Aerosinusitis

Description:

Aerosinusitis — the acute inflammatory disease of adnexal bosoms of a nose arising in a consequence of their traumatizing at sharp change of pressure of atmospheric air. The aerosinusitis can be observed at pilots, scuba divers, participants of lacunar works or experiments in a pressure chamber. The clinical picture of an aerosinusitis includes a congestion of a nose, pain and a raspiraniye in the field of the inflamed sine, headaches, existence separated from a nose. Diagnosis of an aerosinusitis is carried out by means of a rinoskopiya, a X-ray analysis of adnexal bosoms of a nose, a bacteriological research. Medical actions at an aerosinusitis include an instillation of vasoconstrictive drops, washing and drainage of okolonosovy bosoms, sanitation of a nasopharynx. At existence of indications surgical treatment (a maxillary sinusotomy, a frontotomiya) is performed.

Aerosinusitis reasons:

Sharp pressure difference of the air environment in which there is a person is capable to cause a barotrauma of the structures of its organism filled with air. Except an aerosinusitis at the same time  there can be an injury of a drum cavity (aero-otitis) and lungs (pheumothorax, emphysema). On occurrence frequency among these diseases the aerosinusitis is in the second place after an aero-otitis. Most often the pilots testing considerable pressure differences at sharp ascent or decrease in the airplane, divers at deep immersions, workers in a caisson and also the persons passing tests in a pressure chamber suffer from it.

Aerosinusitis origins.

Emergence of an aerosinusitis is connected with disturbance of balance of pressure of air in an okolonosovy bosom and in external environment. At increase in atmospheric pressure pressure in a sine turns out rather low what promotes accumulation in a bosom of exudate and blood. At decrease in external pressure pressure in a sine is excessive and can injure its walls. In both options noncompensated pressure difference negatively affects a state and blood supply of a mucous okolonosovy bosom that can lead to emergence of inflammatory changes with development of an aerosinusitis. There is a puffiness mucous, submucosal hemorrhages, ventilation of a bosom is broken. In such conditions easily there is an infection of a bosom and the aerosinusitis is complicated by purulent sinusitis.

The modern otolaryngology considers that emergence of an aerosinusitis is promoted considerably by the pathological changes complicating ventilation of sine and breaking passability of the openings reporting them with a nasal cavity. So, the aerosinusitis develops at persons with a curvature of a nasal partition and disturbance of an anatomic structure of a nasal cavity as a result of congenital anomalies or injuries of a nose more often. Inflammatory processes of a nasopharynx (rhinitis, adenoides) and the allergic diseases which are followed by puffiness mucous a nose (a pollinosis, allergic rhinitis) also favor to development of an aerosinusitis.

Aerosinusitis symptoms:

The aerosinusitis has preferential bilateral character. It is shown by an intensive headache and face pain, is frequent in the field of localization of the affected okolonosovy bosoms. Pains at an aerosinusitis can irradiate in a temple or have diffusion character. As a rule, they are followed by feeling of excessive pressure, a raspiraniye or weight in the inflamed sine. Patients with an aerosinusitis complain of a congestion of a nose and the expressed difficulty of nasal breath. Nasal bleedings are in some cases noted.

Accession of consecutive infection at an aerosinusitis is characterized by fervescence, emergence of the general symptoms (an indisposition, weakness, fatigue) and the dense allocations from a nose having yellow or chartreuse color.

Most often the aerosinusitis develops with defeat of a frontal sinus and is followed by frontal sinusitis symptoms. Less often the maxillary aerosinusitis which is shown characteristic symptoms of antritis meets.

Diagnosis:

In diagnosis of an aerosinusitis inquiry of the patient concerning his profession and identification in the anamnesis of the fact of a barotrauma is important. At survey of the patient with an aerosinusitis the otolaryngologist can reveal expansion of skin capillaries in the affected adnexal bosoms of a nose. Also breath of the patient through a mouth attracts attention.

Inspection of a nasal cavity — a rinoskopiya is performed. It allows to diagnose morbid conditions of a nasopharynx which promoted emergence of an aerosinusitis and are capable to aggravate its current. At a rinoskopiya puffiness and a hyperemia mucous, an effluence separated from openings of the affected okolonosovy bosoms is observed. The X-ray analysis of okolonosovy bosoms at an aerosinusitis reveals blackout in them, sometimes on the roentgenogram liquid level is noted. The bacteriological research of a smear from a nasopharynx and separated from a nose is made for identification of species of pathogenic microflora and its sensitivity to antibacterial drugs.

At suspicion on an aerosinusitis combination to an aero-otitis the hearing research (audiometriya) and an otoskopiya, for diagnosis of damages of pulmonary fabric — a X-ray analysis of lungs is conducted.

Treatment of an aerosinusitis:

For the period of treatment patients with an aerosinusitis are exempted from the works connected with flights by the airplane, caissons, pressures chamber and divings. The main objectives  of treatment of an aerosinusitis are: removal of puffiness mucous, recovery of passability and normal drainage of the affected adnexal bosoms. For this purpose carry out an instillation to a nose of vasoconstrictive drugs (Halazolinum, назол, називин, Naphthyzinum and so forth), drainage and washing of okolonosovy bosoms by means of a suction by the cuckoos method or way a sine evacuation with use a sine catheter. At an intensive pain syndrome purpose of analgetic and antiinflammatory medicines is shown.

Treatment of the associated diseases of a nasopharynx aggravating a current of an aerosinusitis is important. The aerosinusitis complicated by consecutive infection demands performing system antibiotic treatment which is appointed on result of an antibiotikogramma. Use of physical therapy is effective: UVCh, diadynamic currents, соллюкс, ультрафонофорез, inhalations. However its carrying out is possible only at the normal body temperature of the patient.

In most cases an aerosinusitis conservative therapy is rather productive and leads to recovery of the patient. At impossibility of adequate drainage of a bosom the threat of development of purulent complications arises by conservative methods and accumulation of a large amount of purulent exudate in a cavity of a sine: abscess of a brain, purulent meningitis, osteomyelitis. In such situations surgical treatment of an aerosinusitis is shown. Operation of a maxillary sinusotomy or frontotomiya which consists in opening according to maxillary or a frontal sinus, removal from it of pus and nekrotizirovanny fabrics, creation of conditions for normal drainage is performed.