Pathology of chronic sinusitis

2021-01-31 12:00 AM

The medial nasal mucosa oedema, sometimes degenerating into polyps. The appearance of Kauffman ledge, due to enlargement of the mucous membrane in middle nasal passages into a long ledge line, like a second nasal pass

It is due to an irreversible change in the sinus mucosa, causing dysplasia, polyps, secretions, mucus secretions or purulent inflammation.


Due to inadequate treatment of acute sinusitis, many recurrences.

Scoliosis of the high septum, hypertrophy of the middle nasal passages, allergies, causing poor drainage, prolonged failure to drain the pus from the sinuses (because the natural opening is blocked) or after acute sinusitis with necrosis bone in infection, flu, measles ... or after a purulent sinus infection caused by teeth.

The role of the local body is also very important, especially the atopic form. Allergies lead to an infection that develops and, when infected, aggravates the allergy. So, the treatment is in remission, but rarely completely cured.



Pain: Chronic inflammation is usually painless except for episodes of inflammation. Usually just the feeling of headaches, location depends on the inflamed sinus type. Anterior sinus infection often aches around the eyes, fangs. The posterior sinus infection is often painful deep in the eye or in the occipital region.

Frequent stuffy nose.

Nasal discharge extending to the anterior nose, green pus or yellow pus, if the anterior sinusitis is chronic. Posterior sinusitis: pus or mucus running down the throat, patients must sniff, spit, and spit often. Or have eye complications such as optic neuritis after the eyeball, iris inflammation ...


Symptoms of chronic anterior sinus group inflammation.

The middle nasal passages are damp and wet or pus is flowing from the middle nasal passages to the lower nose, or there is little dry pus on the lower banks of the middle nose.

Big lower nose curl.

The medial nasal mucosa oedema, sometimes degenerating into polyps. Appearance of Kauffman ledge (due to enlargement of mucosa in middle nasal passages into a long ridge line, looking like a second nasal roll outside middle nasal canal).

Post nasal examination: pus accumulates on the nasal floor or in the lower end of the nose.

Symptoms of chronic posterior sinus inflammation.

If you have a nose scan, you can often see nothing.

Post nasal exam: pus mucus is seen coming from the upper niche to the posterior nasal opening, radiating down the nasopharynx.

Pharyngeal examination: the posterior wall of the throat is chronically inflamed with many red lymphocytes and thick mucus.


Blondeau and Hirtz are valuable in definitive diagnosis: regular fuzzy sinus shape, thick mucosa shape, polyps shape ...


Functional symptoms: frequent stuffy nose, thick runny nose out the front or back door.

Physical symptoms: stasis of pus in the medial nasal passages, posterior nasal passages, or middle nasal mucosa oedema, degenerative polyps.


Sinus puncture.

X-rays: Blondeau, Hirtz and CT Scan posture


Conservative treatment for chronic poly sinusitis

Antibiotics, anti-inflammatory, analgesic ... (if inflammation occurs).

Nebulizers, Proetz ...

Jaw to drain, wash and pump medication.

Extraction and treatment of teeth if due to teeth.

Vaccines against infections.

Vitamins A and B.

Desensitization if there is an allergy.

Surgical methods of chronic polycystitis

Open the jaw sinus frequently in the lower nasal passages.

Functional Endoscopic Sinus Surgery (FESS).

Jaw screening surgery (Caldwell Luc).

Septum surgery (if the cause is septum malformation).

Indications for sinus surgery:

Sinusitis causes complications: brain, eyes, external ...

Sinusitis is caused by foreign bodies in the sinuses.

Sinusitis has degenerative polyps.

Tumours in the sinuses (benign or malignant tumours).

Chronic purulent sinusitis, jaw sinus puncture to drain and wash several times if 10 times does not help should switch to surgery.