Polypoid sinusitis: treatment, causes and symptoms
Polypoid sinusitis is an inflammatory process that occurs in one or more paranasal sinuses and contributes to the appearance and growth of polyps.
Polyps in the nose are quite common. According to various sources, up to 4% of all people on earth suffer from this pathology. Men are more susceptible to the disease than women. Often polypous growths in the nose are diagnosed with recurrence of chronic sinusitis.
The nasal polyp is an abnormal epithelium located on the stroma. Polyps do not have nerve endings; they may contain a small amount of glands and blood vessels.
Content:
- Causes of polyposis sinusitis
- Symptoms of polyposis sinusitis
- Treatment of polyposis sinusitis
Causes of polyposis sinusitis
The causes of polyposis sinusitis are diverse, otolaryngologists identify the following factors that influence the development of the disease:
- Polypoid sinusitis, which occurs due to disturbances in air microcirculation in the nasal passages against the background of structural features of the nasal cavity (congenital and acquired). If the nasal septum is curved, then the mucous membrane of the nose and sinuses becomes irritated as a result of the constant improper effect of the air stream on it, which occurs during inhalation. It is known that in just a day a person inhales at least 20,000 times, which, with certain anatomical anomalies, leads to edema, impaired drainage and aeration, and then to the formation of polyps;
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Polypoid sinusitis with bacterial or mycotic inflammation of the sinuses. In this case, the cause of the formation of polyps is prolonged irritation of the nasal mucosa with purulent discharge from the sinuses. Bacterial sinusitis is most often provoked by streptococci and staphylococci, hemophilic and Pseudomonas aeruginosa, as well as moraxella. Fungal sinusitis is less common than bacterial sinusitis, but can also provoke the growth of polyps;
- Polypoid sinusitis included in the aspirin triad in combination with aspirin intolerance and existing bronchial asthma. In this case, polyposis sinusitis occurs against the background of a disease of the whole organism as a whole, which is associated with the pathological production of arachidonic acid and allergic reactions.
Modern otolaryngology classifies polyposis sinusitis as polyetiologic diseases that require a selective approach to treatment.
Symptoms of polyposis sinusitis
Symptoms of polyposis sinusitis cannot go unnoticed by a person, since they are inextricably linked with impaired respiratory function.
The clinical picture of the disease is characterized by the following symptoms:
- Nasal congestion and shortness of breath;
- Violation of the olfactory function, up to its complete loss;
- Feeling of discomfort in the nasal passages, it is possible that there is a feeling that a foreign object is constantly in the nose;
- If polyposis sinusitis occurs against the background of a purulent process in the nasal sinuses, then a liquid mucous content of yellow or green with an unpleasant odor is separated from the nose;
- In the area of the inflamed sinus, painful sensations arise that can radiate to various parts of the head and ears;
- Possibly a feeling of ear congestion;
- A person's sleep is disturbed, which provokes the development of chronic fatigue. In general, the body experiences a lack of oxygen, which negatively affects the functioning of all organs;
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If the disease is acute, then the body temperature can rise to high values. In the chronic course of polyposis sinusitis, body temperature can remain normal or reach subfebrile levels.
Treatment of polyposis sinusitis
Treatment of polyposis sinusitis will directly depend on what caused the development of the disease. However, in addition to medical correction, surgical intervention is always required, since an already formed formation in the nasal cavity cannot be eliminated on its own.
- Treatment of polyposis sinusitis with anatomical disorders of the nasal septum. If polyposis sinusitis develops as a result of the curvature of the nasal septum, then surgical intervention is required, which is reduced to performing septoplasty or submucosal cryostomy. Polypectomy is performed in parallel. As a rule, prophylactic drug treatment is not required for this group of patients.
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Treatment of polyposis sinusitis of a bacterial or fungal nature. If polyposis sinusitis develops against the background of a bacterial infection, then antibiotic therapy is necessary. Most often, drugs from the group of penicillins (Amoxiclav) and respiratory fluoroquinolones (Moxifloxacin, Levofloxacin) are used for this purpose. Topical corticosteroids in combination with antibiotics can improve the course of the disease and accelerate recovery. This allows you to normalize the drainage of the anastomoses, quickly relieve swelling, and reduce inflammation.
The basic antimycotics for the treatment of polyposis sinusitis against the background of a fungal infection are Fluconazole and Amphotericin B.
With regard to surgical intervention, endoscopic surgery using a shaver is indicated to remove polyps. If the mucous membrane of the nasal sinuses has undergone irreversible changes, then endonasal intervention with the opening of the ethmoid labyrinth cells and complete resection of the mucous membrane is necessary.
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Treatment of polyposis sinusitis of an allergic nature. If polyposis sinusitis develops against the background of the aspirin triad, it is necessary to wait until the period of exacerbation of bronchial asthma and an attack of hay fever disappears. Mometasone or Fluticasone is injected into the patient's nasal cavity 2 weeks or a month before the proposed operation. 3 days before the operation, Dexamethasone or Prednisolone is prescribed intravenously. The same drugs are administered after surgery. The operation itself involves a polypetmoidotomy, in which the ethmoid labyrinth is completely opened.
In general, the prognosis for recovery is favorable with adequate therapy aimed at eliminating the cause of the development of polyposis sinusitis. Although no otolaryngologist can give 100% guarantees of recurrence of the disease.
The author of the article: Lazarev Oleg Vladimirovich | ENT
Education: In 2009, he received a diploma in the specialty "General Medicine" at the Petrozavodsk State University. After completing an internship at the Murmansk Regional Clinical Hospital, he received a diploma in Otorhinolaryngology (2010)
