Sinusitis is an inflammation of the maxillary sinus, which is treated with conservative methods (drug therapy, physiotherapy procedures). A sinus puncture in sinusitis is an operative method of treatment and is used for purulent disease. The procedure is not complex, moderately painful, aimed at evacuating the pathological contents of the maxillary sinus.
- What is a puncture of the nose with genyantritis
- Indications for a puncture of the maxillary sinus
- Who is dangerous for sinus puncture
- Procedure Procedure
- Needle of Kulikovsky
- Is it worth it to make a puncture
- Possible complications of puncture
- Postoperative period
- Puncture of the maxillary sinus in pregnancy
- Alternative to puncture
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What is a puncture of the nose with genyantritis
The operation to remove purulent discharge from the nasal sinuses with subsequent washing is called a puncture (puncture) of the sinus. It is also one of the methods for diagnosing sinusitis. This procedure causes discomfort in the patient, but it is the only possible method of treatment for severe disease.
Indications for a puncture of the maxillary sinus
The sinus puncture is prescribed in such cases:
- ineffectiveness of drug therapy;
- risk of complications;
- low level of immune protection (HIV infection, diabetes mellitus);
- acute infectious processes;
- marked intoxication of the body;
- intensive pain syndrome;
- abundant fetid purulent runny nose, presence of fluid in the sinus on the roentgenogram (purulent maxillary sinusitis);
- carrying out with a diagnostic purpose - the introduction of a contrast medium, to exclude other pathological formations.
The sinus puncture eliminates the main problem of purulent sinusitis - it evacuates the discharge. The basic principle of surgery is pus to let out. The patient's condition is improving rapidly.
Who is dangerous for sinus puncture
This operation is not assigned in such cases:
- children under 1 year;
- To old people;
- weakened and emaciated patients;
- patients with decompensated form of diabetes mellitus;
- patients with anatomical sinus deformities;
- when blood coagulability is violated;
- patients with mental disorders.
In such cases, carrying out this procedure can worsen a patient's condition. Methods of treatment should be selected by others.
The operation is performed in the hospital by an ENT doctor. Before puncture, the nose is washed with a solution of furacilin or physiological saline (NaCl 0.9%). In case of a stuffy nose, vasoconstrictive drops are used - Naphthysine, Nazivin, Otrivin.
Many patients ask a doctor about the pain of the puncture. This procedure causes discomfort. For anesthesia, a local anesthetic (Dikain, Lidocaine) is administered into the nasal cavity. In parallel with the analgesic agent, a solution of epinephrine is injected to remove the mucosal edema and facilitate the outflow of sinus contents. Before this, you must find out the presence of a drug allergy. Adequate anesthesia eliminates pain.
Needle of Kulikovsky
The puncture of the sinuses of the nose is performed with a Kulikovsky needle, which is curved at the end, has a cannula and a special holder. A successful puncture causes the doctor to feel a needle failure, which means getting into the sinus cavity, then it is advanced 5 mm deep.
A syringe joins the needle, the doctor pulls the piston toward him. The extracted material is sent to the bacteriological laboratory for the study of microflora and sensitivity to antibiotics.
Usually the contents of the sinus freely exit through the nasal passage, but sometimes it is too thick mucus and requires dissolution. For this purpose, 100 ml of physiological saline is injected through the syringe, the contents passively enter the tray.
Important! It is necessary to wash the nose after puncture with an antiseptic solution (Furacilin, Chlorhexidine) in the amount of 10 ml or an antibiotic (Cefazolin, Augmentin).
There are cases when pus is so thick that it is necessary to administer proteolytic enzymes (Chymotrypsin, Lydase, Lysozyme). Preparations are available in the form of powders for the preparation of solutions. The resulting fluid is injected into the cavity of the sinus and left in it for 10-15 minutes. After this, the sine is washed with an antibacterial preparation.
How many punctures do you make? Usually, only one procedure is sufficient, and to facilitate the lavage of the sinus, drainage is left in it. For complete recovery, 7-10 sessions are necessary.
Is it worth it to make a puncture
The purulent focus is in the area of the facial skull and is adjacent to the orbit, mouth cavity. Pus can dissolve any tissue of the body, including bone, to spread with blood to the brain.
If you let the disease into its own right, serious consequences are possible, for example:
- meningitis, encephalitis, brain abscess;
- suppuration of the orbit;
- osteomyelitis of the upper jaw;
- the transition of the disease into a chronic form.
Important! A sinus puncture will help to avoid dangerous consequences. Do not be afraid of this procedure.
Possible complications of puncture
Complications develop extremely rarely if the procedure is performed by a qualified physician. These include the following states:
- After the puncture, blood comes from the nose. The degree of bleeding is slight, easily eliminated by a tamponade of the nose.
- The puncture of the upper wall of the sinus and the release of purulent contents into the orbit.
- Infection of infected secretions in the soft tissues of the face and the formation of an abscess.
- Allergic reaction to anesthetic or antimicrobial drug.
Genyantritis after a puncture does not pass independently, antibacterial therapy is required (7-14 days). At first antibiotics of a wide spectrum of action are appointed, and at reception of bacteriological result - according to sensitivity of flora to antibiotics.
The temperature can be maintained after a puncture, the condition is facilitated with the help of antipyretic agents. If the head hurts, use anti-inflammatory drugs. Also, nasal congestion can be maintained, then vasoconstrictive drops are prescribed in the nose. With a strong swelling of the mucosa, drops with glucocorticosteroids (hormonal) can be used.
Many worry the question: does the puncture in the nose grow? Yes, bone tissue is prone to regeneration. The hole is overgrown for several days. It is necessary to wash the nasal passages with Furacilin solution for 3 months. It is required to carry out a control x-ray of the maxillary sinuses in a direct projection.
Also, physiotherapy is prescribed for the site of the projection of the sinuses for the elimination of inflammation. Conducting health measures after the process is subsided (hardening, immunomodulating therapy, intake of vitamins).
Puncture of the maxillary sinus in pregnancy
Conservative drug therapy of sinusitis is dangerous for the development of the fetus, so the operation will be its alternative. This procedure in pregnancy is not contraindicated. Treatment will be local, the fetus does not suffer.
A sinus puncture in sinusitis in children is usually performed under general anesthesia. This operation is prescribed to babies only in especially severe cases, when other methods of treatment can not give a positive result.
Important! Conditions of insurance medicine allow you to conduct an operation for free. If a person is more comfortable receiving medical services in private clinics, the procedure will cost 2000-4000 rubles.
Alternative to puncture
There are non-invasive methods of treating sinusitis:
- The cuckoo method. An antiseptic solution is injected into one nostril, and an electric pump is placed in the other. Used for mild forms of sinusitis.
- Laser therapy, which eliminates inflammation, but the pathological contents of the sinus (pus, mucus) does not excrete.
- Use of the sinus catheter "Yamik", with which the contents of the sinus are first removed, and then solutions are introduced.
If the diagnosis of maxillary sinusitis is established, then treatment should not end with sinus puncture. Genyantritis well succumbs to conservative therapy, but with the development of resistance to antibiotics, a sinus puncture in the near future will regain a leading position.