What does the frontal sinus not mean? Clinical anatomy of the paranasal sinuses The structure of the frontal sinuses.

Frontal sinusitis or frontal sinusitis is an inflammation of the frontal paranasal sinus. IN modern world this disease is one of the most common. Frontitis affects about 10-15 percent of the entire population of the world. About 10 percent of all patients suffer from the chronic form of this disease.

Recently, the incidence of this disease not only does not decrease, but is gradually progressing. Among the population Russian Federation frontal sinusitis affects about 1 million people a year. To understand the etiology and causes of the disease, it is necessary to know the anatomy of the frontal sinuses.

A distinctive feature of the frontal sinuses is their absence at the time of birth.

The paranasal sinuses adjacent to the nasal cavity are divided into:

• maxillary or maxillary;
• wedge-shaped;
• frontal;
• lattice maze.

They are small cavities located in the bones of the skull that open up the nasal passages. The sinuses, according to the norm, should contain air.

The sinuses have important functions, namely:

• lighten the bones of the skull;
• moisturize and warm the air that enters the human body;
• play a buffer role in various facial injuries;
• protect eyeballs and the roots of the teeth from temperature fluctuations;
• act as a voice resonator.

In the frontal bone of the skull, there are two frontal sinuses, which have a pyramidal shape, while the pyramid is located with the base down and is divided into two parts using a bony septum.

Each frontal sinus has 4 walls: the orbital or inferior, anterior, inner and posterior. The thickest is the anterior sinus septum, and the thinnest is the lower one. As for the size of the sinus, they can vary depending on the individual characteristics of the structure of the bones of the skull. In 10 percent of people, frontal sinusitis is completely absent - this pathology is hereditary. The volume of the frontal sinus can range from 3 to 5 cm 3.

From the inside, the frontal sinuses are lined with a mucous membrane (a continuation of the nasal mucosa), which does not contain cavernous tissue. If we compare the thickness of the sinuses and nasal mucosa, then in the former it is thinner. The frontal sinuses are connected to the nasal cavity through a narrow convoluted canaliculus and open with a small opening in the front of the nasal passages.

Etiology of the disease

Frontal sinusitis is characterized by inflammation of the mucous membrane that lines the frontal sinuses. The severity and form of the disease directly depend on the causative agent of the disease. Most often, frontal sinusitis is provoked by:

• infections;
• allergic reactions;
• nasal polyps;
• foreign bodies;
• pathology in the structure of the nose;
• injuries to the paranasal sinuses and nose.

Infection

penetrating into the human body, pathogenic microorganisms provoke inflammation of the mucous membrane of the nasopharynx, which can spread to the mucous membrane of the frontal sinuses

Frontal sinusitis is most often caused by infections that enter the frontal sinuses from the nasal cavity. Inflammation of the mucous membrane can develop not only in the frontal, but also in the maxillary sinuses, in which case the patient is diagnosed with two diseases - frontal sinusitis and sinusitis. The causes of infection in the human body are respiratory diseases of the upper respiratory tract (sore throat, ARVI, flu), as well as diseases such as diphtheria, measles, scarlet fever and others.

As for the causative agents of the disease, they are different depending on the form of frontal sinusitis (viral and bacterial). For the viral form, the causative agents are rino-, adeno- and coronoviruses, as well as respiratory-sentimental viruses. The bacterial form is provoked by such microorganisms as: staphylococci, streptococci and pneumococci.

Pathogenic fungi can also provoke frontal sinusitis. If there are foci of fungal infection in the body, for example, abscess, carious teeth and others, fungi enter the bloodstream hematogenously (through the blood), provoking inflammation of the mucous membrane.

Allergic reactions

Diseases such as bronchial asthma or vasomotor rhinitis (allergic rhinitis, especially its chronic form) can provoke edema and inflammation in the mucous membrane of the frontal sinuses. With swelling of the mucous membrane, the opening through which the fluid leaves the frontal sinus is blocked.

The cause of frontal sinusitis is allergic reactions, namely vasomotor rhinitis.

Nasal polyps

Benign formations with a rounded shape and caused by the degeneration of the mucous membrane are called polyps. When nasal polyps develop, the patient experiences swelling of the mucous membrane, which, in turn, makes it difficult for fluid to drain from the frontal sinuses and leads to its stagnation, as well as difficulty breathing, which can adversely affect work of cardio-vascular system and the functioning of the respiratory system. As a result of fluid stagnation in the frontal sinuses, inflammation of the mucous membrane occurs, which is called frontal sinusitis.

Foreign bodies

The ingress of foreign bodies and their prolonged stay in the nasal passages also causes inflammation of the mucous membrane of the paranasal sinuses. Most often, foreign bodies are the cause of frontal sinusitis in young children.

Nasal polyps, as well as foreign bodies in the nasal passage, make it difficult for natural ventilation of the nasopharynx

Pathology of the structure of the structures of the nose

Pathological changes (acquired or congenital), for example, curvature of the nasal septum, can also disrupt the outflow of fluid, and with it the pathogenic microflora from the paranasal sinuses, as a result of which the inflammatory process begins. It is only possible to completely cure frontal sinusitis caused by pathological changes in the nasal structures surgically.

Trauma

Injuries to the face, accompanied by severe bruising or damage to the bones of the skull, can also provoke frontal sinusitis, since the injury causes tissue edema, as a result of which their blood supply is disrupted, which becomes the cause of inflammation of the mucous membrane of both the nasal passages and the frontal sinuses. Due to edema, the outflow of fluid from the paranasal sinuses is disturbed, and some damage can provoke a pathological change in the nasal structures.

Congenital or acquired curvature of the nasal septum disrupts the natural circulation of air in the nasal cavity. thereby provokes the onset of inflammatory processes both in the nasal passages themselves and in the paranasal sinuses

Frontal sinusitis symptoms

Depending on the course of the disease, frontal sinusitis can be of two types: acute and chronic. The course of the disease is much more severe than other sinusitis and can provoke serious complications.

Signs acute form frontal sinusitis are:

• severe and sharp pain in the forehead, which is aggravated by pressure or palpation;
• discomfort during inner corner eyes;
• photophobia, lacrimation;
• cramps and pain in the eyes;
• hindered nasal breathing and nasal congestion;
• abundant mucous discharge from the nose (if you do not start treatment on time, then over time the discharge becomes purulent);
• if a right-sided or left-sided frontal sinusitis develops, then the discharge will be observed in the corresponding half of the nose;
• in some cases, the patient changes the color of the skin directly above the frontal sinuses;
• as a rule, there is an increase in body temperature (38-39 degrees), but in some cases the patient's body temperature may have only minor deviations from the norm;
• the patient has a general intoxication of the body, as a result of which the patient is characterized by a feeling of lethargy and drowsiness;
• with rhinoscopy, the patient has mucosal edema, inflammation, and mucopurulent discharge.

For chronic frontal sinusitis, the following symptoms are characteristic:

• crushing or it's a dull pain in the frontal region;
• when pressed, there is a sharp pain in the inner corner of the eye;
• purulent discharge from the nasal passages, having bad smell;
• in the morning, a large amount of purulent sputum is released.

The chronic form of the disease develops 4-8 weeks after the onset of frontal sinusitis, and the causes of the onset are inadequate treatment or complete neglect of the acute form of frontal sinusitis.

With frontal sinusitis, the patient has a sharp pain in the frontal region

Diagnosis of the disease

To determine an accurate diagnosis, an otolaryngologist can use the following types of diagnostics:

• rhinoscopy;
• collection of anamnesis;
• endoscopy of the nose;
• ultraviolet examination of the paranasal sinuses;
• transillumination (diaphanoscopy);
• thermography;
• bacteriological examination of discharge from the nasal passages;
• x-ray of the paranasal sinuses;
• computer research (tomogram);
• cytological studies of secretions.

Radiography makes it possible to assess the volume of accumulated fluid in the frontal sinus, the size and structural features of the sinuses

The general purpose of diagnostics is a detailed collection of patient complaints and clarification of symptoms of the disease. By performing rhinoscopy, it is possible to determine the presence of an inflammatory process, notice redness and swelling of the mucous membrane, and also reveal the presence of polyps or pathological changes in the nasal structures, which, in turn, can provoke or complicate the course of frontal sinusitis. To identify the volume of inflammation, as well as to control the effectiveness of therapy, an ultrasound of the frontal sinuses is prescribed.

To determine the microorganisms that provoke frontal sinusitis, a bacteriological examination of the contents of the nasal cavity is carried out. Together with cytology, bacterial inoculation makes it possible not only to determine not only the pathogen, but also its sensitivity to antibiotics. Thanks to the data laboratory research the otolaryngologist can prescribe the most effective treatment... Instead of lengthy clinical trials, the patient is often offered to undergo a rapid test for pathogenic microflora and its sensitivity to antibiotics. A feature of this research method is the ability to obtain a result within a few minutes after taking the secretion released from the nasal passages.

Frontal sinusitis types

Frontitis is divided depending on the form of the course, localization and type of inflammatory process.

By the shape of the flow:

• acute;
• chronic.

By localization:

• one-sided (left- or right-sided);
• double-sided.

By the type of inflammatory process:

• catarrhal;
• purulent;
• cystic, polyposis;
• parietal hyperplastic.

Depending on the localization of the inflammatory process, the course and cause of the disease, a classification is carried out different types frontal sinusitis

Acute frontal sinusitis

The causes of the disease are allergic rhinitis, facial injuries, infectious diseases... The symptoms are pronounced. For treatment, antibiotics, vasoconstrictor drugs, pain relievers and antipyretics are used.

Chronic frontal sinusitis

Diseases cause prolonged acute frontal sinusitis or its recurrence, acute rhinitis, previous flu, polyps in the nose, pathological changes in nasal structures, for example, curvature of the nasal septum, foreign body in the nasal passages, weakening of local immunity. The symptoms are not as pronounced as in acute frontal sinusitis, but they bring the patient not only physical, but also emotional discomfort (especially purulent discharge).

For treatment, decongestants, vasoconstrictor and homeopathic medicines, antibiotics, electrophoresis, lavage, expansion of the frontal-nasal valve, sinus puncture are used.

Unilateral form of the disease

The unilateral form of the disease is characterized by the presence of discharge from only one nasal passage (right or left), headache, and an increase in body temperature up to 39 degrees. The cause may be bacteria, viruses, allergens, decreased local immunity, facial trauma. For treatment, decongestants, antihistamines, pain relievers, antipyretic and anti-inflammatory drugs, as well as antibiotics, and in case of ineffectiveness conservative treatment - surgical intervention.

Bilateral form of the disease

The bilateral form has the same symptoms and causes as unilateral frontal sinusitis, only discharge is observed from both nasal passages. For therapy, conservative treatment is used, and if it is ineffective, frontal sinusitis is treated surgically.

With inflammation of the frontal sinuses, the patient feels pain in the frontal region. Depending on the form of the course and localization of the inflammation, the pain can be equally strong or periodically intensify

Catarrhal form

It is characterized by severe headache, fever and puffiness under the eyes. The disease occurs as a result of inflammatory and infectious processes in the nasal mucosa. For treatment, rinsing of the nasal cavity, vasoconstrictor, antiallergenic drugs, antibiotics, drugs that normalize the microflora are used.

Purulent frontal sinusitis

The disease is characterized by purulent discharge from the nasal cavity, intoxication of the body, weakness, severe headaches, high temperature, shortness of breath. Bacteria provoke disease, as well as polyps or pathological changes in the nasal structures. The presence of a focus of infection in the body can also provoke frontal sinusitis. As a treatment, antibiotics, pain relievers and anti-inflammatory drugs, decongestants, and a puncture to remove pus are used.

Polyposis form

The main symptoms are aching pain in the frontal region, shortness of breath, mucous discharge. The causes are pathological growth of the nasal mucosa and the formation of cysts. Treatment is carried out only surgically: the frontal sinus is opened and these formations are removed.

Parietal hyperplastic form of the disease

This form of the disease is also characterized by aching pain, profuse discharge, shortness of breath and proliferation of the mucous membrane of the paranasal sinuses. Bacterial infections cause illness, individual reactions immune system on inflammation, increased division of mucosal cells. For treatment, antibiotics and vasoconstrictor drugs are used.

Drug treatment of the disease

Medication therapy for frontal sinusitis should be prescribed only by the attending physician, since self-medication can lead to serious complications. Some forms of frontal sinusitis do not require antibiotics: viral or allergic frontal sinusitis. Taking antibiotics for these forms of the disease leads to a worsening general condition patient, decreased immunity and dysbiosis. Other forms of the disease are treated in a comprehensive manner, including taking antibiotic-containing drugs.

Treatment of frontal sinusitis is conservative. In case of its ineffectiveness, they resort to surgical intervention

For the treatment of the disease, it is extremely important to carry out rinsing of the nasal cavity, as they help clear the nasal passages of discharge. To speed up recovery, in addition to washing, electrophoresis, UHF therapy, laser therapy, and sollux are prescribed.

If conservative treatment is ineffective, they resort to surgical intervention, the patient is punctured by the frontal sinus, through which its contents are removed. The procedure is carried out under local anesthesia using a special device - trephine. Operative intervention it is extremely important in the treatment of frontal sinusitis caused by pathological changes in the nasal structures (curvature of the septum, proliferation of the mucous membrane, the formation of cysts and polyps).

Pregnancy therapy

During pregnancy, as well as during lactation, taking antibiotics can have a negative effect on the baby, therefore antimicrobial agents are prescribed in the minimum effective doses, and a qualified otolaryngologist and gynecologist should supervise the treatment process itself.

Traditional medicine methods

Treatment of frontal sinusitis at home is allowed for mild forms of the disease. The treatment prescribed by the doctor can be supplemented with inhalations, ointments and warming agents. Traditional methods can help to cope with the disease more efficiently and faster. However, it is necessary that the results of treatment are monitored by ENT.

There is an indicator that this method of treatment is right for you. If, after the procedure, tapping on the central region of the forehead does not cause pain, this means that the frontal sinus has been freed from mucous contents and microorganisms.

There is only one limitation: it must be remembered that in no case should you warm your forehead with purulent frontitis. This can lead to the spread of pus into the surrounding tissue.

Facilities traditional medicine for the treatment of frontal sinusitis can be used only after agreement with the attending physician

Possible complications

With inadequate or untimely treatment, the likelihood of the spread of the inflammatory process to other paranasal sinuses increases, as a result of which sphenoiditis, sinusitis, ethmoiditis occurs. Frontitis causes complications of the eyes such as abscess of the eyelids, edema of the tissue of the orbit, phlegmon of the orbit, and others. The most severe complications of frontal sinusitis are sepsis, brain abscess, and meningitis.

Prevention of frontal sinusitis

As a preventive measure, it is recommended to strengthen local and general immunity, take vitamin complexes and immunostimulating drugs, temper, avoid communication with people, patients with respiratory diseases of the upper respiratory tract and contact with allergens.

Timely treatment colds also refer to preventive measures from frontal sinusitis.

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 dimensions and configuration of the sinuses have different people individual characteristics. 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

Most common reason the occurrence 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 infections, 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.);
• weakened immunity;
• foreign bodies in the nasal cavity.

Chronic frontal sinusitis develops against the background of improper or untimely treatment of the acute form of the disease, it is facilitated by features anatomical structure paranasal sinuses and / or nasal septum.

The chronic form of frontal sinusitis can take a persistent course with periodic relapses.

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 \u200b\u200bthe 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 intensifies with tilting the head, in sleep, during palpation, may radiate to the temporal region and is not stopped by taking analgesic drugs. Also, symptoms of frontal sinusitis may 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.

The clinical picture of chronic frontal sinusitis in adults is less pronounced compared 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, much more often frontal sinusitis in this age group is diagnosed as a component of pansinusitis.

The causative agents of frontal sinusitis can be viruses, bacteria or microscopic fungi.

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 in relation to inflammation of the paranasal sinuses, primarily, the duration of the disease is longer than in acute respiratory infections. Specific symptoms of frontal sinusitis in children include:

• stubborn 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 some cases, against the background of frontal sinusitis, conjunctivitis develops in children.

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 infectious agent, 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 or cT scan (help to identify the anatomical features of the nose and paranasal sinuses and the prevalence of the pathological process).

If necessary, additional studies can be applied:

• cytological analysis of the contents of the nasal cavity;
• scintigraphy;
• thermography;
• diaphanoscopy, etc.

All age groups are equally susceptible to the disease, men suffer from frontal sinusitis more often than women.

Needed differential diagnosis frontitis with inflammatory diseases other paranasal sinuses, trigeminal neuralgia, inflammation of the meningeal membranes, etc.

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, use vasoconstrictor local action, which 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.

General therapy of acute frontal sinusitis consists in the use of broad-spectrum antibacterial drugs, antihistamines and anti-inflammatory drugs.

In addition to drug treatment frontal sinusitis, physiotherapeutic methods such as laser therapy, UHF therapy, electrophoresis with drugs, etc. can be used.

The most dangerous is the purulent form of frontal sinusitis, since with inadequate or insufficient treatment, it can cause serious complications.

With the ineffectiveness of conservative treatment, the appearance of complications and a pronounced deterioration in the patient's condition, surgical intervention (trepanopuncture) is indicated. With trepanopuncture, penetration into the frontal sinus is carried out through the area of \u200b\u200bthe 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, surgical intervention is performed endoscopic method... If all other methods are ineffective, trepanation of the frontal sinus is resorted to: after dissecting the skin with a scalpel, the sinus is opened, washed with an antiseptic, a plastic tube is inserted into the canal connecting the frontal sinus with the nasal cavity for drainage, then the incision is sutured.

In the treatment of chronic frontal sinusitis, the general approach is used, however antibacterial drug is selected taking into account the sensitivity of the infectious agent to it, anti-inflammatory therapy is carried out using glucocorticoid drugs. Vitamins and other agents are prescribed to help strengthen the immune system. Positive effect also provides physiotherapy (magnetotherapy, UFO, etc.).

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;

  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 a poor prognosis and can be fatal.

  Prevention

  1. Timely treatment of respiratory diseases.
  2. Rejection of bad habits.
  3. Avoiding hypothermia.

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The second in size after the maxillary paranasal cavities are the frontal sinuses, otherwise called frontal. They are located in the thickness of the frontal bone just above the bridge of the nose and represent a paired formation, divided by a septum into two parts. However, not all people have frontal sinuses; about 5% of the population does not even have their rudiments.

Normally, the final formation of the frontal sinuses ends by 12-14 years. It is by this age that they become fully functional structures with a volume of 6-7 ml and play an important role in nasal breathing, the formation of the voice and facial skeleton. This fact explains the absence of pathology of the frontal cavities in children - from 2 to 12 years old, they may develop diseases of only the maxillary accessory sinuses.

The frontal sinuses are lined with a mucous membrane, the epithelium of which constantly produces a small amount of mucus. Through a narrow frontal-nasal duct, which opens under the middle nasal concha, the sinuses are cleared of mucus - with it, microorganisms and dust particles trapped in them are removed from the sinuses.

The presence of this channel under certain conditions can greatly impede drainage, since with severe edema of the mucous membrane, the duct is blocked, and cleansing of the frontal sinuses becomes impossible. Such a permanent blockage of drainage does not occur, for example, with diseases maxillary sinuses, which are connected to the nasal cavity not by a canal, but in most cases by an opening. It is important to remember this when prescribing the treatment of pathologies of the frontal cavities.

When is cleansing of the frontal sinuses necessary?

Most frequent illnesses paranasal sinuses are their inflammation caused by penetration into nasal cavity and further into the sinuses of the pathological microflora. In most situations, sinusitis (inflammation of the sinuses) becomes a complication of an infectious rhinitis, but cases of isolated damage to the paranasal sinuses, as well as a pathological process in the paranasal cavities of allergic origin, are also recorded.

In terms of frequency, in the first place are various inflammations of the maxillary sinuses, in the second - frontal, ethmoiditis and sphenoiditis (lesions of ethmoid and sphenoid sinuses) are more rare.

With frontal sinusitis (inflammation of the frontal sinuses) of an infectious or allergic nature, edema of the mucous membrane of the sinuses and the frontal-nasal duct always occurs. In this case, the epithelium begins to produce an increased amount of mucus, which is a protective reaction.

Its value lies in the removal of harmful viruses and bacteria with mucus, their toxins, decay products, destroyed epithelial cells, and allergic agents. If the inflammation is infectious, then the abundant content of the frontal cavities is a mixture of mucus and pus. If allergic, then the discharge does not contain a purulent component.

Cleansing the frontal sinuses is necessary for any form of inflammatory process, since the mass of the swollen mucous membrane secreted with persistent obstruction of the frontal-nasal canal cannot be drained independently. Its accumulation causes a characteristic clinical picture frontitis.

These are symptoms of intoxication (with infectious inflammation) with an increase in body temperature to 38-39 degrees, severe and excruciating pain in the forehead and eye sockets, nasal congestion, profuse flow of mucus and pus from it (when drainage is restored), impaired smell and voice timbre.

It is also necessary to clear the frontal sinuses in time because of the risk of serious complications.So, with the accumulation of a huge amount of mucus and pus in them, the "melting" of the bone wall of the sinus and the breakthrough of the contents into the cavity of the orbit or damage meninges, which is very dangerous for the patient's life.

Therefore, when symptoms of frontal sinusitis appear, you do not need to take any independent steps in treatment, you must immediately contact a doctor who diagnoses the pathology and prescribes therapeutic measures to cleanse and sanitize the frontal cavities.

What are the ways to cleanse the frontal sinuses?

When a patient turns for help, all the necessary diagnostic measures are prescribed to determine the form of inflammation, as well as to differentiate frontal sinusitis from diseases of the maxillary sinuses or from other sinusitis. Using the methods of anterior and posterior rhinoscopy, the ENT doctor ascertains changes in the nasal cavity, the presence of hyperemia in a certain area and the nature of the contents.

By tapping, you can find out the localization of pain, and by blood test, you can determine an infectious or allergic inflammation. To obtain final data for the diagnosis of inflammation of the frontal, maxillary and other cavities, additional instrumental research... It includes diaphanoscopy, radiography, computed tomography, ultrasound.

With the help of these methods, it is possible to determine whether there is an accumulation of contents in the sinus, whether it is draining, whether there is a blockade of the frontal-nasal canal. These data determine which method of cleansing the frontal sinuses will be chosen by a specialist, conservative or surgical.

In most situations, conservative therapy is sufficient to clear the maxillary or frontal paranasal sinuses. This means that the application of certain medications it is quite capable of both reducing the production of mucopurulent discharge, and restoring the normal cleansing of the cavities by eliminating the edema of the mucous membrane of the excretory ducts.

Therefore, first of all, etiotropic treatment is prescribed, aimed at an infectious agent or allergic agent (antibiotics or antihistamines), then - vasoconstrictor nasal drugs (Galazolin, Nazol, Naphthyzin) strictly according to medical recommendations, with intoxication - antipyretic drugs.

If the patient does not have elevated temperature body, it is very useful to do physiotherapy. With inflammation of the frontal or maxillary sinuses, UHF, KUF, local and general warming procedures are very effective.

If these methods fail to remove a persistent blockade of the frontal-nasal duct, then the doctor has to resort to more radical methods. Depending on the patient's condition, the form and severity of the disease, it is recommended to flush with the YAMIK sinus catheter, puncture the frontal sinus with an endoscope through the drainage canal or through a transosseous puncture of the anterior or lower wall with further flushing and sanitation of the cavity.

Cleansing the frontal sinuses with frontal sinuses of any origin is the leading direction in therapy. It is important to choose the most optimal method for the patient and do the cleansing procedures in a timely and correct manner.

In addition to the ethmoid labyrinth, the sphenoid and maxillary sinuses, the frontal sinuses also belong to the paranasal sinuses. All these air cavities are also called paranasal sinuses. Distinctive feature frontal sinuses - the absence at the time of birth of a person.They develop only by the age of eight and are not fully formed until after puberty.

The frontal sinuses are located in the frontal bone behind the eyebrows. These cavities are paired and have the shape of a trihedral pyramid. The inner surface is covered with a mucous membrane. They are formed by several walls:

• front or front;
• back or cerebral;
• bottom;
• an internal or sinus septum.

The internal part divides the frontal bone into two parts - left and right. Most often they are not symmetrical, since the bony septum is deflected to one side of the midline. The base of the sinus is top wall orbits, and the apex is located at the junction of the front wall with the back. With the help of the frontal-nasal canal, it is also called an anastomosis, each frontal sinus opens into the nasal passage.

The front wall of the sinus is the thickest - we can feel it by running our hand over the forehead just above the eyebrows. In its lower part, between the brow ridges, there is the bridge of the nose, and the frontal tubercles are located just above. The back wall is connected to the bottom at a right angle.

However, the structure of the sinuses is not always the same as described above. There are rare cases when the internal septum separating the sinuses is not located vertically, but horizontally. In this case, the frontal sinuses are located one above the other.

There are other deviations in the structure of the cavities. For example, inside them, incomplete partitions can be observed - a kind of bone ridges. Such a sinus consists, as it were, of several bays or niches. Different, more rare anomaly, are full partitions - they divide one of the cavities into several, forming multi-chambered frontal sinuses.

Functions of the frontal sinuses

Along with others accessory cavities of the nose, the frontal sinuses serve for the efficient functioning of the body. Given the fact that they are absent at birth, there is a hypothesis that the main function of the frontal sinuses is to reduce the mass of the skull... In addition, the frontal cavities:

• act as a kind of shockproof "buffer" that protects the brain from injury;
• participate in the breathing process: air from the nasal passages enters the cavities, where, interacting with the mucous membrane, it is additionally moistened and warmed;
• take part in the formation of sounds, increase voice resonance.

Diseases of the frontal sinuses

Given that the frontal sinuses are hollow formations lined with mucous membranes, they can be affected by viral or bacterial infections. Pathogenic microbes penetrate along with the inhaled air. With low body resistance, an inflammatory process can occur.

Frontit

Inflammation "arises", as a rule, on the nasal mucosa, and then spreads through the nasolacrimal canal into the frontal sinuses. Edema occurs, as a result of which the canal is blocked, and the outflow of fluid from the sinuses becomes impossible. This is how the frontitis develops. The isolated environment that forms is ideal for bacteria to grow and pus to form.

Basically, frontal sinusitis is treated with drugs... In this case, complex therapy is prescribed: vasoconstrictor, anti-inflammatory and antibacterial agents... Physiotherapy can be carried out according to the doctor's prescription. An operation to open the cavities is required only in cases where treatment does not lead to recovery and there is a possibility of complications.

Unlike others, the thinnest back wall is not formed bone tissueand spongy. Therefore, even with insignificant inflammatory processes it can collapse and allow infection to spread to other organs.

Frontal sinus cyst

A frontal sinus cyst is a small, spherical container filled with fluid and thin, elastic walls. The size and location of such a neoplasm may vary. This tumor occurs under the same circumstances as frontal sinusitis.

As a result of inflammation, the outflow of fluid is disrupted, but mucus continues to be produced and accumulated. And since she has nowhere to go, over time, the formation of a cyst occurs. The treatment of such a disease is surgery.

Diagnosis of sinus diseases

The symptoms of frontal sinus disease, whether it be frontal sinusitis or a cyst, are the same. The only difference is that the cyst, if it is small, is quite long time may not appear at all in the form of any signs. In addition, a minor neoplasm is not always detected during routine examinations at the ENT.

Disease symptoms

The main symptoms of frontal sinus disease are:

• pain in the forehead, which increases with pressure and with overwork;
• purulent discharge from the nose, often odorless;
• violation of normal breathing, usually from the side of the affected cavity;
• swelling and redness of the skin at the site of the inflamed sinus;
• a sharp increase in body temperature;
• general weakness.

Survey

If there is even the slightest suspicion that a frontal sinusitis or cyst is developing, you must immediately contact an otolaryngologist. After interviewing the patient, this doctor will perform a rhinoscopy - an examination of the nasal cavity and paranasal cavities. An x-ray may be done to confirm the diagnosis and to determine the presence and level of pus.

In especially advanced cases, computed tomography is performed. This view research also allows you to determine how large the frontal sinuses are, the presence of additional partitions in them, which is important when performing surgical intervention... To identify the causative agent of the disease, microbiological studies of the secretions are carried out.

X-rays are often used if the maxillary sinuses - the frontal cavities are also clearly visible in the images. For the diagnosis of other sinuses, this type of study is ineffective, since they are poorly visible in the image.

Potential consequences and prevention

In cases of incomplete recovery or with advanced frontalitis, the disease can take on a chronic form. This is dangerous with frequent relapses and other serious consequences in the form of meningitis or inflammation of the brain.

In order to prevent the disease, try to avoid hypothermia., temper the body, treat acute respiratory diseases and runny nose in a timely manner. And then you don't have to study the frontal sinuses with the help of a photo, their structure and functions, resort to consulting an otolaryngologist and carry out treatment.

Inflammation of the frontal sinuses is an acute or chronic frontal sinusitis, manifested by inflammation of the mucous membrane of the frontal sinus with the formation of serous or purulent exudate.

Swelling of the mucous membrane leads to a violation of the outflow of the contents of the sinus, the gradual formation of the fluid level, tissue edema.

Frontitis requires an early start of treatment, which is due to the high risk of complications due to the spread of infection as a result of a breakthrough of the abscess. The most dangerous complications include meningitis, purulent fusion of the bones of the facial skull, and rhinogenic sepsis.

Paranasal paranasal sinuses - these are air cavities (sinuses), which are located in the bones of the facial skull. The paranasal sinuses (sinuses) are air cavities located in the bones of the skull. The paranasal sinuses maintain the shape and density of the facial bones and reduce their weight.

There are the following sinuses:

• frontal (frontal);
• maxillary (maxillary);
• wedge-shaped;
• lattice labyrinth.

Diagnosis of frontal sinus inflammation includes a doctor's examination general practice or a therapist to identify common symptoms diseases, ENT examination, laboratory tests and x-rays of the nasal sinuses.

Acute frontal sinusitis can be suspected by diagnostic signs:

• purulent discharge by lateral wall the nasal passage from the middle turbinate;
• thickening of the mucous membrane;
• bright hyperemia.

In addition, tenderness is determined on palpation and percussion in the region of the anterior wall of the frontal sinus, the medial angle of the eye on the affected side.

X-ray examination is performed in frontal and lateral projections, allows you to assess the volume and depth of the sinus, to identify the presence of a pathological process in it. The reasons for the development of inflammation of the frontal sinuses is the penetration of inflammatory exudate from the nasal cavity with a severe runny nose.

Frontitis is of bacterial, viral, fungal etiology, complications of influenza, ARVI. The frontal sinus becomes inflamed with some childhood infections, such as severe diphtheria or scarlet fever.

The symptoms of inflammation of the frontal sinuses are divided into local and general manifestations.

Local include:

• nasal congestion;
• serous or purulent discharge;
• pain in the affected area (forehead, bridge of the nose);
• swelling around the eyes;
• swelling of the bridge of the nose;
• pain when bending forward.

Common symptoms:

• heat;
• chills;
• headache;
• decreased appetite;
• decreased performance;
• fever.

When the infection spreads to the bones of the ethmoid labyrinth, ethmoiditis develops, a similar course of the disease in a patient indicates an aggressive flora, requires an urgent start of antibiotic therapy, possibly in a hospital setting. Damage to the bones of the orbit leads to the penetration of bacteria into the outer meninges.

Treatment of drug-induced inflammation of the frontal sinuses includes the use of drugs:

• vasoconstrictor (sprays, drops) to facilitate breathing;
• solutions for washing the sinuses (in the form of a spray with sea water or saline);
• antihistamines (especially if an allergic history is aggravated, to relieve edema);
• mucolytic (stimulation of the outflow of sinus contents, restoration of mucociliary clearance);
• antibiotics, antimycotics, antiviral (depending on flora).

Treatment begins only after being examined by a specialist doctor, if indicated, the doctor will give a referral to physiotherapy procedures, some of which can be performed independently at home.

Warming up and UHF procedures are carried out only with a catarrhal course of the disease or a stage after a puncture, emptying the sinus from purulent contents.

After a puncture, physiotherapy is carried out only under the supervision of a specialist to exclude a repeated exacerbation of the disease. In the chronic course of frontal sinusitis, physiotherapy reduces atrophic changes in the mucous membrane, destructive changes in the bone structures of the paranasal sinuses. With allergic frontitis in the background bacterial infection warming up can aggravate the clinical picture due to increased edema.

Traditional recipes for treating inflammation of the frontal sinuses include wet steam inhalation, which can be carried out only in the initial phases of the development of the disease. When pus appears in the sinus, warming up leads to stimulation of the growth of bacterial flora and the development of life-threatening complications.

In the absence of contraindications, you can perform warming up:

• potato (mash boiled potatoes in a saucepan, keeping your head above the steam under a terry towel, take deep breaths for 7-10 minutes);
• herbal (a decoction of chamomile, sage, mint herbs is boiled over high heat, after which inhalations are carried out for 15 minutes);
• garlic (5 cloves of garlic are crushed, a glass of boiling water is added, after 5 minutes they breathe over the resulting steam for up to 6 minutes);
• menthol (asterisk balm, eucalyptus oil, pour a glass of boiling water, breathe for 10 to 20 minutes).

Before you start preparing the mixture, you should watch a photo and video of the inhalation process in order to avoid the risk of overheating or burns. The person should not be brought close to the source of steam, at least 15 cm.

Home procedures for inflammation of the frontal sinuses:

• washing (self-rinsing without pressure using a conventional pipette or soft spray balloon. Three full pipettes in each nostril above the sink 3-4 times a day will speed up the process of exudate outflow);
• inhalation (folk recipes are quite effective, you can diversify inhalations by using essential oils and specialized products that are sold in pharmacies);
• warming up (local exposure through the skin to boiled eggs or hot salt bags increases the blood supply to the sinus);
• massage (to enhance blood flow and lymph flow, it is performed with boiled warm eggs, special massagers or fingertips in the form of light pinching and patting).

Prevention of frontal sinus inflammation is aimed at early treatment runny nose and acute rhinitis, especially if the disease is severe. With severe nasal congestion, you cannot blow your nose with great effort, since the resulting turbulent mucus flows are thrown into the paranasal sinuses and the mouth of the Eustachian tube.

Prevention includes hardening, means to increase the body's immune properties. Taking Eleutherococcus or Echinacea, as one of the most available funds, significantly increase a person's resistance to infection. After the transferred frontal sinusitis, you should drink a course of the vitamin and mineral complex to restore health.