Frontit code ICD 10

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How to treat ear otomycosis

Every person needs to know what otomycosis is, since the incidence is gradually increasing. This is important for timely treatment, which will help avoid complications and chronicity of the process.

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The latter is especially unpleasant, since it negatively affects the general condition of patients, but also contributes to a gradual decrease in hearing acuity.

What is otomycosis

This disease refers to inflammation of various parts of the hearing organ of fungal etiology. The most common pathogens are fungi of the genus Candida. Often the pathology is provoked by mold fungi - penicillins, aspergillus.

At risk are people with immunodeficiencies, hypovitaminosis, endocrine disorders, and severe allergic reactions. Also, those patients who take antibiotics and cytostatics for a long time, often clean the hearing organ with cotton swabs (microtraumatization occurs), have undergone a course of radiation therapy.

People who often swim in open water and pools, suffer from excessive sweating, and are often exposed to stress should be careful.

What does he look like

Most often, otomycosis appears as external inflammation. Upon visual examination, the presence of swelling and white or yellowish discharge is noted. Photos of otomycosis fully reflect its course; from them it is easy to remember what this disease looks like.

Otomycosis code according to ICD 10

Pathology has its own code in the international classification of diseases. The code for otomycosis according to ICD 10 is H62.2. Under this heading is a diagnosis called otitis externa with mycotic lesions. In some cases, otomycosis can be encrypted under code B 36 - other superficial mycoses.

Classification and symptoms

This disease is classified according to several criteria. They look like this:

  1. Patients can be diagnosed with unilateral and bilateral otomycosis.
  2. According to the nature of the disease, this disease can be acute or chronic. The acute form is characterized by the presence of symptoms that can be distinguished as precursors, after which a pronounced clinical picture of the disease appears. The chronic form is characterized by alternating periods of remission and relapse of otomycosis.
  3. There are also various forms of otomycosis depending on the localization of the inflammatory process - external, mycotic otitis media, mycotic myringitis. With the first type of pathology, the presence of a pathological process in the area of ​​the external auditory canal is diagnosed, with the second, inflammation spreads to the middle part of the organ. With myringitis, patients are diagnosed with damage to the eardrum.

It is also worth noting that there is such a form as postoperative otomycosis. This type develops as a result of various surgical interventions on the ear. The risk of such inflammation increases in situations of long-term use of antibacterial drugs.

Before the acute onset of pathology, many patients complain of a sensation of a foreign body or ear congestion. In some situations, this symptomatology can be mistaken for blockage of the auditory tract with a sulfur test, but after diagnosis, doctors find the true cause.

Then signs of acute mycotic inflammation of the organ develop. Patients complain of pain in the ear, the appearance of discharge that is usually white, and decreased hearing acuity as a result of blockage of the passage. Patients are also concerned about itching and swelling of the organ. Sometimes pain in the organ becomes bursting in nature, which also negatively affects people’s well-being.

In especially severe cases, intoxication becomes more pronounced, patients are worried about increased body temperature, headaches and dizziness, severe general weakness, and myalgia. It is important to note that the inflammatory process can spread to the lymph nodes and salivary glands.

Treatment of otomycosis in children and adults

Symptoms and treatment of otomycosis in adults and children are inextricably linked. Based on the symptoms, the tactics of the therapy, as well as the conditions under which it will be carried out, are determined.

Treatment of otomycosis at home is carried out for mild to moderate severity of the pathology. If the process generalizes, complications arise, or the patient’s general poor condition, it is necessary to hospitalize him.

On an outpatient basis, patients need ear rinsing, after which medications are prescribed. It is important to note that the use of antibiotics and cytostatics during this period should be stopped.

Patients are prescribed antimycotic drugs in the form of tablets and products for external use. Antihistamines and nonsteroidal anti-inflammatory drugs, antiseptics, vitamin complexes, and immunomodulators are also needed.

Patients need to follow a gentle regimen, avoid hypothermia and trauma to the organ of hearing during the period of therapy.

Features of therapy during pregnancy

Treatment of otomycosis during pregnancy has its own characteristics. The selection of therapy must be more careful. Typically, patients are prescribed the use of antiseptic solutions (for example, Miramistin), which must be used to clean the affected area. When the temperature rises, Paracetamol is allowed, and the use of folk remedies is also acceptable.

Medicines

Several groups of drugs are used to treat otomycosis. First of all, antifungal agents are needed. The most commonly prescribed are Nystatin and Fluconazole, for external applications - Exoderil, Terbinofen. The duration and quantities of drugs are determined only by the doctor, who also corrects these indicators.

Patients also take antihistamines - Loratadine, Fenkarol. Non-steroidal anti-inflammatory drugs include nimesulide and ketoprofen. Hydrogen peroxide and Miramistin are used as antiseptics.

Also, the doctor may consider it necessary to administer interferon drugs to enhance the function of the immune system and means to normalize the intestinal microflora - for example, Bioflor.

Folk remedies

Treatment of otomycosis with folk remedies is prescribed in addition to the main therapy and only after consulting a doctor. For this purpose, herbal medicine methods are usually used.

For therapy at home, a decoction of celandine and aloe juice are used. The first one needs to be instilled 2-3 drops into the affected organ twice a day, while the decoction itself should be at room temperature. Aloe juice can be used in the same quantities, but three times a day for a week.

Find out what tubootitis is.

Prevention

It is important to carry out regular measures to prevent the development of inflammation in the ears, including mycotic ones. Regular hygiene of the auricle and ear canal is necessary with the help of special cleansing preparations; the use of cotton swabs for this purpose is prohibited.

It is also important to protect organs from water penetration into them in public swimming areas. All ear pathologies must be treated completely and in a timely manner, this will help avoid the occurrence of chronic pathologies, including otomycosis.

Proper nutrition is useful, with all the necessary set of vitamins and microelements. It is also important to exercise regularly and not to treat any hearing pathology on your own. If you suspect a disease, you must visit a doctor to diagnose and prescribe the correct therapy.

Conclusion

It is important for patients to have information about what this pathology is, as well as how and with what to treat otomycosis of the ears. It is important for patients to see a doctor immediately, this will help them recover quickly and avoid complications. Patients also need to keep in mind that self-treatment is unacceptable, as this can only worsen the situation.

Directory of main ENT diseases and their treatment

All information on the site is for informational purposes only and does not claim to be absolutely accurate from a medical point of view. Treatment must be carried out by a qualified doctor. By self-medicating you can harm yourself!

Source: http://gorlonos.com/ushi/kak-lechit-otomikoz.html

Types of sinusitis - accurate diagnosis using ICD 10 code

Sinusitis is an acute or chronic inflammation of one or more paranasal sinuses. It has many manifestations and arises from many causes, therefore, over many years of studying this disease, a huge number of different classifications of this inflammatory process have been proposed.

In order not to get confused in the mass of forms, stages and manifestations, we will first divide them into the main types of sinusitis, and then consider them in more detail.

Forms of sinusitis

It develops against the background of allergic rhinitis; with this form, sinusitis and ethmoiditis often develop. The remaining sinuses are affected extremely rarely. Allergic sinusitis is caused by a hypertrophied response of the immune system to external irritants - allergens.

It develops extremely rarely. The main causative agents of infection are fungi of the genus Aspergillus, Mucor, Absidia and Candida. Fungal sinusitis is divided into non-invasive - in people with a normal immune system and invasive - in patients with immunodeficiency.

In the invasive form, the fungal mycelium grows into the mucous membrane with the development of a large number of complications, many of which are life-threatening.

It develops due to the anatomical proximity of the teeth and the sinus cavity. In addition, the maxillary sinus has a common blood supply with the teeth of the upper jaw, so bacteria can enter the maxillary sinus as a result of tooth extraction when the alveolus is damaged, and during filling, filling material can be carried into the sinus cavity.

The transition of infection is possible with periodontitis, pulpitis and other inflammatory diseases of the dentofacial apparatus.

Develops as a consequence of an abnormality of the sinus mucosa. With some developmental abnormalities, cavities form between epithelial cells, which are filled with intercellular fluid over time. After a certain period of time (it’s different for everyone), the fluid stretches the surrounding cells and a cyst forms. It can block the anastomosis like edema.

Develops as a result of chronic changes in the nasal passages. A long-term inflammatory process changes the structure of the ciliated epithelium lining the mucous membrane. It becomes dense, and additional growths appear on it.

The cells of these growths begin to multiply - proliferate. In those areas where cell proliferation is especially intense, a polyp develops. Then there are several of them, and then they completely fill the nasal passages, blocking not only the removal of fluid, but also breathing.

Refers to chronic forms. Characterized by the absence of nasal discharge. This is due to the fact that as a result of prolonged exposure to a bacterial infection, the nasal structures lose their functions in producing secretions and begin to accumulate them.

As the name suggests, it develops as a result of damage to the wall of the paranasal sinus, more often the maxillary or frontal sinus. Damage to the wall is observed with fractures directly, the upper jaw and the zygomatic bone.

Types of sinusitis

When describing the focus of the inflammatory process, its localization is always mentioned, so sinusitis is called by the name of the sinus in which the inflammation developed. So they distinguish:

Sinusitis is inflammation of the maxillary sinus. The sinus is located in the maxillary bone under the eye socket, and if you look at the face, it is on the side of the nose.

Frontitis is inflammation of the frontal sinus. The frontal sinus is paired and is located in the thickness of the frontal bone above the bridge of the nose.

Ethmoiditis is inflammation of the cells of the ethmoid labyrinth. The ethmoid sinus belongs to the posterior paranasal sinuses and is located deep in the skull behind the nose visible from the outside.

Sphenoiditis is inflammation of the sphenoid sinus. It also belongs to the posterior paranasal sinuses and is located deeper in the skull than the others. It is located behind a lattice labyrinth.

Polysinusitis. When several sinuses are involved in the inflammatory process, for example, with bilateral sinusitis, this process is called polysinusitis.

Hemisinusitis and pansinusitis. If all sinuses on one side are affected, right-sided or left-sided hemisinusitis develops, and when all sinuses become inflamed, pansinusitis develops.

Inflammatory processes are also divided according to their course, that is, according to the time that passes from the onset of the disease to recovery. Highlight:

Acute inflammation develops as a complication of a viral or bacterial infection. The disease is manifested by severe pain in the sinuses, which intensifies when turning and tilting the head.

Pain in the acute form and adequate treatment usually lasts no more than 7 days. The temperature rises to 38 degrees or more, chills occur. The feeling of nasal congestion bothers me, my voice changes - it becomes nasal. With proper treatment, complete restoration of the mucous membrane occurs in about 1 month.

The subacute course is characterized by a milder clinical picture and lasts up to 2 months. The patient experiences mild symptoms of sinusitis for a long time, mistaking it for a common cold. Accordingly, no special treatment is undertaken and the subacute stage progresses into the chronic stage.

The chronic form is less responsive to treatment than others, and the disease can last up to several years. This form of sinusitis develops as a result of improper treatment or its complete absence.

Chronic forms include odontogenic, polypous and fungal sinusitis. This form is characterized by very sparse symptoms - nasal discharge is constant, but not abundant, pain, if it develops, is unexpressed and dull, it also does not bother the patient very much, fever, as a rule, does not occur.

But chronic sinusitis tends to periodically worsen and manifest itself with all the symptoms of acute sinusitis.

There is a special form of the chronic form – hyperplastic sinusitis. This form develops when different types are combined - purulent and allergic sinusitis. Due to the presence of an allergic process, the mucous membrane grows, polyps can develop in it, which block the anastomosis between the sinus and the nasal cavity.

The World Health Organization proposes to classify various diseases according to the International Classification of Diseases (ICD 10), where each form is assigned a specific code. For example, here is the ICD code for sinusitis. Coding diseases greatly simplifies working with statistical data.

ICD sinusitis

  • J01 Acute sinusitis;
  • J01.0 Acute maxillary;
  • J01.1 Acute frontal;
  • J01.2 Acute ethmoidal;
  • J01.3 Acute sphenoidal;
  • J01.8 Other acute.
  • J32 Chronic sinusitis;
  • J32.0 Chronic maxillary;
  • J32.1 Chronic frontal;
  • J32.2 Chronic ethmoid;
  • J32.3 Chronic sphenoidal;
  • J32.8 Other chronic sinusitis.

By mucus production

There are exudative and catarrhal sinusitis. The difference between these two forms is the secretion of secretion by the mucous membrane of the paranasal sinus. With catarrhal inflammation, only hyperemia and swelling of the mucous membrane is observed, without discharge.

During the exudative process, the main place in the formation of the clinical picture of the disease is occupied by the production of mucous secretion, which, when the anastomosis is blocked, accumulates in the sinus cavity.

Viral and bacterial

These types differ in the nature of the pathogen that caused the disease. In the viral form, respectively, these are influenza, parainfluenza, measles, scarlet fever and others viruses. In the bacterial form, the causative agents are often staphylococci and streptococci and other types of bacteria.

Diagnosis of sinusitis

Diagnosis always begins with asking the patient about how long ago the disease began, how it began, and what happened before it. This information, even without additional research methods, will help the doctor to navigate and make the correct diagnosis at an early stage and prescribe the correct treatment.

During a visual examination, the doctor will determine the severity of the inflammatory process and accurately determine its location - whether it is right-sided or left-sided sinusitis. The condition of the nasal mucosa and the patency of the anastomosis will also be assessed.

It will allow you to determine the degree of damage to the inflamed sinus, assess the condition of the mucous membrane - how thick or atrophic it is, whether there are polyps in the sinus. X-rays can also be used to assess the volume of fluid in the sinuses.

A type of X-ray research method is computed tomography (CT) - it allows you to more accurately assess the condition of the sinuses by obtaining separate images of different parts of the sinus.

In general, it is advisable to study in more detail all the methods for diagnosing sinusitis, so as not to make a mistake in choosing the procedure you need.

When examining a general blood test, it will be determined in what state the body’s immune forces are, how much it needs help - is it worth just helping it or will it be necessary to prescribe drugs and operations that will do everything instead of immunity.

A fairly rare procedure, in general it provides the same information as an x-ray, however, it is safer due to the lack of radiation exposure and can be used in pregnant women.

In diagnosing sinusitis, it is no better than computed tomography, except, again, for the lack of radiation exposure. It is absolutely contraindicated if there are any metal implants in the body.

Risk factors

All people are susceptible to sinusitis to one degree or another. But in addition to this, there are risk factors that increase the possibility of sooner or later discovering this disease. These include:

  • Professions related to chemical or bacteriological production;
  • Children and old age;
  • Cystic fibrosis (increased secretion viscosity);
  • Smoking;
  • Kartagener's syndrome (weak activity of mucosal cilia).
  • Immune system dysfunction, in particular:
  • Psychological disorders;
  • Having allergies;
  • Asthma;
  • Diabetes;
  • Hypofunction of the thyroid gland;
  • Nasal polyps.

In order to quickly cure sinusitis, you need to start this process by identifying the reason why it began to develop. Otherwise, you can spend a lot of money, time and effort without budging.

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Source: http://gaimoritus.ru/sinusit/vidi-diagnostika-sinusit-kod-mkb-10.html

Sinusitis microbial 10

Bacterial sinusitis very often leads to the accumulation of purulent contents in the paranasal cavities. The main line of therapy in this case is the fight against pathological bacteria with the help of antibiotics. Along with suppressing the bacterial flora in the inflamed sinuses, every doctor has a second task - restoring the drainage function of the maxillary sinuses. And if…

Ceftriaxone is a fairly strong antibiotic that is often used for sinusitis. In this case, you should understand how to properly carry out treatment and what precautions should be taken. Features of the antibiotic Ceftriaxone is a third generation antibiotic that has a fairly wide spectrum of action. At the same time, it is prescribed to treat the following problems: infections of the lower and…

For sinusitis, rinsing is often prescribed. In this case, various drugs and saline solutions are used. A special effect can be obtained by using the drug furatsilin, which has a disinfecting effect. It is important to know and understand how to properly carry out the rinsing procedure in order to get the maximum effect. Features of the drug The drug Furacilin belongs to the nitrofuran group of drugs. He has…

The inflammatory process that occurs in one or more paranasal sinuses is called sinusitis. Sinusitis can occur in two forms - acute and chronic.

Classification according to ICD 10

According to the International Classification of Diseases, Tenth Revision, acute sinusitis (J01) is divided into:

  • J01.1 Front
  • J01.2 Ethmoidal
  • J01.3 Sphenoidal
  • J01.4 Pansinusitis

In turn, chronic sinusitis (J32) is divided into:

  • J32.0 Maxillary
  • J32.1Front
  • J32.2 Ethmoidal
  • J32.3 Sphenoidal
  • J32.4 Pansinusitis
  • J32.8 Other chronic sinusitis
  • J32.9 Chronic sinusitis, unspecified

The terminology of the disease depends on the location of sinusitis. Most often, the disease occurs in the maxillary sinuses, which are located in the maxillary part of the head. If the inflammatory process affects only the maxillary sinuses, then this condition is characterized as sinusitis.

Maxillary sinusitis (sinusitis) (ICD10 code J32.0.) – inflammation in the upper paranasal sinuses of the nasal cavity. The disease can occur at any age. Statistics show that every tenth person has suffered from this disease.

It is very important to begin treating the disease at the initial stage of development, otherwise it will turn into a purulent form and subsequently can provoke the development of serious complications.

Causes

In most cases, sinusitis (ICD code 10) occurs as a result of repeated incompletely treated colds and rhinitis. But in addition to ARVI and a runny nose, the main cause of the disease is neglected teeth affected by caries, especially in the upper jaw (odontogenic). Diseases that cause disturbances in the immune system (allergies, paritosis and other long-term chronic diseases) can trigger the development of maxillary sinusitis.

An important cause of sinusitis is infection. Quite often, during the diagnosis of sinusitis in a person, staphylococcus is detected from a swab taken from the nasal cavity. During the period of occurrence of the most common and harmless cold, staphylococcus begins to manifest its pathogenic properties.

Also in medical practice, the following reasons are identified, as a result of which maxillary sinusitis develops:

  • entry of pathogenic bacteria and chemicals into the nasal mucosa
  • severe hypothermia
  • abnormal anatomical structure of the nasopharynx
  • congenital pathologies of the secretory glands
  • nasal septum injuries
  • the presence of polyps or adenoids in a person, etc.

Regular and long-term use of nasal medications is the main factor that provokes abundant accumulation of mucus in the paranasal maxillary sinuses, as a result of which sinusitis develops (International Classification of Diseases 10).

Symptoms

The main signs of the development of maxillary sinusitis include:

  • The appearance of copious mucous discharge from the nasal passages. At the initial stage of development of the disease, nasal discharge is clear and liquid. Then acute sinusitis develops (ICD 10 J32.0.), and nasal discharge becomes thicker in consistency and acquires a yellow-green color. If a patient has developed chronic maxillary sinusitis (International Classification of Diseases 10), then nasal discharge may be bloody.
  • Memory impairment.
  • Problems with night sleep.
  • Weakness and disability.
  • Increased body temperature and chills (sometimes the temperature can rise to 38 ° C, and in some cases up to 40 ° C).
  • Severe headaches.
  • Lack of appetite.
  • Pain in the temples, back of the head and frontal part of the head.

When the first symptoms of the disease appear, you should immediately consult a doctor.

Currently, the most common and most frequently encountered types of illness in medical practice are distinguished:

Each type of disease has its own distinctive causes, signs and forms of progression.

Spicy

The main factor causing acute sinusitis (international classification of diseases 10 J32.0.) is infections that enter the upper respiratory tract of a person, as well as untreated colds, causing an inflammatory process in the mucous membrane of the maxillary sinus. Against the background of the onset of the disease, the patient experiences severe swelling of the mucous membrane of the nasal passages.

Acute sinusitis and its symptoms

In mild cases, acute maxillary sinusitis provokes an increase in pressure in the area of ​​the inflamed sinuses, as a result of which the patient has trouble breathing through the nose. Initially, the discharge from the nasal passages is clear or white. If treatment is not carried out to eliminate foci of infection, then over time they acquire a yellow-green color and become denser. All these symptoms mean that the patient has developed a purulent inflammatory process. At the acute stage of the disease, a person begins to experience dizziness, drowsiness, pain in the eyes, cheekbones, occipital and frontal parts of the head.

After final confirmation of the diagnosis, treatment should be started immediately, since over time the disease becomes chronic.

Treatment of acute sinusitis

As a rule, acute maxillary sinusitis responds to effective conservative treatment. Therapy consists of taking antibiotics and antihistamines to reduce swelling of the mucosa.

Chronic

An inflammatory process in the mucous membrane of the maxillary sinuses, which lasts more than one month, develops into chronic maxillary sinusitis (International Classification of Diseases 10).>

Signs of chronic sinusitis

The symptoms of the disease are variable. During remission, there are virtually no symptoms. During an exacerbation, the patient may exhibit such signs of illness as congestion in the nasal passages, mucous discharge from the nasal cavity becomes green or yellow, a slight increase in body temperature (no more than 38°C), weakness, severe malaise, headache, sneezing, etc. .d.

Causes of chronic maxillary sinusitis

Quite often, chronic sinusitis occurs when the disease is not treated or if the patient received ineffective drug therapy during an exacerbation. Also, the chronic stage of the disease occurs if a person has a congenital or acquired abnormal structure of the nasal septum.

The chronic form of the disease should not be left to chance, as it can cause the following complications: tonsillitis, laryngitis, otitis media, pharyngitis, dacryocystitis, apnea and mental impairment.

During remission, the nasal cavity should be rinsed with a weak saline solution, saline solution and other nasal solutions. During an exacerbation, drug therapy is administered. If the disease does not respond to conservative treatment, surgical intervention (sinusrotomy) is performed.

Odontogenic

The causative agent of odontogenic maxillary sinusitis (International Classification of Diseases 10) is infections such as staphylococcus, escherichiosis, and streptococcus. Also, odontogenic sinusitis in humans can occur due to the presence of deep caries in the oral cavity.

Signs of odontogenic sinusitis

When the first symptoms of the disease appear, you should consult a doctor, as the following serious consequences may occur: severe swelling, inflammation of the eye sockets, poor circulation in the head.

Odontogenic maxillary sinusitis is characterized by such symptoms as general malaise, severe pain in the head, slight increase in temperature, disturbance of night sleep, decreased immunity, and pain is felt in the maxillary sinus area.

Before carrying out therapy, it is necessary to determine the localization and cause of the inflammatory process in the maxillary sinuses. If odontogenic inflammation was caused by caries, then it is necessary to sanitize the oral cavity. In the future, antibacterial and vasoconstrictor drugs are prescribed.

Preventive measures are as follows: you should visit the dentist at least twice a year, do not overcool, increase physical activity, take vitamins comprehensively to strengthen the immune system, do breathing exercises in the morning, and promptly treat viral diseases.

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Acute sinusitis (J01)

Included:

  • abscess acute, sinus (adnexal) (nasal)
  • acute empyema, sinus (adnexal) (nasal)
  • acute infection, sinus (adnexal) (nasal)
  • acute inflammation, sinus (adnexal) (nasal)
  • acute suppuration, sinus (adnexal) (nasal)

If it is necessary to identify the infectious agent, an additional code (B95-B98) is used.

Excludes: chronic sinusitis or NOS (J32.-)

In Russia, the International Classification of Diseases, 10th revision (ICD-10) has been adopted as a single normative document for recording morbidity, reasons for the population's visits to medical institutions of all departments, and causes of death.

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. No. 170

The release of a new revision (ICD-11) is planned by WHO in 2017-2018 .

With changes and additions from WHO.

Processing and translation of changes © mkb-10.com

Source: http://mkb-10.com/index.php?pid=9004

Classification of sinusitis according to ICD 10

Like other diseases, sinusitis has its own code in the basic regulatory medical document ICD. This publication is published in three books, the contents of which are updated once every ten years under the supervision of the World Health Organization.

Classification according to ICD 10

Like other human knowledge, the health care industry has classified and documented its standards, which are systematically contained in the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD 10).

With the help of ICD 10, the correlation of information on diagnoses, approaches to diagnosis and treatment of diseases between different countries and continents is ensured.

The purpose of ICD 10 is to create maximum conditions for the analysis and systematization of statistical information on the level of morbidity and mortality in different countries, within one country. To do this, all diseases were given a special code, which consists of a letter and a number.

For example, acute sinusitis refers to acute respiratory diseases of the upper respiratory system and has code J01.0, and xr. sinusitis belongs to other diseases of the respiratory system and has code J32.0. This makes it easier to record and store necessary medical information.

ICD 10 code for acute sinusitis (sinusitis):

  • J01.0 – Acute sinusitis (or acute sinusitis of the maxillary sinuses);
  • J01.1 – Acute sinusitis (acute sinusitis of the frontal sinuses);
  • J01.2 – Acute ethmoiditis (acute ethmoidal sinusitis);
  • J01.3 – Acute sphenoidal sinusitis (acute sphenoiditis);
  • J01.4 – Acute pansinusitis (inflammation of all sinuses simultaneously);
  • J01.8 – Other acute sinusitis;
  • J01.9 – Acute sinusitis, unspecified (rhinosinusitis).

Sinusitis (sinusitis) is called chronic if there are more than 3 episodes of exacerbation per year.

ICD 10 code for chronic sinusitis:

  • J32.0 – Chronic sinusitis (chronic sinusitis of the maxillary sinuses, chronic anthritis);
  • J32.1 – Chronic sinusitis (chronic frontal sinusitis);
  • J32.2 – Chronic ethmoiditis (chronic ethmoidal sinusitis);
  • J32.3 – Chronic sphenoidal sinusitis (chronic sphenoiditis);
  • J32.4 – Chronic pansinusitis;
  • J32.8 – Other chronic sinusitis. Sinusitis involving inflammation of more than one sinus, but not pansinusitis. Rhinosinusitis;
  • J32.9 – Chronic sinusitis, unspecified (chronic sinusitis).

The name of sinusitis depends on the location of the inflammation. More often it is localized in the maxillary sinuses and is called sinusitis. This happens because the outlet from the maxillary sinuses is very narrow and is in a disadvantageous position, therefore, combined with the curvature of the nasal septum, the complex shape of the nasal ridge, it becomes inflamed more often than other sinuses. With simultaneous inflammation of the nasal passages, the disease is called acute/chronic. rhinosinusitis, which is more widespread than isolated sinusitis.

Clarification

If there is a need to indicate the pathogen. sinusitis, then the auxiliary code is added:

  • B95 – the causative agent of infection is streptococcus or staphylococcus;
  • B96 – bacteria, but not staphylococcus or streptococcus;
  • B97 – the disease is caused by viruses.

An auxiliary code is set only if the presence of a particular pathogen is proven by special laboratory tests (cultures) in a particular patient.

Causes

Sinusitis (sinusitis) may appear for the following reasons:

  1. After an injury.
  2. After suffering from a cold or flu.
  3. Bacterial infection.
  4. Fungal infection (usually combined with inflammation caused by bacteria). It plays a major role in persistent protracted purulent processes.
  5. Mixed reasons.
  6. Allergic inflammation. Rarely seen.

The main cause of sinusitis is a bacterial infection. Among various bacteria, streptococci and staphylococci are most often detected (in particular St. Pneumoniae, beta-hemolytic streptococci and S. Pyogenes).

Haemophilus influenzae is in second place, Moraxella is slightly less common. Viruses are often sown; recently, fungi, mycoplasma and chlamydia have become widespread. Basically, the infection enters through the nasal cavity or from the upper carious teeth, less often with blood.

Prevalence of sinusitis

The dependence of the development of sinusitis on the geographic location of a person has not been determined. And, interestingly, the identified bacterial flora in the sinuses of people living in different countries is very similar.

Most often, sinusitis is recorded in the winter season after suffering from the flu or an epidemic of colds, which significantly undermine the human immune system. Doctors note the dependence of the frequency of exacerbation of sinusitis on the state of the environment, i.e. The incidence of the disease is higher where the air contains more harmful substances: dust, gas, toxic substances from vehicles and industrial enterprises.

Every year, approximately 10 million of the Russian population suffers from inflammation of the paranasal sinuses. In adolescence, sinusitis or frontal sinusitis occurs in no more than 2% of children. At the age of up to 4 years, the incidence rate is negligible and does not exceed 0.002%, because in young children the sinuses are not yet formed. The main convenient and simple way of mass examination of the population is x-ray of the sinuses.

Women are twice as likely as men to suffer from sinusitis and rhinosinusitis because they have closer contact with children of school and preschool age - they work in kindergartens, schools, children's clinics and hospitals, women help with homework for their children after work.

Frontal sinusitis occurs much more often in adults than in children.

Classification

Sinusitis can be acute or chronic. Acute symptoms appear for the first time in life after a cold or hypothermia. It has a bright clinic with pronounced symptoms. With proper treatment, it is completely cured and never bothers the person again. Chronic sinusitis/frontal sinusitis is a consequence of an acute process that does not end within 6 weeks.

Chronic sinusitis occurs:

Severity

Depending on the symptoms of the disease, there are three degrees of sinusitis:

In accordance with the severity of the disease, medications are selected. This is important because mild cases can be treated without antibiotics.

Symptoms

The main, and sometimes the only, complaint of patients is nasal congestion. In a bright clinic in the morning, mucous discharge and pus appear. An important symptom is heaviness, pressure or pain in the area of ​​the canine fossa, the root of the nose.

Sinusitis is often accompanied by high fever, general weakness and weakness, headaches and facial pain.

Treatment

Treatment of sinusitis, especially in a pregnant woman or child, should always be carried out under the supervision of a doctor.

It includes vasoconstrictor nasal drops and hypertonic rinsing solutions. In most cases, antibiotics are prescribed that penetrate well into all environments of the body and are destructive to a wide range of bacteria - amoxicillins, cephalosporins, macrolides. In severe cases, hormones, puncture, and surgery are prescribed.

Treatment of acute sinusitis and rhinosinusitis lasts from 10 to 20 days, chronic from 10 to 40 days.

The information presented should be used for informational purposes only – it does not claim to be medically accurate. Do not self-medicate and let your health take its course - consult a doctor. Only he will be able to examine the nose and prescribe the necessary examination and treatment.

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Chronic frontal sinusitis

Chronic frontal sinusitis (chronic inflammation of the frontal sinus, frontitis chronica) is a long-term frontal sinusitis, manifested by periodic pain in the corresponding half of the forehead and nasal discharge, hyperplasia of the mucous membrane with the development of polyps and granulations.

ICD-10 code

J32.1 Chronic frontal sinusitis.

ICD-10 code

Epidemiology of chronic sinusitis

There are clear indications of the connection between the disease frontal sinusitis and atmospheric pollution with toxic waste and violation of environmental standards. In the area where large industrial enterprises are located, the incidence of frontal sinusitis is much higher.

Cause of chronic sinusitis

The causative agents of the disease are representatives of the coccal microflora, in particular staphylococci. In recent years, reports have appeared on the isolation and quality of causative agents of the association of three opportunistic microorganisms Haemophilus influenzae, Streptococcus pneumoniae and Maxarelae catharrhalis. Some clinicians do not exclude anaerobes and fungi from this list.

Symptoms of chronic sinusitis

Frontal sinusitis is a disease of the whole organism, so it has general and local clinical manifestations. General symptoms include hyperthermia as a manifestation of Intoxication and diffuse headache as a consequence of impaired cerebral blood and liquor circulation. General weakness, dizziness and other autonomic disorders are often noted. Local clinical manifestations include local headache, nasal discharge, and difficulty in nasal breathing.

The leading and earliest clinical sign of frontal sinusitis is a local spontaneous headache in the eyebrow on the side of the affected frontal sinus; in a chronic process, they are diffuse in nature.

Where does it hurt?

Classification of chronic sinusitis

There are catarrhal, purulent, polypous, polypous-purulent and complicated chronic sinusitis.

  1. Pneumosinus of the frontal sinus, caused by the presence of a valve mechanism in which air can enter the sinus cavity, but it cannot exit from it. In this case, inflammation is usually absent, but increased pressure in the sinus occurs, accompanied by pain.
  2. Chronic closed (often latent) and open (with manifestations) forms of frontal sinusitis.
  3. Etiological by type of microbiota: banal microbiota, anaerobic, specific, mycotic.
  4. Pathogenetic forms: rhinonasal, allergic, traumatic, etc.
  5. Pathomorphological forms: chronic catarrhal (vacuum sinus type) or transudative form, complete, cystic, exudative, purulent, caseous, osteoiscrotic, hyperplastic, mixed forms.
  6. Symptomatic forms: latent oligosymptomatic, neuralgic secretory, anosmic.
  7. Age forms: frontal sinusitis for children, mature people, old people.
  8. Complicated forms with damage to the eyelids, lacrimal ducts, deep cellulitis and orbital phlegmon, thrombophlebitis of the longitudinal and cavernous sinuses, meningitis, abscess of the frontal lobe, etc.

This classification, like many described earlier, does not pretend to be a holistic scientific approach, but reflects only the variety of sides and positions from which inflammatory processes in the paranasal sinuses can be considered, and therefore is exclusively didactic in nature.

Diagnosis of chronic sinusitis

At the stage of assessing the anamnesis, it is important to collect information about previous diseases, acute respiratory viral infections, sinusitis and exacerbations of frontal sinusitis, and the characteristics of treatment, including surgery.

Among the complaints, one can immediately identify local headaches and pain in the area of ​​the eyebrow that are typical for frontal sinusitis, clarify its nature and intensity, the side of the lesion, the presence of irradiation to the temple or crown; appearance and consistency of discharge, time and characteristics of its entry into the nasal cavity or nasopharynx

Screening

A method for mass non-invasive examination of a large number of people could be diaphanoscopy of the frontal sinuses.

What needs to be examined?

Who to contact?

Treatment of chronic sinusitis

Before obtaining the results of a microbiological examination of the discharge, amoxicillin + clavulanic acid is prescribed, after which targeted antibiotics are prescribed. If there is no discharge from the sinus or cannot be obtained, continue the previously started treatment. Fenspiride can be used as the drug of choice in complex anti-inflammatory therapy. Vasoconstrictor nasal drops (decongestants) are prescribed; at the beginning of treatment, a mild vasoconstrictor is prescribed (a solution of ephedrine, dimethindene and in combination with phenylephrine). In the absence of discharge, decongestant therapy (furosemide, intravenous administration of 200 ml of 1% calcium chloride solution) and the use of antihistamines are recommended.

Medicines

Medical Expert Editor

Portnov Alexey Alexandrovich

Education: Kiev National Medical University. A.A. Bogomolets, specialty - "General Medicine"

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Frontal sinusitis (acute frontal sinusitis)

Frontitis is an inflammation of the frontal paranasal sinus. With this disease, the inflammatory process develops in the mucous membrane lining the frontal sinus.

The occurrence of the disease Frontitis (acute frontal sinusitis)

The cause of acute frontal sinusitis is an infection (bacterial, viral, fungal) that penetrates the sinuses from the nose during acute runny nose (rhinitis). Most often, acute frontal sinusitis develops as a complication against the background of influenza and ARVI, as well as some infectious diseases (scarlet fever, diphtheria, etc.). Other causes include injuries to the nose and paranasal sinuses.

Symptoms of the disease Frontitis (acute frontal sinusitis)

There are acute and chronic sinusitis. Acute frontal sinusitis often occurs with influenza, rhinitis, measles, and can develop with injury to the frontal bone, especially in the area of ​​the frontonasal canal. Due to the development of edema of the mucous membrane and obstruction of the frontonasal canal, inflammatory phenomena rapidly progress. The transition from an acute to a chronic process is facilitated by insufficient drainage of the frontal sinus, which is often observed with hypertrophy of the anterior end of the middle turbinate and severe curvature of the nasal septum. Reducing the body's resistance is important. Chronic sinusitis, as a rule, is accompanied by damage to others near the nasal (paranasal) sinuses.

In acute frontal sinusitis, there are sharp pains in the forehead, aggravated by pressing or tapping on the anterior wall of the frontal sinus and the upper wall of the orbit in the medial corner of the eye, headache of another localization, pain in the eyes, photophobia, lacrimation, difficulty in nasal breathing, profuse (at first serous, then serous-purulent) odorless discharge from the corresponding half of the nose. Body temperature rises to 38-39°, but may be low-grade. Swelling of the soft tissues is often observed, especially at the medial corner of the eye. Anterior rhinoscopy reveals mucopurulent discharge under the middle concha. The anterior end of the middle concha is swollen, the mucous membrane is hyperemic.

The clinical picture of chronic sinusitis is less pronounced than acute sinusitis. The headache is aching or pressing in nature and is most often localized in the area of ​​the affected sinus. In case of obstructed outflow of exudate and increased pressure inside the sinus, the pain intensifies, and when pressing on the upper wall of the orbit and at its inner corner, it becomes sharp. Purulent nasal discharge is especially abundant in the morning and often has an unpleasant odor; Often during sleep, discharge flows into the nasopharynx, so in the morning the patient coughs up a large amount of sputum. During rhinoscopy, discharge from the frontal sinus can best be detected in the morning when the patient moves to an upright position, because The pus that has accumulated in the sinus overnight flows more easily into the middle nasal passage. The mucous membrane of the anterior end of the middle turbinate in chronic sinusitis. hyperemic and edematous.

Frontitis (usually chronic) can be complicated by the transition of the inflammatory process to the anterior bone wall of the frontal sinus, followed by its necrosis, sequestration and fistula formation. Less commonly, the process spreads to the lower wall of the frontal sinus, causing purulent inflammation of the tissues of the orbit; involvement of the posterior wall in the process leads to intracranial complications - extradural abscess, brain abscess or meningitis. Sepsis may develop.

Complications: the inflammatory process can spread to areas adjacent to the maxillary sinus - the orbit and skull, causing intraorbital (edema of the eyelids and orbital tissue, eyelid abscess, orbital phlegmon) and intracranial (meningitis, brain abscesses) complications.

Diagnosis of the disease Frontitis (acute frontal sinusitis)

The diagnosis of frontal sinusitis is relatively easy to establish based on subjective and objective signs. X-ray examination of the frontal sinuses allows one to judge their shape, the presence of exudate in them, and swelling of the mucous membrane. Differential diagnosis is carried out with neuralgia of the first branch of the trigeminal nerve, inflammation of other paranasal sinuses.

Treatment of the disease Frontitis (acute frontal sinusitis)

Treatment of frontal sinusitis: conservative, carried out in an ENT hospital.

To reduce swelling of the nasal mucosa and improve the outflow of pathological contents of the frontal sinus, vasoconstrictor nasal drops are used: Naphthyzin, Galazolin, Oxymetazolin, Sanorin, Tizin, Farmazolin. One of these drugs is instilled 2-3 drops into each half of the nose 3-4 times a day.

After instilling vasoconstrictor drops, you can irrigate the nasal cavity with one of the aerosols: Bioparox, Kameton, Proposol.

In case of acute frontal sinusitis, antibiotics are prescribed for 7-10 days; the choice of drug depends on its tolerability and the severity of the disease. The most commonly used drugs are: Augmentin, Flemoxin Solutab, Sumamed, Sporidex (cephalexin), Rovamycin, Ampiox, Duracef, Cefazolin, ceftriaxone - intramuscularly, Cifran.

In parallel with antibiotics, one of the antihistamines is used: Suprastin, Diphenhydramine, Diazolin, Tavegil - 1 tablet per day, for 7-10 days. These drugs reduce swelling of the nasal mucosa.

To liquefy thick purulent secretions, use ACC-long (600 mg) 1 tablet. Once a day, the drug promotes easier release of pus from the sinuses.

Homeopathic drugs (Cinnabsin, Sinupret) are also used in complex treatment; they help reduce inflammation in the sinuses, swelling, and pain. The drugs can be used independently, if you are allergic to other medications, or if the disease is milder.

A good effect is achieved by rinsing the nasal cavity using the “cuckoo” method. For washing, solutions with antimicrobial and anti-inflammatory effects are used - a solution of chlorophyllipt, furacillin, etc.

Surgical intervention - puncture of the frontal sinus, is carried out when conservative treatment is ineffective, as well as in the presence of pus in the sinus and severe headaches, i.e. when the outflow of sinus contents through the natural anastomosis is impaired.

The prognosis in the case of an uncomplicated course with timely and correct treatment is favorable.

Which doctors should you contact if you have Frontitis (acute frontal sinusitis)

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