Sinusitis - description, causes, symptoms (signs), diagnosis, treatment. Odontogenic sinusitis: cause of the disease, symptoms, diagnosis, treatment Right-sided sinusitis ICD code 10

Treatment of sinusitis includes restorative and anti-inflammatory medications. Antibacterial therapy and physiotherapy.
Sinusitis is usually not an indication for hospitalization; treatment is possible on an outpatient basis.
In the treatment of sinusitis, conservative (medicines and physical procedures) and surgical methods are used. Sinusitis should be treated under the supervision of an otorhinolaryngologist (ENT doctor).
Conservative therapy.
At the core drug treatment For sinusitis, local procedures must be used - irrigation in the form of drops, sprays, inhalers that can eliminate swelling of the mucous membrane.
Vasoconstrictor drugs include: naphazoline (“Naphthyzin”, “Sanorin”), tetrizoline (“Tizin”), xylometazoline (“Galazolin”, “Dlyanos”), oxymetazoline (“Nazol”, “Nazivin”). For sinusitis, it is necessary to adhere to certain rules for pouring medicinal liquids into the nose. Only after using these drops can you instill others that have an antibacterial, anti-inflammatory or analgesic effect.
Antibacterial drugs (preferably cephalosporins) and antihistamines (Claritin, Telfast, etc.) are also used in treatment. Rinse the nose with antiseptic solutions (for example, furatsilin, sodium hypochlorite). Physiotherapy procedures include such techniques as ultraviolet irradiation of the nasal cavity, UHF on the paranasal sinuses, etc.
Puncture maxillary sinus– surgical method of treating sinusitis. Indications for urgent surgical intervention are the addition of complications - such as abscesses, phlegmon, meningitis, sepsis.
A puncture (puncture) is done in order to pump out pus from the sinus, rinse the sinus, and then inject antibiotics and anti-inflammatory drugs into it. This procedure accompanied by unpleasant sensations, but its effectiveness is very high. Currently, after a puncture, special tubes are installed in the sinus - catheters, through which the sinus can be washed daily. When using this method the patient recovers very quickly. But everything has its own indications, and in the initial stages of sinusitis it is not always necessary to perform a puncture; you can get by with rinsing the nose.
It should be noted that the use of sinus puncture as a treatment method is not widely used in other countries. For example, in the USA, puncture is recommended only as diagnostic procedure- to collect the contents of the sinus for further cultural and/or microscopic examination.
Treatment of sphenoiditis involves frequent lubrication of the nasal mucosa with vasoconstrictors to ensure the outflow of secretions from the sinuses. In case of prolonged illness, probing and rinsing of the sinuses with antibiotic solutions is recommended. Sometimes shown surgical intervention(for example, resection of the posterior end of the middle concha).
In acute frontal sinusitis, conservative treatment is indicated. The outflow of secretions from the sinus is ensured by lubricating the mucous membrane of the middle nasal passage with a 0.1% solution of naphthyzine, 0.2% solution of galazolin. The same solutions can also be used as nasal drops. In the first days of illness, bed rest is recommended, taking acetylsalicylic acid, analgin, inhalation of antibiotic aerosols, physiotherapy (warming with a blue light lamp, Sollux. UHF therapy). In severe cases, intramuscular administration of antibiotics is indicated. Surgical method treatment is indicated only if conservative therapy fails. During surgical intervention, an operation is performed - trephination of the skull in the area of ​​the frontal sinus (local anesthesia of superficial tissues is first performed - injection of lidocaine / novocaine, then a trepanation hole with a diameter of about 5 mm is created using a drill, after which a catheter is inserted into this hole, subsequently through which the frontal sinus is washed).

Acute sinusitis is a lesion of the nasal sinuses, which manifests itself, depending on the type of pathology, with various symptoms with mucus secretion, headache, fever, weakness, and so on. This course of the disease often becomes chronic or causes a number of complications throughout the body. Therefore, it is important to choose the right therapy according to the type of sinusitis, severity and cause of development.

About the disease

Sinusitis is an inflammation of the paranasal sinuses, which is accompanied by quite pronounced symptoms. The disease in adults and children requires complex and complete treatment, as it often not only becomes chronic, but also causes a number of complications, including damage to the meninges, periosteum, decreased vision and other negative consequences.

The ICD-10 code is J01. Accordingly, the disease is divided by type.

Types and localization

Types of sinusitis are divided depending on where the source of inflammation is located:

• In the maxillary sinuses;
• Sphenoid sinuses;
• Frontal sinuses;
• Sinuses of the ethmoidal labyrinth.

Localization of sinusitis

Sinusitis

Affects the paranasal maxillary sinuses. It is the most common type of sinusitis. Causes a mass discomfort in the area of ​​the nose and cheeks, and the pain can radiate to the teeth.

Sphenoiditis

Sphenoiditis occurs less frequently, but is often more intense than sinusitis. This is explained by the peculiar structure of the sphenoid sinus.

It rarely manifests itself as an independent pathology; most often it occurs in conjunction with ethmoiditis.

Ethmoiditis

– inflammation of the sinuses of the ethmoid labyrinth (in the area of ​​the bridge of the nose). As a rule, it is either viral or bacterial in nature.

A characteristic feature is the rapid spread of the inflammatory process to neighboring sections. In acute cases, it is often complemented by other types of sinusitis.

Frontit

- inflammation of the frontal sinuses. It ranks second in frequency after sinusitis. In this case, painful sensations are localized in the forehead and eyebrows. In this case, the pain can radiate to the teeth and ears, which is why patients often mistake this disease for dental pathologies or otitis media.

Classification

Sinusitis is also divided according to the location and type of inflammation, the reasons that could cause them:

• Double-sided and single-sided;
• One-sided, in turn, is divided into right-sided and left-sided;
• They are also classified according to the type of pathogen - bacterial, viral, fungal, allergic;
• According to the type of discharge: mucous, purulent, purulent-mucous, with impurities of blood;
• By severity: light, medium, heavy.

The photo shows the classification of sinusitis

Causes of acute sinusitis

If we talk about specific reasons, then sinusitis is initially provoked by either allergens or pathogens. In the latter case, the disease usually develops against the background of other pathologies:

• , flu, ;
• Neoplasms in the nose and sinuses - cysts, polyps, and so on;
• Facial bone injuries;
• Availability ;
• deviated septum;
• Abnormal structure of the sinuses of the congenital type;
• Allergy;
• The presence of a viral, bacterial and/or fungal infection;
• Infectious diseases accompanied by a runny nose: measles, and so on.

But even with such a cause without risk factors, sinusitis may not develop. These include:

• Bad habits;
• Constant overvoltage, stress;
• Improper and inadequate nutrition;
• Decreased immunity;
• Gas pollution, dry air;
• Recent infectious pathologies of the ENT organs;
• The presence of diseases, factors or conditions affecting the immune system (HIV, diabetes, chemotherapy, use of hormonal drugs, etc.)

Symptoms

TO general symptoms include such manifestations as:

• Nasal discharge of mucous, purulent-mucous, purulent or bloody type;
• Headache;
• A feeling of fullness and pain in the affected area (especially intense when pressing on the area of ​​inflammation);
• Temperatures;
• Impairment or loss of smell;
• Swelling of the soft tissues of the face.

This general manifestations, which are generally characteristic of all types of sinusitis. But doctors distinguish them, which means they also have specific symptoms:

• With sinusitis, pain is localized in the area maxillary sinuses. When pressure is applied to the cheek area closer to the nose, unpleasant and uncomfortable sensations develop. At the same time, there is a feeling of fullness. The pain tends to intensify in the evening and gradually go away during sleep.
• With frontal sinusitis, the pain is localized in the forehead above the eyebrows, closer to the bridge of the nose. There are also bursting pains, but in this part of the face. At the same time, unpleasant symptoms tend to intensify in the morning after waking up.
• With sphenoiditis, pain is often localized in the back of the head. In this case, deterioration is most often observed at night.
• With ethmoidal sinusitis, painful sensations develop and are localized to the greatest extent in the area of ​​the bridge of the nose and eyes. It gets worse throughout the day. In this case, patients may experience a slight protrusion of the eyeballs with swelling of the conjunctiva and eyes in general, and deteriorating vision may also appear.

What tests and studies need to be done?

The following types of research are required:

• Blood for biochemistry and other pathogens;
• A swab from the nasal cavity or sinus for bacterial culture;
• X-ray of sinuses;
• Ultrasound of the sinuses.

As a rule, an ENT doctor can make a diagnosis during an examination, but if there are doubts or suspicions of complications, then a detailed diagnosis is considered necessary.

How to properly treat sinusitis:

A visit to the doctor is required. Only he will decide, based on the indications, what type of treatment may be required and whether neighboring sections are involved in pathological processes. Based on this, you usually choose:

• Medication;
• Physiotherapeutic;
• Surgery.

The first consists of vasoconstrictor, anti-inflammatory, mucolytic, immunomodulatory, antihistamine, antibacterial, antiviral, antimycotic drugs.

Moreover, each product has its own duration of use, which should also be taken into account. Not all of them need to be applied at the same time. For example, antivirals are used for viral sinusitis, antimycotics for fungal infections, and for bacterial ones.

Physiotherapeutic involves rinsing the sinuses. Now this is done not only with the help of a puncture, but also with the help of a YAMIK catheter. The procedure is generally unpleasant, but effective and painless, since a tube is simply inserted into the sinus through which an antiseptic is supplied, and the medication and the contents of the sinuses are sucked out through another tube through the adjacent nasal passage.

Surgical treatment is usually prescribed only in cases of urgent need, if the patient’s condition is assessed as severe and there is a risk of developing serious complications such as sepsis, abscess. It is impossible to refuse the procedure, since such conditions threaten to result in disability and even death of the patient.

Prevention

Prevention of sinusitis is quite simple:

• Timely treatment infectious diseases ENT and respiratory organs;
• Strengthening the immune system;
• Normalization of the daily routine;
• Normalization of nutrition;
• Rejection of bad habits;
• Taking vitamins;
• Timely medical examination;
• Do not overcool;
• Maintain oral and nasal hygiene standards;
• Regularly ventilate the room where you live and work, and also humidify the air;
• Hardening the body;
• Prevent allergies if there is a history of allergies;
• If you come into contact with a patient with ARVI or influenza, you should use sinus rinses or special irrigating sprays.

Forecast

Forecasts acute illness generally positive if therapy is started on time. It is possible to cure sinusitis completely and without consequences without the risk of relapse.

When the pathology starts, sinusitis either becomes chronic or causes severe complications, which significantly worsens the patient’s condition, and in some cases is life-threatening.

The basic regulatory document in this area is the International Statistical Classification of Diseases and Problems Related to Human Health (ICD). This publication includes 3 volumes - an alphabetical index, instructions and the classification itself.

This collection was compiled by the World Health Organization. Every 10 years it revises the document and makes various additions. Thanks to the ICD, it is possible to compare data on diseases between different countries. At the moment, the document after the 10th revision is valid - ICD-10.

This document has been compiled in order to create optimal conditions for processing statistical data and analyzing them. This way you can analyze various diseases and mortality rates, and compare such rates between countries.

Thanks to the ICD-10 classification, any diagnosis is transformed into a code, a set of letters and numbers, which greatly facilitates the process of analyzing and storing information.

Classification structure

The structure is quite simple. After the introduction of the tenth version of the document, a new feature appeared. Now, in addition to 4 digits, the code will also contain a letter. Thanks to this trick, the dimensional structures were doubled, as approximately 300 new three-digit categories appeared.

By the way, all letters are taken from the Latin alphabet, and only U remains as a spare. In other words, codes U00-U49 are used only as temporary ones. They are used to refer to diseases that currently do not have a clearly understood origin. But codes U50-U99 are used only for various studies.

In addition, the code numbers have been expanded from A00.0 to Z99.9, and all diseases are divided into 21 classes. By the way, there are also diseases that appear after medical intervention.

• chronic sinusitis according to ICD-10 has code J32.0;
• the frontite is numbered J32.1;
• ethmoiditis – J32.2;
• sphenoiditis – J32.3;
• pansinusitis - J32.4.

Other types of sinusitis, including the chronic form, should be noted under number J32.8. If it is unspecified, then code J32.9 must be entered.

Types of sinusitis depending on the location of inflammation

Sinusitis is a very common disease. Moreover, scientists have not established dependence on the region. In almost every country, the microflora of microorganisms is very close.

The most common reason that causes this disease is the influenza epidemic, which recurs cyclically. This increases the risk of developing a chronic disease. And human immunity is constantly weakening.

However, in last years Another relationship becomes noticeable - between the development of the disease and unfavorable factors environment. For example, gas pollution, toxic emissions into the atmosphere, and dust influence.

Sinusitis is often confused with sinusitis; in fact, they are not the same disease. Sinusitis is considered a term that unites all diseases associated with inflammatory processes in the sinuses near the nose.

There are 4 main forms of sinusitis:

1. Sinusitis - inflammatory processes occur in one or two maxillary sinuses.
2. Frontal sinus disease - only the frontal sinuses are affected.
3. Ethmoiditis - the labyrinth becomes inflamed.
4. Sphenoiditis – the sphenoid sinuses are affected.

Separately, rhinosinusitis is also distinguished. This is a disease in which both the mucous membranes of the nasal canals and the paranasal sinuses become inflamed. For example, with this disease, sinusitis is often combined with a simple runny nose.

The maxillary sinus is a paired nasal sinus. If we consider the projection onto the face, it turns out that they are located directly under the eyes - on the left and right side from the bridge of the nose. Sinusitis can develop in one or both sinuses. Depending on the side of the lesion, it is classified as left-sided, right-sided or bilateral.

You can even identify the variety visually, since mucus will be released from only one nostril. Severe pain is also felt on one side of the face. Inflammatory processes are always accompanied by the appearance of swelling, so there will be bags under the eyes. By their appearance, the type of disease can be determined. If the swelling appears only on one side, then the inflammation is also located in one sinus.

In this case, standard treatment procedures are applied. If this does not help in the acute form, then you will have to puncture the sinuses.

Forms depending on the course of the disease

Depending on the course of the disease, there are the following forms:

There are differences in symptoms, consequences and duration of the disease.

Acute sinusitis

It is the result of a complication. Usually this form lasts about a month. In this case, the patient develops a headache, body temperature rises, and chills occur. He feels slightly unwell.

If you often tilt your head forward, the painful sensations will begin to become more intense. This is due to the fact that pressure from the front surface of the sinus increases. Sometimes photophobia and intense production of tears appear.

With this form, it is very difficult or impossible to breathe through the nose due to severe congestion. The patient begins to worry because of the copious secretion of mucus and clots of pus in it. The sense of smell will disappear, the eyelids will swell, and the cheeks will swell.

Treatment of the acute form is carried out using a conservative method. Anti-inflammatory drugs and rinsing are mandatory. You can't warm up your nose.

Chronic sinusitis

It is long lasting, usually lasting about 2 months, and sometimes more. At the same time, the patient constantly suffers from malaise, gets tired quickly, and feels weak. The headache gets worse in the evening, as does the congestion.

Since inflammatory processes do not stop for a long time, they can cause serious side effects. For example, the meninges or tissue of the orbit swell, meningitis, brain abscess, and venous thrombosis develop.

Chronic sinusitis is usually treated with physiotherapeutic procedures. Inhalation helps well, you can use dry heating. The chronic form of sinusitis takes much longer to treat than the acute form.

It must be remembered that mucous membranes change due to disease. Sinusitis may be accompanied by active secretion of pus and mucus, or the membrane itself will begin to actively change. Depending on this, exudative or productive forms are distinguished.

Exudative sinusitis

Mucus and pus come out abundantly, making it difficult to breathe. Depending on the discharge itself, sinusitis will be purulent or catarrhal. In the catarrhal form, the discharge is liquid, but viscous. The mucous layers swell, the intensity of discharge increases. This condition is dangerous due to the fact that if it is not treated, stagnation of mucus leads to the formation of a purulent form.

To treat this form, you will need medications that have vasoconstrictor properties. This will help reduce swelling. You also need to wash it regularly.

Productive form of sinusitis

In the productive form, not only inflammatory processes develop, but the mucous membrane also begins to change. In this case, degeneration causes sinusitis of the polypous and hyperplastic type.

In the polypous form, growths can be found on the mucous membranes - these are polyps. They can completely close the canals so that the mucus does not drain. There are problems with breathing and smell. In severe cases, it will be painful for a person to swallow.

With the hyperplastic form, the mucous membranes begin to thicken. It is because of these processes that the lumen of the canals begins to become thinner. Sometimes treatment is complicated by the fact that the nasal septum is curved. In this case, surgery will be required.

Inflammatory processes in the cavities near the nose can be caused for various reasons. These can be viral, bacterial, fungal infections, taking medicines, influence of toxic substances, injuries.

Sinusitis in the ICD-10 classification is listed as a type of sinusitis, although it is one of the most well-known diseases. By the way, if diagnosed incorrectly, this disease can indeed be confused with other forms of sinusitis, which are very diverse.

Add a comment Cancel reply

Treatment should only be prescribed by a doctor!

What is sinusitis according to ICD 10?

If a person has sinusitis, ICD-10 has a special code for any type of this disease. Typically, people consider sinusitis to be inflammation of any sinuses near the nose. In fact, this disease refers only to inflammatory processes in the sinus of the upper jaw. Everything else is other types of sinusitis (the same rhinosinusitis). But sinusitis is the most common chronic disease among all other ENT pathologies.

ICD-10 is an international document that contains a list of all diseases, pathologies and injuries by section. Like all other industries, medicine and healthcare also has various classifications, which are documented according to certain standards and criteria.

The International Classification of Diseases was developed by the World Health Organization. Thanks to ICD-10, the correlation between data on diagnoses and the diagnosis itself is carried out in different countries of the world. The same applies to the process of treating illnesses, since they are different countries have different names, but thanks to ICD-10, all data is standardized, which is convenient not only for collecting, but also storing and analyzing information. This is precisely the main purpose of ICD-10. This document allows you to systematize all the obtained statistical data on mortality and morbidity levels both in different countries of the world and within one state.

To systematize the data, all ailments are given a separate code, which consists of alphabetic and digital values. The tenth revision of the edition made some changes. For example, now not only a 4-digit code is used, but also 1 letter is added to them. This makes coding easier, simplifying the entire process.

Letters from the Latin alphabet are used. Of the 26 letters, only 25 are used, but the letter “U” is a reserve. In other words, all codes with this letter from 00 to 49 are used to designate various diseases that have not been studied and have an unknown origin. These codes are temporary. But codes from 50 to 99 with this letter are used for research tasks.

ICD-10 has now increased the number of codes. Numbers from A00.0 to Z99.9 are used. All pathologies and diseases are divided into classes - 21 categories in total. Another innovation is the inclusion in the list of pathologies of those diseases that appeared after medical intervention. For example, after gastric surgery, some people develop dumping syndrome.

For all pathologies and diseases in ICD-10 there is a code, including for sinusitis. For example, the acute form of the disease refers to acute respiratory ailments of the upper organs of the respiratory system. The number used is J01.0. If a person has chronic sinusitis, according to ICD-10 it is classified as other diseases respiratory system, so the code will be different - J32.0. Thanks to this, accounting for information is noticeably easier, as is its storage.

Acute sinusitis is accompanied by increased body temperature, headaches, chills, and deterioration of health. When a person tilts his head, the pain in the forehead and eyelids intensifies. Breathing problems appear. Sometimes the secretion of tears increases, and intolerance to light appears. The discharge is copious and contains clots of pus.

For the most severe form of sinusitis, separate numbers are used. If this is an acute form of sinusitis, then number J01.0 is used, and the maxillary sinuses become inflamed. If the frontal sinuses are inflamed, then code 01.1 is written with the same letter. This disease is called frontal sinusitis. For the acute form of ethmoiditis, number 01.2 is used. If the patient has sphenoidal type sinusitis, then code 01.3 from this group is used. When inflammatory processes cover all the sinuses around the nose at once, this disease is called pansinusitis. In this case, doctors use number 01.4 if a person has another acute form of sinusitis. If the patient has an unspecified form of this disease, then the code with the last digit 9 is used. This is rhinosinusitis.

The chronic form of the disease is characterized by the same symptoms as the acute stage, but they clearly manifest themselves only during the period of exacerbation. By the way, you need to take into account that the disease can provoke various complications: meningitis, brain abscess, swelling of the eye, blood clots.

Chronic sinusitis is diagnosed if there have been at least 3 exacerbations in a year. In ICD-10, separate codes have also been created for the chronic form of sinusitis. For example, the chronic form of sinusitis requires the use of number J32.0. For frontite in chronic form the code is 32.1, and the letter will be the same. If the patient has chronic ethmoiditis, then code 32.2 is written. When sphenoiditis has become chronic, then code 32.3 with the letter J is used. If inflammatory processes become chronic in all paranasal sinuses, then code 32.4 is used, and this disease is called chronic pansinusitis. If another sinusitis is found in a chronic form, then code J32.8 is used. Typically, this number is assigned when the pathology affects several sinuses, but not all, so it is not pansinusitis. If the disease is unspecified in a chronic form, then code J32.9 is written.

It is also necessary to take into account that the disease is classified depending on the zone of localization of inflammation. There are unilateral and bilateral sinusitis. The first, in turn, is divided into left- and right-handed.

In addition, it is necessary to take into account that clarifications are also written depending on what caused the illness. For example, if the pathogens are streptococcal or staphylococcal infection, then code B95 is written. If this bacterial infections, but not streptococcus or staphylococcus, then number B96 is assigned. When the disease is viral in nature, doctors use the code B97. However, such an additional code is written only if the causative agent of the disease is accurately identified using special laboratory tests - a culture is performed for the patient.

There are several provoking factors that cause inflammatory processes to develop in the maxillary sinuses.

1. 1. Sinusitis of viral origin. The disease is caused by viruses. Appears less frequently than other forms. Usually develops against the background of a respiratory infection. A large amount of mucus accumulates in the sinuses, but there is no purulent mass. It is more difficult for the patient to breathe due to swelling of the mucous layers. Treatment requires drugs with antiviral properties. Usually the swelling goes away only after 3-4 weeks.
2. 2. Bacterial sinusitis is caused by pathogenic microorganisms. They multiply in the nasal sinus, and incubation period lasts a couple of weeks. The patient's body temperature rises. Another feature is the content of pus in nasal discharge. A severe cough may also cause pain. To determine the causative agent of the disease, a bacteriological study is carried out. Antibiotics are needed for treatment. In addition, the causative agent of the disease must be tested for susceptibility to the drug.
3. 3. Sinusitis of fungal origin develops due to the fact that fungal microorganisms are activated. They are present in the body of every person, but under certain conditions their number increases, and the immune system does not have time to suppress them. For example, such a disease develops due to severe illnesses experienced, long-term antibiotic therapy, AIDS and other problems. Distinctive feature Sinusitis of this origin is that the discharge has a dark tint (sometimes even black).
4. 4. Sinusitis allergic origin. This disease is caused by allergens that enter the respiratory system through airborne droplets. For example, this is pollen, wool, dust and other particles. The peculiarity is that the discharge is very abundant and watery. As soon as contact with the allergen stops, the disease goes away on its own.
5. 5. Sinusitis of a traumatic nature. The cause here is a broken nose. This type of sinusitis can also occur due to foreign objects entering the nasal cavity or an unsuccessful operation.

To determine the type of sinusitis, they take into account how the mucous layers in the maxillary sinus change, and also pay attention to nasal discharge. Depending on this, productive and exudative forms are distinguished:

1. 1. Exudative sinusitis. This disease is characterized by copious nasal discharge, which makes it difficult for the patient to breathe. The discharge itself may have a mucous and purulent tint. If a person has a catarrhal form of the disease, then a secretion is released in large quantities. It's very plentiful. Due to the increased blood flow, the sinuses swell and the volume of secretions increases. But the purulent form develops due to the fact that the patient long time ignored his painful condition and did not begin to treat the catarrhal form of the disease in time. If the patient has an exudative type of sinusitis, then the therapy will be traditional medication. It is aimed at eliminating swelling of the mucous membranes, removing inflammatory processes and reducing mucus secretion. To facilitate the breathing process, additional agents with vasoconstrictor properties are prescribed. They also relieve swelling. It is also important to rinse the nasal cavity to restore normal secretions.
2. 2. Productive. This form of the disease is characterized by the growth of the mucous layer. In addition, its structure gradually changes, like the mucosal tissues themselves, which leads to the formation of polyps or the formation of hyperplastic type swelling.

If the disease takes on a polypous form, then the mucous membrane gradually grows, and new growths appear from its tissue. It is because of them that many patients have difficulty breathing, a weakened sense of smell, and discomfort when swallowing. Due to such neoplasms, the passage is blocked, so that air does not enter the maxillary sinuses. The exit is also closed for the outflow of secretions. If the polyps have not grown much, then to determine them you need to take an x-ray and computed tomography. If the disease is actively progressing, polyps will be visible when examined by a doctor. Treatment of the polypous form of sinusitis involves the use of conservative methods in order to reduce the rate of progression of the disease. If this method does not help, then the tissue is removed surgically.

With the hyperplastic form of the disease, the mucous layers become denser, and the lumen of the nasal canal decreases in diameter. Breathing is difficult, but not completely impaired. If the patient also has a deviated nasal septum, then surgery is required.

If a patient has sinusitis, the ICD-10 code will differ depending on the type of disease. There are several forms of sinusitis depending on where the mucous layers become inflamed - in which sinus near the nose, and sinusitis is only one of the varieties of this disease, but the most common. The ICD-10 code is used by doctors to facilitate the process of collecting, storing and analyzing data.

All information on the site is provided for informational purposes. Before using any recommendations, be sure to consult your doctor.

Full or partial copying of information from the site without providing an active link to it is prohibited.

Position and codes of sinusitis in the ICD

ICD (International Classification of Diseases) – special document, which is used to classify and record diseases, pathogens and causes of death. It is this document that makes it possible to collect and study information received by doctors from different parts of the world at different periods of time.

Each disease is assigned a specific number - ICD code. For example, acute sinusitis corresponds to the value J01.0, which is included in the section of acute respiratory infections. Chronic sinusitis has a different meaning, but more on that below.

History of the creation of the classification

The first attempts to systematize data on various pathologies and causes of death were undertaken back in the 18th century. However, these classifications did not cover the entire diversity of disease data and could not be used as the main classification of the whole world.

The first International Congress of Statistics was held in the capital of Belgium in 1853, where two Genevan doctors Farr and Marc d'Espin were tasked with developing key provisions classifications of causes of death that could be used internationally.

In France in 1855, at the second conference, doctors presented the results of their work, which differed from each other and were based on completely different criteria. Congress analyzed the data and developed a list of 139 rubrics that combined the work of both doctors. This classification was subsequently revised five times until 1886.

In 1893, Jacques Bertillon, head of the Paris statistical service, presented at the International Conference in Chicago a classification of causes of death, which was based on the division of diseases taking into account the affected organ or anatomical region.

This document has been approved and used in several European countries. In 1989, the American Association, at a meeting in the capital of Canada, decided to introduce the Bertillon classification in the USA, Mexico and Canada, and also proposed to revise it every decade.

Thus, the classification proposed by Bertillon in 1893 served as the beginning of a series of documents on the international classification of diseases, which are constantly updated with new information.

Modern ICD

Once every ten years, the ICD is reviewed under control World Organization Health (WHO).

Today, they use the international classification of diseases, tenth revision, which was adopted at the International Conference in Geneva in 1989.

Among the innovations: a separate section has been included for conditions that arose after execution medical procedures, for example, postoperative nosebleeds and others.

When developing the Russian analogue of the international classification of diseases, it was necessary to adapt and correlate WHO clinical diagnostic criteria with the peculiarities of domestic medicine. The WHO Moscow Center coped with this task, working closely with other medical institutions in the country, and in 1999, Russian medicine switched to ICD-10.

Structure of the classification

ICD-10 includes three volumes, the first of which is the classification itself, and the second and third contain instructions for its use and an alphabetical index.

The basis is an alphanumeric approach to encoding. A four-character category consists of one letter followed by three numbers. A00.0 – Z99.9

ICD-10 is divided into 21 classes. Each class corresponds to a specific type of disease, be it mental disorders or respiratory diseases.

Classes consist of three-digit rubrics, indicated by numbers, and the rubric, with the help of the last digit separated by a dot, forms a sub- rubric. Subcategory defines different localizations or variants of the course of one disease.

Codes for various forms of sinusitis in ICD-10

Acute and chronic sinusitis belong to class 10 (J00-J99) “Respiratory diseases”. Next comes the division:

Acute sinusitis is classified under the heading (J00-J06) “Acute respiratory infections of the upper respiratory tract.”

Chronic sinusitis in the section (J30-J39) “Other diseases of the upper respiratory tract.”

If there is a need to clarify the nature of the pathogen that caused sinusitis, then an additional code (B95-B97) is used.

• B95 – strepto and staphylococci, as the cause of diseases located in other headings;
• B96 - other bacterial agents, B97 - viruses that provoked the onset of the disease.

What operations are there for sinusitis?

Antibiotics as a treatment for sinusitis

How to avoid a puncture if you are very scared?

Technique for performing acupressure massage for sinusitis

How to treat sinusitis for pregnant women?

Traditional recipes for the treatment of sinusitis

How is sinusitis pierced, and what is the danger?

Drops and sprays effective for sinusitis and runny nose

Sinusitis (acute and chronic): code according to ICD 10

In this publication we will explain what the international classification of diseases, 10th revision, means for the disease - sinusitis (ICD code 10). The discussion will naturally focus on chronic and acute types of illness.

Sinusitis is a problem characterized by activation of the inflammatory process in the maxillary canals. They are also called maxillary.

This disease is accompanied by damage to the mucous membrane and blood vessels, localized in these sinuses. The main causes of the problem are adenovirus and rhinovirus infections, which are activated after influenza.

All characteristics of the disease are indicated in the regulatory document; all disease codes are recorded in it.

Sinusitis - ICD 10

According to the international classification of diseases, sinusitis belongs to the tenth class, code J32.0.

It is divided into the following forms:

1. Aggravated. According to ICD 10, this condition is called “acute respiratory infection upper respiratory tract";
2. Chronic. The form belongs to the heading “other upper respiratory tract diseases”.

The pathology is classified separately depending on what pathogen provokes it.

These categories are marked with code B95-B97. The first code B95 refers to pathogens such as streptococci and staphylococci. Code B96 is a designation for an illness caused by other bacteria. B97 means that the disease began due to viral infections.

Chronic and acute forms may have an unspecified ICD 10 code.

Both adults and children are equally susceptible to infection. According to statistics, inflammation of the maxillary sinuses is the most common disease among all ENT pathologies.

Healthy and inflamed sinuses

Acute sinusitis - code according to ICD 10

The inflammatory process refers to acute sinusitis. The symptoms of this condition are pronounced. In this case, pain is felt in the cheek area closer to the nose. Body temperature also rises, there is discomfort under the eyes when tilting the head forward.

Acute sinusitis in a person can also manifest itself as severe pain that is difficult to endure. Sometimes the tear duct is affected, and as a result, increased lacrimation.

If you don’t know which medicine for stomatitis is best to use for children, you can look at us.

Treatment of the pathological condition should begin immediately. The whole complexity of this form of the disease is that the walls of the maxillary sinuses are thin and there is a possibility of infection of the brain, but this condition occurs extremely rarely. And infectious damage to the orbit and membrane of the eye occurs much more often during an acute course of the disease.

An untreated illness can provoke a complication in the form of constantly recurrent bronchitis.

Chronic sinusitis - code according to ICD 10

Chronic accompaniment of pathology belongs to group J32. This condition occurs due to an advanced period. In this case, secretions will accumulate in the maxillary sinuses over a long period of time.

It often happens that initially the inflammation is one-sided, but as it continues for a long time, it spreads to the other side. Then the disease becomes bilateral.

Single sided and double sided type

Chronic sinusitis (ICD code 10) is less severe. Symptoms include pain with prolonged nasal congestion. Painful sensations in the sinus area they are usually moderate or completely absent.

Nasal congestion causes a lot of discomfort to a person, since this symptom will often result in lethargy, fatigue, headaches, etc.

Symptoms are more pronounced during exacerbation of the chronic form of the disease:

• body temperature rises;
• headache;
• swelling of the cheeks and eyelids.

Swelling of the face due to inflammation

According to the ICD, chronic sinusitis can be allergic, purulent, catarrhal, complicated, odontogenic, cystic and fibrous. Only a qualified specialist can accurately diagnose and prescribe treatment. A normative document helps to make the correct diagnosis.

When looking for what dermatitis looks like in children or adults, you can look at photos of its manifestations.

Acute sinusitis: etiology of the disease, symptomatic manifestation and difference from other forms

Another name for acute sinusitis is maxillary sinusitis. This is an inflammatory process that occurs on the mucous membrane of the largest maxillary sinus. The acute form of the disease is considered when it lasts no more than 12 weeks and completely disappears clinical manifestations. The disease is a complication of acute respiratory infection.

Classification by ICD-10 code

The disease is characterized by a prolonged inflammatory process of the mucous membrane of the sinuses.

It is characterized by the presence of purulent discharge, an unpleasant odor and swelling of the cheeks. An x-ray will show darkening in the part where the mucus has accumulated and is not coming out.

Acute sinusitis develops against the background of influenza, rhinitis, whooping cough and measles. Its appearance can be triggered by injuries, surgical procedures performed on the nose, or exposure to allergens. In the ICD-10 classification of diseases, acute sinusitis is assigned code J01. The following categories are at risk of infection:

1. Adults and children who often get colds
2. Having an allergy, the manifestation of which is swelling of the nasal passages
3. Patients with nasal septum defects
4. Having problems with the health of the upper teeth

Forms and types of disease

Acute sinusitis has its own classification. The division is based on the content type. It could be:

The disease can be divided according to the severity of its course. There are no clear division boundaries; they are more based on the patient’s own feelings and are assessed on a ten-centimeter scale, which is called VAS.

The disease can occur in mild (0-3 cm), moderate (4-7 cm) and severe (8-10 cm) degrees. The viral and allergic nature of the appearance of sinusitis usually refers to mild degree. Can be bilateral, left-sided or right-sided.

How acute sinusitis differs from chronic sinusitis, see our video:

Symptoms of acute sinusitis

Depending on the severity, acute sinusitis has different symptoms. Common symptoms characteristic of the disease are:

• Difficulty in nasal breathing
• Congestion
• Copious clear or pus-laced nasal discharge
• Dulled sense of smell
• Pain in the frontal region and in the area of ​​mucosal inflammation

With moderate or severe manifestations, body temperature rises and severe headaches appear. The eyelids and cheekbones may become swollen, and the sinuses may seem to be bursting from the inside. In this case, there is a high probability of inflammation spreading to the brain, especially in a child whose sinuses are not fully formed.

The difference between acute sinusitis and other forms

In order not to confuse the acute form of sinusitis with similar chronic symptoms, you should clearly understand the differences between them.

The chronic form of the disease is practically asymptomatic, while the acute form is characterized by the presence of obvious signs of the disease. Another difference between maxillary sinusitis is that it appears immediately after an influencing factor (infection, acute respiratory infection, trauma).

Features of treatment

The patient will not be able to independently diagnose sinusitis, much less determine its form and degree. The disease can be easily confused with another disease that has similar symptoms.

To identify maxillary sinusitis, it is better to consult an otolaryngologist. Before the final diagnosis is made, the following studies are recorded in the medical history:

1. Visual inspection. Necessary for collecting disturbing symptoms and drawing up a preliminary clinical picture.
2. X-ray. It is done to study the contents of the maxillary sinuses.
3. CT scan. Rare because it is a rather expensive procedure for examining the nasal cavity.
4. Puncture. This diagnostic method is performed when it is not possible to take an x-ray. A puncture is taken from the maxillary sinuses to determine their contents.

When treating acute sinusitis, hospitalization of the patient is not required; treatment can be continued at home. Only if the sinuses are cleansed by a puncture can the patient be left under medical supervision for 2-3 days. The rest of the therapy is carried out by the patient at home. There he takes the medications prescribed to him and performs the necessary manipulations for his nose. If the course of treatment involves attending physiotherapeutic procedures, then they are performed medical workers in the clinic.

Its use is painless, and the procedure itself does not involve violating the integrity of the nasal cavity, as happens with a puncture.

How to treat sinusitis, watch our video:

Possible complications

If you let the development of the disease take its course, there is a very high risk of developing dangerous and unpleasant complications. Increased body temperature can cause the patient to lose consciousness. In addition, they suffer:

Forecast

With timely treatment, acute sinusitis is completely cured without consequences or complications within a month. It is important to follow all medical recommendations and take prescribed medications.

Sinusitis microbial 10

Bacterial sinusitis very often leads to the accumulation of purulent contents in the paranasal cavities. The main line of therapy in this case is the fight against pathological bacteria with the help of antibiotics. Along with suppressing the bacterial flora in the inflamed sinuses, every doctor has a second task - restoring the drainage function of the maxillary sinuses. And if…

Ceftriaxone is a fairly strong antibiotic that is often used for sinusitis. In this case, you should understand how to properly carry out treatment and what precautions should be taken. Features of the antibiotic Ceftriaxone is a third generation antibiotic that has quite wide range actions. At the same time, it is prescribed to treat the following problems: infections of the lower and…

For sinusitis, rinsing is often prescribed. In this case, various drugs and saline solutions are used. A special effect can be obtained by using the drug furatsilin, which has a disinfecting effect. It is important to know and understand how to properly carry out the rinsing procedure in order to get the maximum effect. Features of the drug The drug Furacilin belongs to the nitrofuran group of drugs. He has…

An inflammatory process that occurs in one or more paranasal sinuses ah nose, is called sinusitis (sinui?t). Sinusitis can occur in two forms - acute and chronic.

Classification according to ICD 10

According to the International Classification of Diseases, Tenth Revision, acute sinusitis (J01) is divided into:

In turn, chronic sinusitis (J32) is divided into:

• J32.0 Maxillary
• J32.1Front
• J32.2 Ethmoidal
• J32.3 Sphenoidal
• J32.4 Pansinusitis
• J32.8 Other chronic sinusitis
• J32.9 Chronic sinusitis, unspecified

The terminology of the disease depends on the location of sinusitis. Most often, the disease occurs in the maxillary sinuses, which are located in the maxillary part of the head. If the inflammatory process affects only the maxillary sinuses, then this condition is characterized as sinusitis.

Maxillary sinusitis (sinusitis) (ICD10 code J32.0.) – inflammation in the upper paranasal sinuses of the nasal cavity. The disease can occur at any age. Statistics show that every tenth person has suffered from this disease.

It is very important to begin treating the disease at the initial stage of development, otherwise it will turn into a purulent form and subsequently can provoke the development of serious complications.

Causes

In most cases, sinusitis (ICD code 10) occurs as a result of repeated incompletely treated colds and rhinitis. But in addition to ARVI and a runny nose, the main cause of the disease is neglected teeth affected by caries, especially in the upper jaw (odontogenic). Diseases that cause disturbances in immune system(allergies, paritosis and other long-term chronic diseases) can provoke the development of maxillary sinusitis.

An important cause of sinusitis is infection. Quite often, during the diagnosis of sinusitis in a person, staphylococcus is detected from a swab taken from the nasal cavity. During the period of occurrence of the most common and harmless cold, staphylococcus begins to manifest its pathogenic properties.

also in medical practice allocate following reasons, as a result of which maxillary sinusitis develops:

• entry of pathogenic bacteria and chemicals into the nasal mucosa
• severe hypothermia
• abnormal anatomical structure of the nasopharynx
• congenital pathologies of the secretory glands
• nasal septum injuries
• the presence of polyps or adenoids in a person, etc.

Regular and long-term use of nasal medications is the main factor that provokes abundant accumulation of mucus in the maxillary sinuses, resulting in the development of sinusitis (International Classification of Diseases 10).

Symptoms

The main signs of the development of maxillary sinusitis include:

• The appearance of copious mucous discharge from the nasal passages. At the initial stage of development of the disease, nasal discharge is clear and liquid. Then acute sinusitis develops (ICD 10 J32.0.), and nasal discharge becomes thicker in consistency and acquires a yellow-green color. If a patient has developed chronic maxillary sinusitis (International Classification of Diseases 10), then nasal discharge may be bloody.
• Memory impairment.
• Problems with night sleep.
• Weakness and disability.
• Increased body temperature and chills (sometimes the temperature can rise to 38 ° C, and in some cases up to 40 ° C).
• Severe headaches.
• Lack of appetite.
• Pain in the temples, back of the head and frontal part of the head.

When the first symptoms of the disease appear, you should immediately consult a doctor.

Currently, the most common and most frequently encountered types of illness in medical practice are distinguished:

Each type of disease has its own distinctive causes, signs and forms of progression.

Spicy

The main factor causing acute sinusitis (international classification of diseases 10 J32.0.) is infections that enter the upper respiratory tract of a person, as well as untreated colds, causing an inflammatory process in the mucous membrane of the maxillary sinus. Against the background of the onset of the disease, the patient experiences severe swelling of the mucous membrane of the nasal passages.

Acute sinusitis and its symptoms

In mild cases, acute maxillary sinusitis provokes an increase in pressure in the area of ​​the inflamed sinuses, as a result of which the patient has trouble breathing through the nose. Initially, the discharge from the nasal passages is clear or white. If treatment is not carried out to eliminate foci of infection, then over time they acquire a yellow-green color and become denser. All these symptoms mean that the patient has developed a purulent inflammatory process. At the acute stage of the disease, a person begins to experience dizziness, drowsiness, pain in the eyes, cheekbones, occipital and frontal parts of the head.

After final confirmation of the diagnosis, treatment should be started immediately, since over time the disease becomes chronic form leakage.

Treatment of acute sinusitis

As a rule, acute maxillary sinusitis can be treated effectively conservative treatment. Therapy consists of taking antibiotics and antihistamines to reduce swelling of the mucous membrane.

Chronic

An inflammatory process in the mucous membrane of the maxillary sinuses, which lasts more than one month, develops into chronic maxillary sinusitis (International Classification of Diseases 10).>

Signs of chronic sinusitis

The symptoms of the disease are variable. During remission, there are virtually no symptoms. During the period of exacerbation, the patient may exhibit such signs of illness as congestion of the nasal passages, mucous discharge from the nasal cavity becomes green or yellow, slight increase in body temperature (no more than 38°C), weakness, severe malaise, headache, sneezing, etc.

Causes of chronic maxillary sinusitis

Quite often, chronic sinusitis occurs when the disease is not treated or if the patient received ineffective drug therapy during an exacerbation. Also chronic stage The disease occurs if a person has a congenital or acquired abnormal structure of the nasal septum.

The chronic form of the disease should not be left to chance, as it can cause the following complications: tonsillitis, laryngitis, otitis media, pharyngitis, dacryocystitis, apnea and mental impairment.

During remission, the nasal cavity should be rinsed with a weak saline solution, saline solution and other nasal solutions. During an exacerbation, drug therapy is administered. If the disease does not respond to conservative treatment, surgical intervention (sinusrotomy) is performed.

Odontogenic

The causative agent of odontogenic maxillary sinusitis (International Classification of Diseases 10) is infections such as staphylococcus, escherichiosis, and streptococcus. Also, odontogenic sinusitis in humans can occur due to the presence of deep caries in the oral cavity.

Signs of odontogenic sinusitis

When the first symptoms of the disease appear, you should consult a doctor, as the following serious consequences may occur: severe swelling, inflammation of the eye sockets, poor circulation in the head.

Odontogenic maxillary sinusitis is characterized by symptoms such as general malaise, severe pain in the head, a slight increase in temperature, disruption of night sleep, decreased immunity, pain in the maxillary sinus area.

Before carrying out therapy, it is necessary to determine the localization and cause of the inflammatory process in the maxillary sinuses. If odontogenic inflammation was caused by caries, then it is necessary to sanitize the oral cavity. In the future, antibacterial and vasoconstrictor drugs are prescribed.

Preventive measures are as follows: you should visit the dentist at least twice a year, avoid hypothermia, increase physical exercise, take vitamins comprehensively to strengthen the immune system, in the morning you should do breathing exercises, promptly treat viral diseases.

Attempts to systematize data on various pathologies and causes of death were made in the field of medicine back in the 18th century. Prototype of the modern version International classification diseases (ICD-10) was approved in Chicago in 1893 and was the result of the work of Jacques Bertillon, director of the statistical service of the French capital. In this article we will talk about sinusitis.

What is an ICD-10 code

ICD-10 is an international document in 3 volumes of the tenth revision, adopted in 1989 in Geneva. It includes a classification of diseases (volume 1), instructions for working with volume 1 (volume 2) and an alphabetical index (volume 3).

According to the ICD-10 classification, sinusitis belongs to class 10 – “Diseases of the respiratory system” (code J00 – J99), further subdivided into acute (J01. 0) and chronic (J32. 0) maxillary sinusitis. When clarifying the nature of the causative agent of sinusitis, additional designations may be added to the code:

• B-95 – strepto and staphylococci;
• B-96 – other bacterial agents;
• B-97 – viruses.

When examining patients with sinusitis, it turned out that adults are most susceptible to the disease. In children, due to the poor development of the nasal sinuses, the disease is much less common. improper or insufficient treatment of colds and acute respiratory viral infections.

Causes of sinusitis in adults

For sinusitis (maxillary sinusitis) to occur, the paranasal sinuses, which communicate with each other through anastomoses, must become inflamed. When the mucous membrane is inflamed, the anastomosis narrows, and pathogenic mucous secretions remain in the sinuses, turning into pus.

Sinusitis: healthy and inflamed paranasal sinus

The causes of sinus inflammation can be very different:

• Pathogenic microflora (viruses, bacteria, fungi) penetrating the nasopharynx;
• Colds in advanced form;
• Nearby sources of infection (purulent caries,);
• Constant irritating effects on the mucous membrane (harmful production, household chemicals, polluted air);
• Hypothermia, acute respiratory viral infections and acute respiratory infections;
• Injuries or abnormalities in the structure of the nasal septum;
• Weakened immunity;
• Failure in the normal functioning of the secretory glands;
• to external stimuli;
• Radiation sickness, tuberculosis, tumors.

Uncontrolled use of regular drops for the common cold can cause mucus to stagnate in the maxillary sinuses and cause sinusitis.

Sometimes strong drugs, used in the treatment of rhinitis, provoke the destruction of blood vessels and cause nosebleeds.

Symptoms and signs of sinusitis

If, after suffering from a cold or a visit to a busy place, your nose suddenly becomes blocked, purulent discharge appears, or your head hurts when bending forward, then you should visit a doctor and consult about your condition.

Symptoms of sinusitis: purulent discharge from the sinuses, headache, lacrimation

Symptoms of sinusitis are not limited to those listed, they can be as follows:

1. Strong pressure in the sinuses;
2. Fever, sometimes accompanied by chills;
3. Headaches that get worse when turning the head;
4. Difficulty breathing and night attacks of dry cough;
5. General weakness, fatigue, poor sleep;
6. Loss of appetite and memory loss.

Symptoms can be pronounced in acute cases of the disease and weakly in chronic cases, which is more dangerous, since such a condition can go unnoticed for quite a long time.

Chronic sinusitis, progressing sluggishly, at any time under the influence of external factors can become acute and cause serious illness.

Possible complications

The sinuses are located near the organs of hearing, vision, breathing and, most importantly, the brain. All these organs are interconnected, and inflammation of one can, if not treated carefully, cause inflammation of another.

Incorrect or prolonged treatment of sinusitis can provoke:

• Abscess of the orbit. Symptoms: swelling of the eyelids, conjunctivitis, immobility eyeball, redness and soreness of the skin around the eyes;
• . Symptoms: ear congestion, fever, shooting pain;
• Bronchitis and pneumonia. Symptoms: shortness of breath, fever, general weakness, severe cough;
• Meningitis. Symptoms: severe headache with vomiting and nausea, temperature changes, impaired vision and consciousness (delirium, hallucinations);
• Sepsis (blood poisoning). Symptoms: dehydration, weakness, sudden increase in temperature, delirium.

All complications are serious enough to require treatment of sinus inflammation with due responsibility, while remembering the dangers of self-medication and the importance of timely medical care.

Treatment of sinusitis

When treating inflammation of the maxillary sinuses, one should distinguish between acute and chronic forms of the disease.

Acute inflammation requires urgent removal of pus from the sinuses; at this stage, heating the paranasal area is strictly prohibited. In the chronic form, a comprehensive systematic approach to the selection of medicines.

Drug therapy - what medications can be taken

The main goal of treating sinusitis is to cleanse the sinuses of pus and sanitize them. For this purpose, medications from the group of antiseptics are most suitable:

• . The drug is used for rinsing and instilling the nose. Contraindicated only for people with a possible allergic reaction;
• Protorgol. Contains silver, used for instillation into the nose, there are no contraindications;
• Dioxidine. A 1% solution for washing is produced in ampoules. Not recommended for use in the treatment of pregnant women, nursing mothers and children;
• Furacillin. For washing, a 0.2% solution is used. Complete cure is achieved after 5-10 procedures.

Nasal drops

Drops for a runny nose are prescribed for sinusitis to relieve swelling of the mucous membrane and reduce nasal congestion. It should be remembered that vasoconstrictor drugs are not recommended for use for more than 5 days to avoid addiction. Before instillation, it is necessary to clear the nose of mucus. For this, the use of the following products is effective: Aqualor, Quicks-spray, Dolphin for sinusitis. Then, depending on the form of sinusitis and the patient’s condition, one of the drugs is instilled:

• With an antibiotic (Isofra, Sinuforte, Polydexa with phenylephrine);
• Vasoconstrictors (Nazivin, Glazolin, Dlyanos);
• Antihistamines (Cetirizine, Allergodil, Loratidine).

Nasal drops, like any medicine, have side effects and should be used only as prescribed by a doctor.

Antibiotics

Antibiotics should be prescribed only after preliminary identification (in laboratory tests) of the causative agent of the disease. The medicine is selected taking into account the strength of the effect various drugs for certain groups of pathogenic microbes:

1. Penicillins: Panclave, Ampiksid, Unazin. Most effective in the fight against streptococci;
2. Cephalosporins: Cefixime, Pancef. The drugs suppress streptococci, Haemophilus influenzae, Moraxella, Klebsiella;
3. Marcolids: Josamycin, Clarithromycin, Azithromycin. Antibiotics of this group are the most effective, but have some side effects.

Even if a given antibiotic has helped treat a disease in the past, it should not be used unless prescribed. Various factors could have changed (the state of immunity, previous diseases, living conditions), as a result of which the body will react to the medicine in an unexpected way.

How to treat chronic sinusitis using traditional medicine

Sinusitis - enough serious illness, because the nasal sinuses are located near the organs of hearing, vision, and brain. It should be treated under the supervision of a doctor. But sometimes, due to health reasons or other circumstances, this is not possible. ethnoscience offers proven recipes for treating sinus inflammation:

1. Instill 3-4 drops of sea buckthorn, rosehip or melted butter into each nostril 5-6 times a day;
2. Carry out inhalations with propolis (0.5 tsp 30% tincture per 3 liters of boiling water) or with honey;
3. Warm the projections of the maxillary sinuses with a hard-boiled egg, heated salt or flaxseed;
4. Do rinses with decoctions medicinal herbs: chamomile, sage, calendula, St. John's wort, marsh grass, yarrow, peppermint, lemon balm;
5. Apply grated black radish to the sore area, first placing it on it soaked in vegetable oil gauze. Keep the compress for 10 minutes, the course of treatment is 10 days;
6. Pour boiling water over 3 packs of bay leaves and leave. Use the infusion for compresses for 6 days;
7. Instill 2-3 drops into the nose several times a day with a 2% solution of mumiyo while simultaneously taking 0.15 g orally for 10 days. Take a 5-day break. To cure, take 3-4 courses (Vanga’s recipe);
8. Apply a few drops of comb honey to your nose every 3 hours until improvement occurs.

All these procedures, especially thermal ones, can be performed for chronic sinusitis, when there is a free outflow of mucus. Treatment acute forms must be carried out under mandatory medical supervision.

The acute form of sinusitis is characterized by fever and lack of appetite. During this period, it is recommended to give up solid foods and take more fortified and antiseptic drinks: fruit and vegetable juices, decoctions and infusions of medicinal herbs.

Types of sinusitis depending on the affected sinuses

Prevention at home

Very often, sinusitis occurs as a consequence of an untreated prolonged runny nose. With a chronic runny nose, mucus can accumulate in the sinuses, and with the slightest hypothermia or other provoking factors, the runny nose turns into sinusitis. Therefore, the main preventive measure is to try to complete the treatment started.

There are several other reasons that have a significant impact on the occurrence of inflammatory processes in the sinuses:

• Air humidification. Dry air can interfere with normal sinus drainage. To restore moisture, you can breathe in steam or use a humidifier;
• Self-massage of the area on which the maxillary sinuses are projected. At the same time, blood flow improves, warming and outflow of mucus occurs;
• A kind of sinus ventilation: for 2 seconds you need to draw in air through your nose. At the same time, stagnant air from the sinuses escapes into the nose;
• Constantly clearing mucus from the nose by blowing your nose, and pinching one nostril is not recommended.

On initial stages The disease can be significantly slowed down and reversed by active warming up, warm drinking, and inhalations.

We should not forget that the main preventive measure in preventing any disease is immunity, which can be increased by eating antiseptic foods: garlic, onions, honey, lemon, raspberries, horseradish.

Video

conclusions

Inflammation of the maxillary sinuses most often overtakes a person during seasonal temperature changes, when the body is weakened after winter (in spring) or has not yet prepared for the autumn cold. In order not to develop into a complex disease fraught with serious complications, it is necessary, along with preventive measures, don't forget about the rules healthy image life:

• Balanced diet;
• Strong physical activity;
• Normal conditions of sleep and rest;
• Lack of stress;
• Giving up bad habits.

These factors are the key to strong immunity, the main barrier to any disease.

In cases where, try to get advice from a competent specialist and undergo an examination to establish the correct diagnosis.

RCHR (Republican Center for Health Development of the Ministry of Health of the Republic of Kazakhstan)
Version: Clinical protocols Ministry of Health of the Republic of Kazakhstan - 2017

Acute sinusitis (J01), Chronic sinusitis (J32)

Otorhinolaryngology, Pediatric Otorhinolaryngology, Pediatrics

general information

Short description

Approved
Joint Commission on Quality medical services
Ministry of Health of the Republic of Kazakhstan
dated November 10, 2017
Protocol No. 32

Sinusitis is an inflammation of the mucous membrane, submucosal layer, and sometimes the periosteum and bone walls of the paranasal sinuses.
N.B.! This is one of the most frequent illnesses that doctors deal with general practice and otolaryngologists. According to the duration of the course, acute sinusitis is distinguished - with a duration of the disease of up to 8 weeks and chronic - with a longer course of the pathological process or with four or more relapses of acute sinusitis per year.
Any of the paranasal sinuses may be involved in the inflammatory process, but most often in adults and children over 7 years of age, the maxillary sinus is affected, then the ethmoid sinus, the frontal sinus, and somewhat less commonly, the sphenoid sinus. The process can develop simultaneously in two or more sinuses of one or both sides: sinusitis, hemisinusitis, pansinusitis or polysinusitis.

INTRODUCTORY PART

ICD-10 code(s):

Classification

According to the course and form of the lesion:

· Acute (catarrhal, purulent, necrotic).
Chronic (catarrhal, purulent, parietal hyperplastic, polypous, fibrous, cystic, mixed forms, complicated - osteomyelitis, cholesteatoma, pyomucocele, spread of the process to the orbital tissue, cranial cavity).
· Vasomotor (allergic, non-allergic).

By etiology:
· rhinogenic;
· odontogenic;
· traumatic.

According to the nature of the pathogen:
· viral;
· bacterial aerobic;
· bacterial anaerobic;
· fungal;
· mixed.

According to the prevalence of the process:
· ethmoiditis (anterior, posterior, total);
· sinusitis;
frontal sinusitis;
· sphenoiditis;
· ethmoid sinusitis;
hemisinusitis (right, left);
pansinusitis.

Diagnostics

DIAGNOSTIC METHODS, APPROACHES AND PROCEDURES

Diagnostic criteria

Complaints:
· violation of nasal breathing;
localized pain depending on the sinus lesion:
- in the infraorbital region (sinusitis);
- superciliary (frontitis);
- occipital (sphenoiditis);
- in the area of ​​the bridge of the nose (ethmoiditis);
· purulent discharge from the nasal cavity;
· nasal congestion;
· swelling of soft tissues in the cheek area, at the root of the nose;
· malaise.

From the anamnesis: We find out the timing and frequency of the disease.

Physical examination:
· Rhinoscopy: hyperemia, swelling of the mucous membrane, purulent discharge from under the middle turbinate, purulent discharge in the posterior parts of the nose, discharge with a fetid odor.
Palpation of the projection of the paranasal sinuses:
- Frontal;
- Lattice;
- Maxillary sinuses.
N.B.! When pressing with the thumbs of both hands on the points of the first and second branches trigeminal nerve their soreness is checked, which should not normally be present. The anterior walls in the area of ​​the canine fossa are palpated using gentle pressure. Signs of involvement pathological process The ethmoid labyrinth and frontal sinuses may cause pain on palpation in the area of ​​the inner surface of the medial and upper orbits.
Percussion in the projection of the paranasal sinuses: with the middle finger bent at a right angle, percussion is carried out on the anterior walls of the paranasal sinuses.

Laboratory research:
· general analysis blood: leukocytosis, increased ESR;
· study of microflora: identification of the pathogen;
· cytological examination: neutrophyllosis, desquamated epithelial cells, mucus.

Instrumental studies:
· Endoscopy of the nose and paranasal sinuses: using a flexible endoscope, a rigid endoscope 0, 30 and 45 degrees. with a diameter of 4 mm, using a rigid endoscope 0, 30 and 45 degrees. with a diameter of 2.8 mm in children. To identify features anatomical structure
· X-ray examination of the paranasal sinuses (nasomental, nasofrontal, lateral projections): decreased pneumatization of the paranasal sinuses, sometimes it is possible to determine the horizontal level of fluid in the sinus (if the shooting was done in a sitting position).
· Contrast radiography: performed to clarify the form of the chronic process in the sinuses.
· Fluorography of PPN: changes in the mucosa, presence of exudate.
· Puncture of the maxillary sinus: presence of purulent contents.

Indications for consultation with specialists:
· consultation with an ophthalmologist - if intraorbital complications are suspected;
· consultation with a neurologist, neurosurgeon - for intracranial complications;
· consultation with a dentist, maxillofacial surgeon - in the presence of dental damage (sinusitis of odontogenic origin).

Diagnostic algorithm:

Differential diagnosis

Differential diagnosis and rationale for additional studies:

Treatment abroad

Get treatment in Korea, Israel, Germany, USA

Get advice on medical tourism

Treatment

Drugs (active ingredients) used in treatment

Treatment (outpatient clinic)

TREATMENT TACTICS AT THE OUTPATIENT STAGE: for mild cases of the disease and for moderate sinusitis, the patient is treated on an outpatient basis under the supervision of an otolaryngologist. The basis therapeutic measures consists of systemic or local antibacterial therapy.

Treatment regimen for sinusitis on an outpatient basis:

Non-drug treatment:
· Mode - general;
· Diet No. 15.

Drug treatment: For sinusitis of a bacterial nature, antibacterial drugs are used; to free the sinus from pus, it is opened. For viral sinusitis, antibiotic therapy is not indicated, since antibiotics in this case are ineffective and can aggravate the disorder of the immune status, disrupt the normal composition of the microflora of the upper respiratory tract and cause the process to become chronic. Also, patients with acute sinusitis are prescribed antihistamines and absorbable drugs to prevent the formation of adhesions in the inflamed sinuses. Antiallergic therapy is indicated for patients with sinusitis of allergic etiology.

Treatment (inpatient)

TREATMENT TACTICS AT THE INPATIENT LEVEL: for severe sinusitis, and in some cases for moderate disease, hospitalization of the patient in the otolaryngology department is indicated. Treatment tactics include a complex of general and local medications and physiotherapeutic prescriptions.

Patient observation chart, patient routing (schemes, algorithms):

Non-drug treatment:
· Mode - general;
· Diet No. 15.

Drug treatment: the main task of the ongoing drug therapy- eradication of the pathogen and restoration of the biocenosis of the paranasal sinuses. When choosing an antibiotic for the treatment of sinusitis, the severity of the patient's condition is taken into account.

List of essential medicines(having a 100% probability of application):

Hospitalization

INDICATIONS FOR HOSPITALIZATION, INDICATING THE TYPE OF HOSPITALIZATION

Indications for planned hospitalization:
· hospitalization in the otorhinolaryngology department for sanitation and reconstruction of the nasal cavity and PPN.

Indications for emergency hospitalization:
· presence of a purulent-inflammatory process in the nasal cavity and PPN not stopped with outpatient treatment;
· presence of signs of intracranial rhinogenic complications;
· pronounced symptoms of intoxication with a tendency to worsen general condition sick.

Information

Sources and literature

1. Minutes of meetings of the Joint Commission on the Quality of Medical Services of the Ministry of Health of the Republic of Kazakhstan, 2017
   1. 1) Itzhak Brook, Kaparaboyana Ashok Kumar, Maggie Kramper, Richard R. Orlandi Clinical Practice Guideline: Adult. Society of Otorhinolaryngology, oct.2014 2) Bezrukov V.M., Brusova L.A. Guide to dental surgery and maxillofacial surgery. M., 2005. -366 p. 3) Bogomilsky M.R., Chistyakova V.R. Pediatric otorhinolaryngology. Textbook for universities. M.: Geotar-Med. -2002.S. 259-268. 4) Kryukov A.I., Ivoilov A.Yu., Turovsky A.B., Khamzalieva R.B., Tovmasyan A.S. Conservative therapy and surgery chronic tonsillitis in children. Bulletin of Otorhinolaryngology, No. 4, 2013. P.15-21. 5) Ovchinnikov Yu.M., Gamov V.P. Diseases of the nose, pharynx, larynx and ear. - M., 2005, -328 p. 6) Palchun V.T. Classification and treatment tactics for chronic tonsillitis. Bulletin of Otorhinolaryngology, No. 3, 2013. P.8-11. 7) Soldatov I.B. Guide to otorhinolaryngology. – M.: Medicine/608с. 8) Beahm E.K., Walton R.L. Auricular reconstruction for microtia: Part I. Anatomy, embryology and clinical evolution // Plast. Reconstr. Surg.-2002.-Vol.109, No. 7.-P.2473-2484. 9) Likith V. Reddy, Zide F. M. Reconstruction of skin cancer defects of the auricle // J. Oral Maxillofac. Surg. 2004. - Vol.62, N12. - P.1457-1471. 10) NachlasN. Otoplasty // Plastic and reconstructive facial surgery Ed. A. D. Peipla. M.: BINOM Laboratory of Knowledge, 2007. -R.340-352. 11) Bonding P., Ectopic adenoid tissue in the choanae // J. Laryngol. Otol.-2001/Vol.115, No. 3. R.198-201.

Information

ORGANIZATIONAL ASPECTS OF THE PROTOCOL

List of clinical protocol developers:
1) Azhenov Talapbek Muratovich - Doctor of Medical Sciences, head of the surgical department No. 1 of the Republican State Enterprise at the PVC "Hospital" medical center Administration of the President of the Republic of Kazakhstan."
2) Baimenov Amanzhol Zhumagaleevich - Candidate of Medical Sciences, Associate Professor of the Department of Otorhinolaryngology of Astana Medical University JSC.
3) Bekpanov Almat Zhaksylykovich - Candidate of Medical Sciences, pediatric otorhinolaryngologist of the Branch of the KF "UMC" National Scientific Center for Maternity and Childhood.
4) Smagulova Gaziza Azhmagievna - Candidate of Medical Sciences, Head of the Department of Propaedeutics of Internal Diseases and Clinical Pharmacology of the RSE at the West Kazakhstan State University medical University named after M.O. Ospanova."

Disclosure of no conflict of interest: No.

Reviewer:
Ismagulova Elnara Kireevna - Doctor of Medical Sciences, Professor, Head of the Course of Otorhinolaryngology, Department of Surgical Diseases No. 1, RSE at the West Kazakhstan State Medical University named after M.O. Ospanova."

Indication of the conditions for reviewing the protocol: review of the protocol 5 years after its publication and from the date of its entry into force or if new methods with a level of evidence are available.

Attached files

Attention!

• By self-medicating, you can cause irreparable harm to your health.
• The information posted on the MedElement website and in the mobile applications "MedElement", "Lekar Pro", "Dariger Pro", "Diseases: Therapist's Guide" cannot and should not replace a face-to-face consultation with a doctor. Be sure to contact medical institutions if you have any diseases or symptoms that bother you.
• The choice of medications and their dosage must be discussed with a specialist. Only a doctor can prescribe the right medicine and its dosage, taking into account the disease and condition of the patient’s body.
• MedElement website and mobile applications"MedElement", "Lekar Pro", "Dariger Pro", "Diseases: Therapist's Directory" are solely information and reference resources. The information posted on this site should not be used to unauthorizedly change doctor's orders.
• The editors of MedElement are not responsible for any personal injury or property damage resulting from the use of this site.