Sinusitis (maxillary sinusitis, maxillitis) is an inflammation of the mucous membrane of the maxillary (maxillary) sinuses. The sinuses are connected by common bony walls with the nasal cavity, mouth and orbit (orbit) and are normally filled with air.

Sinusitis is an inflammation of the mucous membrane of the maxillary sinuses.The main functions of the maxillary sinuses, along with the frontal, sphenoid and ethmoid, are:.

formation of individual sounding of the voice;

warming and purifying the inhaled air;

equalization of pressure in the cavity formations of the skull in relation to external atmospheric pressure.

Through small holes, all the sinuses communicate with each other, but if for some reason these holes are closed, their cleansing and ventilation stops. It promotes microbial accumulation and inflammation..

The development of maxillitis is accompanied by an increase in body temperature, swelling of the cheek and eyelid from the side of the lesion, intense pain in the bridge of the nose and in the wings of the nose, mucopurulent discharge from the nasal passages and difficulty in nasal breathing. With timely started therapy, which is prescribed by an otolaryngologist (ENT), serious complications can be avoided - osteomyelitis, phlegmon of the orbit, brain abscess, meningitis, otitis media, as well as kidney and myocardial damage.

Inflammation of the mucous membrane of the maxillary sinuses occurs in people of all ages, however, in children under 5 years of age, pathology develops extremely rarely, since they have insufficiently developed paranasal sinuses.

Types of sinusitis Code of sinusitis according to ICD-10 (international classification of diseases 10th revision, developed by the World Health Organization).

acute sinusitis: J01 (class - respiratory diseases, heading - acute respiratory infections of the upper respiratory tract);

chronic sinusitis: J32 (class - respiratory diseases, rubric - other diseases of the upper respiratory tract).

Maxillitis can be exudative or catarrhal. These forms of the disease are accompanied by a large amount of mucus or purulent discharge.. Depending on the nature of the discharge, purulent, mucous and serous sinusitis are distinguished..

According to the prevalence of the process, maxillitis is unilateral, which, depending on the affected side, is subdivided into right-sided and left-sided, as well as bilateral.

Sinusitis can be unilateral or bilateral. Classification according to the course of the disease:.

acute: symptoms are similar to a runny nose, acute respiratory viral infection, and other colds. Usually the duration of inflammation ranges from 14 to 21 days;

chronic: can develop in the absence of adequate therapy for acute sinusitis. The duration of this form of the disease is usually 2 months or more.. Symptoms may go away almost completely and then come on again.;

recurrent: characterized by the onset of symptoms two, three, or more times a year.

Classification by etiological factor:.

viral;

traumatic;

bacterial, subdivided into bacterial aerobic and bacterial anaerobic;

fungal;

endogenous, subdivided into vasomotor, otogenic, odontogenic;

mixed;

allergic;

perforated;

iatrogenic.

Often, chronic sinusitis is accompanied by a nocturnal cough that does not respond to conventional therapy. The reason for its appearance is pus flowing down the back wall of the pharynx from the maxillary sinus.

Classification by the route of infection:.

hematogenous: the infectious agent enters through the blood. Most often, this form of sinusitis develops in children.;

rhinogenic: infection enters through the nasal cavity. Usually occurs in adults;

odontogenic: microbes enter the maxillary sinus from the molars of the upper jaw;

traumatic;

Chronic sinusitis, by the nature of morphological changes, is divided into the following types:.

productive (parietal-hyperplastic, atrophic, necrotic, polyposis, purulent-polyposis, etc.). Against its background, changes in the mucous membrane of the maxillary sinus are observed (hyperplasia, atrophy, polyps, and others);

exudative (purulent and catarrhal), in which pus is formed.

In the chronic course of the disease, due to blockage of the mucous glands, small pseudocysts and true cysts of the maxillary sinus are often formed. The most common forms of chronic inflammation are polyposis and polyposis-purulent. Catarrhal allergic and parietal-hyperplastic forms are found in rare cases, and necrotic, ozeous, cholesteatomic and caseous - in very rare cases..

Causes and risk factors for the development of inflammation The causative agents of sinusitis can be viruses, chlamydia, fungi, staphylococci, streptococci, Haemophilus influenzae and mycoplasma. In adults, viruses, pneumococci and Haemophilus influenzae most often cause maxillitis, in children - mycoplasma and chlamydia. In case of impaired immunity and in weakened patients, inflammation can occur due to saprophytic and fungal microflora.

Possible causative agents of the disease - staphylococci, streptococci, viruses, chlamydia, fungi, mycoplasma and haemophilus influenzae Risk factors for the development of maxillitis are pathologies and conditions that impede the ventilation of the maxillary sinus and facilitate the penetration of infection into its cavity. These include:.

congenital narrowness of the nasal passages;

acute respiratory viral infection, acute and chronic rhinitis of any origin;

chronic tonsillitis, pharyngitis;

adenoids (in children);

curvature of the nasal septum;

surgical interventions performed on the alveolar process of the upper jaw or teeth;

carious lesion of the upper molars.

The risk of developing the disease increases in the autumn-winter period, which is due to a natural seasonal decrease in immunity.

Symptoms Symptoms of Acute Sinusitis Inflammation begins acutely. The patient has an increase in body temperature to febrile (38–39 ° C), pronounced signs of general intoxication and, possibly, chills. In some cases, the body temperature can remain normal or subfebrile (37.1-38 ° C). The main complaints of the patient are pain in the area of \u200b\u200bthe affected maxillary sinus, forehead, root of the nose and zygomatic bone. On palpation, the pain intensifies, it can radiate to the corresponding half of the eyelid and temple. A diffuse headache of varying intensity is also possible..

On the side of inflammation, nasal breathing is disturbed, and in cases of bilateral sinusitis, nasal congestion forces the patient to breathe through the mouth. Due to blockage of the lacrimal canal, the development of lacrimation is sometimes observed. Nasal discharge from serous and fluid gradually becomes greenish, cloudy and viscous..

Symptoms of chronic sinusitis Usually chronic sinusitis develops as a result of an acute process. During the period of remission, the general condition, as a rule, does not worsen. With an exacerbation, symptoms of general intoxication appear in the form of headache, weakness and weakness, and the body temperature can rise to febrile or subfebrile.

With exudative forms of maxillitis, the amount of discharge increases during the period of exacerbation, and when the patient's condition improves, it decreases. Catarrhal sinusitis is characterized by a liquid and serous discharge, with an unpleasant odor, with a purulent form, it is a thick, yellowish-green, abundant, viscous mucus that dries up and turns into crusts.

As a rule, the headache develops only during the exacerbation of the chronic form of maxillitis or against the background of a violation of the outflow of discharge from the maxillary sinus. The patient may experience a pressing or bursting headache, which is localized behind the eyes and intensifies with pressure on the infraorbital regions and with raising the eyelids. When lying down or during sleep, the severity of pain syndrome decreases, since in a horizontal position the outflow of pus resumes.

To avoid the development of side effects and to obtain a high concentration of the drug in the focus of inflammation, local antibiotics are used.

Often, chronic sinusitis is accompanied by a nocturnal cough that does not respond to conventional therapy. The reason for its appearance is pus flowing down the back wall of the pharynx from the maxillary sinus.

In chronic maxillitis, skin lesions (oozing, maceration, swelling or cracking) are often detected in the run-up to the nasal cavity.. Many patients develop concomitant keratitis and conjunctivitis.

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