Are sinus infections contagious? Here we will discuss it deeply. Sinus infection is a pathology of the upper jaw in which there is a combination of wall deformities and collapse of the maxillary sinus. Clinical manifestations are:
- Unilateral enophthalmos and hypothalamus.
- Facial asymmetry.
- Visual impairment.
- The smoothness of the zygomatic arch and retraction of the eyelid against the background of the absence of pain and intoxication syndromes.
Diagnosis is based on visual examination, nasal endoscopy, CT, and MRI of the accessory sinuses. Surgical treatment ensures the outflow of contents from the maxillary sinus and restores the lower wall of the orbit.
Are sinus infections contagious? (SMS) or maxillary sinus atelectasis is a rare disease in otorhinolaryngology. In medical practice, this term has been used since 1994. For the first time, the combination of clinical manifestations characteristic of this syndrome was described in 1964 by V.V. Montgomery, a professor at the Harvard School of Medicine. Most often, SMS develops in people over 45-50 years old. Pathology is found everywhere, with the same frequency found among males and females. In more than 70-85% of cases, after a qualitatively performed surgical treatment, reverse development of all disease symptoms is observed.
- The actual cause of the disease is unknown. Most experts assign a leading role in the etiology of sinus ventilation disorders. Various factors: acute or chronic inflammatory lesions of the nasal cavity, mechanical blockage of the natural inlet of the maxillary sinus. Thus, the main reasons for the occurrence of SMS are considered to be:
- Infectious diseases. The maxillary sinus’s atelectasis is often associated with chronic rhinitis, frontal sinusitis, and sinusitis of bacterial, viral, or fungal etiology.
- Traumatic injury. The formation of pathology is facilitated by severe injuries of the facial skull, accompanied by the destruction of the maxillary sinus walls. This also includes endoscopic endonasal interventions, orbital decompression.
- Volumetric formations. Cysts, polyps, benign and malignant tumors located in the area of the sinus fistula and interfering with normal ventilation can act as provoking factors.
- Developmental anomalies. Includes congenital and acquired deformities of the upper jaw affecting the maxillary sinus, including hyperplasia and hypoplasia of the uncinate process. They determine the tendency of the sinus walls to deformations, collapse, and formation of SMS.
The disease’s development mechanism is based on prolonged hypoventilation of the maxillary sinus, provoked by a violation of its anatomical characteristics. An essential role is played by the deformations of the uncinate process, in which this anatomical formation changes its position in the process of breathing as a valve. As a result, a low-pressure environment is formed inside the sinus, accompanied by the resorption of gases and increased secretion. The sinus cavity is gradually filled with transudate. The fluid is transformed into thick mucus masses that support chronic sluggish inflammation after a while. Against the background of these processes and low pressure, thinning and retraction into the walls of the sinus occurs – the collapse of the sinus.
When diagnosing atelectasis of the maxillary sinus in otolaryngology, they are guided by the X-ray classification Kass. Are sinus infections contagious it depends on the classification? Making it possible to adjust the tactics of treatment and reasonably decide the question of the nature of the surgical intervention. The classification includes three stages of SMS:
- I – membrane deformation. The image shows the lateral displacement of the Fontanilla – abnormal areas of the medial walls of the sinus that do not have a bone base.
- II – bone deformity. It is characterized by protrusion of one or more walls inward, a significant decrease in the sinus volume.
- III – clinical manifestations. The sinus cavity is practically not visualized. Clinical symptoms of the disease are revealed.
Symptoms of Silent Sinus Syndrome
Pathology develops gradually, for a long time. From the moment of exposure of the etiological factor to the first significant manifestations, it takes from 2-4 months to several years. The most common primary symptom of the pathology is unilateral deformation of the facial skeleton in the upper jaw and enophthalmos – a deeper eyeball displaced into the orbit. The majority of patients complain of “retraction” of the cheeks and hypothalamus – drooping of the lower edge of the rotation. Less commonly, there is discomfort when the eye moves on the affected side, deepening of molars, and retraction of the upper lip.
With further progression of atelectasis of the maxillary sinus, a one-sided deterioration in visual function is observed – visible acuity decreases, vertical diplopia occurs, which increases when looking up. Are sinus infections contagious? The answer is the retraction of the upper eyelid and the asymmetry of the face progress. The zygomatic arch flattens on the affected side. A characteristic feature of SMS is the absence of apparent clinical signs of acute inflammation of the maxillary sinus: pain syndrome, fever, catarrhal or purulent nasal discharge, worsening of nasal breathing, etc.
Making a diagnosis requires an otolaryngologist to analyze anamnestic data thoroughly, the results of an external examination, and data from hardware imaging methods. Laboratory tests are of low diagnostic value. When interviewing a patient, attention is paid to previous diseases of the accessory sinuses of the nose, trauma and surgery, and the dynamics of the development of current changes. Are carried out:
During an external examination of the patient’s face. The doctor notes a characteristic asymmetry due to unilateral exophthalmos, enophthalmos, retraction, and upper eyelid. On palpation and percussion of the affected area, pain is absent.
- Endoscopy of the nasal cavity. When examining the nasal cavity, the anastomosis of the maxillary sinus is not determined. Retracted into the sinus. A concomitant curvature of the nasal septum is often found.
- CT scan of the paranasal sinuses. Computed tomography is the “ gold standard” for SMS diagnostics. According to its results, a unilateral decrease in internal dimensions and a darkening of the maxillary sinus, a compensatory increase in the volume of the orbit are visualized. The images also show a hook-shaped deformation of the lateral wall of the sinus, expansion of the retrolental fatty plate, and the middle nasal passage.
- MRI of the paranasal sinuses. On the T1 weighted image, it is possible to reveal a decrease in the maxillary sinus volume. The concavity of its walls, an inhomogeneous signal from the contents in combination with the downward movement of tissue from the orbit. On T2 VI, a hyperintense signal from the internal mucous membranes is additionally determined.
Changes in SMS are differentiated with diffuse lipodystrophy, linear scleroderma, Parry-Romberg syndrome. In some cases, differential diagnosis is necessary with benign and malignant tumors of this localization and congenital anomalies in the development of the maxillary sinus.
Are sinus infections contagious? Yes, it is, and treatment is also available.
The main therapeutic tactic for SMS is surgical, which includes two consecutive stages. The essence of the first is endoscopic sanitation of the sinus cavity and ensuring regular sinus aeration. Further, the effectiveness of the performed manipulations is monitored, and the regression of enophthalmos is assessed. Often, the first stage is enough to stop all manifestations of the disease. In case of persistence of visual impairments and dystopia of the eyeball for 6-9 months from the moment of the primary intervention, in the absence of positive dynamics, they resort to the second stage – reconstruction of the lower wall of the orbit. Additionally, correction of concomitant deformities of the nasal cavity and the treatment of existing infectious diseases of the paranasal sinuses is performed.
The prognosis for life and health with silent sinus syndrome is favorable. Are sinus infections contagious is? The main question is, but we can control it. A timely surgical intervention allows you to restore up to 20% of the maxillary sinus volume and stop all ophthalmic disorders. Specific prevention of SMS has not been developed. Non-specific preventive measures are aimed at preventing the impact of potential etiological factors, include:
- Early treatment of infectious and oncological diseases of the nasal cavity and accessory sinuses.
- Correction of congenital malformations of this area.
- Prevention of traumatic injuries.