Sinusitis is a non-specific inflammation of nasal mucosa, which is a common and frequently-occurring disease in rhinology. The so-called sinus is the air-containing cavity of the skull around the nasal cavity; There are four pairs on the left and right: frontal sinus, maxillary sinus, ethmoid sinus and sphenoid sinus. Because of its anatomical characteristics, each sinus can develop independently, and it can also form multiple sinusitis or total sinusitis. The disease is generally divided into acute and chronic types, and its causes are many and complicated. Acute sinusitis is mostly caused by acute rhinitis; Chronic sinusitis is often caused by acute sinusitis that is not completely cured or recurrent. In addition, when swimming, sewage enters the sinuses, the infection of adjacent organs spreads, the nasal cavity tumor hinders the drainage of the sinuses, and trauma can all cause sinusitis.

(1) Clinical manifestations

Headache: The headache caused by acute sinusitis is severe and can be located in the forehead, face or occipital back. Headache gets worse when you bend your head, exert yourself and cough. A few days after the onset, the swelling of mucous membrane at the opening of the sinus was relieved, and the secretions in the sinus were discharged, so the headache was relieved. The headache of chronic sinusitis is not obvious, and generally it only shows a heavy and oppressive feeling in the head.

Nasal congestion: Patients with acute sinusitis often have heavy nasal congestion. After blowing off the nose, the nasal ventilation can be temporarily improved, but soon they feel nasal obstruction. Patients with chronic sinusitis may also have a sense of nasal obstruction. If accompanied by nasal septum deviation or turbinate hypertrophy, the nasal obstruction will be aggravated.

Snuff: patients with sinusitis often complain that they have more snot, and some can blow it forward; Some of them flow into the nasopharynx through the posterior nostril, causing patients to complain of "excessive phlegm".

Olfactory disorder: some patients may have decreased or lost sense of smell. This symptom is mostly temporary. However, in patients with sinusitis and atrophic rhinitis, olfactory dysfunction is not easy to recover.

Nasal empyema: nasal empyema is one of the important signs of sinusitis. Due to the different opening positions of sinuses, the position of pus accumulation is also different. The frontal sinus, maxillary sinus and anterior ethmoid sinus all open to the middle nasal meatus. The posterior ethmoidal sinus opens to the superior nasal meatus, while the sphenoid sinus opens to the sphenoid recess. Therefore, according to the location of pus, it is of certain value to diagnose a sinus inflammation. If no pus is found in the examination, postural drainage or repeated examination is needed.

(2) Physical and chemical inspection

X-ray film of paranasal sinuses: In acute sinusitis, the mucosa of paranasal sinuses shows thickening. If there is secretion retention, the density of sinus cavity is increased. Chronic sinusitis shows blurred, turbid and increased density of sinuses. Sometimes, liquid level or polyp shadow can be seen.

(3) treatment

Western medicine treatment

Nasal drop: Use vasoconstrictor to drop nasal drops three times a day.

Puncture and irrigation of maxillary sinus: used for maxillary sinusitis. Generally speaking, it should be performed after acute inflammation is basically controlled and chronic maxillary sinusitis.

Positive and negative pressure replacement therapy: only for subacute and chronic sinusitis patients. This method is prohibited for acute sinusitis.

Many sinus infections are related to allergic reactions, and targeted treatment should be carried out when there are some factors.

For patients with acute sinusitis, antibiotics and sulfonamides should be used in time and in sufficient quantity to control infection and avoid complications.

Surgery: When chronic sinusitis is ineffective after conservative treatment, surgical treatment can be considered.

Chinese traditional treatment

Single prescription

① Xanthium sibiricum, Flos Magnoliae, Radix Scrophulariae each 9g, Radix Angelicae Dahuricae and Radix Scutellariae each 5g, Herba Asari, Radix Glycyrrhizae and Herba Menthae each 3g. Put the medicine in a jar, add water and decoct with strong fire. The patient sits at the decocting place, aiming at the medicine pot, so that the medicine gas enters the nasal cavity with breathing. Clear and warm clothes after frying. Take it three times a day.

② 0.5g of bezoar and musk, 0.5g of chrysanthemum heart and realgar, 0.5g of centipede and 0.5g of borneol. Grind goose herbivorous and chrysanthemum into fine powder, then grind all the medicines with a mortar and mix them evenly, put them into a magnetic bottle and seal them for later use. When using, dip them in a little medicine and twitch their noses, 3-4 times a day.

Acupuncture and Moxibustion: Take the points of Cranial Club, Yingxiang and Shangxing, and hang moxibustion until the patient feels hot and the skin is flushed, every other day 1 time.

External treatment: nasal drops with Dibiling, 3-4 times a day.

Physiotherapy: Physiotherapy has a certain effect on promoting inflammation regression and improving local circulation.

(4) Nursing and prevention

Fasting spicy food, abstaining from alcohol and tobacco. Exercise, enhance physical fitness, prevent colds, reduce the occurrence of acute sinusitis, and prevent it from turning into chronic sinusitis. Pay attention to oral hygiene, actively treat adjacent lesions, such as chronic tonsillitis, and correct nasal deformities.