Sphenoid sinus

introduction

The sphenoid sinuses (lat. Sphenoid sinus) are already preformed cavities in the skull of every human being, more precisely inside the cuneiform bone (Sphenoid bone). The sphenoid sinus is created in pairs, that is, there is one on the left and another on the right side of the skull. The two cavities are through one Septum separated in the middle. Together with the maxillary and frontal sinuses and the ethmoid cells, the sphenoid sinus belongs to the paranasal sinuses.

anatomy

The sphenoid sinus lies in the sphenoid bone (Sphenoid bone) in the so-called brain skull. The bone in which the two cavities are located is shifted deep back about in the middle of the skull. There is a connection between all of the sinuses. In addition, everyone is in contact with the nasal passage and therefore with the external environment. The sphenoid sinus drains into the upper nasal passage (meatus nasi superior). The inside of the sphenoid sinus is lined with nasal mucous membrane, which consists of small cilia and continuously produces a rather tough secretion in order to keep the inside of the nose and the nasal sinuses moist and with as few germs as possible. Other important structures in the area of ​​the sphenoid sinuses are the pituitary gland (Pituitary gland), which rests directly on the roof of the cavity, as well as the main supply artery of the brain (Internal carotid artery) and the optic nerve (Optic nerve).

function

The main function of the sphenoid sinus is to save weight by creating air-filled cavities (Pneumatization of the bone). The surrounding bone is not exposed to any particular stress in this area, which is why the associated loss of stability in the area of ​​the skull is bearable. Other functions (e.g. as Resonance space to Voice training) are controversial or not yet fully clarified.

Causes of inflammation

Due to the connection of the sphenoid sinuses to the outside Infectionswhich originally develop in the area of ​​the nose up to the paranasal sinuses, i.e. also to the sphenoid sinus, hike. One then speaks of a sinus infection, a Sinusitis. These inflammations are usually caused by viral pathogens that have already caused discomfort in the main nasal cavity in advance.

But bacteria can also be the cause of an inflammation of the sphenoid sinus or colonize secondarily in already weakened areas. Often it comes to one Accumulation of secretions and Pus inside of the cavities, since the Inflow and outflow path just a relative narrow gap is.

Symptoms

Such a sinus infection manifests itself with a feeling of pressure over the forehead and nose as well as below the eyes, headache, a previous or still current cold (rhinitis) and occasionally also a fever. Most of the time, the symptoms increase when bending over and leaning forward. Some patients also report severe ear pain. You feel weak and exhausted

therapy

A acute viral sinusitis usually heals completely within a few days to weeks. The use of decongestant drugs makes sense, further interventions are usually not necessary. In addition, pain relievers and antipyretic Preparations.

The same applies to those occurring for the first time acute bacterial infections. In many cases, antibiotics are not necessary. However, the sphenoid sinus is an excellent retreat for pathogens, so that bacteria can settle there over a longer period of time. In some cases, this leads to long-term illnesses, sometimes chronify and then break out again and again (recurrent chronic sinusitis). Unfortunately, the antibiotic level that can be achieved by administering medication in the sphenoid sinus is always lower than in the rest of the body. Nevertheless, antibiotic therapy is the first choice if a bacterial infection is suspected.

Additionally act cortisone-containing nasal sprays locally against the inflammation. In the event of unsuccessful attempts at therapy or above-average infections, the next step in the therapy concept is a surgical rehabilitation of the paranasal sinuses to disposal. This usually takes place endoscopic through the nose (transnasal access) so that no large cuts are necessary. In the course of the operation, pus and excess secretion are removed, the sphenoid sinus is rinsed together with the other paranasal sinuses and any anatomical features that can promote inflammation are eliminated. These include, for example benign mucosal growths (Polyps) or one crooked nasal septum. Part of the frequently inflamed mucous membrane can be removed, thus reducing the future risk of infection.

Due to the anatomical location, this type of therapy, even if it is just a minor intervention, is not entirely safe. Complications arise, for example, when injuring the eyes or the Eye socket (Orbit) or the pituitary gland. Also Bleeding and subsequent infections are among the operational risks. All in all, because of their location, the infection and inflammation of the sphenoid sinus is significantly less common than that of the other paranasal sinuses.

diagnosis

In principle, these typical symptoms are sufficient to make a diagnosis Sinusitis deliver. Especially in the case of severe unclear processes, there is an additional one Nasoscopy into consideration with the doctor with the help of a Rhinoskopes look at the nasal spaces from the inside and so on Mucous membranes can judge. In addition, both an x-ray and computed tomographic images of the nose and paranasal sinuses can be made in order to determine the exact anatomical features and the localization of an inflammation. Acute viral sinusitis usually heals completely within a few days to weeks.

forecast

Inflammation of the sphenoid sinus usually heal without complications and swiftly from. In very rare Cases it can become one Encroaching on neighboring organs, for example the Eye socket or the meninges or the brain come. Further Disappearances then join in languor, clear feeling of illness, high fever and Visual disturbances Noticeable when the eye socket is involved or headache and neck pain when the brain or meninges are involved. A further spread of the infection into the ears is also possible. A secondary one is often observed, especially in children Otitis media.

prophylaxis

Sinus infections are not always completely avoidable, but some tips can be used to minimize the risk of the disease. On the one hand, what helps strengthen the immune system as a whole; In addition to a healthy, balanced diet, this also includes sufficient Sleep, general hygiene measures (Wash hands, dispose of handkerchiefs early, do not sneeze into your hand) and one adequate hydration - especially in dry ambient air. Also the Give up cigarettes is recommended because smoking attacks the mucous membranes of the nose and thus increases the risk of infection not insignificantly.

The way in which the nose is blown also plays an important role, especially for the sinuses. It is important not to press in both nostrils at the same time and use a lot of force, because this can cause it to Disorders of the discharge of secretions come. Lightly blowing your nose with little pressure is the better method. That too Sneeze should not suppress, as this increases the pressure inside the nose and secretion may be flushed backwards into the sinuses.