5 - ENT - Rhinology - Rhinosinusitis - Chronic RS and Complications of Infective RS Flashcards
CRS onset/cause
usually follows ARS but may have more insidious onset
CRS - factors contributing/causing
bact inf fungal spores allergy mucociliary impairment dental disease anatomical variations nasal polyps
CRS - clinical features
obstruction discharge - yellow (eosinophils) smell disturbance pain usually only during acute flare up exacerbated during URTI, flying
CRS - diagnosis
-what if facial pain/pressure
diagnosis is same as ARS but for >12 weeks
facial pain/pressure unlikely to be just CRS
CRS - mgmt - 1st line
steroid drops
nasal douching
CRS mgmt - other Tx principles
treat allergic rhinitis (allergen avoidance, antihistmines)
ABs - broad spec eg penicillin, metronidazole - or macrolides eg clarithromycin
CRS mgmt - indications for surgery + what is done
no improvement after 8 weeks > Ent referral
Nasoendoscopy (+CT) to confirm - look for inflamed turbinates
Functional Endoscopic Sinus Surgery FESS - drainage pathways cleared - may still need topical steroids
Complications of infective sinusitis - 6
CRS osteomyelitis periorbital cellulitis/abscess facial cellulitis mucoceles intracranial complications
Osteomyelitis - tumour name? what is it?
Pott’s puffy tumour - subperioesteal abscess and osteomyelitis of frontal bone
Periorbital cellulitis/abscess - due to? risk of?
due to erosion form ethmoid sinuses
risk of optical nerve pressure and vision damage
Facial cellulitis - from where?
from maxillary or frontal sinus, or from orbital cellulitis
Mucoceles - late complication of ?? how does it happen?
late comp of ARS - collections of sterile mucus in obstructed sinus > facial swelling + visual disturbances - possible secondary bact infection
Intracranial complications - how does this happen?
direct spread,
venous thrombophlebitis, perineural tissue of olfactory nerve
Intracranial complications - includes?? 3 things
meningitis
cavernous sinus thrombosis
abscesses
Intracranial complications - Abscesses - where? due to?
cerebral, extradural, subdural - all usually due to frontal sinusitis
