Types of sinusitis. Chronic sinusitis


Types of sinusitis. Chronic sinusitis.

The sinuses are air-filled cavities of the skull, developed during the growth period of the organism and whose functions are to maintain constant and optimal pressure in the skull, to purify the air circulating through the nasal passages and to cushion any shock received by the mid-facial floor. There are 4 pairs of sinuses, located as follows:

The frontal sinuses

The ethmoid and sphenoid sinuses – two pairs each, located deep in the skull, between the orbit and the nose

Maxillary sinuses – a pair of sinuses located on either side of the nostrils that can frequently become inflamed due to dental disease or following extractions of upper lateral teeth that have their roots located in the sinus.

Sinusitis is a relatively common disease manifested by inflammation of the mucus lining these cranial cavities. The origin of the inflammation may be bacterial, viral, fungal, allergic or may be a complication of some dental disease or extraction.

Sinusitis occurs when the opening through which the fluid drains from the sinuses is blocked and the fluid remains and stagnates inside the cavity. Mucus builds up and breathing through the nose may become difficult.

Causes

Chronic sinusitis is the presence of symptoms and stagnation of mucus for a period of at least 3 months and can have the following causes:

Nasal polyps – these formations commonly discovered in childhood are hypertrophied tissues that end up blocking the nasal passages or sinuses. They are most often operated on in childhood and the outcome is favorable.

Allergies – some allergens such as dust can overwhelm the sinuses’ ability to purify the inhaled air and end up blocking the drainage pathway, resulting in chronic sinusitis.

Deviated septum – statistically almost the entire population of the planet has been found to suffer from a deviated septum, with the degree of the condition varying from individual to individual. The nasal septum is the wall that separates the two nostrils and if it is severely deviated, the drainage orifice of the maxillary sinus may be blocked in the direction of the deviation.

Trauma to the middle floor of the face – through mechanical obstruction caused by a displaced bone fragment following trauma, the sinus drainage pathway may be blocked, mucus accumulating in the affected sinus.

Respiratory infections – viruses are seasonal and occur mainly in the cold season. They can block the natural drainage pathway and create conditions for the microbial growth of the sinuses..

The diagnosis of chronic sinusitis is established on the basis of imaging (panoramic X-ray or CT), endoscopy (a flexible tube with a fiber-optic light is inserted through the nose allowing the doctor to visualize the nasal cavities and sinuses on a screen), correlated with the clinical manifestations reported by the patient or observed by the doctor.

Chronic sinusitis is more difficult to treat than acute sinusitis because of the mucosal changes that occur over a 3-month time span. The aim is to reduce mucosal inflammation and restore the natural drainage pathways.

The first-line treatment is medicinal, consisting of nasal decongestants and antibiotics, and endoscopic sinus surgery may be performed if symptoms persist.

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