Sinekhiya of a nose cavity — the soyedinitelnotkanny, bone or cartilaginous crossing points formed in a nose cavity as a result of congenital malformations, the postponed inflammatory diseases, surgical interventions or injuries of a nose. Clinically sinekhiya of a cavity of a nose are shown by a nose congestion, decrease or lack of sense of smell, education in a nose of crusts. Causing violation of nasal breath, sinekhiya of a cavity of a nose can lead to a number of diseases: to pharyngitis, laryngotracheitis, otitis, bronchitis, pneumonia and so forth. Survey and a rinoskopiya allows to diagnose sinekhiya. Treatment is performed in the surgical way and can is carried out by both an open, and endoscopic way.
Sinekhiya of a nose cavity
Sinekhiya cavities of a nose happen congenital and acquired. Congenital sinekhiya of a cavity of a nose are formed during pre-natal development as a result of violations of formation of a facial skull. Congenital syphilis can be their cause. Most often congenital sinekhiya of a cavity of a nose are localized in back departments of a nose and often combined with an atresia Joán.
Sinekhiya cavities of a nose of the acquired character result from development of granulations and cicatricial changes after injuries of a nose, chemical and thermal burns of a nasal cavity, the postponed inflammatory diseases (syphilis, sypny typhus, diphtheria, scarlet fever, system red a wolf cub, a scleroma), medical coagulations (for example, at nasal bleeding) and surgeries in a nose cavity (removals of new growths and polyps of a nose, correction of an atresia Joán, operations on nasal sinks, etc.).
Classification of sinekhiya of a cavity of a nose
Sinekhiya nose cavities in otolaryngology are classified depending on what department of a nasal cavity they occupy. Forward sinekhiya of a cavity of a nose are localized in anticipation of a nose and can lead to occlusion of nostrils. Median sinekhiya of a cavity of a nose occupy a middle part and settle down between a nasal partition and nasal sinks (most often lower). Back sinekhiya of a cavity of a nose are in area Joán and can lead to their overlapping with violation of intake of air from a nasal cavity in a throat.
As fabric which formed nose cavity sinekhiya they are subdivided on soyedinitelnotkanny, bone and cartilaginous. Most often sinekhiya of a cavity of a nose have soyedinitelnotkanny character. Bone and cartilaginous sinekhiya, as a rule, are congenital.
Symptoms of sinekhiya of a cavity of a nose
Sinekhiya cavities of a nose can have unilateral or bilateral character. Insignificant sinekhiya usually are not followed by any clinical manifestations. Sinekhiya the nose cavities significantly blocking its gleam lead to violation of normal air circulation during the respiratory act. Normal the inhaled air stream passes through the nasal courses and through openings Joán gets into a throat. Passing through a nose, air is humidified, warmed and exempted from dust and other pollution which settle on a mucous nasal cavity and are gradually brought out of a nose, thanks to work of eyelashes of an epithelium its mucous.
Sinekhiya the nose cavities interfering passing through it of air lead to violation of nasal breath and emergence of a nasal shade of a voice. Patients complain of a nose congestion, deterioration or total absence of sense of smell, impossibility to blow the nose normally. Like the ozena, sinekhiya of a cavity of a nose are followed by continuous formation of crusts, however their quantity is not so high.
the nasal courses, nose cavity sinekhiya, break normal ventilation of okolonosovy bosoms that can become the cause in them inflammatory process — sinusitis (a frontit, antritis, an etmoidit). Violation of nasal breath leads to the fact that the cold and crude air inhaled by a mouth gets into a throat and the top airways. It in turn provokes development of inflammatory diseases of the top airways (pharyngitis, quinsy, laryngitis, tracheitis, laryngotracheitis), can lead to development of bronchitis and even pneumonia. The cold air getting into a throat can become the reason of an evstakhiit and average otitis.
Congenital sinekhiya of a cavity of a nose cause sucking violation in babies. At full overlapping of both nasal courses newborns have heavy violations of breath: lack of normal shout and the first breath after the birth, cyanosis of the person, extreme concern, lack of breath at the closed mouth.
Diagnostics of sinekhiya of a cavity of a nose
Forward sinekhiya of a cavity of a nose can be diagnosed by the otolaryngologist at survey of the patient. Average and back sinekhiya of a cavity of a nose come to light when carrying out a rinoskopiya. The type of sinekhiya (bone, cartilaginous or soyedinitelnotkanny) is established by means of their probing by the pugovchaty probe. For diagnostics of the accompanying inflammatory changes carry out also a faringoskopiya, a laringoskopiya, a research of passability of an acoustical pipe, an otoskopiya, a research of okolonosovy bosoms (a X-ray analysis, a computer tomography, ultrasonography). Carrying out a bakissledovaniye of dabs from a pharynx and a nose helps to establish an etiology of the revealed inflammatory diseases.
Treatment of sinekhiya of a cavity of a nose
Sinekhiya cavities of a nose are the indication to surgical treatment only when they cause essential violations of nasal breath. In the absence of significant clinical changes in treatment there is no need as postoperative scarring can lead to heavier violations. Congenital sinekhiya at newborns can become the indication to urgent surgery in connection with life-endangering respiratory violations.
Removal of soyedinitelnotkanny sinekhiya consists in their excision by a scalpel. Cartilaginous sinekhiya of a cavity of a nose are removed by means of a konkhotom, and bone — are hollowed out with application of a chisel. Removal of sinekhiya can be followed by a resection of the lower nasal sink, the lower osteokonkhotomiya and other interventions on nasal sinks. More sparing method is endoscopic removal of sinekhiya which is made under local anesthesia and has shorter postoperative period.
For prevention of repeated formation of solderings after operation for healing enter glove rubber, celluloid or a special foil into a cavity of a nose. With the same purpose at sinekhiya of an entrance to a nasal cavity apply a skin rag on a leg which is fixed hair seams or tampons to closing of wound defect.
Forecast and prevention of sinekhiya of a cavity of a nose
Sinekhiya cavities of a nose differ in high degree of a retsidivirovaniye. Their persistent education after repeatedly carried out surgical treatment can lead to even big violations of nasal breath and emergence of deformation of a nose.
The main prevention of sinekhiya is: timely treatment of inflammatory and infectious diseases, rendering the qualified help at nose injuries, competent carrying out surgical interventions in cavities of a nose and implementation in the postoperative period of the actions interfering rough scarring with development of sinekhiya.