Antritis – an inflammation of a Highmore's bosom.
The Highmore's bosom, is a pair adnexal bosom of a nose, the small cavity located in a skull on each side from the nasal courses. The cavity is covered by a mucous membrane. (1-3rd) the Highmore's bosom is reported by small pass with a nose. Highmore's bosoms play an important role: in them the air inhaled by a nose (that is why it is necessary to inhale air a nose, but not a mouth) is warmed and purified, besides, they perform function of resonators when pronouncing sounds. At antritis both of these functions are broken.
Most often antritis develops as a complication after the postponed viral infection – ORZ, a SARS or flu. Viral infections are followed by rhinitis during which the mucous membrane of a nasal cavity inflames and swells. As it is directly connected with a mucous membrane of Highmore's bosoms, the inflammation is inevitably transferred there. That is why at cold the voice changes, gets special sounding, "in a nose". As passes, the connecting Highmore's bosoms with a nose, are very narrow, because of hypostasis of a mucous membrane they can be blocked completely. Thus, in the closed cavity of Highmore's bosoms with the inflamed mucous membrane slime and other products of an inflammation accumulates, and pus is formed afterwards. So antritis begins.
Inflammatory process in upper molars can be the cause of hit of an infection in a Highmore's bosom. In this case there is odonotogenny antritis to which rhinitis does not precede. One more reason of development of antritis – an allergy, namely, allergic rhinitis.
Antritis can be one - or bilateral.
On a clinical current acute or chronic.
On character of an inflammation acute antritis can be catarral or purulent. Chronic antritises happen the following types;
Symptoms of antritis appear usually for the fifth or seventh day of a disease of a viral infection when instead of the expected simplification there occurs deterioration in the general state, temperature rises, there is a headache. Pain amplifies when pressing on cheeks in a nose bridge. A symptom of antritis is change of nature of allocations from a nose which become purulent and get an unpleasant, congestive smell.
Symptoms of antritis in a chronic form are shown periodically as the current with remissions and aggravations is peculiar to chronic antritis. During aggravations chronic antritis proceeds is similar with acute, and during remissions of the patient nothing can disturb, or frequent headaches disturb.
Symptom of antritis in a chronic form is also exposure to viral infections as, first, the center of persistent infection in an organism undermines immunity even more, and secondly, the mucous membrane of Highmore's bosoms does not perform the functions on cleaning and warming of the air coming to a nasopharynx. Thanks to changes in a mucous membrane there is one more symptom of antritis – "nasal" sounding of a voice.
Antritis at children up to four years does not happen because of anatomic features. The matter is that up to four years Highmore's bosoms at children are not developed, they represent the narrow cracks which are not containing air. By four years, in process of growth of facial bones of a skull, bosoms form in the form in which adults have them – in the form of the cavities covered by a mucous membrane. From this age antritis at children can arise owing to the same reasons, as antritis at adults.
Feature of course of antritis at children is tendency to more rapid current of process. As well as many other infectious diseases, antritis at children more often happens acute, than chronic. Other feature of antritis at children is that the inflammation is easier, than at adults, extends out of limits of Highmore's bosoms, for example, in infraorbital space. Because children in general have respiratory infections and cold more often, often antritis at children long time remains not distinguished.
Treatment of antritis is in most cases made in the conservative way, using the general and local medicamentous therapy, and also physiotherapeutic means. However in the heavy, started cases resort to operational treatment of antritis.
The general treatment of antritis is appointed, proceeding from the reason and a form of a disease. At antritises of an infectious origin antibacterial and anti-inflammatory drugs can be appointed. Recently medical tactics concerning prescription of antibiotics at antritis changed. The general antibioticotherapia which was earlier considered necessary, now is carried out only according to serious indications now, preference is given to topical administration of antibacterial drugs.
The matter is that it was found out that because of hypostasis blood circulation in a mucous membrane of Highmore's bosoms at antritis is broken, and antibiotics from blood arrive to the destination in extremely insignificant, trace quantities. At the same time a large number them circulates on an organism. At the same time it is necessary to consider that an antibioticotherapia always the side effect has immunity suppression. As a result antibiotics at antritis are in most cases inefficient as harm causes more, than advantage.
For treatment of antritises of an allergic origin appoint antihistaminic drugs.
However at any kinds of antritises the main treatment consists in local therapy. Topical treatment of antritis consists in purpose of vasoconstrictive drops in the first five days of a disease, for the purpose of removal of hypostasis of a mucous membrane and creation of outflow. It is necessary to consider that in the next days and at chronic antritis vasoconstrictive drops are not effective. Washing of a nose solutions of anti-inflammatory drugs is appointed each 3-4 hours.
If it is not possible to create outflow and to remove pus from Highmore's bosoms, in polyclinic conditions do a bosom puncture, by means of a long needle. It allows to evacuate decomposition products and to directly wash out a bosom cavity solutions of antiseptic agents.
For treatment of antritis in a chronic form fortifying means are appointed, the physical therapy is very effective in this case: UVCh, microwave oven, lazero-and magnitnoterapiya. Sanitation of an oral cavity is also necessary to exclude penetration of an infection from carious teeth of an upper jaw.
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