frontal sinusitisThe frontal sinusinusis was a type of sinusitis. It referred to the inflammation that occurred in the frontal sinuses.
** 1. Cause of illness **
1. infection factors
- The acute inflammation infection could invade the frontal nasal membrane, causing the frontal nasal membrane to be congested and oozing with edema. For example, an upper respiratory tract infection such as a cold could cause frontal sinuosis, and a bacteria or virus infection could affect the frontal sinuously.
2. Nasal cavity related factors
- Rhinoceros, nasal deviation, turbinate hypertrophied, thickened mucus membrane, nasal cavity tumors and foreign bodies may be related to chronic suppurative frontal sinusis. In addition, the blockage of the nasal cavity would hinder the discharge of frontal secretions. For example, when the frontal cavity was stimulated by inflammation, the discharge of frontal secretions would not be smooth, resulting in increased pressure in the frontal cavity, which would lead to inflammation.
3. Near Sinus Infected
- The chronic frontal sinuosity is often secondary to acute frontal sinuosity or an infection of the adjacent sinuses, especially the ethmoidal sinuses.
** 2. Condition **
1. local symptom
- Headaches were a common symptom. The pain was usually located in the forehead, and sometimes it radiated to the eye sockets and the top of the head. The symptoms of chronic frontal sinuosity are usually swelling pain or dull pain in the forehead, which may be accompanied by supraorbital nerve pain.
- The nasal obstruction was obvious, and it was usually heavier in the morning because of the increase in nasal secretions.
- Rhinus, nasal mucus is purulent or sticky purulence, more in the morning, and head position drainage.
- If the patient has chronic frontal sinuicitis accompanied by frontal bone marrow inflammation, a fistulous tract in the front of the frontal sinuses can be formed. Some patients would also have pain in the brow area, especially when patients with acute frontal sinuicitis had a headache.
2. constitutional symptoms
- In patients with chronic suppurative frontal sinuicitis, there may be symptoms such as loss of appetite, fever, fear of cold, etc., but chronic frontal sinuicitis generally does not have obvious general symptoms; if acute suppurative frontal sinuicitis is not handled properly, the mucus membrane is prone to serious damage, which can turn into chronic inflammation.
** 3. Diagnose **
1. History and symptoms
- Knowing the patient's headache characteristics, whether he had a recent cold or a history of nasal cavity diseases, and other conditions, such as the characteristics of the forehead pain, would be helpful in the diagnosis.
2. local examination
- Anteronasal examination may reveal nasal mucus congestion, pus and nasal discharge in the upper part of the middle nasal meatus.
3. imageological examination
- Sinus X-rays, especially CT scans, showed increased density of the frontal sinuses or thickened shadows of the mucus membrane, which was helpful for the diagnosis.
** 4. Treatment **
1. conservative treatment
- General medication: In the case of acute symptoms or suppurative complications, the patient should be given general antibiotics, or supplemented with Chinese patent medicine.
- Topical Steroids: Contraction of swollen mucus membranes, anti-inflammation and anti-edema, which is beneficial for nasal cavity ventilation and drainage.
- Decongestant: It should be used for 7 - 10 days.
- [Slime Discretion Booster: Dilute mucus and promote its discharge, and is conducive to the recovery of mucus and cilia clearance function.]
- frontal sinuidal irrigation: repeated puncture and irrigation (1 - 2 times per week). At the same time, antibiotics, hormones, and other drugs can also be injected into the sinuidal cavity for combined treatment.
- Negative pressure replacement method: Negative pressure suction method is used to change the pressure in the nasal cavity and parantrum to allow the liquid to enter.
- General physical therapy, such as ultrasonic fogging, diaphoretic therapy, medium, short, or ultra-short wave therapy, could also be used to illuminate the nasal cavity with a defocused chloride-neon laser.
2. operative treatment
- For chronic frontal sinuicitis, nasal arthroscopic surgery was the first choice. Opening the frontal sinuses through the nose could effectively relieve symptoms and help the inflammation subside. Antibiotic, mucus clearance agent, and nasal steroid spray should be used after surgery.
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Poster-frontal photographyPoster-to-frontal photography had different requirements for different parts. For example, the patient needed to take a posterior-front chest photography. The patient needed to take a posterior-front position with both hands behind his hips and elbows rotated inward. The upper edge of the box was 150px beyond the collarbone, and the lower edge included the 12th vertebra. The central line passed through the 6th vertebra and shot into the film vertically. The standard image should meet the requirements of having the shadow structure of the hilum of the lung distinguishable, the lung markings distinguishable in the collarbone, the lung apex fully displayed, the scapula projected outside the lung field, the sternoclavicular joints on both sides symmetrical, the diaphragm included completely and with sharp edges, and the heart and mediastinal edges clear and sharp. As for the head part in the posterior-frontal position, the patient had to lie prone on the photographic table, with his elbows bent, his hands placed on both sides of his body or beside his head, and his feet slightly raised by placing sandbags under his ankles. The middle of his head faced the midline of the table and was vertical to the table, his forehead and nose were close to the table, and the auditory line was vertical to the table. The upper edge of the box was beyond the head, and the lower line included the mandible, or the nasal root was placed in the center of the box.
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