral water, tea, various decoctions and infusions, compotes, jelly, juices, fruit drinks are best suited.

      Conclusion

      Every person who often develops sinusitis should know what ethmoiditis is. This is a disease in which inflammatory processes affect the cells of the ethmoid bone. The disease develops due to infection in this area, both viral and bacterial. Ethmoiditis can be primary or appear against the background of other ailments.

      Source: http://vashilegkie.ru/lor/etmoidit.html