Symptoms and treatment of chronic sinusitis, code of illness according to ICD-10

1 Classification of sinusitis

Each disease, according to ICD-10, has its own number, that is, the code. Since sinusitis refers to the forms of sinusitis, then in the system it is worth searching among the inflammations of the paranasal sinuses.

Acute sinusitis corresponds to the ICD code J01, and then the disease is divided into types depending on the location of the inflammatory process:

• frontal sinusitis - inflammation of the mucous membranes of the frontal, i.e. frontal, sinuses - J01.1;
• etmoidal sinusitis - inflammation in the trellis labyrinth - J01.2;
• sphenoidal sinusitis( sphenoiditis) - inflammatory process in the sphenoid sinus - code for ICD-10 J01.3;
• pansinusitis - inflammation in all paranasal sinuses - J01.4.

If the nasal mucous membranes and paranasal sinuses have inflamed, then it has developed rhinosinusitis, it has a different name when the inflammatory or chronic sinusitis forms are strongly pronounced - sinusitis.

Chronic sinusitis also has a separate code - J32, and among the listed types( frontal, ethmoidal, sphenoidal, etc.) first is the maxillary, according to the international classification having the designation J32.0.

Thus, if the inflammation spreads in the maxillary region and affects the maxillary sinuses, then the chronic maxillary sinusitis is diagnosed.

This disease does not belong to rare ailments, and, according to statistics, it is tolerated by 1 person out of 10 regardless of age.

Sinusitis requires treatment at an early stage, otherwise the disease will flow into more serious forms, which are fraught with various complications.

2 Causes of the development of the disease

The most common inflammation of the maxillary sinuses develops on the background of not cured colds and a cold. In addition, carious teeth, especially those located in the upper jaw, and malfunctions in the functioning of the immune system can trigger the maxillary sinusitis - allergic reactions, etc.

To the causes of the disease can be attributed to infectious pathogens. Often, when staging a sinusitis in a smear of discharge from the nose, a staphylococcal bacterium is found that is activated with reduced immunity.

Chronic maxillary sinusitis can occur in the following cases:

• when ingested mucous membranes of pathogenic bacteria;
• if the body has received severe hypothermia;
• with abnormalities in the structure of the nasopharynx;
• if there are pathologies of the glands of a congenital character;
• after the injuries that affected the nasal septum;
• in case the patient has polyps and adenoids, etc.

If we talk about the factors contributing to the development of such diseases, the main one is the excessive use of nasal drugs. Their use promotes the accumulation of mucous formations in the region of the paranasal sinuses.

3 Clinical picture of pathology

The first symptom is abundant discharge from the nose. At first they are colorless and have a liquid, watery consistency. After this, acute maxillary sinusitis develops( ICD-10 code is J32.0), nasal discharge becomes thicker, greenish-yellow. If the disease flows into a chronic form, then in the mucus from the nose may be an admixture of blood.

In addition, in case of worsening of the patient's condition, the following signs of the disease are present:

• memory impairment;
• insomnia;
• general weakness, fatigue;
• increases body temperature, in some cases to critical levels;
• chills;
• headache;
• the patient refuses to eat;
• pain in the temporal, occipital, frontal areas.

Sometimes there is an external symptom of the disease - swelling of the nose.

The disease can progress rapidly enough, so it is necessary to seek medical help at the first symptoms.

4 Possible complications of

If primary signs are ignored, the sinusitis leads to very serious, and often irreversible, consequences:

• to the development of acute purulent inflammation of the orbital fiber( phlegmon) followed by tissue death;
• purulent inflammation of the lower eyelid;
• inflammatory processes in the ear( otitis);
• damage to the organs of the bronchopulmonary system;
• kidney disease, heart muscle.

Among the most serious consequences can be noted meningitis, purulent inflammation of the brain tissue and blood infection.

5 Diagnostic methods

At the primary admission during examination and questioning of the patient, the ENT can be suspected that the patient has sinusitis in chronic form. If the mucous thickened, reddened, with edema, in addition, the patient is tormented by viscous and purulent currents from the nose, then these are the true signs of the disease.

And to find out exactly whether the doctor is right, the following diagnostic methods will help:

• studies of bacteria in mucus from the nasal cavity;
• Rhinoendoscopy - examination of the condition of the mucous membranes of the nose and sinuses when using a special device;
• X-ray of the nasal sinuses.

In some cases, the puncture of the affected sinus is prescribed, as well as allergotests in order to determine the immune status of the patient.

6 Treatment measures

Unfortunately, there is no remedy capable of permanently curing chronic maxillary sinusitis. During periods of exacerbations, compulsory complex treatment is required, which not only helps to eliminate symptoms, but also eliminates the pathogenic agent of sinusitis.

First of all, the treatment consists in cleaning( sanitation) of the nasal sinuses, in which the infection accumulates.

Antibacterial agents belonging to the group of cephalosporins( Ceftriaxone, Ceftibuten, Cefix) or fluoroquinols( Moxifloxacin, Ciprofloxacin, Levofloxacin, Gatifloxacin, Sparfloxacin) are prescribed to stop the growth and multiplication of bacteria.

Antibacterial agents for local administration, for example Bioparox spray, are prescribed concomitantly with antibiotic preparations.

To get rid of abundant mucous secretions and to remove puffiness, sprays and drops of vasoconstrictive action - Nazivin, Galazolin, etc., are prescribed. But it is necessary to follow the instruction and not to use drugs longer than prescribed. Otherwise, the body can become addicted to the components of the remedies.

In modern medicine for the treatment of chronic sinusitis, the drug Renoflumacil is actively used, which dilutes the mucus accumulated in the sinuses and removes swelling.

To cleanse sinuses from pathogenic microorganisms, prescribe a course of disinfecting washes using Dioxydin, Furacilin.

In most cases, patients with sinusitis have a significant decrease in immune defense, so it is mandatory to consult an immunologist. To correct the state of immunity, the following drugs can be prescribed: Ribomunil, Imudon, IRS-19.

If the disease is allergic, it can be prescribed antihistamines - Eden, Telfast - or drugs containing hormones, such as Nazonex.

In addition to drug therapy, physiotherapeutic procedures are also used as a supplement:

• treatment with salt caves - speleotherapy;
• ultrasound in the area of ​​infected nasal sinuses;
• electrophoresis with the addition of Lidase;
• application of high-frequency radiation( UHF) to the affected area;
• using magnetotherapy on the pharynx;
• laser therapy.

If a large amount of pus accumulates in the sinuses and this threatens the patient's life, then an emergency drainage of the maxillary sinuses and subsequent removal of their contents is carried out. After the procedure for a stronger effect, antibacterial agents are injected locally into the affected area.

Do not be afraid of these procedures, since this is the fastest way to help in emergency situations, which does not affect the relapse of the disease.

In the most difficult cases, the patient is threatened with surgical intervention - maxillary sinusitis, that is, opening of the sinuses and their subsequent purification.