Odontogenic sinusitis ntawm maxillary sinus yog ib qho kab mob inflammatory txheej txheem uas tshwm sim los ntawm pathologies ntawm cov hauv paus hniav ntawm cov hniav, pob txha cov ntaub so ntswg los yog cov pos hniav ntawm lub puab tsaig sab sauv. Tus kab mob no tuaj yeem tshwm sim thawj zaug hauv cov hluas, thaum cov mis nyuj hloov mus rau molars. Raws li kev txheeb cais, tus kab mob no tshwm sim hauv yim feem pua ntawm cov neeg mob ntawm tag nrho cov kab mob sinusitis.
Vim li cas thiaj tshwm sim?
Lub txheej txheem ntawm kev loj hlob ntawm tus kab mob no tau piav qhia los ntawm qhov sib thooj ntawm qhov ntswg qhov ntswg thiab lub puab tsaig. Cov hauv paus hniav ntawm cov hniav nyob rau hauv lub puab tsaig sab sauv (los ntawm plaub mus rau yim tus hniav) yog nyob ze rau hauv qab ntawm lub paranasal sinuses. Nruab nrab ntawm nws thiab incisors lies ib pob txha phaj. Qee lub sij hawm cov hauv qab no nyias nyias kom cov hniav hauv paus hniav sib cais los ntawm nws.soft tissue xwb.
Tus kab mob no paub dab tsi?
Sinusitis niaj hnub no tau lees paub tias yog kab mob otolaryngological ntau tshaj plaws uas yuav tsum tau kuaj xyuas kom zoo thiab muab kev kho mob tsim nyog. Ib qho ntawm ntau yam ntawm tus kab mob no yog ib qho mob inflammatory txheej txheem uas tshwm sim nyob rau hauv lub maxillary sinuses. Hauv cov tshuaj, tus kab mob no txhais tau tias yog odontogenic sinusitis ntawm maxillary sinus, uas yog ib qho mob uas tau kis mus rau cov mucous daim nyias nyias ntawm lub sinuses.
Tus kab mob txaus ntshai yog dab tsi?
Thaum tsis kho raws sijhawm, tus kab mob tuaj yeem cuam tshuam rau periosteum nrog cov pob txha. Tom qab kuaj pom tus mob odontogenic maxillary sinusitis, kev kho mob yog nqa tawm los ntawm kws kho hniav, kws phais lossis kws kho mob otolaryngologist, nyob ntawm seb tus mob thiab kev noj qab haus huv ntawm tus neeg mob. Qhov no kuj coj mus rau hauv tus account qhov ua rau tus kab mob.
Yam yuav tsum ua ntej rau tus kab mob
Qhov ua rau odontogenic sinusitis yog cov txheej txheem inflammatory uas tshwm sim los ntawm kev tsim tawm ntawm cov kab mob pathological uas tau nkag mus rau hauv maxillary sinus los ntawm qhov ncauj kab noj hniav. Cov kws tshaj lij txheeb xyuas cov xwm txheej hauv qab no uas ua rau muaj qhov pib ntawm tus kab mob no:
- Kev ua rau hauv qab ntawm qhov sinus thaum cov hniav txhaws. Vim yog qhov nkag ntawm cov khoom ntim rau hauv thaj tsam ntawm maxillary sinus, tib neeg feem ntau tsim cov kab mob fungal odontogenic sinusitis ntawm maxillary sinus.
- Kev nkag mus ntawm ntau lub cev txawv teb chaws mus rau thaj tsam ntawm mandibular sinus. Feem ntau qhov no tshwm sim tawm tsam keeb kwm yav dhau ntawm kev kho hniav. Qhov ua rau mob yog, piv txwv li, cov cuab yeej kho hniav tawg lossis turundas, tawg ntawm cov hauv paus hniav ua tsis tiav, thiab lwm yam. Txawm hais tias qhov txhab nkag tsis raug cais tawm, uas tsis tshua muaj ntau.
- Pathology ntawm cov hniav thiab cov pos hniav tuaj yeem ua rau qhov pib ntawm cov kab mob sinusitis. Cov no feem ntau yog xws li pathologies xws li kab mob periodontal, granuloma thiab cyst ntawm cov hniav hauv paus nrog rau subperiosteal abscesses, fistulas thiab apical periodontitis. Txhua qhov purulent foci ntawm cov molars me thiab loj uas nyob ib sab ntawm maxillary sinus tuaj yeem ua rau tus kab mob.
- Kab mob ntawm cov pob txha ntawm lub puab tsaig kuj ua rau mob, xws li osteomyelitis lossis periostitis.
Shapes
Nyob ntawm qhov ua rau ntawm txoj kev loj hlob ntawm pathology, tsis yog-perforative thiab perforated odontogenic sinusitis yog qhov txawv. Nrog rau daim ntawv perforated, muaj kev ua txhaum ncaj qha ntawm kev ncaj ncees ntawm cov hauv qab ntawm cov maxillary sinuses, thiab nrog ib tug tsis-perforative xwm ntawm chav kawm, o tuaj yeem tshwm sim nws tus kheej tawm tsam keeb kwm yav dhau los ntawm cov hniav uas twb muaj lawm, cov pob txha ntawm lub puab tsaig. los yog cov pos hniav.
Raws li qhov tshwm sim ntawm qhov mob, lub aeration kua dej ua haujlwm ntawm maxillary sinuses raug cuam tshuam. Qhov no ua rau stagnation ntawm serous los yog mucous secretion, uas ua hauj lwm raws li ib tug zoo kawg nkaus ib puag ncig rau kev loj hlob ntawm pathogenic kab mob, piv txwv li, rau cov kab mob thiab fungi. Kev sib cuag ntau ntxiv ntawm cov kab mob pathogenic nrog rau cov mucosa ntawm maxillary sinuses kuj tau yooj yim los ntawm kev ua haujlwm tsis zoo.epithelium.
Nyob rau hauv cov xwm txheej uas cov pathology tau mus ntev thiab tsis muaj kev kho mob, qhov ntswg mucosa tau hloov pauv tsis tau, thiab tawm tsam keeb kwm ntawm suppuration muaj cov tsos mob ntawm tus kab mob kis ntawm paranasal sinuses. Tam sim no cia saib seb cov tsos mob twg tuaj yeem ua rau tus kab mob no.
Cov cim qhia ntawm pathology
Cov tsos mob ntawm odontogenic sinusitis nyob ntawm theem ntawm tus kab mob. Cov theem mob hnyav yog tus cwj pwm los ntawm daim duab kho mob hauv qab no:
- Raws kub kom siab, uas yog mus rau peb caug yim lossis peb caug cuaj degrees.
- Qhov tsos mob taub hau nrog rau kev ua tsis taus pa.
- Tshuaj paug tawm ntawm qhov ntswg los ntawm sab o.
- Kev muaj qhov ntswg congestion ua ke nrog tsis hnov tsw tsw.
- Qhov tshwm sim ntawm qhov mob siab ntawm qhov sib txawv ntawm kev siv zog. Muaj peev xwm irradiation ntawm qhov mob nyob rau hauv lub tuam tsev, tom qab ntawm lub taub hau, nyob rau hauv lub puab tsaig sab sauv thiab pob ntseg.
- Cov tsos mob ntawm cov hniav, uas yuav nce ntxiv thaum zom zaub mov.
- Nws yog qhov yuav muaj kev txhim kho ntawm edema ntawm cov ntaub so ntswg ntawm lub plhu, txawm li cas los xij, qhov no tsis yog ib txwm tshwm sim thiab ncaj qha nyob ntawm qhov ua rau ntawm kev loj hlob ntawm o.
- Qee lub sij hawm tej zaum yuav muaj submandibular lymphadenitis nrog nce qhov loj ntawm cov qog nqaij hlav thiab lawv qhov mob.
- Cov tsos mob tshwm sim ntawm periostitis, cysts, osteomyelitis thiab fistula. Lwm cov kab mob hniav uas ua rau cov tsos mob tsis suav nrog.odontogenic sinusitis..
Ntau zaus, ib qho kev mob hauv cov neeg mob tsim los ua tus kab mob tseem ceeb, tab sis nws kuj tuaj yeem tshwm sim tom qab tus neeg mob mob hnyav. Cov neeg mob feem ntau yws ntawm qhov mob taub hau me ntsis thiab qhov kev xav ntawm qhov hnyav ntawm lub puab tsaig. Tej zaum yuav muaj paug tawm ntawm qhov ntswg. Qee zaum cov ntxhiab tsw tsw phem tuaj yeem los ntawm lub qhov ntswg hauv qhov mob odontogenic sinusitis.
Kev poob qis hauv kev ua tau zoo
Cov neeg mob tawm tsam keeb kwm yav dhau los ntawm tus kab mob ntev raug kev txom nyem los ntawm kev txo qis hauv kev ua haujlwm. Qhov no tshwj xeeb tshaj yog pom nyob rau hauv cov neeg koom nrog kev puas siab puas ntsws. Nyob rau hauv cov kev tshwm sim uas ib tug ntau ntau ntawm cov kua paug accumulates nyob rau hauv lub maxillary sinus, mob taub hau yuav nce, thiab nyob rau tib lub sij hawm, tsis xis nyob raws cov hlab ntsha trigeminal. Maj mam, tej zaum yuav muaj kev hloov pauv ntawm lub sijhawm ntev mus rau theem ntawm exacerbation ntawm pathology nrog ntxiv cov kab mob sib kis.
Vim li no, cov tsos mob ntawm odontogenic sinusitis ntawm maxillary sinus yuav tsum tsis txhob ignored.
Diagnostics
Raws li ib feem ntawm kev kuaj mob ntawm tus kab mob no, tus neeg mob tuaj yeem raug xa mus rau cov kev tshawb fawb kho mob hauv qab no:
- Orthopantomogram.
- Ua x-ray ntawm paranasal sinuses.
- Kev siv CT scan.
- Kev tshuaj ntsuam puncture. Raws li ib feem ntawm cov txheej txheem no, purulent los yog mucous exudate raug kuaj.
Kev nqis tes uakev kho mob
Kev kho tus kab mob xws li odontogenic sinusitis (raws li ICD 10 - qhov no yog J32.0 code) raug txo rau ob txoj haujlwm uas yuav tsum tau ua kom sai li sai tau. Nov yog:
- Kev tshem tawm ntawm qhov tseem ceeb ntawm kev kis kab mob (txuag tus neeg mob ntawm cov teeb meem kho hniav).
- Kev tshem tawm ntawm qhov mob hauv qhov maxillary sinus.
Thaum twg ua tau, kws kho hniav siv zog txuag cov hniav, tab sis nws yog ib qho tseem ceeb kom tshem tawm cov kab mob uas twb muaj lawm uas tau tsim nyob rau hauv cov hauv paus hniav, thiab ntxiv rau, cov ntaub so ntswg mos. Nws muaj peev xwm ua tiav kev kho mob hauv tsev kho mob lossis chaw kho mob sab nraud.
Restoring natural sinus ventilation
Kev kho mob ntawm odontogenic maxillary sinusitis yog txo kom rov qab los ntawm lub qhov cua qhov cua. Rau qhov no, tus neeg mob tau pom zoo kom siv cov tshuaj vasoconstrictor tshuaj pleev ib ce, piv txwv li, Galazolin, Nazivin, Naphthyzin, Sanorin, Otilina thiab lwm yam. Cov tshuaj tua kab mob hauv qhov ncauj kuj yuav tau noj. Hauv qhov no, cov tshuaj tua kab mob los ntawm qeb ntawm penicillins, xws li Amoxiclav, ua cov tshuaj. Koj tuaj yeem tig mus rau kev siv cov tshuaj fluoroquinolones, rau qhov no, Levofloxacin haum nrog Moxifloxacin thiab lwm yam tshuaj. Txhawm rau tsim kom muaj qhov siab tshaj plaws ntawm cov tshuaj tua kab mob hauv cov sinuses, cov tshuaj tua kab mob hauv zos tau siv, piv txwv li, Isofra.
Yog tias qhov mob sinusitis nyuaj los ntawm qhov mob taub hau hnyav, thiab ntxiv rau, o ntawm cov nqaij mos ntawm lub ntsej muag lossis mob intracranial, tom qab ntawd nws yuav tsum tau ua tus neeg mob yuav tsum mus pw hauv tsev kho mob. Kev kho tsis tau tiav yog lub hauv paus rau kev cuam tshuam kev phais. Thaum tshem tawm cov causative incisor, muaj qhov ua tau ntawm qhov tsis xav tau qhib ntawm cov sinuses uas nyob ib sab. Hauv qhov no, fistula uas tshwm tuaj yeem kaw ntawm nws tus kheej vim kev kho mob nrog iodine tincture. Nyob rau hauv cov xwm txheej uas nws kho tsis tshwm sim, lub fistula yuav tsum tau kaw nrog cov ntaub so ntswg mos ntawm palate los yog cov pos hniav.
Yuav kom tshem tawm cov kua paug tawm ntawm qhov sinuses, nws yog ib qho tsim nyog los tso lawv. Ua li no, lub sinus yog ntxuav los ntawm txoj kev khiav tawm. Rau kev tua kab mob, cov tshuaj tua kab mob yog siv, piv txwv li, "Furacilin" lossis "Rivanol", "Potassium Permanganate" thiab lwm yam. Ib qho tshuaj tua kab mob thiab cov enzymes proteolytic kuj raug txhaj ncaj qha rau hauv lub qhov ntswg.
mob odontogenic sinusitis kho li cas?
mob ntev kuj kho tau zoo. Qhov kev xav tau ntawm kev phais mob tsuas yog tshwm sim nrog kev tsim ntawm daim ntawv polyposis ntawm tus kab mob, nrog rau cov xwm txheej necrotic ntawm tus kab mob thiab rau kev kho hniav. Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias yog ib feem ntawm kev kho mob, kev ntsuas huab cua yog siv los ntawm cov kws kho mob nkaus xwb nyob rau hauv cov xwm txheej uas mob odontogenic sinusitis pib, thiab tsis yog tus neeg mob txoj kev noj qab haus huv nkaus xwb, tab sis kuj yog nws lub neej muaj kev pheej hmoo. Yog li ntawd, nyob rau hauv thawj manifestation ntawm ib tug los ntswg qhov ntswg, raws li zoo raws li tawm tsam keeb kwm ntawm qhov mob nyob rau hauv lub cheeb tsamlub puab tsaig, choj ntawm lub qhov ntswg los yog qhov ncauj, nws yog qhov zoo tshaj plaws mus cuag tus kws kho mob tam sim ntawd. Kev kuaj mob raws sij hawm nrog rau kev kho mob yuav pab kom tsis txhob muaj qhov tshwm sim loj.
Tam sim no cia saib seb yuav tshwm sim dab tsi yog tias tus kab mob no tsis kho.
Txoj kev tshwm sim ntawm pathology
Nws yog ib qho tseem ceeb kom nco ntsoov tias kev ncua ntawm kev kho tus kab mob no tuaj yeem ua rau muaj kev phom sij rau tus neeg mob. Piv txwv li, cov teeb meem hauv qab no tuaj yeem ua tau:
- Zoo ntawm cov pos hniav abscess.
- Kev tshwm sim ntawm polyps, osteomyelitis thiab kis tus kab mob mus rau lwm qhov sinus.
- Qhov tshwm sim ntawm abscesses thiab phlegmon hauv thaj chaw qhov muag.
- Qhov tshwm sim ntawm sinus cancer lossis meningitis.
- Qhov tshwm sim ntawm kev qaug dab peg ntawm lub cev uas muaj teeb meem xws li lub plawv, lub raum, thiab lwm yam.
Chronic form
Cov chav kawm ntawm kev txiav txim siab pathology yog qhov tshwm sim ntawm qhov mob hnyav ntawm cov kab mob. Nws kuj tshwm sim raws li tus txheej txheem tseem ceeb subacute lossis mob ntev. Cov chav kawm ntawm tus kab mob no tsis muaj perforation yog undulating thiab nyob rau hauv ntau yam zoo ib yam li cov duab kho mob ntawm mob rhinogenic sinusitis. Ib qho exacerbation feem ntau tshwm sim tom qab hypothermia, kab mob otolaryngological, los yog tej zaum yuav tshwm sim nrog ib tug exacerbation ntawm mob periodontitis.
Daim duab kho mob muaj ntau txoj hauv kev zoo ib yam li cov txheej txheem mob. Thaum lub sij hawm tshem tawm, mob sinusitis muaj ib qho kev tshem tawm cov tsos mob: ib ntus, cov neeg mob muaj kev xav.hnyav nyob rau hauv qhov chaw sinus, thiab thaum sawv ntxov tej zaum yuav muaj serous purulent paug. Cov neeg mob kuj yuav muaj kev qaug zog ntxiv nrog rau qhov kub thiab txias me ntsis.
