{"id":14508,"date":"2018-02-13T03:39:00","date_gmt":"2018-02-13T03:39:00","guid":{"rendered":""},"modified":"2020-09-25T02:42:46","modified_gmt":"2020-09-25T02:42:46","slug":"nasul-sinusurile-mirosul","status":"publish","type":"post","link":"https:\/\/rubyskynews.com\/index.php\/2018\/02\/13\/nasul-sinusurile-mirosul\/","title":{"rendered":"Nasul, sinusurile, mirosul"},"content":{"rendered":"
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Structura nasului \u015fi a sinusurilor. Pe pere\u0163ii laterali ai foselor nazale se afl\u0103 c\u00e2te trei reliefuri rulate \u00een form\u0103 de p\u00e2lnie, situate unul deasupra altuia, numite cornete (superior, mijlociu \u015fi inferior). Sinusurile sunt cavit\u0103\u0163i situate \u00een grosimea oaselor fe\u0163ei, pline cu aer \u015fi acoperite de o mucoas\u0103 identic\u0103 cu cea care acoper\u0103 fosele nazale. Ele se deschid \u00een nas. Men\u0163ion\u0103m celulele etmoidale anterioare \u015fi posterioare, sinusurile sfenoidale, sinusul frontal \u015fi sinusurile maxilare. Tot \u00een nas se deschide canalul prin care lacrimile trec din sacul lacrimal \u00een nas.
Fosele nazale au rol \u00een ap\u0103rarea de infec\u0163ii a c\u0103ilor respiratorii, \u00een vorbire prin func\u0163ia de cavitate de rezonan\u0163\u0103 \u015fi \u00een declan\u015farea unor reflexe. Organul mirosului este constituit din por\u0163iunea superioar\u0103 a mucoasei, care este diferen\u0163iat\u0103 ca organ receptor la excitan\u0163ii chimici adu\u015fi de aer. Sinusurile au rol de cavit\u0103\u0163i de rezonan\u0163\u0103 \u00een vorbire \u015fi rol \u00een \u00eenc\u0103lzirea \u015fi umidificarea aerului respirat. Corpii str\u0103ini \u00een nas sunt de obicei unilaterali \u015fi mici, mai frecvern\u0163i la copii. Bolnavul prezint\u0103 o senza\u0163ie de \u00eenfundare a nasului, secre\u0163ie nazal\u0103 galben\u0103-purulent\u0103, uneori amestecat\u0103 cu s\u00e2nge. La examenul nasului se constat\u0103 prezen\u0163a corpului str\u0103in care determin\u0103 congestia \u015fi uneori ulcerarea mucoasei nazale, acoperit\u0103 de secre\u0163ii purulente. Tratamentul efectuat numai de medic const\u0103 \u00een extragerea corpului str\u0103in cu pense \u015fi c\u00e2rlige speciale, dup\u0103 o anestezie a mucoaseri nazale. \u00cen caz de e\u015fec, corpii str\u0103ini sunt \u00eempin\u015fi \u00eenapoi \u015fi cule\u015fi \u00een co\u015fule\u0163ul unui ap\u0103s\u0103tor de limb\u0103 \u00eempins p\u00e2n\u0103 \u00een fundul g\u00e2tului. Epistaxisul sau hemoragia nazal\u0103 este de obicei de cauz\u0103 local\u0103, prin traumatisme (sc\u0103rpinat, lovit) la nivelul petei vasculare de pe septul nazal (regiune bogat\u0103 \u00een vase). Cel de cauz\u0103 general\u0103 se \u00eent\u00e2lner\u015fte \u00een bolile cardiovasculare (hipertensiune arterial\u0103), emfizemul pulmonar, boli de ficat \u015fi rinichi, tumori ale g\u00e2tului, intoxica\u0163ii, boli infecto-contagioase, boli de s\u00e2nge (leucemie). Tratamentul const\u0103 \u00een m\u0103suri generale: lini\u015ftirea bolnavului \u015fi a persoanelor emotive din jurul lui, deschiderea gulerului, sl\u0103birea centurii, a\u015fezarea bolnavului \u00eentr-o pozi\u0163ie potrivit\u0103 (ridicat cu b\u0103rbia \u00een piept, sau culcat pe partea care s\u00e2ngereaz\u0103 \u00een caz de tendin\u0163\u0103 la le\u015fin). M\u0103surile locale pentru oprirea hemoragiei sunt: compresiunea petei vasculare efectuat\u0103 cu degetul prin intermediul aripii nasului ce se poate face chiar de c\u0103tre bolnav. Este util\u0103 aplicarea unui tampon de vat\u0103 \u00eembibat \u00een solu\u0163ie de aspirin\u0103 10% (un comprimat de aspirin\u0103 la o lingur\u0103 de ap\u0103 c\u0103ldu\u0163\u0103) prin intermediul c\u0103ruia se comprim\u0103 pata vascular\u0103, m\u0103sur\u0103 de obicei suficient\u0103. \u00cen caz de e\u015fec, am\u00e2narea prezent\u0103rii la medic nu are nici o justificare. Devia\u0163ia septului nazal este o afec\u0163iune \u00een care peretele ce desparte cele dou\u0103 fose nazale este deviat de la pozi\u0163ia sa median\u0103 prezent\u00e2nd, fie o creast\u0103 osoas\u0103 sau cartilaginoas\u0103, fie o bombare anormal\u0103 \u00een una din fose, duc\u00e2nd la astuparea acesteia. Deformarea septului poate fi datorit\u0103 unui traumatism sau unor vicii de dezvoltare a masivului facial, dar nu produce tulbur\u0103ri dec\u00e2t c\u00e2nd este accentuat\u0103. Tratamentul este chirurgical, cu rezultate foarte bune.<\/p>\n

Rinita acut\u0103 (coriza acut\u0103) este o boal\u0103 frecvent \u00eent\u00e2lnit\u0103 \u00een special prim\u0103vara \u015fi toamna, fiind favorizat\u0103 de st\u0103rile de oboseal\u0103, subalimenta\u0163ie, respirarea unui aer viciat cu gaze \u015fi pulberi toxice. Infec\u0163iile virotice \u015fi bacteriene la care se adaug\u0103 ac\u0163iunea nociv\u0103 a frigului (exercitat \u00een special asupra cefei \u015fi extremit\u0103\u0163ilor) sunt considerate factorul determinant. Boala \u00eencepe cu senza\u0163ie de \u00eenfundare a nasului, usturime \u015fi usc\u0103ciune la nivelul nasului \u015fi g\u00e2tului, str\u0103nuturi dese \u00eenso\u0163ite de secre\u0163ie nazal\u0103 apoas\u0103, abundent\u0103, l\u0103crimare, senza\u0163ie de \u00eenfundare a urechilor. \u00cen zilele urm\u0103toare secre\u0163ia devine galben\u0103-purulent\u0103, diminu\u00e2nd p\u00e2n\u0103 la dispari\u0163ie dup\u0103 o s\u0103pt\u0103m\u00e2n\u0103. Ca semne generale, bolnavul prezint\u0103 dureri de cap, indispozi\u0163ie, mici frisoane, stare subfebril\u0103, lipsa poftei de m\u00e2ncare, insomnie. Tratamentul la \u00eenceput const\u0103 \u00een instilarea \u00eennas de Mentorin 6 \u2013 8 pic\u0103turi de 3 ori pe zi, Rinofug 2 \u2013 3 pic\u0103turi. Medicamentele antihistaminice (Romergan, Avil, Feniramin) dau rezultate bune. \u00cen perioada de stare se instileaz\u0103 \u00een nas substan\u0163e antiseptice \u015fi vasoconstrictoare (Mentorin, Rinofug), se fac instila\u0163ii cu alcool mentolat 4% (1 linguri\u0163\u0103 la un litru de ap\u0103 fierbinte; vaporii se aspir\u0103 pe nas 10 minute prin intermediul unui cornet aplicat deasupra vasului cu medicament) repetat de 2 \u2013 3 ori pe zi. Tratamentul medicamentos general const\u0103 \u00een antitermice (aspirin\u0103, piramidon), vitamin\u0103 C, calciu \u015fi b\u0103i calde la picioare. Concediul medical, atunci c\u00e2nd este necesar, nu se utilizeaz\u0103 pentru rezolvarea unor probleme gospod\u0103re\u015fti personale, ci pentru odihn\u0103, cel mai bine repaus la pat. Rinitele cronice catarale se manifest\u0103 prin senza\u0163ie de nas \u00eenfundat \u015fi jen\u0103 accentuat\u0103 la respira\u0163ia pe nas, \u00een special \u00een pozi\u0163ie culcat, scurgere nazal\u0103 mucoas\u0103 sau mucopurulent\u0103 ce poate ajunge \u015fi \u00een g\u00e2t, d\u00e2nd o senza\u0163ie de corp str\u0103in. Bolnavul se mai pl\u00e2nge de sc\u0103derea mirosului, dureri de cap, oboseal\u0103, sc\u0103derea auzului, somn neodihnitor, inflama\u0163ii repetate faringiene, amigdaliene \u015fi bron\u015fice. Tratamentul const\u0103 \u00een instila\u0163ii nazale cu substan\u0163e antiseptice (colargol, protargol), solu\u0163ii uleioase (oleugomenolat 1 \u2013 2%), sau Mentorin, Rinofug, c\u00e2te 5 \u2013 6 pic\u0103turi \u00een fiecare nar\u0103, repetat de 3 \u2013 4 ori pe zi. Tabletele \u201eInhalant\u201d sunt de asemenea utile. Dup\u0103 inhala\u0163ie, bolnavul nu va p\u0103r\u0103si camera 20 de minute. Pentru cre\u015fterea rezisten\u0163ei organismului se recomand\u0103 vitamine (A,B,C,D), preparate de calciu, fosfor, fier, alimenta\u0163ie bogat\u0103 \u00een proteine (lapte, carne, ou\u0103), cu excluderea condimentelor. Se vor \u00eenl\u0103tura toate focarele infec\u0163ioase din vecin\u0103tate (sinuzite, amigdalite) \u015fi cauzele de obstruc\u0163ie nazal\u0103 (vegeta\u0163ii adenoide, devia\u0163ii de sept nazal). Rinitele cronice hipertrofice se caracterizeaz\u0103 printr-o degenerare a mucoasei nazale de tip edematos polipoid. Mucoasa nazal\u0103, \u00een special la nivelul cornetelor (capul \u015fi coada mai ales a cornetului inferior) se \u00eengroa\u015f\u0103, devine edematoas\u0103, albicioas\u0103\u2013alb\u0103struie, neregulat\u0103, astup\u00e2nd fosele nazale. Bolnavul se pl\u00e2nge de usc\u0103ciunea gurii, are mirosul \u015fi auzul sc\u0103zute, sfor\u0103ie \u00een somn, somnul este neodihnitor. La \u00eenceput, obstruc\u0163ia nazal\u0103 apare la o singur\u0103 nar\u0103, alternativ, \u00een special \u00een pozi\u0163ia culcat (la nara situat\u0103 dedesubt), apoi devine bilateral\u0103 \u015fi permanent\u0103. Tratamentul, \u00een afara ma\u0103surilor amintite la rinita cronic\u0103 cataral\u0103, const\u0103 \u00een repermeabilizarea foselor nazale prin provocarea unor cicatrice retractile la nivelul cornetelor (prin galvanocauteriz\u0103ri, injec\u0163ii cu substan\u0163e sclerozante), iar la nevoie extirparea mucoasei nazale \u00een exces (extirparea cozii de cornet hipertrofiate etc.). Ozena sau rinita cronic\u0103 atrofic\u0103 ozenoas\u0103 este o boal\u0103 \u00eent\u00e2lnit\u0103 mai des la femei, caracterizat\u0103 prin atrofia nasului \u015fi prezen\u0163a de cruste nazale cu miros resping\u0103tor. Crustele nazale de culoare galben\u0103-verzuie rezult\u0103 din uscarea secre\u0163iei \u015fi prezint\u0103 un miros resping\u0103tor ce provoac\u0103 repulsia celor din jur. Cauzele determinante ale bolii sunt necunoscute. Tratamentul const\u0103 \u00een sp\u0103l\u0103turi nazale zilnice cu ser fiziologic c\u0103ldu\u0163 (la 1 litru de ap\u0103 clocotit\u0103 se pune o linguri\u0163\u0103 de sare de buc\u0103t\u0103rie, se las\u0103 s\u0103 se r\u0103ceasc\u0103 \u015fi se toarn\u0103 \u00een pumn, aspir\u00e2ndu-se solu\u0163ia pe nas) care \u00eenmoaie crustele \u015fi u\u015fureaz\u0103 dezlipirea lor. Se picur\u0103 apoi \u00een nas oleugomenolat 1 \u2013 2% sau vitamina A uleioas\u0103. Se mai fac badijon\u0103ri ale mucoasei nazale cu solu\u0163ii de Lugol \u015fi glicerin\u0103, untur\u0103 de pe\u015fte, solu\u0163ii de streptomicin\u0103. Inhala\u0163iile cu ape sulfuroase (C\u0103ciulata, Govora) sunt \u015fi ele utile. Ca tratament general se administreaz\u0103 vitamine \u015fi calciu. Tratamentul chirurgical urm\u0103re\u015fte: combaterea usc\u0103ciunii nazale prin devierea lacrimilor \u00een meatul mijlociu nazal, sau a secre\u0163iei parotidiene \u00een sinusul maxilar; reducerea calibrului foselor nazale prin apropierea pere\u0163ilor laterali ai foselor de septul nazal. Rezultatele sunt \u00een general satisf\u0103c\u0103toare. Sinuzita acut\u0103 este inflama\u0163ia acut\u0103 a mucoasei sinusului. Ea poate interesa un singur sinus (maxilar, etmoid, sfenoid), mai multe sinusuri (polisinuzit\u0103 fronto-etmoido-maxilar\u0103), toate sinusurile de pe o parte (pansinuzit\u0103 acut\u0103 dreapt\u0103, st\u00e2ng\u0103) sau de ambele p\u0103r\u0163i (pansinuzit\u0103 acut\u0103 bilateral\u0103).<\/p>\n

Simptomele principale acuzate de bolnav sunt durerea de cap, scurgerea nazal\u0103 mucopurulent\u0103, \u00eenfundarea nasului, sc\u0103derea mirosului, febr\u0103, ame\u0163eli, lipsa poftei de m\u00e2ncare. Sediul durerii variaz\u0103 dup\u0103 sinusul inflamat (\u00een obraz, \u00een sinuzita maxilar\u0103; \u00een arcada spr\u00e2ncenoas\u0103, \u00een sinuzita frontal\u0103; \u00een unghiul intern al orbitei, \u00een sinuzita etmoidal\u0103 anterioar\u0103; \u00een cre\u015ftetul capului, \u00eenapoia ochilor \u015fi \u00een ceaf\u0103, \u00een sinuzita etmoido-sfenoidal\u0103). Radiografia sinusurilor arat\u0103 opacifierea lor datorit\u0103 umplerii cu secre\u0163ii purulente. Tratamentul const\u0103 \u00een repaus \u00een cas\u0103, b\u0103i fierbin\u0163i la picioare, instila\u0163ii nazale cu Rinofug, Mentorin, ser fiziologic efedrinat 2% de 3 \u2013 4 ori pe zi, inhala\u0163ii cu alcool mentolat 4% sau \u201eInhalant\u201d (o tablet\u0103 la 1 litru de ap\u0103 fierbine) repetate de de 3 \u2013 4 ori pe zi. La nevoie se recurge la administrarea de antibiotice (de preferat cele cu spectru larg: tetraciclin\u0103, aureomicin\u0103). Sinuzita cronic\u0103 este inflama\u0163ia cronic\u0103 a mucoasei sainuzale ce urmeaz\u0103 unei sinuzite acute nevindecate deplin \u00een 2 \u2013 3 luni. Ea poate interesa un singur sinus, mai multe sinusuri sau toate sinusurile. Bolnavul se pl\u00e2nge de o scurgere nazal\u0103 purulent\u0103 permanent\u0103, uneori r\u0103u mirositoare \u015fi o senza\u0163ie de greutate care \u00een perioadele de acutizare se poate transforma \u00een durere localizat\u0103 \u00een raport cu sinusul bolnav. Secre\u0163ia nazal\u0103 \u015fi modific\u0103rile mucoasei produc \u00eenfundarea nasului \u015fi sc\u0103derea mirosului p\u00e2n\u0103 la dispari\u0163ie. Datorit\u0103 \u00eenghi\u0163irii puroiului, bolnavul prezint\u0103 tulbur\u0103ri digestive \u015fi inflama\u0163ii repetate ale faringelui, laringelui, traheei \u015fi bronhiilor. Tratamentul sinuzitei cronice acutizate este acela\u015fi cu al sinuzitei acute. Cele recent cronicizate beneficiaz\u0103 de tratament conservator; \u00een sinuzitele maxilare se fac punc\u0163ii sinuzale \u015fi sp\u0103l\u0103turi cu ser fiziologic steril urmate de instilarea de solu\u0163ii antibiotice, hidrocortizon \u015fi alfachimotripsin\u0103. \u00cen formele vechi, cu modific\u0103ri ireversibile ale mucoasei sinuzale, se procedeaz\u0103 la drenarea supura\u0163iei \u015fi \u00eenl\u0103turarea mucoasei bolnave pe cale chirurgical\u0103.<\/div>\n

<\/div>","protected":false},"excerpt":{"rendered":"

Structura nasului \u015fi a sinusurilor. Pe pere\u0163ii laterali ai foselor nazale se afl\u0103 c\u00e2te trei reliefuri rulate \u00een form\u0103 de p\u00e2lnie, situate unul deasupra altuia, numite cornete (superior, mijlociu \u015fi inferior). Sinusurile sunt cavit\u0103\u0163i situate \u00een grosimea oaselor fe\u0163ei, pline cu aer \u015fi acoperite de o mucoas\u0103 identic\u0103 cu cea care acoper\u0103 fosele nazale. Ele […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[1],"tags":[],"aioseo_notices":[],"yoast_head":"\nNasul, sinusurile, mirosul - Jobs\/ Internships\/ Scholarships\/<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/rubyskynews.com\/index.php\/2018\/02\/13\/nasul-sinusurile-mirosul\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Nasul, sinusurile, mirosul - Jobs\/ Internships\/ Scholarships\/\" \/>\n<meta property=\"og:description\" content=\"Structura nasului \u015fi a sinusurilor. Pe pere\u0163ii laterali ai foselor nazale se afl\u0103 c\u00e2te trei reliefuri rulate \u00een form\u0103 de p\u00e2lnie, situate unul deasupra altuia, numite cornete (superior, mijlociu \u015fi inferior). Sinusurile sunt cavit\u0103\u0163i situate \u00een grosimea oaselor fe\u0163ei, pline cu aer \u015fi acoperite de o mucoas\u0103 identic\u0103 cu cea care acoper\u0103 fosele nazale. 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Pe pere\u0163ii laterali ai foselor nazale se afl\u0103 c\u00e2te trei reliefuri rulate \u00een form\u0103 de p\u00e2lnie, situate unul deasupra altuia, numite cornete (superior, mijlociu \u015fi inferior). Sinusurile sunt cavit\u0103\u0163i situate \u00een grosimea oaselor fe\u0163ei, pline cu aer \u015fi acoperite de o mucoas\u0103 identic\u0103 cu cea care acoper\u0103 fosele nazale. 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