sinusitis
That type of simple viral sinusitis occurs frequently in children, but it is often difficult to diagnose, diagnosed as nominated or Nechle, what has not evolved to the form of acute bacterial or under acute or chronic.
Before I go into details, it is appropriate to have some idea of the sinuses Sinuses, where there are five pairs of the human sinus key, namely:
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Enclaves of the nose Moazian Paranasal sinuses: two in terms of anatomy and tissue composition Amtdadan the nasal cavity.
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Enclaves Alvkian Maxillary sinuses
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Enclaves Almsvujan Ethmoid sinuses
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Enclaves Aljbhoyan Frontal sinuses: They are not taking shape in children only after two years of age.
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Enclaves Alocdian Sphenoid sinuses: not taking shape only after the age of five.
The movement of cilia Ciliae in cavities that line these pockets, and paid and mucus secretions formed in those enclaves consistently abroad through the nose, play a most important role in the prevention of inflammation of the sinuses, and every reason hindering the movement of these cilia, or leading to accumulation and retention of secretions displays within the enclaves of inflammation, such as:
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Exposure to cigarette smoke. Inhalation of cold air and dry. Exposure to viral Nechle.
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Allergic rhinitis. Swimming and water enters the nose and ultimately into the pockets.
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Gastric regurgitation into the esophagus and nose. Diabetes Almosklp fibrosis. HIV.
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Congenital defect in the mobility of cilia Ciliary dyskinesia. Stuffy nose for any reason, such as: foreign object F. B, Boulib Polyp, the magnitude of redundancies Adenoid hypertrophy, tumor Tumor, trauma Trauma, or serious delinquency in Hijab nasal Septal deviation
Thus, any obstruction to the movement of mucus and secretions and stagnation within the sinuses, forming a fertile ground for the growth of bacteria and thus inflammation of the sinuses.
The most important bacteria responsible for inflammation of the sinuses is
1.
Pneumococcus
2.
H. influenza
3.
Streptococcus
4.
Staphylococcus
The clinical picture Clinical manifestation
You should know that the symptoms of sinusitis in children differ from those in adults, the model These symptoms suffered by adults (such as headaches, facial pain, with tenderness upon pressure, and edema of the face, etc. ..) are not seen in children, but is (cough, and runny nose) of the most important symptoms in young children.
Cough: occurs during daylight hours, but increased when the child lying on his back, both in the nap in the afternoon or night hours of sleep.
And runny nose: It may be Raiqa or Qyahya. You may also see ulceration of the throat Sore throat as a result of rebound nasal secretions to the throat during sleep. Another sign that we see on the child: sneezing and snoring Sniff Snort, a physiological means to clean the nose.
The older children: they may suffer from heat, with a sense of pain or pressure or semi-reluctantly in the facial area, with foul breath odor, and decrease the sense of sniff out.
How to differentiate between regular Alnclp simple and sinusitis.!?
Then, how to differentiate between the different cases of sinusitis.!?
Alnclp: a simple viral disease, affects the upper respiratory tract, associated with the heat and ran my nose and cough, but it does not last for more than a week to ten days, all symptoms of this kind more than ten days is inflammation of pockets and not Nechle, and degrees: a viral inflammation of the pockets of a simple, As mentioned above, and acute bacterial But Bacterial: and symptoms of high fever, may exceed 39 degrees C, with a purulent Dhaiat, with severe headache, and sometimes swelling or swollen eyes.
If symptoms persist - even if simple, runny nose with a cough - for more than a month, then are called sub acute sinusitis or chronic Sub acute Or Chronic.
Clinical examination: nasal mucosa find a red and congested, and here must be Nfrgah on the status of allergic rhinitis Allergic rhinitis is characterized by the fact that the nose with Mkrotha pale and spongy form (Pale and boggy). You may also see clinical examination Aldhaiat nasal She is a graduate of the outside or bounce back to the throat, causing blistering .. It is an important sign indicating the doctor clinical examination, the sign of tenderness Tenderness resulting from the slightest pressure over sinuses inflamed.
Complications of sinusitis
Ranging from inflammation of the middle ear O. M to inflammation of the soft tissue around the eye socket Peri orbital cellulitis eye socket to the outlying areas Orbital abscess, inflammation of the optic nerve Optic neuritis. That the most important complications are inflammation of the brain and its accessories, including meningitis Meningitis is relatively rare praise God
Screening requirements
1.
Rays of the sinuses, or CT it: where we find one or more of the following X-ray data:
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Thickness of the buccal pockets Mucosal thickening
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Sprinkle water Air - fluid level
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Intensity and bleaching inflamed sinuses Sinus opacification
2.
Analysis Aldhaiat nasal smear microscopy: You may find the
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Exudate cells Pus celles, the legacy of dead white blood cells.
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The remnants of dead cells, mucous Cellular debris
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If, however, found microscopic examination of large amounts of eosinophils Alhamziat situation closer to the shape allergic Allergic rhinitis
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Planting Aldhaiat nasal does not correspond with the laying of the sinuses, and therefore is not useful, and we are having.
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The examination is the most important plant inflamed sinus mucosa by direct entry Penidl sterile through the face, the only way that we have the type of bacteria, the type of antibiotic is appropriate for it, but we do not resort to this method is usually only in cases of dangerous life-threatening, or cases HIV, or disease that did not respond to standard treatment.
Treatment
Treatments should be effective for this disease to avoid complications above that may be dangerous and life-threatening, is achieved by three conditions:
1.
Good selection of antibiotic, which covers the microbial causes of this disease, and the beginning Bomukcecilin Amoxicillin is a good start, and often choose Alomuksi board (Omuksi Clough), may add him and one of the second or third generation cephalosporins for the 2nd and 3rd generation of cephalosporin
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Goad dose dose of good
3.
Length of time sufficient: they must continue the treatment period from 14 to 21 days, or for a week after the disappearance of the symptoms completely.
What about decongestants and antihistamines deconjestant Anti histamines.!?
May cause some improvement in clinical symptoms, but does not accelerate the healing, but may have the opposite effect than the thickness of nasal secretions, and thereby inhibit movement and cause Anhbasha, and the worsening condition.
Best of all Normal Saline drops for the nose, repeat several times before feeding and before sleep, they are useful, helping to soften Aldhaiat and easy disposal
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