Monday, January 28, 2013

chronic maxillary sinusitis

 Chronic maxillary sinusitis is a chronic inflammation of the lining of the maxillary sinus with an evolution of more than 3 months. Factors that cause chronic maxillary sinusitis include:
- Rhinology factors (causes of chronic nasal obstruction)
- Environmental factors (pollution) contaminant, dust, smoke
- Infectious factors
- Dental outbreaks that may cause odontogenic maxillary sinusitis
- Traumatic factors
- Tumor factors
- Lowered immunity due to various reasons.
Symptoms of chronic maxillary sinusitis are:
- Feeling of pressure, tension in the cheek
- pain of lower intensity
- Nasal obstruction
- Rhinorrhea (runny nose) mucopurulent, sometimes foul-smelling
- Disorders of smell
- Morning cough with expectoration
When examining ENT it is found the submit purulent of secretions in the nasal cavities, which can be sometimes fetid and the nasal mucosa is congestive.
Is necessary to conduct investigations such as the:
- X-ray of anterior and posterior facial sinuses
- Nasal endoscopic examination
- MRI
- examination Computed tomography: of the lining sinus can appears modifications, liquidian level, polyps, obstruction ostiomeatal, calcification, etc..
- Bacteriological and mycological examination of secretion with anti-biograma
- Dental checkup and dental radiography if it is a suspected a cause dental of sinusitis.
- Allergy testing
- Biopsy examination (if applicable)
- Sometimes sinus puncture
How to treat chronic maxillary sinusitis?
The prophylactic treatment is very important and consists in treating all factors that determine the nasal obstruction such as a deviated nasal septum, chronic hypertrophic rhinitis, nasal polyps, etc.
Curative treatment for this disease is medically and surgically.
Medical treatment is the first choice in chronic maxillary sinusitis and consists in the administration of:
- Broad spectrum antibiotic for several weeks
- Aerosol with anti-inflammatory substances
- Dezobstruante nasal vasoconstrictor
- Vitamins and minerals
- mucolytics
- inhalations
The surgical treatment is reserved for patients who have not responded to medical treatment correctly.
The surgical treatment in chronic maxillary sinusitis aims at draining of  maxillary sinus, this can be done by endoscopic (meatotomie medium) or the classic way  depending on each patient.
Pre-operative must be performed the following analyzes:
- Complete blood counts
- Tests of liver
- coagulogram
- Tests of renal
- C.T.sau R.M.N.
- glucose

- Pulmonary Radiography, EKG and cardiology checkup if intervention takes place in general anesthesia
It is very important to know before surgery if the patient follows chronic medical treatments or is allergic to some medicine.
Also, before surgery, must be obtained the consent of the patient.
Post-operatively the patient remains with nasal swab  about 24 hours with special buffers nasal type Merocel, after of-buffer (removing nasal swab) will practice daily nasal toilet with aspiration of secretions and crusts, followed by tables nasal vasoconstrictor solutions.
The post operative checks  are mandatory and consist in grooming of nasal cavities, daily initially and then at 3-4 days until healing. These controls postoperative are essential for the therapeutic success long-term.

5 comments:

  1. This article has been quite informative and maxillary sinusitis is a condition that has to be avoided where possible and when contracted it has to be effectively treated.

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