2. Inflammation of the paranasal sinuses

Question 1

What are the paranasal sinuses?

Answer 1

Air cavities within facial bones lined by mucoperiosteum (1 mm thick)

Question 2

What are the theoretical functoins of the paranasal sinuses?

Answer 2

humidification and heating

aid in olfaction

reduction of cranium weight

addition of resonance to voice

protection and insulation of cerebrum and orbits

evolutionary unwanted space

Question 3

What are the 4 paranasal sinuses?

Answer 3

maxillary

ethmoid

frontal

sphenoid

Question 4

How can maxillary molar PA dz affect the floor of the maxillary sinus?

Answer 4

no change - integrity of floor may be maintained though mucoperisteum may be thickened

Floor of sinus may be lost due to complete destruction

Cysts can elevate the floor of the sinus

Question 5

What can be causes of paranasal sinus inflammation?

Answer 5

Extension of inflammation of the nasal mucosa (rhinitis)

Block of sinus’s ostium (deviation of nasal septum hindering sinus drain)

Extension of adjacent inflammation (teeth)

Question 6

What are three forms of radiographically examining the paranasal sinuses?

Answer 6

Conventional radiography - depicts imflammatory changes of the sinus

CT

MRI - not used to evaluate inflammation but to inspect neoplasia of the sinuses

Question 7

What are the 5 different inflammation of the sinus conditions?

Answer 7

Sinusitis (acute & chronic)

Polyps

Mucous retention phenomenon

Mucous retention cyst

Mucocele

Question 8

S/S of acute sinusitis

Answer 8

often a complication of nose cold

nasal discharge or pharyngeal drainage

Pain, tenderness over involved sinus

teeth may be sensitive to percussion

fever, chills, malaise, elevated leukocyte count

Question 9

S/S of chronic sinusitis

Answer 9

sequel of an unresolved acute infection

no extreme symptoms except in case of acute exacerbations

might be a complication of anatomic derangements, allergic rhinitis, asthma, cystic fribrosis or dental infections

Question 10

Radiographic features of sinusitis

Answer 10

radiodensity - due to mucosal thickening and accumulation of secretions

uniform or polypoid

shape/acrhictecture/extent

air-fluid level - fluid denotes acute phase with typical flat with meniscus on sides appearance

effects on adjacent structures

Question 11

What are the possible causes of the air fluid level?

Answer 11

pus due to infection

blood from trauma

Question 12

How does the air-fluid level appear?

Answer 12

straight superior surface with tapered edges

always horizontal