Acute Sinusitis

Acute sinusitis is an acute inflammation of the mucous membrane of one or several paranasal sinuses.

ICD-10 code

• J01 Acute sinusitis.
• J01.0 Acute maxillary sinusitis (acute anthritis).
• J01.1 Acute frontal sinusitis.
• J0.2 Acute ethmoid sinusitis.
• J01.3 Acute sphenoidal sinusitis.
• J01.4 Acute pancinusitis.
• J01.8 Another acute sinusitis (acute sinusitis involving more than one sinus, but not pansinusitis).
• J01.9 Acute sinusitis, unspecified.

Epidemiology of acute sinusitis

Inflammatory diseases of the paranasal sinuses are considered one of the most urgent problems of otorhinolaryngology. Among patients treated in otorhinolaryngological hospitals, from 15 to 36% are people who suffer from sinusitis.

An even greater percentage is made up of sinusitis among outpatient diseases of the upper respiratory tract. According to the National Center for US Disease Statistics, in 1994, sinusitis became the most common chronic disease in this country. Almost every eighth person in the US is sick, they have ever had sinusitis, in 1998 in the United States, 34.9 million people were registered with sinusitis.

In Germany over the past decade, ranging from 7 to 10 million diagnosed with acute and chronic sinusitis.

In connection with this, the treatment of rhinosinusitis is now considered one of the most urgent problems of otorhinolaryngology. So. In the USA in 1996, the costs associated with the diagnosis and treatment of sinusitis amounted to $ 5.8 billion.

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Causes of Acute Sinusitis

The development of inflammation of the mucous membrane of the paranasal sinuses is facilitated by conditions of both general and local nature. The general state of individual reactivity, constitutional prerequisites, immune forces of the body, as well as various adverse environmental factors. Among the local factors most often inflammation in the sinuses is promoted by those in which the drainage function of the discharge holes is disturbed, sinusal ventilation and the work of the mucociliary transport system.

Acute sinusitis - Causes and pathogenesis

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Symptoms of acute sinusitis

Acute sinusitis is not only a local lesion, but a disease not of an organism with the reaction of many systems and organs. Manifestations of a general reaction to inflammation of the paranasal sinuses, in particular, are febrile state and typical changes in blood (with acute and exacerbation of chronic sinusitis), as well as general malaise, weakness, headaches. Since these symptoms are accompanied by other focal infections, in the diagnosis of sinusitis, local manifestations of inflammation are of primary importance.

Acute sinusitis - Symptoms

Classification of acute sinusitis

Localization of the process is distinguished by:

• acute maxillary sinusitis;
• acute etmoiditis;
• sharp front;
• acute sphenoiditis.

When all the paranasal sinuses are involved in the pathological process, the diagnosis of pansinusitis is made, with the involvement of the sinuses only in one half - hemisinusitis.

The etiological factor distinguishes between viral and bacterial sinusitis, pathophysiological - catarrhal and purulent sinusitis. Most often, viral sinusitis corresponds to the catarrhal form, bacterial - purulent.

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Screening

Screening of acute sinusitis consists in radiographic examination of paranasal sinuses in patients with acute respiratory diseases. As an alternative to radiography, ultrasonic diagnostic methods can be used.

Diagnosis of acute sinusitis

Important in the detection of sinusitis is the consistent conduct of anterior, middle and posterior rinoscopy. Rhinoscopic signs of sinusitis include: detachable in the nasal passages, hyperemia, swelling and hyperplasia of the mucous membrane.

The pathological discharge and the middle nasal passage (anterior rhinoscopy), as a rule, indicates a possible lesion of the frontal and maxillary sinuses, anterior and middle cells of the latticed labyrinth, in the upper nasal passage (posterior rhinoscopy) - about possible damage to posterior cells of the latticed labyrinth and sphenoid sinus. However, the absence of a pathological spit in the cavity of the spit does not exclude sinus disease. In particular, the discharge may not be (periodically or permanently) if the patency of the sinus of the affected sinuses is violated with the nasal cavity or with a high viscosity of the separated.

The most common complaints with inflammation of the paranasal sinuses are: headaches, difficulty in nasal breathing, pathological discharge from the nose and nasopharynx, smell disorder.

Acute sinusitis - Diagnosis

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Indications for hospitalization

• Severe clinical course of acute sinusitis, suspected complications.
• Acute sinusitis on the background of severe concomitant pathology or immunodeficiency.
• Impossibility of conducting special outpatient manipulations in outpatient settings.
• Social indications.

Acute sinusitis - Treatment

Objectives of treatment of acute sinusitis

• Evacuation of the pathological discharge from the paranasal sinuses.
• Elimination of the focus of infection and inflammation.
• Restoration of normal drainage and aeration of the paranasal sinuses.

Prevention of acute sinusitis

The occurrence of an overwhelming number of acute rhinosinusitis leads to sinus infection due to rhinitis. Therefore, the main preventive area is timely and adequate therapy of acute respiratory diseases and acute rhinitis (relief therapy, restoration of aeration drainage of the paranasal sinuses).

With odontogenic maxillary sinusitis, prevention consists in the timely sanitation of the upper jaw teeth.

Anatomical defects of the nasal cavity (curvature of the nasal septum hypertrophy of nasal concha) can also lead to acute sinusitis, the question of surgical correction of these defects is put only in the development of chronic sinusitis.

Forecast

With adequate therapy for acute sinusitis, the prognosis is favorable. Complete elimination of the pathological process occurs within 7-10 days. If the treatment is inadequate and untimely, the process may transition to the chronic phase.

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