Frontit
The content of the article:
- Causes and risk factors
- Forms of the disease
- Frontal sinusitis symptoms
- Features of the course of frontal sinusitis in children
- Diagnostics
- Frontitis treatment
- Possible complications and consequences
- Forecast
- Prevention
Frontitis is a disease in which an inflammatory process develops in the mucous membrane of the frontal (frontal) sinus.
Frontal sinuses are paired cavities located in the frontal bone of the skull on either side of the midline. The size and configuration of the sinuses have individual characteristics in different people. In some cases, the frontal sinuses may be undeveloped or completely absent. The close location of the frontal sinuses to the anterior cranial fossa and orbits is fraught with serious complications of inflammation.
All age groups are equally susceptible to the disease, men suffer from frontal sinusitis more often than women.
Frontitis is an inflammatory process in the mucous membrane of the frontal sinus
Causes and risk factors
The most common cause of acute frontal sinusitis is an infectious process that has spread to the mucous membrane of the frontal sinus from the nasal cavity in acute respiratory, as well as other infectious diseases. The causative agents can be viruses, bacteria or microscopic fungi.
Risk factors for the development of frontal sinusitis include:
- injuries to the nose and / or paranasal sinuses;
- congenital or acquired curvature of the nasal septum;
- violation of breathing through the nose (polyps, adenoids, vasomotor rhinitis, etc.);
- hypothermia;
- weakened immunity;
- foreign bodies in the nasal cavity.
Chronic frontal sinusitis develops against the background of incorrect or untimely treatment of the acute form of the disease, it is facilitated by the peculiarities of the anatomical structure of the paranasal sinuses and / or the nasal septum.
Forms of the disease
Depending on the nature of the pathological process, frontal sinusitis is divided into acute, recurrent, subacute and chronic.
By prevalence:
- one-sided (left- or right-sided);
- bilateral.
Depending on the etiological factor:
- bacterial;
- viral;
- fungal;
- allergic;
- traumatic;
- mixed.
Along the path of infection:
- rhinogenic - develops against the background of rhinitis;
- hematogenous - the pathogen penetrates into the frontal sinus with blood flow;
- traumatic - occurs as a result of damage to the skull in the area of the frontal sinuses.
By the nature of the inflammation:
- catarrhal;
- serous;
- purulent;
- polypous (cystic).
The most dangerous is the purulent form of frontal sinusitis, since with inadequate or insufficient treatment, it can cause serious complications.
Frontal sinusitis symptoms
In acute frontalitis, patients complain of a sharp pain in the superciliary region, which increases with tilting the head, during sleep, during palpation, may radiate to the temporal region and is not stopped by taking analgesic drugs. Also, symptoms of frontal sinusitis can be headaches of another localization, unpleasant bursting sensations in the bridge of the nose, photophobia, eye pain, abundant discharge from the nose, odorless or with an unpleasant odor and particles of pus (with purulent frontitis), difficulty in nasal breathing. These phenomena are accompanied by an increase in body temperature, cough with sputum in the morning, deterioration in general condition, and sleep disturbance.
In acute frontalitis, patients complain of severe pain in the superciliary region
The clinical picture of chronic frontal sinusitis in adults is less pronounced in comparison with acute. As a rule, the chronic form of the disease is accompanied by inflammation of other paranasal sinuses, especially often ethmoid (ethmoiditis). The pain in the forehead is aching, increases with pressure, its intensity changes during the day. Discharge from the nose often has an unpleasant odor, there is a decrease in the sense of smell, up to a complete loss. Swelling of the eyelids indicates the spread of the pathological process to the orbit. Chronic frontal sinusitis is characterized by alternating periods of exacerbation and remission. Signs of frontal sinusitis during remission may be a feeling of heaviness in the superciliary region, decreased sense of smell, nasal discharge.
Features of the course of frontal sinusitis in children
In children under 5-7 years of age, the frontal sinuses are not developed, so they do not suffer from frontal sinusitis, the disease is detected in primary school and adolescence. Isolated inflammation of the frontal sinuses is rare in children; frontal sinusitis in this age group is much more often diagnosed as a component of pansinusitis.
In general, children are characterized by a severe course of frontal sinusitis with bilateral lesions of the sinuses, the clinical picture is similar to acute respiratory infections, however, it is alarming regarding inflammation of the paranasal sinuses, first of all, the duration of the disease is longer than in acute respiratory infections. Specific symptoms of frontal sinusitis in children include:
- persistent headache, aggravated by head movements;
- pain in the projection of the frontal sinuses, aggravated by pressure;
- purulent discharge from the nose;
- nasal voice;
- lacrimation;
- cough in the morning;
- stuffy nose and ears.
In children, frontal sinusitis is difficult with bilateral damage to the sinuses
In some cases, against the background of frontal sinusitis, children develop conjunctivitis.
There are also a number of non-specific signs of the disease:
- rise in body temperature (rarely above 38.5 ° C);
- pallor of the skin;
- difficulty or complete impossibility of nasal breathing;
- swelling;
- decreased appetite;
- weakness, fatigue;
- irritability;
- sleep disorders.
Frontitis in children tends to spread to other paranasal sinuses (if it was isolated), as well as to rapidly flow into a chronic form.
Diagnostics
The diagnosis is made based on the results of the following studies:
- collection of anamnesis (the presence of a previous respiratory disease, sinusitis of other localization, duration of manifestations, etc.);
- objective examination;
- rhinoscopic examination (helps to determine the presence of an inflammatory process in the nasal cavity);
- bacteriological examination of nasal discharge (makes it possible to identify an infectious agent, to determine its sensitivity to antibacterial drugs);
- general and biochemical blood test, urinalysis (determines the signs of the inflammatory process, allows you to assess the general condition of the body);
- X-ray examination (allows for differential diagnosis of purulent frontal sinusitis and non-suppurative forms of the disease, damage to other sinuses, to establish the presence of curvature of the nasal septum);
- magnetic resonance imaging or computed tomography (helps to identify the anatomical features of the nose and paranasal sinuses and the prevalence of the pathological process).
Rhinoscopic examination shows inflammation in the nasal cavity during frontalitis
If necessary, additional studies can be applied:
- cytological analysis of the contents of the nasal cavity;
- scintigraphy;
- thermography;
- diaphanoscopy, etc.
Differential diagnosis of frontal sinusitis with inflammatory diseases of other paranasal sinuses, trigeminal neuralgia, inflammation of the meningeal membranes, etc. is required.
Frontitis treatment
Treatment of frontal sinusitis is selected depending on the form of the disease, the prevalence of the pathological process, age, general condition of the patient and other factors.
Acute frontal sinusitis is an indication for hospitalization in an otolaryngological hospital.
To reduce the swelling of the nasal mucosa and paranasal sinuses in order to create conditions for the outflow of pathological contents from the inflamed frontal sinuses, local vasoconstrictors are used to lubricate the mucous membranes of the nasal cavity (these drugs are also used in the form of drops and sprays). After removing the edema, antiseptic, anti-inflammatory drugs are injected into the sinuses.
Vasoconstrictor drops help eliminate swelling of the nasal mucosa and begin the main treatment of frontal sinusitis
General therapy for acute frontal sinusitis consists in the use of broad-spectrum antibacterial drugs, antihistamines and anti-inflammatory drugs.
In addition to the drug treatment of frontal sinusitis, physiotherapeutic methods such as laser therapy, UHF therapy, electrophoresis with drugs, etc. can be used.
With the ineffectiveness of conservative treatment, the appearance of complications and a pronounced deterioration of the patient's condition, surgical intervention (trepanopuncture) is indicated. With trepanopuncture, penetration into the frontal sinus is carried out through the area of the frontal bone of the smallest thickness. Manipulation can be done in two ways - by piercing the bone tissue or drilling. After removing the pathological secretion, the sinus is washed with an antiseptic solution, treated with an antibacterial and anti-inflammatory drug. With proper care of the puncture site, the puncture heals without scar and scarring. In some cases, surgery is performed using the endoscopic method. If all other methods are ineffective, they resort to trepanation of the frontal sinus: after dissecting the skin with a scalpel, the sinus is opened, washed with an antiseptic, and installed in the canal,connecting the frontal sinus with the nasal cavity, a plastic tube for drainage, then the incision is sutured.
In the treatment of chronic frontal sinusitis, the general approach is used, however, the antibacterial drug is selected taking into account the sensitivity of the infectious agent to it, anti-inflammatory therapy is carried out with the help of glucocorticoid drugs. Vitamins and other agents are prescribed to help strengthen the immune system. Physiotherapy (magnetotherapy, ultraviolet irradiation, etc.) also provides a positive effect.
Treatment of acute frontal sinusitis lasts from several days to a week, chronic - 1-2 weeks or more.
Possible complications and consequences
In the absence of the necessary treatment, acute frontal sinusitis can turn into a chronic form - this is the most frequent complication. Also, frontal sinusitis can be complicated by the following conditions:
- atrophy of the nasal mucosa;
- conjunctivitis;
- phlegmon of the orbit;
- decreased visual acuity;
- photophobia;
- otitis;
- involvement of other paranasal sinuses in the inflammatory process;
- sepsis;
- persistent headaches;
- deterioration of smell; and etc.
Chronic hypoxia may develop against the background of disturbed nasal breathing, in addition, this may lead to the onset of obstructive sleep apnea syndrome ("the disease of respiratory arrest during sleep"). Involvement in the pathological process of the optic nerve is fraught with a decrease, and in severe cases, loss of vision. With the spread of inflammation deep into the skull, life-threatening conditions such as rhinogenic meningitis, brain abscess, encephalitis, purulent inflammation of the skull bones, etc. can develop.
Forecast
With timely and adequate treatment, the prognosis is favorable. The chronic form of frontal sinusitis can take a persistent course with periodic relapses.
Intracranial complications of frontal sinusitis are characterized by an unfavorable prognosis and can be fatal.
Prevention
- Timely treatment of respiratory diseases.
- Body hardening.
- Balanced diet.
- Rejection of bad habits.
- Avoiding hypothermia.
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Anna Aksenova Medical journalist About the author
Education: 2004-2007 "First Kiev Medical College" specialty "Laboratory Diagnostics".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
