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A. Exudative forms:
catarral; serous; purulent.
B. Productive forms:
C. Alternative forms:
cholesteatomic; caseous; necrotic; atrophic
purulent polypoid
catarral parietal hyperplastic allergic
1. 2. 3. 4.
maxillary sinus (maxillary sinusitis) ethmoidal sinus (ethmoiditis) frontal sinus (frontal sinusitis) basilar sinus (sphenoiditis)
Etiology
The microorganisms that vegetate on the mucous tunic of the upper airways: staphylococcus, streptococcus, blue pus bacillus, Proteus bacillus, colon bacillus, anaerobes, viruses, fungi.
the inflammation of the mucous tunic of the nasal cavity and the paranasal sinuses the edema of the mucous tunic the closing of the natural anastomosis of the sinuses (the drainage disfunction) the change of the pressure in the sinus (decreasing) the vasodilatation and the transudation of the fluid the migration of the neutrophils with the pus formation (in case of the infection) the development of the sensitizing as a result of the absorption of the toxins
Pathogenesis
Clinical picture
The clinical picture depends on:
the stage of the disease (remission, exacerbation); sinusitis form; localisation of the process; extent of the affection (one or several sinuses); kind and virulence of the microorganisms; permeability of the natural anastomosis.
Clinical picture
Rise in temperature, headache, deterioration of the state of health, pain in the area of the projection of the sinuses, edema of the eyelids, inflammatory shift in blood.
Rhinoscopic picture
purulent sinusitis
polypous sinusitis
Diagnostics of Sinusitis
Anamnesis Diagnostic puncturing of the maxillar sinus X-ray (CT)
6.
7.
vasoconstrictors endonasal
punctures and drainage of the paranasal
sinuses
Surgical Treatment
Operations on the the maxillary sinus: Kaldvell-Lukes operation, Rudakovs operation. Videoendoscopic maxillary sinusotomy
Kaldvell-Lukes operation
1. incision of the mucous tunic in the area of the vestibule of the mouth
3. application of the anastomosis between the maxillary sinus and the inferior nasal meatus