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風邪や虫歯による歯痛が原因で起こる副鼻腔炎の症状と治療法

歯

歯の病気と鼻の病気は一見関係なさそうに感じますが、身体の部位同士何らかのつながりがあって、一か所が具合が悪くなると、他の箇所も悪くなるということが起こります。そのため、虫歯による歯痛や風邪になると、副鼻腔炎を起こすということもあるのです。

では、風邪や虫歯による歯痛が原因となって、なぜ副鼻腔炎が起こるのでしょうか?また、その症状や治療法はどのようなものがあるのでしょうか。

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風邪で副鼻腔炎が起こる理由

鼻水

副鼻腔炎は、蓄膿症とも呼ばれており、原因はさまざまあります。例えば、風邪をひくことで副鼻腔に炎症が起こり、膿が溜まるということです。その他にも鼻の湾曲や虫歯、アレルギーなどの病気によって起こると言われています。

風邪によって副鼻腔炎が起こる理由については、副鼻腔は鼻から喉にかけて加湿や加温を調整する働きをしています。この部分が外部とつながっているので、ウイルスや細菌が侵入して炎症が起こります。そのため、鼻水や痰が出始めますが、炎症が起こると本来異物を排出する機能が働かなくなり、膿が溜まります。風邪をひいても治療しなかったり、風邪が長引いていたりする時に副鼻腔炎になりやすいです。

虫歯による歯痛で副鼻腔炎が起こる理由

虫歯は鼻腔に隣接している上顎洞が歯の根の先の近くにあるため、歯や歯周組織の炎症が簡単に上顎洞に移行してしまいます。歯の炎症から上顎洞の炎症を起こしたものを「歯状性上顎洞炎」と言い、症状は副鼻腔炎とほとんど同じですが、歯が痛くなったり顔が腫れたりします。

副鼻腔炎の症状

副鼻腔炎の症状の代表的なものとしては、鼻詰まりがあります。副鼻腔の炎症が鼻腔に広がって鼻腔の粘膜が腫れたり、粘り気のある鼻水が鼻腔に詰まったりして、鼻づまりを起こします。そのため、口呼吸をするようになります。

また、鼻水もあります。最初はサラサラとした水のような鼻水が出ますが、副鼻腔に分泌物や膿がたまるにつれて、だんだんと粘り気のある黄色っぽい鼻水になっていきます。鼻水が鼻から出る場合を「鼻漏」、喉へ流れる場合を「後鼻漏」と言います。後鼻漏は、特に慢性副鼻腔炎で見られることが多く、痰として吐き出されたり、後鼻漏が刺激となって咳が出たりするため、風邪が長引いていると間違われやすいです。

他にも、頭痛や顔面痛、歯痛、嗅覚障害、咳、痰、鼻ポリープがあります。痛みが出る場所については、炎症が起こっている場所によって異なります。上顎洞の炎症では頬や歯に、前頭洞の炎症では額に痛みが現れ、蝶形骨洞の炎症では頭痛や頭の重い感じになります。においを感知する神経に異常が起こっている場合には、嗅覚に異常が現れ、匂いが分からなくなることもあります。

副鼻腔炎の治療法

副鼻腔炎の治療法には、いくつかの種類があります。

①薬物療法

急性副鼻腔炎の場合には、消炎酵素薬や解熱鎮痛剤などの症状を抑える薬とともに、抗菌薬をだいたい2週間以内の間服用することが一般的です。慢性副鼻腔炎の場合には、少量の抗菌薬を長期間飲み続けるという特殊な治療法が行われることもあります。

その他にも、気道粘膜修復薬や気道粘膜溶解薬、気道潤滑薬など、痰や鼻水を出しやすくする薬が使われます。

②鼻吸引

局所麻酔薬や血管収縮薬を使用して、鼻腔と副鼻腔をつなぐ孔の周りの腫れを抑え、溜まった鼻水を吸引して取り除く方法です。鼻吸引に続いて、ネブライザー療法を行うと効果的です。

③鼻洗浄

上顎洞に炎症がある場合には、鼻粘膜に麻酔をかけて上顎洞に針を刺したり、細い管を鼻腔から副鼻腔に挿入したりして、生理食塩水を注入して上顎洞を洗浄するという方法を行います。洗浄した後に、抗菌薬などを注入することもあります。

④ネブライザー療法

抗菌薬やステロイドを含んだ薬液を霧状にして、鼻などから吸引し、副鼻腔に送りこむ方法です。幼児や高齢者でも簡単に行えます。使用する薬の量が少量で済み、全身への薬の影響も少ないため、副作用が起こりにくい治療法です。

⑤手術療法

薬物療法や鼻吸引、鼻洗浄などの方法を行っても治らない場合には、手術を行って炎症を起こしている粘膜やポリープを取り除くことがあります。最近では、内視鏡を使った手術を行うことが増えており、患者の身体の負担が軽くなりますが、術後には薬物療法や鼻吸引、ネブライザー療法をしっかりと続ける必要があります。

まとめ:風邪が長引いたり、虫歯があって歯が痛かったりするときには副鼻腔炎に要注意

ウイルスや細菌の感染による風邪や、歯や歯の周りに炎症がある場合には、そのウイルスや細菌が副鼻腔に侵入し、副鼻腔炎を起こすことがあります。風邪や虫歯をしっかり治療し、副鼻腔炎を起こさないようにしましょう。

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