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Inflammatory diseases of the paranasal sinuses
Inflammatory diseases of the paranasal sinuses
Acute and chronic inflammation of the mucous membrane and bony walls of the sinuses are found in 25-30% of cases.
The most commonly occurs in inflammation of the maxillary - maxillary sinus - sinusitis. This is due to the fact that the evacuation of the contents of the sinuses is difficult due to the location of anastomosis with the nasal cavity in the upper third of the medial wall, as well as the fact that inflammation of the posterior roots of the four upper teeth may move to his bosom. In addition, the maxillary sinuses are the largest and below the other.
The second highest frequency is inflammation of the ethmoidal labyrinth cells - ethmoiditis, behind the frontal sinuses - frontal and sphenoid sinus - sphenoiditis.
However, most often inflammation does not extend to one, but several of the sinuses - appears polisinuit. The most common combination is combined sinusitis and etmoidita. In some cases there is inflammation of the paranasal sinuses - pansinuit, or sinuses, located on a single left or right side - gemisinuit.
Causes an acute inflammation of the sinuses are most often:
acute respiratory infections
flu
supercooling
cold
the injury.
Coryza is usually accompanied by acute inflammation of the sinuses.
Chronic sinuity result from prolonged or frequent repetition of the current acute process under the influence of various general and local adverse factors, such as lowering the reactivity and the general weakening of the body, impaired drainage of the sinuses, deviated septum, as well as diseases of the teeth.
In the etiology and pathogenesis of essential role played by pathogenic microflora, although in some cases are reported aseptic sinuity. Purulent form of the disease is most often caused by streptococci and staphylococci, pneumococci sometimes, fungi and other microflora.
When odontogenic sinusitis abnormal discharge from the sinuses, usually contains a microflora, whereas allergic, vasomotor, hyperplastic, serous forms are usually aseptic discharge. Purulent discharge with chronic sinus sometimes does not contain microflora.
The inflammatory process may pass through the bony walls of the vessels and sinuses okolososudistym spaces. More often due to the introduction of infection occurs thrombosing veins, perforating the bone wall. After melting the clot and the vessel appeared granulation and osteoclasts, which break down bone, forming a perforation of the wall. Penetrating through these perforations, infection results in local and general complications - phlegmon of the orbit, subperiosteal abscess or extradural.
The spread of infection from the sinuses and possibly multiple venous anastomoses, which explains why in some cases of severe intraorbital and intracranial complications.
