Acute sinusitis ICD 10

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.

Table of contents:

• Types of sinusitis - accurate diagnosis using ICD 10 code
• Forms of sinusitis
• Types of sinusitis
• ICD sinusitis
• By mucus production
• Viral and bacterial
• Diagnosis of sinusitis
• Risk factors
• Acute sinusitis (J01)
• Classification of sinusitis according to ICD 10
• Classification according to ICD 10
• Clarification
• Causes
• Prevalence of sinusitis
• Classification
• Severity
• Symptoms
• Treatment
• Sinusitis microbial 10
• Classification according to ICD 10
• Causes
• Symptoms
• Spicy
• Chronic
• Odontogenic
• Similar articles
• Acute sinusitis ICD 10
• Sinusitis: features, symptoms, treatment methods
• Forms and types
• Causes and predisposing factors
• First signs
• Diagnostics
• Treatment of sinusitis
• Medicines
• Treatment at home
• Consequences
• Video
• Chronic sinusitis
• Epidemiology
• Causes of chronic sinusitis
• Pathogenesis
• Symptoms of chronic sinusitis
• Where does it hurt?
• Forms
• Diagnosis of chronic sinusitis
• Physical examination
• Analyzes
• Instrumental studies
• What needs to be examined?
• How to examine?
• Differential diagnosis
• Indications for consultation with other specialists
• Who to contact?
• Treatment of chronic sinusitis
• Indications for hospitalization
• Non-drug treatment of chronic sinusitis
• Drug treatment of chronic sinusitis
• Surgical treatment of chronic sinusitis
• Further management
• Patient Information
• More information about treatment
• Prevention
• Forecast
• Features of the treatment of bilateral sinusitis
• Symptoms
• Treatment
• Folk remedies
• Features of treatment in children

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.

What operations are there for sinusitis?

Antibiotics as a treatment for sinusitis

How to avoid a puncture if you are very scared?

Technique for performing acupressure massage for sinusitis

How to treat sinusitis for pregnant women?

Traditional recipes for the treatment of sinusitis

How is sinusitis pierced, and what is the danger?

Drops and sprays effective for sinusitis and runny nose

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

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.

• Sinusitis (32)
• Nasal congestion (18)
• Medicines (32)
• Treatment (9)
• Folk remedies (13)
• Runny nose (41)
• Other (18)
• Rhinosinusitis (2)
• Sinusitis (11)
• Snot (26)
• Frontit (4)

Copyright © 2015 | AntiGaymorit.ru |When copying materials from the site, an active back link is required.

Source: http://antigaimorit.ru/gaimorit/gajmorit-mkb10.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:

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.

Similar articles

Bacterial sinusitis very often leads to the accumulation of purulent contents in the paranasal cavities. The main line of therapy in this case is...

Ceftriaxone is a fairly strong antibiotic that is often used for sinusitis. At the same time, you should understand how to properly carry out treatment 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…

This article does not have a comment yet. Share your opinion about this article, and many will be grateful to you.

Join and receive useful information about health and medicine

Source: http://www.blogoduma.ru/gajmorit-mkb-10

Acute sinusitis ICD 10

Sinusitis: features, symptoms, treatment methods

Sinusitis (ICD code 10 - j32) is an acute inflammatory process localized in the maxillary sinuses. Mucus forms in these sinuses, which quickly becomes purulent. The infection affects the internal epithelium of the sinuses themselves, which quickly leads to sinusitis. It is extremely rare that the disease appears immediately. Therefore, most often sinusitis is the result of human carelessness.

The first phases of the disease are diagnosed as rhinitis or ordinary sinusitis. These are not such complex processes and often do not require radical treatment. If a runny nose is in the initial stage or there is a risk of its occurrence, then sinusitis can be stopped even with folk remedies.

Usually the patient has approximately 5-7 days to localize the process and prevent it from developing into sinusitis. The only exceptions are those people who have a history of a chronic form of the disease. In this case it proceeds differently.

Forms and types

Sinusitis is classified according to its form, symptoms and pathogens. There are two forms: chronic and acute. In acute sinusitis, the causative agent is a sudden viral infection, which has become a complication after the following diseases:

• measles;
• scarlet fever;
• rhinitis;
• ARVI;
• acute respiratory infections; from this article you can find out what to do when a cough does not go away after an acute respiratory infection.
• cold (flu).

The acute form progresses aggressively, almost certainly involving the patient's ears. In general, sinusitis is dangerous precisely because it is closely connected to the ear. Such a chain is dangerous for those who have predispositions.

position to otitis.

The chronic form is not so active even during exacerbations. Here the character is often sluggish, in which exacerbations are replaced by temporary remissions. The inflammation is almost constant, the symptoms are more even, with the main signs retained.

The infection most often affects both sides, but its type can be different: infectious or bacterial. Viral sinusitis, in which the harmful agent is “introduced” by the primary disease. The cause of the bacterial type is the entry of bacteria from the coccus class.

Sinusitis is also divided according to the severity of its course and manifestation:

1. catarrhal form. Sudden and acute form caused by a virus, but without complications;
2. purulent form. Bacteria joined the attack of the virus, as a result the mucous membrane swelled;
3. traumatic. After the injury, blood remained in the sinuses, which caused infection.

Two additional forms appear as chronic: the fungal type and polyposis. They develop slowly, without bursts. Rarely detected immediately, they are usually incidental findings during routine examinations.

Causes and predisposing factors

Three main causes of sinusitis

Sinusitis is a capricious disease, its nature depends on the timeliness of treatment. It is important to pay attention to its provocateurs, especially if there is a history of predisposition to ENT diseases. The following can cause infection and create ideal conditions for illness:

What is the treatment for thick sniffles in a child is indicated in this article.

An adult has brown snot, what to do about it can be understood from this article.

The child’s snot flows like water, what to do about it is indicated here: http://prolor.ru/n/lechenie-n/sopli-kak-voda-u-rebenka-chem-lechit.html

In these cases, sinusitis is secondary and takes the form of a complication. But it is dangerous because it always triggers a fatal connection: sinusitis - otitis media. It is extremely important to protect yourself from any hypothermia, especially your legs. The body's first reaction to cold is a runny nose. And then the infection began to “walk” through the body. If there is such a threat, you need to immediately stop the likelihood of consequences. This is especially critical in the off-season, when the immune system weakens and diseases no longer obey protective barriers.

First signs

The first sign of sinusitis is the duration of the runny nose. If the body is able to cope with the virus or bacteria on its own, then the cure will take place within a week with minimal intervention from you. But if a runny nose has been going on for two weeks or more, this is already a reason to talk about sinusitis. Yes, often by this time the patient’s mucus color changes. It becomes thick, viscous, and changes color to yellow or green.

However, there is also a catarrhal form of the disease, in which the mucus may remain transparent. Sinusitis is necessarily accompanied by several constant signs:

1. headache;
2. buzzing in the head;
3. soreness in the frontal lobes;
4. constant congestion;
5. general poor condition.

If the process is purulent, it can cause different temperatures, worsening the condition. Hearing may decrease, the sense of smell disappears, and taste sensations change.

Diagnostics

In general, the diagnosis of sinusitis includes three components:

But experts rarely follow this order. Only an x-ray of the sinuses is required. This is a necessary step to determine the neglect of the condition. Then the sinuses are examined, and based on complaints, an addition to the overall picture is made.

Treatment of sinusitis

Medicines

In almost 95% of cases, treatment of sinusitis begins with a procedure such as sinus puncture. An extremely unpleasant procedure, but almost painless. The patient is given local anesthesia and then the surgeon begins the puncture. During the operation, the person will feel a lot of pressure on the head and inside the nose. This is because the doctor presses on the head with one hand, and with the other hand makes efforts to break through the septum. The whole process takes approximately 10 minutes.

The danger of sinusitis is so great and fraught with complications that even with complaints of otitis media, the patient’s sinuses are first checked.

At the slightest suspicion of sinusitis, a puncture is prescribed. This method allows you to completely remove the mucus. If necessary, a catheter is placed for further rinsing. Usually the catheter is placed for 5 days, but puncturing can be done more than once. Until the doctor sees the dynamics of improvement, the patient lies in the clinic.

At the same time, powerful modern antibiotics are prescribed for sinusitis, usually Cefotaxime. The drug is a third generation antibiotic, well tolerated and has a huge spectrum of action. It is possible that the antibiotic will not be absorbed by the body and there will be no improvement. Normally, the doctor himself can see this by the growing white blood cell count. But there are predisposing forms of sinusitis and otitis, which are extremely difficult to treat.

If you have had or have a history of severe treatment problems, tell your doctor. Draw his attention to poor absorption of antibiotics, if this has already happened. Then the drug will be prescribed intravenously, which will make the result extremely effective.

Antiviral drugs are also prescribed: Arbidol, Sinupret. More often it is Sinupret, since its direction is the relief of sinusitis and sinusitis. If we are talking about the treatment of chronic disease, Sinupret-forte is prescribed. It is longer-acting and does not require hourly administration.

The therapy necessarily includes antihistamines: Suprastin, Diazolin. They help cope with swelling and prevent the body from allergic reactions to other drugs.

Treatment at home

Nebulizer inhalations are especially suitable for the treatment of sinusitis.

Sinusitis can be treated at home only after examination by a doctor:

• for mild forms;
• when combined with the main treatment regimen;
• during rehabilitation after a severe form.

To ease breathing and relieve residual inflammation, propolis-based inhalations for sinusitis are well suited. Add 30% of the tincture to 3 liters and actively breathe in the healing steam. What drops to treat sinusitis? You can prepare drops: take aloe, honey and celandine in equal parts. Everything is mixed and diluted with water. Important: be careful with celandine! The grass is extremely poisonous and, if oversaturated, can cause allergies and signs of intoxication. Drops are effective, but first make sure the herb is tolerable: take more honey and aloe, and a pinch of celandine. This way you will not suffer and, at most (if you have an allergy), you will break out in hives.

Sea buckthorn is ideal in its pure form as drops. It will relieve swelling, protect the epithelium from drying out and stimulate the immune system.

Consequences

Sinusitis is terrible “in anger”; its minimal complication is otitis media. But this is only one of the possible options. There is a whole range of complications:

1. purulent, serous meningitis;
2. brain abscess;
3. damage to the membrane and its swelling;
4. reactive edema of the brain or retina.

After some sinusitis, people go blind, deaf forever. Therefore, when treating a disease, it is better to raise the alarm in vain than to leave it to chance. And also do not forget about the prevention of sinusitis during a runny nose.

Video

Learn more about sinusitis in this video:

Sinusitis can leave a formidable imprint, especially when neglected. The mortality rate is increasing by 3% every year. Only earlier treatment can protect you from such “acquaintance”.

Chronic sinusitis

Chronic sinusitis - chronic inflammation of the maxillary sinus, chronic maxillary sinusitis (sinusitis maxillam chronica, highmoritis chronica).

A method for mass non-invasive examination of a large contingent of people could be diaphanoscopy of the maxillary sinuses or fluorography of the paranasal sinuses.

ICD-10 code J32 Chronic sinusitis J32.0 Chronic maxillary sinusitis

Epidemiology

The epidemiology of the disease is not related to residence in a particular region of the world. In various regions of Ukraine and a number of other countries, the microbial flora in chronic paranasal sinusitis is often similar in composition. Regularly recurring epidemics of influenza and respiratory viral infections cause a decrease in all protective factors of the nasal cavity and paranasal sinuses. In recent years, a connection has been made between the occurrence of sinusitis and unfavorable environmental factors: dust, smoke, gas, toxic emissions into the atmosphere.

Causes of chronic sinusitis

The causative agents of the disease are often representatives of coccal microflora, in particular streptococci. In recent years, there have been reports of the isolation of three opportunistic pathogens as pathogens: Haemophilus influenzae, Streptococcus pneumoniae and Moraxella catharrhalis. Fungi, anaerobes, and viruses were often sown. The formation of various types of aggressive associations that increase the virulence of pathogens is also noted.

Pathogenesis

The lower wall of the sinus is formed by the alveolar process: in a significant number of people, the roots of 4 or 5 teeth protrude into the lumen of the sinus, which in some of them are not even covered with mucous membrane. In this regard, the inflammatory process from the oral cavity often spreads into the lumen of the maxillary sinus. When a dental granuloma develops, it can be hidden for a long time and detected by chance.

The upper wall of the sinus, which is the lower wall of the orbit, is very thin, it has a large number of dehiscences, through which the vessels and nerves of the mucous membrane communicate with similar formations of the orbit. When the pressure in the sinus lumen increases, pathological discharge can spread into the orbit.

It has been proven that the disease often develops in people with a mesomorphic type of facial skeleton structure. The main role belongs to varying degrees of obstruction of the natural outlet of the maxillary sinus, which causes disruption of the drainage and aeration of its mucous membrane. Of no small importance is impaired nasal breathing associated with deformations of the nasal septum, synechiae, adenoids, etc. The development of the disease is facilitated by an increase in the aggressiveness of pathogenic microorganisms, the formation of their associations (bacterial-bacterial, bacterial-viral, viral-viral), and a decrease in the speed of mucociliary transport in the lumen sinuses and nasal cavity. In addition, a predisposing factor is considered to be incomplete recovery from acute rhinitis, when inflammatory phenomena of the nasal mucosa spread to the structures of the ostiomeatal complex, especially in the presence of pathology in the structure of its constituent structures. This disrupts the movement of air and flywheel transport, promoting the formation of sinusitis. Sinusitis is often accompanied by involvement of nearby paranasal sinuses (ethmoid and frontal) in the inflammatory process. Currently, it is believed that allergic factors, the state of general and local immunity, microcirculation disorders of the mucous membrane, vasomotor and secretory components, and significant impairment of vascular and tissue permeability play a role in the development of sinusitis, including maxillary sinusitis.

Pathological anatomy. Of certain clinical interest is the above-mentioned classification by M. Lazeanu, in relation to chronic sinusitis, which, although not fundamentally different from the classification of B. S. Preobrazhensky, allows us to look at the problem from the point of view of concepts and interpretations accepted abroad. The author identifies the following pathomorphological forms:

1. chronic catarrhal maxillary sinusitis vacuo (closed form), in which the drainage function of the sinus is absent or reduced to a level that does not provide normal ventilation; in this form, the mucous membrane of the sinus is diffusely hyperemic, thickened, and there is a serous transudate in the sinus; characterized by frequent exacerbations;
2. chronic purulent maxillary sinusitis; characterized by the presence in the sinus of “old” thick pus with caseous masses, extremely fetid; the mucous membrane is productively thickened, gelatinous in appearance, gray in color, sometimes fleshy-red, with areas of ulceration, extensive areas of necrobiosis, at the level of which areas of exposed bone with elements of osteitis and osteomyelitis are found;
3. chronic polynosal maxillary sinusitis, in which various types of natomorphological changes may occur in the mucous membrane; the most typical of them is the proliferation of the epithelium, which most often retains the multilayer cylindrical structure of the ciliated epithelium and the ability to secrete mucous glands; this type of proliferation of stratified columnar epithelium is called “saw teeth” and, taking into account the abundant secretion of goblet cells and mucous glands, it is this that forms the basis for the formation of polypous masses;
4. chronic cystic maxillary sinusitis, the occurrence of which is caused by retention of the secretion of the mucous glands; the resulting microcysts can be thin-walled, lying in the superficial layer of the mucous membrane and thick-walled, lying in the deep layers of the sinus mucosa;
5. chronic hyperplastic maxillary sinusitis is characterized by thickening and hyalinization of the choroid plexuses, combined with fibrosis of the mucous membrane;
6. chronic caseous maxillary sinusitis is characterized by the filling of the entire maxillary sinus with fetid caseous masses, which, putting pressure on the surrounding tissues, destroy them and spread into the nasal cavity, forming extensive communications of the latter not only with the maxillary sinus, but also with the ethmoidal labyrinth and the frontal sinus;
7. chronic cholesteatoma maxillary sinusitis occurs when the epidermis penetrates into the sinus cavity, which forms a peculiar white shell with a pearlescent tint (matrix), consisting of tiny epithelial scales, inside of which there is a pasty fat-like mass that has an extremely unpleasant odor.

This is the pathological picture of chronic purulent maxillary sinusitis. Their various forms can occur in various combinations, but always progress in the sequence noted above.

Symptoms of chronic sinusitis

Quite often, the only complaint of patients outside of exacerbation is difficulty in nasal breathing, expressed to varying degrees, up to its absence. Nasal discharge in acute sinusitis is profuse, its nature is mucous, mucopurulent, often purulent, especially during periods of exacerbation. A pathognomonic sign is considered to be the greatest amount of discharge in the morning,

With sinusitis, there are often complaints of a feeling of “pressure” or “heaviness” in the area of ​​the canine fossa and the root of the nose on the side of inflammation, and the pain can radiate to the superciliary or temporal region. In a chronic process, especially during periods of exacerbation, the nature of the pain is diffuse, the clinical picture is similar to trigeminal neuralgia.

Often, a chronic inflammatory process in the maxillary sinus is accompanied by a violation of the sense of smell in the form of hyposmia, sometimes anosmia. Quite rarely, lacrimation occurs due to the closure of the nasolacrimal duct.

Sinusitis is often bilateral. An exacerbation is characterized by hyperthermia with febrile numbers, malaise and general weakness with the preservation of all these signs of the disease.

Clinical forms of chronic sinusitis are classified by some authors according to the following criteria:

1. according to etiology and pathogenesis - rhinopathies and odontogenic sinusitis;
2. according to pathomorphological signs - catarrhal, purulent, polyposis, hyperplastic, osteomyelitic, infectious-allergic, etc.;
3. on a microbiological basis - banal microbiota, influenza, specific, mycotic, viral, etc.;
4. based on the dominant symptom - secretory, obstructive, cephalgic, anosmic, etc.;
5. based on clinical severity - latent, often exacerbating and permanent forms;
6. based on prevalence - monosinusitis, hemisinusitis, polyhemisinusitis, pansinusitis;
7. based on complexity - simple uncomplicated and complicated forms;
8. according to age - sinusitis in childhood and old age.

It should, however, be noted that this classification is purely didactic in nature, indicating only different aspects of a single pathogenetic process, in the development of which all or most of the indicated signs are present, and the appearance of some signs may be sequential, or may appear simultaneously.

Symptoms of chronic sinusitis are divided into local subjective, local objective and general.

Subjective local symptoms of chronic sinusitis are reflected in patient complaints of unilateral purulent nasal discharge (with monosinusitis), constant headaches, which periodically intensify with the localization of the painful focus in the maxillary sinus. The pain crisis coincides with periods of exacerbation of the chronic process, pain radiates to the temporal and orbital region. With odontogenic chronic sinusitis, pain is combined with odontalgia at the level of the diseased tooth. Patients also complain of a feeling of fullness and distension in the area of ​​the affected sinus and surrounding tissues, an unpleasant, sometimes putrid odor from the nose (subjective cacosmia), which causes nausea and loss of appetite in the patient. One of the main subjective symptoms is a complaint of difficulty in nasal breathing, nasal congestion, and deterioration of the sense of smell, which is obstructive in nature.

Objective local symptoms of chronic sinusitis. When examining the patient, attention is drawn to diffuse hyperemia and swelling of the outer membranes of the eye and the mucous membrane of the lacrimal ducts, the phenomena of chronic dermatitis in the area of ​​the vestibule of the nose and upper lip, caused by constant purulent discharge from the corresponding half of the nose (impetigo, eczema, excoriation, fissures, etc.). etc.), which sometimes provoke the occurrence of sycosis and boils of the nasal vestibule. During exacerbations of chronic sinusitis, pain is detected upon palpation of the corresponding points: in the area of ​​the exit of the inferoorbital nerve, in the area of ​​the canine fossa and the inner corner of the eye. V.I. Voyachek’s fluff test or rhinomanometry indicates unilateral incomplete or complete difficulty in nasal breathing. When examining a used handkerchief, yellow spots with dense caseous inclusions and streaks of blood are found. When wet, these spots emit an extremely unpleasant putrefactive odor, which differs, however, from the fetid odor of ozena and the sweetish-sweet odor of rhinoscleroma. At the same time, objective cacosmia is also determined. Usually, with banal chronic sinusitis, the sense of smell is preserved, as evidenced by subjective cacosmia, however, when the cells of the ethmoidal labyrinth are involved in the process and the formation of polyps obstructing the olfactory gap, unilateral, less often bilateral, hypo- or anosmia is observed. There are also objective signs of dysfunction of the lacrimal function due to swelling of the mucous membrane in the area of ​​the lacrimal punctum and disturbances in the pumping function of the mucus.

During anterior rhinoscopy, thick mucopurulent or creamy discharge is detected in the nasal passages of the corresponding side, often mixed with caseous masses, dirty yellow in color, drying into crusts that are difficult to separate from the mucous membrane. Polyps of varying sizes are often found in the middle and common nasal passages; the middle and inferior turbinates are enlarged, hypertrophied and hyperemic. A picture of a false double middle turbinate is often observed, which is caused by swelling of the mucous membrane infundibulum, prolapsing from the upper part of the middle meatus into the common nasal meatus (Kaufmann's pad). The middle turbinate often has a bullous appearance, is hyperemic and thickened.

When the mucous membrane in the area of ​​the middle nasal meatus becomes anemic, a sign of abundant purulent discharge from the maxillary sinus is revealed, which, when the head is tilted forward, continuously flows down the inferior nasal concha and accumulates at the bottom of the nasal cavity. Their removal leads to a new accumulation of pus, which indicates the presence of a voluminous reservoir of secretions in the maxillary sinus. During posterior rhinoscopy, the presence of purulent masses in the choanae is noted, which are released from the middle nasal passage to the posterior end of the middle turbinate in the direction of the nasopharynx. Often, the posterior end of this shell in chronic sinusitis takes on the appearance of a polyp and increases to the size of a choanal polyp.

Examination of the teeth of the corresponding half of the alveolar process can reveal their diseases (deep caries, periodontitis, apical granuloma, fistula in the gum area, etc.).

General symptoms of chronic sinusitis. Headaches that worsen during exacerbations and when tilting the head, coughing, sneezing, blowing the nose, shaking the head. Cranio-cervico-facial neuralgic crises that occur during periods of exacerbation, most often in the cold season; general physical and intellectual fatigue; signs of a chronic focus of infection.

The clinical course is characterized by periods of remissions and exacerbations. In the warm season, there may be periods of apparent recovery, but with the onset of cold weather, the disease resumes with renewed vigor: general and radiating headaches occur, mucopurulent, then purulent and putrefactive nasal discharge appears, nasal breathing worsens, general weakness increases, and the temperature rises body, signs of a general infectious disease appear in the blood.

Where does it hurt?

Forms

There are catarrhal, purulent, parietal hyperplastic, polypous, fibrous, cystic (mixed forms), complicated and allergic sinusitis.

Diagnosis of chronic sinusitis

At the stage of assessing anamnestic data, it is important to collect information about previous diseases of the respiratory tract, including other paranasal sinusitis, ARVI. The patient should be asked in detail about the presence of pain and the area of ​​the upper jaw, dental examinations, possible manipulations and interventions on the teeth and structures of the alveolar process. It is necessary to inquire about previous exacerbations of the disease, their frequency, features of treatment of surgical interventions on the structures of the nose and paranasal sinuses, the course of the postoperative period,

Physical examination

Palpation in the area of ​​the projection of the anterior wall of the maxillary sinus in a patient with chronic sinusitis causes a slight increase in local pain, which is sometimes absent. Percussion of the anterior wall of the sinus is not informative enough, since a significant amount of soft tissue is located above it

Analyzes

In the absence of complications of the disease, general blood and urine tests are not very informative.

Instrumental studies

Anterior rhinoscopy reveals hyperemia and edema of the nasal mucosa, while the lumen of the middle nasal passage is often closed. In these cases, anemization of the mucous membrane is performed. The pathognomonic rhinoscopic symptom for sinusitis is a “stripe of pus” in the middle meatus, that is, from under the middle of the middle turbinate,

The presence of polyps in the nasal cavity indicates the cause of a violation of the drainage function of the natural outlet openings of one or more sinuses. The polypous process is rarely isolated and almost always bilateral.

During oropharyngoscopy, attention is paid to the characteristics of the mucous membrane of the gums, the condition of the teeth from the inflamed maxillary sinus, carious teeth and fillings. If there is a filled tooth, percussion of its surface is carried out; in case of pathological changes in it, it will be painful. In this case, consultation with a dentist is required.

A non-invasive diagnostic method is diaphanoscopy with a Hering light bulb. In a darkened room, it is inserted into the patient’s mouth, who then tightly clasps its base with his lips. The transparency of the inflamed maxillary sinus is always reduced. The method is required for use in pregnant women and children. It should be remembered that a decrease in the intensity of the glow of the maxillary sinus does not always indicate the development of an inflammatory process in it.

The main method of instrumental diagnosis is radiography. If necessary, an X-ray and contrast study of the sinus is performed during its diagnostic puncture, introducing 1-1.5 mi of a contrast agent into its lumen. It is best to administer it directly in the X-ray room. It is recommended to carry out the procedure with the patient lying on his back for shooting in the floor axial projection, and then in the lateral one, on the side of the inflamed sinus. Sometimes on radiographs with a contrast agent you can see a rounded shadow in the area of ​​the alveolar process, indicating the presence of a cyst, or a “serration” symptom, indicating the presence of polyps in the lumen of the sinus.

Using CT, it is possible to obtain more accurate data on the nature of destruction in the walls of the maxillary sinus, the involvement of other paranasal sinuses and nearby structures of the facial skeleton in the inflammatory process. MRI provides more information if there are soft tissue formations in the lumen of the sinus.

In the absence of clear evidence of the presence of an inflammatory process in the maxillary sinus, but the presence of indirect signs, a diagnostic puncture can be performed using a Kulikovsky needle. The needle is inserted into the vault of the lower nasal passage, then the curved part is turned medially and the wall of the sinus is pierced.

Another method of invasive diagnostics is endoscopy, which makes it possible to clarify the nature and characteristics of the inflammatory process through direct visual examination. The study is carried out after microsinusrotomy using a trocar or cutter by introducing an optical endoscope with a certain angle of view.

What needs to be examined?

How to examine?

Differential diagnosis

First of all, it is necessary to differentiate the disease from trigeminal neuralgia, in which the pain is “burning” in nature, appears suddenly, and its appearance can be provoked by a stressful situation or a transition from a warm room to the street, where the temperature is lower. The pain is paroxysmal in nature, expressed on palpation of the scalp, and is often accompanied by paresthesia and synesthesia of half the face. Pressure on the exit points of the branches of the trigeminal nerve causes sharp pain, unlike in patients with sinusitis.

When clinical symptoms are dominated by local headache and there is no nasal discharge, the decisive element in the differential diagnosis is anemization of the mucous membrane of the middle nasal passage, after which exudate or a “stripe of pus” appears in the nasal cavity, which indicates a blockage of the natural outlet of the maxillary sinus.

Indications for consultation with other specialists

The presence of dental or oral pathology requires consultation with a dentist. If sanitation measures are necessary: ​​treatment of carious teeth, extraction of them or their roots, etc. Sometimes a consultation with a specialist in maxillofacial surgery may be required. If there are clinical signs of trigeminal neuralgia, a consultation with a neurologist is indicated for a thorough differential diagnosis.

Who to contact?

Treatment of chronic sinusitis

The goals of treating chronic sinusitis are: restoration of drainage and aeration of the affected sinus, removal of pathological discharge from its lumen, stimulation of reparative processes.

Indications for hospitalization

The presence of signs of exacerbations of chronic sinusitis: severe local pain, nasal discharge against the background of hyperthermia, confirmed radiological signs of the disease, as well as the lack of effect of conservative treatment for 2-3 days, the appearance of clinical signs of complications.

Non-drug treatment of chronic sinusitis

Physiotherapeutic treatment: electrophoresis with antibiotics on the anterior wall of the sinus, phonophoresis of hydrocortisone, including in combination with oxytetracycline, exposure to ultrasound or ultra-high frequencies on the sinus area, radiation from a therapeutic helium-neon laser, intrasinus phonophoresis or irradiation with a helium-neon laser.

In “fresh” forms of chronic sinusitis, which are characterized by the involvement of the mucous membrane of the sinus and limited areas of the periosteum in the pathological process, cure can be achieved by non-operative methods (as in acute sinusitis), including puncture, drainage, injection of proteolytic enzymes into the sinus followed by lavage of the sinus, removal of lysed pus and administration of antibiotics mixed with hydrocortisone. Non-operative treatment gives a quick effect with the simultaneous sanitation of the causative foci of infection of odontogenic or lymphadenoid localization, with the use of medicinal effects on endonasal structures, as well as the removal of polypous formations from the nasal cavity to improve the drainage function of the remaining paranasal sinuses. Antiallergic measures using antihistamines are of great importance in non-operative treatment.

S.Z. Piskunov et al. (1989) proposed an original method for the treatment of chronic sinusitis using polymer-based drugs. The authors point to antibiotics, corticosteroids and enzymes as medicinal substances, and cellulose derivatives (methylcellulose, sodium salt of CMC, hydroxypropylmethylcellulose and polyvinyl alcohol) can be used as a polymer carrier.

Repeated preventive courses conducted during the cold season, when exacerbations of chronic sinusitis occur especially often, as a rule, do not always lead to complete recovery, even if a number of preventive measures are observed and the risk factors for this disease are radically eliminated (sanitation of foci of infection, strengthening the immune system, eliminating bad habits, etc.).

Thus, despite the continued improvement of methods of non-surgical treatment of inflammatory diseases of the paranasal sinuses, recently their number has not decreased, and according to some data, has even increased. This, according to many authors, is due to both a tendency to change the pathomorphosis of the microbiota as a whole, and changes in the body’s immune defense that are not for the better. As noted by V.S. Agapov et al. (2000), an immunodeficiency state according to various indicators is observed in almost 50% of healthy donors, and its degree increases with the development of the inflammatory process in the body. This is partly due to the increase in antibiotic-resistant forms of microorganisms as a result of the widespread and sometimes irrational use of biological antibacterial drugs, as well as general changes in the body towards a weakening of systemic and local homeostasis when using chemotherapeutic agents, the effects of unfavorable environmental living and industrial conditions, and other risk factors. All this leads to a decrease in the activity of immunological and nonspecific reactivity, disruption of neurotrophic functions both at the level of macrosystems and in the area of ​​cellular membranes. Therefore, in the complex treatment of patients with diseases of the paranasal sinuses and ENT organs in general, in addition to generally accepted symptomatic and antibacterial agents, it is necessary to include immunomodulatory and immunocorrective therapy.

At present, despite a fairly complete arsenal of medications to influence the reactivity of the body as a whole and local reparative and regenerative wound processes, it is impossible to speak with confidence about the existence of a scientifically proven comprehensive system that effectively “works” in the indicated direction. For the most part, the prescription of appropriate drugs is empirical in nature and is based mainly on the principle of “trial and error”. In this case, preference is given to chemo- and biological drugs, and systemic enhancement of immunity and nonspecific resistance is resorted to only when traditional treatment does not give the desired result. When using chemotherapy and antibiotics, as rightly noted by V. Sagapov et al. (2000), they are invariably included in the metabolism of the macroorganism, which often leads to the occurrence of allergic and toxic reactions and, as a consequence, to the development of significant violations of the natural mechanisms of specific and nonspecific defense of the body.

These provisions encourage scientists to search for new, sometimes unconventional means of treating inflammatory diseases of bacterial origin in various organs and systems, including ENT organs and the maxillofacial system. The morphogenetic, innervation, adaptation-trophic, circulatory, etc. unity of the last two organ systems allows us to speak about the commonality and possibility of applying to them identical principles of therapy and the same means of treatment in the event of chronic purulent-inflammatory diseases.

Medical ozone is an ozone-oxygen mixture obtained from ultra-pure medical oxygen. Methods and areas of application of medical ozone, as well as its dosage, depend mainly on its properties, concentration and exposure, established at a specific stage of treatment. At higher concentrations and prolonged action, medical ozone gives a pronounced bactericidal effect, at lower concentrations it stimulates reparative and regenerative processes in damaged tissues, helping to restore their function and structure. On this basis, medical ozone is often included in the complex treatment of patients with sluggish inflammatory processes, including purulent diseases and insufficient effectiveness of antibacterial treatment.

By sluggish purulent inflammation we mean a pathological process with steady progression in a hypoergic course, which is difficult to respond to traditional non-operative treatment. Using the experience of using medical ozone in maxillofacial and plastic surgery in otorhinolaryngology, it is possible to achieve significant success in the complex treatment of many ENT diseases, in which the effectiveness of treatment can largely be determined by the properties of medical ozone. Such diseases may include ozena, chronic purulent sinusitis and otitis in the pre- and postoperative period, abscesses, phlegmon, osteomyelitis, wound oncological processes in the ENT organs, etc.

Local application of medical ozone consists of introducing ozonized isotonic sodium chloride solution along the periphery of inflammatory infiltrates, washing purulent wounds and cavities (for example, paranasal sinuses, the cavity of an opened peritonsillar abscess or the cavity of an otogenic or rhinogenic brain abscess after surgery, etc.) with ozonized distilled water. General ozone therapy includes intravenous infusions of ozonized isotonic sodium chloride solution and minor autohemotherapy, alternating every other day.

Drug treatment of chronic sinusitis

Until the results of a microbiological examination of the discharge are obtained, broad-spectrum antibiotics can be used - amoxicillin, including in combination with clavulanic acid, cefotaxime, cefazolin, roxithromycin, etc. Based on the culture results, targeted antibiotics should be prescribed. If there is no discharge from the sinus or cannot be obtained, continue treatment with the same drug. Fenspiride can be prescribed as one of the anti-inflammatory drugs. Antihistamine treatment is carried out with mebhydrolin, chloropyramine, zbastine, etc. Vasoconstrictor nasal drops (decongestants) are prescribed, at the beginning of treatment - a mild action (ephedrine solution, dimethindene with phenylephrine, and instead of nightly administration of drops or spray, a gel can be used), if there is no effect in Treatment with imidazole drugs (naphazoline, xylometozoline, oxymetazoline, etc.) is carried out for 6-7 days.

Anemization of the mucous membrane of the anterior part of the middle nasal passage is carried out using vasoconstrictor drugs (solutions of epinephrine, oxymetaeolin, naphazoline, xylometazoline, etc.).

The movement of drugs is carried out after anemization of the mucous membrane for the introduction into the sinuses of mixtures of drugs, including broad-spectrum antibiotics and a suspension of hydrocortisone. The pressure difference due to which the mixture moves into the lumen of the sinus is created as a result of the isolation of the nasal cavity and nasopharynx by the soft palate when the patient pronounces a vowel sound (for example, “u”) and the negative pressure in the nasal cavity created by an electric aspirator.

Using a YAMIK catheter, negative pressure is created in the nasal cavity, which allows pathological contents to be aspirated from the paranasal sinuses of one half of the nose, and their lumen to be filled with a drug or contrast agent.

Surgical treatment of chronic sinusitis

Puncture treatment of sinusitis in our country is the “gold standard” and is used for both diagnostic and therapeutic purposes - to evacuate pathological contents from its lumen. If you receive white, dark brown or black masses from the washing fluid during sinus puncture, a fungal infection can be suspected, after which it is necessary to discontinue antibiotics and carry out antifungal treatment. If anaerobes are suspected as the causative agent (unpleasant odor of discharge, negative result of bacteriological examination of the contents), oxygenation of the sinus lumen should be carried out after washing its cavity with humidified oxygen for a period of minutes.

If it is necessary to drain the sinus for a long time and introduce drugs into its lumen 2-3 times a day, a special synthetic drainage made of thermoplastic mass is installed into it through the lower nasal passage. which can be left for up to 12 days without disturbing tissue trophism.

Microsinusrotomy is performed using special trocars (Kozlova - Karl Zeiss, Germany; Krasnozhenz - MFS, Russia) in the center of the anterior wall of the sinus above the roots of the 4th tooth. After inserting the funnel into the lumen of the sinus, it is examined with rigid endoscopes with 0° and 30° optics and subsequent therapeutic manipulations are carried out, performing the assigned tasks. A mandatory element of the intervention is the removal of formations that impede the normal functioning of the natural outlet, and the restoration of full drainage and aeration of the sinus. Sutures are not applied to the soft tissue wound. In the postoperative period, conventional antibacterial therapy is carried out.

Extranasal opening according to Caldwell-Luc is performed by making a soft tissue incision in the area of ​​the transitional fold from the 2nd to 5th teeth through the anterior wall of the sinus. A hole sufficient for inspection and manipulation in its lumen is formed. Pathological formations are removed from the sinus and the discharge is placed in the area of ​​the inner wall and in the lower nasal passage with an anastomosis with the nasal cavity. When removing a significant amount of the changed mucous membrane, a U-shaped flap from its unchanged area is placed on the bottom of the sinus. Soft tissues are sutured tightly.

Further management

Mild vasoconstrictor drugs are used for 4-5 days. In the postoperative period, gentle wound care is necessary; do not use a toothbrush; after meals, rinse the vestibule of the oral cavity with astringents;

The approximate period of disability for exacerbation of chronic sinusitis without signs of complications in the case of conservative treatment with sinus punctures is 8-10 days. The use of extranasal intervention extends the time by 2-4 days.

Patient Information

• Beware of drafts.
• Vaccinate with anti-influenza serum in the autumn-winter period.
• At the first signs of acute respiratory viral infection or flu, contact a specialist.
• If recommended by the attending physician, perform surgical sanitation of the nasal cavity to restore nasal breathing and the normal architecture of its structures.

More information about treatment

Prevention

Prevention is the preservation of free nasal breathing and the normal anatomy of the structures of the nasal cavity, especially the ostiomeatal complex. Preventing disease by maintaining proper hygiene. To prevent the development of chronic sinusitis, surgical sanitation of the structures of the nasal cavity is necessary to restore nasal breathing.

Forecast

The prognosis is favorable if the specified tips and rules are followed.

Features of the treatment of bilateral sinusitis

Bilateral sinusitis is one of the most common and serious diseases. Improper treatment of this disease can lead to it becoming chronic. This disease can also affect children. In order to correctly diagnose and correctly prescribe treatment, you need to consult a doctor. What symptoms accompany bilateral sinusitis?

Symptoms

If sinusitis begins to develop in two sinuses at once, then the disease is quite severe.

1. Body temperature rises above 38 degrees.
2. The nose is constantly stuffy.
3. There is an unpleasant odor from the mouth.
4. First, small purulent discharge from the nose appears, then this discharge becomes thick and yellow.

Depending on what forms of sinusitis occur, the symptoms depend. If the inflammation is catarrhal or serous, then all manifestations will not bother you much. Usually breathing is difficult, pain appears in the area of ​​​​the bridge of the nose and forehead. There is copious discharge from the nose. When purulent bilateral sinusitis develops, the nose becomes clogged with mucus, so bacteria develop very quickly and pus is formed. During this period of time the following symptoms appear:

• chills, fever, high temperature;
• weakness, loss of strength;
• headache.

How to treat a runny nose in a newborn is indicated in this article.

How to cure a runny nose quickly with folk remedies is indicated in the article.

How a runny nose is treated during pregnancy with folk remedies can be found here: http://prolor.ru/n/lechenie-n/lechim-nasmork-pri-beremennosti-narodnye-sredstva.html

In the video - bilateral sinusitis:

If a purulent process has occurred, then the patient is not so worried about the lack of normal breathing. More serious processes will begin if this type of sinusitis is not treated. Otitis media, meningitis and a number of other diseases may appear.

A person with chronic sinusitis will not feel any very strong changes. A stuffy nose and fairly thick discharge will bother you. The sense of smell also disappears, and this, in turn, makes it difficult for the brain to function. As a result, a person gets tired quite quickly.

It is worth noting that preschoolers practically do not suffer from this disease. Sinusitis often occurs after 10 years. If inflammation is not treated well at this age, it will lead to negative consequences.

1. Acute form - manifests itself as a result of the penetration of bacteria or infections into the sinuses, the ducts of the maxillary sinuses are clogged.
2. Chronic form - usually occurs if the acute form is not treated. But it can also occur if there are other foci of infection nearby, for example, in the oral cavity.

Depending on what form of inflammation occurs, the following types are distinguished:

1. Catarrhal type is the mildest type of bilateral sinusitis. With this form, only the upper layers of the mucosa are affected as a result of a viral infection. Edema occurs, but manifests itself only slightly. There is discharge from the nose that is odorless and colorless.
2. Serous or exudative - in this case, the production of a large amount of serous fluid begins, and mucous discharge is formed. But as a result of the disruption of the flow of mucus from the nose, bacterial infections begin to occur, resulting in the formation of ulcers.
3. The purulent form is already a complicated form of catarrhal or serous process. In this case, the patient suffers from more complicated symptoms. The mucus that comes out of the nose becomes viscous and the smell becomes unpleasant. It is purulent bilateral sinusitis that occurs more often than others. Pain in the bridge of the nose interferes with sleep, discomfort is felt, and the temperature can often be elevated. The main thing is that the first symptoms are very similar to a cold. In this regard, people do not go to see an otolaryngologist, which leads to serious consequences. How to treat purulent sinusitis without a puncture is indicated in the article.

The video shows treatment of bilateral sinusitis in a child:

There is the International Classification of Diseases, or ICD 10 for short. This document records all pathogens, classification and cause of death. Each disease carries with it a specific ICD code. Acute sinusitis has code J01.0. This species belongs to acute respiratory diseases. But chronic sinusitis has a different code - J32.0.

The article contains reviews of Albucid for runny nose in children.

What folk remedies for a runny nose during pregnancy are most often used is indicated in the article.

How a runny nose is treated with folk remedies at home is indicated here: http://prolor.ru/n/lechenie-n/narodnye-recepty-ot-nasmorka.html

It is known that sinusitis can be caused by various pathogens. In this regard, additional code is used. B95 is the causative agent of the disease, streptococcus or staphylococcus. B96 – other bacteria, B97 – viruses that provoked the onset of the disease.

The photo shows bilateral sinusitis:

Treatment

The most important thing in treatment is to remove pathogenic microflora. 90% of cases are accompanied by the development of the disease against the background of a bacterial infection. In order to accurately determine the pathogen, it is necessary to take the secreted mucus for research. Drug treatment mainly consists of the following drugs:

1. Drops that constrict blood vessels. Due to their use, the swelling of the mucous membrane is reduced, which means that the passages are no longer clogged and the person can breathe. Such drops can be used for no more than 5 days, because in the future they will cause a habit, and then the nose will not be able to breathe without their help.
2. Rinsing the nose - this procedure is quite important. Due to the solutions used, mucus is better removed, and pathogenic microflora is destroyed. Washing can be done both in the clinic and at home. At home, you can use saline solution, herbal decoction, drugs that are sold in pharmacies such as Rotokan, Chlorophyllipt. Washing is done frequently; at least 4 procedures must be done per day.
3. Use of anti-inflammatory drugs. These drugs contain antibacterial components. Such drops include Pinosol, Sinuforte. And Sinupret can be used internally.
4. Antibiotics. It is very difficult to do without them in the treatment of sinusitis. Cephalexin, Macropen are prescribed for various forms of sinusitis. The most important thing is to take antibiotics in courses. You need to drink them to the end, otherwise you may not achieve a complete cure.
5. Antihistamines. Such drugs are usually prescribed to children. Swelling is relieved and breathing improves. You can take such drugs in case of allergies.
6. Warming up. It is used when accumulations of pus have been removed.

It is worth considering that it can be used if there is no severe pain when pressing on certain areas of the face and the body temperature is not elevated. How warming occurs during sinusitis with salt is indicated in the article.

If all these types of conservative treatment do not help alleviate the condition, then a procedure such as a puncture is used. The nasal area is numbed and the area between the sinus and nasal passage is pierced - through the bony septum. The entire puncture area is washed with an antiseptic, excess mucus is removed, and the medicine is injected into the sinus area.

Folk remedies

Traditional methods are used as additional measures to the main treatment:

1. Inhalations. Potatoes will help with this. You need to take 1 kg of potatoes, but do not peel them. When the potatoes are cooked, you need to drain the water and breathe in the steam. It is necessary to cover the top with a towel so that the potato vapors do not escape quickly. The procedure time is not limited: it all depends on the person’s abilities. After completing the procedure, you need to lie on the bed without a pillow and tilt your head back. Place onion solution in your nose. You need to prepare it as follows: squeeze 15 drops of onion juice and mix them with 15 drops of alcohol, 96% concentration. Place 2 drops into each nasal passage. At first this procedure will cause a strong burning sensation, but after 20 seconds everything will pass. It is best to do this procedure at night. By morning all symptoms will go away.
2. Eggs and garlic. You need to boil 1 hard-boiled egg. Now you need to warm up your sinuses with it. Instead of eggs, you can use salt, heated in a frying pan and wrapped in canvas paper. After warming up, rub the garlic over the skin over the area where the inflammation is located. Then you need to rub in a mixture of burdock root and birch coals. The procedure lasts 30 minutes. You can achieve a worthwhile effect after 2-3 procedures.
3. Oil and herb. You will need 100 g of olive oil, you can also take sunflower oil, 1 tbsp. l. chopped wild rosemary. After mixing these components, place them in a dark place for 3 weeks, remembering to periodically stir the composition. Then you need to strain the solution, ridding it of wild rosemary impurities. You can put this oil in your nose. The first time you need to drop 2-3 drops into each passage, subsequent times - 1 drop 4 times a day. The course lasts one week. Acute sinusitis, or rather a runny nose, will pass within this period of time, but chronic sinusitis must be treated for 2 weeks.
4. Tomato tops. You need to take the tops of dried tomatoes, fill them with water and boil. This solution should be used for inhalation. Covering yourself with a blanket, you need to inhale through your right and left nostrils and your mouth alternately. Sessions must be carried out over 10 days. The effect will not be long in coming. It is better not to undergo this procedure for young children.
5. Star balm. You need to boil 5 or 6 liters of water, add 1 tbsp to the container. l. soda and a little star balm. If there is none, then you can buy liquid for inhalation at the pharmacy. It wouldn’t hurt to add 2 tbsp. l. vodka or alcohol. You need to breathe this solution for 20 minutes. At first it is better to breathe through your mouth to get used to it, it will take about 10 minutes. Then you can breathe through your nose, so the nasal passages and nasopharynx will warm up. The next stage is washing. You need to prepare the following solution: pour 25 drops of pharmaceutical propolis, ½ tsp. into 200 ml of boiled water. salt and 1 tsp. soda You need to rinse your nose with this solution using a syringe, but without a needle, or a special syringe. After these procedures, you need to drip your nose with a solution of oil, which must be prepared 10 days before the start of the procedures. Mix 200 g olive oil with 1 tbsp. l. dry mint, 20 g propolis. Leave the oil to infuse for 10 days and then strain. You need to add 1-2 drops into each passage. Complete this entire complex for 10 days.

The video explains whether it is worth agreeing to the protocol for bilateral sinusitis:

Features of treatment in children

Children most often develop a chronic form of the disease due to the structure of the nose.

When treating, it is best to use sprays and aerosols rather than drops, since the spray is evenly distributed in the nasal cavity. When using antibiotics, you first need to do a test to see how the child reacts to them.

This will help avoid side effects and wasted time. Of course, a treatment method such as puncture is used only in the most extreme cases. When choosing traditional methods of treatment, also pay attention to the composition of the products. The child can also undergo acupressure and breathing exercises.

Source: http://neb0ley.ru/gajmorit/ostryj-gajmorit-mkb-10.html