一个或多个鼻窦发生炎症称为鼻窦炎，累及的鼻窦包括：上颌窦、筛窦、额窦和蝶窦，这是一种在人群中发病率较高的疾病，影响患者生活质量。鼻窦炎可分为急性、慢性鼻窦炎2种。急性鼻窦炎多由上呼吸道感染引起，细菌与病毒感染可同时并发。慢性鼻窦炎较急性者多见，常为多个鼻窦同时受累。
\n鼻窦炎可分为急性、慢性鼻窦炎2种。急性鼻窦炎病程＜12周，主要表现为持续的较重的上呼吸道感染症状，包括鼻堵、脓涕、头痛等。慢性鼻窦炎的病程＞12周。根据严重度的视觉模拟刻度（VAS）评分（10cm），将这种疾病分为轻度和中/重度：轻度=VAS 0～4cm；中/重度=VAS 5～10cm。
\n1、急性鼻窦炎
\n急性鼻窦炎多由上呼吸道感染引起，细菌与病毒感染可同时并发。常见细菌菌群是肺炎链球菌、溶血性链球菌和葡萄球菌等多种化脓性球菌，其次为流感嗜血杆菌和卡他莫拉菌属，后者常见于儿童。其他的致病菌还有链球菌类、厌氧菌和金黄色葡萄球菌等。由牙病引起者多属厌氧菌感染，脓液常带恶臭。真菌及过敏也有可能是致病因素。
\n急性鼻窦炎的感染常来自于：窦源性感染、鼻腔源性感染、邻近组织源性感染、血源性感染、创伤源性感染，还有全身因素和中毒因素导致的。
\n2.慢性鼻窦炎
\n（1）由急性鼻窦炎转变而来 多因对急性鼻窦炎治疗不当，或对其未予彻底治疗以致反复发作，迁延不愈，使之转为慢性。此为本病之首要病因。
\n（2）阻塞性病因 鼻腔内的阻塞性疾病，如鼻息肉、鼻甲肥大、鼻腔结石、鼻中隔偏曲、鼻腔肿瘤、鼻腔填塞等阻碍鼻腔鼻窦通气引流，是本病的重要病因。
\n（3）致病菌毒力强 某些毒力较强的致病菌，如患猩红热时的乙型溶血性链球菌，其所致的急性鼻窦炎，极易转为慢性。
\n（4）牙源性感染 因上列磨牙的牙根与上颌窦底部毗邻，若牙疾未获根治，易成为牙源性慢性上颌窦炎。
\n（5）外伤和异物 如外伤骨折、异物存留或血块感染等，导致慢性鼻窦炎。
\n（6）鼻窦解剖因素 由于各个鼻窦特殊的或异常的解剖构造，不利于通气引流，亦为不可忽略的自身因素。
\n（7）全身性因素 包括各种慢性疾病、营养不良、疲劳过度而导致的机体抵抗力低下。同时，还有各种变应性因素及支气管扩张所诱发的病因。
\n治疗
\n急性鼻窦炎
\n（1）全身治疗 采用足量抗生素控制感染，因多为球菌感染，以青霉素类、头孢菌素类为首选药物，药物治疗强调选择敏感抗生素，足量、足疗程使用。若头痛或局部疼痛剧烈，可适当用镇静剂或镇痛剂。一般疗法与急性鼻炎相同。中医中药治疗以散风清热、芳香通窍为主，以解毒去瘀为辅。
\n（2）改善鼻窦引流 常用含1%麻黄素的药物滴鼻，收缩鼻腔，改善引流。急性鼻窦炎还可以通过体位改变进而改善鼻窦的通气引流而减轻头痛。
\n（3）上颌窦穿刺冲洗术 急性上颌窦炎宜在全身症状消退、局部急性炎症基本控制后施行。冲洗后可注入抗菌溶液，每周1～2次。
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患病时，应适当休息，多饮开水，鼻塞时，不可强行擤鼻，可配合“结缘通窍膏”尽快的缓解鼻窦炎带来的不适，或捏住双侧鼻孔擤鼻，以防细菌进入咽鼓管引起中耳炎。注意观察呼吸、心率，体力等病情变化。急性鼻窦炎通常由感染引起，若饮食能提供大量维生素和矿物质以增强身体的抵抗力，则有助于身体康复和阻止病情恶化。
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\n根据临床经验，建议您采用外用药和内服药相结合的治疗方法。使用进行鼻腔清洗介入疗法的外用药物，目的是造成鼻腔、鼻窦的引流通畅，反复清洗，促使炎性物质彻底排泄，给鼻腔、鼻窦创造一个清洁的环境。同时，内服调气养血、活血化瘀的中药来改善病变组织粘膜，促其逆转为正常的粘膜组织来保护鼻窦。就如同一颗大树，树皮完好无损，树干就不至于腐坏一样，只有鼻粘膜组织恢复正常，您的鼻窦炎才会彻底治愈。但对于严重的病例，药物就无能为力了，现代鼻科学选择了鼻内窥镜鼻窦手术使其治愈率大大提高达到85－95％。
\n鼻内窥镜鼻窦手术八十年代初引入我国，已发展成为广泛应用于耳鼻咽喉、头项外科的综合微创外科技术，手术操作在鼻孔内进行，鼻面部没有切口，它是既能祛除疾病又保留正常生理功能的手术技术，应视为近一个世纪以来鼻科学的一次革命。
\n\n
鼻腔及鼻窦由于解剖隐蔽，组织间的沟、隙、折叠曲折，常规检查法，对鼻腔的观察范围都是有限的，对于光线及视线无法达到的部位则形成盲区，无法窥查清楚局部情况。通常对于鼻窦的观察，多是依据分泌物的来源间接地进行推断，而并非明视下直接观察到鼻窦内的实际病变情况。
\n鼻窦内窥镜由于其导光性强、多角度、视野大，可直接窥视到鼻腔内的许多重要部位（如各个鼻窦开口，各个沟、鼻窦内部等隐蔽狭窄处）及鼻咽部的细微病变，除了临床诊断，还可取活检，也可同时进行摄像，可保存资料，以供会诊、教学观摩及科研总结。
\n一些人慢性鼻炎和鼻窦炎长期不愈，必定有他鼻腔鼻窦结构上的病因，这种结构上的不正常才导致了其功能上的不正常。通过鼻内窥镜的检查，找到结构异常的病因，那么慢性鼻炎和鼻窦炎就有可能彻底根治了。
\n如何治疗呢？在鼻内窥镜下配合特制的手术器械，利用内窥镜多视角、可准确而彻底地清除病变组织，并尽可能保持鼻腔及鼻窦的正常结构以维持其生理功能，使传统的根治性或破坏性手术转化为功能性手术。鼻内窥镜手术的适应症为：1、慢性及慢性复发性鼻窦炎，保守治疗无效；2、鼻息肉；3、霉菌性鼻窦炎；4、慢性泪囊炎；5、鼻腔、鼻窦良好肿瘤；6、鼻腔、鼻窦恶性肿瘤探察术；7、垂体腺瘤；8、脑脊液鼻漏经鼻修补术；9、鼻腔止血术；10、眶减压术；11、视神经管减压术；12、鼻、鼻窦、眶内、颅底异物取出术等。此外，鼻窦内窥镜手术还可以扩大到鼻神经外科或鼻眼相关外科领域。
\n鼻窦炎是鼻科中的常见病，也是疑难病。病变是指鼻窦粘膜的急、慢性化脓性炎症。重者不仅影响鼻窦粘膜累及骨质，而且还可引起周围组织和邻近器官的并发症。人的鼻窦，窦口小，鼻窦粘膜与鼻腔相连，各窦口相邻，这些都不利于炎性物质引流，各鼻窦之间相互感染而反复发病。由于您患有慢性鼻窦炎，鼻窦粘膜长期处于炎性刺激中，其病理改变为组织瘀血、水肿、增厚、血管增生、淋巴细胞和浆细胞浸润、上皮纤毛脱落等一系列难以逆转的现象。所以，一旦罹患感冒，就会形成慢性鼻窦炎急性发作。
\n根据临床经验，建议您采用外用药和内服药相结合的治疗方法。使用进行鼻腔清洗介入疗法的外用药物，目的是造成鼻腔、鼻窦的引流通畅，反复清洗，促使炎性物质彻底排泄，给鼻腔、鼻窦创造一个清洁的环境。同时，内服调气养血、活血化瘀的中药来改善病变组织粘膜，促其逆转为正常的粘膜组织来保护鼻窦。就如同一颗大树，树皮完好无损，树干就不至于腐坏一样，只有鼻粘膜组织恢复正常，您的鼻窦炎才会彻底治愈。但对于严重的病例，药物就无能为力了，现代鼻科学选择了鼻内窥镜鼻窦手术使其治愈率大大提高达到85－95％。
\n鼻内窥镜鼻窦手术八十年代初引入我国，已发展成为广泛应用于耳鼻咽喉、头项外科的综合微创外科技术，手术操作在鼻孔内进行，鼻面部没有切口，它是既能祛除疾病又保留正常生理功能的手术技术，应视为近一个世纪以来鼻科学的一次革命。
\n鼻腔及鼻窦由于解剖隐蔽，组织间的沟、隙、折叠曲折，常规检查法，对鼻腔的观察范围都是有限的，对于光线及视线无法达到的部位则形成盲区，无法窥查清楚局部情况。通常对于鼻窦的观察，多是依据分泌物的来源间接地进行推断，而并非明视下直接观察到鼻窦内的实际病变情况。
\n鼻窦内窥镜由于其导光性强、多角度、视野大，可直接窥视到鼻腔内的许多重要部位（如各个鼻窦开口，各个沟、鼻窦内部等隐蔽狭窄处）及鼻咽部的细微病变，除了临床诊断，还可取活检，也可同时进行摄像，可保存资料，以供会诊、教学观摩及科研总结。
\n一些人慢性鼻炎和鼻窦炎长期不愈，必定有他鼻腔鼻窦结构上的病因，这种结构上的不正常才导致了其功能上的不正常。通过鼻内窥镜的检查，找到结构异常的病因，那么慢性鼻炎和鼻窦炎就有可能彻底根治了。
\n如何治疗呢？在鼻内窥镜下配合特制的手术器械，利用内窥镜多视角、可准确而彻底地清除病变组织，并尽可能保持鼻腔及鼻窦的正常结构以维持其生理功能，使传统的根治性或破坏性手术转化为功能性手术。鼻内窥镜手术的适应症为：1、慢性及慢性复发性鼻窦炎，保守治疗无效；2、鼻息肉；3、霉菌性鼻窦炎；4、慢性泪囊炎；5、鼻腔、鼻窦良好肿瘤；6、鼻腔、鼻窦恶性肿瘤探察术；7、垂体腺瘤；8、脑脊液鼻漏经鼻修补术；9、鼻腔止血术；10、眶减压术；11、视神经管减压术；12、鼻、鼻窦、眶内、颅底异物取出术等。此外，鼻窦内窥镜手术还可以扩大到鼻神经外科或鼻眼相关外科领域。
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