Disease of the nose and paranasal sinuses. (1991)

In the ENT clinic of diseases, the patient is examined.

There is an inflammatory and non-inflammatory nature of the lesion of the nose and paranasal sinuses.

The examination of the patient begins with an examination of the external nose and the projection of the paranasal sinuses on the surface of the face.

Pay attention to the shape of the nose, symmetry, deformation of its departments, the condition of the skin.

The nature of breathing through the nose is determined by a breakdown with cotton wool.

Determination of odors by probes.

Next, palpate the walls of the frontal sinuses, the slope of the nose, the anterior wall of the maxillary sinuses in the area of the canine fossa, at the same time the outlet of the trigeminal nerve, retromandibular submandibular lymphocollectors.

Perform the first position of anterior rhinoscopy, in which the vestibule of the nasal cavity is examined, where boils occur.

With the help of a nasal dilator, the second position of rhinoscopy is performed.

By changing the position of the patient's head, the anterior parts of the nasal cavity are examined.

Diagram of the anterior sections of the nasal cavity.

With the help of a heated nasopharyngeal mirror and a spatula, a posterior rhinoscopy is performed, which allows to examine the posterior parts of the nasal cavity and nasopharynx.

The figure shows what is visible during such an inspection.

All the results of the examination are recorded in the computer memory.

Information about the condition of the paranasal sinuses is obtained using a scanning technique.

X-rays of the nose and sinuses.

The causes of vasomotor rhinitis are neurovegetative and allergic changes in the nasal mucosa.

Patients complain of difficulty breathing through the nose of a transient nature.

The doctor determines the diagnosis.

Cartoon explaining vasomotor rhinitis.

X-ray of a patient with vasomotor rhinitis.

Vasomotor allergic rhinosinusopathy.

Treatment is reduced to local and general medical events.

The patient is prescribed endonosal electrophoresis with a 2% solution of calcium chloride or lithium solution.

Phonophoresis with hydrocortisone is prescribed.

Treatment is supplemented with a complex of physical exercises, breathing exercises and water procedures that affect vasoconstrictors.

The girl is warming herself in the bath, swimming in the pool.

If the treatment is ineffective, ultrasound disintegration of the lower nasal conchs is performed under local anesthesia.

A cartoon explaining this operation.

With true hypertrophy, the introduction of adrenaline does not lead to a change in the state of the mucous membrane.

During epipharyngoscopy, hypertrophied posterior ends are visible, obstructing the lumen of the hoan.

In this case, a gentle lower conchotomy is shown.

A cartoon explaining such manipulation.

After ARVI, the patient had pain, swelling and redness in the area of the right cheek.

Purulent runny nose.

In such cases, the temperature often rises.

Thermometer.

Anterior rhinoscopy shows a strip of pus coming from the middle nasal passage.

Cartoon explaining the processes taking place in acute and chronic sinusitis.

Overview radiograph.

To clarify the nature of the lesion, a diagnostic puncture of the maxillary sinus is performed.

After anemization and anesthesia of the mucous membrane of the lower and middle nasal passages, the lateral wall of the nasal cavity in the lower nasal passage is pierced with a Kulikovsky needle.

The contents of the sinus are aspirated with a syringe.

Pus was obtained.

The sinus is washed with an antiseptic solution.

Contrast radiograph of the paranasal sinuses.

Indications for surgical intervention.

The purpose of the operation is the rehabilitation of the sinus and the formation of an artificial junction with the nasal cavity.

The technique of performing the operation.

A patient with polypous ethmoiditis.

The scheme of sinus lesions in this diagnosis.

X-rays of the patient.

Removal of polyps with local anesthesia.

A cartoon explaining this operation.

A cartoon explaining the occurrence of polyps.

Inflammation of the frontal sinuses among young people who do not wear hats in the cold.

Acute and chronic frontitis.

Determination of this disease by X-ray.

To clarify the nature of the lesion, trepanopuncture of the frontal sinus is performed.

The technique of performing the operation.

If the frontal-nasal junction is impassable, radical surgery is performed on the frontal sinus.

The purpose of the operation is to sanitize the focus of infection, the formation of a wide frontal-nasal anastomosis.

The technique of performing the operation.

As a prevention of diseases of the nose and paranasal sinuses, hardening and a healthy lifestyle are recommended, do not overcool.

A child is swimming in the pool.

Children are playing on the playground.