Trepanopuncture of the frontal sinus is a procedure in which the cavity in the front of the human skull is cleaned of pus and mucus. This operation is a radical method of treating the effects of a prolonged runny nose or other infectious disease, accompanied by nasal congestion.
Diseases leading to trepanopuncture
Nasal congestion in the common cold is not considered a dangerous disease. However, swelling of the mucous membrane is able to permanently block the ducts connecting the numerous sinuses in the facial part of the skull. This greatly complicates or even stops the outflow of mucus from these cavities. If they get infection, inflammation begins and the mucus turns into pus. This condition is extremely dangerous for human life, because pus and inflammation can pass to the brain.
Several types of sinus diseases are distinguished, their pathologies were named according to the places of origin:
- With sinusitis, inflammation occurs in the maxillary sinuses located near the nose in the upper jaw.
- Inflammation of the sinuses in the forehead is called frontal sinusitis.
- With inflammation of the ethmoid frontal sinuses, ethmoid sinusitis is diagnosed.
- Sphenoid sinusitis is called inflammation in the sphenoid sinus.
It happens that in a person all the sinuses on one side of the face become inflamed. This phenomenon is called hemisinusitis, and with polysinusitis, various sinuses are inflamed throughout the facial part of the skull.
Signs of inflammation in the sinuses
A person is not used to paying attention to such a “frivolous” disease as a runny nose. But if during the course of the disease, in addition to the fact that it has been going on for several weeks, other symptoms appear, you should immediately consult a doctor. Indeed, in the early stages of the disease, treatment with conservative methods is still possible, whereas if the situation worsens, the case may end with trepanopuncture of the frontal sinus.
Signs that the runny nose situation has worsened are as follows:
- The mucus from the nose becomes either greenish, then yellowish, or even brown.
- Frequent headache.
- There is a pain syndrome when leaning forward, localization is concentrated at the same time in the forehead or upper jaw.
- The temperature rises.
- A large amount of mucus enters the larynx.
- The sense of smell is broken or completely gone.
- The patient’s voice changes, he begins to speak “with a swear.”
Trepanopuncture of the frontal sinus
The purpose of the operation is to remove pus from the profile sinus, thereby cleaning it from the epicenter of inflammation. Despite the awesome name for an unprepared person, the technique of trepanopuncture of the frontal sinus is quite simple and even a young doctor can cope with it.
After the procedure, the patient quickly recovers, as the sinuses are cleared and the inflammation is eliminated. The procedure is performed in people of all ages and both sexes. Anesthesia does not involve immersion in sleep. The surgical field is simply anesthetized.
Indications for surgery
It must be understood that trepanopuncture of the frontal sinus is only due to failure with conservative treatment and with a sharp deterioration in the patient's condition. That is, it is the most extreme measure.
Trepanopuncture can be performed in case of emergency:
- in situations when the patient is tormented by severe pain in the frontal sinuses;
- in the absence of nasal breathing per se;
- when pus is released from the nose with blood and the smell of rot;
- if it is impossible to bring down the high body temperature of the patient caused by inflammation in the sinuses.
No need to fear that after the operation, pus will remain in the sinuses. Firstly, it is washed during the procedure with antiseptic drugs, and secondly, after this, the patient must undergo an X-ray examination of the sinuses for their complete cleaning.
Contraindications to the procedure
Trepanopuncture - the procedure is simple, but even for it there are a number of contraindications.
The operation is not performed when the frontal sinusitis is a consequence of an injury to the bones of the forehead.
An operation cannot be performed if such a procedure has already been carried out in the context of several years, or if the sinuses are underdeveloped even during the period of intrauterine growth.
You can’t perform an operation if the patient has an infectious or systemic disease - diabetes, high blood pressure, tuberculosis.
Operation progress
The technique for performing trepanopuncture of the frontal sinus is generally the same in all cases.
First of all, the place of surgery is anesthetized. For this, an anesthetic is injected into the mucous membrane of the nasal sinuses. A series of injections with an anesthetic are also carried out around the area of the skin through which the instrument will be injected.
At the stage of preparation for surgery, the surgeon determines the point of insertion of the instrument into the sinus. This is achieved using previously obtained x-rays of the facial part of the skull.
The puncture instrument is selected individually depending on the thickness of the septum and the back wall of the sinus. It must never be pierced.
Trepanopuncture is carried out through the forehead bone, which means that a drill is necessary. If the operation is performed on a children's skull, the doctor manages a thick needle, since the bones of a small patient are still thin.
After the bone is pierced, a plastic tube is inserted into the hole, through which an antiseptic is fed and pus is pumped through it. So that the tube does not fall out of the hole, it is fixed with a patch.
At the end of the washing, a contrast agent is introduced into the cavity, which is reflected in the X-ray photographs. This helps the doctor determine how successful the operation was.
All drugs and fluids are selected taking into account the individual characteristics of the patient's body. Even the likelihood of an allergic reaction is taken into account.
Tubes along which fluid was pumped out of the frontal sinuses are removed 5-6 days after the procedure. The holes remaining in this place, over time, completely overgrow.
Complications
As with any surgical operation, there is always the possibility of complications of trepanopuncture of the frontal sinus.
From excitement, the patient may lose consciousness. There are cases when such a state was amplified by collapse.
Incorrectly selected anesthesia drugs can cause anaphylactic shock. In order to prevent this from happening, the patient is asked before the operation about the existence of such a reaction in his past. If he is at a loss to answer, the doctor should be prepared for surprises during anesthesia. But the simplest way is to conduct a test of the drug before surgery, introducing a small dose of it under the skin of the patient.
During the procedure, severe bleeding can occur as a result of damage to the blood vessel.
The most dangerous consequence of trepanopuncture of the frontal sinus is damage to the posterior wall of the appendage.
Complications after surgery include severe swelling of the nasal mucosa and soft tissues. Inadequate or inept wound care may result in inflammation.
You should never forget about the risk of death, therefore, the doctor conducting the operation should be prepared for any surprises and be able to call into the operating room specialists of a different profile - a cardiologist, anesthesiologist, resuscitator.
Prevention
Despite the positive reviews about trepanopuncture of the frontal sinus, it is possible to avoid this procedure by simply observing the rules for the prevention of diseases that cause swelling of the mucosa with subsequent complications. All measures in this case are aimed at preventing colds.
First of all, it is hardening of the body by pouring cold water on it. It is necessary to pour over water from the summer and do it regularly until the onset of winter frosts. During this time, the body gets used to the procedure and develops resistance to colds.
You definitely need to move more and play sports - this strengthens the body's immune system. Immunity grows stronger and with proper nutrition. Fresh vegetables and fruits should prevail in the human diet. The meat should be boiled and not fat. It is necessary to exclude cakes, pastries, soda and other sweets from the diet.
Maybe it's an allergy?
Often rhinitis occurs against the background of an allergic reaction, therefore, it is necessary to find out what the person is allergic to, and to avoid these pathogens in the future. To improve health and reduce the likelihood of an allergy, it is very important to get rid of bad habits, namely smoking and drinking alcohol.
At least once a year, you need to undergo a full examination with a doctor using modern diagnostic equipment, namely x-rays, ultrasound and computed tomography.