How dangerous is purulent frontal sinusitis? Sinusitis, sinusitis and other sinusitis
Sinusitis(from the Latin “sinus” - sinus) is an inflammation paranasal sinuses- cavities in the bones of the skull, which communicate with the nasal cavity through openings. Sinuses exist in the maxillary bones ( maxillary sinuses ), in the frontal bones ( frontal sinuses ), in the ethmoid bone ( ethmoid sinuses ). In addition to them, there is also a wedge-shaped ( sphenoid sinus ), located behind the ethmoid sinuses in upper section nose
Based on this, there are several types of sinusitis. – inflammation of the maxillary (maxillary) sinus, frontal sinusitis– inflammation of the frontal sinus, ethmoiditis- inflammation lattice labyrinth And sphenoiditis- inflammation of the sphenoid sinus. Sinusitis can be unilateral or bilateral, affecting one or all sinuses. The most common types of sinusitis are sinusitis and sinusitis.
There are two types of sinusitis - acute, which occurs as a result of acute sinusitis and lasts 2-3 weeks, and chronic, which occurs as a result of insufficiently cured sinusitis. There are also 3 forms of sinus inflammation - purulent when there is pus in the sinuses, catarrhal when inflammation affects the surface of the mucosa, and discharge in the form of mucus is observed, as well as mixed form .
Diagnosis of sinusitis determines the main causes of sinusitis, which are:
- not fully cured cold, acute rhinitis, ( flu , , );
- chronic runny nose;
- diseases of the roots of the 4 upper back teeth;
- sick;
- immunity disorders, which can result from long-term chronic diseases;
- hypertrophied rhinitis;
- congenital developmental disorders anatomical features nose;
- nasal injuries.
During decreased immunity or hypothermia, the body cannot fight back pathogenic bacteria, which leads to their contact with the nasal mucosa. This leads to disruption of sinus ventilation, which is isolated from the nasal cavity, and in which mucus begins to be released, filling the sinus. Bacteria multiply in the mucus, pus is formed, which, entering the blood, is sent to the body. If sinusitis is not treated, it becomes chronic and complications of sinusitis occur.
Symptoms of sinusitis
Symptoms of sinusitis are:
- and pain in the cheekbones, cheeks, teeth, worsening in the evening;
- feeling of fullness, pressure in the forehead, nose, cheeks;
- nasal congestion, alternating congestion of both nostrils is possible, mucous or purulent discharge from the nose;
- increased body temperature;
- the appearance of heightened sensitivity of a part of the face;
- night cough;
- weakness, fatigue, irritability;
- weakening of the sense of smell.
One of the most common types of sinusitis is sinusitis. It usually occurs against the background of a runny nose and other diseases, as well as as a consequence of inflammation of the roots of the 4 rear upper teeth.
The main symptoms of sinusitis are a feeling of pressure in the inflamed sinus area, as well as headaches in the forehead, cheekbones, pain involving half of the face, and also when pressing on the cheeks. The pain may increase with changes in head position. It may also be observed toothache, which intensifies when chewing. In patients with sinusitis, the nasal breathing, a nasal voice appears, as well as clear or purulent discharge from the nose. Patients may complain of lacrimation, photophobia, and decreased sense of smell. Sometimes body temperature rises and worsens general state, the person becomes lethargic and cannot concentrate. There may be swelling of the cheek on the side of the affected sinus, swelling of the lower eyelid, and discomfort in the ears.
The acute form of sinusitis usually lasts 2 weeks, and if it is not treated, then sinusitis becomes chronic. There are also rhinogenic , odontogenic , hematogenous And traumatic sinusitis.
Frontit is an inflammation of the frontal paranasal sinuses. When you have frontal sinusitis, you experience pain in the forehead, which intensifies with pressure and bending, impaired nasal breathing, and discoloration. skin above the sinuses, as well as swelling in the forehead. Chronic sinusitis is accompanied by hypertrophy of the nasal mucosa And polyps .
Ethmoiditis has the following symptoms:
- swelling of the soft tissues around the eyes and eyelids;
- pain between the eyes;
- partial loss of smell.
Symptoms sphenoiditis:
- ear pain;
- pain around the neck.
All indicated symptoms Sinusitis worsens when the head is tilted forward.
Diagnosis of sinusitis
ENT diagnoses acute catarrhal and purulent sinusitis based on a patient interview, examination of the nasopharyngeal cavity and the results of an x-ray of the paranasal sinuses. Swelling of the mucous membranes causes the sinuses to darken on x-ray, and the accumulation of exudate (pus) appears as a fluid level.
For diagnosis chronic sinusitis The doctor prescribes a computed tomography scan of the paranasal sinuses, which will reveal cysts, polyps and other changes.
Treatment of sinusitis
In case of allergic sinusitis it is prescribed antihistamine therapy ( , ). For people prone to allergies, prevention of sinusitis is important in order to avoid relapses of the disease.
An important element in the treatment of sinusitis is nasal rinsing. antiseptic solutions (moving method or “cuckoo”), due to which the nasal mucosa is cleared of germs, dust, and inflammation is reduced.
If the inflammation of the sinuses has become purulent, then . The choice of antibiotics depends on the infectious agent, and is usually prescribed, loracarbef , axetil . These drugs are used both orally in the form of tablets, and intramuscularly and intravenously for 1-2 weeks. Alternative drugs are macrolides , cephalosporin , .
Applicable complex treatment sinusitis including homeopathic medicines ( , ), which help reduce pain and inflammation in the sinuses.
Corticosteroids help restore outflow from the sinuses and reduce the severity of allergic reactions. However, they are not prescribed for purulent sinusitis. If sinusitis occurs due to allergic rhinitis or, then treatment of the underlying disease is mandatory.
If drug treatment for sinusitis is not effective, then lavage of the sinus cavity and puncture (puncture) of the maxillary and frontal sinuses are prescribed. In this case, the sinuses are cleared of the pus accumulated there, the sinuses are washed and antibiotics, anti-inflammatory and antiseptic drugs ( , , sore throat), as well as eliminating factors that predispose to the development of inflammation in the sinuses. It is important to harden the body, exercise regularly, avoid hypothermia, often be in the fresh air, take vitamins and immune-supporting medications. Avoid swimming in swimming pools because... chlorine irritates the mucous membranes of the nose.
Complications of sinusitis
Complications of sinusitis can include diseases such as meningitis , edema meninges , eyelid thrombosis , i.e. various intraorbital and intracranial diseases, as well as pneumonia , otitis .
Do you have a headache, a headache, a decreased sense of smell, or a stuffy nose? This may indicate the presence of sinusitis, one of the types of which is sinusitis. In this article, we will look at you, dear readers, what frontal sinusitis is, what its symptoms are, its causes, and how to treat frontal sinusitis using traditional and folk remedies. So…
Frontit– inflammation of the mucous membrane of the frontal sinuses, which are the paranasal sinuses.
Frontitis is part of a group of diseases called -, and due to its location, it is sometimes called - frontal (frontal) sinusitis or acute frontal sinusitis.
The main cause of frontal sinusitis is various infections– viruses, fungi, bacteria, so treatment is mainly aimed at eliminating them, i.e. is based on antibacterial therapy.
Of all sinusitis, frontal sinusitis is the most difficult disease in terms of course and treatment, because the frontal sinus in most people is virtually isolated from common system nasal passage by the ethmoidal labyrinth ( ethmoid bone). It is worth noting here the fact that in infants and children under 7-8 years of age, the frontal sinuses are not separated from the nose, the ethmoid labyrinth is absent, and begins to form after this age. The so-called “septum” of bone is fully formed by puberty, although ENT doctors testify that in 5% of the population it is absent for the entire period of a person’s life.
The complexity of treatment, especially if we're talking about about the operation (puncture), lies in the close location of the frontal sinuses with the eyes and brain.
Frontit. ICD
ICD-10: J01.1
ICD-9: 461.1
As we already said at the beginning of the article, dear readers, inflammation of the frontal sinus most often has an infectious etiology (cause), therefore, in most cases, this disease develops against the background or as complications of such infectious diseases, like – sinusitis ( , etc.), etc.
In addition, the cause of frontal sinusitis may be:
- injuries to the nose and paranasal sinuses;
- curvature of the nasal septum;
— ;
— infections – Haemophilus influenzae, adenoviruses, rhinoviruses, coronaviruses, etc.;
- difficulty breathing through the nose (adenoids, polyps);
- small foreign objects - beads, designer parts, etc. (in children).
Symptoms of sinusitis
Signs of frontal sinusitis include:
- pain in the forehead, sometimes in the eyes, temples, most often manifested in morning time;
- difficulty breathing through the nose;
- nasal discharge, often with an unpleasant odor, on initial stages transparent, then purulent;
- morning expectoration of sputum.
Complications of frontal sinusitis are expressed by the following symptoms:
Symptoms intensify when pressing with your hand in the area of the frontal sinus.
Complications of frontal sinusitis
If sufficient attention is not paid to the treatment of frontal sinusitis, it can develop into diseases such as -, purulent inflammation eye sockets, eyelid abscess, brain abscess, and other complex and sometimes fatal diseases.
Types of frontal sinusitis
Frontitis is classified as follows:
By localization:
- Left-handed
- Right-handed
- Bilateral
With the flow:
- Acute frontal sinusitis
- Chronic frontal sinusitis
By form:
- Exudative frontitis:
— Catarrhal sinusitis;
— Purulent frontal sinusitis - Productive frontitis:
— Polypous, cystic frontal sinusitis
— Parietal-hyperplastic frontitis
By etiology:
- Allergic
- Traumatic
- Viral
- Bacterial
- Fungal
- Mixed
- Medication
Diagnosis of frontal sinusitis
Diagnosis of frontal sinusitis includes the following methods:
- History taking
- sinuses
- Rhinoscopy
- paranasal sinuses
- Nasal endoscopy
- Diaphanoscopy (transillumination)
- Thermal imaging (thermography)
- Bacteriological study of secretions from the nasal cavity
- Cytological examination contents of the nasal cavity
Treatment of frontal sinusitis includes:
- reduction of swelling of the nasal and paranasal sinuses;
- removal from the sinuses purulent exudate;
— destruction of pathogenic microflora, if present;
- restoration of normal functioning of the sinuses.
Sometimes surgical intervention may be required - a puncture of the sinus to empty it of purulent formations. But first things first.
1. To remove pathological contents from the sinuses, in the beginning, as a rule, vasoconstrictors are used: “Galazolin”, “Naphthyzin”, “Oxymetazoline”, “Sanorin”, “Farmazolin”. These products are used to lubricate the mucous membranes of the nasal passages, or use them as drops, instilling 2-3 drops into each nostril 3-4 times a day. These drugs relieve swelling inside the nasal passages, so that drugs against pathological microflora can be introduced into the necessary sinuses, be it the frontal or the rest.
2. The nasal passages are irrigated with means, having antimicrobial and anti-edematous properties: “Bioparox”, “Kameton”, “Proposol”.
3. If you have acute sinusitis(an acute clinical manifestation of the disease with copious purulent discharge), antibiotics are used: “Ampiox”, “Augmentin”, “Duracef”, “Rovamycin”, “”, “”, or intramuscularly - “”. The type of antibiotic is prescribed after diagnosis and identification of the type of causative agent of inflammation. Period antibacterial therapy is 7-10 days. For complications, antibiotics can be administered intramuscularly or intravenously.
4. To maintain intestinal microflora When using antibiotics, probiotics are used: “Bifikol”, “Lactobacterin”, “Linex”, “Probiovit”. Probiotics support immune system, and also preserve beneficial microflora in the digestive organs, necessary for its normal functioning.
5. If there is a thick purulent secretion, they use drugs to dilute it: “ACC-long” (600 mg). Take 1 tablet 1 time/day. These medications will help remove purulent formations from the sinuses as quickly as possible.
6. To reduce the manifestation of a possible allergic reaction, use antihistamines: “Diazolin”, “”, “Tavegil”. Antiallergic drugs help reduce swelling of the nasal and paranasal sinuses, including the frontal sinus. They are used for 7-10 days, 1 tablet 2-3 times a day.
7. For rinsing all nasal and paranasal sinuses Rinsing helps a lot, especially the “cuckoo” method, which involves inserting one tube into one of the nasal passages special drug, which has secretion-thinning and antibacterial effects, while through a tube inserted into the second nasal passage the secretion is sucked out of all sinuses. Solutions of furacillin, chlorophyllipt and other agents for the treatment of sinusitis and other types of sinusitis are used as rinsing agents.
8. For decreasing common symptoms frontal sinusitis, such as elevated temperature body, headache, anti-inflammatory drugs are used: “ Acetylsalicylic acid», « », « ».
9. Additionally may prescribe warming up the sinuses with a lamp of blue color, treatment infrared lamp(sollux), laser therapy, UHF therapy.
10. If all else fails, and based on the personal diagnosis of the attending physician, they may prescribe surgical intervention, which implies a puncture of the frontal sinus and removal of pathological secretions from it. The puncture is performed under local anesthesia. The operation can be performed in two ways - through the nasal passage or through the anterior wall of the skull. This operation is also necessary if the patient’s frontal sinusitis begins to show complications or goes away with strong clinical manifestations, when there is no time for standard treatment methods.
Treatment of frontal sinusitis at home can be carried out using rinsing, inhalation, heating and other treatment methods, but only after consultation with your doctor!
Before any of the types traditional treatment frontal sinusitis at home, the nose must first be cleaned, and if it is blocked, use vasoconstrictors (Naphthyzin, Noxprey, Farmazolin, etc.). After the nasal and paranasal sinuses are open, they can be treated with the following folk remedies - rinsing, inhalation, drops, ointments, etc.
Washing for frontal sinusitis
Salt, soda, tea tree. Dissolve 1 teaspoon of salt, a pinch of soda and 3 drops of oil in a glass of warm water tea tree. First, thoroughly clean the nasal passages so that the product can enter the frontal sinuses. Washing can be done using a syringe or other device for this procedure. Rinsing should be done with pressure, several times a day.
Onion. Grind one onion to a pulp and pour a glass of boiling water over it. Let the product cool, then add 1 teaspoon to it. Before use, this remedy for frontal sinusitis must be strained.
Chamomile. Brew the flowers, then cool the broth, strain, and rinse with it several times a day.
Chlorophyllipt. Dilute 1 tbsp. a spoonful of chlorophyllipt alcohol solution 500 ml of warm boiled water. Rinse your nose with this product 3-4 times a day.
Inhalations for frontal sinusitis
All inhalations are best done under a covered towel. An excellent device for inhalation is a nebulizer.
Bay leaf. Place 7-10 bay leaves in a pan and fill them with water. Bring to a boil, then reduce the heat so that the boiling process is slow. Carry out inhalation, breathing through your nose for 5 minutes. After the procedure, pus may come out for several days. If necessary, repeat inhalation.
Chamomile and tea tree. Brew chamomile flowers and add a few drops of tea tree or eucalyptus oil to the decoction. Breathe through the vapor through your nose for several minutes. Carry out the procedure several times a day.
Potato. Boil the potatoes in their jackets, mash them and breathe in their steam.
Garlic and apple cider vinegar. Mix 4 crushed cloves, 100 ml of apple cider vinegar and 200 ml of boiling water in a container. You need to breathe the vapors of the mixture for 15 minutes, 3 times a day. As the mixture cools, add boiling water.
Drops for the treatment of sinusitis
After instillation of the nasal passages, massage well the nose and all the places opposite to which the sinuses are located - forehead, eyebrows, between the eyebrows, cheeks. This is necessary for normal distribution of the drug throughout all sinuses. Then lie down straight and lie with your head tilted back so that the product spreads. When using some drops, active discharge may begin that needs to be blown out.
Cyclamen. Cyclamen juice is used by some manufacturers to make medical supplies. It can also be used as a folk remedy against sinusitis. To prepare it, you need to chop thoroughly washed cyclamen tubers and squeeze their juice out of the pulp. Next, the cyclamen juice needs to be filtered and diluted with water in a ratio of 1:4 (cyclamen juice: water). It is better to drip this product into your nose before going to bed, 2 drops into each nasal passage.
Black radish. Wash, peel and grate the black radish well. Squeeze the juice from its pulp, which you use as drops 3-4 times a day. Black radish juice does a good job of removing various mucus from the sinuses.
Kalanchoe. Pick a few large leaves and put them in the refrigerator for three days to infuse. After this, grind them thoroughly and squeeze the juice out of them. Dilute Kalanchoe juice with boiled water and drip this mixture into your nose 2-3 times a day.
St. John's wort, chamomile and marsh grass. Brew separately with a glass of boiling water 15 g, 10 g of chamomile flowers and 10 g of marsh cudweed. Let the decoctions cool, then strain them, mix, and instill them in each nostril 3 times a day, 5 drops.
Prevention of frontal sinusitis
As preventive measures, directed against the appearance and development of frontal sinusitis are distinguished:
— timely treatment And ;
— strengthening the immune system;
- eating foods fortified
Frontit(frontal sinusitis) - inflammation of the frontal paranasal sinus. Last decade Sinusitis (inflammation of the sinuses) is considered one of the most common diseases in the world. Today, about 10-15% of the population suffers from them. A tenth of patients with sinusitis are diagnosed with acute or chronic sinusitis. Over the past 5 years, the incidence of frontal sinusitis has tripled and continues to increase. In Russia, the number of people suffering from manifestations of frontal sinusitis reaches 1 million people per year. Among those hospitalized, there are more males, and among those treated on an outpatient basis, females are more common.
Anatomy of the frontal sinuses
Adjacent to the nasal cavity are the paranasal sinuses:
- two maxillary (maxillary)
- two frontal
- two lattice mazes
- one wedge-shaped (main)
- humidify and warm the inhaled air
- makes the skull bones lighter
- isolate the roots of teeth and eyeballs from temperature fluctuations
- act as a buffer for facial injuries
- act as a vocal resonator
There are four walls of the frontal sinus:
- inferior (orbital)– the thinnest
- front– the strongest and thickest
- back– separates the sinus from the cranial fossa
- internal, aka partition– divides the cavity into right and left half
The frontal sinus (like the other sinuses) is lined from the inside with mucous membrane, which is a continuation of the nasal mucosa. But it is much thinner and does not contain cavernous tissue. The sinus is connected to the nasal cavity by a narrow, winding canaliculus, which opens with a small hole in the front of the nasal passage.
Causes of frontal sinusitis
With frontal sinusitis, inflammation of the mucous membrane that lines the sinus occurs. The causes of frontal sinusitis can be varied, often depending on the form and severity of the disease.Infection
Most often, sinusitis occurs as a result of infection from the nasal cavity. In this case, inflammation can occur in parallel in both the maxillary and frontal sinuses. In this case, the patient is diagnosed with sinusitis and frontal sinusitis. The cause of the disease can be influenza, ARVI, diphtheria, scarlet fever.The most common causative agents of viral frontal sinusitis are:
- adenoviruses
- coronaviruses
- rhinoviruses
- respiratory syncytial viruses
- Streptococcus pneumoniae
- Haemophilus influenzae
- Pyogenes
- Staphylococcus aureus
The cause of inflammation of the frontal sinus can be fungal infection. In some cases, infection with bacteria and fungi can occur through the blood (hematogenous). This happens if there are foci of infection in the human body: carious teeth, abscesses.
Allergy
Bronchial asthma and prolonged allergic rhinitis (vasomotor rhinitis) cause inflammation and swelling of the mucous membrane. This closes the hole that allows fluid to exit the frontal sinus.Nasal polyps
Nasal polyps are benign formations round shape, which arise as a result of degeneration of the mucous membrane. In this case, there is swelling of the mucous membrane, difficulty breathing, and the outflow from the nasal sinuses is blocked. Injuries to the nose and paranasal sinuses
Inflammation can result from trauma to the skull bones. A bruise causes tissue swelling and disruption of normal blood circulation in the mucous membrane of the nose and paranasal sinuses.Deviation of the nasal septum and hypertrophy of the nasal turbinates
The curvature may be congenital anomaly, the result of injury or illness. Twisted nasal septum can also interfere with the free flow of mucus and germs from the sinuses.Foreign bodies
Long stay Foreign bodies in the nasal passages cause inflammation, which spreads to the nasal cavity and sinuses. Especially often small objects (beads, construction parts) cause frontal sinusitis in children.Symptoms and signs of frontal sinusitis
Frontal sinusitis is a serious disease that is more severe than other forms of sinusitis. According to the nature of the course, there are two forms of frontal sinusitis: acute and chronic. Each of them has its own characteristics and characteristics. Acute frontal sinusitis
In the acute form of the disease, the following complaints arise:- sharp pain in the forehead, aggravated by tapping or pressing on the anterior wall of the frontal sinus (forehead area above the bridge of the nose)
- discomfort occurs in the area of the inner corner of the eye
- eye pain, lacrimation, photophobia
- nasal congestion and difficulty breathing through the nose
- copious discharge from the nose, at first - transparent, mucous, over time can turn into purulent
- with right- or left-sided frontal sinusitis, discharge from the corresponding half of the nose;
- swelling of the face, especially at the inner corner of the eye
- the color of the skin over the sinus may be changed
- temperature rises to 39°, but in some cases the temperature may be low;
- feeling of weakness, weakness as a result of general intoxication of the body
- When examined by an ENT specialist, mucopurulent discharge, redness and swelling of the nasal mucosa are detected
Pain when acute frontal sinusitis is cyclical. During periods when the outflow of mucus from the frontal sinus is disrupted, the pain intensifies. This stagnation causes the condition to worsen in the morning. The pain becomes severe, radiating to the eye, temple, and the corresponding half of the head. After the sinus is freed from the contents, the pain subsides.
Chronic frontal sinusitis
Acute frontal sinusitis develops into chronic stage 4-8 weeks after the onset of the disease. This can happen as a result of incorrectly selected treatment or complete ignorance of the manifestations of the disease.
Symptoms chronic sinusitis somewhat less pronounced than acute:
- aching or pressing pain in the area of the frontal sinus, which intensifies when tapping
- when pressed sharp pain in the inner corner of the eye
- profuse purulent discharge from the nose in the morning, with bad smell
- a large amount of purulent sputum in the morning
Diagnosis of frontal sinusitis
An experienced otolaryngologist (ENT) will quickly diagnose correct diagnosis based on patient complaints. Additional Research necessary to clarify the severity of the disease and correct selection treatment regimens. The main research methods are described below.| Type of diagnosis | Purpose of diagnosis | How it is produced |
| History taking | Collect complaints, clarify symptoms, determine the cause and moment of onset of the disease | The doctor asks questions regarding the course of the disease |
| Rhinoscopy |
| Nasal speculums (dilators) and a nasopharyngeal speculum are used |
| Ultrasound of the paranasal sinuses | Identify the extent of inflammation and monitor the effectiveness of treatment | The study of the frontal sinuses is carried out with ultrasonic linear sensors with a frequency of 8 to 10 MHz. As a result, an image of the source of inflammation appears on the monitor screen |
| Nasal endoscopy |
| A thin flexible tube with a microscopic camera is inserted into the sinus through the frontonasal canal. The image is displayed on the screen |
| Diaphanoscopy (transillumination) | Allows you to identify developmental abnormalities and areas of inflammation | Transillumination of the sinuses with a bright beam of light from the tube of the device. Produced in a dark room |
| Thermal imaging (thermography) | Allows you to get a picture of temperatures in different parts of the body | The thermographic camera records thermal radiation. Based on the results, you can determine where the hotter areas are. They are foci of inflammation |
| X-ray of sinuses |
| A picture of the head is taken using an X-ray machine |
| Bacteriological study of secretions from the nasal cavity | Determine which microorganisms cause inflammation and their sensitivity to antibiotics and other medicines | During the examination, the doctor makes a smear. In the laboratory, a sample of mucus is inoculated onto nutrient media, the type of microorganism and means for effective fight with him |
| Cytological examination of the contents of the nasal cavity | Determine which cells are present in the mucus. This is necessary in order to find the cause of the disease | A sample of nasal contents is taken and examined under a microscope. |
| Computer tomogram | One of the most informative and reliable methods. Allows you to determine the presence of inflammation, its stage, structural features of the skull bones | The study is carried out using a computed tomograph. The method involves the use of x-rays |
Types of frontal sinusitis
There are several classifications of frontites. Let's take a closer look at them.Classification by flow form inflammatory process
| Type of frontite | Cause of occurrence | Best Practices treatment | |
| Acute frontal sinusitis | Severe headaches that get worse with tapping and pressure. |
|
|
| Chronic frontal sinusitis |
|
|
|
Classification by type of inflammatory process
| Type of frontite | Symptoms and external manifestations | Cause of occurrence | Optimal Treatment Methods |
| Exudative frontal sinusitis | |||
| a) Catarrhal frontitis |
| Occurs as a consequence of infection and inflammatory processes in the nasal mucosa |
|
| b) Purulent frontal sinusitis |
|
|
|
| Productive frontitis | |||
| Polypous, cystic frontal sinusitis |
| Pathological proliferation of mucous tissue lining the sinus. Cyst formation | Opening the frontal sinus, removing cysts and polyps |
| Parietal-hyperplastic frontitis caused by an overgrowth of the sinus mucosa |
|
|
|
Classification by process localization
| Type of frontite | Symptoms and external manifestations | Cause of occurrence | Optimal Treatment Methods |
| Unilateral frontal sinusitis | |||
| Headache and mucopurulent discharge from one nostril Body temperature 37.3-39°C | Caused by bacteria, viruses, fungi, allergens. It can also be a consequence of injuries and decreased local immunity | The choice of treatment method depends on the cause of the disease. Use:
|
| Bilateral frontitis | |||
| Double-sided form | Pain occurs symmetrically on both sides. Can give to different areas heads. Discharge from both nostrils. | The causes of inflammation are the same as for unilateral frontal sinusitis. | Drug treatment appropriate medications. Surgical methods treatment |
Treatment of frontal sinusitis
Traditional methods of treating frontal sinusitis
Treatment of frontal sinusitis at home is allowed for mild forms of the disease. Treatment prescribed by a doctor can be supplemented with inhalations, ointments and warming agents. Traditional methods can help cope with the disease more effectively and quickly. However, it is necessary that the results of treatment are monitored by an ENT specialist.
There is an indication that this method treatment is suitable for you. If after the procedure tapping on the central area of the forehead does not cause pain, this means that the frontal sinus has been freed of mucous contents and microorganisms.
There is only one limitation: you must remember that under no circumstances should you heat your forehead if you have purulent frontal sinusitis. This can lead to the spread of pus into surrounding tissues.
Inhalations for the treatment of sinusitis
- Boil the potatoes in their skins, drain the water. Mash the potatoes and breathe in the steam over the pan. For greater effect cover your head with a terry towel.
- Brew chamomile flowers, add a few drops of tea tree or eucalyptus essential oil to the hot broth. Breathe steam over the mixture.
- Bring one and a half liters of water to a boil, throw in 7-10 bay leaves. Turn the heat to low and breathe steam over the pan for five minutes.
- Grind 4 cloves of garlic, add half a glass of apple cider vinegar and half a glass of boiling water. Breathe over the solution for 15 minutes, 3 times a day, covered with a towel. Add more hot water as it cools.
- Boil water in a saucepan and add a small amount of “Star” balm or dry menthol. Remove from heat and breathe in the steam for five minutes, covering your head with a towel.
Solutions for rinsing the nose for sinusitis 
Washing is a mandatory procedure for any form of frontal sinusitis. In order for it to bring maximum benefit, before rinsing it is necessary to clear the nose and drip vasoconstrictor drops (Naphthyzin, Farmazolin, Noxprey). This will help open the gaps in the paranasal sinuses. Then you need to lean over the sink, while keeping your head straight. Using a small rubber bulb or a special bottle, the liquid is poured under pressure into one nostril. The rinsing solution, along with mucus from the sinuses, is poured out of the other nostril. After this procedure, significant relief occurs.
- Grind one medium onion on a grater or in a blender and pour a glass of boiling water. When the mixture has cooled, add a teaspoon of honey. Strain and rinse your nose with this mixture three to four times a day. This product kills bacteria, helps relieve inflammation and improve local immunity. Not suitable for frontal sinusitis caused by allergic reaction.
- In one warm glass boiled water you need to dissolve one teaspoon of salt, a pinch of soda and three drops of tea tree oil. Use for rinsing 3-4 times a day. This composition disinfects the nasal cavity and has a strong antiviral and anti-inflammatory effect.
- Prepare a decoction of flowers pharmaceutical chamomile, it is a strong antiseptic and antimicrobial agent. Cool, strain and use for rinsing every two hours.
- Dissolve a tablespoon of chlorophyllipt alcohol solution in half a liter of warm boiled water. It has an antibacterial effect and fights even those microorganisms that have developed resistance to antibiotics. The solution is used for washing 3-4 times a day.
- It is also effective to rinse your nose saline solution. You can make it yourself (one teaspoon of salt per liter of boiled water) or buy it ready-made at the pharmacy. This product cleanses well of mucus, germs and allergens without irritating the mucous membrane.
Drops for the treatment of sinusitis
Traditional medicine uses juices and decoctions to treat frontal sinusitis and other sinusitis medicinal plants. In order for them to have the maximum effect, you must first clear it of its contents - blow your nose well and rinse with saline solution. After instillation, lie down for a few minutes with your head thrown back so that the medicine is evenly distributed throughout the nasal passages.- Take black radish, peel and grate. Squeeze the juice and use for instillation 3-4 times a day. The juice contains a large amount essential oils and helps cleanse the sinuses of mucus.
- Wash the cyclamen tubers thoroughly, chop them and squeeze out the juice. It must be diluted with water (one part juice to four parts water) and strain well. At night, place two drops in each nostril and massage the sinuses well. Cyclamen is considered a remedy that helps defeat the disease at any stage.
- Pluck large Kalanchoe leaves and keep in the refrigerator for three days. After this, grind them and squeeze out the juice using gauze. Dilute the liquid twice with water and drop it into the nose 2-3 times a day. Kalanchoe helps to liquefy the contents of the nose and its rapid elimination.
- Place a small piece of propolis in the freezer for several hours. After this, quickly pound it in a mortar and pour in refined vegetable oil. Let it brew for three days in a dark place. The product helps fight inflammation and soothes the nasal mucosa. Do not use when allergic rhinitis.
- Take 10 g of chamomile flowers, 10 g of marsh grass, 15 g of St. John's wort. Brew the components separately with a glass of boiling water, cool and strain. Place 5 drops in each nostril 3 times a day. This composition helps relieve inflammation and open clogged frontal sinuses.
- Mix equal parts of celandine juice and chamomile juice. Place 1-2 drops in each nostril. This composition effectively fights frontal sinusitis caused by polyps.
Ointments for frontal sinusitis
- Take 4 parts pork fat and one part kerosene. Mix and store in the refrigerator. Rub the ointment into the forehead and wings of the nose several times a day. You can insert cotton swabs soaked in this ointment into your nose. The procedure lasts 3 hours once a day. The product disinfects and dissolves adhesions.
- Melt the crushed powder in a water bath laundry soap(1/2 piece), teaspoon vegetable oil, 70% alcohol, honey and milk. Cool and soak cotton wool with ointment. Apply 3 times a day for 15 minutes. The course of treatment is two weeks. If necessary, repeat the course after 10 days. The ointment disinfects, cleanses and relieves inflammation.
- Prepare an ointment from equal parts of honey, aloe juice, onion juice, cyclamen juice, and Vishnevsky ointment. Mix all ingredients thoroughly until smooth and store in the refrigerator. Turunda soaked in ointment are placed in the nose for 30 minutes. The course of treatment is three weeks.
- Crush a clove of garlic and mix with an equal amount butter. Store this ointment in the refrigerator and lubricate your forehead before going to bed. Garlic phytoncides penetrate deeply into tissues and help get rid of the disease.
For these purposes, medical White clay. It must be diluted with water or chamomile decoction to the consistency of a thick dough. The cake should be warm, about 1 cm thick. Apply this compress in the evening, while lying in bed, for two hours. Repeat for 14 days.
It is worth noting that treatment of frontal sinusitis with folk remedies should complement the measures prescribed by the doctor. This will prevent re-inflammation in frontal sinus and transition of the disease to a chronic form. At the first signs of an allergy, it is worth stopping the use of traditional medicine and replacing them with others.
Dry heat treatment
- Heat 3-5 tablespoons of sand or salt in a frying pan. Pour into a fabric bag and apply to the forehead in the frontal sinus area. The duration of the procedure is 20-30 minutes.
- Boil an egg and apply to your forehead. While it is too hot, you can wrap it in a handkerchief. Keep it until it cools down.
- Wear a wool bandage on the forehead. This warming up can last for several hours. After the procedure, it is important to avoid hypothermia outdoors.
Drug treatment
When should you start taking antibiotics?
To the question “When should you take antibiotics for frontal sinusitis?” Only the attending physician can give an answer. For inflammation of the frontal sinuses caused by allergies or viruses, antibiotics will not help. They can only worsen the situation: lead to dysbiosis and decreased immunity. Therefore, you cannot take them on your own, without a doctor’s prescription.The indication for the use of antibiotics for frontal sinusitis is purulent discharge. They mean that bacteria have settled in the sinus. The doctor should take a sample of the discharge for laboratory analysis. Using this, it is possible to determine which microorganisms caused the inflammation and their sensitivity to antibiotics. This is collateral successful treatment. For chronic frontal sinusitis, this procedure is mandatory.
Indications for the use of antibiotics for frontal sinusitis are: severe general condition of the patient and severe headache, as well as if more gentle treatment has not brought results.
What antibiotics are usually prescribed for frontal sinusitis?
In milder cases, medications are prescribed local action Bioparox antibiotic spray, Isofra and Polydex drops. Antibiotics are also prescribed in the form of tablets Augmentin, Cefazolin, Ceftriaxone, Sporidex.The most effective is intramuscular or intravenous administration antibiotics. If necessary, an antibiotic solution is injected directly into the frontal sinus through a hole made in the frontal bone.
For acute frontal sinusitis, antibiotics are prescribed wide range actions, for example Sumamed 500 mg per day.
In the treatment of chronic frontal sinusitis, when the sensitivity of bacteria to antibiotics is determined, narrowly targeted drugs are prescribed. If the cause is Haemophilus influenzae, then Ampicillin and Amoxiclav are prescribed.
Administered intramuscularly or intravenously in a daily dose of 200-400 mg. Tetracycline antibiotics are used against pneumococcus: Abadox, Biocyclinde, Medomycin, Doxacin, Doxylin, Extracycline, Isodox, Lampodox. The daily dose for adults is 0.2 g.
The course of antibiotic treatment should be at least 7-10 days.
What other medications are taken to treat frontal sinusitis?
Antiallergic drugs are often prescribed in parallel: Suprastin, Tavegil, Diazolin, Diphenhydramine. They relieve allergies and reduce nasal swelling.In cases where it is necessary to remove thick pus from the frontal sinus, ACC-long (600 mg) is prescribed, 1 tablet once a day.
To maintain intestinal microflora, probiotics are taken: Lactobacterin, Probiovit, Bifikol, Linex. They help maintain balance beneficial microorganisms and support immunity.
Homeopathic remedies. Sinuforte – has an anti-inflammatory effect and promotes the opening and ventilation of the sinuses. Cinnabsin – facilitates nasal breathing, relieves swelling, improves immunity. Sinupret - thins the thick contents of the sinuses, relieves inflammation.
To fight infection without antibiotics is also used sulfa drugs Sulfadimezin, Norsulfazol, Etazol.
To reduce headaches, the following are prescribed: Analgin, Amidopyrine, Nurofen.
Physiotherapeutic procedures
In a clinic or hospital, the “cuckoo” procedure is used to rinse the nose. As a result of such rinsing with furatsilin or another solution of drugs, it is possible to cleanse the sinuses well.To speed up recovery, the following physiotherapeutic procedures are prescribed: electrophoresis with 2% potassium iodide, laser therapy, Sollux, UHF therapy. They are aimed at warming the frontal cavity, ensuring free outflow of its contents, relieving inflammation, and improving blood circulation.
When is a puncture done for frontal sinusitis?
A puncture for frontal sinusitis or a puncture of the frontal sinus is prescribed only when it is not possible to alleviate the patient’s condition with the help of medications.Pus in the sinus, severe headaches and lack of outflow, cysts in the sinus cavity - these are the signs that indicate the need for a puncture in frontal sinusitis.
When preparing for a puncture, the most important step is an X-ray examination of the structure of the frontal sinuses. This is necessary to accurately determine the puncture site for frontal sinusitis.
There are several puncture techniques:
- through the lower thin wall of the frontal sinus (through the nasal cavity)
- through the anterior wall of the frontal sinus (through the forehead)
Complications with frontal sinusitis
If treated incorrectly, it may develop serious complications with frontal sinusitis:- The inflammatory process can spread to adjacent paranasal sinuses. This leads to sinusitis, ethmoiditis, sphenoiditis
- Intraorbital complications (edema of the eyelids and orbital tissue, orbital phlegmon, eyelid abscess)
- Intracranial complications(meningitis, brain abscesses)
- IN severe cases Possible blood poisoning - sepsis
Prevention of frontal sinusitis
Among preventive measures, special attention is paid to timely and adequate treatment colds. They are the main cause of frontal sinusitis. It is also necessary to take care of strengthening the immune system and hardening the body, avoiding hypothermia and maintaining active image life. Following these simple recommendations is the key to your health.
What is the difference between frontal sinusitis, sinusitis, ethmoiditis, sphenoiditis, sinusitis?
Sinusitis- general term. It refers to inflammation of any paranasal sinuses (another name for sinuses is sinuses). Sinusitis– inflammation of the maxillary, or maxillary sinuses. Ethmoiditis- inflammation lattice labyrinth(cells of the ethmoid bone). Sphenoiditis– inflammatory process in the sphenoid sinus. The symptoms of these two diseases can be very similar, which sometimes makes it difficult to diagnose the disease.At neuralgia of the first branch trigeminal nerve I am worried about attacks of headaches, pain occurs when pressing in the eyebrow area, where the indicated branch of the nerve enters the face.
What kind of procedure is this - “cuckoo”?
“Cuckoo” is a nasal rinsing method developed by the American doctor Arthur Proetz. It is used for frontal sinusitis, ethmoiditis, and sinusitis. During the procedure, the patient lies on the couch with his head hanging and tilted at approximately 45°. A warm antiseptic solution is poured into one nostril, and through the other it is pumped out along with the pus. A “seething stream” seems to be created in the patient’s nose.
While rinsing the nose, the patient must constantly say “ku-ku,” which is how the method got its name. While pronouncing these syllables soft sky presses against back wall pharynx, thereby closing the communication between the nose and throat.
Thanks to the constant flow of antiseptic and the pronunciation of the syllables “ku-ku”, negative pressure is created in the nasal cavity. Pus and other pathological contents come out of the paranasal sinuses into the nasal cavity.
Typically, rinsing continues for 10-15 minutes. It can be carried out in a clinic or hospital setting. After the procedure, it is not recommended to go outside for 30 minutes in the warm season, and for 1-2 hours in cold weather.
Possible complications of the procedure:
- sneezing due to irritation of the nasal mucosa;
- nose bleed;
- slight headache;
- burning in the nose;
- redness of the eyes.
This disease is characterized by severe difficulty in nasal breathing; the nose is usually blocked on both sides, but alternating blockage of the right and left nostrils also occurs. In most cases, the patient experiences mucous (transparent) or purulent discharge from the nose. However, if the nose is very stuffy, there may not be a runny nose, since the outflow of mucus from the sinuses is difficult.
Unpleasant sensations in the nose and paranasal area, and sometimes pain due to sinusitis, gradually increase: in the evening they are more pronounced than in the morning. In acute sinusitis, body temperature can rise to 38 C and higher. At chronic process it rarely increases. General malaise is manifested by fatigue, weakness, sleep disturbances, including difficulty breathing.
Manifestations of the disease depend on which sinus is affected. In case of inflammation of the frontal sinus - frontal sinusitis - they are concerned dull pain in the forehead area, often in the morning when a person wakes up. For inflammation maxillary sinus(sinusitis) pain occurs in the area upper jaw and teeth, pain is felt when touching the cheek on the affected side. Due to the close location of the sinuses to the tear duct in the corner of the eye, inflammation may be accompanied by swelling of the eyelid and pain in the area between the eyes. In addition, the sense of smell is sometimes impaired and pain occurs when touching the nose and swollen area. Inflammation of the sphenoid sinus (sphenoiditis) is rare.
Then the localization disappears and the whole head begins to ache if both halves of the nose are blocked, but if the inflammatory process is one-sided, then the headaches are one-sided, and there is pain in the ears and neck.
Description
Sinusitis (sinusitis, frontal sinusitis, ethmoiditis, sphenonditis) is an infectious inflammation of the paranasal sinuses, in which swelling of the mucous membrane occurs and blocks the anastomosis between the nasal cavity and the maxillary sinus. A person has several of them: these are the maxillary sinuses (maxillary sinuses), which are located in the thickness of the upper jaw; lattice, located behind the bridge of the nose; sphenoidal, located at the base of the skull, and the frontal sinus. Each of them opens into the nasal passages. Through the openings (ostia) of these sinuses, air is exchanged and mucus is released. The mucous membrane of the paranasal sinuses passes into the nasal cavity. Therefore, any inflammatory process in the nasal cavity, which causes swelling of the mucous membrane, causes an inflammatory process in the sinuses. This happens in the following sequence: swelling of the mucous membrane - closure of the anastomosis - accumulation of mucus in the sinus cavity. It puts pressure on the walls of the sinus, which causes pain. In the sinus, the production of mucus continues, which, due to a violation of the outflow, stagnates and gradually the process becomes inflammatory nature. This exudate is a breeding ground for the introduction of new and development of existing bacteria and viruses in the body. In the process of life, they produce toxins that are carried through the bloodstream throughout the body and become the cause of general malaise.
Gradually, the mucus turns into pus of a viscous consistency, so it is poorly evacuated from the sinus; even when the anastomosis is open, it can fill the entire sinus. If treatment is not started promptly, purulent contents may break into the surrounding structures. For example, in the eyes: gradually increasing swelling of the eyelids appears, they turn red, and even protrusion of the eyeball forward (exophthalmos) may appear.
There are many reasons for the occurrence of sinusitis. But the main one is an infection: bacteria or viruses penetrate into maxillary sinus through the nasal cavity (mouth, pharynx) or through the blood and cause an inflammatory process. Conditions that impair nasal breathing predispose to the development of sinusitis: congenital developmental disorders anatomical structures nasal cavities, deviated nasal septum, vasomotor rhinitis, hypertrophic rhinitis (enlargement of the nasal turbinates), in children - adenoids, hay fever.
Immunity disorders and untimely or incorrect treatment ARVI and rhinitis create an almost 100% guarantee of the development of this disease.
A bacteria called staphylococcus can for a long time live in the nasopharynx and do not manifest itself in any way, but in unfavorable conditions, for example, during a cold, it causes inflammation in the sinuses.
But most often, sinusitis is provoked by acute respiratory viral infections, influenza, parainfluenza, infections penetrating from diseased teeth ( odontogenic sinusitis), allergies (allergic sinusitis)... Almost all viruses that infect the upper respiratory tract (causative agents of ARVI) can cause sinusitis, since the epithelium of the paranasal sinuses is very similar to the epithelium of the respiratory tract and viruses also infect this part of the respiratory tract. Fortunately, viral infections such as influenza, parainfluenza, and adenovirus provoke only acute forms of sinusitis; they are not capable of causing chronic sinusitis. Despite the fact that the main role in the development chronic sinusitis bacteria (streptococci, staphylococci), as well as protozoa - chlamydia and mycoplasma (often cause sinusitis in children), it is important to treat and viral diseases, otherwise replace viral infection bacterial may come.
Diseases of the ENT organs are no less common cause of sinusitis than infections. Spicy and chronic rhinitis can lead to the development of sinusitis due to blockage of the outlet of the maxillary sinus (connects the cavity of the maxillary sinus with the nasal cavity) through which drainage and cleansing of the sinus is carried out. Chronic tonsillitis can serve as a source of infection, which is introduced into the maxillary sinus when blowing the nose. Chronic pharyngitis, as well as chronic tonsillitis may play the role of a source of infection in the development of sinusitis. A deviated nasal septum can cause sinusitis due to pathological narrowing of the new passage and impaired drainage and ventilation of the maxillary sinus.
Diagnostics
The doctor can assume that the patient is suffering from sinusitis based on the symptoms. However, it is not always possible to accurately localize the affected sinus. To clarify the diagnosis and identify the main focus of the inflammatory process, radiography or more is prescribed informative method diagnostics - computed tomography (CT) of the paranasal sinuses.
Treatment
Even theoretically, sinusitis, unlike acute rhinitis, will not go away on its own, and self-medication can end very badly. Therefore, at the first suspicion of sinusitis, you should immediately contact an otolaryngologist.
The basis of treatment is the fight against swelling of the nasal mucosa. This means that you need to ensure a good outflow of discharge from the sinuses.
It is necessary to promptly treat the chewing teeth of the upper jaw - in 10 percent of cases of sinusitis, inflammation developing on the tops of the teeth is to blame.
Be sure to take a responsible approach to the treatment of influenza, ARVI, rhinitis and support immune protection body.
Doctor Peter
The inflammatory process that affects the mucous membrane of the paranasal sinuses is referred to by the general term “sinusitis.” Sinusitis of various sinuses has common reasons development and similar clinical picture course of the disease, but differ in a number of symptoms characteristic of inflammation of a particular area.
Depending on the location of the lesion in a particular sinus, the names of the disease occur.
Sinusitis cannot be frontal, although the clinical signs of damage to these two areas are similar and often combined inflammation of the frontal and maxillary sinuses occurs.
Clinical picture of the disease
With frontal sinusitis, the frontal sinus becomes inflamed, which is a steam sinus and is located in the thickness of the frontal bone. It borders the orbit and anterior cranial fossa, which determines the characteristics of symptoms and the likelihood of developing severe complications with the progression of the inflammatory process.
General clinical signs of frontal sinusitis:
- Symptoms of body intoxication: weakness, lethargy, headache, loss of appetite;
- Temperature rise;
- Nasal congestion and loss of olfactory sensations;
- Nasal discharge (clear to yellow-green).
Features of symptoms, similarities and differences between frontal sinusitis and sinusitis:
Pain syndrome.
With frontal sinusitis, the headache occurs in the forehead area, or rather, in its center a couple of centimeters above the bridge of the nose. With sinusitis there is pain in the area of the upper jaw and temples.
Pain intensity.
It does not depend on the location of the inflammatory process, but the pain becomes stronger when moving the head, both with frontal sinusitis and sinusitis.
Discharge from the nose.
It is of a different nature and is observed in both diseases. But with frontal sinusitis, more often than with sinusitis, there is no discharge from the nose, since the outlet of the frontal sinus is easily blocked due to the peculiarities anatomical structure.
Swelling.
Swelling with frontal sinusitis extends to upper eyelid, soft fabrics above the eyebrows and forehead area. With sinusitis, swelling is localized in the area of the lower eyelid and soft tissues of the cheek.
The duration of the disease rarely exceeds two weeks, but with inadequate therapy the process takes on the characteristics of a disease.
Diagnostic criteria
The diagnosis is made taking into account the patient’s complaints, ENT examination data and the results of X-ray studies. If complications develop, an additional consultation with an ophthalmologist and neurologist is prescribed.
! Important
Many consider the main symptom of frontal sinusitis to be headache in the forehead area. However, large quantity people experience underdevelopment of the frontal sinus or its absence.
This means that they cannot have frontal sinusitis. Therefore, you should not self-diagnose or self-medicate headaches, but visit a specialist to confirm the diagnosis.
Approaches to treating the disease
Conservative treatment of frontal sinusitis does not differ from the treatment of sinusitis and is carried out in the same directions:
- Treatment antibacterial drugs. Antibiotics of the penicillin, cephalosporin series or macrolides (etc.) are chosen;
- Taking antihistamines and anti-inflammatory drugs to reduce swelling (Zavegil, Zodak, Zyrtec, etc.);
- Local treatment includes the use of nasal drops and sprays with different effects, rinsing and irrigating the nasal cavity with saline solutions;
- Taking medications that help liquefy and evacuate pathological discharge (sinupret, acetylcysteine, etc.);
- Physiotherapy: UHF, phonophoresis, magneto and laser therapy, inhalations;
- Traditional methods of treatment: biological massage active points, breathing exercises;
- Taking immunomodulators of plant and synthetic origin.
If the patient has severe forehead pain or conservative treatment doesn't bring desired result, then trephine puncture is performed.
The essence of the procedure: Based on X-ray data, the location of the sinus is determined. Before the operation, mark the trephine puncture point and after preliminary local anesthesia drill a hole in the anterior wall of the sinus in the forehead using special tools.
After this, the sinus is washed with an antiseptic solution, which is poured through the nose, and medications are injected into it. A special catheter is inserted into the resulting hole to subsequently remove the discharge.
Washing with Yamik catheter.
As a non-puncture method for removing pus during sinusitis, you can use the YAMIK sinus catheter, which creates negative pressure and allows you to remove pathological secretions from the sinuses and inject them into them medicinal substances. The principle of operation is no different from carrying it out during frontal sinusitis.
Surgery.
Carry out in cases of blockage of the outlet, in the absence of results from conservative therapy or with the development of ocular and intracranial complications.
Endonasal drainage.
With the help of endoscopes, endonasal (through the nasal cavity) drainage of the frontal sinus according to Draf is carried out in several variations depending on the characteristics of the pathological process.
Open Jansen-Ritter operation.
Traditional open radical surgery on the frontal sinus according to Jansen-Ritter, it is performed through an incision near the inner corner of the eye and continued along the eyebrow.
There are a number of others surgical interventions(according to Killian, according to Riedel, etc.), the choice of which is made by the attending physician, taking into account the anatomical structure of the sinus and other features of the body.
