Diseases of the Nasal Cavity, Paranasal Sinuses, and Respiratory Allergy Flashcards
What is sinusitis? What is the etiology of sinusitis? What can cause the types of sinusitis? What are the three categories of sinusitis?
What are the steps in sinusitis?
Sinusitis is swelling+ obstruction of the the mucous membranes. There is obstruction of the mucus membranes, then there is bacterial invasion. pus develops, postnasal drainage (obstructs nasal passages and inflames throat), sinuses are blocked by inflamed/mucus lining.
Describe the various the periods in sinusitis?
Acute Sinusitis: 10-30 days
Sub-acute Sinusitis: more than 30 days
Chronic Sinusitis: 10 weeks and 4+ episodes/year with resolution between and acute exacerbation of chronic rhino sinusitis.
What is the treatment for chronic sinusitis?
Ventilation and drainage of osteomeatal Complex
What are clinical presentations of sinusitis ?
Periorbital edema,
cellulitis,
nasal mucosa is red/swollen
percussion or palpation tenderness over a sinus
thick (sometimes yellow/green) postnasal discharge, difficult transillumination, swelling of turbinates, boggy pale turbinates, +/- polyps
What are the subjective symptoms of sinusitis?
History of URI or allergic rhinitis
History of pressure change,
pressure/pain/tendernes over sinuses
increased pain in the morning, subsiding in the afternoon
malaise
low grade temperature
persistent nasal discharge/often purulent
post-nasal drip
worsened cough at night
mouth breathing/snoring
history of previous episodes of sinusitis
sore throat bad breath
headache
What are the complications of sinusitis?
Orbital Cellulitis.abcess
Brain/Cranium: Meningitis, Abcess, subdural empyema (pus)
Asthma exacerbation/status asthmaticus
Cavernous Sinus Thormbosis
What is allergic rhinitis?
Allergic rhinitis is when there is inflammation of the inside of the nose, caused by allergen
What are the complications of allergic rhinitis?
Eye: conjunctivitis
Ears: OM
Throat: pharyngitis/laryngitis/OSA
Face: developmental issues
Nose: Rhinosinusitis, polyps
Mouth: altered taste
Cranium: migraine
Lungs: asthma
What can be the sinus causes of allergic sinusitis?
It can be because of Birth defects in the maxillary, ethmoid, and sphenoid sinuses.
From ages 4-7 years old frontal sinuses can cause problems
What can be the mouth, nasopharynx, larynx, and skin symptoms/causes of allergic rhinitis?
in mouth: crowded teeth and high palate
Nasopharynx: swollen adenoids and lateral pharyngeal bands
Larynx: polyploid vocal cord changes
Skin: pruritic rash–> food allergy
What are the diagnostic tests for rhino sinusitis?
They are sputum cultures.
For imaging: it is indicated in children if antibiotics aren’t working after 48 hours, toxic appearance, chronic/recurrent bouts, chronic asthma
What are the treatment options for chronic sinusitis?
Surgical removal of the infected bone, secretions that are like concrete, and sinus polyp.
For complicated cases: give antibiotics 10-14 days (amoxicilin/augmentin, biaxin, cephalosporins, quinolones)
No antibiotics for complicated cases (less than 101.5 fever, mild pain, f/u)
Treatment Is given for high risk patients as well.
What are the symptomatic relief therapies for chronic sinusitis?
It is antihistamines, decongestants, saline, humidification, hydration, heat, analgesia, leukotriene antagonists, combo nasal sprays
What are patient education methods for those with chronic rhino sinusitis?
It is no diving, no airplanes, eliminate home triggers, treat family as needed
