Reduced pneumatization of the maxillary sinuses

Posted on by admin

Paranasal sinuses are pneumatized: norm and pathology

The paranasal sinuses are cavities in the facial bones filled with air. They perform many functions, including a protective function to prevent harmful substances and particles of dust and dirt from entering the lungs.

Table of contents:

Pneumatization of the paranasal sinuses is a natural process and not a disease, as it might seem at first glance. It is not the pneumatization itself that needs treatment, but its disruption.

Paranasal sinuses are pneumatized: what is it?

Pneumatization of the paranasal sinuses is the presence of air-filled bone cavities

The paranasal sinuses are small spaces in the facial bones that are pneumatized during breathing, that is, filled with air, cleaned, warmed, and then passed into the lungs. The sinuses perform an important protective function, and are also responsible for the process of sneezing, smell, and create the timbre of a person’s voice.

The phrase “paranasal sinuses are pneumatized” can be seen as a result after an x-ray of the facial bones. If pneumatization is preserved, then there are no complications, but if pneumatization is increased or decreased, we can talk about pathology.

All nasal sinuses are lined inside with epithelium, which produces mucus in small quantities and helps cleanse the sinuses. There are several types of paired sinuses: maxillary, frontal, sphenoid, ethmoid. They are located in different parts of the face.

The most common problems encountered are impaired pneumatization of the maxillary sinuses caused by inflammation of their mucous membrane (sinusitis).

There are 3 types of pneumatization of the paranasal sinuses, which can be detected in conclusion after examination:

  • Pneumatization is preserved. This is a normal condition of the sinuses when they are leaking air. Breathing in this case is not impaired. If there is inflammation, it has not yet spread; severe swelling of the mucous membrane and accumulation of mucus are not observed.
  • Pneumatization is reduced. Deterioration of sinus pneumatization occurs as a result of mucus accumulation, foreign body entry, or edema. In this case, the general condition of the body worsens, since air cannot circulate normally through the sinuses and into the lungs.
  • Pneumatization is increased. This diagnosis is quite rare. It is usually associated with various disorders of the endocrine system and pathologies of the development of facial bones. Increased pneumatization, for example, occurs with gigantism.

Any deviations from the norm when diagnosing pneumatization require treatment, since disruption of normal nasal breathing can lead to various complications and oxygen starvation.

Causes and symptoms of deviations from the norm

Difficulty nasal breathing is a sign of decreased pneumatization of the paranasal sinuses

With a decrease in pneumatization of the paranasal sinuses, severe swelling of the nose is observed, which persists for a long time and is relieved with vasoconstrictor drugs only for a short time, there is also swelling of the eyelids, cheeks, redness of the inflamed sinus area, headaches, a feeling of fullness, which intensifies when the head is tilted.

With severe swelling, lacrimation occurs. In some cases, the disease occurs with elevated body temperature, especially if it is bacterial in nature. With a bacterial infection, you may experience profuse green purulent discharge from the nose.

The reasons for decreased pneumatization of the paranasal sinuses can be very different:
  • Sinusitis. Inflammation of the maxillary sinuses occurs very often as a complication of ordinary rhinitis. The mucous membrane of the maxillary sinuses swells, mucus production increases, and pneumatization is significantly reduced, which leads to impaired nasal breathing and severe swelling. Sinusitis can be either viral or bacterial, as well as allergic in nature (with seasonal allergies to pollen).
  • Frontit. Frontitis occurs when the frontal facial sinuses become inflamed. The frontal sinuses are located next to the eye sockets, so this disease often causes eye complications if left untreated. Treatment is usually done with antibiotics or with endoscopic surgery to remove mucus from the sinuses and administer disinfectants.
  • Ethmoiditis and sphenoiditis. With ethmoiditis, the mucous membrane of the ethmoid sinuses, which are located next to the eye sockets and the anterior cranial fossa, becomes inflamed. This disease is accompanied by pain in the bridge of the nose. Sphenoiditis is difficult to detect because the sphenoid sinuses are very small, and often the disease is accompanied only by headaches in the back of the head.
  • Cysts and neoplasms. The formation of cysts and tumors in the sinuses interferes with normal air circulation and causes a decrease in pneumatization. Treatment, as a rule, is only surgical.
  • Congenital pathologies. Reduced pneumatization is caused by congenital anomalies of the facial bones and narrowing of the paranasal sinuses.

Diagnosis and treatment methods

X-ray is an effective diagnosis of the condition of the paranasal sinuses

Diagnosis and treatment are prescribed by an otolaryngologist. The doctor examines the nose, palpates the sinuses, identifies painful areas, and also collects anamnesis. The main diagnostic method is x-ray of the paranasal facial sinuses.

Inflamed sinuses with impaired pneumatization appear as dark spots on x-rays. If the sinuses are filled with pus, then they speak of a total darkening.

Treatment methods depend on the causes of pneumatization disorders:
  • Antibiotics. Antibacterial therapy is necessary when pus appears in the sinuses, as well as to prevent complications and bacterial infection. For sinusitis, Amoxicillin, Ciprofloxacin, Amoxiclav, Sumamed are most often prescribed. The dosage and drug are prescribed by the doctor depending on the age and severity of the patient’s condition.
  • Local treatment. Local treatment consists of using anti-inflammatory hormonal sprays, creams and drops. They are effective for sinusitis, but for other types of sinusitis and cysts they may be powerless. Sprays and drops are also often used to flush out mucus and pus from the paranasal sinuses.
  • Vasoconstrictor drugs. With a decrease in pneumatization, severe nasal congestion is observed. To relieve it, you have to use vasoconstrictor drugs based on xylometazoline, oxymetazoline, and phenylephrine. They help quickly relieve swelling, but are addictive.
  • Surgical intervention. Puncture of the paranasal sinuses is sometimes the only method of normalizing pneumatization. The puncture allows you to remove fluid from the sinuses and immediately introduce disinfectants. The effect comes quickly.
  • Folk remedies. Traditional recipes can help in the initial stages of inflammatory sinus diseases. For tumors and abnormal structure of the facial bones, folk remedies are powerless. Typically, warming compresses and homemade drops from herbs, juices, and honey are used. They help with sinusitis, but drug treatment cannot be ruled out.

Possible complications and prevention

The paranasal sinuses are located to important structures and organs. If left untreated, inflammation can spread to other tissues, causing severe complications. Prevention, timely diagnosis and treatment will help to avoid unwanted consequences.

  • Meningitis. The most dangerous complication of sinusitis. Inflammation of the meninges is life-threatening and without timely help leads to death. Meningitis is accompanied by severe headaches, dizziness, fever, and loss of consciousness.
  • Abscess of the orbit. The eye socket becomes inflamed when pus penetrates through the thin bony septa from the maxillary and frontal sinuses to other tissues. The eyeball is surrounded by fatty tissue, which can become very inflamed. An orbital abscess is manifested by swelling of the eyelids, a feeling of pain and burning in the eyes, a sensation of a foreign body, redness of the eye, and purulent discharge.
  • Otitis. Acute forms of otitis media are one of the most common complications of sinusitis. The facial sinuses are located close to the middle ear. With otitis media, shooting pain in the ear, a feeling of ear fullness, pain in the head, purulent discharge from the ear canal, and increased body temperature occur.
  • Sepsis. If purulent inflammation of the facial sinus lasts long enough, a bacterial infection occurs and at the same time immunity decreases, the infection spreads through the bloodstream to other tissues. Blood poisoning leads to loss of consciousness, dehydration, a sharp increase in body temperature and a decrease in blood pressure.
  • Bronchitis. Infection through the respiratory tract and bloodstream can enter the bronchi, causing their inflammation and active production of sputum. With bronchitis, there is a dry cough, which over time turns into a wet one, shortness of breath, sometimes elevated body temperature, and weakness.

Useful video - Diseases of the nose and paranasal sinuses:

You can avoid complications and sinus inflammation by strengthening your immune system. It is also important to treat ARVI and rhinitis in a timely manner so that inflammation does not spread, identify allergens and carry out symptomatic treatment of allergies. If symptoms of sinusitis appear, you should immediately consult a doctor, as the disease quickly becomes chronic.

Readers liked:

Share with your friends! Be healthy!

leave a comment

Diseases of the nose

We recommend reading:

Our pages

Discussions

  • Ksenia – I used to constantly wake up with incredible feelings. – 02/22/2018
  • Lena - Flemoxin has become completely useless. Effective. – 02/22/2018
  • Elena - I had this happen to me. – 02/21/2018
  • Irina - I tried a lot of things like this. – 02/21/2018
  • Irina - I have 3 children and... – 02/21/2018
  • Zhanna - Lisa, what if it’s serious? – 02/21/2018

The medical information published on this page is strictly not recommended for self-medication. If you feel negative changes in your health, immediately contact an ENT specialist. All articles published on our resource are for informational purposes only. If you use this material or a fragment of it on your website, an active link to the source is required.

Source: http://tvojlor.com/lor/nose/okolonosovye-pazuhi-pnevmatizirovany.html

Pneumatization of the nasal sinuses

Often, after visiting a doctor, a patient sees an incomprehensible term in the medical history - pneumatization of the sinuses. Few people know what this means, so many questions arise. This term cannot be considered a diagnosis, it is just a description of an x-ray of the paranasal cavities. This indicator can be used to determine the inflammatory process in the nasal appendages, the accumulation of purulent contents, swelling and the formation of cysts. Patients diagnosed with sinusitis are referred for an X-ray examination.

Pneumatization - what is it?

The bones of the face are not a solid structure; throughout their entire thickness they have cavities that differ in size and anatomical shape. All of these cavities are located around the nose and are called paranasal sinuses. The appendages are frontal, maxillary, ethmoidal and sphenoid. All these sinuses are complex structural formations that simultaneously perform several important functions.

In the sinuses, the inhaled air is warmed, moistened and cleaned of dust impurities. Only then does the air enter the underlying respiratory organs. In addition, the sinuses, together with the vocal cords, influence the timbre of the voice.

The nasal appendages can function normally if there are no abnormalities in their structure. Each appendage is lined with a thin mucous membrane, which produces a little mucus. This mucus helps to humidify the air entering the respiratory organs. The nasal appendages communicate with the nasal cavity through small anastomoses, so the air in the sinuses changes all the time.

Pneumatization is a medical term that means the entire volume of the nasal appendages is filled with air. At the same time, the air circulates freely and is constantly renewed.

Only if the paranasal sinuses are pneumatized normally can the sinuses perform their functions fully. If the air circulation in the paranasal sinuses is impaired, this means that the person has some kind of disease.

Increased or, conversely, decreased pneumatization is the main criterion for the diagnosis of certain pathologies.

Causes of impaired pneumatization

Each person has a different shape and size of their sinuses, so each individual person has a different volume of air in their sinuses. However, when examining a patient, the total volume of air in the appendages is not measured; the level of pneumatization of a particular sinus is determined by other criteria.

This includes instrumental examination, assessment of the condition of the mucous membrane and drainage channels. Doctors pay attention to foreign growths in the sinuses, as well as disturbances in the structure of bone tissue.

When assessing the filling of the paranasal sinuses with air, the patient’s age must be taken into account. Thus, in children, the paranasal sinuses have a special structure. By the age of two, the child has only the maxillary sinuses, and only as he grows older do the other three pairs of paranasal appendages develop. Only by the age of 12 do all paranasal sinuses function fully.

If the frontal sinuses of an 8-year-old child are insufficiently pneumatized, then this can be considered a physiological condition, but only if there are no symptoms of an inflammatory disease. Basically, if pneumatization of the paranasal sinuses is preserved, then this indicates the absence of a pathological process in the appendages.

When bacteria and viruses penetrate the paranasal sinuses, the mucous membrane that lines the sinuses becomes very inflamed. The blood capillaries dilate and become overflowing with blood. This ultimately leads to severe swelling. The mucous membrane noticeably thickens in size and already occupies more sinus space than it occupied in the physiological state. In such a case, physiological pneumatization persists for a couple of days, after which it begins to decrease.

Pneumatization of the maxillary and other sinuses is always reduced if a lot of mucus or pus accumulates in them. In this case, the air filling decreases, since most of the appendage is filled with exudate. Moreover, the more severe the disease, the more purulent contents or mucus is formed in the paranasal sinus. The more pronounced the swelling of the drainage ducts, the worse the accumulated mucus and pus are discharged.

These are the main mechanisms of disruption of pneumatization of the paranasal sinuses. The most common cause of such disorders is infectious pathologies.

Similar processes occur in allergic diseases. Under the influence of an allergen, the mucous membrane that lines the sinuses becomes inflamed and this ultimately leads to disruption of the outflow of fluid from the cavities. In case of allergic pathologies, only mucous exudate is formed in the paranasal sinuses; pus can only appear when a bacterial or viral infection is attached.

The level of pneumatization and the presence of pathological processes can only be determined using an x-ray.

In what cases does pneumatization decrease and increase?

In a physiological state, the paranasal sinuses are pneumatized to a sufficient extent. Disturbances are observed in acute and chronic inflammatory processes in the sinuses. In addition, disturbances in filling the nasal sinus with air can occur due to polyps, cysts, or underdevelopment of the cavities.

Depending on the location of the inflammatory process, a person may be diagnosed with the following diseases:

  • Sinusitis if pneumatization of the maxillary sinuses is reduced.
  • Frontitis, if inflammation affects the frontal sinuses.
  • Ethmoiditis is inflammation of the ethmoid sinus.
  • Sphenoiditis is inflammation of the sphenoid paranasal sinus.

In particularly severe cases, pansinusitis may be diagnosed. In this condition, all paranasal appendages are involved in the pathological process. It is in such cases that various complications arise most often.

More often there are inflammatory processes in the frontal and maxillary nasal appendages. This can be attributed to the peculiarity of their location. To clarify the diagnosis, the patient must be sent for an x-ray. If the pneumatization of the maxillary sinuses is impaired, then we can confidently speak of sinusitis. This disease develops under the influence of viruses and bacteria, although allergens can also be the cause.

If inflammation is accompanied by the accumulation of pus or mucus in the sinus, then the volume of exudate can be seen on an x-ray. In this case, there is always no air in the lower part of the sinus. This pathology can only be detected if the x-ray is performed with the patient in an upright position. The pathological process can involve either one nasal appendage or both at once.

Diseases of the nose are not always the cause of impaired pneumatization. The maxillary nasal appendages often become inflamed in some dental pathologies. This is due to the too thin wall between the maxillary sinuses and the roots of the teeth. During dental procedures, the apex of the tooth root can be damaged along with the thin wall that separates the teeth from the maxillary appendages. In this case, particles of drugs and filling composition enter the cavities and provoke inflammation.

If the frontal sinuses are pneumatized to a normal extent, this is a physiological condition. If the volume of air is reduced, then they speak of frontal sinusitis. In the case when the volume of fullness is exceeded, endocrine diseases can be assumed. In case of such disorders, treatment is no longer carried out by an ENT doctor, but by a specialist.

When making a diagnosis, not only the data from the obtained image are taken into account, but also the patient’s complaints, as well as the general results of the examination.

When to go to the hospital

If the main sinus is pneumatized and there is pneumatization in other sinuses, then this often manifests itself with certain symptoms. If signs of illness appear, you should see a doctor as soon as possible. The danger of inflammation of the nasal appendages is that they are in close proximity to other important organs. With sinusitis, inflammation of the brain can develop, which often leads to serious complications. The following symptoms should alert you:

  • pain in the face, which intensifies when the head is tilted forward;
  • feeling of fullness around the nose;
  • prolonged nasal congestion and any amount of purulent discharge;
  • heat;
  • lacrimation;
  • abnormal weakness and apathy;
  • foul odor from the nose.

All these symptoms mean the onset of an inflammatory process in the sinuses. Only a specialist can make a correct diagnosis; you should not self-medicate, as you can waste precious time.

All pathologies that cause disturbances in the pneumatization of the nasal sinuses are highly treatable. But you need to understand that the earlier the correct diagnosis is made and treatment started, the more favorable the prognosis.

Source: http://pulmono.ru/nos/drugie3/pnevmatizatsiya-nosovyh-pazuh

What leads to impaired pneumatization of the maxillary sinuses?

  • Physiological features
  • Diagnosis of diseases
  • Exceptions to the rules - pathologies
  • Types of sinusitis

Impaired pneumatization of the maxillary sinuses is associated with the development of inflammation in the maxillary sinus due to the thin structure of its lower wall. The reasons for the violations may be problems with the patient’s teeth. During treatment and filling, filling material sometimes gets into the air cavities, which causes problems. Reduced pneumatization of the maxillary sinus can be seen in photo 1, which shows an x-ray image.

All these diseases are different in their form, nature and location.

Thus, there are 4 groups of inflammation of the mucous membrane of the adnexal cavity: sinusitis, sphenoiditis, frontal sinusitis and ethmoiditis. All of them are united under a single name - sinusitis.

These diseases can be either viral or bacterial in nature. Patients suffer from sinusitis as complications after acute runny nose or infectious diseases, as well as after an injury.

Physiological features

The paranasal cavities through which air passes are located in the bone tissue of the brain and facial skull and connect to the nose to supply air and serve as voice resonators. The following groups are distinguished:

  • the paired maxillary cavity is located in the maxillary region;
  • the frontal cavity is located in the frontal bone of the skull;
  • the sphenoid is located in the body of the main bone;
  • The ethmoid labyrinth is formed by the cells of the ethmoid bone.

Photo 1. Reduced pneumatization of the maxillary sinus.

The accessory nasal cavities begin to develop from the prenatal period until human puberty. In their middle there is an epithelium, the cells of which secrete mucus. The largest sinus is the maxillary sinus. It opens into the middle nasal passage and has 4 recesses (coves). Depending on the pneumatization of the air cavity, additional depressions may become deformed and change it.

The sinus, located in the frontal bone, is divided into 2 parts by a septum. The frontal cavity is connected to the middle nasal meatus, and its sections are pneumatized to varying degrees. The same situation is observed in the sphenoid sinus, which is divided by a septum into 2 parts with varying degrees of pneumatization of the sections.

But the excretory section of the air cavity is located closer to the upper part of the anterior wall of the sinus and exits into the nasal cavity. The ethmoid labyrinth consists of cells opening into the upper and middle nasal passages.

Diagnosis of diseases

To assess the condition of the paranasal sinuses, the doctor will conduct an external examination, during which he will be able to examine the nasal and oral cavity, the palate for swelling, hyperemia, and the presence of a fistula. Palpation will help identify the location of pain. For a deeper examination of the inner surface and branches of the nose, rhinoscopy is used.

One of the most difficult methods for studying the patency of the anastomosis of the sinuses and nose is probing. It is carried out through the frontal cavity, less often through the sphenoid cavity.

Before the procedure, the nose is treated with a local anesthetic and a drug that constricts blood vessels, usually a solution of dicaine and ephedrine. Then a Lansberg cannula probe is inserted through the middle turbinate.

To get rid of fluid, mucus and pus, the sinuses are washed and a special radiopaque substance is injected into them. Sometimes a puncture of the paranasal sinuses is performed using a special Dufault or Kulikovsky needle through the lower nasal passage. The needle is immersed no more than 1 cm into the lumen of the sinus. This is a very complex procedure, where a doctor’s mistake is fraught with serious consequences. The liquid obtained as a result of the puncture undergoes bacteriological testing. The puncture site is washed with an antiseptic.

Exceptions to the rules - pathologies

There are cases of improper development and formation of additional partitions or the absence of some cavities. Excessive pneumatization and pathologies of bone walls are diagnosed. Congenital pathologies do not manifest themselves, but cause complications.

Nasal problems occur after injury directly to the nasal sinus or after a closed intracranial one. The sign is always eye pain, and sometimes the person suffers traumatic shock or loses consciousness. Bone fragments can shift, causing bleeding, and if the ethmoidal labyrinth is affected, liquorrhea occurs. On examination, an uneven fracture line and displacement of the shadows of the lines of the sinus walls are observed.

Types of sinusitis

Inflammation of the nasal air sinuses is accompanied by increased temperature, pain at the site of inflammation, and impaired sense of smell. The patient feels heaviness in the forehead and eyes, especially when tilting the head forward or down. The patient complains of discomfort with sudden head movements and thick nasal discharge. The x-ray shows darkening of the sinus. With the growth of polyps and the presence of more exudate in the mucosa, swelling occurs, and this causes a decrease in pneumatization of the sinus.

If a patient suffers from allergies, he is diagnosed with rhinosinusitis, an allergic rhinosinusopathy. The signs of the disease are the same as those of rhinitis, and the photographs show significant swelling of the mucous membrane, which is reflected by darkening of the sinuses. The outlet of the paranasal sinus is closed for a long period due to injury, cystic distension (mucocele, pyocele, empyema). Such problems reveal their presence by protrusion or thinning of the lower wall of the mucous membrane, which crunches when touched.

The inflammatory process in the maxillary sinuses is one of the most common diseases, which is becoming more frequent due to possible infection from the teeth.

This is a seasonal disease because the peak of inflammation occurs during outbreaks of influenza and other acute colds. Most often, the cause of sinusitis is considered to be infection through the blood, nose or teeth, or injury to the sinus walls of the nose. There are acute and chronic forms with formations of a catarrhal or purulent nature.

The main signs of sinusitis:

  • headaches in the forehead;
  • pain during sneezing and coughing;
  • runny nose with copious discharge of mucus or pus;
  • temperature 37.5-38°C;
  • feeling of weakness.

To confirm the diagnosis, it is imperative to take an x-ray of the chin-nasal position. The image will show noticeably reduced pneumatization of the inflamed sinus and marginal darkening, which is a sign of parietal thickening of the mucosa. Total darkening indicates a large amount of fluid in the maxillary sinus, which is formed due to streptococci and pneumococci.

With constant pain in the parietal, frontal or temporal regions, the patient may be diagnosed with a cyst in the maxillary segment. The diagnosis will be confirmed by an image showing a clear homogeneous shadow. A special place is occupied by benign and malignant tumor formations. An adenoma develops in the form of a node, and a papilloma affects most of the surface of the cavity and is formed after long-term chronic allergic or inflammatory diseases of the nose.

In 8 out of 10 cases, benign tumors develop into malignant tumors; the clinical picture is asymptomatic or sluggish. Typically, patients experience: unilateral difficulty breathing, pathological mobility of teeth, swelling of the cheeks and headaches. Malignant tumors can be diagnosed only after a thorough analysis: external examination by a specialist, rhinoscopy, pharyngoscopy, tomography and x-ray, and the results of examination of biopsy material.

The parietal location of small malignant formations is identified using an endoscope.

  • Angina
  • Sinusitis
  • Cough
  • Laryngitis
  • Runny nose
  • Otitis
  • Sinusitis
  • Pharyngitis
  • ethnoscience
  • Other

Treatment of wet cough in children with effective folk remedies

Cough in children in the evening: causes

How can granulosa pharyngitis be treated in adults and children?

What to do if you have a wheezing cough?

There is foul-smelling pus coming from the gums, or rather through the canals from the roots.

The article is very professional, gives information about a variety of things.

Please help me figure it out. My husband has tinnitus.

Antibiotics do not need to be taken too often, Nozzle patch.

Source: http://lor03.ru/drugoe/narushenie-pnevmatizacii-verxnechelyustnyx-pazux.html

Sinusitis: symptoms, signs and causes

Sinusitis is an insidious disease in that the first symptoms and signs of sinusitis are very similar to a common cold and therefore often remain without proper attention. When obvious distinctive symptoms of the disease appear, time may be lost and the disease turns out to be in full swing - in an acute form.

Sinusitis is a disease that requires immediate treatment, since the disease is dangerous because inflammation occurs near the eyes and brain, and if effective treatment is not started in a timely manner, the disease can lead to very serious complications, including death. It should be noted that sinusitis is one of the most common diseases of the ENT organs.

In the article below, you will find information about what sinusitis is and its symptoms, photos and schematic images, where the source of inflammation is located, how the chronic and acute forms differ, the ICD-10 code, what this disease leads to if it do not treat.

The success of treatment largely depends on the degree of trust between the patient and the doctor, therefore, if your relationship with the doctor does not work out, you can always turn to another specialist. This article is intended to help you. With its help, you can familiarize yourself with the disease, receive additional information and more complete answers to questions if any arise after visiting your doctor. The article is for informational purposes only and is not an instruction for self-medication.

Author of the article: doctor Patrusheva E.V.

What is sinusitis?

Sinusitis is more common in adults than in children. According to the latest medical statistics, 10-15% of the population in all developed countries falls ill with sinusitis every year, and this number increases annually by 2-3%. The statistics are somewhat scary.

What kind of disease is this?

Sinusitis is an inflammation of the maxillary sinuses. Very often they are called maxillary or maxillary, since the sinuses are located in the thickness of the upper jaw. Consequently, sinusitis and maxillitis are two different names for the same disease.

Moreover, in ICD-10 (“International Classification of Diseases”) the disease is designated as maxillary sinusitis J01.0.

It is important to know that the symptoms of sinusitis in the initial stages are non-specific and similar to a common cold. Moreover, chronic and persistent nasal diseases can mask the disease, making it difficult to make a correct diagnosis. That is why, if any changes in your health status occur, you should consult a doctor.

You can learn about what sinusitis is and how to treat it by watching this video with Elena Malysheva and Doctor of Medical Sciences, Professor G.Z. Piskunov.

Sinusitis and sinusitis - what's the difference?

Very often in the diagnosis we read the name “sinusitis”, but the doctor said that it was sinusitis. How do they differ from each other, which diagnosis is correct? Or maybe it's one and the same?

If we open the document that doctors use when making any diagnosis - the International Classification of Diseases (ICD-10) - and read it, we will not find in the document a disease called “sinusitis”; its place is taken by “sinusitis”.

In fact, “sinusitis” is a general name for inflammatory diseases of all sinuses. There are 4 paired sinuses - the frontal, ethmoid, sphenoid and the familiar maxillary sinuses. The inflammation of each of these sinuses has its own name:

  • Inflammation of the frontal sinuses - frontal sinusitis or frontal sinusitis.
  • Inflammation of the ethmoid sinuses – ethmoiditis or ethmoidal sinusitis.
  • Inflammation of the sphenoid sinuses – sphenoiditis or sphenoidal sinusitis.
  • Inflammation of the maxillary sinuses – sinusitis, maxillitis or maxillary sinusitis.

That is why in ICD-10 there is only sinusitis, as a general name for all inflammatory diseases of the paranasal sinuses, and it is designated J01. That is, sinusitis and sinusitis are the same name for the same disease - inflammation of the maxillary sinus. And the correct diagnosis may sound: “sinusitis of the maxillary sinuses”, “maxillary sinusitis” or “sinusitis” - the difference is only in the words.

Since sinusitis most often occurs as a complication of a runny nose (rhinitis), it is also called rhinosinusitis.

How dangerous is sinusitis and can you die from it?

Regardless of the name, “sinusitis,” “maxillitis,” or “sinusitis,” this is a dangerous disease. In the absence of qualified and timely medical care, serious complications can occur, for example, the disease can develop into meningitis. If the disease is not treated or self-medicated, death may occur from its complications.

To better understand what sinusitis is and why it is dangerous, what it can lead to, it is necessary to consider the anatomical features of the structure and location of the human nasal sinuses.

The structure of the human nasopharynx

The structure of the nasopharynx is quite simple. We can say that this is a cavity located in the human skull that connects the oral and nasal cavities. The nasopharynx also communicates with the sphenoid, occipital bone, with the cervical vertebrae and neck, with the tympanic cavities, with the lateral auditory openings and the eustachian tubes.

If you look at the structure of the human nasopharynx in the diagram, you can see that the nasopharynx connects all the cavities in the human skull.

All nasal cavities are interconnected with each other and with the nasopharynx. This structure contributes to the rapid spread of infection during sinusitis, and if left untreated, severe complications and even death can easily occur.

The structure and location of the paranasal (maxillary) sinuses

As stated above, there are 4 paired paranasal sinuses. The diagram shows their location, it is clear where they are located (with the exception of the sphenoid sinus).

  • The frontal sinuses of the nose are located above the superciliary arches and through the frontal canal they communicate with the anterior part of the middle nasal meatus.
  • The ethmoid sinuses look like cells that communicate with each other and with the nasal cavity.
  • The sphenoid sinuses are located in the body of the sphenoid bone.
  • The maxillary sinuses are paired. These nasal sinuses are located in the thickness of the upper jaw, symmetrically on both sides of the back of the nose. The photo below schematically shows the inflammatory process in the maxillary sinus.

The sinus is covered from the inside with mucous membrane. It secretes mucus, which contains substances that neutralize microbes. The formed mucus flows into the nasal cavity through a special anastomosis.

Special cilia (ciliated epithelium) help mucus move directionally from the sinus into the nasal cavity. They are in constant motion and, moving, create a kind of current that moves mucus to the anastomosis.

If the size of the anastomosis is normal, the contents of the sinus flow freely through it even during ARVI. If the size of the anastomosis is changed (for example, due to swelling), mucus may stagnate in the sinus. Changing the size of the maxillary sinus anastomosis can lead to various complications, including sinusitis.

All sinuses communicate with the nasal passages and with each other, so the inflammatory process of one sinus can spread to the others. According to medical statistics, in more than 70% of cases, sinusitis develops in two or more sinuses; in 1.5-2% of patients, sinusitis spreads to all sinuses. This very serious disease is called "pansinusitis" or "hemisinusitis" if all sinuses are affected, but only on one side.

In addition, the process can extend beyond the sinuses. Intraorbital inflammatory processes may occur. If an infection enters the orbit, thrombosis of the orbital veins may occur. With further infection in the brain, sinusitis can develop into meningitis and a brain abscess can develop, which can be fatal.

Maxillary sinuses: location and photos, x-rays

A survey X-ray shows all the paranasal sinuses (see photo), with the exception of the sphenoid (main sinus), which is located at the base of the skull.

In the photo you can see where the maxillary sinuses are located, the structure of the human maxillary sinuses, and the walls of the maxillary (maxillary) sinus.

Pneumatization of the paranasal sinuses - what is it?

As shown in the image above, the sinuses are normally filled with air. In medical language this is called “pneumatized sinuses.” Pneumatized sinuses are responsible for the resonance and timbre of the voice, and also reduce the mass of the skull bones.

Thus, the meaning of such phrases as: “the frontal sinuses are pneumatized,” “the paranasal sinuses are pneumatized,” “the paranasal sinuses are pneumatized,” “the main sinus is pneumatized” means the normal healthy state of the paranasal sinuses. There's nothing to worry about.

Pneumatization of the maxillary sinuses is reduced - what does this mean?

When there is inflammation in any nasal sinus, inflammatory fluid accumulates, and its pneumatization decreases. The maxillary sinus in the photo (right) is filled with fluid, pneumatization is reduced, which indicates inflammation. Thus, the phrase: “reduced pneumatization of the maxillary (maxillary) sinuses” indicates sinusitis.

What causes sinusitis?

Having understood the anatomy and various names of the disease, it is necessary to understand what causes sinusitis.

The main condition for the development of inflammation in the sinus is difficulty in the outflow of mucus. Normally, a small amount of mucous fluid is constantly formed in the maxillary sinus, which washes the inner walls of the sinus, removes microbes and flows through the anastomosis of the maxillary sinus with the help of the directed movement of special cilia of the ciliated epithelium.

If the outflow is disrupted, mucus stagnates in the sinus. Subsequently, microbes multiply in the stagnant mucus inside the sinuses. Pus forms and symptoms of sinusitis appear.

The outflow of mucus may be impaired as a result of edema - allergic or infectious, as well as against the background of various inflammations of the nose as a result of trauma to the nose or congenital anomalies in the structure of the nasopharynx (deviated nasal septum, abnormal development of the nasal turbinates, etc.).

One of the most common causes of sinus blockage is nasal congestion, as the anastomosis (entrance to the sinus) is blocked. Nasal congestion develops as a result of swelling (increase in the size of the mucous membrane) and accumulation of mucus. This leads to blocking the access of oxygen through the nose, including into the sinuses.

Infection in the maxillary sinuses can enter in several ways:

  • Hematogenous. Microbes enter the sinuses from foci of infection in other organs through the bloodstream.
  • Nasal. The infection enters from the nasal cavity through the sinus anastomosis.
  • Odontogenic. The infection enters the sinuses from the inflamed roots of the upper 4 molars, which are in close contact with the walls of the sinuses. In addition, infection can enter through the canals of the teeth during various dental procedures.
  • Traumatic. The infection occurs through various injuries to the nose, upper jaw and other bones of the facial skull.

The main reasons for the development of sinusitis:

  • ARVI (acute respiratory viral infection);
  • prolonged runny nose (more than 2 weeks);
  • sore throat (tonsillitis);
  • ear inflammation, otitis (otogenic sinusitis);
  • caries of the upper 4 molars (odontogenic form).

Predisposition to the disease may be due to:

  • low immunity;
  • curvature of the nasal septum, adenoids, etc.;
  • the presence of pathogenic bacteria in the nasopharynx, for example, Staphylococcus aureus, the rapid development of which occurs due to weakened immunity.

It should be remembered that untreated sinusitis can cause relapses (new cases) of the disease. This is due to the fact that after treatment with antibiotics, many dead cells remain in the sinuses. They “clog” the sinuses and become a favorable environment for the development of new inflammation.

Do not stop treatment just because you feel better. It is necessary to completely clear the maxillary sinuses. This can be done in several ways:

  • by the body's own forces through the release of mucus through the nasal canals and with the help of lymphatic drainage through lymphatic capillaries and vessels.
  • rinsing the sinuses with antiseptics;
  • surgical operation (puncture or puncture).

To help your sinuses clear faster, you can help your immune system. You can stimulate the immune system and speed up the removal of toxins and dead cells using a special medical device called Vitafon. More information about the method of treating sinusitis in remission (weakening or disappearance of symptoms) using this device can be found here. Before use, carefully read the instructions and consult your doctor. This simple method will help avoid complications and serious surgical interventions in the future.

Psychosomatics: Louise Hay and Liz Burbo

Psychologists say that not a single emotion passes without a trace for us. Any negative experience affects our health, both psychological and physical. “Psychosomatics” studies the psychological causes of various diseases. Like many other diseases, sinusitis (sinusitis) can have psychosomatic (psychological) causes.

The most famous foreign scientists in this field are Louise Hay (USA) and Lise Burbo (Canada). According to Louise Hay, sinusitis is suppressed self-pity, unshed tears. A prolonged situation of “everyone is against me” and an inability to cope with it.

For a more accurate understanding of the psychosomatics of sinusitis, we can give an example:

A person has constant stress, he is always worried about himself and his loved ones, suppresses feelings of fear and self-pity. At the same time, he believes that the whole world is against him, and no one will help him. Over time, this becomes the norm. A constant feeling of fear leads to breathing problems, which becomes the root cause of a runny nose and sinusitis.

To change this situation, you need to reconsider your attitude towards life, do what you can do, and not be afraid to ask for help from the people around you. You don't have to be perfect, you just need to love yourself as you are.

It is worth understanding that psychosomatics is good in its time and place. If you have symptoms of sinusitis, you should consult a qualified doctor. Psychosomatics can be considered for the prevention of the disease or its repeated relapses (new cases of exacerbation of the disease).

What is sinusitis?

There are several types of this disease depending on the location, cause, features of development and complications of the disease.

The duration of the disease is 2-3 weeks. The disease manifests itself once or occurs no more than once a year. The first symptoms are similar to ARVI and other colds.

The disease in its acute form recurs 2 to 4 times a year. The symptoms are similar to those of acute sinusitis. This type of disease develops due to insufficient cleaning of the contents and tissues of the maxillary sinuses after an illness, as well as against the background of weak immunity.

The disease recurs more than 4 times a year or the disease lasts for 2 or more months. The symptoms either subside or reappear. This type of sinusitis can appear in the absence of proper treatment in the acute form of the disease.

Depending on the cause of the disease (according to the etiological factor), sinusitis can be:

Triggered by a viral infection. According to the famous doctor E.O. Komarovsky viral sinusitis occurs with any acute respiratory viral infection (ARVI) and goes away with it, unless complications occur in the form of a bacterial infection.

Bacterial (aerobic and anaerobic)

It is caused by a bacterial infection and in most cases is a complication after ARVI.

Develops as a result of decreased immunity and fungal infection.

As a result of injury. In case of violation of the integrity of the sinus, the type of disease will be determined as perforated.

It manifests itself as an allergic reaction to allergens entering the body.

Occurs as a result of medical interventions. Most often found in dentistry.

It occurs as a result of internal processes occurring in the body. For example, as a result of otitis (otogenic sinusitis), due to pathological processes occurring in the apices of the roots of the upper teeth (odontogenic sinusitis) or vasomotor - due to vegetative-vascular dystonia, vasomotor rhinitis (runny nose) or long-term use of vasoconstrictor drugs (medicinal sinusitis ).

When combining several causes (infections).

According to the form of the disease.

Exudative (catarrhal). The disease is accompanied by the release of inflammatory fluid. Depending on its nature, there are:

  • serous (discharge resembles watery fluid).
  • mucous (discharge resembles mucus).
  • purulent (discharge similar to pus).

Productive. These forms are accompanied by proliferation of the mucous lining of the sinuses. Depending on the nature of growth, they are divided into:

  • parietal-hyperplastic (parietal sinusitis): characterized by thickening and swelling of the mucous membrane of the maxillary sinus, as well as the absence of purulent contents;
  • polypous: growths in the nose and sinuses in the form of a polyp (thickening on a stalk).

If there are complications during the development of the disease, for example, the spread of the process to the orbit of the eyes, venous vessels and brain, this type of sinusitis is called complicated.

Depending on the prevalence of the process, unilateral sinusitis is distinguished, that is, the disease can be on one side (left-sided or right-sided sinusitis) and bilateral sinusitis. Regardless of the location of the disease, the inflammatory process can be acute, purulent, or any other of the above types.

Knowing the type of disease determines how to treat it!

Diagnosis of sinusitis

Based on the patient's complaints, the doctor can make a preliminary diagnosis. But it is possible to say for sure whether there is sinusitis or not only after additional examination methods and the necessary tests.

Additional research methods for sinusitis

  • X-ray examination of the paranasal sinuses (x-ray/x-ray). This is the most common, accessible and inexpensive method. During this study, the body experiences severe radiation exposure. This study is not suitable for pregnant women; in addition, an x-ray cannot determine the cause and nature of inflammation (mucous or purulent) of the disease. There are other methods for this.
  • Computed tomography (CT) is a very informative, but expensive method. In addition, not all medical institutions have the necessary equipment. Therefore, it is not used often, only in difficult cases to clarify the diagnosis. In addition, this method is contraindicated during pregnancy.
  • Magnetic resonance imaging (MRI) is also used only in complex cases to clarify the diagnosis. Not all medical institutions have the necessary equipment.
  • Ultrasound of the maxillary sinuses. The method is very informative for sinusitis and has virtually no contraindications. It is rarely used, as it requires special equipment and trained personnel. On the other hand, this method is suitable for pregnant women.
  • Therapeutic and diagnostic puncture (puncture). It is considered the “gold standard for diagnosis” in the absence of other methods. It is an invasive (requiring a puncture of the skin or mucous membrane) procedure during which the contents of the sinus cavity are obtained.
  • Laboratory research methods. A general blood test for sinusitis will show signs of an inflammatory process: increased ESR - above 12 mm/h, increased number of leukocytes, detection of the presence of bacterial inflammation (which makes it possible to distinguish a bacterial type of disease from a viral one). The method is auxiliary to confirm the presence of the disease; it alone is not enough.

Sinusitis is a serious disease, so only the attending physician can accurately diagnose the disease and determine what tests are needed. After the doctor has made a diagnosis, the patient must strictly but consciously follow his recommendations in order to avoid complications and ultimately get rid of this disease.

What does sinusitis look like on an x-ray?

It is difficult for an ordinary person to identify sinusitis in an image; future doctors are taught this at the institute. We will help our readers learn to identify the disease in photographs.

The image shows the paranasal sinuses. Normally, they appear dark on both sides of the nose. The color of the sinuses in the photo should match the color of the eye sockets.

In the picture (see photo) we see a discoloration on the right side in the sinus area (right-sided sinusitis)

If a discoloration is visible in the area of ​​the paranasal sinuses on both sides, then this is bilateral sinusitis.

Note: An x-ray is a negative, just like regular photographic film. Dense structures (bones, edema, inflammatory fluid) are light in color in the image. Less dense structures and air are darker. Therefore, when the sinuses acquire a lighter color in the picture, they speak of darkening, total or subtotal (complete or incomplete) - accordingly, these are signs of sinusitis.

In this photo you can see an x-ray before and after treatment of sinusitis.

Questions that often arise:

Where to take an x-ray of the maxillary sinuses?

X-rays of the paranasal sinuses can be done in a clinic or hospital as prescribed by the attending physician if they have an X-ray machine appropriate for the task.

How often can an x-ray be taken?

There is no definite answer, there are only contraindications. At least one x-ray is necessary to diagnose the disease and it is advisable to undergo an examination after treatment to ensure that the sinuses are clean. However, in some cases additional images may be required. Your doctor will determine the required number of images.

The first signs and symptoms of sinusitis

Symptoms of sinusitis are very similar to those of ARVI and influenza: fever, runny nose, decreased sense of smell, general malaise. Subsequently, these symptoms intensify and signs characteristic of bacterial sinusitis join:

  • pain in the sinuses;
  • headache;
  • dizziness;
  • unpleasant odor from the nasopharynx.

Possible coughing, bleeding from the nose, nausea, toothache, swelling and pain in the eyes.

How to identify and recognize sinusitis?

In the initial stages of sinusitis, signs and symptoms may not be expressed; sometimes sinusitis occurs without fever, runny nose and nasal congestion, so you need to remember what symptoms of sinusitis will help you recognize it.

Temperature

The temperature during sinusitis can vary from very high (over 39 o C) to low-grade (within 37 o C) and normal. This depends on the age of the patient, the type of disease, the state of immunity, and the presence of concomitant diseases in the patient.

In some cases, the disease can be very insidious. It would seem that the runny nose has gone away, the temperature has returned to normal, and suddenly pain and heaviness appear in the sinuses. In this regard, it should be remembered that sinusitis can be without fever, runny nose and nasal congestion, so the main symptom is still pain in the area of ​​the maxillary sinuses.

Inflammation of the sinuses - pain in the sinuses

In most cases, inflammation of the maxillary sinuses is accompanied by a symptom such as pressing pain in the sinuses. This is due to the fact that the inflammatory fluid presses on the walls of the sinus, as a result, the pressure in them increases and the pain nerve endings are irritated. Pain in the maxillary sinuses is most severe when bending or making sudden movements of the head. This symptom will help to recognize the disease, especially if sinusitis without a runny nose.

Headache

A headache with sinusitis can be felt in the forehead, nose, cheekbones, and sometimes radiates to the back of the head. With inflammation of the maxillary sinuses, the pain can be severe, pressing, bursting. The feeling of pressure in the forehead and bridge of the nose increases when the head is tilted.

Discharge and blood from the nose

Nasal discharge is mucous or mixed with pus, and sometimes with blood clots. The discharge (snot) may have an unpleasant odor. The color of nasal discharge may vary depending on the stage of the disease, from white, transparent to yellowish-green. Regardless of the type of snot associated with sinusitis, whether it exists or not, if the above symptoms occur (headache, fever and pain in the sinuses), you should immediately consult a doctor.

Nosebleeds, snot and runny nose with blood during sinusitis can be associated with frequent blowing of the nose and damage to small vessels.

But sometimes there may be no discharge. This condition is called "dry sinusitis."

Sinusitis without nasal discharge

Sinusitis can occur without nasal discharge. This is observed with very severe swelling, when mucus does not flow out of the sinus at all. Other symptoms of sinusitis come to the fore: sinus pain, headache, fever and nasal congestion.

Nasal congestion

Nasal congestion is associated with swelling of the mucous membrane of the nasal passages and maxillary sinuses, including without the formation of pus. Swelling may be accompanied by snot and an unpleasant smell in the nose when you have a runny nose.

Unpleasant odor from the nasopharynx

This sign appears at the height of the disease and indicates the addition of microbial putrefactive flora, which is the cause of the unpleasant odor of pus in the nose.

Cough

Inflammation of the sinuses may occur with a cough. This is due to the fact that mucus flows into the oropharynx. Cough with sinusitis worsens at night and when lying down.

Dizziness and nausea

Sometimes dizziness occurs with sinusitis. Nausea and dizziness can be associated with intoxication of the body, inflammation and increased pressure in the maxillary sinus. Dizziness, nausea, headache, temperature above 37 o C, nasal discharge - these signs are characteristic of an acute process. In the chronic form of the disease, such symptoms may not be expressed clearly.

Toothache

Toothache with sinusitis is an uncommon symptom. It can appear with a long-term disease, the accumulation of a large amount of pus in the nasal sinuses and the spread of the process to the roots of the 4 upper teeth, which are closely adjacent to the lower wall of the maxillary sinus.

There may also be a reverse process, when first the teeth hurt, and then sinusitis develops. This is observed with advanced caries of molars. Pathological processes occurring in the apices of the roots of the upper teeth extend to the maxillary sinus. This type of disease is called odontogenic.

Pain in the eyes

Inflammation of the maxillary sinuses may cause swelling of the eyelids and pain in the eyes. This suggests that the purulent process has spread to the orbit (orbital region). This is an extremely dangerous symptom, since there is a danger of pus breaking through the thin wall of the orbit and through the vessels into the brain.

It should be remembered that sinusitis is not just nasal congestion and runny nose. This is a serious disease and, in the absence of timely and qualified treatment, can lead to serious complications. At the first signs of the disease, you should consult a doctor and not self-medicate.

Complications and consequences

Without adequate treatment, sinusitis can cause serious complications. Acute sinusitis can become chronic and then plague you with constant exacerbations. Well, that's not the worst part. The terrible consequences of sinusitis in adults and children are meningitis, brain abscess, thrombosis of the cavernous sinuses (blood vessels), and swelling of the optic nerves. These complications of the disease require serious treatment in a hospital setting.

If after the main treatment of sinusitis the temperature remains at 37 o C, this means that the inflammatory process in the body continues or ends. If the temperature persists for a week, this means that the source of inflammation is not completely cured and you need to see a doctor again.

After sinusitis, residual effects in the form of nasal congestion may persist. This is due to hypertrophy (parietal thickening) of the mucous membrane of the maxillary (maxillary) sinuses and their incomplete cleansing of dead cells.

Vibroacoustic therapy using the Vitafon medical device allows you to eliminate these phenomena at home. More detailed information about the device and methods of treating sinusitis in remission can be found here.

Having analyzed the reviews about the Vitafon device, we can say that the device gives positive results only with correct and long-term use. To get a good result from Vitafon treatment, read the instructions and consult with your doctor.

How to understand that sinusitis is going away?

There are several signs (symptoms) of recovery: body temperature drops to normal or subfebrile 37–37.2 o C, purulent discharge stops, when the sinuses are washed there is no purulent discharge, the sense of smell returns, headaches and pain in the nose, sinuses and forehead disappear.

But remember that you cannot stop treatment on your own. Otherwise, you risk getting chronic sinusitis. Your attending physician can determine that sinusitis has been cured after the necessary examinations.

Is sinusitis contagious?

Sinusitis itself is not contagious to others, is not an infectious disease and is not transmitted by airborne droplets from person to person, but it must be remembered that it often occurs against the background of ARVI and other viral and bacterial diseases transmitted by airborne droplets, which are very contagious.

Is it possible to walk in winter?

You can’t walk if you have sinusitis in winter. Since cold air will increase blood supply and activate the glands of the sinuses. As a result, the amount of mucus in the sinuses will increase, and with complicated outflow, this will only worsen the situation. In addition, general hypothermia of the body and sinuses also negatively affects the healing process.

Is it possible to smoke?

Tobacco smoke greatly irritates the nasopharynx and, penetrating into the sinuses, increases their secretion. In addition, substances found in tobacco smoke impair the absorption of vitamin C, and the walls of blood vessels become fragile. The answer is obvious - smoking with sinusitis is contraindicated.

How long does the temperature last?

A high temperature indicates the severity of inflammation and the body’s resistance. In the acute form, a high temperature (above 38 o C) usually lasts for 3-4 days in case of adequate treatment. If treatment is ineffective or delayed, the temperature may remain high for a longer time. A low temperature (up to 37.8 o C) may persist throughout the entire treatment until complete recovery. With chronic sinusitis, the temperature may be normal or not high throughout the entire process.

Is your nose breathing?

One of the signs of the disease is impaired nasal breathing and nasal congestion. In some cases, the nose does not breathe with sinusitis, but periodically the nose can breathe (first one or the other nostril).

How to distinguish sinusitis from a runny nose?

A normal runny nose lasts no more than 2 weeks. Also, with a normal runny nose, there is no unpleasant smell from the nose, soreness of the sinuses and severe headache. In any case, symptoms such as nasal congestion, runny nose and high fever, regardless of duration, require consultation with a doctor.

The following medical literature was used in preparing the article:

  1. "Bulletin of Otorhinolaryngology", No. 2, 2015.
  2. Clinical and morphological features of chronic inflammation of the maxillary sinus. Palchun V. T., Mikhaleva L. M., Gurov A. V., Muzhikova A. V. // Journal “Fundamental Research”. – 2010 – No. 7.
  3. Clinical otolaryngology. Textbook - Mishenkin N.V., Drachuk A.I., Ivanov L.I., Dashkevich Yu.M. Omsk, 1990
  4. Otorhinolaryngology. Textbook - Kiselev A., Usachev V.I., Soldatov I.B., St. Petersburg, 2000.
  5. Differential X-ray diagnosis of lesions of the paranasal sinuses, tumors of the skull and brain, cranial injuries, intracranial and extracranial foreign bodies: recommendations for practitioners. M. Kh. Faizullin. — Kazan, 1971
  6. "Listen to your body." Liz Burbo, 2008

Author of the article: doctor Patrusheva E.V.

You can ask questions (below) on the topic of the article. We will try to answer them competently.

198097, St. Petersburg, Ogorodny lane, building 23

The information published on the site is for informational purposes only. Described methods of diagnosis, treatment, traditional medicine recipes, etc. It is not recommended to use it yourself. There are contraindications, you need to consult a specialist!

Source: http://immunitet.org/gajmorit-simptomy-priznaki