Sphenoiditis is an inflammation of the sphenoid sinuses, which are one of four pairs of paranasal sinuses. Isolated sphenoiditis is extremely rare (1-2% of all cases of acute and chronic sinusitis). Most often sphenoiditis occurs as a result of inflammation in the adjacent ethmoid sinuses, which is called "ethmoiditis".
Sphenoiditis is the most dangerous inflammation of the sinuses, when compared with the effects of inflammation of the other sinuses. The sphenoid sinuses are located at the base of the skull, and the purulent inflammation of these sinuses progresses extremely rapidly and causes severe complications.
Predisposing factors for IS include nasal power when swimming and snorkeling, allergic rhinitis, synonasal polyps, bronchial asthma, septum deviation, moderate / superior anomalous shells, radiation therapy, immunosuppression, diabetes, and cocaine abuse.
- Acute and chronic inflammatory diseases of the nose and throat -
these include: acute and chronic rhinitis of a bacterial, viral or allergic nature, nasal septum deviation, chronic nasal congestion, polyps and tumors in the nasal passages, adenoids.
Inflammation of nearby formations can also lead to sphenoiditis:
→ ethmoiditis (inflammation of the ethmoid sinuses),
→ sinusitis (inflammation of the sinuses of the nose),
→ frontal sinusitis (inflammation of the frontal sinuses),
- Swimming -
water in the nose during swimming and snorkeling in some cases can also lead to the development of sphenoiditis. According to statistics, this reason accounts for about 10% of all cases of sphenoiditis (24stoma.ru)Advertising
Sphenoiditis has practically no “original” symptoms, so the diagnosis of this disease is rather complicated. Most often, patients may experience the following symptoms -
- headaches (especially in the back of the head, crown, temples, near the eyes),
- runny nose
- blurred vision (possible)
- fever, severe weakness, fatigue,
- pains in different parts of the face,
- mucopurulent nasal discharge,
- runoff of mucus and pus on the back of the throat.
How is sphenoiditis diagnosed?
Undoubtedly, patient complaints (symptoms) are important in making a correct diagnosis, however, a definitive diagnosis of sphenoiditis is possible only by relying on additional methods of examination.
Additional methods include, for example, nasal endoscopy. However, nasal endoscopy alone is also not enough, since in about 50-60% of cases, endoscopy does not reveal anything pathological. Conventional radiography of the skull is not very informative and, as a rule, useless.
The only methods that can most likely determine sphenoiditis are computed tomography (CT) or magnetic resonance imaging (MRI) -
Acute and chronic sphenoiditis treatment is carried out at the ENT doctor. If symptoms are mild and there are no signs of complications, then conservative therapy is performed. If the inflammation is severe and there are symptoms of complications, or conservative therapy does not bring success - the role of the surgical operation is decided.
The main directions of conservative therapy: firstly, to remove nasal congestion, eliminate swelling of the nasal mucosa and improve the discharge of inflammatory exudate from the sphenoid sinuses with the help of sprays from the common cold, secondly, antibiotic therapy (it is also possible to use corticosteroids).
Recommended Cold Sprays -
ordinary vasoconstrictor drops from a cold in any sinusitis can not be used for more than 2 or 3 days. The reason for this is that the traditional components of the spray in 2-3 days cease to act effectively, they develop addiction, and they gradually begin to have opposite effects.
When sphenicitis optimal use of the following remedies for a cold:
- Spray "Rinofluimucil" (Italy, price from 250 rubles) -
the active components of the spray reduce the release of pus and mucus, improve their discharge, and also reduce nasal congestion by reducing swelling of the nasal mucosa. Rinofluimucil also goes well with the preparations "Sinuforte" and "Sinupret", which accelerate the cleansing of the sinuses from pus and mucus.
- Spray "Nasonex" (Belgium, from 500 rubles) -
contains a low dosage of glucocorticoids, which allows you to well remove the swelling of the nasal mucosa and nasal congestion. This spray is one of the few that can be applied in courses of 2-3 months, which is especially important if long-term treatment is required, and especially if allergic rhinitis is the cause of inflammation. Nasonex also goes well with the drugs described below.
Drugs accelerating the clearance of sinuses from pus and mucus -
The herbal components of these drugs stimulate the function of the ciliated epithelium on the mucous membrane surface, which leads to a more rapid cleansing of the sinuses (which are lined from the inside by the mucous membrane and communicated through small holes in the nasal cavity) from the mucus and pus.
- Dragee or drops "Sinupret" (Germany) -
active ingredients of plant origin have anti-inflammatory effects, as well as facilitate the evacuation of pus and mucus from the sinuses. The drug is manufactured by the famous European pharmaceutical company "Bionorica". The price is about 350 rubles.
- Drops for nose "Sinuforte" (Spain) -
The drug is produced on the basis of an extract of one of the medicinal plants. Promotes cleansing of the sinuses, like the previous preparation. The cost will be from 2300 rubles.
Antibiotics for sphenoiditis -
Depending on the severity of inflammation, antibiotics can be administered orally or intravenously. Amoxicillin in combination with clavulanic acid is considered to be the best choice of antibiotic for sphenoiditis. Drugs containing this combination, for example: "Amoxiclav" or "Augumentin".
If the penicillin group antibiotics are intolerant or when the effect is insufficient, macrolide antibiotics (for example, Azithromycin "or" Clarithromycin "), as well as groups of fluoroquinolones (for example," Ciprofloxacin ") may be prescribed.
Surgical treatment of sphenoiditis -
If conservative therapy has proved ineffective, or at the time of patient's treatment, there are already symptoms of severe purulent complications, an urgent surgical operation is performed using an endoscope and micro-surgical instruments (with access through the nasal passages). We hope that our article on the topic: Phenoid symptoms and treatment - was useful to you!
Author: dental surgeon Kamensky KV, 19 years experience.