Sinus tenderness

Introduction Sinus tenderness is a common symptom of sinusitis, accompanied by nasal congestion, runny nose, headache and other symptoms. Patients with acute sinusitis may be associated with fever and general malaise. Nasal or nasal endoscopy revealed swelling of the nasal mucosa, purulent secretions in the middle nasal passage or olfactory fissure, and tenderness in each corresponding sinus area.

Cause

The sinus is a gas-filled cavity of the skull around the nasal cavity; there are 4 pairs on the left and right sides: the frontal sinus, the maxillary sinus, the ethmoid sinus, and the sphenoid sinus. Because of its anatomical features, each sinus can be isolated, and it can also form multiple sinusitis or total sinusitis. The disease is generally divided into acute and chronic 2, for many reasons and more complicated. Acute sinusitis is caused by acute rhinitis; chronic sinusitis is often caused by acute sinusitis that is not completely cured or recurrent. It is currently believed that the cause of sinusitis is mainly due to sinus occlusion caused by various causes of infection in the sinus. Nasal polyps are an important cause of sinus opening obstruction, and inflammatory stimulation of the sinus in turn promotes the growth of nasal polyps. . In addition, sewage enters the sinus while swimming, adjacent organs spread, nasal tumors hinder sinus drainage, and trauma can cause sinusitis.

an examination

Related inspection

Paranasal sinus sinus angiography

Sinus X-ray filming is helpful for diagnosis.

The tenderness examination method in each sinus area is as follows:

(1) Maxillary sinus: After the doctor's hands are fixed on both ears of the patient, the thumb is placed on the left and right crotch and pressed backwards to inquire whether there is tenderness, and whether there is any difference in tenderness between the two sides. You can also use the right middle finger to hit the ankle and ask if there is any pain.

(2) Frontal sinus: Support the patient's occipital part with one hand, and put it on the upper edge of the eyelid with another thumb or finger. Or fix the head with both hands, put your thumb on the inner side of the upper edge of the eyelid and press it upwards. Ask for the presence or absence of another thumb or finger on the inside of the upper edge of the eyelid and press it back and forth. Ask if there is tenderness, there is no difference on both sides, you can also use the middle finger to slam the area and ask if there is any slap pain.

(3) ethmoid sinus: After fixing the ears on both sides of the patient with both hands, the bilateral thumb is placed between the base of the nose and the iliac crest of the eye to press back to ask for tenderness.

(4) sphenoid sinus: because the anatomical position is deep, it can not be examined on the body surface.

Differential diagnosis

Differential diagnosis of sinus tenderness:

Intranasal pain: intranasal pain due to dryness and rupture of the nasal mucosa, may be associated with nosebleeds. Intranasal pain is also one of the symptoms of nasal cancer.

When the turbinate is hypertrophy, the nasal septum is bent, the nasal polyps, and the nasal mucosa is inflamed and swollen due to cold or infection by adjacent lesions, it may cause mechanical obstacles in the nasal cavity, hinder the opening of the sinus, and the drainage is not smooth, causing inflammation of the sinus.

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