Pus from the nostrils

Introduction Nostril pus is a pathological change of mucosa characterized by edema, thickening, vascular hyperplasia, lymphatic thoracic and plasma cell infiltration, epithelial cilia shedding or squamous metaplasia and polypoid changes. If the glandular duct is blocked, cysticity may occur. change. There are many reasons for this. It can also cause pus in the nostrils due to the fire on the body. Treatment of this disease should pay attention to the treatment of allergic causes, remove the source of infection; improve ventilatory drainage, maintain physiological functions and appropriate surgery.

Cause

Chronic suppurative sinusitis is the most common disease in nasal diseases, often formed by acute sinusitis that has not been completely cured or recurrent. Odontogenic maxillary sinusitis and some ethmoid sinusitis can also begin to become chronic. Chronic suppurative sinusitis can be a single sinus, but often multiple. Anyone with inflammation on one or both sides of the sinus is called total sinusitis.

an examination

Related inspection

Otolaryngology CT examination nasal endoscopy

First, physical examination

Taking a medical history gives us a first impression and revelation, and also guides us to a concept of the nature of the disease.

Second, laboratory inspection

Laboratory examinations must be summarized and analyzed based on objective data learned from medical history and physical examination, from which several diagnostic possibilities may be proposed, and further consideration should be given to those examinations to confirm the diagnosis. Such as: sinus endoscope visible pus, polypoid changes, X-ray sinus tablets showing blurred or liquid level, maxillary sinus puncture flushing with pus to help diagnose.

Differential diagnosis

Nostril pus needs to be differentiated from chronic frontal sinusitis, chronic rhinitis, acute sinusitis, chronic ethmoid sinusitis, and chronic sphenoid sinusitis:

Chronic frontal sinusitis: 30 days after the onset of acute frontal sinusitis, there is still inflammation prolonged, called chronic frontal sinusitis. Often under certain conditions, acute attacks are often accompanied by chronic ethmoid sinusitis.

Chronic rhinitis: Chronic rhinitis is a chronic inflammation of the nasal mucosa and submucosa. It is characterized by chronic congestion and swelling of the nasal mucosa, called chronic simple rhinitis. If it develops hypertrophy of the nasal mucosa and turbinate bone, it is called chronic hypertrophic rhinitis.

Acute sinusitis: acute sinusitis (acute sinusitis) is an acute inflammation of the sinus mucosa. More secondary to acute rhinitis. Acute infectious diseases, root infections, allergies, barotrauma, nasal foreign bodies, tumors, adenoid hypertrophy, chronic diseases, and poor body resistance can be induced. Pathogenic bacteria are more common with pyogenic cocci, such as pneumococci, streptococci, staphylococcus and the like. There are fewer fungal infections. The main symptoms are nasal congestion, purulent sputum, headache, severe chills, fever, and general malaise. More than the upper jaw and ethmoid sinus. X-ray examination is one of the means of diagnosis.

Chronic ethmoid sinusitis: In the sinus, the anatomy of the ethmoid sinus is the most complicated, especially the semilunar rupture at the opening of the anterior ethmoid sinus and its nearby uncinate process and sieve funnel. It is a small protrusion and a groove-like gap in the middle nasal passage. Known as the sinus rhinoplasty complex. This is where the nasal inhalation airflow is impacted, and it is also the most invasive part of bacteria, viruses, and inhaled antigens (allergens). Regardless of infection or allergic reaction, it begins with swelling of the mucosa, ciliary movement stops, ethmoid sinus ventilation and drainage are blocked, and then spread to other sinuses. Because the ethmoid sinus drainage is not smooth, if the inflammation is not easy to dissipate, it is easy to prolong to become chronic.

Chronic sphenoid sinus: In the past, sphenoid sinusitis was considered a rare nasal disease. According to Liu Junqian (1958), 660 cases of sinus X-ray films, only 6 cases of chronic sphenoid sinusitis alone, accounting for 0.9%. Because the position of the sphenoid sinus is deep, the nose is not adequately illuminated, and the opening is not seen. The symptoms of sphenoid sinusitis are not clear, so the incidence of sphenoid sinusitis is considered to be the lowest. In recent years, due to the advent of cold light source nasal endoscopes, various angles of view can be utilized to improve the illumination and visibility throughout the nose, and the limitation of visual field is overcome, so the incidence of chronic sphenoid sinusitis is also significantly improved. According to Zhao Ruran and other data (1988), in 700 routine nasal endoscopy, 58 cases of sphenoid sinusitis, accounting for 8.3%.

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