Sphenoid sinus inflammation

definition

Since the sphenoid sinuses are two communicating, air-filled cavities in the cranial sphenoid bone and are lined with nasal mucosal skin, they include the sinuses, as well as the sinuses and ethmoidal sinuses. Like all paranasal sinuses, they serve to reduce the weight of the cranial bone system and as a resonance chamber in vocal or phonetic formation. Only the ethmoidal cells are already created at birth, all other paranasal sinuses develop only with advancing childhood: the sphenoid sinuses are at second development site and form - after the frontal sinuses and in front of the maxillary sinuses - around the 3rd-6. Age out.

The sphenoid sinuses are anatomically linked to the superior turbinate and have close proximity to the pituitary gland (located just above the sphenoid sinus, allowing access through the sinus system during surgery). Cerebellar sinusitis is therefore one of the viruses or bacteria-induced sinusitis (sinusitis), the infestation of the sphenoid sinuses is rather rare (most commonly the maxillary sinus (sinusitis maxillires) and the ethmoidal cells (ethmoid sinusitis) ( see also: inflammation of the ethmoidal cells) infested It can be acute or chronic for a long time.

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reason

The causes of the development of a sphenoid sinus inflammation coincide with those of all other sinus infections: in most cases it is a secondary infection of the sinus mucosa by viruses or more rarely bacteria, which differs from an already existing respiratory diseases (nose / throat infections such as a cold ) spread over the nasal passages in the Nebenhölensystem. The causative agents are usually transmitted by a droplet infection. In 70-80% of cases, these are cold viruses such as rhinoviruses or adenoviruses. A single infection by bacteria is rather rare, usually it is a kind of "additional infection", as the attacked by the viral infection and swollen sinus mucosa forms an optimal breeding ground for bacteria (eg for Hemophilus influenza or Streptococcus pneumoniae).

Rarely, an inflammation of the paranasal sinuses may also occur alone, without preceding respiratory disease as a primary infection, with diseased tooth roots (dentogenic sinusitis), pathogens in bathing water (Badesinusitis) or extreme pressure fluctuations during diving or flying (barosinusitis) are considered as causes. But also in the context of allergies, a paranasal sinus involvement may well occur.

Various anatomical features may favor the development of sinusitis (sphenoid inflammation) and are therefore considered as risk factors. On the one hand, a crooked nasal septum (congenital or acquired) and, on the other hand, so-called nasal mucous polyps can hinder the removal of the mucus formed in the sinuses via the nasal passages into the nasal cavity. This leads to an accumulation of mucus in the sinus system, which narrows them and less well ventilated. All together, it promotes the colonization, survival and proliferation of viruses and bacteria and can lead to the development of initially acute, but later also chronic sinusitis if the risk factors are not eliminated.

symptoms

Headaches are usually characterized by an acute, sore, pulsating or stinging sensation of pressure, whereby the exact location of the discomfort depends on the particular affected sinuses. So if the sphenoid sinuses are inflamed, the feeling of pressure or the headache is more likely to be found in the area of ​​the back of the head (headache), but it can also be a diffuse, not exactly localizing headache. In addition, it can often lead to an exacerbation of head complaints as soon as the upper body is tilted forward and the head is guided downwards. Often there is a simultaneous cold (rhinitis) before and a nasal obstruction, a limited sense of smell and taste, an altered nasal language and increased secretory discharge from the nose and throat, the secretion at the beginning usually watery, later viscous and in a bacterial infection may even purulent yellow-greenish discolored.

In addition, fever, body aches, fatigue and coughing can also be caused by the general infection, with the latter leading to irritation by phlegm occurring preferably at night, along the pharynx and the respiratory tract. If chronic sphenoid sinusitis is present, the headache tends to appear with an intermittent and lower intensity (sometimes stronger, sometimes weaker), physical performance is limited, and sufferers often suffer from a chronic fatigue syndrome. The symptoms of acute sinusitis (the sphenoid sinus) usually clear after a short time (on average after 2 weeks), but at the latest it should be over after 8-12 weeks. If this is not the case and the symptoms are still present after 2-3 months, it is called a chronic sinusitis.

diagnosis

The diagnosis of sphenoid sinus or paranasal sinus inflammation is usually already close, if the person concerned reports the characteristic symptoms / symptoms (headache, runny nose, olfactory / taste disorders, clogged, runny nose). To further consolidate the diagnosis, an endoscopic examination may be performed by a physician in which an endoscope inserted through the nostrils or mouth visually displays the sinuses. Thus, it can be precisely determined which sinus / s is / are affected and if there are any anatomical peculiarities that could represent a possible cause. In addition, a removal of sinus secretions during endoscopy is possible, so that - if necessary - sent to a laboratory and the causative agent be determined microbiologically. Knowing the exact pathogen allows a very specific therapy, since it can then be optimally adjusted to the germ.

If the diagnosis by the anamnesis and endoscopy proves difficult or the resulting findings are not clear, further imaging techniques can be used: CT (computed tomography) is the best method of choice, as the resulting cross-sectional images are one possible Secretion, inflammatory reactions, anatomical features and mucosal swelling in the affected sinus can represent. In addition, the preparation of CT images prior to any planned surgical intervention is essential to gain a precise overview of the spatial extent of the inflammation.

therapy

In the treatment of sphenoid sinusitis or sinusitis in general, both conservative and surgical therapies are available. In many cases, the symptoms of acute sinusitis may even resolve on their own after a few days, so that no or only supportive therapy is necessary. On the other hand, chronic sinusitis, which persists for a long time, can often be eliminated by surgery.

If, in the case of acute sinusitis, a viral origin is assumed, a nasal spray (or nose drop) that reduces the size of the mucous membranes is usually first prescribed by the attending physician. Eventually, the decongestant ingredient is also combined with cortisone to simultaneously provide an anti-inflammatory effect. Sea salt-based nasal douches and warm steam baths can also help drain the tight secretion. In support of other expectorant drugs (eg ACC) can be taken, although a healing acceleration here is not entirely uncontroversial. If other symptoms of infection such as fever exist in parallel, antipyretic and anti-inflammatory analgesics (eg ibuprofen, paracetamol) can also be taken.

Since it is usually a virus, the immediate administration of an antibiotic is ineffective. Only in those cases in which there is evidence of a primary bacterial infection or a suspected additional bacterial infection (usually when the secretion is purplish yellow-green discolored), the antibiotic administration is indicated. If the cause of acute or even chronic sinusitis is an allergy, then antiallergic drugs and hyposensitization are a suitable therapy option. If the symptoms can not be alleviated by all these remedies and / or if chronic sinusitis is present, various surgical interventions can still provide relief: on the one hand a sinus puncture can be performed to drain off the accumulated secretion, and on the other hand anatomical features can be eliminated become. These include straightening the nasal septum, removing nasal polyps or reducing the nasal turbinates. The surgical procedures are usually performed under general anesthesia and by means of an endoscope.


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