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Chronic frontitis
Last reviewed: 23.04.2024
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Chronic frontitis (chronic frontal sinus inflammation, frontitis chronica) is a long-flowing frontitis, manifested by periodic pain in the corresponding forehead part and nasal discharge, hyperplasia of the mucosa with the development of polyps and granulations.
ICD-10 code
J32.1 Chronic frontal sinusitis.
Epidemiology of chronic frontitis
There are clear indications of a link between the disease of the frontis and the pollution of the atmosphere with toxic waste, a violation of environmental norms. In the zone of location of large industrial enterprises, the incidence of the frontitis is much higher.
Cause of chronic frontitis
The causative agents of the disease are most likely representatives of the coccal microflora, in particular staphylococci. In recent years, there have been reports of the isolation and quality of pathogens of the association of three conditionally pathogenic microorganisms Haemophilus influenzae, Streptococcus pneumoniae and Maxarelae catharrhalis. Some clinicians do not exclude anaerobes and fungi from this list.
Chronic Frontitis - Causes and Pathogenesis
Symptoms of chronic frontitis
Frontite is a disease of the whole body, so it has common and local clinical manifestations. To general, hyperthermia is included as a manifestation of intoxication and diffuse headache as a consequence of cerebral blood and liquor circulation disorders. Often noted general weakness, dizziness and other vegetative disorders. Local clinical manifestations are represented by local headache, nasal discharge, difficulty in nasal breathing.
The leading and the earliest clinical sign of a frontitis is a local spontaneous headache in the superciliary on the side of the affected frontal sinus, with a chronic process they have a diffuse character.
Where does it hurt?
Classification of chronic frontitis
Distinguish catarrhal, purulent, polypous, polypous-purulent and complicated chronic frontitis.
- Pneumosynus of the frontal sinus, due to the presence of a valve mechanism, which may allow air to enter the sinus cavity, but its exit from it is impossible. In this case, inflammatory phenomena, as a rule, are absent, but there is an increased pressure in the sinus, accompanied by a pain syndrome.
- Chronic closed (often latent) and open (with manifestations) forms of the front.
- Etiological microbiota: banal microbiota, anaerobic, specific, mycotic.
- Pathogenetic forms: rhinorrhagic, allergic, traumatic and others.
- Pathomorphological forms: chronic catarrhal (type of vacuum sinus) or transudative form, full-blown, cystic, exudative, purulent, caseous, osteochkrotic, hyperplastic, mixed forms.
- Symptomatic forms: latent oligosymptomatic, neuralgic secretory, anosmic.
- Age forms: children front, mature man, old man.
- Complicated forms with lesions of eyelids, lacrimal passages, deep cellulite and phlegmon of orbit, thrombophlebitis of longitudinal and cavernous sinuses, meningitis, abscess of frontal lobe, etc.
This classification, like many described earlier, does not pretend to be a holistic scientific approach, but reflects only the diversity of sides and positions from which inflammatory processes in the paranasal sinuses can be considered, and therefore have an exclusively didactic character.
Diagnosis of chronic frontitis
At the stage of assessing anamnesis, it is important to collect information on previous diseases, ARVI, sinusitis and exacerbation of the frontitis, features of treatment, including surgical.
Among the complaints, one can immediately identify typical local headaches, pain in the region of the eyebrows, clarify its nature and intensity, the side of the lesion, the presence of irradiation in the temple or the crown; appearance and consistency of the discharge, time and peculiarities of its entry into the nasal cavity or nasopharynx
[14], [15], [16], [17], [18], [19]
Screening
A method of mass noninvasive examination of a large number of people could be diaphanoscopy of the frontal sinuses.
What do need to examine?
Who to contact?
Treatment of chronic frontitis
Before receiving the results of the microbiological examination of the detachable, amoxicillin + clavulanic acid is prescribed, followed by antibiotics of directed action. If the discharge from the sinus is absent or can not be obtained, the treatment begun earlier is continued. The drug of choice in complex anti-inflammatory therapy can be used fenspiride. Assign vasoconstrictive drops in the nose (decongestants), at the beginning of treatment - a mild vasoconstrictive action (a solution of ephedrine, dimethindene and combination with phenylephrine). In the absence of secretions, it is recommended to perform anti-edema therapy (furosemide, intravenous injection of 200 ml of 1% calcium chloride solution), use of antihistamines.