Is facial pain always caused by sinus infections. How to differentiate between sinusitis and migraines. What are the common symptoms of sinus infections. How long do sinus infections typically last. What treatments are available for sinus-related facial pressure.

Understanding Facial Pain and Pressure: Beyond Sinus Infections

Facial pain and pressure are common complaints that can significantly impact an individual’s quality of life. While many people and even some healthcare providers quickly attribute these symptoms to sinus infections, the reality is often more complex. Let’s delve into the intricacies of facial pain, its potential causes, and how to distinguish between various conditions that may manifest with similar symptoms.

The Challenge of Diagnosing Facial Pain

Facial pain presents a unique challenge in both diagnosis and treatment. It’s often a diagnosis of exclusion, meaning other potential causes must be ruled out before a definitive diagnosis can be made. This process can lead to:

• Multiple consultations with various specialists
• Numerous treatments, including potentially unnecessary surgeries
• High levels of healthcare utilization
• Significant morbidity for patients

The complexity of facial pain diagnosis underscores the importance of a thorough and systematic approach to evaluating patients presenting with these symptoms.

Rhinosinusitis: Understanding the Basics

Rhinosinusitis, commonly referred to as a sinus infection, occurs when the nasal cavities become inflamed, infected, and swollen. But what exactly are sinuses, and how do they become infected?

What Are Sinuses?

Sinuses are air-filled pockets located in the facial bones. They can be found in several areas:

• Behind the forehead
• On either side of the nose
• Behind the eyes
• Behind the cheeks

When these sinuses become blocked with fluid, they create an environment where bacteria and viruses can thrive, leading to infection.

Causes of Sinusitis

While viruses are the most common cause of sinusitis, other factors can contribute to sinus symptoms and pain:

• Bacterial infections
• Allergies
• Nasal polyps
• Deviated septum
• Tooth infections

Understanding the underlying cause is crucial for effective treatment and management of symptoms.

Acute vs. Chronic Sinusitis: Duration and Implications

Sinusitis can be categorized into two primary forms based on duration: acute and chronic. How long does each type typically last?

Acute Sinusitis

Acute sinusitis typically lasts for a short period, usually up to four weeks. It often follows a viral upper respiratory infection and may resolve on its own without specific treatment.

Chronic Sinusitis

Chronic sinusitis persists for 12 weeks or longer despite treatment attempts. It can significantly impact quality of life and may require more aggressive management strategies.

The distinction between acute and chronic sinusitis is crucial for determining the appropriate treatment approach and assessing the potential need for further investigation into underlying causes.

Differentiating Sinusitis from Migraines: A Common Diagnostic Challenge

One of the most significant challenges in diagnosing facial pain is distinguishing between sinusitis and migraines. Why is this differentiation so important, and how can it be achieved?

Overlapping Symptoms

Sinus infection headaches and migraines can be easily confused due to overlapping symptoms, including:

• Nasal congestion
• Facial pain and fullness
• Rhinorrhea (runny nose)

Both conditions may also worsen when bending forward, further complicating the diagnostic process.

Key Differences

Despite the similarities, there are several key differences that can help distinguish between sinusitis and migraines:

1. Migraines are often aggravated by bright light or noise, while sinusitis is not.
2. Nausea and vomiting are common with migraines but not typically associated with sinusitis.
3. Sinusitis usually occurs after a cold or viral upper respiratory infection.
4. Thick, discolored nasal mucus is more indicative of sinusitis.
5. Decreased sense of smell is more common in sinusitis.

Recognizing these distinctions can help healthcare providers make more accurate diagnoses and provide appropriate treatment.

Sinus Infection Symptoms: Beyond Facial Pain

While facial pain is a common symptom of sinus infections, it’s not the only indicator. What other symptoms should individuals be aware of?

Common Sinus Infection Symptoms

A comprehensive list of sinus infection symptoms includes:

• Nasal congestion or stuffiness
• Postnasal drip
• Coughing
• Discolored (greenish) nasal discharge
• Fever
• Pain in teeth
• Tenderness of face (especially at the bridge of the nose or under the eyes)
• Bad breath
• Fatigue

The presence of multiple symptoms from this list, particularly in combination with facial pain, increases the likelihood of a sinus infection diagnosis.

Sinus Pain Locations

Sinus pain can manifest in various locations, depending on which sinuses are affected:

• In your forehead
• On either side of your nose
• In your upper jaws and teeth
• Between or behind your eyes

Understanding these pain patterns can help individuals better communicate their symptoms to healthcare providers and aid in accurate diagnosis.

Treatment Approaches for Sinus Infections

Once a sinus infection has been diagnosed, what treatment options are available? The approach to treatment often depends on the underlying cause and severity of the infection.

Conservative Treatment Methods

For many cases of sinusitis, especially those caused by viruses, conservative treatment methods can provide significant relief:

• Nasal decongestant sprays
• Nasal corticosteroids
• Saline nasal irrigation
• Over-the-counter pain relievers
• Staying hydrated
• Using a humidifier

These approaches can help manage symptoms and support the body’s natural healing processes.

Antibiotic Treatment

While antibiotics are often prescribed for sinus infections, their use should be carefully considered. Why? Overuse of antibiotics can lead to antibiotic resistance, a growing concern in modern medicine.

Most allergists recommend only using antibiotics if symptoms have persisted for more than 7-10 days, indicating a likely bacterial infection rather than a viral one.

Surgical Interventions

In cases where medications are ineffective or there are underlying structural issues, surgery may be recommended. Surgical interventions can correct defects in the bone separating the nasal passages, remove nasal polyps, or enlarge sinus openings to improve drainage.

Prevention Strategies for Sinus Infections

While not all sinus infections can be prevented, there are several strategies individuals can employ to reduce their risk. What are some effective prevention methods?

Lifestyle Modifications

Simple lifestyle changes can significantly impact sinus health:

• Practicing good hand hygiene to reduce exposure to viruses and bacteria
• Avoiding known allergens or irritants that can trigger sinus inflammation
• Using a humidifier to keep nasal passages moist
• Avoiding smoking and secondhand smoke
• Managing allergies effectively

Nasal Care

Regular nasal care can help maintain healthy sinuses:

• Using saline nasal sprays or rinses to keep nasal passages clear
• Blowing your nose gently and correctly to avoid pushing mucus into the sinuses
• Staying hydrated to help thin mucus and promote drainage

By incorporating these prevention strategies into daily routines, individuals can potentially reduce the frequency and severity of sinus infections.

When to Seek Medical Attention for Facial Pain

While many cases of facial pain can be managed at home, there are instances where medical attention is necessary. How can individuals determine when it’s time to see a healthcare provider?

Red Flags for Immediate Medical Care

Certain symptoms warrant immediate medical attention:

• Severe headache or facial pain, especially if it’s sudden or worsening
• Visual changes or eye swelling
• High fever (over 101°F or 38.3°C)
• Confusion or altered mental state
• Stiff neck
• Difficulty breathing

These symptoms could indicate a more serious condition requiring prompt evaluation and treatment.

Persistent or Recurrent Symptoms

Even if symptoms are not severe, medical attention may be necessary if:

• Facial pain or pressure persists for more than 10-14 days
• Symptoms improve but then worsen again
• Over-the-counter treatments are not providing relief
• Sinus infections occur frequently (more than 3-4 times per year)

In these cases, a healthcare provider can perform a thorough evaluation to determine the underlying cause and develop an appropriate treatment plan.

Understanding facial pain and pressure, particularly in relation to sinus infections, is crucial for effective management and treatment. By recognizing the diverse causes of facial pain, distinguishing between conditions with similar symptoms, and knowing when to seek medical attention, individuals can better navigate their healthcare journey and find relief from these often debilitating symptoms. Remember, while sinus infections are a common cause of facial pain, they are not the only possibility, and a comprehensive evaluation is often necessary to ensure accurate diagnosis and appropriate treatment.

Is My Facial Pain or Facial Pressure Caused by a Sinus Infection?

Facial pain is linked with high levels of healthcare utilization and significant morbidity and continues to be a challenge in both diagnosis and therapeutic approaches for both doctors and patients. It’s often diagnosed on the basis of exclusion. 

Those suffering from facial pain often undergo various repeated consultations with various specialists and end up receiving a number of treatments, including surgery. Many individuals and doctors mistakenly attribute facial pain and facial pressure as being caused by rhinosinusitis when, in fact, this isn’t the case. 

What is Rhinosinusitis (Sinusitis)?

Rhinosinusitis, or a sinus infection, occurs when your nasal cavities become inflamed, infected and swollen. 

Your sinuses are typically air-filled pockets in your facial bone. They’re located:

If they become blocked by fluid, bacteria or germ like viruses can multiply in these hard-to-reach, dark areas, causing an infection.

Sinusitis is typically caused by a virus and can persist even after the symptoms of an upper respiratory condition have disappeared. Sometimes, bacteria might cause a sinus infection. Other disorders can contribute to sinus symptoms and pain such as:

Is Sinusitis the Same as Sinus Infection?

The answer is essentially yes. Sinusitis is actually the same thing as a sinus infection. The term “itis” refers to swelling or inflammation often caused by an infection and “sinus” is the area of facial swelling.

How Long Does a Sinus Infection Last?

There are a couple of primary forms of sinus infections or sinusitis — acute and chronic.  

From a clinical standpoint, it’s important to distinguish between “sinogenic” and “non-sinogenic” facial pain to avoid the wrong treatment.

Distinguishing Between Chronic Sinusitis-Related Facial Pain and a Migraine?

Sinus infection headaches and migraines are simple to confuse because the symptoms and signs of both types of headaches might overlap.

Both migraine headache and sinusitis pain frequently become worse when you bend forward. Migraine can also be accompanied by a variety of nasal symptoms and signs, including:

Migraines are often misdiagnosed as sinus headache in around 42% of individuals because they share: 

• Overlapping symptoms (nasal congestion, facial pain-fullness and rhinorrhoea)

• Common areas with chronic rhinosinusitis

• Precipitating triggers (allergies, weather changes and environmental irritants)

Also, migrainous and sinonasal conditions might often co-exist as comorbidities. Chronic rhinosinusitis might increase migraine-linked frequency and morbidity through aggravation of trigeminal nerve receptors.

Studies have found around 90% of individuals who visit their doctor for sinus headaches receive a migraine diagnosis instead.  However, sinusitis typically isn’t aggravated by bright light or noise or associated with nausea or vomiting — all common with migraines.

Sinusitis typically occurs after a cold or viral upper respiratory infection and includes:

• Discolored, thick nasal mucus

• Pain in upper teeth or one cheek

• Decreased sense of smell

Sinus infection-related headaches frequently last days or longer, whereas migraines often last hours to a day or two.

Sinus Infection and Facial Pain 

So, is your facial pressure or facial pain due to a sinus infection?  Pain is a common sinusitis symptom. You have a few different sinuses below and above your eyes and behind your nose. When you have a sinus infection, these can hurt.

Swelling and inflammation make your sinuses ache with dull pressure. You might feel pain:

The relentless sinus infection and facial pressure and sinus swelling can cause headache symptoms. Sinus pain can also give you:

Sinusitis headaches are frequently worse in the morning since fluids have been gathering all night long.  

Other Symptoms of Sinus Infection

Common sinus infection symptoms include:

• Nasal congestion or stuffiness

• Postnasal drip

• Coughing

• Discolored (greenish) nasal discharge

• Fever

• Pain in your teeth

• Tenderness of your face (especially at the bridge of your nose or under your eyes)

• Bad breath

• Fatigue

How is a Sinus Infection Treated?

First, you will need to find out what’s causing your sinus infection. Is it bacterial or viral? If it’s viral, it will not likely last more than a couple of weeks. To obtain relief from symptoms of a sinus infection, you can use:

Antibiotics are often prescribed for bacterial infection. But, you don’t want to jump too quickly to antibiotics because being overprescribed antibiotics can lead to you developing antibiotic resistance. Usually, allergists suggest you only take antibiotics if your symptoms have lasted over seven to 10 days. If medications don’t work for you, your doctor might recommend surgery to correct defects in the bone that separates your nasal passages, open closed passages or remove nasal polyps.

How is Chronic Sinusitis Treated?

Treatments for chronic sinusitis include:

1. Medications

• Saline nasal irrigation: These include nasal solutions or sprays which reduce drainage and rinse away allergies and irritants.

• Nasal corticosteroids: These are nasal sprays that help treat and prevent inflammation. Some include budesonide, fluticasone and triamcinolone. If these aren’t effective enough, the physician may suggest rinsing with a saline solution mixed with budesonide drops or using a nasal mist made from the solution.

• Aspirin desensitization treatment:  If your body reacts to aspirin and it causes sinusitis, your doctor might have you take larger doses of aspirin, under their medical supervision, to increase your tolerance.

• Injected or oral corticosteroids: These are medicines used for relieving inflammation from severe sinusitis, particularly if nasal polyps is also present. Oral corticosteroids, when used long-term, can serious side effects, so they’re typically only used for treating severe symptoms.

2. Antibiotics

Antibiotics, in some cases, are necessary to treat sinusitis if you’re suffering with a bacterial infection. Your doctor may suggest an antibiotic, sometimes with other medicines, if they can’t rule out an underlying infection.

3. Immunotherapy

If allergies are contributing to your sinusitis, immunotherapy (allergy shots) that help decrease your body’s reaction to certain allergens may improve your condition.

4.Surgery

If your chronic sinusitis is resistant to medication or treatment, your doctor may recommend endoscopic sinus surgery. The doctor will use a flexible, thin tube with an endoscope (light) attached to explore your sinus passages during this procedure. Depending on the source of your obstruction, your doctor may use a variety of instruments for removing tissue or shaving away a polyp that’s causing your nasal blockage. 

Balloon sinuplasty, which is a minimally invasive outpatient procedure can improve sinus drainage, particularly if medications aren’t effective enough. Balloon sinuplasty can offer relief from chronic sinuplasty and is FDA approved.

Contact Houston ENT & Allergy Services

If you’re wondering if your facial pain/pressure or other symptoms are related to a sinus infection or chronic sinusitis, give Houston ENT & Allergy Services a call. While we’ve become a large doctor group, we continue to treat every patient as though they’re the only one we have. Contact us today to schedule your appointment with one of Houston’s most trusted and best ENT & Allergy Doctors. 

Chronic sinusitis

Chronic sinusitis is inflammation of the linings of the sinuses that surround the nose that lasts a long time or keeps coming back.

It’s caused by anything that constantly or regularly irritates the lining of the nose.

• About sinusitis
• Symptoms
• Causes
• Diagnosis
• Treatment
• Prevention
• Special considerations
• Further information
• Sources
• Related topics

About sinusitis

What are the sinuses?

The sinuses are air-filled spaces behind the bones of your face that open up into the nose cavity. They are lined with the same membrane as your nose. This is called the mucous membrane and it produces a slimy secretion called mucus to keep the nasal passageways moist and to trap dirt particles and bacteria.

You have four main sets of sinuses.

• The maxillary sinuses are in each cheekbone.
• The frontal sinuses are on either side of your forehead, above your eyes.
• The smaller ethmoid sinuses are behind the bridge of your nose, between your eyes.
• The sphenoid sinuses are between the upper part of your nose and behind your eyes.

The maxillary sinuses are the largest of the sinuses and the ones most commonly affected by sinusitis.

What is sinusitis?

Sinusitis is inflammation of the mucous membranes of one or more of your sinuses.

Sinusitis lasting anything from a few days up to a month is called acute sinusitis (see Related topics). When it lasts three months or more it’s known as chronic sinusitis. The medical terms acute and chronic refer to how long the condition lasts for, rather than how severe it is.

Symptoms

If you have chronic sinusitis, your symptoms may include:

• pain and pressure in your face, which is worse when you lean forwards
• a blocked or runny nose with green or yellow mucus, which can drain down the back of your nose into your throat and cause a sore throat and cough
• a headache when you wake in the morning
• a reduced sense of smell
• bad breath (halitosis)

Any pain you may experience will depend on which of your sinuses are affected.

• Frontal sinusitis can cause pain just above your eyebrows, and your forehead may be tender to touch.
• Maxillary sinusitis can cause your upper jaw, teeth and cheeks to ache and may be mistaken for toothache.
• Ethmoid sinusitis can cause pain around your eyes and the sides of your nose.
• Sphenoid sinusitis can cause pain around your eyes, at the top of your head or in your temples. You may also have earache and neck pain.

Causes

The mucus that is produced by the mucous membranes in your sinuses normally drains into your nose through small holes called ostia. The ostia can become narrow or even blocked if the sinuses get infected and inflamed so the mucus cannot drain properly.

Chronic sinusitis can be caused by anything that constantly or regularly irritates the lining of the nose and so results in inflammation of the mucous membranes. Examples of irritants include:

• infection from viruses, bacteria or fungi
• airborne allergens such as grass and tree pollen
• smoke and air pollution
• sprays containing chemicals (eg household detergents)
• nasal decongestants, if overused
• chronic drug misuse (snorting substances such as cocaine)

People who have allergy-based asthma often have chronic sinusitis as well. There are a number of medical conditions such as cystic fibrosis that can also cause sinusitis.

Any problem with the nose that blocks the drainage holes can cause chronic sinusitis such as a structural blockage resulting from a growth from the membrane (polyp).

Diagnosis

Your GP will ask you about your symptoms and will examine you. He or she may also ask about your medical history.

If you have chronic sinusitis, your GP may refer you to a doctor who specialises in ear, nose and throat conditions for further tests. These may include a nasendoscopy, where your doctor will insert a small, flexible tube with a light and a camera lens at the end (endoscope) into your nostril to examine the inside of the sinuses. He or she will look through this and the image will usually be projected onto a video screen. A nasendoscopy is performed under local anaesthesia. This completely blocks feeling from the sinus area and you will stay awake during the operation.

You may need to have a computerised tomography (CT) scan. A CT scan uses X-rays to build up a three-dimensional picture of your sinuses.

Treatment

Self-help

Home remedies may provide some relief for your symptoms. It may be helpful to gently flush out your nose, using a syringe and a glass of warm water with a teaspoon of salt added. This can dislodge some of the mucus in your nose and sinuses, and bring some relief. An alternative is to use pre-filled squeeze bottles, which are available from a pharmacy.

Some people find that breathing in steam from a bowl of hot (but not boiling) water containing a few drops of menthol oil (eg Olbas oil or Karvol) may provide some relief from the symptoms. However, this is not scientifically proven. Another method is to sit in the bathroom with the hot shower running and inhale steam this way. Some people find that applying a warm compress on the areas of the face that are painful and sleeping with their head and shoulders propped up with pillows provides relief, but there is no scientific evidence that this works.

Medicines

Nasal sprays containing mild steroids such as beclometasone (eg Beconase) are available over-the-counter and on prescription from your GP. This is usually one of the first treatments to try if you have chronic sinusitis. Your GP may also prescribe antibiotics if you have a bacterial infection. Antifungal medicines may be prescribed if chronic sinusitis is caused by a fungus.

If you have chronic sinusitis and an allergy then you may find that controlling your allergy helps to reduce the symptoms of your sinusitis. Antihistamine tablets such as loratadine (eg Clarityn) may help to do this.

If your sinusitis does not get better with these medicines, your GP may prescribe some steroid tablets.

Always read the patient information leaflet that comes with your medicine and ask your pharmacist or doctor for advice.

Surgery

If your chronic sinusitis doesn’t get better with home or medical (drug) treatments, you may need surgery.

In functional endoscopic sinus surgery (FESS) the surgeon washes out the sinuses sinuses and widens the drainage holes using an endoscope. This can be done under a local or a general anaesthesia. A general anaesthetic means that you will be asleep throughout the operation.

Other types of surgery can remove nasal polyps or correct an obstruction in the nose that may be the cause of your sinusitis. Ask your doctor for more information about the different types of surgery.

Prevention

There are a number of things you can do to help prevent sinusitis developing such as:

• taking a short course (usually no longer than seven days) of decongestant medicine when you have a cold
• keeping your allergy symptoms under control – ask your doctor or pharmacist for advice
• having a flu vaccination
• maintaining good general health by eating healthily and taking regular exercise
• staying well hydrated by drinking plenty of fluids
• not smoking
• staying away from smoky environments

Special considerations

If you are flying or diving, the changes in pressure can make the air trapped in your sinuses expand or contract. Usually this just causes increased discomfort, but if you are diving to depth you may be at risk of serious damage. If you are considering going diving, you should always consult your doctor first if you have sinusitis.

Further information

The British Association of Otorhinolaryngologists (ENT-UK)

Sources

• ENT UK. www.entuk.org, accessed 24 May 2007
• Clinical Knowledge Summaries. www.cks.library.nhs.uk, February 2006
• Ah-See K, Evans AS. Sinusitis and its management. BMJ 2007; 334:358-36
• National Institute of Allergy and Infectious Diseases, National Institute of Health, US department of health and human services. www.niaid.nih.gov, accessed 23 May 2007
• Collier J, Longmore M, Scally P. Oxford Handbook of Clinical Specialities. 6th ed. Oxford: Oxford University Press, 2003
• Simon C, Everitt H, Kendrick, T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2005 (pg 918)
• Psychostimulant Working Group Report. Scottish Executive, Substance Misuse Division, 2002. www.scotland.gov.uk, accessed 08 June 2007

Related topics

Acute sinusitis

Sinusitis in children

The Link Between Sinus Headaches, Eye Pain & Computer Use

A headache is a common malady that can be brought on by a variety of different factors, such as stress, anxiety, noise, hunger and poor sleep. In recent years, there has been an alarming increase in the number of teenagers and young adults who suffer from headaches on an almost-daily basis. This is no surprise considering the large amount of time spent on computers and hand-held electronic devices.

Many of these patients also complain of facial pain and pain with eye movement, especially after long bouts of computer usage. A great number of these people were diagnosed with chronic sinus headache or migraine disorder and tried many of the recommended medications and treatments, yet saw little to no improvement in their condition. In the majority of these cases, it’s possible that Binocular Vision Dysfunction was present but wasn’t diagnosed because it was never even considered as a possible cause and/or because a proper binocular vision evaluation was never performed.

How Prolonged Computer Use Affects the Eyes

A large amount of effort is required and it is very taxing to the visual system to keep one’s eyes focused and the vision clear while staring at a computer screen (or that of some other digital device) for hours at a time. If the eyes are out of alignment as well, the eye muscles become even more overworked as they struggle to correct the misalignment. This can then lead to eye strain, facial pain and headaches.

How a NeuroVisual Examination Can Help

A detailed NeuroVisual Evaluation by the doctors at Vision Specialists of Michigan can find even the smallest of misalignments. Developed by our very own Dr. Debby Feinberg, this comprehensive ocular and binocular vision exam takes about an hour and a half. If a misalignment is present, no matter how slight, this evaluation will identify it. Once a binocular vision disorder is diagnosed, the condition can be treated with a pair of glasses containing specialized micro-prism lenses, which will correct the misalignment and allow the overworked eye muscles to relax. This customized prescription may require tweaking a time or two, but for most people, the glasses greatly reduce or even eliminate the symptoms within a short period of time.

Could It Be Your Eyes?

If you’re suffering from headaches, migraines, eye or facial pain, or dizziness and nausea, start by taking our online BVD questionnaire. To set an appointment, contact Vision Specialists of Michigan at (248) 258-9000. If we determine that Binocular Vision Dysfunction is present, we can quickly help you receive relief from your symptoms and get you back on your way to a life free of eye pain and visual problems.

Sinus Infection in Eye – SmartDocMD

Sinus infections are a common cause of illnesses in patients. SmartDocMD features information on sinus infection symptoms and causes frequently. Many patients that experience sinus infections describe symptoms that involve their eyes, or around their eyes. In fact, many questions they have revolve around sinus infection in eye, and watery eyes sinus infections. If you believe that you have any infection in your eye, you should consult a doctor. Read more about sinus infection in eye and related symptoms.

Can a Sinus Infection Spread to Your Eyes?

It is extremely unlikely that a sinus infection can spread and cause an infection in your eyes, however many people that experience a sinus infection will have symptoms from the sinus infection that affect their eyes.

Some Symptoms of a Sinus Infection that Involve the Eye are:

• Itchy eyes
• Red Eyes
• Swollen Eyes
• Watery Eyes
• Eye Pain or Pain on your Face around your Eyes
• Feeling as if you have pressure behind your eyes
• Headache just behind your eyes

Acute Sinus Infections usually stem from the common cold virus infection. It can also be caused by bacteria that settles in the sinus cavities. If you experience chronic sinusitis, chronic sinus infections, then you could possibly have some other cause of your sinus infections. SmartDocMD can treat acute sinus infections and make recommendations for further treatment for chronic sinus infections.

If you think that you have a sinus infection, SmartDocMD wants to help! Start your care now, and skip the waiting room. Don’t waste time driving to an appointment, only to sit for a long period of time in a waiting area, or filling out health screening forms. SmartDocMD started as an idea between one patient and one doctor: offer convenient, quality health care for basic problems without the waiting room.

If you think you have a sinus infection please complete the FREE online patient interview (OPI) so we may better understand your problem. At the end, we will tell you if you need a prescription or evaluation by one of our SmartDocMDs.

Learn more about the strongest antibiotic for sinus infection, and other related health articles on our website. We provide helpful information on common sinus infection symptoms and causes.

How Does Sinus Affect Your Eyes – Health & Wellness

As we move from winter into spring, many who suffer from seasonal sinusitis or allergies maybe a little hesitant to embrace the warmer weather and change of season.

Severe headaches, fever, nasal congestion, pressure or facial tenderness, a blocked nose, a sore and itchy throat and an uncomfortable cough are common symptoms that indicate that your sinuses or allergies are acting up. But, did you know swelling eyelids, bulging and red eyes, impaired eye movement and double vision can also be signs that you are suffering from the seasonal change?

Seasonal flares…

A large percentage of our population suffers from allergies, and seasonal allergies are the most common of them. From severe dryness, itchy eyes to eye tearing and redness, these are a few of the symptoms of eye allergies that are associated with climate changes. While these symptoms and effects of allergies can create great discomfort, it also builds pressure behind the eye, which is unhealthy and needs to be treated with urgency. An infection of the sinuses can also cause pressure build up behind the eye, which in effect can create pain in one or both eyes.

It’s complicated…

Known as an orbital complication, which is quite common among sinus suffers, the infection travels to the tissue of the back of the eye. This infection then can cause pain in the eye, redness, swelling eyelids, bulging eyes, impaired eye movement and double vision. If you have these symptoms, it’s advisable that you visit your GP, as you might need an antibiotic to clear the infection and to gain some relief.

Let’s treat it…

Often a simple anti-allergy pill, like an antihistamine, or a sinus medication over the counter should provide some relief, but if the symptoms persist you will need to visit your doctor. While being on medication, you can also do cold compresses to the eye area, frequently use refrigerated artificial tears throughout the day, reduce contact-lens wear and rather opt to wear your specs to avoid straining your eyes. If you do visit your GP, ask about prescribed eyedrops, nasal steroids and nasal antihistamines to lessen the symptoms and provide comfort.

To learn more, visit your nearest Spec-Savers branch, or speak to a medical practitioner.

Eye Related Sinus Disorders | GW Hospital

Surgeons at The George Washington University Hospital use minimally invasive endoscopic procedures for eye-related diseases of the nose and sinuses. 

Graves’ Orbitopathy

Patients with Graves’ disease often experience proptosis or bulging of the eyes. In addition to cosmetic concerns, patients with Graves’ disease may also develop visual problems, such as corneal exposure and compression of the optic nerve. These concerns can be often improved with minimally invasive endoscopic orbital decompression surgery through the nose and sinuses.

Compressive Optic Neuropathy

Patients may suffer from loss of vision due to pressure on the optic nerve caused by trauma, sinonasal or orbital tumors, Graves’ disease or chronic sinusitis. Endoscopic optic nerve decompression through the nose and sinuses can relieve pressure on the optic nerve and in many cases restore vision to the patient’s eye.

The treatment may include removing a displaced bone fragment, excising a sinus or orbital tumor or opening up the sinuses to relieve pressure on the eye and optic nerve.

Orbital Abscess, Subperiosteal Abscess

Abscesses, or pockets of pus, around the eye caused by bacterial, fungal or parasitic infections in the sinuses or eyes can be opened and drained through the nose using an endoscope and minimally invasive surgical instrumentation. The natural nasal opening allows surgeons to address these vision-threatening diseases with simple, minimally invasive approaches, which  eliminate disfiguring scars.

Epiphora/Blepharitis (abnormal/excessive tearing of the eye and infections)

This condition is often caused by a blockage of the lacrimal (tear) ducts located next to the nose. Surgeons correct the blockage with a minimally invasive approach, known as endoscopic dacryocystorhinostomy. This procedure can improve the normal tearing of the eye by opening the lacrimal sac into the nose, while at the same time correcting nasal problems such as a deviated nasal septum and large turbinates (the bony projections in the nose that help humidify the air you breathe).

Midland Optometrist Explains How a Sinus Infection Can Impact Vision

Midland Optometrist Explains How Sinus Infection Can Impact Vision

Lori Wirth

28.04.2014

Midland Optometrist

Anybody who suffers from or has suffered from chronic sinus infections can tell you how much this illness can affect vision. There are several reasons why. Sinus infections cause swelling of the sinus cavities in the bones around the nasal passages and the eyes. Swelling and inflammation can cause pressure on the eyes themselves, resulting in vision distortion, eye pain, and blurred vision. It is even possible to get a viral or bacterial infection in the eye, usually evident by itching, oozing eyes, and sticky and/or colored mucus draining from the eyes. If you are experiencing eye irritation it is important to work with an optometrist to ensure good eye health.

For those who suffer from chronic sinus infections, seeing an Ear, Nose, and Throat (ENT) specialist in conjunction with a Midland eye doctor is recommended. One way to make sure that your eyes stay healthy is to visit a Midland optometrist at least once a year. If you suffer from more than three sinus infections per year or your sinus infections seem to be hurting your eyes more and more often share this information with your optometrist as it may be a sign of other complications. The more information you give your eye doctor the better equipped they are to protect your vision as well as our overall health.

Springtime is a season of beauty, life, and growth. However, for people with chronic allergies and sinus infections, it can also be a time of watery irritated itchy eyes and a stuffy head. If this describes you, call today to schedule a visit with one of our Traverse Vision Midland optometrists to ensure good eye health.

90,000 Manifestations of sinusitis (inflammation of the paranasal sinuses)

The nose is the first to meet the pathogenic microbes coming from the external environment, therefore, it is in it that inflammatory processes often develop – local “battles” of immunity with the pathogenic flora.

Sinusitis is a general name for inflammation of the paranasal sinuses (from Latin sinus – sinus, the names of inflammatory diseases have the ending “it”). Inflammation of the maxillary sinus (sinusitis), frontal sinus (frontal sinus), ethmoid sinus (ethmoiditis), sphenoid sinus (sphenoiditis) is possible. Sphenoiditis is extremely rare, almost always together with ethmoiditis.

Signs of inflammation of the paranasal sinuses (if you find two or more of the symptoms listed, you need to consult a specialist):

• Headache and / or pain in the area of ​​the teeth, eyes, cheekbones, cheeks
• Feeling of fullness in the area of ​​the nose, eyes, forehead, jaw
• Acute sensitivity of a part of the face
• Redness of the face or part of it
• Pain points in the face
• Nasal congestion and / or runny nose
• Increased body temperature

Inflammatory diseases of the sinuses of the nose (sinusitis, frontal sinusitis, ethmoiditis)

Inflammation in the paranasal sinuses usually develops according to the following scenario:

1. Pathogenic microbes enter the sinus, and the body cannot give the necessary resistance to infection. Reasons – decreased immunity, cooling, allergies, high activity of pathogenic microbes
2. Ventilation of the sinus is stopped. Possible causes are inflammation and swelling of the anastomosis, curvature of the nasal septum, the presence of outgrowths (polyps, spines) inside the sinus. The sinus becomes isolated from the nasal cavity, but mucus (which is formed and secreted normally) is constantly secreted in it, which gradually fills the sinus. This creates ideal conditions for microbial growth
3. In the paranasal sinus, inflammation erupts, decay products (pus) are released.Because there is no outflow from the sinus, the decay products are in it under pressure and are intensively absorbed into the bloodstream, poisoning the entire body. In addition, the excess pressure irritates the sinus wall. Hence the characteristic symptoms of

How is it treated (sinusitis, frontal sinusitis, ethmoiditis)

Our principles of treatment of acute sinusitis and other sinuitis are simple and clear:

1. Create an outflow of contents from the affected sinus
2. Rinse the sinus and nasal cavity with antimicrobial and anti-inflammatory drugs
3. Inject (topically and / or as a tablet or injection) a medicine that blocks the growth of microbes
4. Prevent swelling and occlusion of sinus fistula
5. Tidy up the immune system

The first and main stage of treatment is the evacuation of pus from the sinus. For this, the following technique has been successfully used in our clinic for a long time:

method of movement or “cuckoo”, and, only in extreme cases, puncture of the sinus with a special low-traumatic needle.

If necessary, an immunologist is involved in further treatment.

There are contraindications. Read the instructions or consult a specialist.

Removal and treatment of cysts in Kazan.Removal of neoplasms of the maxillary sinus

• Treatment of chronic rhinitis
• Curvature of the nasal septum
• Snoring Treatment
• Removal of adenoids
• Treatment of vasomotor rhinitis

• Removal of nasal polyps
• Removal of cysts – in the paranasal sinuses and tonsils
• Treatment of chronic tonsillitis with laser
• Lacunotomy

Cysts are a common disease in the practice of otolaryngologists. Pathology is classified as the consequences of rhinitis and sinusitis. The formation of cysts provokes poor-quality treatment of rhinological diseases. Our medical center offers services for the surgical removal and treatment of cysts.

What is a paranasal sinus cyst?

The cysts are benign. Tumors appear as fluid-filled sacs. The walls of the formations are thin, elastic. About 80% of clinical cases are due to the detection of cysts in the maxillary, maxillary sinus.Less commonly, tumors are identified in the area of ​​the ethmoid labyrinth, frontal and wedge-shaped areas.

Cyst growth occurs without discomfort. Dentists identify the trouble during the preparation of patients for dental prosthetics. Tumors are visible on the scans based on the results of computed tomography of the skull. The diagnostic method allows you to establish the exact location and dimensions of the cyst.

How does a sinus cyst appear?

The mucous membranes of the sinuses are dotted with secretory glands. The latter produce substances to moisturize tissues and reduce the dryness of the inhaled air. The excretory ducts of the glands are located in the upper layers of the mucous membranes. As a result of certain malfunctions, microscopic holes are clogged. However, liquid secretions continue to be released to the outside. The result is the appearance of an elastic sac filled with watery contents.

Blockage of the glands in the nasal sinuses occurs against the background of chronic inflammation of the tissues of the nasopharynx.In addition to untreated rhinitis and sinusitis, the disease causes abnormalities in the development of local tissues.

Symptoms of the cyst of the maxillary and nasal sinus

Signs of cyst formation are as follows:

• discomfort in the frontal area during head bending;
• mild pain in the vicinity of the cheeks, affecting the jaw and cheekbones;
• a feeling of heaviness, light pressure around the eye sockets;
• Periodic runoff of an abundance of viscous mucous secretions along the pharyngeal wall;
• Difficulty in nasal breathing along with the absence of colds and other respiratory diseases;
• Regular headache attacks of varying intensity.

Usually, people do not experience any discomfort in the early stages of paranasal sinus cyst growth. In some cases, tumors do not make themselves felt for decades. In the later stages, pathological formations can cause visual impairment due to pressure on the eyeballs. For this reason, patients often seek advice from ophthalmologists, avoiding visiting an otolaryngologist.

Endoscopic surgery to remove the maxillary sinus cyst

The method of therapy involves the elimination of the tumor with a special manipulator.The device looks like an elastic tube. The end of the device contains a video camera. The endoscope is painlessly inserted into the maxillary sinus. The doctor monitors the actions by monitoring the image on the monitor.

The otolaryngologist carefully removes the liquid contents of the cyst, removes pathological tissues. The affected area is treated with antiseptics. The removed tumor is sent to the laboratory. A test is performed to determine if the sample is malignant.

Endoscopy of the maxillary sinus cyst has a number of advantages:

• in contrast to outdated surgical methods does not require incisions;
• the introduction of the manipulator into the problem area allows you to safely track the degree of development of the pathology;
• low tissue trauma guarantees quick recovery after surgery, minimizes the likelihood of complications.

Removal of the cyst by endoscopy takes about half an hour. The patient of the clinic does not suffer from intense pain in the postoperative period. At the site of exposure, a slight edema is formed, which disappears within a few days. External scars are completely absent.

Recovery period after sinus surgery

After endoscopy of the maxillary sinus cyst, the respiratory functions of the nose return to normal in about a month. Passing a course of antiseptic therapy allows you to avoid another blockage of the secretory glands and relapse of the disease.

During the recovery, the patient of the clinic must follow a number of rules:

• instill the nose with saline at intervals as recommended by the doctor;
• rinse your mouth after each meal;
• avoid smoking, drinking alcohol;
• to minimize physical activity, exclude sports;
• refuse to visit baths and saunas;
• to use medications prescribed by the otolaryngologist.

During the recovery phase, it is important to see a doctor for endoscopic monitoring of the rate of tissue healing. In parallel with computed tomography, the method makes it possible to assess the quality of rehabilitation.

Risks and complications after surgery

Due to the minimal degree of trauma of endoscopic surgery, complications are likely in exceptional cases. Patients rarely suffer from minor nosebleeds. Sometimes there is mild nausea, slight dizziness.Among the troubles is changing the timbre of the voice.

When is removal of a cyst indicated?

Doctors advise removing cysts of the paranasal sinuses in situations:

• chronic difficulty breathing through the nose;
• frequent development of rhinitis and sinusitis;

90 011 regular edema of facial tissues;

• periodic occurrence of dizziness, pain syndrome;
• sensations of a foreign body in the nose, pressure on the eyes.

Detection of these troubles requires an immediate appointment for an examination. Ignoring the problem threatens overgrowth of the cyst and blockage of the lumen of the nasal sinuses.

When is removal of a cyst contraindicated?

Cyst endoscopy has several limitations. The operation is not allowed to be performed by people suffering from poor blood clotting. The list of contraindications includes cancer, epilepsy, chronic cardiovascular disorders.Surgical removal of the cyst is not recommended for patients with renal and hepatic pathologies, diabetes mellitus at a severe stage of development.

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Eye Condition – General Health Indicator

Ophthalmological examination allows not only to ascertain good or poor eyesight, but also to learn a lot about the health of the body.

No other organ is capable of giving such a clear picture of the state of veins and arteries as the eyes. Metabolic disorders affect blood vessels, and an ophthalmologic examination is an essential step in the early diagnosis of such diseases. The condition of the eyes can indicate symptoms of diseases that also affect vision, so it is extremely important to get regular check-ups with an ophthalmologist, even if you do not experience any vision problems. Your eyes will tell a story that only a doctor can understand.

During the examination, the doctor pays attention to the following symptoms:

Headache

Causes of headaches are not always related to external factors, for example, increased sensitivity to weather changes. Headaches, especially in the forehead and eyes, can be symptoms of serious medical conditions.

The range of diseases with symptoms of headache is quite wide – from inflammation in the sinuses, undetected tumors or glaucoma (glaucoma – increased intraocular pressure), to functional disorders of the eye muscles, leading, for example, to strabismus.That is why it should be noted the importance of timely diagnosis and treatment of the causes of headaches.

Hypertension (high blood pressure)

One of the early symptoms of hypertension is uneven and narrowed blood vessels, so an eye examination by an ophthalmologist, in addition to identifying possible vision problems, is also a way to diagnose hypertension in the early stages.

Diabetes

If you often feel feverish, thirsty, or experience periodic deterioration in vision and weight fluctuations, this may be a symptom of diabetes.To confirm the diagnosis, the ophthalmologist just needs to look at the patient’s retina. Small hemorrhages or deposits in the retina, in the form of “cotton-like” foci, can be symptoms of diabetes. Changes in visual acuity due to changes in blood sugar levels during the day may also indicate the presence of this disease. An ophthalmic examination can detect diabetes in the early stages.

Stroke

Those suffering from hypertension need to be sure that the prescribed treatment can stop all cases of a sharp increase in pressure during the day.A retinal examination provides important information to enable your doctor to tell if you are at risk of stroke. If an ophthalmological examination reveals characteristically altered retinal vessels, a timely warning from a doctor will help you avoid a stroke.

Increased cholesterol content

Do you like delicious food? Well, who doesn’t love … But what about the level of fat in the blood? During an ophthalmological examination, the doctor can notice in time the consequences of your “hobby”. Fats adhere from the inside to the walls of the retinal vessels, changing their structure. Sclerosis (any abnormal thickening or thickening of body tissues) and blockage of blood vessels by fatty plaques lead to hypertension, heart disease and increase the risk of stroke. Early detection of high blood cholesterol levels will help prevent these effects and prolong your life.

Multiple sclerosis

Double vision, narrowing of the visual field, uncoordinated or involuntary twitching of the eyes may be the first symptoms of multiple sclerosis.Of course, an ophthalmological examination will not replace a thorough examination by a doctor of the appropriate profile, but the eyes can tell a lot about the patient’s health.

Identify problems before you start to feel them

The eyes are prone to “eye” diseases, many of which occur with a minimal number of symptoms, leading to various complications – from blurred vision to blindness. You need to take responsibility for your eye health – take care of yourself!

Take a look at your own eyes in the mirror once a day and ask yourself simple questions:

• Are my eyes feeling good?
• On the outside, do my eyes look good?
• Can I see well?

If you answer “no” to any of these questions, you should see your ophthalmologist. A routine examination by an ophthalmologist is painless and most often involves an external examination of your eyes.

Most common ophthalmic diseases:

Glaucoma

Glaucoma is a persistent increase in intraocular pressure due to the loss of the eye’s ability to regulate its own internal pressure. The danger of glaucoma is that it develops asymptomatically, and the patient does not realize the danger until it is too late.The tissues of the eye are under the influence of increased pressure, which continues to rise gradually unnoticed by the patient. Glaucoma is one of the most studied ophthalmic diseases, but still one of the most dangerous. Therefore, early detection of glaucoma is the main way to prevent vision loss.

Untreated glaucoma leads to blindness due to atrophy (degeneration, degeneration, pathological changes in tissue) of the optic nerve caused by its compression due to persistent increased intraocular pressure.Glaucoma treatment includes various methods: from the simple application of eye drops at an early stage of the disease to laser and surgical treatment in severe cases. It is necessary to know that a dead nerve cannot be restored, but a healthy one can be saved. Regular examination for the presence of glaucoma (at least once a year) by an ophthalmologist is one of the MANDATORY procedures for everyone who cares about their own health.

Cataract (clouding of the lens of the eye)

The natural lens of the eye, called the lens, becomes cloudy with age.In some cases, a genetic predisposition can also cause cataracts in young people. This is a natural progressive process, which sooner or later almost every person faces. If you have cataracts, you only become aware of this when your vision is impaired.

In this case, the lens must be removed and replaced with a synthetic lens made of special plastic. It is one of the most common surgical procedures performed all over the world. In connection with cataracts, it is necessary to know that exposure to ultraviolet rays accelerates the progression of cataracts, which is why the eyes need protection from UV rays, which are provided by sunglasses and contact lenses (contact lenses with a UV filter do not replace sunglasses with a UV filter, since they do not completely cover the eye and the area around the eye). But remember that decreased vision is not always caused by clouding of the lens of the eye. In case of visual impairment, you should consult an ophthalmologist.

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What is frontal and why is it dangerous?

If at some time during a runny nose you felt pressure behind the eyes, then most likely you have already encountered such a disease as frontal sinusitis or frontal sinusitis. What is this disease, where does it come from and how to recognize its symptoms?

The paranasal sinuses, or paranasal sinuses, are cavities filled with air.They are located inside the bones of the facial skull – around the nose and eyes. The name of each sinus comes from the name of the bones next to which they are located:

• Maxillary sinus (maxillary sinuses) is the paired sinus, which is located in the thickness of the upper jaw.
• Ethmoid sinuses (ethmoidal sinuses) – located between the eyes and slightly behind the nose.
• Frontal sinuses (frontal sinus) are located in the frontal bone – just above the eyes.
• Sphenoid sinus (sphenoidal) is located in the body of the sphenoid bone – in the upper part of the nose and behind the eyes.

Inflammation of any of the paranasal sinuses (or several sinuses at the same time) is collectively referred to as “sinusitis”. Depending on the localization of the inflammatory process, several types of sinusitis are distinguished:

• With inflammation of the maxillary sinuses, sinusitis develops ,
• With inflammation of the ethmoidal (ethmoidal) sinus – ethmoiditis ,
• (sphenoidal sinus inflammation) – sphenoiditis .

The frontal sinuses, together with the rest of the sinuses, produce mucus that drains through the nasal passages. Acute disease frontal sinusitis develops if the frontal sinuses become inflamed and at the same time the process of mucus outflow is disturbed.

Where does the frontitis come from?

The main culprit for the development of this disease is the accumulation of excess mucus due to inflammation of the frontal sinuses. Several factors can affect the amount of mucus production and the ability of the frontal sinuses to ensure its normal outflow:

The most common cause of frontal sinusitis is colds viral diseases.During a cold or flu, the production of mucus increases in the sinuses, which increases the likelihood of sinus congestion and sinus inflammation.

Our nasal cavity is filled with tiny hairs called cilia. These hairs prevent foreign microorganisms from entering the paranasal sinuses. Unfortunately, the cilia are not able to trap every bacterium, because of which the latter can still penetrate deep into the nasal cavity and reach the sinuses.

Often, a bacterial infection in the sinuses appears immediately after a viral infection.This is because bacteria can thrive in a mucus-rich environment more easily. In most cases, it is a bacterial infection that causes the most severe symptoms of sinusitis, regardless of the location of the process.

Polyps are abnormal growths that form on the mucous membrane. Polyps in the frontal sinuses can prevent the sinuses from filtering air and also contribute to excess mucus buildup.

• Curvature of the nasal septum

In people with a deviated nasal septum, one of the nostrils inhales more air than the other.In this case, uneven air circulation can lead to inflammation of the frontal sinuses.

Who is most at risk of developing frontal sinusitis?

Increased risk factors include:

• Frequent colds,
• Enlarged adenoids,
• Allergies,
• Smoking,
• Presence of a fungal infection in the body,
• Weakened immunity,
• Structural differences in the paranasal sinuses, from – for which their drainage ability is complicated.

What are the symptoms of frontal sinusitis?

The most common symptom of frontal sinus inflammation is facial pain around the eyes or forehead. Other signs of frontal sinusitis can vary in severity depending on the type of inflammation or infection (viral or bacterial). These include:

• Pressure sensation behind the eyes,
• Nasal discharge,
• Inability to distinguish between odors,
• Cough that becomes more pronounced at night,
• General malaise and fatigue,
• Fever,
• Pain in throat,
• Unpleasant (sometimes sour) odor from the mouth.

What is the diagnosis of frontal sinusitis?

If your symptoms resemble inflammation of the frontal sinuses, in this case you should see an otolaryngologist. The doctor will ask about the symptoms typical of frontal sinusitis and their duration in order to understand whether it is really frontal sinusitis or a common cold.

Also, the doctor will lightly tap on the forehead in the area of ​​the frontal sinuses to assess the degree of sensitivity and pain. After that, the specialist will examine the nasal cavity and, if necessary, take a sample of mucus for further examination.

Sometimes, in the process of diagnosing frontal sinusitis, the otolaryngologist prescribes one or more additional studies, including:

Frontitis: treatment and prevention

The choice of treatment tactics depends on what exactly caused the inflammation of the frontal sinuses – a virus, bacteria, polyps or some other factors.

In most cases, viral infections are the culprit of frontal sinusitis. An ENT may recommend the use of nasal sprays or decongestants (vasoconstrictors).They help improve mucus flow and reduce pressure in the frontal sinuses.

Sometimes frontal sinusitis treatment is not complete without pain relievers, which help to reduce pain in the frontal sinuses. Children should not be prescribed aspirin because this drug can cause a life-threatening illness called Reye’s syndrome.

If the symptoms of frontal sinusitis persist after 7-10 days, a bacterial infection may be the cause of the inflammation. In this case, the doctor will most likely prescribe antibiotics.

If the cause of the frontal sinusitis is the curvature of the nasal septum, the patient is offered to undergo an operation to align it.

How to treat frontal sinusitis at home?

One of the simplest, cheapest and most effective methods of treating sinusitis of any localization is nasal lavage. By preparing the solution at home, the patient can relieve symptoms and also reduce the frequency of using sprays and drops. Even scientists from Harvard Medical School confirm the effectiveness of nasal lavages.They recommend preparing the solution and performing the procedure as follows:

1. Pour 2 cups of distilled or boiled water into a previously prepared clean container. Add half a teaspoon of non-iodized salt and half a teaspoon of baking soda there. Stir the resulting solution.
2. Fill a small syringe with solution.
3. Lean over the bathtub or sink, insert the tip of the syringe into your nostril and gently squeeze out the saline solution. During the procedure, fluid will flow either from the same nostril or from the opposite one.
4. Repeat the procedure for the other nostril. Use at least 1 full syringe of solution for each one. If you feel that the saline solution is burning your nasal cavity, use less salt.
5. Thoroughly flush the syringe after each procedure using boiled or distilled water.

This completes the treatment of frontal sinusitis at home. As you can see, there is absolutely nothing difficult about rinsing your nose. But the effectiveness of this procedure cannot be overestimated.

How long does the disease last?

In most cases, the symptoms of acute frontal sinusitis disappear after a few days. Although the patient should not stop the treatment prescribed by the ENT, it may take several weeks for the inflammation to go away completely.

If the symptoms of frontal sinusitis persist for 12 or more weeks, the disease becomes chronic. Chronic sinusitis does not respond well to treatment and sometimes requires surgery to improve mucus drainage. Although the chronic form of this disease is very rare, it is important not to self-medicate or wait for the inflammation to clear up on its own.

Complications of this disease are rare, but they should not be discounted. Indeed, among them there are those that pose a threat to human life, including ocular and intracranial complications: an abscess (accumulation of pus) of the eye socket and brain, as well as meningitis. In order to avoid the development of complications, it is better to consult an otolaryngologist as early as possible.

Sources:

1. Acute Frontal Sinusitis, HealthLine,
2. Sinus Anatomy, American Rhinologic Society,
3. Acute Sinusitis, Patient.info,
4. What to do about sinusitis, Harvard University,
5. Clairmont AA, Per -Lee JH, Complications of acute frontal sinusitis, Am Fam Physician, 1975 May; 11 (5): 80-4.

Diagnostics of infectious mononucleosis – to pass the analysis to SZCDM

Infectious mononucleosis is an infectious disease that also has several more names: Filatov’s disease, Epstein-Barr virus (EBV), monocytic tonsillitis, benign lymphoblastosis. It is characterized by a febrile condition, damage to the pharynx, lymph nodes, spleen and liver, changes the composition of the blood.

The causative agent of mononucleosis is the Epstein-Barr DNA genomic virus of the herpesvirus family (Herpesviridae). Divide into two types A and B, which are similar in symptoms and course of the disease.

Herpesvirus is widespread – 50% of children are carriers, among adults the incidence reaches 90%. In the vast majority of cases, a person is a carrier.Symptoms do not appear. Such a person is called seropositive or seropositive.

Sometimes the disease causes serious complications: airway obstruction, closed damage to the soft tissues of the spleen, and neurological syndromes. The main diagnostic method is serological analysis. The therapy is symptomatic and supportive. Once infected, a person becomes a carrier of the virus for life.

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Transmission routes

The virus does not live outside the human body. Dies at high temperatures and from disinfectants. It is transmitted by biological fluids and by airborne droplets during close contact of a healthy and seropositive person. Infection occurs in both acute and chronic phases.

The most common method of transmission is kissing, and the rarest is through blood transfusion. You can become infected by using shared utensils, clothes, bed linen and towels. Outbreaks of the disease occur in crowded places: dormitories, small families, children’s institutions.Most often, herpesvirus is detected in social groups with a low level of income, due to the cramped living conditions.

Mononucleosis symptoms

In young children under 5 years of age, primary EBV infection is asymptomatic in most cases. Symptoms of infectious mononucleosis develop more often in adolescents, slightly less often in adults. The average incubation period is 40 days. At this time, the patient experiences increased fatigue.

The disease proceeds in 3 phases:

1.Fever – The temperature rises during the day, reaching its peak in the evening. It reaches +40 C, but may be higher, and decreases by morning.

2. Pharyngitis (inflammation of the pharynx and tonsils) – is difficult, with severe pain. The mucous membranes turn red, swell, the formation of exudate may be observed.

3. Adenopathy – generalized enlargement of the lymph nodes. Changes can be noticed visually and on palpation of the posterior and anterior cervical lymph nodes, submandibular, axillary and inguinal.The lesion is symmetrical, can be observed on any group of nodes. In some cases, adenopathy may be the only sign of infection.

Depending on the individual characteristics of the body and the presence of other diseases, mononucleosis in some people can cause the following symptoms:

• Splenomegaly – enlargement of the spleen, occurs in 50% of cases.

• Hepatomegaly – an increase in the size of the liver, pain when tapping.

Other symptoms include yellowness of the integument, puffiness around the eyes, ruptured capillaries (petechial rash).

Complications

With the initial infection, the Epstein-Barry virus can be asymptomatic in the body, and in some cases cause serious consequences. First of all, these are respiratory complications.

• Upper airway obstruction – the lymph nodes may become large enough to make breathing difficult.

• Pulmonary infiltrates – replacement of the lung area of ​​normal airiness with denser enlarged tissues. More common in young children.

Complications of mononucleosis can affect individual organs:

• Liver. In 95% of patients, the level of aminotransferase increases 2 – 3 times.The skin may acquire a slight jaundice tint. The liver will be enlarged, painful on percussion.

• Spleen. With mononucleosis, the spleen and capsules increase significantly in size, which leads to rupture. The maximum swelling is observed 10 to 21 days after infection. On average, the complication is observed in half of the patients. The rupture can be painful, or it can go away painlessly with hypotension (low blood pressure).

Hematological complications are also noted, which, as a rule, do not require medical intervention and are stopped on their own. This includes:

• Granulocytopenia – a decrease in the content of granulocytes in the peripheral blood.

• Thrombocytopenia – a decrease in the number of platelets, an increased risk of bleeding.

• Hemolytic anemia – premature breakdown of red blood cells

Similar symptoms are observed in 50% of patients.In rare cases, hematological complications are difficult and can lead to bacterial infections.

The nervous system also suffers from EBV. In extremely rare cases, against the background of infectious mononucleosis, encephalitis, Guillain-Barré syndrome, cranial nerve palsies, meningitis, and myelitis can develop.

Diagnostics

To carry out these tests, it is necessary to assume the presence of an infectious mononucleosis virus by typical signs.These symptoms include swollen lymph nodes in the back of the neck or generalized adenopathy in combination with enlargement of the liver and spleen, exudative pharyngitis, and high fever.

You should also pay attention to diseases that are similar in symptomatology and exclude them.

Differential Diagnostics

When diagnosing, it is necessary to make sure that the patient has exactly herpesvirus, since there are several infections similar to EBV.Among them:

• Primary HIV infection. It can be excluded by conducting tests for the quantitative determination of HIV RNA in blood plasma and a combined enzyme-linked immunosorbent assay for antibodies and p24 antigen.

• Primary HIV infection has symptoms similar to EBV. All patients at risk should be tested for HIV without fail.

• Cytomegalovirus.It is similar to EBV in everything except pharyngitis. To exclude this disease, serological testing, analysis for antigens or CMV DNA is necessary.

• Toxoplasmosis. A parasitic disease, which, like cytomegalovirus, differs from mononucleosis in the absence of pharyngitis. For differentiation, he conducts serology of blood serum, analysis for the level of IgG antibodies.

In practice, there are cases of simultaneous infection with several types of viruses that are in the body in an active phase.Differentiation is also carried out in case of ineffectiveness of treatment, prolonged course of the disease, with insufficient results for remission.

Laboratory diagnostic methods for mononucleosis

The main criterion for making a diagnosis is a serological analysis for EBV. Atypical lymphocytes can be present in influenza, hepatitis B, HIV, cytomegalovirus, and other viral diseases. But, only with primary mononucleosis, they are produced in very large quantities.

Serological analysis is confirmed by a test for specific (heterophilic) antibodies to EBV. The most productive research is when working with biological materials of adolescents and adults. In children under 5 years old, it shows a positive result only in 50% of cases.

Important to know! In HIV-infected individuals, heterophilic antibody testing may be false positive. It is recommended to conduct the study twice with an interval of 7 to 10 days.

The presence of IgG antibodies to EBV VCA indicates primary EBV infection. They can be detected from the first days of infection within three months. Antibodies to EBV-IgG are produced later, about 2 months after the onset of the disease. They are stored in the blood throughout a person’s life.

Instrumental diagnostics

To diagnose, assess the severity, control therapy, the following types of instrumental diagnostics are used:

• ultrasound examination of the peritoneal organs;

• electrocardiogram;

• chest x-ray;

• echocardiography;

• neurosonography;

• electroencephalography;

• X-ray of the paranasal sinuses.

Instrumental examination of the patient allows determining the size of the liver, spleen and lymph nodes to assess the severity of the disease: mild, moderate, severe. When diagnosing “infectious mononucleosis”, they indicate the specifics of the course of the disease: clinical, nosological form, severity, duration. The presence of complications and concomitant diseases is entered in a separate line.

Treatment of infectious mononucleosis

Treatment of infectious mononucleosis is aimed at arresting palogolic processes, preventing their development in the future, preventing complications, residual effects and the chronic course of the disease.

First of all, the patient needs to ensure peace. During the period of enlargement of the spleen, physical activity and sports are prohibited. Lifting heavy objects should be avoided to reduce the risk of ruptured spleen. To reduce symptoms and accelerate recovery, methods of drug and non-drug treatment are used.

Drugs for etiotropic, symptomatic therapy and immunocorrection are indicated:

• interferons;

• immunoglobulins;

• nucleosides and nucleotides, other than reverse transcriptase inhibitors;

• derivatives of propionic and acetic acid;

• derivatives of triazole;

• adrenergic agonists;

• antibiotics;

• macrolides;

• glucocorticoids;

• solutions that affect the water-electrolyte balance for detoxification;

• mucolytic drugs and others, depending on the symptoms.

Antibiotics are prescribed only for viral and bacterial infections, confirmed by microbiological diagnostics. Corticosteroids may also be prescribed if complications are present. They are believed to help get rid of fever faster and reduce the appearance of pharyngitis. They are useful for complications such as threatened airway obstruction, hemolytic anemia, and thrombocytopenia.

The most effective non-drug treatments include physical therapy, nasal debridement, and frequent ventilation.Depending on the degree of the course of the disease, treatment can be carried out on an outpatient basis and in a hospital.

Forecast and prevention

In most healthy people, the acute phase of infectious mononucleosis goes away on its own. However, a person will forever remain a carrier of the virus. A severe course and complications are observed in 10 – 20% of cases, depending on the age group. The presence of chronic diseases and immunodeficiency conditions increases the risk of a severe course of the disease.Mortality is low, less than 1%, complications that develop against the background of infection lead to it: airway obstruction, encephalitis, rupture of the spleen.

The duration of the acute phase of the disease is about 2 weeks. After this period, in the absence of symptoms, the patient can return to school or work. Among the indications for discharge: normalization of temperature, absence of signs of intoxication and inflammation in the nasopharynx, normalization of the size of the lymph nodes, liver and spleen.However, it is necessary to continue a sparing sleep-wakefulness regime, to avoid increased mental and physical stress. High fatigue will persist for several more weeks, in some patients for many months.

After mononucleosis, the body’s sensitivity to respiratory diseases and the herpes virus increases. Many people report the onset of frequent skin lesions on the upper or lower lip after recovery from EBV.

Advantages of the laboratories of SZDTSM JSC

• Our own laboratory and state-of-the-art equipment guarantee fast and accurate results.

• Qualified staff and friendly staff – anonymity, comfortable stay, no queues.

• Convenient location of the terminals – easily accessible not only by car, but also by public transport.

• There are several ways to get the results – in person, by email specified during registration.

You can get tested for infectious mononucleosis in St. Petersburg, Leningrad Region, Veliky Novgorod, Staraya Russa, Okulovka, Kaliningrad and Pskov.

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90,000 Ethmoiditis: symptoms, diagnosis and treatment

Ethmoiditis is a type of sinusitis. The inflammation spreads to the ethmoid labyrinth of the nose.Emoiditis is dangerous because in its acute form it affects the bony walls of the nasal septa and spreads to nearby organs. Because of this, there is a high risk of serious complications, which, in particular, affect the patient’s eyes.

Symptoms

In adults and children, ethmoiditis proceeds in the same way. The disease makes itself felt with aching pain in the area of ​​the base of the nose and the bridge of the nose. If the patient tries to take pain medication, the pain does not go away. It is almost impossible to distinguish the disease from other forms of sinusitis without special examinations.But if the patient feels localized pain in the region of the bridge of the nose, and not in the sinuses, then the chance that it is ethmoiditis is very high.

Other symptoms of ethmoiditis include:

• visual impairment;
• pain in the eye socket area;
• swelling of the periorbital region;
• redness of the skin around the eyes;
• heaviness in the area of ​​the nose, especially when the head is tilted forward;
• increase in body temperature to 38 degrees.

Nasal discharge rarely accompanies ethmoiditis. This is due to the fact that mucus is secreted from the sphenoetmoidal pocket. From there, it is closer to her to reach the back of the pharynx, where she safely and removed.

In young children, sinusitis (including ethmoiditis) is suspected if, after successful treatment of the common cold, after a few days it returns again, and is accompanied by an increase in body temperature.

Do you have symptoms of ethmoiditis?

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Reasons for development

Ethmoiditis develops in the same way as other types of sinusitis. The cause may be an infection or dysregulation of the tone of small vessels (vasomotor ethmoiditis).

Infectious sinusitis is the most common. An infection that has entered the body can be viral, bacterial, or fungal. All of these can cause any type of sinusitis, including ethmoiditis.Most often it develops as a complication of scarlet fever.

Vasomotor ethmoiditis most often occurs in adult patients, children practically do not suffer from it. The disease causes excessive dryness of the air that a person breathes constantly and for a long time. Vasomotor ethmoiditis is often chronic in nature and worsens in the winter months, when it is dry outside, and central heating is working in the apartments, which dries up the air even more.

How can you get infected

Emoiditis can occur when you get the flu, staphylococcal or streptococcal infection.Adenovirus and rhinovirus can also provoke ethmoid sinus inflammation. The disease is transmitted by airborne droplets, by contact and through non-sterile skin lesions. The body is especially susceptible to infections with reduced immunity, for example, if you have just had a cold, are suffering from depression or a lack of vitamins.

Risk factors

Emoiditis most often affects patients aged 3 to 15 years, but older people are not protected from it (as, indeed, from other forms of sinusitis).This disorder often develops in people who have had some type of sinusitis. At risk are patients with congenital or acquired pathologies of the structure of the nose, for example, curvature of the nasal septum.

If you suffer from a weakened immune system, ethmoiditis or other forms of sinusitis will not keep you waiting. Consult a physician to find out the reason for the weakening of protective functions. At risk are people suffering from serious illnesses, for example, HIV or AIDS, tuberculosis, diabetes mellitus.Immunity also decreases in some cancers.

Complications

Acute ethmoiditis in the absence of proper treatment can develop into a chronic one. In this case, the patient will suffer from periodic attacks of the disease, therefore, it is better not to postpone the treatment of the acute form. Chronic ethmoiditis causes permanent thickening of the nasal mucosa. In this case, the patient may develop in parallel granulations and polyposis neoplasms in the cell walls, in the middle course and on the middle shell.

Polypoid ethmoiditis involves the development or presence of polyps in the nasal cavities in the patient. You can only get rid of them surgically.

The most unpleasant complication is ethmoid empyema. Due to the obstructed outflow of pus, the inflammation spreads to the orbital tissue. The patient has swelling of the eyelids and tissues around the eye sockets. The eyeball is either pushed outward (anterior ethmoid cell empyema) or deflected (posterior ethmoid cell empyema).In this case, the patient suffers from visual impairment.

When to see an otolaryngologist

All forms of sinusitis are treated by an otolaryngologist. It is almost impossible to determine the type of sinusitis on your own (unless you suffer from a chronic form of one of them and feel an exacerbation), so you need to make an appointment with a doctor, paying attention to the general symptoms of inflammation of the nasal mucous membranes:

• heaviness in the nose;
• Swelling and swelling around the nose, sinuses and / or eye sockets;
• pain when blowing out.

Be sure to tell your doctor if you experience blurred vision and pressure in your eyes. This will help the specialist quickly diagnose and begin effective treatment.

Diagnostics

Usually the doctor makes a diagnosis of “sinusitis” during the initial examination, but sometimes a series of examinations is required to clarify it. To unambiguously separate ethmoiditis from other forms of sinusitis, you will have to resort to:

• x-ray;
• sinus puncture;
• computed tomography of the paranasal sinuses.

The latest diagnostic procedure allows you to accurately determine the condition of the nasal septum, turbinates, paranasal sinuses and ethmoid walls.

Treatment

Drug treatment of ethmoiditis is ineffective, and therefore rarely used. Antibiotics for ethmoiditis (and any other forms of sinusitis) do not give the desired effect.

In many cases, the otolaryngologist prescribes surgical treatment – endoscopic ethmoid sinus surgery.Ethmoidotomy is the most effective treatment for the disease. The procedure immediately returns the patient to normal nasal breathing, relieves the feeling of pressure and allows inflammation to subside. The availability of high-quality modern equipment allows the surgeon to reach the patient’s sinuses and remove their pathological contents without unnecessary punctures and incisions.

As an adjunct to surgery, the otolaryngologist may prescribe vasoconstrictor drugs, pain relievers, and antipyretics.The choice of drugs depends on the causes of ethmoiditis.

Home Treatment

Folk remedies for combating inflammation of the mucous membranes are highly discouraged if you suspect you have ethmoiditis. Attempts to cure an acute inflammatory process with homemade recipes will only lead to the development of a chronic form of this disease. Instead, listen to your doctor’s prescription for advice on how to treat ethmoiditis.

Prevention

To protect yourself from ethmoiditis and avoid re-development of the disease, try to strengthen the immune system.In the vast majority of cases, sinusitis is caused by an infectious disease and should therefore be avoided. Wear a mask during a flu epidemic, avoid socializing with sick colleagues or friends, and maintain hand hygiene.

Dangerous Myths About Sinusitis

Most of the myths and misconceptions have accumulated around the surgical treatment of ethmoiditis and other sinusitis. Many people believe that a “puncture” is a painful, traumatic and even harmful operation, which later will have to be repeated over and over again.This is not true. Puncture of the sinus leaves no traces and heals completely within 3-4 days. And constant and repeated “punctures” are required only if the causes of the development of the disease (for example, polyps or a curved septum) have not been eliminated.

The fear of surgery leads patients to seek conservative treatments. The truth is, most types of sinusitis cannot be effectively treated with conventional medications. Typically, the patient needs surgery.But there is no need to be afraid. Ethmoidotomy is a completely painless, quick and minimally invasive procedure.

Another dangerous misconception is the belief in the harmlessness of sinusitis. Some people expect that ethmoiditis will go away on its own, but this is not possible. In the absence of treatment for the acute form, ethmoiditis will simply migrate into a chronic one, but it will certainly not be cured.

Some patients are convinced that the absence of nasal discharge is a sure sign of the absence of ethmoiditis, but this is not the case.Due to the localization of the inflammation, mucus flows down the back of the larynx, and not through the nostrils. Therefore, during ethmoiditis, a runny nose, as a rule, does not happen.

How to make an appointment with the specialists of JSC “Medicine” (Clinic of Academician Roitberg)

You can make an appointment with the specialists of JSC “Medicine” (the clinic of Academician Roitberg) on ​​the website – an interactive form allows you to choose a doctor by specialization or search for an employee of any department by name and surname.Each doctor’s schedule contains information about visiting days and hours available for patient visits.

The administrators of the clinic are ready to accept an application for an appointment or call a doctor at home by phone +7 (495) 775-73-60.

Convenient location on the territory of the central administrative district of Moscow (CAD) – 2nd Tverskoy-Yamskaya lane, 10 – allows you to quickly get to the clinic from the metro stations “Mayakovskaya”, “Novoslobodskaya”, “Tverskaya”, “Chekhovskaya” and “Belorusskaya” …

Adenocarcinoma of the intestinal type – MyPathologyReport.ca

What is intestinal adenocarcinoma?

Intestinal adenocarcinoma (ITAC) is a type of cancer. The tumor begins in the tissue lining the inside of the nasal cavity or sinuses, such as the ethmoid or maxillary sinuses. ITAC is an aggressive type of cancer that quickly spreads to other parts of the head, including the area around the eyes and the brain.

Nasal cavity and paranasal sinuses

When we breathe, air enters our body through our nose and mouth and through a long tube called the trachea into the lungs.The inside of the nose is called the nasal cavity, and it helps warm and clear the air before it reaches our lungs.

The nasal cavity is surrounded by small paired air-filled spaces called the paranasal sinuses, which are connected to the nasal cavity by small openings. The paranasal sinuses include the maxillary sinus, the frontal sinus, the ethmoid sinus, and the sphenoid sinus. Because the nasal cavity and sinuses are connected to each other, pathologists describe this area of ​​the body as the sinuses.

Inside the nasal cavity and sinuses are lined with special epithelial cells that form a barrier called the epithelium. The tissue under the epithelium is called the stroma and is made up of blood vessels and small, round structures called glands that make a substance called mucin. The epithelium and underlying stroma combine to create a layer of tissue called the synonasal layer. mucous membrane.

What causes intestinal adenocarcinoma?

Most patients who develop ITAC have worked with wood dust, leather dust, textile dust, or formaldehyde for a long period of time.These chemicals damage tissues inside the nasal cavity and sinuses, which can lead to the development of cancer.

How do pathologists make this diagnosis?

ITAC is usually diagnosed after a small tissue sample is removed in a procedure called a biopsy. The diagnosis can also be made after the entire tumor has been removed using a procedure called resection. The tissue is then sent to a pathologist who examines it under a microscope.

When examined under a microscope, the tumor is very similar to a type of cancer that usually develops in the colon called adenocarcinoma (hence the tumor is called “intestinal”).Tumor cells often join together to form circular structures called glands or long, finger-like projections called papillae. The glands can be located back to back, which pathologists describe as cribriform. A type of cell death called necrosis is often observed, especially on the inside of the glands. Pathologists use the term “dirty necrosis” to describe this type of cell death.

Your pathologist may perform a test called immunohistochemistry to confirm the diagnosis.When performed, tumor cells in ITAC are usually positive for markers commonly seen in the colon, including CK20, CDX-2, and villin. Tumor cells can also be positive for CK7, another marker often found in the digestive tract.

Before diagnosing ITAC, your pathologist will likely review your medical history, in particular any recent imaging studies that have been performed to confirm that you have no history of gastrointestinal cancer (especially colon cancer) and that there are no suspicious formations in your body.gastrointestinal tract. This information is important because metastatic gastrointestinal tumor under the microscope may look the same as intestinal adenocarcinoma, and metastases must be ruled out before ITAC is diagnosed.

What to look for in your report after tumor removal

Tumor size

This is the largest tumor size in centimeters. However, sinus tumors are often removed in several parts.As a result, your pathologist will not be able to accurately measure the size of the tumor. In this case, the approximate size of the tumor can be described.

Perineural invasion

Nerves are like long wires made up of groups of cells called neurons. Nerves carry information (such as temperature, pressure, and pain) between the brain and body. Perineural invasion is the term pathologists use to describe cancer cells attached to a nerve.

Perineural invasion is important because cancer cells attached to a nerve can use the nerve to invade tissue outside of the original tumor.For this reason, perineural invasion is associated with a higher risk of the tumor returning to the same area of ​​the body (local recurrence) after treatment.

Lymphovascular invasion

Blood moves through the body through long, thin tubes called blood vessels. Another type of fluid called lymph contains waste products and immune cells that travel through the body through the lymphatic channels. Cancer cells can use blood vessels and lymph vessels to travel from the tumor to other parts of the body.Moving cancer cells from a tumor to another part of the body is called metastasis.

Before cancer cells can metastasize, they must enter a blood or lymph vessel. This is called lymphovascular invasion. Observing lymphovascular invasion increases the risk of finding cancer cells in the lymph node or distant part of the body such as the lungs.

Fields

A margin is any tissue the surgeon has cut to remove a tumor from your body.Whenever possible, surgeons will try to cut tissue outside the tumor to reduce the risk that any cancer cells will remain after the tumor is removed.

Negative margin means there were no cancer cells at the very edge of the cut tissue. The limit is considered positive if the cancer cells are at the very edge of the cut tissue. A positive margin is associated with a higher risk of a tumor growing (recurring) in the same area after treatment.

Because these tumors are often removed in multiple parts, your pathologist may not be able to reliably assess the tumor boundaries.For this reason, in most reports on the pathology of intestinal adenocarcinoma, there is no information about the boundaries.

Lymph node

The lymph node is a small immune organ located throughout the body. Cancer cells can travel from the tumor to the lymph node through lymphatic channels located in and around the tumor (see Lymphovascular invasion above). The movement of cancer cells from a tumor to a lymph node is called metastasis.

Lymph nodes in the neck are sometimes removed at the same time as the underlying tumor in a procedure called neck dissection.The lymph nodes that are removed are usually taken from different areas of the neck, and each area is called a level. The neck levels include 1, 2, 3, 4, and 5. Your pathology report will often indicate how many lymph nodes were found at each level sent for examination. The lymph nodes on the same side as the tumor are called ipsilateral, and the lymph nodes on the opposite side of the tumor are called contralateral.

Your pathologist will carefully examine each lymph node for cancer cells.Lymph nodes that contain cancer cells are often called positive, and those that do not contain cancer cells are often called negative. Most reports indicate the total number of lymph nodes examined and the number of cancer cells, if any. The number of lymph nodes containing cancer cells and their location in the body is used to determine the nodal stage (see Pathologic Stage below).

Tumor deposits

A group of cancer cells inside a lymph node is called tumor deposition.If a tumor deposit is found, your pathologist will measure it and your report will show the largest tumor deposit found. Large tumor deposits are associated with a worse prognosis. The size of the largest tumor deposit is also used to determine the nodal stage (see Pathologic Stage below).

Pathological stage (pTNM)

Pathologic staging of intestinal adenocarcinoma is based on the TNM staging system, an internationally recognized system originally established by the American Joint Committee on Cancer.This system uses information about the primary tumor (pT), lymph node (pN), and distant metastatic disease (pM) to determine the complete pathologic stage (pTNM). Your pathologist will examine the tissue presented and assign a number to each part. In general, a higher number means more advanced disease and worse. forecast.

Tumor stage (pT) for tumors that begin at

nasal cavity or ethmoid sinus

These tumors have tumor stages from 1 to 4.The stage of the tumor depends on how far the tumor has spread outside the nasal cavity or ethmoid sinus.

• T1 – The tumor is confined to the nasal cavity or ethmoid sinus. It has not spread to the surrounding bones.
• T2 – The tumor has spread from the nasal cavity or ethmoid sinus.
• T3 – The tumor has spread to the wall or bottom of the orbit (the cavity where the eye is located), the maxillary sinus, the palate (palate), or the ethmoid plate (the area at the top of the nasal cavity).
• T4 – The tumor has spread to the eye, the skin of the nose or cheeks, the cranial cavity (the space in which the brain is located), the pterygoid plates (the bones at the bottom of the cranial cavity), the sphenoid or frontal sinuses.

Tumor stage (pT) for tumors that begin at

maxillary sinus

These tumors are assigned a tumor stage from 1 to 4. The stage of the tumor depends on how far the tumor has spread outside the maxillary sinus.

• T1 – The tumor is limited to the maxillary sinus.It has not spread to the surrounding bones.
• T2 – The tumor has spread from the nasal cavity or ethmoid sinus.
• T3 – The tumor has spread to the bone in the back of the maxillary sinus, subcutaneous tissue, the bottom or wall of the orbit (the cavity where the eye is located), the pterygoid fossa, or ethmoid sinuses.
• T4 – The tumor has spread to the eye, the skin of the nose or cheeks, the cranial cavity (the space in which the brain is located), the pterygoid plates (the bones at the bottom of the cranial cavity), the sphenoid or frontal sinuses.

Nodal stage (pN) tumors that begin at

nasal cavity or sinuses

These tumors are assigned nodal stage 0 to 3 based on the following three characteristics:

1. Number of lymph nodes containing cancer cells.
2. The size of the tumor deposit.
3. Are the lymph nodes with cancer cells on the same side (ipsilateral) or on the opposite (contralateral) side of the tumor.

Nodal stage will be higher if any of the tumor deposits are larger than 3 cm, more than one lymph node contains cancer cells, cancer cells are found in lymph nodes on both sides of the neck, and if any of the lymph nodes shows extranodal enlargement.

If no cancer cells are found in any of the examined lymph nodes, the nodal stage is N0. If the lymph nodes are not sent for pathologic examination, the node cannot be identified and the stage is indicated as NX.

Metastatic stage (PM) of intestinal adenocarcinoma

Adenocarcinoma of the intestinal type is assigned a metastatic stage (pM) of 0 or 1, depending on the presence of cancer cells in a distant part of the body (for example, in the lungs). The metastatic stage can only be determined if tissue from a distant site is sent for pathological examination. Since this tissue is rarely present, the stage of metastasis cannot be determined and designated as MX.

Jason Wasserman MD, FRCPC (updated 29 Aug 2021)

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